Health Information Management System

Standard Operating Procedures

th
4 Edition 2020
FORWORD
It is the belief of the Ghana Health Service that achievement of the Sustainable
Development Goals (SDGs) is highly reliant on having quality data to guide
decision making across all levels of the health system. Consequently, the Service is
committed to periodically updating the existing Standard Operation Procedures
(SOPs) for Health Information Practices into a more standardised and
comprehensive document that will guide and ensure uniform health information
practices nationwide.
The first edition of the SOP provided a document to guide the process for the
capturing, collation and analysing data in the Service. The second edition trained health workers in
public, faith-based, quasi-government and private sectors, created awareness about the availability of
information, stimulated a better understanding of health information management issues, engendered the
production of quality data and stimulated the use of information for decision making by managers. The
third edition of the SOP sought to enhance information use for decision-making, improve efficiency in
service delivery, improve supervision and monitoring, and contribute to pre-service training of health
workers.

This fourth edition of the HIMS SOP seeks to revise and update the previous editions to reflect the new
health sector objectives and current realities such as the introduction of digitised registers at the lower
level, agreed strategic information indicators with partners, how this is derived and generated in
DHIMS2, update the programme indicators over the past two years as well as all RCH respective datasets
and monthly reports that have been revised and updated but not available in the current GHS HIMS SOP.

There are new guidelines on automating respective data sets from other systems to DHIMS 2. Hence,
information about the newly introduced systems such as Ghana Integrated Logistics Management
Information System (GiLHMIS), Human Resource Information Management Software (HRIMS) and the
Planning and Budget Management Information System (PBMIS) for the Service will be included in this
SOP to guide how data in these systems are captured and integrated with the DHIMS2 The SOP will also
include a detailed description of the routine methods and activities of programmes and systems for
managing data within the health sector. This would ensure that the specified supervisory personnel
responsible for the monitoring and evaluation of all services follow the requisite standard procedures for
data management with consistency.

A key milestone for this edition is the Ada declaration on DHIMS2 data lock from the current 90-day
stratagem to a much-reduced stratagem of 60 days to push districts and facilities and programmes to take
up much greater oversight and support the guiding principles for data verification and validation as
stipulated in the SOPs is produced on time.

I am hopeful that this SOP will reflect the data quality improvements that has taken place in the Service
and direct the way managers use health service data for improved decision making.

DR. PATRICK KUMA-ABOAGYE

1
Director General, Ghana Health Service

2
ACKNOWLEDGEMENT

We acknowledge the staff of the Policy Planning Monitoring Evaluation Division especially the
Information Monitoring and Evaluation Department and the Centre for Health Information Management
(CHIM) who put together the first edition and coordinated the subsequent editions of the SOP.

We appreciate with much gratitude the effort of all the Divisions, Programs, Regional and District Health
Directorates of the Ghana Health Service and Christian Health Association of Ghana who provided and
reviewed definitions for each element on the reporting forms and contributed immensely to the
compilation of this very important document.

We are also very grateful to Mr. Daniel Darko the past head of CHIM whose contribution to all the four
editions cannot be over emphasized.

We further acknowledge the financial and technical assistance of the following donor partners and
programs in the development of the various editions of the SOP.

Editions Contributors
First Edition World Health Organization (WHO)
USAID Focus Region Health Project
Policy Planning Monitoring and Evaluation Division
Second Edition Global Fund
PHD - National Malaria Control Programme (NMCP)
Malaria Care
Population Council
Policy Planning Monitoring and Evaluation Division
Third Edition Global Fund
USAID Systems for Health Project
Policy Planning Monitoring and Evaluation Division
Fourth Edition USAID Accelerate Project
Global Fund
Policy Planning Monitoring and Evaluation Division

3
LIST OF ABBREVIATIONS

ACT Artemisinin Combination Therapy

ADH Adolescent Health
ADHD Attention Deficit Hyperactive Disorder
AERF Adverse Event Reporting Form
AFP Acute Flaccid Paralysis
ALOS Average Length of Stay
ANC Ante Natal Clinic
ART Anti Retroviral Therapy
ARV Anti-Retroviral
BF Blood Film
BMC Budget Management Centre
BMI Body Mass Index
BOR Bed Occupancy Rate
BP Blood Pressure
BTR Bed Turnover Rate
CBSV Community Based Surveillance Volunteer
CCTH Cape Coast Teaching Hospital
CHAG Christian Health Association of Ghana
CHIM Centre for Health Information Management
CHO Community Health Officer
CHPS Community-Based Health Planning and Services
CHRC Child Health Record Card
CIC Community Initiated Clinics
CoD Cause of Death
CSO Civil Society Organization
CWC Child Welfare Clinic
DDHS District Director of Health Services
DG Director General
DHIMS District Health Information Management System
DHIO District Health Information Officer

4
DHMT District Health Management Team
DHS Demographic and Health Survey
DQA Data Quality Audit
DST Drug Susceptibility Test
EBF Exclusive Breast Feeding
EPI Expanded Programme on Immunization
FH Foetal Heart
FHD Family Health Division
FP Family Planning
FPG Fasting Plasma Glucose
GF Global Fund
GHS Ghana Health Service
GoG Government of Ghana
GRMA Ghana Registered Midwife Association
Hb Haemoglobin concentration
HIO Health Information Officer
HITWG Health Information Technical Working Group
HIV Human Immuno-Deficiency Virus
HPG Hour Plasma Glucose
HTH Ho Teaching Hospital
ICD Institutional Care Division
IGF Internally Generated Fund
IMCI Integrated Management of Childhood Illnesses
IME Information Monitoring and Evaluation
IPT Intermittent Preventive Treatment
ITC Institutional TB Coordinator
ITN Insecticide Treated Nets
KATH Komfo Anokye Teaching Hospital
KBTH Korle Bu Teaching Hospital
LWR Labour Ward Register
MCCD Medical Certificate of Cause of Death
MDA Ministries Departments and Agencies
MICS Multiple Indicator Cluster Survey
5
MOH Ministry of Health
MTB Mycobacterium Tuberculosis
MTMSG Mother-to-Mother Support Group
MUAC Mid- Upper Arm Circumference
NA Not Applicable
ND Not Done
NGO Non-Governmental Organization
NHIS National Health Insurance Scheme
NMCP National Malaria Control Programme
NTP National Tuberculosis Programme
OPD Out-Patient Department
OPV Oral Polio Vaccine
PC Personal Computer
PMTCT Prevention of Mother to Child Transmission
PNC Post Natal Care
PPFP Post-Partum Family Planning
PPMED Policy Planning Monitoring Evaluation Division
RCH Reproductive and Child Health
RDHS Regional Director of Health Services
RHIO Regional Health Information Officer
RHMT Regional Health Management Team
RMS Regional Medical Store
RR Rifampicin Resistance
RS Rifampicin Sensitive
SD Standard Deviation
SDP Service Delivery Point
SHR School Health Register
SP Sulphurdoxine Perimethamine
TB Tuberculosis
TBAs Traditional Birth Attendants
TD Tetanus Diphtheria
TT Tetanus Toxoid
TTH Tamale Teaching Hospital
6
USAID United States Agency for International Development
VVF Vesico-Vaginal Fistula
WHO World Health Organization
WIFA Women in Fertility Age

7
TABLE OF CONTENT
FORWORD.......................................................................................................................................................................... 1
ACKNOWLEDGEMENT......................................................................................................................................................... 2
LIST OF ABBREVIATIONS..................................................................................................................................................... 3
CHAPTER ONE................................................................................................................................................................... 10
INTRODUCTION TO STANDARD OPERATING PROCEDURES FOR HEALTH INFORMATION
MANAGEMENT................................................................................................................................................................. 10
PURPOSE........................................................................................................................................................................ 10
AIM...................................................................................................................................................................................10
OBJECTIVES................................................................................................................................................................... 10
GUIDING PRINCIPLE.................................................................................................................................................... 10
FLOW OF DATA..............................................................................................................................................................11
CHAPTER TWO.................................................................................................................................................................. 13
DATA MANAGEMENT RESPONSIBILITIES...............................................................................................................13
FACILITY LEVEL............................................................................................................................................................. 14
DISTRICT LEVEL..............................................................................................................................................................14
REGIONAL LEVEL........................................................................................................................................................... 14
NATIONAL LEVEL........................................................................................................................................................... 15
CHAPTER THREE................................................................................................................................................................ 16
ACTIVITIES AND TASKS FOR THE VARIOUS LEVELS..........................................................................................16
SERVICE PROVIDERS (ALL LEVELS)...........................................................................................................................16
DISTRICT HEALTH DIRECTORATE LEVEL..................................................................................................................25
REGIONAL HEALTH DIRECTORATE LEVEL...............................................................................................................29
CENTRE FOR HEALTH INFORMATION MANAGEMENT (CHIM)...............................................................................32
NATIONAL SUPPORT FOR DATA MANAGEMENT......................................................................................................36
CHAPTER FOUR................................................................................................................................................................. 38
TASKS AND ACTIVITIES OF HEALTH INFORMATION OFFICER AT ALL LEVELS.......................................38
FACILITY LEVEL.............................................................................................................................................................38
DISTRICT LEVEL............................................................................................................................................................ 41
REGIONAL LEVEL..........................................................................................................................................................44
TASKS AND ACTIVITIES HEAD OF CHIM.................................................................................................................46
CHAPTER FIVE................................................................................................................................................................... 48
REPORT WRITING FORMAT.........................................................................................................................................48
FORMAT FOR ANNUAL REPORT..................................................................................................................................48
CHAPTER SIX..................................................................................................................................................................... 51
DATA REQUEST FORMS.................................................................................................................................................51
DISTRICT REPORT/RETURNS LOGBOOK....................................................................................................................51
DATA CHANGE REQUEST FORM IN DHIMS2.............................................................................................................52
FACILITY CREATION REQUEST FORM..........................................................................................................................0
DATA REQUEST FORMS..................................................................................................................................................0
APPENDIX ONE................................................................................................................................................................... 1
REGISTERS AND FORMS FOR INSTITUTIONAL CARE DIVISION (ICD)..............................................................1
REGISTERS (ICD)............................................................................................................................................................. 1
FORMS (ICD).................................................................................................................................................................. 19
APPENDIX TWO................................................................................................................................................................ 56

8
 REGISTERS AND FORMS FOR FAMILY HEALTH DIVISION (FHD).....................................................................57
REGISTERS (FHD)..........................................................................................................................................................57
FORMS (FHD)............................................................................................................................................................... 100
APPENDIX THREE............................................................................................................................................................ 134
REGISTERS AND FORMS FOR HEALTH PROMOTION DIVISION (HPD).........................................................134
REGISTERS (HPD)........................................................................................................................................................ 134
FORMS (HPD)............................................................................................................................................................... 139
APPENDIX FOUR............................................................................................................................................................. 146
REGISTERS AND FORMS FOR PUBLIC HEALTH DIVISION (PHD)....................................................................146
DISEASE SURVEILLANCE DEPARTMENT..................................................................................................................146
EXPANDED PROGRAMME ON IMMUNISATION (EPI).............................................................................................170
NATIONAL AIDS CONTROL PROGRAMME................................................................................................................179
NATIONAL MALARIA CONTROL PROGRAMME (NMCP)..........................................................................................221
NATIONAL TB CONTROL PROGRAMME (NTP).........................................................................................................226
DATA ELEMENT/ATTRIBUTE............................................................................................................................................ 227
DESCRIPTION.................................................................................................................................................................. 227
PURPOSE........................................................................................................................................................................ 227
SOURCE.......................................................................................................................................................................... 227
BLOCK 1. Surveillance of drug resistance.....................................................................................................................250
QUARTERLY REPORTING ON DR-TB TREATMENT OUTCOMES............................................................................257
REGISTERS AND FORMS FOR NON-COMMUNICABLE DISEASES (NCD)..............................................................265
REVISED CONSULTING ROOM REGISTER.......................................................................................................................... 265
REPORTABLE NON-COMMUNICABLE DISEASES AND ACTIVITIES...............................................................269
NCD SCREENING REGISTER.......................................................................................................................................282
MONTHLY NCD REPORTING FORM.........................................................................................................................285
MONTHLY NCD SCREENING REPORTING FORM.................................................................................................286
MONTHLY NCD REFERRAL REPORT.......................................................................................................................287
QUARTERLY REPORTING FORM FOR WELLNESS CLINIC SERVICES..........................................................288
NATIONAL VIRAL HEPATITIS CONTROL PROGRAMME..........................................................................................289
APPENDIX FIVE............................................................................................................................................................... 306
REGISTERS AND FORMS FOR NON-SERVICE DELIVERY DIVISIONS.............................................................306
POLICY PLANNING MONITORING AND EVALUATION............................................................................................306
TRANSPORT DEPARTMENT........................................................................................................................................312
STORES SUPPLIES AND DRUG MANAGEMENT (SSDM)..........................................................................................317
HUMAN RESOURCE DEVELOPMENT DIVISION (HRDD)........................................................................................318
GLOSSARY....................................................................................................................................................................... 319
NON COMMUNICABLE DISEASE CONTROL PROGRAMME INDICATORS....................................................319
REVISED CONSULTING ROOM REGISTER................................................................................................................323
NCD SCREENING REGISTER.......................................................................................................................................324
MONTHLY NCD MORBIDITY REPORTING FORM.....................................................................................................325
MONTHLY NCD REFERRAL REPORTING FORM......................................................................................................326
MONTHLY NCD SCREENING REPORTING FORM....................................................................................................327
MONTHLY NCD SCREENING REPORTING FORM....................................................................................................328
FAMILY HEALTH DIVISION DATA DICTIONARY.................................................................................................329
FAMILY HEALTH INDICATORS...................................................................................................................................329
NUTRITION AND CHILD HEALTH INDICATORS...........................................................................................................0
HEALTH PROMOTION DIVISION DATA DICTIONARY..........................................................................................11
HEALTH PROMOTION INDICATORS............................................................................................................................11
9
 PUBLIC HEALTH DIVISION DATA DICTIONARY....................................................................................................19
NATIONAL VIRAL HEPATITIS CONTROL PROGRAMME INDICATORS....................................................................19
NON-SERVICE DELIVERY DATA DICTIONARY.........................................................................................................3
POLICY PLANNING MONITORING AND EVALUATION INDICATORS........................................................................3
FINANCE DIVISION DATA DICTIONARY.....................................................................................................................18
TRANSPORT DEPARTMENT DATA DICTIONARY........................................................................................................19
STORES SUPPLIES AND DRUG MANAGEMENT (SSDM) DATA DICTIONARY.........................................................22
HUMAN RESOURCE FOR DEVELOPMENT DIVISION (HRDD) DATA DICTIONARY...............................................25
ACCESS TO HEALTH SERVICES INDICATORS..........................................................................................................0
NUMBER OF COMMUNITY RESIDENT NURSE PER DISTRICT...................................................................................0
NUMBER OF OUTREACH SERVICES CARRIED OUT BY SPECIALIST FROM TERTIARY, SECONDARY AND
DISTRICT HOSPITAL........................................................................................................................................................0
POPULATION TO DOCTOR AND NURSE RATIO BY REGION.................................................................................1
OUTPATIENT VISIT PER CAPITA BY REGION...............................................................................................................1
DISTRICT HOSPITAL ADMISSION RATE........................................................................................................................3
INDICATORS ON MEASURES OF EFFICIENCY AND SERVICE QUALITY...........................................................4
BED OCCUPANCY RATE (BOR)......................................................................................................................................4
AVERAGE LENGTH OF STAY (ALOS)..............................................................................................................................4
BED TURNOVER RATE (BTR)..........................................................................................................................................5
PERCENTAGE TRACER DRUG AVAILABILITY..............................................................................................................5
ADA DECLARATION ON DHIMS2 DATA LOCK..........................................................................................................6
GUIDELINES AND FEES FOR THE RELEASE HEALTH SERVICE DATA.............................................................9

10
CHAPTER ONE
INTRODUCTION TO STANDARD OPERATING PROCEDURES FOR HEALTH
INFORMATION MANAGEMENT

PURPOSE
This Standard Operating Procedures (SOPs) provides a formalized system to guide data collection,
collation, storage, analysis, reporting and utilization. These standard procedures start before data
collection and continue after reporting and utilization, requiring ongoing coordination and oversight.
These procedures outline how to manage data to obtain quality information to facilitate decision making
in the service.
It also specifies the minimum data quality and quantity requirement as well as the procedures that will be
used to analyse and report those data.

