CHO-HWC Performance Monitoring System
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ANM Details
HWC-CHO Monthly Performance Monitoring Format
Health Institution Information
Year
2021
2022
2023
2024
Month
Choose a Month:
April
May
June
July
August
September
October
November
December
January
February
March
District
Select District
Baksa
Barpeta
Bongaigaon
Cachar
Chirang
Darrang
Dhemaji
Dhubri
Dibrugarh
Dima Hasao
Goalpara
Golaghat
Hailakandi
Jorhat
Kamrup Metro
Kamrup Rural
Karbi Anglong
Karimganj
Kokrajhar
Lakhimpur
Morigaon
Nagaon
Nalbari
Sivasagar
Sonitpur
Tinsukia
Udalguri
Outside State
Biswanath
Charaideo
Hojai
Majuli
South Salmara
West Karbi Anglong
Bajali
State HQ
Tamulpur
BPHC
Choose a BPHC:
Sub Centre/HWC
Choose a SC/HWC:
No of Villages
Population under the HI
Annual Target of PW:
Date of sumbission of report:
Population above 30 years
Estimated Infant (0-1 year)
ManPower
No of ANMs
No of MPWS
No of ASHAs
List of ASHAs
CHO Emp ID:
Name of the CHO:
CHO Stays at Quarter
Yes
No
Emp ID of ANM 1
Name of ANM 1
Emp ID of ANM 2
Name of ANM 2
Emp ID of ANM 3
Name of ANM 3
Emp ID of MPW
Name of MPW (Male)
Infrastructure
Govt. Building
Yes
No
Labour Room
Yes
No
CHO Cubicle
Yes
No
Electricity
Yes
No
Water Source
Yes
No
Power back up(Inverter/Generator)
Yes
No
CHO Quarter Available
Yes
No
ANM Quarter Available
Yes
No
Equipments(Please tick the options)
Delivery Table
Available
Not Available
Functional
Not Functional
Delivery Equipments
Available
Not Available
Functional
Not Functional
Autoclave & Sterilizer
Available
Not Available
Functional
Not Functional
BP Apparatus
Available
Not Available
Functional
Not Functional
Radiant Warmer-NBCC
Available
Not Available
Functional
Not Functional
Digital Hemoglobinometer
Available
Not Available
Functional
Not Functional
Glucometer
Available
Not Available
Functional
Not Functional
Training/Capacity Building(Y/N)
SBA Training
CHO
ANM 1
ANM 2
MPW (M)
NSSK Training
CHO
ANM 1
ANM 2
MPW (M)
IUCD Training
CHO
ANM 1
ANM 2
MPW (M)
NCD Training
CHO
ANM 1
ANM 2
MPW (M)
Community outreach & Social Mobilization:
Whether HWC-SC Monthly Meeting held
Yes
No
No of VHND Seessions Planned
No of VHND Seessions held .....
No of VHND Sessions attended by CHO
No of VHND Sessions attended by ANM/MPW
No of VHND Sessions attended by ASHA
Is the monthly VHSNC held
Yes
No
Nos of VHSNC meeting held during the month
Number of VHSNC meeting attended by CHO
Number of VHSNC meeting attended by ANM/MPW
Number of VHSNC meeting attended by ASHA
Total Population enumeration done
Total CBAC Form filled
Reproductive Health Services
No of Eligible Couples(EC)
No of EC updated in RCH Register/portal
No of beneficiaries counseled for FP services
No of CC distributed
No of OCP distributed
No of women mobilised for IUCD
No of women IUCD inserted
Maternal Health Services
No of PW Registered
No of PW Regd within 1st Trimester
Full ANC and Hb Test
Number of Hb test conducted during any ANC
No of PW registered who received any ANC during the month
Number of PW due for 4th ANC
No of PW received 4 ANC
No of PW detected with High Risk Pregnancy(HRP)
No of HRP being followed up
No of deliveries conducted at the SC by CHO
No of deliveries conducted at the SC by ANM
Total deliveries conducted
No of Home Deliveries
No of delivery cases referred
Child Health Services
Total number of registered children whose immunization was due for the month
Number of Children who received immunization as per schedule in the month
Number of child born in last 2 months
Number of Newborns due for HBNC visit for the months
Number of Newborns rececievd HbNC visit as per schedule
% of Newborns received full HbNC visit
No of Sick New Born referred
No of children received full immunisation
Total no of diarehea cases treated with ORS & Zinc
Total no of diarehea cases referred to higher facility
No of Pneumonia cases treated
Total no of Pneumonia cases attende & referred
Total no of SAM cases identified with medical complications & referred
No of children received full HBNC visit
NCD Services
Diabetes: Screened .
Diabetes: Suspected .
Diabetes: Refered to higher facility
Diabetes: under regualar treatment & follow up
Hypertension: Screened .
Hypertension: Suspected .
Hypertension: Refered to higher facility
Hypertension: under regualar treatment & follow up
Oral Cancer: Screened .
Oral Cancer: Suspected .
Oral Cancer: Refered to higher facility
Oral Cancer: under regualar treatment & follow up
Breast Cancer: Screened .
Breast Cancer: Suspected .
Breast Cancer: Refered to higher facility
Breast Cancer: under regualar treatment & follow up
Cervical: Screened .
Cervical: Suspected .
Cervical: Refered to higher facility
Cervical: under regualar treatment & follow up
Diagnostic Services
Hb Estimation
Available
Not Available
No of Hb estimation tests:
Urine for pregnancy/PTK
Available
Not Available
No of Urine for pregnancy/PTK test
Blood Sugar
Available
Not Available
No of Blood Sugar Test:
Urine for Sugar
Available
Not Available
No of Urine for Sugar test:
Urine for Albumin
Available
Not Available
No of Urine for Albumin test:
RDK for Malaria
Available
Not Available
No of RDK for Malaria< test:
Total number of patients availed Diagnostic Services
Drugs
No. of Drugs avilable out of 19 as per EDL of HWCs
Any Stock out in the last month
Yes
No
Name of drugs not available
Any alternative available:
Yes
No
Name of alternative drugs
No. of Paitents dispensed with drugs for diabetes & Hypertension
No. of drugs available for diabetes .
No. of drugs available for Hypertension .
OPD Services
Total No. of OPD Cases
(As per OPD Register & Screening Register)
Attended by
OPD
Screening
Total
CHO
ANM
MPW (M)
Total
Out of OPD no. of pateints sent for sputum for AFB (Proportion of cases referred for TB screening)
No. of patients found positive for TB out of suspected cases
No. of patients currently taking DOTS and being followed up
No. of TB cases completed treatment
No. of Fever cases examined for Malaria ( Blood Slide /RDK)
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