AIM
The aim of these SOPs is to reach maximum accuracy, completeness, integrity, and traceability of the
data generated and collated by Ghana Health Service (GHS) and other health implementing agencies.

OBJECTIVES
1. Provides guidelines for maintaining a reliable data management system for the health sector.
2. Provides guidelines for ensuring complete, accurate and timely data for health service, its donor
partners and the other stakeholders
3. Provides guidelines for monitoring and evaluation
4. Provides guidance to support program implementation

GUIDING PRINCIPLE
At all levels of the health system, health service staff are involved in diverse data related activities which
include, but not limited to, data management, monitoring and evaluation. The SOP is a written document
designed to guide the routine methods and activities employed for managing data within the health sector.
The document ensures that all service providers follow the same procedures in all facilities. These
procedures should not change as a result of change of personnel. All health personnel should be
thoroughly familiar with this SOP. Deviation from the SOP will affect data quality and integrity.

11
FLOW OF DATA
Ghana’s Health Management Information System is organised into five levels: facility, Sub District,
District, Region and national. To improve access to healthcare, the health sector is opened up to a wider
range of providers, both public and private, at all levels. Health interventions are packaged and delivered
in CHPS compounds, Health Centres, Private Health facilities, District hospitals, Regional hospitals,
Teaching Hospitals as well as other specialised health facilities.

Figure 1 illustrates the flow of health data and information from the health facilities to sub districts,
districts through the regions to the national level. It also illustrates the feedback mechanism from the
national level through regions and districts to health facilities at the Sub District level.

The Health Sector requirement is that all health facilities both private and public report on all services
provided according to the agreed respective schedule. Facilities are to report through the Districts /
Municipals / Sub-Metropolitan/ Metropolitan Health Directorates in which they are located as specified in
Ghana Health Service Act, 525.

The District Health Information Management System (DHIMS) shall serve as the final destination for all
routine Health service data. All health facilities using Electronic Medical Record System (EMRs) shall
follow approved guidelines in procuring these systems to permit interoperability with the DHIMS.

The Teaching Hospitals Information Management System (THIMS) shall be the repository of routine
health data for all teaching Hospitals in Ghana. THIMS will receive routine reports from EMRs being
used by the hospitals. The EMR data maybe manually entered into THMIS or automated base on standard
protocol to ensure compatibility.

Summaries of facility data collected are verified by in-charges and documented. The data shall be
validated for entry into District Health Information Management System (DHIMS). Facilities using
etracker for MCH, HIV and TB shall have their data validated and automated into DHIMS on the 5 th of
the ensuing month.

Facilities without access to computers shall submit their verified data to the sub-district for verification
and data entry. Districts are to collate quarterly activity reports of sub-districts/facilities and submit to
regions. Regions are to collate quarterly activity reports from districts and submit to National level.

Regional Hospitals and some specialized health facilities perform day-to-day duties without the direct
oversight of the District Health Directorates in which they are located. Reports from these facilities are
transmitted manually or electronically through the Region to the National level.

The GHS shall give periodic report to MOH on THIMS to deliver as feedback to all teaching hospitals
while the rest of other health facilities; public and private shall receive feedback from
GHS/Programs/CHIM through the districts and regions.

12
 Figure 1: Report and Feedback Flow

13
CHAPTER TWO

DATA MANAGEMENT RESPONSIBILITIES

The health system in Ghana is organized as a three-tier system- District, Region and National. To
improve access to health care, the sector has opened up to a wider range of providers, both public and
private, at the national, regional and district levels; with the district having a sub-district level that
incorporates a community health delivery system. Health interventions are packaged and delivered in
communities, clinics, health centres, district, regional and tertiary hospitals. Each level of service delivery
has its management functions and activities.

Figure 2: Organisation of health services in Ghana

Figure 1: Organisation of Health Services in Ghana

National (MOH): Provid ing

policy guidance, regulation
and strategic direction

Mainly Korle-Bu,
Ko mfo Anokye
and Tamale
Tertiary (Apex of Teaching hospitals
the referral system with independent
Mainly Ghana Boards
Health Service
(GHS) and
Psychiatric Regional (Provides
Hospitals in Accra, specialised clinical and
Pantang and diagnostic care etc) Mix of Providers,
Ankaful GHS fo r public
Districts (A district hospital provides facilit ies, Faith
support to sub-districts in various Based Facilit ies
aspects including including CHA G
referrals, emergencies and training) and Private Sector
Providers
Sub-districts (A health centre services a
geographical area with population of between
15,000 to 30,000. It provides basic curative
care, disease prevention services and maternity
services/primary health care)

Community (Health delivery through community health

nurses, outreach programmes, resident or itenerant
herbalists, birth attendants and/or retail drug peddlers)

14
FACILITY LEVEL
Routine data collected at the point of service delivery are first recorded into standard registers. Data is
then collated from these registers into standardized reporting forms. Data on these reporting forms are
then verified and validated for entry into the DHIMS. Data compilation and entry at facility shall be
completed by the 5th day of the following month.

The head of the facility shall review and endorse the collated facility/sub-district data after it has been
cleared by the data validation team, before submission to district.

Sub-districts and Hospital activity reports shall be provided to the District Health Directorate (DHD) on
quarterly basis. Reports shall be provided by the end of the second week of the month after the quarter
(second week of April/ before the 15th of April).

DISTRICT LEVEL
Facilities/sub-districts without data entry capacity have up to the 5 th of the following month to submit
their data to the DHD. The district will then validate the data for entry into the DHIMS. The district has
10 days to, validate and enter data into DHIMS before signing off electronically on the 15 th of the same
month.

The District Director of Health Services (DDHS) is responsible for final review and endorsement of
district data before submission to region after validation. District activity reports which includes summary
of all sub-district activity reports shall be provided to the Regional Health Directorate (RHD) on a
quarterly basis. Reports should be provided by the end of the third week of the month after the quarter.
First quarter report should be due (third week of April/ before the 22th of April).

REGIONAL LEVEL
Monthly district data will be provided through DHIMS by 15 th of the following month to the regions. The
region will have 10 days to validate data in DHIMS before electronically approving on the 25 th of the
same month.

Regional activity reports which includes summary of all district activity reports shall be provided to the
Policy Planning Monitoring Evaluation Division (PPMED-GHS) on quarterly basis. Reports should be
provided by the first week of the second month after the quarter (first week of May/ before the 8 th of
may).
1. The Regional Health Information Officer (RHIO) is responsible for coordination of the validation
of data from districts at the end of every month before it is electronically approved.
2. It is mandatory that Regional Validation Team reviews the data entered into DHIMS by the
districts to ensure consistency, completeness and accuracy before data is electronically approved.
3. The Regional Director of Health Services (RHDS) is responsible for final review of the regional
data before electronically approving.
15
NATIONAL LEVEL
Monthly Regional data will be available for use through the DHIMS by 25 th of the following month by
which time the region would have electronically approved of the data.
Regional divisional and program reports should be provided to GHS- PPMED by the first week of the
second month after the quarter.
GHS activity reports which includes regional, programs, and divisional reports shall be provided to the
Ministry of Health- PPMED (MOH- PPMED) on a quarterly basis. Reports should be provided by the
third week of the second month after the quarter (third week of April/ before the 25th of April).
1. The National Health Information Officer (NHIO) is responsible for coordination of the validation
of data from regions after it has been electronically approved by the regions.
2. It is mandatory that the National Validation Team reviews the data approved by the regions to
ensure consistency, completeness and accuracy.

The NHIO appointed by Director General is responsible for final review, analysis and endorsement before
submission to the GHS-PPMED. The Director General is responsible for the final review and approval
before the submission to the MOH.

Approval and signing off data electronically- this means an authorizing

officer (e.g. DDHS) at the defined level fills an electronic cover sheet
acknowledging ownership and approving of the data in DHIMS.

16
CHAPTER THREE

ACTIVITIES AND TASKS FOR THE VARIOUS LEVELS

SERVICE PROVIDERS (ALL LEVELS)

DATA CAPTURE

Outpatient Services
Front Desk Instructions:
 Patient Reception:
 Patient Registration: This may be manual or electronic.

Manual Registration:
 Check if patient has visited facility before and has a patient number and folder.
 If patient has visited before, locate the patient number and retrieve folder.
 If patient has not visited before and has no patient number then assign a patient number and issue
a folder.
 Register patient in Outpatient Register.
 Designate patient as NEW PATIENT or OLD PATIENT as appropriate. NEW PATIENT is
one making first attendance at the facility in the calendar year. OLD PATIENT is one making
subsequent attendance at the facility in the calendar year.
For other services use appropriate standard registers to register the patient e.g. Dental Register or
Physiotherapy Register.
 Record using blue or black indelible ink/pens so that it is legibly written and readable.
 Complete ALL fields in the register.
Electronic Registration:
 Perform electronic search to determine if patient has visited before.
 If patient has visited before, locate the patient number and retrieve folder (electronic or paper
based).
 If patient has not visited before and has no patient number then register patient electronically,
assign or generate a patient number and issue a folder.
 Designate patient as NEW PATIENT or OLD PATIENT as appropriate.
 Complete ALL fields in the electronic register using font size 12 and SANS SERIF font type.

17
 Instruction for Consulting Room Register:
 Manual:
o Register the client using the standard consulting room register.
o Complete register with assistance from prescriber.
o Complete ALL fields and make sure no field is blank.

 Electronic:
o Follow instructions given for the particular software.
o Complete ALL fields and make sure no field is blank.
o Use font size 12 and sans serif font type.
o Clinical cases seen outside the regular general OPD department should be recorded and
added to the general OPD cases. E.g. clinical case seen at ANC such as malaria in
pregnancy.

Emergency cases:
Proceed to provide emergency services if the patient is unconscious
 Register clients using the appropriate register.
 Complete ALL fields and make sure no field is blank.
 Include total number of clients served at the emergency unit for every given month to the
relevant service report for the month (e.g. Total OPD attendance = Facility OPD
attendance + Emergency Unit OPD attendance).

Outreach/ Home Visit services:

 Register clients using the appropriate register.
 Complete ALL fields and make sure no field is left blank.
 Include total number of clients served for each service area during outreach for every given month
to the relevant service report for the month (e.g. Total ANC attendance = Facility ANC attendance
+ Outreach ANC attendance or Total OPD attendance = Facility OPD attendance + Outreach OPD
attendance).
Inpatient Services (Refer Medical Records Policy):
 Register client at the records office using the Admission Register.
 Additionally, Register the client in the ward using the Ward Register.

18
  Complete ALL fields in the registers.

19
Mortuary services:
 Register bodies using the Mortuary Register.
 Complete ALL fields in the registers.
 Label the bodies appropriately.

DATA COLLATION

This shall be a daily activity at all Service Delivery Points.

 Use standard tally sheet or books.
 Under each event/disease count the number of events. Do this by drawing tally marks to keep
an accurate account of the data being collated using the five-bar-gate system.
 Sum up the tallies daily. Ensure to do this at the end of every clinic session.
 Sum up the tallies at the end of every week
 Sum up the weekly summaries at the end of the month.
 Collate data from the first to the last day of the month (e.g. 1st to 31st of July). Data collated
for a particular month shall not overlap into the next month.
 Recheck totals of every event/disease.
 Add the outreach, emergency and other services rendered in various parts of the facility.
 Keep tally sheets/books filed for audit purposes.
 Transfer totals unto appropriate standard reporting forms at the end of the month.
 Complete ALL fields that require data in the standard reporting forms.
 Facility In-charge or a designated person shall cross- check (validate) and sign all reporting
forms.
 Hospitals and other health facilities with the capacity to enter data shall do so from the
reporting forms into DHIMS.
 Complete ALL data fields in DHIMS.

20
DATA VERIFICATION AND VALIDATION
 Facility heads should set up Facility Data Validation Teams. The facility head is the
chairperson of this team.
 Data verification and validation routine for all services:
o Meet monthly to verify and validate data before submission.
o Data validation meetings should be held between the 1 st and the 4th of the following month
(e.g. January data validation should be done between 1st to 4th of February)
For manual Registries:
o Cross-check figures on the reporting forms with tallies from the register (verification)
o Crosscheck total figures on the reporting forms for accuracy and completeness of reports
(validation).
o Check for accuracy and completeness of data
o Cross-check data consistency across returns
o Look for unusually low or high values for events/diseases to recheck and confirm.
o Compare with previous months and same period the year before to detect unusual
trends
o Do necessary corrections before submission
For electronic registries:
o For all automatically aggregated data to DHIMS2, facilities are required to validate and
complete the data set reports by the 5th of the ensuing month
 Chairperson of the facility validation team shall approve the reports as validated.
 All errors detected after the submission of the reports can be changed upon submission of a
completed Data Change Request Form to the DDHS. Upon approval the data can be
changed (see Chapter 6).

LOCKING SYSTEM THAT WILL PREVENT DATA FROM BEING

ALTERED
DATA WILL BE LOCKED 60 DAYS AFTER IT HAS BEEN ENTERED
AND CAN NOT BE ALTERED AFTER THE ENTRY FIELDS HAVE
BEEN LOCKED

21
DATA TRANSMISSION
This can be manual or electronic. Transmit completed and validated reporting forms to the next level
within the deadline (Facility to District – 5th of the following month) e.g. January data should be
submitted by 5th of February.

Manual transmission
 All forms being submitted to the DHD shall be in duplicate (2 copies).
 The submitting officer shall ensure that both copies of all reports submitted to the DHD are
stamped and the name and signature of the receiving officer as well as the date and time of
receipt appended on them.
 A copy of the stamped duplicate forms shall be retained and properly filed at the facility level.
 The officer submitting the reporting forms shall ensure that the facility dispatch book is signed
by the receiving officer at the district.
 The submitting officer shall ensure that the report is logged in the district reporting log book.
(See Chapter 5)
Electronic Transmission
 Data is entered into DHIMS.
 The officer in-charge of the facility shall approve the data entered electronically by the 5 th of
the following month (e.g. January data should be submitted by 5th of February).

DATA ANALYSIS
 Check the level of completion of data being used for the analysis.
 Run simple frequencies for events and cases and any other variables of interest.
 Cross tabulate events/cases by months, age, sex, location etc.
 Compare performance with targets and/or historical data.
 Draw graphs to demonstrate performance and trends.
 Interpret findings and discuss results.
(Refer to Data Utilization Manual)

22
REPORT WRITING
 Use findings from analysis to write routine performance report quarterly, half yearly and
annually using standardized report writing format (Chapter 5).
 Write exception report: that is reports on special events and activities such as disease outbreak
response, rare diseases and diseases targeted for eradication or elimination.

DATA STORAGE
Manual Storage
 All registers shall be kept permanently or archived electronically if there is need to destroy
them.
 District and Regional Directors of Health Services shall put in place an archival system to
ensure the storage of the registers.
 Provide adequate and secure space for cabinets for storing registers.
 File all tally sheets/books by type chronologically and store in secured place.
 File all reporting forms by type chronologically and store in secured place.

Electronic Storage
 Set up and ensure daily data updates and back-up.
 External drives/Storage devices shall be used for back-up and update data and reports
generated from DHIMS
 Establish an OFFSITE (outside the facility) back up system.
 Keep rooms where data are stored physically secured and out of bounds to unauthorized
persons.
Filing and Record Keeping
Items Needed: Folder, external storage media (External hard drive, etc.)
 Assign separate folders for keeping both soft copies and hard copies of primary source data
(registers) and aggregated data/records.
 At the end of each day of update, save data on computer and an assigned external storage
medium.
 At the end of every month, save data on computer and a copy on an external storage medium
(e.g. flash drive, external hard drive)
 Print hard copies and place in designated folders and keep in a cabinet (or any other records
keeping system used in the facility), monthly, quarterly or as required.
23
  The filing and record keeping system used should allow for easy retrieval of information.
DATA REQUEST/RELEASE
Medical Superintendents and Medical Directors shall authorize data request from their facilities.

External Request (Request from outside the GHS)

All data requests shall be written and duly endorsed by the person/organization making the request stating
reasons for the request.

Processing of Data Request:

 Ensure that all data requests are well documented and filed as evidence
 If the authorizing officer approves the request, he/she shall assign officer(s) to work on it; after
which the authorizing officer shall release the data so requested.
 The authorizing officer shall ensure that copies (electronic/manual) of all data released are duly
filed
 All data shall not be patient identifiable and not linked to client records
Client Personal information shall not be released to any person other than the client, or his authorized
representative except with the consent of the client or the consent of the authorized representative or as
required by law. (Refer to Code of Ethics of GHS)

Internal Request (Request from within GHS)

 An Internal memo shall be written and duly signed by person or department making the request.
 Individuals and departments can make request through their respective heads for data within the
GHS at all levels. Request shall include reasons and uses to which report or data will be put to.
 If the authorizing officer approves the request, then he/she shall assign officer(s) to work on it;
after which the authorizing officer shall release the data so requested.
 The authorizing officer shall ensure that copies (electronic/manual) of all data released to
persons/organizations are duly filed
 All data shall not be patient identifiable and not linked to client records

SYNCHRONIZATION OF DATA SYSTEMS WITH DHIMS

This section address verification and completeness, updating, overwriting values and organization unit
synchronization during data sets automation to DHIMS2 from other systems used in the health sector

24
such as eTracker, Hospital information systems for clinical care, GHiLIMS, PBMIS and other systems
that are required to generate managerial level aggregate data to DHIMS2 across all levels.

AUTOMATED DATASET VERFICATION AND COMPLETENESS

• Facility in charge and the DDHS shall verify and approve the aggregate data automated to
DHIMS.
• To ensure that completeness and timeliness can be tracked.
• Datasets will be marked as complete only after when some compulsory data elements and
additional information which are not part of the service data has been entered manually on the
same form, verified and then completed by 5th to 15th of the ensuing month
• Datasets requiring additional information and manual entry can be marked as complete only after
the additional information has been entered

UPDATING AND OVERWRITING VALUES

• Data shall be transferred monthly on a fixed date until it has been verified and locked
• Transfer or automation shall be done on 5th of ensuing month and every month until the 60 days
when data entry is locked or ”freeze”.
• Updating and overwriting shall go as far back by 60 days in each update or data push to DHIMS2.
• Automated data values shall be updated only within the 2 months that facilities are allowed to
update their data.

FACILITY HIERARCHY UPDATES

DHIMS2 is the master facility registry for all other systems. To support system interoperability,
DHIMS2 data base acts as master facility list to all other systems. Changes, additions, updates will be
done automatically through export and import functionality systems.

There shall be script notifying administrators of missing facilities on systems controlled by GHS . Other
systems not under GHS control shall request for the master facility list to align to DHIMS2 at all times

DATA QUALITY AUDIT (DQA): DATA VALIDATION

Polyclinics, District, Regional and Tertiary Hospitals shall perform DQA quarterly in their respective
facilities.
25
District DQA teams shall perform data quality audit for Hospitals, Health Centres, Clinics and CHPS
Compounds.

26
Steps involved in performing DQA:
 Set up DQA team (Composition of the teams specified in DQA Manual).
 Select relevant indicators for each audit.
 Perform DQA quarterly (use DQA manual as a guide).
 Write report, develop action plan to address identified gaps.
 Implement the action plan.
 Provide feedback to all stakeholders.

DATA DISSEMINATION
 Develop a dissemination plan for the facility.
 Identify and make a list of all stakeholders who will receive the disseminated information.
(E.g. Unit committees, District Health Committees, District Assembly, Facility Boards, NGOs,
Community members etc.)
 Identify appropriate communication channels for dissemination (e.g. Durbars, Information
Centres, FM Stations, Workshops, Media-both electronic and print, Bulletin, Internet, and
Mobile Phones etc.). Facility Head shall authorise sharing of information on social media.
 Implement and document dissemination activities.

FACILITATIVE SUPERVISION
Facilitative supervision will be performed at all levels. Supervisors at all levels shall organize quarterly
supervisory visit to provide technical support to department/units (The principle is to teach, coach, guide
and support officers to do their work better). Within departments it will be necessary to do this more
frequently.
 The supervisor shall have a higher level of technical competence than the supervisee.
 Appropriate tools should be developed and supervisors trained to use the tools.
 Review performance of departments/units prior to supervision in order to identify outliers and
broad issues that require clarification.
 Write supervisory reports.
 Provide feedback to the units/departments.

27
DISTRICT HEALTH DIRECTORATE LEVEL
DATA COLLATION
 Receive and record all reports from facilities.
 The receiving officer shall stamp, and append his/her name, signature, date and time of receipt
to the reports being received. One copy shall be retained and the other given to the submitting
facility for their records.
 Check for the number of returns expected from that particular facility - Use a log book with
the list of facilities in the district and the reports expected from each of them. Write the date
submitted for every report submitted by facility in the log book. (Appendix 2)
 Check to ensure that every required field on all the forms is filled.
 Glance through the reports and give an immediate feed-back if the person submitting the
report is AUTHORISED/qualified or provide written feed-back within 72 hours on
completeness.
 If data is submitted by e-mail, written feedback shall be sent to the Head of Facility to
acknowledge receipt. This shall indicate any follow-ups needed.
 Before data entry into DHIMS, check to see whether all facilities have reported.
 Re-check totals of every event/disease from each facility.
 File reporting forms from all facilities for audit purposes.
 Enter data from the reporting forms into the appropriate screens in DHIMS.

DATA VALIDATION
All District Health Directorates shall form District Data Validation Teams.
The team shall meet monthly to validate data before signing it off. Write minutes of all monthly data
validation meetings and file.
 The DDHS is the chairperson of the validation team.
 Post dates for data validation meetings on district notice boards.
 Establish data validation routine-
o Data validation routine:
 Meet monthly to validate data before signing it off.
 Data validation meetings shall be held by 14th of every month.
 Check for accuracy and completeness of data.
 Crosscheck data consistency across returns.
 Look for unusually low or high values for events/diseases.
 Look for rare events e.g. yellow fever, lassa fever.
 Compare with previous months and same period of previous years.
 Alert facilities on inconsistencies, discrepancies and rare events.
 Follow-up to ensure appropriate corrective actions are taken on unusual and rare
events.

28
  Chairperson of the validation team shall sign off the reports as validated.

29
DATA TRANSMISSION
Transmission of data shall be through the DHIMS
 The medical superintendents at the health facilities shall sign off the data entered
electronically by the 5th of the ensuing month (for January signing off will be on 5 th of
February).
 DDHS shall signs off the data entered electronically by the 15th of the ensuing month (for
January signing off will be on 15th of February).
 Save data on an appropriate storage device both onsite and offsite

DATA ANALYSIS
There shall be analysis and interpretation of service data at the DHD. This shall form the basis for all
planning, monitoring and decision-making process to guide service delivery.

Steps in Data Analysis:

 Always indicate the level of completeness and date of data being used for analysis.
 Run simple frequencies for events and cases and any other variables of interest.
 Cross-tabulate events/cases by months, age, sex, location etc.
 Compare district performance with targets and or historical data.
 Compare performance between sub-districts and between facilities.
 Draw graphs to demonstrate performance and trends.
 Interpret findings and discuss results.

REPORT WRITING
 Use findings from analysis to write routine performance report quarterly, half yearly and
annually using standardized reporting format
 Write exception reports; these are reports on special events and activities such as disease
outbreak response, rare diseases and diseases targeted for eradication or elimination.

DATA STORAGE
Manual storage
 All reporting forms shall be kept for permanently or archived electronically if there is need to
destroy them.
 DHD shall ensure that facilities have adequate secure space for documents storage.
 DHD shall provide an archival system to ensure the storage of the registers from the facilities.
 File all reporting forms by type chronologically and store in a secured place.
30
31
 Electronic storage
 Set up and ensure monthly data updates and back-up.
 External drives/Storage devices shall be used to back-up and update data from all computers
used to collect data, whether networked or stand-alone.
 Establish an OFFSITE (outside the facility) back up system.
 Set up user accounts that define levels of accessibility of data.
 Keep rooms where data are stored physically secured and out of bounds to unauthorized
persons.

DATA REQUEST/RELEASE
District Director of Health Services shall authorize data request from all facilities within the district.

External Request (Request from outside the GHS)

All data requests shall be documented and duly endorsed by the person/organization making the request
stating reasons for the request.

Processing of Data Request:

 Ensure that all data requests are well documented and filed as evidence
 If the authorizing officer approves the request, then he/she shall assign officer(s) to work on it;
after which the authorizing officer shall release the data so requested.
 The authorizing officer shall ensure that copies (electronic/manual) of all data released are duly
filed
 All data shall not be patient identifiable and not linked to client records

Client Personal information shall not be released to any person other than the client, or his authorized
representative except with the consent of the client or the consent of the authorized representative or as
required by law. (Refer to Code of Ethics of GHS)

Internal Request (Request from within GHS)

 An Internal memo shall be written and duly signed by person or department making the request.
 Individuals and departments can make request through their respective heads for data within the
GHS at all levels. Request shall include reasons and uses to which report or data will be put to.
 If the authorizing officer approves the request, then he/she shall assign officer(s) to work on it;
after which the authorizing officer shall release the data so requested.
 The authorizing officer shall ensure that copies (electronic/manual) of all data released to
persons/organizations are duly filed
32
  All data shall not be patient identifiable and not linked to client record.
DATA QUALITY AUDIT
District DQA teams shall perform data quality audit for Hospitals, Health Centres and CHPS
Compounds.
Steps in Data Quality Audit:
 Set up DQA team (Composition of the teams specified in DQA Manual).
 Select relevant indicators for each audit.
 Perform DQA quarterly (use DQA manual as a guide).
 Write report, develop action plan to address identified gaps.
 Implement the action plan.
 Provide feedback to all stakeholders.

DATA DISSEMINATION
 Develop a dissemination plan for the district.
 Identify and make a list of all stakeholders (E.g. Unit committees, District Health Committees,
District Assembly, Facility Boards, NGOs, Community members etc.)
 Identify the relevant information to be communicated to the stakeholders.
 Identify appropriate communication channel for dissemination (e.g. Gong-Gong, Information
Centres, FM Stations, Workshops, Print Media, Bulletin, Internet, and Mobile Phones etc.)
The District Director or relevant authority shall authorise sharing of information on social
media.
 Implement and document dissemination activities.

FACILITATIVE SUPERVISION
Facilitative supervision shall be performed at all levels. Supervisors at all levels shall organize quarterly
supervisory visit to provide technical support to sub-districts/facilities. The principle is to teach, coach,
guide and support officers to do their work better.
 The supervisor shall have a higher level of technical competence than the supervisee.
 Appropriate tools shall be developed and supervisors trained to use them.
 Review performance of departments/units prior to supervision in order to identify outliers and
broad issues that require clarification.
 Write supervisory reports.
 Provide feedback to the units/departments and incorporate them into future supervisory plans.
33
REGIONAL HEALTH DIRECTORATE LEVEL
DATA COLLATION
Data entered into DHIMS at the Districts is visible to the Region. However, the Region cannot work with
it until it is signed off by the district or after the expiration of the official reporting date (15 th of the
ensuing month).
The Region shall:
 Send reminders to districts if data has not been signed off after the 15th of the ensuing month.
 Check in DHIMS for data completeness from the districts.
 Examine the data within 72 hours after it has been signed off by the district and give feedback
on completeness, timeliness and inconsistencies.
 Sign off Regional data by the 25 th of the ensuing month (for January signing off will be on 25 th
of February).

DATA VALIDATION
All Regional Health Directorates shall set up Regional Data Validation Teams.
The teams shall meet monthly to validate data before signing. Write minutes of all monthly data
validation meetings. File minutes and send electronic copies to the National level.

Steps in Data Validation

 The RDHS is the chairperson of this team.
 Post dates for data validation meetings on notice board at RHD.
 Meet monthly to validate data entered into the DHIMS by the 24th of the month.
 Establish data validation routine-
 Data validation routine:
o Check for accuracy and completeness of data
o Crosscheck data consistency.
o Look for unusually low or high values for events/diseases.
o Look for rare events e.g. yellow fever, lassa fever.
o Compare with previous months and same period of previous years.
o Alert districts on inconsistencies, discrepancies and rare events.
 Chairperson of the validation team should sign off the reports as validated.

34
35
DATA TRANSMISSION
Transmission of data shall be through the DHIMS
 Save all Regional data on an appropriate storage device paper based or electronic at both on-
site and off-site.

DATA ANALYSIS
There shall be comprehensive analysis and interpretation of service data at the RHD. This shall form the
basis for all planning, monitoring and decision-making process at the Regional level.

Steps in Data Analysis

 Always indicate the level of completeness and date of the data being used.
 Run frequencies for events and cases and any other variables of interest.
 Cross-tabulate events/cases by months, age, sex, location etc.
 Compare district performance with targets and or historical data.
 Compare performance between districts and between facilities.
 Draw graphs to demonstrate performance and trends.
 Interpret findings and discuss results.
(Refer Data Utilization Manual)

REPORT WRITING
 Use findings from analysis to write routine performance reports quarterly, half yearly and
annually using standardized reporting format
 Write exception reports; these are reports on special events and activities such as disease
outbreak response, rare diseases and diseases targeted for eradication or elimination.

DATA STORAGE
It is recommended that RHD print a summary of the complete regional, districts and facilities reports; and
file appropriately.
For the electronic data:
 Set up and ensure monthly data back-ups and updates.
 External drives/Storage devices shall be used to back-up and update data from all computers
used to collect data, whether networked or stand-alone.
 Establish an OFF-SITE (outside the facility) back up system.
 Set up user accounts that define levels of accessibility of data.
 Keep rooms where data are stored physically secured and out of bounds to unauthorized
persons.

36
DATA REQUEST/RELEASE
Regional Director of Health Services shall authorize data request from the region.

External Request (Request from outside the GHS)

All data requests shall be written and duly endorsed by the person/organization making the request stating
reasons for the request.

Processing of Data Request:

 Ensure that all data requests are well documented and filed as evidence
 If the authorizing officer approves the request, then he/she shall assign officer(s) to work on it;
after which the authorizing officer shall release the data so requested.
 The authorizing officer shall ensure that copies (electronic/manual) of all data released are duly
filed
 All data shall not be patient identifiable and not linked to client records

Client Personal information shall not be released to any person other than the client, or his authorized
representative except with the consent of the client or the consent of the authorized representative or as
required by law. (Refer to Code of Ethics of GHS)

Internal Request (Request from within GHS)

 An Internal memo shall be written and duly signed by person or department making the request.
 Individuals and departments can make request through their respective heads for data within the
GHS at all levels. Request shall include reasons and uses to which report or data will be put to.
 If the authorizing officer approves the request, then he/she shall assign officer(s) to work on it;
after which the authorizing officer shall release the data so requested.
 The authorizing officer shall ensure that copies (electronic/manual) of all data released to
persons/organizations are duly filed

All data shall not be patient identifiable and not linked to client records.

DATA QUALITY AUDIT

All regional health directorates shall set up Regional DQA teams.
Regional DQA teams shall perform data quality audit for Facilities, Districts, and Regional Hospitals.
Regions shall:
 Select relevant indicators for each audit session.
 Perform DQA quarterly (use DQA manual as a guide).
 Write report, develop action plan to address identified gaps.
 Implement the action plan.
 Provide feedback to all stakeholders.

DATA DISSEMINATION
37
All Regional reports shall be disseminated to relevant stakeholders in the region.
The region shall:
 Develop a dissemination plan.
 Identify and make a list of all stakeholders. e.g. Regional Coordinating Council (RCC)
Regional Health Committees, District Assemblies, Traditional/Religious Leaders, Facility
Boards, NGOs, Community members, the Media etc.)
 Identify relevant information to be communicated to the stakeholders.
 Identify appropriate communication channel for dissemination (e.g. Print and Electronic
Media, Bulletin, Internet, Workshops, Meetings, Mobile Phones etc.). Regional Director or
relevant authority shall authorise sharing of information on social media.
 Implement and document dissemination activities.

FACILITATIVE SUPERVISION
The Region shall perform facilitative supervision at all levels. Supervisors shall organize quarterly
supervisory visit to provide technical support to districts, sub-districts and facilities. The principle is
to teach, coach, guide and support officers to do their work better. To ensure an integrated and
effective supervision, the composition of the team shall comprise of technical personnel from all the
departments/units.
 The supervisor shall have a higher level of technical competence than the supervisee.
 Appropriate tools shall be developed and supervisors trained to use them.
 Review performance of districts, sub-districts and facilities prior to supervision in order to
identify outliers and broad issues that require clarification.
 Write supervisory reports.
 Provide feedback to the districts, sub-districts and facilities

CENTRE FOR HEALTH INFORMATION MANAGEMENT (CHIM)

CHIM is the focal unit responsible for the collation, analysis, reporting and presentation of health service
data. CHIM is an integral unit of the Policy Planning Monitoring and Evaluation Division (PPMED) of
Ghana Health Service. The principal objective of CHIM is to generate information for health services
planning and management in Ghana. CHIM provides support to regions, districts, health facilities and
management units in health information management.

38
DATA COLLATION
Data entered into DHIMS from all levels is visible at the National level. However, National cannot work
with it until it is signed off by the Region or after the expiration of the official reporting that is (25 th of the
ensuing month).
 CHIM shall send reminders to regions if they have not signed off the data by the 25th of the
ensuing month the Regions have not signed off the data. Once data is available for use, check
in DHIMS for completeness and timeliness by regions and send feedback.
 Examine the data within 5 working days after it has been signed off by the region and send
feedback on completeness and inconsistencies.
 Chairperson of the data validation team (DVT) shall finally authorize the data for use one
month after the RHD sign-off date.

DATA VALIDATION
The Director of PPME shall set up a National Data Validation Team. The team shall meet quarterly to
validate data before making it available for use for the quarterly reports. Minutes of all quarterly data
validation meetings shall be written.
The Head of Information, Monitoring and Evaluation (IME) of PPME shall be the chairperson of the
team.

The Head of IME of PPME shall:

 Post dates for data validation meetings on CHIM’s notice board, GHS website and by e-mail.
 Establish data validation routine.
 Meet monthly to validate data.
 Data validation meetings shall be held after 25th of the month to the end of the
month.
 Check for accuracy and completeness.
 Cross check data consistency
 Look for unusually low or high values for events/diseases.
 Look for rare events e.g. yellow fever, lassa fever
 Compare with previous months and same period of previous years.
 Alert districts on inconsistencies, discrepancies and rare events.
 Chairperson of the validation team shall send written feedback to regions and districts after the
reports have been validated.
 Regions and districts shall have one month after the scheduled signing off to effect any changes.
 Changes cannot be effected after the next sign-off date

39
  Chairperson of the Data Validation Team (DVT) shall finally authorize the file of the data one
month after the RHD sign-off date.

40
DATA TRANSMISSION
 Transmission of quarterly reports to IME and other Divisions shall be within the stipulated times:
end of 1st week in May, August, Nov and Feb of the following year
 Document the reports sent to IME and other Divisions. Print forwarded email and file.
 File copies of all reports sent out as appropriate.

DATA ANALYSIS
There shall be comprehensive data analysis and interpretation of service data at CHIM to enable them
provide IME and the Division monthly reports. This shall form the basis for all planning, monitoring and
decision-making process within the GHS.

Steps in Data Analysis:

 Always indicate the level of completeness and date and time of data being used.
 Run simple frequencies for events and cases and any other variables of interest.
 Cross-tabulate events/cases by months, age, sex, location etc.
 Compare regional and district performance with targets and or historical data.
 Compare performance between zones, regions, districts and between facilities.
 Draw graphs to demonstrate performance and trends.
 Interpret findings and discuss results.

DATA STORAGE
 Set up and ensure monthly data updates and back-up
 Establish an offsite back-up system. (National level server)
 Set up administrator account to define security levels for user of computers to secure data.
 Keep rooms where data are stored out of bounds to unauthorized persons.

DATA REQUEST/RELEASE
External request
Ensure that all data requests are written and duly signed by the person/organization making the request.
 The Director General of GHS shall approve all data requests.
 The Director General shall refer the request to the Director PPME
 The Director PPME refers to Head of CHIM
 Head of CHIM shall assign a staff to work on the request.
 Director PPME shall certify the data when completed and release it to the person/organization
making the request.
 File all data request letters and forms appropriately.
 File all copies (electronic/manual) of all data released to persons/organizations.
41
Internal Request
Internal memo shall be written and duly signed by person or unit making the request.
 For request emanating from programs, the request shall be routed through the Program
Manager to the Divisional Director.
 The Director PPME shall approve all internal requests, refer to Head of CHIM
 Head of CHIM shall assign a staff to work on the request.
 Head of CHIM shall certify the data and release it to the person or unit making the request.
 File all data requests memos appropriately.
 File all copies (electronic/manual) of all data released to person/unit

DATA QUALITY AUDIT

PPME, ICD and other divisions and Programmes shall set up National DQA teams.
National DQA team shall provide technical and managerial support to the RDQA and DDQA teams to
perform data quality audit at their respective levels.

The National DQA teams shall:

 Select relevant indicators for each audit.
 Perform DQA on request from regions. (use DQA manual as a guide)
Support Regions and Districts to write report, develop action plan to address identified gaps in
DQA.

DATA DISSEMINATION
Reports from analysed data and interpretations shall be disseminated to relevant stakeholders at the
national level.
PPME (IME) shall:
 Identify and make a list of all stakeholders. (e.g. MoH, MDAs, NGOs, Development Partners,
Parliamentary Select Committee on Health, Health Training Institutions, etc.)
 Identify the relevant information to be communicated to the stakeholders.
 Identify appropriate communication channel for dissemination (Print and Electronic Media,
Bulletin, Internet, Workshops, Meetings, Mobile Phones etc.). if social media authorisation
should be sort from the District Director or relevant authority.
 Develop a dissemination plan.
 Implement and document dissemination activities.
42
FACILITATIVE SUPERVISION
Facilitative supervision shall be performed at all levels. National supervisors shall organize quarterly
supervisory visits to provide technical support to Regions and Districts. The principle is to teach, coach,
guide and support officers to do their work better. To ensure an integrated and effective supervision, the
composition of the team shall comprise of technical personnel from all the divisions.
 The supervisor shall have a higher level of technical competence than the supervisee.
 Develop appropriate tools and supervisors trained to use the tools.
 Review performance of regions, districts, sub-districts and facilities prior to supervision in
order to identify outliers and broad issues that require clarification.
 Write supervisory reports.
 Provide feedback to the regions.

NATIONAL SUPPORT FOR DATA MANAGEMENT

The Director General shall establish a Health Information Technical Working Group (HITWG) to
promote and oversee information management. Membership shall be from all stakeholders with
Chairperson from PPME.

Functions of HITWG:

 Set standards for information management.

 Develop and/or adapt Health Sector Indicators.
 Set standards for information management equipment and software.
 Coordinate systems for data management
 Coordinate the development and modification of data management tools.
 Facilitate the procurement and distribution of data management tools by MoH.
 Regulation of health information system deployment in facility.

PPME shall collaborate with other Divisions, Departments and Programmes on information management
issues

These issues include:

a. Collaboration with ICT department and regional IT managers on:

i. Standards setting (software and hardware).
ii. Trouble shooting and hardware support for Regions and Districts
iii. ICT capacity building in use of software.
iv. Advise on eHealth and other ICT innovations in the service.

43
 b. Collaboration with all Divisions on data management issues:
i. Training on DHIMS.
ii. Training on the use of registers and reporting forms.
iii. Capacity building on data management.
iv. Training on Medical Records Management in collaboration with stakeholders.

c. Regulate the deployment of health information system in facilities.

Policy Planning Monitoring and Evaluation Division of the Ghana Health Service is developing a
guideline to guide procurement and management of electronic medical records by facilities.
Meanwhile, facilities are expected to seek clearance from the PPMED before embarking on
procurement of an Electronic Medical Record (eMR). The chosen eMR should be able to perform the
following:

i. It should enable the hospital to manage their patients while they are in the hospital, both
outpatient and inpatient.
ii. It should be interoperable and able to share data with the Basic Laboratory Information
System (BLIS), iHRIS, dhis2 or DHIMS2 in Ghana
iii. It should be able to send health insurance claims electronically to the NHIA.

44
CHAPTER FOUR

TASKS AND ACTIVITIES OF HEALTH INFORMATION OFFICER AT ALL LEVELS

FACILITY LEVEL
Daily/Weekly Basis
Collation of returns (reports)
 Receive and check errors for immediate feedback to departments.
 Follow up on outstanding returns from various departments.
 Support Data entry (DHIMS, e-Tracker and other Programmes).
 File all returns properly.

Analyse data
 Perform Data Analyses and Interpretation using, Graphs, Charts, and Tables etc.
to show trends (see detailed information on data analysis and data use in chapter
3).

Disseminate results of data analysis

 Brief Facility Management on result of data analysis and interpretation.
 Share with relevant stakeholders in the facility
 Submit returns to appropriate level.
 Receive feedback from relevant stakeholders
 Document feedback from relevant stakeholders

Routine activities
 Participate in weekly management meetings.
 Perform daily data updates and back-up.
 Follow up on notifiable diseases seen to appropriate office.
 Provide technical supervision for the health information staff.
 Ensure the physical security of all health records and release data only upon
authorization.
 Perform any other official duties that will be assigned.

Monthly
Compilation of returns
 Follow up on outstanding reports.
 Sort, verify and update returns.
 Undertake data cleaning and reconciliation.
 Train and support key staff on data entry (DHIMS, e-Tracker and other
Programmes).
 Coordinate the data validation process.

45
 Analyse data
 Perform Data Analysis and Interpretation using, Graphs, Charts, and Tables etc.
to show trends.
 Compare trends to detect possible outbreaks, service utilization etc.
(Benchmarking) monthly, quarterly.

Disseminate results of data analysis

 Brief Facility and Department Heads.
 Submit returns to the appropriate level.
 Feedback to whom it may concern.

Other activities
 Participate in monthly meetings.
 Perform monthly data updates and back-up.
 Follow up on notifiable diseases seen to appropriate office.
 Monitor and Supervise units’ staff under your care.
 Update all activity and event monitoring charts.
 Perform other official duties that will be assigned.

Quarterly/Half Yearly
Compilation of reports
 Receive reports
 Follow up on outstanding reports (if any) from departments.
 Sort, verify and update and file reports appropriately.

Analyse data
 Perform quarterly Data Analysis and Interpretation using, Graphs, Charts, and
Tables etc. to show trends.
 Compare trends to detect possible outbreaks, service utilisation and OPD
attendance (Benchmarking) monthly, quarterly.
Reports
 Write quarterly/half yearly reports.

Disseminate data
 Brief Facility Management on result of data analysis and interpretation.
 Share with relevant stakeholders in the facility
 Submit returns to appropriate level.
 Receive feedback from relevant stakeholders
 Document feedback from relevant stakeholders

46
 Other activities
 Participate in Quarterly and Half Yearly Facility meetings.
 Perform quarterly and half yearly data updates and back-up.
 Monitor to identify gaps in technical skills that shall be addressed during supervision.
 Participate in Supervision.
 Update performance monitoring charts (e.g. EPI coverage).
 Participate in surveys conducted by the facility.
 Participate in planning how to achieve set targets for sector wide indicators that are not
achieved.
 Perform in any other official duties that will be assigned.

Annually
Annual compilation of returns
 Receive reports.
 Follow up on outstanding reports.
 Clean and reconcile data.
 Sort, verify, update and file reports.

Analyse data
 Perform annual Data Analyses and Interpretation using, Graphs, Charts, and Tables etc.
to show trends.
 Compare trends to detect possible outbreaks service utilisation (Benchmarking) monthly,
quarterly.

Disseminate data
 Brief facility management.
 Participate in report generation.
 Participate in annually report writing.

Other activities
 Participate in annual facility meetings.
 Perform yearly data updates and back-up.
 Monitor to identify gaps in technical skills that shall be addressed during supervision.
 Participate in Supervision.
 Update performance monitoring charts.
 Conduct surveys on some events.
 Plan on achieving set targets that were not achieved.
47
  Perform other official duties that shall be assigned.

48
DISTRICT LEVEL
WEEKLY Basis

Collation:
 Receive and check data for errors and give immediate feedback.
 Follow up on outstanding reports.
 Train and support key staff on data entry (DHIMS and other programmes.)
 Coordinate data entry by other officers.
 Update all records.
 File reports according to medical records policy.

Analyse data
 Perform Data Analysis and Interpretation using, Graphs, Charts and Tables etc. to show
trends.
 Compare trends to detect possible outbreaks, service utilisation (Benchmarking) monthly,
quarterly.

Disseminate results of data analysis

 Briefing DDHS/DHMT.
 Submit reports to the appropriate level.
 Feedback to whom it may concern.

Routine activities
 Participate in weekly DHMT meetings.
 Perform weekly data updates and back-up.
 Follow up on notifiable diseases and events to appropriate office.
 Provide technical supervision for the medical records staff.
 Ensure the physical security of all health records and release data only upon
authorization.
 Perform any other official duties that will be assigned.

Monthly
Compilation
 Receive and follow up on outstanding data and reports.
 Undertake cleaning and reconciliation.
 Train and support key staff on data entry (DHIMS and other programmes).
 Coordinate data entry by other officers.
 Sort, verify and update data where appropriate
 Coordinate data validation process.

49
 Analyse data
 Perform Data Analysis and Interpretation using, Graphs, Charts, and Tables etc. to show
trends.
 Compare trends to detect possible outbreaks, service utilisation (Benchmarking) monthly,
quarterly.

Disseminate results of data analysis

 Brief Facility Management on result of data analysis and interpretation.
 Share with relevant stakeholders in the facility
 Submit returns to appropriate level.
 Receive feedback from relevant stakeholders
 Document feedback from relevant stakeholders

Routine activities
 Participate in monthly DHMT meetings.
 Perform monthly data updates and back-up.
 Report notifiable diseases and events to appropriate office.
 Monitor and Supervise subordinates.
 Update events and disease monitoring charts.
 Identify those that need training, plan and effect training
 Perform other official duties that will be assigned.

Quarterly/Half Yearly
Compilation of reports
 Receive and follow up on outstanding reports.
 Sort, verify, update and file reports

Analyse data
 Perform Data Analysis and Interpretation using, Graphs, Charts, and Tables etc. to show
trends.
 Compare trends to detect possible outbreaks, service utilisation (Benchmarking) monthly,
quarterly.

Reports
 Participate in writing quarterly/half yearly reports.

Disseminate results of data analysis

 Brief DHMT.
50
  Submit reports to the appropriate level.
 Feedback to whom it may concern.

Routine activities
 Participate in DHMT meetings.
 Perform quarterly and half-yearly data updates and back-up.
 Monitor to identify gaps in technical skills that shall be addressed during supervision.
 Participate in Supervision.
 Updating of performance monitoring charts (e.g. EPI coverage).
 Participate in surveys in the district.
 Coordinate data entry by other officers.
 Participate in planning how to achieve set targets for sector wide indicators that are not
achieved.
 Perform other official duties that will be assigned.

Annually
Annual compilation of reports
 Receive Follow up on outstanding reports.
 Clean and reconcile data in reports.
 Sort, verify and update and file reports.

Analyse data
 Perform Data Analysis and Interpretation using, Graphs, Charts, and Tables etc. to show
trends.
 Compare trends to detect possible outbreaks, service utilisation (Benchmarking) monthly,
quarterly.

Disseminate data
 Brief DHMT
 Participate in report generation for Feedback
 Participate in annually report writing

Routine activities
 Participate in annual review meeting.
 Perform yearly data updates and back-up.
 Monitor to identify gaps in technical skills that shall be addressed during supervision.
 Participate in Supervision.
 Update performance monitoring charts.
 Conduct surveys on some events.
 Coordinate data entry by other officers.
 Plan on achieving targets that were not achieved.
 Perform any other official duties that shall be assigned.

51
52
REGIONAL LEVEL
Weekly Basis
Review of returns
 Check DHIMS for data quality issues and report for immediate feedback.
 Work in collaboration with other programme officers to ensure that they have their data
from DHIMS.
 Follow up on outstanding dataset reports after due dates.
 File any other reports properly.

Analyse data
 Perform Data Analysis and Interpretation using, Graphs, Charts, and Tables etc. to show
trends.
 Print out analysis and file.
 Support other programme heads and units to analyse data.

Disseminate data
 Brief RDHS.
 Submit weekly reports to the RDHS.
 Feedback to who it may concern.
 Report findings from analysis to RHMT and DHMTs.

Other activities
 Participate in weekly RHMT meetings.
 Perform weekly data updates and back-up.
 Provide technical supervision for the Health information staff.
 Ensure the physical security of all health data and release data only upon authorization.
 Perform any other official duties that shall be assigned.

Monthly
Compilation of reports
 Receive and follow up on outstanding reports.
 Coordinate the data validation process.
 Send feedback on findings to Districts and programme Heads
 Prompt districts to sign-off DHIMS data after 15th of each month if not done.

Analyse data
 Perform Data Analysis and Interpretation using, Graphs, Charts, and Tables etc. to show
trends.
 Compare trends to detect possible outbreaks, service utilisation (Benchmarking) monthly,
quarterly.
 Print out analysis and file.

Disseminate data
 Brief RHMT.
 Submit reports to the appropriate level.
53
  Feedback to whom it may concern.

Routine activities
 Participate in monthly RHMT meetings.
 Perform monthly data updates and back-up.
 Report on notifiable and diseases targeted for elimination.
 Provide technical supervision for the Health information staff at Regional, and District
levels including the Hospitals.
 Update performance monitoring charts.
 Perform any other official duties that shall be assigned.
 Participate in monitoring and supervision

Quarterly/Half Yearly
Review of reports
 Check DHIMS for data quality issues and report for immediate feedback.
 Follow up on outstanding reports.
 File all reports properly.

Analyse data
 Perform Data Analysis and Interpretation using, Graphs, Charts, and Tables etc. to show
trends.
 Compare trends to detect possible outbreaks, service utilisation (Benchmarking) monthly,
quarterly.
 Print out analysis and file.

Reports
 Participate in the writing of quarterly/half yearly reports.

Disseminate data
 Brief RHMT.
 Submit reports to the appropriate level.
 Feedback to whom it may concern.

Routine activities
 Participate in monthly RHMT meetings.
 Perform quarterly/half yearly data updates and back-up.
 Report on notifiable and diseases targeted for elimination.
 Provide technical supervision for the health information staff at Regional, and District
levels including the Hospitals.
 Update performance monitoring charts.
 Perform other official duties that shall be assigned.

54
Annually
Annual compilation of returns (check on appropriateness)
 Check DHIMS for data quality issues and report for immediate feedback.
 Follow up on outstanding reports.
 File reports according to medical records policy.

Analyse data
 Perform Data Analysis and Interpretation using, Graphs, Charts and Tables etc. to show
trends.
 Compare trends to detect possible outbreaks, service utilisation (Benchmarking) monthly,
quarterly.
 Print out analysis and file.

Disseminate results of data analysis

 Brief RHMT.
 Participate in report generation for Feedback.
 Participate in annual report writing.

Routine activities
 Coordinate and Participate in annually RHMT meetings.
 Perform annual data updates and back-up.
 Report on to identify gaps in technical skills that shall be addressed during supervision.
 Participate in Monitoring and Supervision.
 Update performance-monitoring charts.
 Conduct surveys on some events.
 Plan on achieving set targets that were not achieved.
 Perform other official duties that will be assigned.
 Conduct training needs assessment at the regional and district levels on information
management activities.
 Facilitate training in information management skills at regional and district levels
including hospitals.

TASKS AND ACTIVITIES HEAD OF CHIM

Compilation and review of reports
 Follow up on outstanding reports from regions.
 Coordinate national level data validation process.
 Prompt regions to sign-off DHIMS data after 25th of each month.
 Liaise and ensure synchronisation of teaching hospitals for data to DHIMS2.

55
 Analyse data
 Perform Data Analysis and Interpretation using enhanced data analytics and other
performance measurements e.g. scorecard, regressions analysis of essential health
services etc.
 Compare trends to detect possible outbreaks, service utilisation (Benchmarking) monthly,
quarterly.
 Print out analysis and file.

Reports
 Provide Monthly, Quarterly and Annual reports to PPME
 Produce Annual Facts and Figures.
 Support the training of health information staff and skills development at all levels.
 Support the work of the HITWG.
 Produce monthly regional performance feedback on performance indicators
 Conduct monthly headquarters data validation meetings.

Routine activities
 Perform data updates and back-up monthly, quarterly, half yearly and annually.
 Monitor to identify gaps in technical skills that shall be addressed during supervision.
 Plan and implement monitoring and supervision of HMIS activities
 Perform other official duties that will be assigned.
 Conduct training needs assessment at the regional and district levels on information
management activities.
 Facilitate training in information management skills at regional and district levels
including hospitals.

56
CHAPTER FIVE

REPORT WRITING FORMAT

Report writing at all levels shall follow the format as described below. It is mandatory that every
District/Region prepares and presents this written report.

FORMAT FOR ANNUAL REPORT

Forward
Acknowledgment
Acronyms
Executive Summary
Should be organised along the strategic objectives of the HSMTD showing highlights of performance
according to these objectives:
1. HO1: Universal access to better and efficiently managed quality health care services
2. HO2: Reduce avoidable maternal, adolescent and child deaths and disabilities
3. HO3: Increase access to responsive clinical and public health emergency services

Chapters One: Introduction

 Organisational overview
 Highlights of key challenges/constraints from previous year
 Summary of Key Priorities from previous year
 Structure of report

Chapter Two: Service Delivery Performance

Subtitles
 Health Status
 Health and related services
o Child & Adolescent Health
o Immunization
o Maternal & Reproductive Health
o Nutrition
o Family Planning
o Communicable Diseases
o Noncommunicable Diseases
o Mental Health
o Community Engagement

Chapter Three: Clinical/Institutional Care

Subtitles
 New health facilities completed & operational, new ones initiated & major gaps
 New health services introduced (where, performance)

57
Chapter Four: Resilient and Sustainable Health Systems
Subtitles
 IDSR
 CBS - reporting rates & major events reported by CBS system
 Public Health emergencies
 Natural disasters

Chapter Five: Leadership and Governance

Subtitles
 Policy reviews & changes
 Planning Activities
 General management issues both internal and external
o Internal (Directors & Divisional meetings, retreats & SMMs, GHS activities, Performance
management processes - Performance agreements, etc.
o External (Health Summits & other meetings with external stakeholders - Business
meetings, working group meetings, Inter Agency leadership meetings, intersectoral
meetings, etc.)
 M & E activities & performance
 Review processes & performance
 Internal Audit

Chapter Six: Health Financing

Subtitles
 Analysis of NHIS activities, coverage by district & region, beneficiaries’ segregation
 Compare financial performance of the hospitals, HCs, & regions
 Sources and breakdown regional & district segregation (e.g. contribution from MMDAs, etc.)

Chapter Seven: Human Resources for Health

Subtitles
 HR planning
 Payroll & nominal role: performance by regions & Divisions
 Compare HR budget with actual expenditure
 Promotions
 Disciplinary issues

Chapter Eight: Support Services

Subtitles
 Health Infrastructure
 Health equipment
 Transport
 Administrative Communication & Records Management System

58
Detailed table of status of projects should be put in annex

Chapter Nine: Stakeholder Engagement

Subtitles
 Community based Services (CHPS)
 Intersectoral Collaboration
 Engagement with Development Partners & NGOs

Chapter Ten: Digital health, M&E and Health Research

Subtitles
 Digital health (HMIS, Telemedicine )
 M&E and Learning
 Health Technologies
 Health research

ANNEXES
Include
Table of Development partner/NGOS, their areas of operation (geographical & service areas)
Details of health statistics that is not in the main body of the report. E.g. details of some hospital statistics,
EPI, MNCH etc.

General Comments
Analysis statistics & issues by geographic, type, gender, etc.
Provide explanations for results
Identify gaps and the needed actions to be taken identified.
The review should include the use of the BNA indicators to review performance.
Put detailed tables in annex

59
CHAPTER SIX

DATA REQUEST FORMS

This chapter addresses respective forms that are used to manage data at the district and the facility level.
This includes:

DISTRICT REPORT/RETURNS LOGBOOK

FOR FACILITIES NOT HAVING DIRECT ACCESS TO DHIMS2
Facilities who do not have access to DHIMS 2 due to unavailability of data capturing equipment and also
for facilities who have limited internet connectivity. These facilities submit their monthly report to the
sub district or district for their data to be captured. These facilities when they submit reports are supposed
to complete the district report/returns logbook which will indicate the date when these facilities submitted
these reports, the facility and officer reporting, returns/report of the facility, outstanding reports, officer
receiving and any remark if necessary. This helps especially during data quality audits from independent
auditors to audit the data that has been reported in DHIMS 2.

DISTRICT REPORT/RETURNS LOGBOOK

Facility and
Returns/Reports (list Outstanding Reports (list Officer
Date Officer Remark
all for each Facility) all for each Facility) Receiving
Reporting

60
DATA CHANGE REQUEST FORM IN DHIMS2
As per this current GHS HMIS SOP, facilities are allowed 60 days to validate and verify their data after
which the data will be locked. Within the 60days, when a facility recognise that their data needs to be
updated into DHIMS2, they cannot just update the data without completing the data change request form
which will need the approval of the District Director before the change can be effected. However, after
the 60 days data change window, the facility needs to seek the approval of the Regional Director and the
Director General. The PPME will be mandated to review the request and if there is merit then the
approval process will have been completed for the data to be updated. The request should include the
reporting form, data element, current value, new value, reasons for requesting change and officer
requesting change. The update or change of value should always be done at the facility level and not any
other level. The completed form has to be filed at the facility for a minimum of three years as reference
and for audit purposes.

DATA CHANGE REQUEST FORM

Facility: ___________________ Sub-district ____________________ District______________
Date Submitted____/____/____ Reporting Period of Form to be Changed____/____/____

Reasons for Officer

Requesting Requesting
Reporting Form Data Element Current Value New Value Change Change

NB: SUBMIT ONE DATA CHANGE REQUEST FORM FOR EACH REPORTING FORM
Remark:
Date: Signature:
Approved by:
To be attached to the original form approved by the facility
61
 FACILITY CREATION REQUEST FORM
As new facilities. sub districts, Districts and Regions are created and start offering services, per the Act that establishes the GHS as an Agency and
the Act that establishes HEFRA, that facility (CHPS, Health Center, CHAG, District Hospital, Regional Hospital etc.) they are to report on the
services that they deliver one month after the start date for the previous month. For a new facility the district health directorate is required to
complete the facility creation request form with key variables such as the coordinates, date of establishment etc. This has to be approved by the
District and Regional Directors of health services and forwarded to PPME for creation of the facility into the DHIMS2. This is to be filed at the
District level. This ensures that DHIMS 2 maintains the facility registry that is required for all the interoperable health systems in Ghana such as
the electronic medical records etc.
REQUEST FOR ORGANIZTION UNIT CREATION AND UPDATE

Organization unit Organization unit Organization unit

Name: Name: Name:

District Sub-District Facility

New Update (If old indicate old) New Update (If old indicate old) New Update (If old indicate old)
Name:
Name: Name:
Type: Ownership:

Poulation: Poulation: Poulation:

Coordinates: Latitude Longitude Coordinates: Latitude Longitude Coordinates: Latitude Longitude

Dataset Dataset Dataset

Assign De-assign Assign De-assign Assign De-assign

Reason(s) for Request

Request by: Date:

Approved By : Date:
DATA REQUEST FORMS
The data request form is to be used by all Agencies that are not under the health sector but are
requesting for data. These Agencies are to complete and submit the forms including the corresponding
fees as part of their data request for this to be processed (See Annex for the guidelines and fees for the
release of health service data). The submitted forms has to be approved by the respective programme
and the Director General before the data is released.

Certified data request form is available at a fee to be determined by the CHIM.

 APPENDIX ONE
REGISTERS AND FORMS FOR INSTITUTIONAL CARE DIVISION (ICD)

REGISTERS (ICD)

OUTPATIENT REGISTER
VARIABL DATA
No. DEFINITION
E SOURCE
SERIAL The numbering of clients as they attend the facility, it is done serially to know
1 Generated
NUMBER the number of clients registered at a given period
Date on which the client visits the facility and shall be in the form
2 DATE Calendar
DD/MM/YYYY

Client’s unique identification issued on the first visit to the facility and
PATIENT
3 retained for life. If the client is not a new client in the facility, then steps shall Patient ID Card
NUMBER
be taken to search for the number assigned on the first visit.

NEW A client visiting the facility for the first time in the current calendar year (Jan –
4 Records
CLIENT Dec), may have visited in the previous year.
OLD All client visiting the facility after their first visit in the calendar year (Jan –
5 Records
CLIENT Dec), shall remain so till year ends
NAME OF Name of client in full without titles, avoid informal names such as: Sister, Insurance
6
CLIENT Maame, Auntie, Wofa, etc. card/Verbal
The exact age of the client in completed years e.g. 30 years. If the child A
Insurance Card /
NEONATE WRITE THE AGE IN DAYS, but from the first month to the first
7 AGE Verbal/Child
birthday (POST NEONATE) state the age in completed months followed by
Welfare card
the word ‘months’, e.g. 9 months
8 SEX Indicate the sex of the client. M for Male and F for Female Observation
TOWN/
9 Name of locality where client resides, e.g. Madina Verbal
LOCALITY
CONTACT
Indicate mobile/telephone number of a client or care giver Verbal
NUMBER
The health insurance status of the client. This is limited only to the national
health insurance schemes.
NHIS
Write “YES”- if the client’s insurance card is valid or active and has not
STATUS
10 expired. Insurance card
(YES OR
Write “NO” if the client is not insured at all or if the card is not valid or active.
NO)
If the health insurance card indicates that the insurance has expired then it
means the client is not insured, treat as non-insured.

NOTE: Staff shall note that this register has nothing to do with the condition for which the
facility is being visited; this is used to complete the statement of outpatient (OPD Attendance)
General: Emergency at the OPD (Refer Medical Records in Emergency in the Medical
Records Policy)
CONSULTING ROOM REGISTER

No
VARIABLE DEFINITION DATA SOURCE
.
Date on which the client is visiting the
1 Date facility and shall be in the form Calendar
DD/MM/YYYY
Client’s unique identification issued on
the first visit to the facility and retained
for life. If the client is not a new client in
2 Patient Number Patient ID Card
the facility, then steps shall be taken to
search for the number assigned on the
first visit.
Insurance The unique insurance identification National Health Insurance
3
Number number of the client Registration Card
Name of client in full without titles,
4 Name of Patient avoid informal names such as: Sister, Insurance card, Verbal
Maame, Auntie, Wofa, etc.
Address The locality in which the client resides
5 Verbal
(Locality) but not the birthplace.
Telephone
Contact number(s) of client or close
6 Number(S) Of Client/Relative
relative
Patient

The exact age of the client in completed

years e.g. 30 years. If the child A
NEONATE WRITE THE AGE IN
7 Age DAYS, but from the first month to the Verbal, insurance card
first birthday (POST NEONATE) state
the age in completed months followed by
the word ‘months’, e.g. 9 months

Indicate the sex of the client. M for Male

8 Sex Observation / Verbal
and F for Female
Provisional The suspected morbidity condition that
9 Clinician
Diagnosis the patient is presenting
Type of Test(S) This is the laboratory investigation(s)
10 Laboratory Request Form
Requested requested by the clinician/prescriber
This is the result(s) from the lab
11 Test Result(S) investigation requested by the Lab result sheet
clinician/prescriber
Principal The main morbidity condition for which
12 Attending Clinician
Diagnosis the patient is being treated

2
 No
VARIABLE DEFINITION DATA SOURCE
.

A CONDITION that is seen at the

facility for the first time for which the
client is beginning treatment. This is
referring to the diagnosis only and it is
not the same as a New Client in the OPD
Status of
register.
Principal Attending Clinician /
13 It is the new cases that are counted and
Diagnosis Records
reported on the Monthly OPD Morbidity
(New Case Tick)
Reporting Form as individual cases.
If it is a chronic condition and there is
evidence of contact with any health
facility it is then recorded as an old case.
e.g. hypertension, diabetes

A condition that treatment has begun at

the facility and the client is coming for
review of the same condition after
Status of treatment has begun.
Principal This condition will remain old until it is Attending Clinician /
14
Diagnosis cured. All old cases are added to the re- Records
(Old Case Tick) attendance on the Monthly OPD
Morbidity reporting form.
The principle is to ensure that no
diagnosis is counted more than once.

Any other diagnosis that the client is

Additional
15 confirmed by the clinician to have in Attending Clinician
Diagnosis
addition to the principal diagnosis

Status of
Additional Tick if additional diagnosis is a new case Attending Clinician /
16
Diagnosis as defined in row 11 above. Records
(New Case Tick)

Status of Tick if additional diagnosis is an old

Additional case, all old cases are added to the re- Attending Clinician /
17
Diagnosis attendance on the OPD Morbidity report. Records
(Old Case Tick) As defined in row 12 above.

This is to indicate if female clients

Pregnant Patient visiting the consulting room are pregnant Lab result / Verbal /
18
(Y/N) or not. If the client is pregnant then, write observation
“Y” and “N” if the client is not pregnant

3
 No
VARIABLE DEFINITION DATA SOURCE
.

The health insurance status of the client.

This is limited only to the national health
insurance schemes.

Write “YES”- if the client’s insurance

card is valid or active and has not
expired.
If ‘YES’, indicate if the patient is under
NHIS Client CAPITATION OR DIAGNOSIS
19 Insurance ID Card
(Y/N) RELATED GROUP (DRG).

Write “NO” if the client is not insured at

all or if the card is not valid or active.

If the health insurance card indicates that

the insurance has expired then it means
the client is not insured, treat as non-
insured.

4
ADMISSION & DISCHARGE REGISTER
No. VARIABLE DEFINITION DATA SOURCE

Client’s unique identification issued on the first visit

PATIENT to the facility and retained for life. If the client is not
1 Patient folder
NUMBER a new client in the facility, then steps shall be taken
to search for the number assigned on the first visit.

Insurance card,
NAME OF Name of client in full without titles, avoid informal
2 Verbal, Patient
PATIENT names such as: Sister, Maame, Auntie, Wofa, etc.
folder
The exact age of the client in completed years e.g. 30
years. If the child A NEONATE WRITE THE AGE
IN DAYS, but from the first month to the first
3 AGE Patient folder
birthday (POST NEONATE) state the age in
completed months followed by the word ‘months’,
e.g. 9 months

Indicate the sex of the client. M for Male and F for

4 SEX Patient folder
Female

The locality in which the client resides but not the

5 ADDRESS Patient folder
birth place

The work the client does. example, Farmer, Teacher,

6 OCCUPATION Patient folder
Nurse, Doctor, etc.

DATE OF The date on which the client was admitted and even
7 Patient folder
ADMISSION for those transferred in from another facility.

DATE OF The date on which client was discharged and even for
8 Patient folder
DISCHARGE those transferred out to another facility.

9 WARD The name of the ward client is admitted to. Patient Folder

OUTCOME OF How the client left the facility. Discharged,

10 Patient folder
ADMISSION Transferred, Died or Absconded

The NHIS number of the client if he or she is

11 NHIS NUMBER NHIS Card
registered and not expired

5
 INPATIENT MORBIDITY AND MORTALITY REGISTER
(Completed only after discharge of patient)

No. VARIABLE DEFINITION DATA SOURCE

Numbering of clients as they are discharged. It is to know

SERIAL
1 the number of clients admitted and discharged in the Records
NUMBER
facility.

Client’s unique identification number issued on the first

PATIENT visit to the facility and retained for life. If the client is not a
2 Patient folder
NUMBER new client in the facility, then steps shall be taken to search
for the number assigned on the first visit.

ADDRESS The locality in which the client resides but not the birth
3 Patient folder
(RESIDENCE) place

The exact age of the client in completed years e.g. 30 years.

If the child A NEONATE, WRITE THE AGE IN DAYS,
4 AGE but from the first month to the first birthday (POST Patient folder
NEONATE) state the age in completed months followed by
the word ‘months’, e.g. 9 months

Indicate the sex of the client. Write “M” for Male clients
5 SEX Patient folder
and “F” for Female clients

The work the client does. example, Farmer, Teacher, Nurse,

6 OCCUPATION Patient folder
Doctor, etc.

EDUCATION The highest level of education that the client has attained,
7 Patient folder
AL STATUS e.g. Primary, JHS, SHS, Tertiary, none, etc.

DATE OF The date on which the client was admitted and even for
8 Patient folder
ADMISSION those transferred in from another facility.

DATE OF The date on which client was discharged and even for those
9 Patient folder
DISCHARGE transferred out to another facility.

The specialty of the case for which the client is being

10 SPECIALTY Patient folder
treated i.e., Medical, Surgical, Paediatric, Maternity etc.

6
No. VARIABLE DEFINITION DATA SOURCE

OUTCOME The final result of the patient’s stay in the facility. How the
11 OF client left the facility. Discharged, Transferred-out, Died or Patient folder
ADMISSION Absconded.

Type of Test(S) This is the laboratory investigation(s) requested by the Laboratory Request
12
Requested clinician/prescriber Form

This is the result(s) from the lab investigation requested by

13 Test Result(S) Lab result sheet
the clinician/prescriber
PRINCIPAL The main morbidity condition for which the patient was
14 Patient folder
DIAGNOSIS admitted and treated

ADDITIONAL Any other diagnosis that the patient was confirmed by the
15 Patient folder
DIAGNOSIS clinician to have in addition to the principal diagnosis

If any surgical procedure performed on the client, write

SURGICAL
16 “Yes” and “No” if no surgical procedure was performed on Patient folder
PROCEDURE
the client.

COST OF The total cost of treating the client for the duration of stay,
17 Patient folder
TREATMENT this is either paid by client, by facility or by NHIS

The health insurance status of the client. This is limited

only to the national health insurance schemes.
*Write “YES”- if the client’s insurance card is valid
NHIS
18 *Write “NO” if not insured, or card not active. Insurance Card
(YES OR NO)
If the health insurance card indicates that the insurance has
expired then it means the client is not insured, treat as non-
insured.

7
 GENERAL WARD REGISTER
No. VARIABLE DEFINITION DATA SOURCE

PATIENT The client’s identification number found on the

1 Patient folder
NUMBER Patient folder

INSURANCE The unique insurance identification number of the

2 NHIS Card
NUMBER client

NAME OF Name of client in full without titles, avoid informal

3 Patient folder
PATIENT names such as: Sister, Maame, Auntie, Wofa, etc.
The main work that the client makes a living from
4 OCCUPATION Patient folder
e.g. Teaching, Farming, Civil Servant, etc.
ADDRESS The locality in which the client resides but not the
5 Patient folder
(LOCALITY) birth place
The Global Position System (GPS) location of the
Post GPS Location Patient folder
client or care giver
9 Contact of person Patient folder
The highest level of education the client has
EDUCATIONAL
6 attained e.g. Primary, JHS, SHS, Tertiary, none, Patient folder
LEVEL
etc.
The exact age of the client in completed years e.g.
30 years. If the child is A NEONATE, WRITE
THE AGE IN DAYS, but from the first month to
7 AGE Patient folder
the first birthday (POST NEONATE) state the age
in completed months followed by the word
‘months’, e.g. 9 months
Indicate the sex of the client. M for Male and F for
8 SEX Patient folder
Female
The date on which the client was admitted and
DATE OF
9 even for those transferred in from another ward or Patient folder
ADMISSION
facility.

PROVISIONAL The initial diagnosis for the client’s admission

10 Patient folder
DIAGNOSIS before investigations are carried out

TYPE OF
This is the laboratory investigation(s) requested by Laboratory Request
11 TEST(S)
the clinician/prescriber Form/Patient folder
REQUESTED
TEST This is the result(s) from the lab investigation Lab result sheet/Patient
12
RESULT(S) requested by the clinician/prescriber folder

FINAL The main confirmed morbidity condition for which

13 Patient folder
DIAGNOSIS the patient was admitted and treated

14 STATUS The confirmed CONDITION that the client is Attending Clinician /

(NEW CASE treated for after laboratory investigations. This is folder
TICK) referring to the diagnosis only

8
No. VARIABLE DEFINITION DATA SOURCE

It is the new cases that are counted and reported

on the Monthly Inpatient Morbidity and Mortality
Reporting Form as individual cases.

If it is a chronic condition and there is evidence of

contact with any health facility it is then recorded
as an old case. e.g. hypertension, diabetes
A condition that has been treated by the facility
STATUS and the client is re-admitted for the same
Attending Clinician /
15 (OLD CASE condition.
folder
TICK) The principle is to ensure that no diagnosis is
counted more than once.
Any comorbidity that the patient was confirmed by
ADDITIONAL
16 the clinician to have in addition to the final Patient folder
DIAGNOSIS
diagnosis
STATUS
Tick if additional diagnosis is a new case as Attending Clinician /
17 (NEW CASE
defined in row 14 above. folder
TICK)
STATUS (OLD Tick if additional diagnosis is an old case as Attending Clinician /
18
CASE TICK) defined in row 15 above folder
The date on which client was discharged and even
for those transferred out to another ward or facility.
DATE OF
19 Patient folder
DISCHARGE
This is referring to the date the clinician certifies
that the episode being managed has ended.
OUTCOME OF How the client left the facility or ward.
20 Patient folder
ADMISSION Discharged, Transferred, Died or Absconded
This is to indicate if female client admitted in the
Lab result / Verbal /
PREGNANT ward is pregnant or not. If the client is pregnant
21 observation / Maternal
PATIENT (Y/N) then, write “Y” and “N” if the client is not
Health Book
pregnant
The health insurance status of the client. This is
limited only to the national health insurance
schemes.

Write “YES”- if the client’s insurance card is valid

or active and has not expired.
NHIS STATUS
22 Insurance Card
(YES OR NO)
Write “NO” if the client is not insured at all or if
the card is not valid or active.

If the health insurance card indicates that the

insurance has expired then it means the client is
not insured, treat as non-insured.

9
No. VARIABLE DEFINITION DATA SOURCE
This list all medicines prescribed by the clinician/
MEDICINES Prescription form/
23 prescriber to the client for the confirmed final and
PRESCRIBED folder
additional diagnosis

MEDICINES This list all medicines dispensed to the client for Prescription form/
24
DESPENSED the confirmed final and additional diagnosis folder

10
 MEDICAL LABORATORY REGISTER
No. VARIABLE DEFINITION DATA SOURCE
1 DATE Date lab test is being done Calendar
Identification number generated and assigned to the
2 PATHOLOGY NUMBER Request Form
client’s/specimen request form

Name of client in full without titles, avoid informal

3 NAME OF CLIENT Request Form
names such as: Sister, Maame, Auntie, Wofa, etc.

Indicate the sex of the client. M for Male and F for

4 SEX Request Form
Female
The exact age of the client in completed years e.g. 30
years. If the child A NEONATE WRITE THE AGE IN
5 AGE DAYS, but from the first month to the first birthday Lab Request Form
(POST NEONATE) state the age in completed months
followed by the word ‘months’, e.g. 9 months

Client’s unique identification issued on the first visit to

the facility and retained for life. If the client is not a new
6 CLIENT NUMBER Lab request form
client in the facility, then steps shall be taken to search
for the number assigned on the first visit

7 NAME OF PRESCRIBER Name of health personal requesting investigation Lab request form

PRESCRIBER’S
8 Telephone number prescriber Lab request form
CONTACT NUMBER

Where the request is originating from; Consulting room,

9 SOURCE OF REQUEST Lab request form
Ward, ANC, Walk-in, CHPS (Name).
10 DIAGNOSIS Disease condition for which test is being requested for. Lab request form
11 TYPE OF SPECIMEN Type of specimen required for the investigation. Lab request form
The type of test that has been requested by attending
12 TEST REQUESTED Lab request form
prescriber

DATE/TIME OF Date and time the sample was collected for analysis from
13 Lab request form
SAMPLE COLLECTION the patient

The health insurance status of the client. This is limited

only to the national health insurance schemes.
NHIS
14 Insurance Card
(YES or NO)
Write “YES”- if client card is active and Write “NO” if
client not insured or card not active.

11
LABORATORY RESULTS LOGBOOK
No. VARIABLE DEFINITION DATA SOURCE
1 DATE Date lab test is being done Calendar
Identification number assigned to the Medical lab
2 PATHOLOGY NUMBER
client/specimen register
Indicate the sex of the client. M for Male
3 SEX Request Form
and F for Female
The exact age of the client in completed
years e.g. 30 years. If the child is a
NEONATE WRITE THE AGE IN
4 AGE DAYS, but from the first month to the Request Form
first birthday (POST NEONATE) state
the age in completed months followed by
the word ‘months’, e.g. 9 months
Client’s unique identification issued on
the first visit to the facility and retained
CLIENT
for life. If the client is not a new client in
5 NUMBER/FOLDER Lab request form
the facility, then steps shall be taken to
NUMBER
search for the number assigned on the
first visit
Where the request is originating from;
6 SOURCE OF REQUEST consulting room, ANC, Self (Walk-in), Lab request form
CHPS (Name).
DATE/TIME FOR
Date and time the sample was received
7 SAMPLE RECEIPT IN Lab request form
in the lab
LAB
Result of the investigation carried out.
Indicate the result against the Machine/Analyser
8 RESULTS OF TEST
appropriate lab investigation listed in or results sheet
the columns
Total number of malaria tests conducted
9
Malaria Parasite Total tests using microscopy
Number of malaria cases tested positive
10 Lab results sheet
MP P. falciparum positive with Plasmodium falciparum infection
Number of malaria cases tested positive
11 Lab results sheet
MP P. malariae positive with Plasmodium malariae infection
Number of malaria cases tested positive
12 Lab results sheet
MP P. ovale positive with Plasmodium ovale infection
Number of malaria cases tested positive
13 Lab results sheet
MP P. vivax positive with Plasmodium vivax infection
Number of malaria cases tested positive
14 Lab results sheet
MP P. knowlesi positive with Plasmodium knowlesi infection
Number of positive malaria cases with
15 Lab results sheet
MP trophozoite positive trophozoite stages seen
Number of positive malaria cases with
16 Lab results sheet
MP schizoints positive schizoints stages seen
Number of positive malaria cases with
17 Lab results sheet
MP gametocyte positive gametocyte stages seen
18 MP Count <200,000p/µl Number of positive malaria cases with Lab results sheet
12
No. VARIABLE DEFINITION DATA SOURCE
parasite counts less than 200,000
parasites/ µl of blood
Number of positive malaria cases with Lab results sheet
19 MP Count (200,000 - parasite counts between 200,000 –
499,000)p/µl 499,000 parasites/ µl of blood
Number of positive malaria cases with Lab results sheet
20 parasite counts greater than 500,000
MP Count ≥500,000p/µl parasites/ µl of blood
Total number of malaria test conducted Lab results sheet
21 using malaria rapid diagnostic tests
mRDT Total tests (mRDTs)
Number of malaria cases positive for pf
22 Lab results sheet
Pf HRP2 positive RDT HRP2 antigen
Number of malaria cases positive for pf-
23 Lab results sheet
Pf-pLDH positive RDT pLDH antigen
Number of malaria cases positive for pf,
24 Lab results sheet
Pan-pLDH positive RDT po, pm& pv pLDH antigen
All others

13
 PHARMACY DISPENSARY REGISTER
No. VARIABLE DEFINITION DATA SOURCE
SERIAL The number on the row on which client record is written in
1 Records
NUMBER the register.
2 DATE The date on which medicine(s) is dispensed Calendar
The health insurance status of the client. This is limited
only to the national health insurance schemes.
NHIS STATUS
3 Insurance Card
(YES OR NO)
Write “YES”- if client card is active and Write “NO” if
client not insured or card not active.
PATIENT
The client’s identification number found on the Patient
4 FOLDER Patient folder
folder
NUMBER
PATIENT Name of client in full without titles, avoid informal names
5 Patient folder
NAME such as: Sister, Maame, Auntie, Wofa, etc.
The exact age of the client in completed years e.g. 30 years.
If the child is A NEONATE WRITE THE AGE IN DAYS,
6 AGE but from the first month to the first birthday (POST Patient folder
NEONATE) state the age in completed months followed by
the word ‘months’, e.g. 9 months
7 WEIGHT (KG) Weight of the client measured in kilograms. Patient folder
Full patient diagnosis corresponding to the Principal and
8 DIAGNOSIS Patient folder
Additional diagnoses as written in patient folder
Enter the dosage form/Name/Strength of medicine
dispensed to the client.
DOSAGE The dosage form could be tablet, capsule, syrup or
FORM/ NAME dispersible Patient Folder/
9
OF MEDICINE/ The name of the medicine is the generic name and not the Prescription Form
STRENGTH brand name
The strength of the medicine could be in mg or ml and is
determined by the weight of the client
QUANTITY The Quantity dispensed by multiplying the quantity per Patient Folder/
10
DISPENSED dose by the frequency and duration of treatment given Prescription Form
COST OF
The Cost of medicines dispensed is determined by Patient Folder/
11 MEDICINE(S)
multiplying the quantity dispensed with the unit price. Prescription Form
DISPENSED

14
MENTAL HEALTH OUT-PATIENTS REGISTER
SN VARIABLE DEFINITION DATA SOURCE
1 Name of Facility The name of the Service Delivery Point Records
(SDP) e.g. Aboaso Health Centre etc.

2 District The name of the district in which SDP Records

is located, e.g. Kwabre.

3 Location Town in which SDP is situated Records

4 Region The name of the region in which the Records

SDP is located e.g. Ashanti.

5 Month The Month in which the transaction Records

took place e.g. July

6 Year Year in which the transaction took Calendar

place e.g. 2010

7 Patients number A count of the number of the individual CR Register

conditions presented by clients. This is
List of the diseases to be reported on.
This shall be new cases only, does not
include cases on review

Patients name
Age
Sex
Referral from criminal
justice system
Referral (In/Out)
Chained / chackled/ roped
Mode of Treatment
(Voluntary/Involuntary)
Outcome
Physical disabilities
Status of clients
NHIA

15
COMMUNITY MENTAL HEALTH ACTIVITY REGISTER
SN VARIABLE DEFINITION DATA SOURCE
The name of the Service Delivery Point
1 Name of Facility
(SDP) e.g. Aboaso Health Centre etc. Records
The name of the district in which SDP is
2 District
located, e.g. Kwabre. Records
3 Location Town in which SDP is situated Records
The name of the region in which the SDP is
4 Region
located e.g. Ashanti. Records
The Month in which the transaction took
5 Month
place e.g. July Records
Year in which the transaction took place e.g.
6 Year
2010 Calendar
7 Date
Community
8
(locality)
9 Name of Client
10 Age
11 Sex
12 Diagnosis
13 Relapse
Adherence to
14
treatment
15 Social support
16 Type of service
17 Site
Client found in
chains or shackles

16
 MATERNITY WARD REGISTER
No DATA RATIONALE
VARIABLE DEFINITION
. SOURCE
Helps count the number of
clients been taken care of
Serial The number on the row on which within a particular period,
1 Records
Number client record is written in the register. determines client load,
determines target so far &
helps in planning
The date on which the client was Helps in record keeping of
Date of
2 admitted OR transferred in from Calendar events for a particular
Admission
another facility. period
Clock in Helps to track the time of
Time of The time the client was admitted OR
3 Maternity treatment initiation
Admission transferred in from another facility.
Ward.
It helps to identify and
Patient Client’s unique identification number ANC
4 retrieve client records in
Number issued on the first visit to the facility. card/Folder
case of loss
Name of client in full without titles, For easy identification of
ANC
5 Patient Name avoid informal names such as: Sister, client & records
card/Folder
Maame, Auntie, Wofa, etc.
Address The locality in which the client ANC For follow ups and home
6
(Locality) resides but not the birth place card/Folder visits
Informs service providers
The exact age of the client in
ANC on the full details of the
7 Age completed years e.g. 30 years.
card/Folder client to provide
individualized care
The number of times a pregnancy has Provides information to the
ANC
8 Parity been carried beyond 28 weeks, service provider for
card/Folder
indicated by the letter “P”. subsequent care
It informs the service
Duration of The age of the pregnancy at the time ANC provider on the gestational
9
Pregnancy of admission in weeks card/Folder age to offer individualized
care
Provides information on
Partograph Use of Chart to monitor the progress ANC how effective labour was
10
Use of active labour. card/Folder` managed

Fetal Heart on Number of times the heart of the ANC It provides information on
11
Admission foetus beats per minute card/Folder the viability of the foetus
Prompts the care provider
Medical conditions that can lead to
Antenatal ANC on the need for timely
12 complications in pregnancy, labour
Risk Factors card/Folder intervention for improved
and delivery
outcomes
Provides information on
Number of baby or babies that were past obstetric history and
Outcome of ANC
13 delivered and their status at the time informs decision for
Delivery card/Folder
of delivery; whether alive or dead. individualized client
centred care

17
No DATA RATIONALE
VARIABLE DEFINITION
. SOURCE
Date on which the woman and baby Provides information on
Date of ANC
14 or babies were discharged or number of days spent and
Discharge card/Folder
transferred to another facility. the level of quality of care
‘Difficult/Extreme/Unexplained’ Provides information on
Complications conditions that required other medical ANC the extent of the need for
15
of Delivery interventions or specialized care card/Folder comprehensive obstetric
during/after delivery care for necessary planning
The health insurance status of the Provides information on
client. This is limited only to the the proportion of clients
national health insurance schemes. registered on the health
insurance scheme and for
Write “YES”- if the client’s insurance planning
NHIS Status
16 card is valid or active and has not Insurance Card
(Yes or No)
expired.

Write “NO” if the client is not

insured at all or if the card is not valid
or active.

18
 FORMS (ICD)

DAILY BED UTILIZATION FORM

No
VARIABLE DEFINITION DATA SOURCE
.

The name of the Health Facility e.g. Aboaso Health Administrative

1 Hospital
Centre etc. records

Administrative
2 Ward Name of the ward, e.g. Male Surgical, Male General
records

3 Month The Month in which the transaction took place e.g. July Calendar

Number of Patients
Remaining at the Number of patients remaining at the last day of the
4 Ward Register
last day of the previous month
previous month

5 Bed Complement Number of beds in the ward available for clients Ward Register

6 Day of the month Serial numbering of the days in the month of reporting Ward Register

7 Admissions Number of clients admitted in the ward for the day Ward Register

8 Discharges Number of clients discharged from the ward for the day Ward Register

9 Deaths Number of deaths recorded in the ward for the day Ward Register

10 Transfers-In Number clients transferred into the ward for the day Ward Register
11 Transfer-Out Number clients transferred out of the ward for the day Ward Register

No. of Clients Number of clients remaining in the ward at the end of the
12 Ward Register
Remaining in Ward day

19
DENTAL TREATMENT RETURNS

No. VARIABLE DEFINITION DATA SOURCE

1 CATEGORY OF CLIENTS (BY AGE AND SEX)

2 Boys (0-5) Number of boys in the age range of 0 to 5years CR Register

3 Girls (0-5) Number of girls in the age range of 0 to 5years CR Register

4 Boys (6-17) Number of boys in the age range of 6 to 17 years CR Register

5 Girls (6-17) Number of girls in the age range of 6 to 17 years CR Register

Adult Males (18 &

6 Number of male 18 years and above CR Register
Above)

Adult Females (18

7 Number of female 18 years and above CR Register
& Above)

8 Attendances Sum total of all visits to the dental clinic CR Register

9 Remarks Any other information /comment Facility Head

Name Of Reporting
10 Person completing the form Facility Head
Officer

11 Signature Signature of person completing the form Facility head

12 Date Date on which form was completed Calendar

20
FACILITY WASH - IPC REPORTING FORM

Variables Definition Data Source

The date on which the information is Facility WASH-IPC

Date
being captured.eg 16th October 2017 Reporting Form

The period in which the information

Facility WASH-IPC
Period is being captured e.g.( 3rd quarter
Reporting Form
2017)

The name of the region in which Facility WASH-IPC

Region
facility is located e.g. Ashanti Reporting Form

The name of the district in which Facility WASH-IPC

District
facility is located e.g. Kwabere Reporting Form

The name of the sub-district in which Facility WASH-IPC

Sub-District
facility is located e.g. Aboabo Reporting Form

The name of the facility where the

Facility WASH-IPC
Name of Facility information is being captured e.g.
Reporting Form
Aboaso Health Centre
Number of staff in the health facility
Total number of health including
Facility Nominal roll
workers in your facility permanent/Temporal/Clinical and
support staff

Total Number of health Number of staff trained in WASH-

workers trained in IPC in the health facility including
Inservice Training
your facility in permanent/Temporal/Clinical and
Record Book
WASH-IPC within the support staff within the past two
past two years years.

WASH-IPC Focal Designated staff and assistant Health Administration

Person and assistant assigned for WASH-IPC activities Records

Trained WASH-IPC
Designated staff assigned for
Focal Person and
WASH-IPC activities has undergone Inservice Training Unit
assistant (Indicate
a 5- day training in WASH-IPC
Number)

Action plans for Documented planned activities on 1. Administration

WASH-IPC for the WASH-IPC for the year under records 2. All Units on
current year in all units review in all units their notice boards.

Water Improved water Water should be on the premises andFacility WASH-IPC

21
 Variables Definition Data Source
at all service delivery points, It
should be continuous in at least the
Services last month. Improved sources Reporting Form
include: piped water, bore hole or
rainwater.
Water from an improved source is
available on site but water was not
available at all service delivery Facility WASH-IPC
Limited water Services
points. Water was not available for Reporting Form
between one and seven days during
the last month
Unprotected dug well or spring,
surface water source, tanker services,
No
well, river or no water source at the Facility WASH-IPC
Services/Unimproved
facility. Improved source available Reporting Form
Water Services
but seven or more days without
water during the last month.
Sanitation facilities are functional
and in use within 50 meters of all
service delivery point in bigger
facilities for Clients and Care givers
Facility WASH-IPC
Improved Sanitation separated for male and females.
Reporting Form
Health workers male and female
separated. Running water available.
Improved Sanitation includes WC
toilets and latrines.
Sanitation facilities are functional
and in use within 50 meters of
Sanita Service delivery point, for some
tion Limited Sanitation service delivery points in bigger
Facility WASH-IPC
facilities. Clients and care givers but
Services Reporting Form
not separated for male and females.
Health workers male and female
have but not separated. No running
water available
No No functional sanitation facility
Facility WASH-IPC
Services/Unimproved available within 50 meters of service
Reporting Form
Sanitation Services delivery points
At least two toilet facility for
Toilet for Disability Facility WASH-IPC
disabled (each for male and female)
persons Reporting Form
in the facility
Health Waste management Components with standardised
Care System logistics (Pedal operated approved
Waste colour coded with liners and lids.
Safety boxes for sharps, a dedicated
transport system for moving to an
enclosed area. A functional
incinerator in place for processing all
wastes. Policy and protocol for waste
22
 Variables Definition Data Source
management in place
Waste is segregated at the source of
generation into a covered coloured*
pedal operated waste bin with the
same colour liner and labelled at
service delivery points. Segregation
carried through to final disposal. No
improved waste Facility WASH-IPC
enclosed storage area for waste.
management services Reporting Form
Sharps, disposed into safety boxes
and incinerated separately into ashes.
Infectious wastes are treated same
within the health facility. NB:
*Coloured; Black, yellow and
brown all with same colour liner.
Waste is segregated at source of
generation into covered coloured*
pedal operated waste bin with the
Limited Waste same colour liner at service delivery Facility WASH-IPC
Management Services points, Storage area Sharps and Reporting Form
infectious waste are mixed at final
disposal site sometimes left-over
waste after incineration at the site.
Waste are mixed up in the waste bins
(infectious, pharmaceutical and
No Waste Management general) is not segregated into Facility WASH-IPC
Services colour coded waste bins, Sharps and Reporting Form
infectious waste are dumped openly
causing danger to people.
Sink with running water/Veronica
Bucket with soap/trash bin for
Hygiene services
disposing, single use towel for hand
drying. Alcohol hand rub
Running water, hand washing
stations with soap and/ or Alcohol
Hygie Improved Hygiene Facility WASH-IPC
hand rub, trash bins and single used
ne Services Reporting Form
towels are available at all service
delivery points
Running water, Soap or Alcohol
hand rub, trash bins and single used
towels are available at some service
Limited Hygiene
delivery points. Running water and Reporting Form
Services
hand washing stations without any
soap, alcohol rub, trash bins and
single used towels
No
No running water or hand washing Facility WASH-IPC
Services/Unimproved
stations available Reporting Form
Sanitation Services

23
24
MONTHLY BED UTILIZATION FORM

No. VARIABLE DEFINITION DATA SOURCE

The name of the Health Facility e.g. Aboaso Health Administrative

1 Hospital
Centre etc. records

2 Month The Month in which the transaction took place e.g. July Calendar

3 Year Year in which the transaction took place e.g. 2010 Calendar

The name of the region in which the Health Facility is Administrative

4 Region
located e.g. Ashanti. records

Administrative
5 Ward Name of the ward, e.g. Male Surgical, Male General
records

6 Admissions Number of clients admitted to the ward in the Month Ward Register

7 Discharges Number of discharges from the ward in the Month Ward Register

8 Deaths Number of deaths recorded in the ward in the Month A&D Register

The last cumulative number of days clients spent in the

9 Patient Days A&D Register
ward for the month

10 Transfer In Number of clients transferred into the ward Ward Register

11 Transfer Out Number clients transferred out of the ward Ward Register

25
MONTHLY CHEMICAL PATHOLOGY REPORTING FORM

NO. VARIABL DEFINITION DATA

E SOURCE
1 Facility The name of the Health Facility e.g. Aboaso health Administrati
Name centre etc. ve records

2 District The name of the district in which Health Facility is Administrati

located, e.g. Kwabre. ve records

3 Region The name of the region in which the Health Facility Administrati
is located e.g. Ashanti. ve records
4 Month The month that the transaction took place e.g. July. Calendar

5 Year Write down the year the report was generated Calendar

6 Male All boys and men reporting at the facility OPD

Register
7 Female All girls and women reporting at the facility OPD
Register
8 Age group Age categorization clients reported segregated by Lab request
male and female form
9 Number of Count of the individual test conducted for the Lab Result
Test clients Log Book
This is a List of the test that is conducted at the
chemical pathology department of the laboratory.
10 Number of Count of all other tests conducted by the facility Lab results
all others within the defined period other than what is listed book
test on the reporting form.
11 Name of Person completing the form Lab duty
Reporting roster/Lab
Officer Manager
12 Signature Signature of person completing the form
13 Date Date on which form was completed Calendar

26
MONTHLY DIETHERAPY REPORTING FORM
NO. VARIABLE DEFINITION DATA
SOURCE
1 Name of The name of the Health Facility e.g. Aboaso OPD Records
Institution health centre etc.

2 Type of The type of Health Facility e.g. public, private, OPD Records
facility quasi-government, faith-based etc.

3 Sub-District The name of the sub-district in which Health OPD Records

Facility is located, e.g. Asawasi

4 District The name of the district in which Health Facility OPD Records
is located, e.g. Kwabre.

5 Region The name of the region in which the Health OPD Records
Facility is located e.g. Ashanti.

6 Month The month that the transaction took place e.g. Calendar
July.
7 Year Write down the year the report is generated Calendar
8 Male Refers to all boys and men reporting at the OPD Register
facility
9 Female All girls and women reporting at the facility OPD Register
10 Age group Age categorization of the OPD attendants OPD Register

11 <28 days Number of children below 28 days OPD Register

12 1-11 months Number of children aged 1-11 months OPD Register

13 1-4 years Number of children aged 1-4 years, male or OPD Register
female
14 5-9 years Number of children aged 5-9 year, male or female OPD Register
15 10-14 years Number of patients aged 10-14 years, male or OPD Register
female
16 15-17 years Number of patients aged 15-17 years, male or OPD Register
female
17 18-19 years Number of patients aged 18-19 years, male or OPD Register
female
18 20-34 years Number of patients aged 20-34 years, male or OPD Register
female
19 35-49 years Number of patients aged 35-49 years, male or OPD Register
female

27
 NO. VARIABLE DEFINITION DATA
SOURCE
20 50-59 years Number of patients aged 50-59 years, male or OPD Register
female
21 60-69 years Number of patients aged 60-69 years, male or OPD Register
female
22 above 70 Number of patients aged 70 years and above, OPD Register
years male or female

23 Conditions A count of the number of individual dietherapy Consulting

conditions presented by clients. room Register

This shall be new cases only, does not include

cases on review
24 Signature Signature of In-charge of the facility reporting Facility Head
25 Rank Rank of the In-charge of the facility reporting Facility Head

26 Date Date of submission of the report Calendar

28
MONTHLY EYE HEALTH REPORTING FORM
DATA
NO. VARIABLE DEFINITION
SOURCE
Name of The name of the Health Facility e.g., Aboaso
1 OPD Records
Institution health centre etc.
Type of The type of Health Facility e.g. public, private,
2 OPD Records
facility quasi-government, faith-based etc.
The name of the sub-district in which Health
3 Sub-District OPD Records
Facility is located, e.g. Kwabre.
The name of the district in which Health Facility
4 District OPD Records
is located, e.g. Kwabre.
5 Region The region the Facility is located in e.g. Ashanti. OPD Records

6 Year Write down the year the report was generated Calendar
The month that the transaction took place e.g.
7 Month Calendar
July.
Age categorization of the client segregated into
10 Age group OPD Register
male and female
Number of conjunctivitis disease reported at the
facility within the defined period. Conjunctivitis is Consulting
23 Conjunctivitis
Inflammation of the conjunctiva of all types. room Register
Affects all ages
Number of Trachoma Follicles disease reported at
Trachoma the facility within the defined period. TF refers to Consulting
24
Follicle (TF) Trachoma Follicles. Follicles are found in the room Register
upper eyelids of children between 1-9 years
Number of Trachoma Trichiasis disease reported
at the facility within the defined period. TT refers
Trachoma
to Trachoma Trichiasis presenting as in turned Consulting
25 Trichiasis
eyelashes, which rub on the cornea. It is found in room Register
(TT)
people 15 years and above and requires to be
operated on.
Number of Cataract disease reported at the facility
within the defined period. Cataract is the opacity
Consulting
26 Cataract of the lens of the eye. It can lead to poor vision
room Register
and blindness. All ages can be affected but it is
mostly found in the aged
Number of glaucoma disease reported at the
facility within the defined period. Glaucoma
Consulting
27 Glaucoma means pressure of the eye. It is symptomless but
room Register
causes blindness. All ages can be affected but
mostly found in people 30 years and above
Number of refractive error disease reported at the
facility within the defined period. Refractive error
Refractive is the defect in the ability of the lens of the eye to Consulting
28
error focus on an image accurately. This gives rise to a room Register
person being near-sighted, farsighted or
presbyopic. Affects all ages

29
 Number of Trauma disease reported at the facility
within the defined period. Trauma is any injury to Consulting
29 Trauma
the eyeball or the eyelid. It could be mechanical, room Register
chemical, thermal injury. Affects all ages
Number of diabetic retinopathy disease reported at
the facility within the defined period. Diabetic
Diabetic Consulting
30 retinopathy occurs when a person with diabetes
Retinopathy room Register
has the disease affecting the posterior part of the
eye, which may cause reduction in vision.
Number of low vision disease reported at the
facility within the defined period. Low Vision is
Consulting
31 Low vision residual vision left after medical or surgical
room Register
intervention which enables the person to be
functionally independent. Affects all ages
Number of pterygium disease reported at the
facility within the defined period. Pterygium is the Consulting
32 Pterygium
overgrowth of the conjunctiva onto the cornea. room Register
Mostly affects the middle and old age people
Number of all other eye conditions reported at the
Other eye facility within the defined period. Any condition Consulting
33
conditions affecting the eye aside those listed above apart room Register
from normal. E.g. Swelling of the eye.
Number of normal eye conditions reported at the
Consulting
34 Normal facility within the defined period. When the vision
room Register
is good. No disease is present
Total number of eye disease conditions seen. It
Total number Consulting
35 can be medical, surgical, or refractive services at
of eye disease room Register
the facility
Total Number
Total number of clients seeking eye services. It
of clients Consulting
36 may be medical, surgical or refractive services at
seeking eye room Register
the facility
services
Total New Consulting
20 Total of each column
Cases Register
Re- Consulting
21 Conditions that came for review
Attendance Register
Consulting
22 Referrals Condition that were referred out Room
Register
Surgeries - Any surgical intervention of the eye, including removal of foreign body
Cataract
Total number of cataract surgeries/operations Theatre
37 surgeries
performed within the defined period i.e. monthly Register
performed
Cataract
Total number of cataract operated people with
operated Theatre
38 visual acuity of >6/18 within the defined period
people VA Register
i.e. monthly
>6/18
Cataract Total number of cataract surgeries/ operations Theatre
39
operations performed with the implantation of Intra Ocular Register

30
 performed
Lens (IOL) within the defined period i.e. monthly
with IOL
Glaucoma
Total number of glaucoma surgeries/operations Theatre
40 surgeries
performed within the defined period i.e. monthly Register
performed
Trachoma
Total number of trachoma trichiasis
Trachealis Theatre
41 surgeries/operations performed within the defined
(TT) surgeries Register
period i.e. monthly
performed
Total number of all other surgeries/operations
Other eye
apart from cataract, glaucoma and trachoma Theatre
42 surgeries
trichiasis performed within the defined period i.e. Register
performed
monthly.
Number of
Count the number of eye outreach services Facility
eye outreach
43 undertaken to neighbouring eye facilities, schools, monthly
services
community, report
conducted?
Number of Count the number of spectacles prescribed by the Facility
spectacles health facility. monthly
prescribed? report
Number of Count the number of spectacles dispensed by the Facility
44 spectacles health facility. monthly
dispense? report
Does this
Capacity of facility to provide specialized
facility offer Facility
Paediatric Ophthalmic service. Please tick if
45 Paediatric monthly
‘YES’, state number
Ophthalmolog report
y services
Does this
facility Capacity of facility to provide laser treatment for
Facility
provide laser Diabetic Retinopathy. Please tick if ‘YES’, state
46 monthly
treatment number
report
/Diabetic
Retinopathy
Does this
facility have Availability of functional visual field equipment Facility
47 functional at facility monthly
visual field Please tick if ‘YES’, state number report
equipment

31
MONTHLY HAEMATOLOGY REPORTING FORM

NO. VARIABL DEFINITION DATA

E SOURCE
1 Facility The name of the Health Facility e.g. Aboaso health OPD Records
Name centre etc.

2 District The name of the district in which Health Facility is OPD Records
located, e.g. Kwabre.

3 Region The name of the region in which the Health Facility OPD Records
is located e.g. Ashanti.

4 Month The month that the transaction took place e.g. July. Calendar

5 Year Write down the year the report was generated Calendar

6 Male All boys and men reporting at the facility OPD

Register
7 Female All girls and women reporting at the facility OPD
Register
8 Age group Age categorization clients reported segregated by OPD
male and female Register
9 Number of count of the individual test conducted for the client Lab Result
Test This is a List of the test that is conducted at the Log Book
haematology department of the laboratory.
10 All others Count of all other tests conducted by the facility :Lab results
test within the defined period other than what is listed on book
the reporting form.
11 Name of Person completing the form Lab duty
Reporting roster/Lab
Officer Manager
12 Signature Signature of person completing the form

13 Date Date on which form was completed Calendar

32
MONTHLY MALARIA DATA RETURNS ON ANTIMALARIALS

No. VARIABLE DEFINITION DATA SOURCE

The name of the Health
1Name of Facility Facility e.g. Aboaso Health Records
Centre etc.
The name of the district in
2District which the Health Facility is Records
located, e.g. Kwabre
The name of the region in
3Region which the Health Facility is Records
located e.g. Ashanti.
The Month in which the
4Month transaction took place e.g. Calendar
July
Year in which the
5Year transaction took place e.g. Calendar
2010
6HEALTH FACILITY RECORDS – MALARIA
Number of suspected malaria
cases treated with anti-
Number of OPD Malaria
malarials (ACTs and Consulting Room Register,
7 Cases Put On Anti-Malarials
Quinine for pregnant Dispensary register
(<5 year, >=5 years)
women), segregated by <5
years and >=5 years old
Total number of suspected
Number Of OPD Malaria
malaria cases treated with Consulting Room Register,
8 Cases put on ACTs (<5 year,
ACTs ONLY segregated by Dispensary register
>=5 years)
<5 years and >=5 years old
Total number of suspected
Number Of OPD Malaria
malaria cases tested for
Cases Tested For Malaria Consulting Room Register,
9 parasites using microscopy,
Parasites Using Microscopy Lab Register
segregated by <5 years and
(<5 year, >=5 years)
>=5 years old
Total number of suspected
Number Of OPD Malaria
malaria cases tested for
Cases Tested For Malaria Consulting Room Register,
10 parasites using RDTs,
Parasites Using RDTs (<5 Lab Register
segregated by <5 years and
year, >=5 years)
>=5 years old
Total number of suspected
Number Of OPD Malaria malaria cases that tested
Cases Tested Positive Using positive for malaria Consulting Room Register,
11
Microscopy (<5 year, >=5 using ,microscopy, Lab Register
years) segregated by <5 years and
>=5 years old
Number Of OPD Malaria Total number of suspected
Consulting Room Register,
12 Cases Tested Positive Using malaria cases that tested
Lab Register
RDTs (<5 year, >=5 years) positive for malaria using

33
No. VARIABLE DEFINITION DATA SOURCE
RDTs, segregated by <5
years and >=5 years old
13Incidence of Adverse Effects
Number of reported side Adverse Event Reporting
Number Of Cases Put On
14 effects cases after taking any Form (AERF)/ Consulting
Acts With Adverse Effects
ACTs Room Register
Number of clients who were
Total Number Hospitalized
hospitalized for reported side AERF / Consulting Room
15 Due To Adverse Effects
effects after taking any Register/ Ward register
From Acts
ACTs
Number Of Pregnant Number of pregnant women
AERF / Consulting Room
16 Women Put On Acts With with reported side effects
Register
Adverse Effects after taking any ACTs
No. VARIABLE DEFINITION DATA SOURCE
Number of pregnant women
Total Number Of Pregnant
hospitalized for reported side AERF / consulting room/
19 Women put on ACTs With
effects after taking any Ward register
Adverse Effects Hospitalized
ACTs
Number Of Pregnant Number of pregnant women
Women put on any Other with reported side effects of
20 AERF / consulting room
Anti malarias with Adverse any other antimalarial other
Effects than ACTs
Total Number of Pregnant Number of pregnant women
Women Put On Any Other hospitalized for reported side
21 AERF / consulting room
Anti malarias With Adverse effects of any other
Effects Hospitalized antimalarial other than ACTs
Number Of Children Under Number of children under 5
22 5 Put on ACTs With with reported side effects AERF / consulting room
Adverse Effects after taking any ACTs
Number of children under 5
Total Number Of Children
hospitalized for reported side AERF / consulting room/
23 Under 5 Put On Acts With
effects after taking any Ward register
Adverse Effects Hospitalized
ACTs
DRUG AND OTHER COMMODITIES– DOSES/ PACKS FOR ACTs and
24
QUININE, PIECES for INJECTIONS and OTHER COMMODITIES
Quantity of the commodity
Dosages Dispensed dispensed to clients within Dispensary Inventory control
25
(Consumed) the month (this is in doses/ card
packs and not tablets)
Quantity of the commodity
remaining in the dispensary
Balance Of At The End Of Dispensary Inventory control
26 at the end of the month (this
The Month card
is in doses/ packs and not
tablets)
Shortage of any malaria
Stock Out For More Than 7
27 commodity for more than 7 Inventory control card
Days
days within that month

34
No. VARIABLE DEFINITION DATA SOURCE
Date on which the report was
28Date Of Submission Calendar
being submitted
Name and signature of the
Name And Signature Of
29 In-charge of the facility / Facility Head
Facility/BMC Head
BMC reporting
Name of Person who
30Submitted By submitted the form (not the Records
currier)
Stamp and Signature of
Received By (Stamp & person who received the
32 Records
Signature) completed report at the next
higher level.

35
MONTHLY MICROBIOLOGY REPORTING FORM
NO. VARIABLE DEFINITION DATA
SOURCE
1 Facility Name The name of the Health Facility e.g., Aboaso OPD Records
health centre etc.
2 District The name of the district in which Health Facility OPD Records
is located, e.g. Kwabre.
3 Region The name of the region in which the Health OPD Records
Facility is located e.g. Ashanti.
4 Month The month that the transaction took place e.g. Calendar
July.
5 Year Write down the year the report was generated Calendar
6 Male All boys and men reporting at the facility OPD Register
7 Female All girls and women reporting at the facility OPD Register
8 Age group Age categorization clients reported segregated by OPD Register
male and female
9 Number of Count of the individual test conducted for the Lab Result
Test clients Log Book
This is a List of the test that is conducted at the
chemical pathology department of the laboratory.
10 Number of all Count of all other tests conducted by the facility Lab results
others test within the defined period other than what is listed book
on the reporting form.
11 Name Of Person completing the form Lab duty
Reporting roster/Lab
Officer Manager
12 Signature Signature of person completing the form
13 Date Date on which form was completed Calendar

36
MONTHLY HISTOPATHOLOGY/CYTOPATHOLOGY FORMS
NO. VARIABL DEFINITION DATA
E SOURCE
1 Facility The name of the Health Facility e.g. Aboaso health OPD Records
Name centre etc.

2 District The name of the district in which Health Facility is OPD Records
located, e.g. Kwabre.

3 Region The name of the region in which the Health Facility OPD Records
is located e.g. Ashanti.

4 Month The month that the transaction took place e.g. July. Calendar

5 Year Write down the year the report was generated Calendar

6 Male All boys and men reporting at the facility OPD Register

7 Female All girls and women reporting at the facility OPD Register

8 Age group Age categorization clients reported segregated by OPD Register

male and female
21 Number of Count of the individual test conducted for the clients Lab Result
Test This is a List of the test that is conducted at the Log Book
chemical pathology department of the laboratory.
22 Number of Count of all other tests conducted by the facility Lab results
all others within the defined period other than what is listed on book
test the reporting form.
23 Name Of Person completing the form Lab duty
Reporting roster/Lab
Officer Manager
24 Signature Signature of person completing the form

25 Date Date on which form was completed Calendar

37
MONTHLY OUTPATIENTS MORBIDITY RETURNS

No. VARIABLE DEFINITION DATA SOURCE

The name of the Health Facility e.g. Aboaso

1 Name Of Facility Records
Health Centre etc.

The name of the district in which the Health

2 District Records
Facility is located, e.g. Kwabre.

3 Location Town in which the Health Facility is situated Records

The name of the region in which the SDP is
4 Region Records
located e.g. Ashanti.

The Month in which the transaction took

5 Month Records
place e.g. July
Year in which the transaction took place e.g.
6 Year Calendar
2010
A count of the number of the individual
conditions presented by clients. This is List of
Disease (New Cases Consulting Room
7 the diseases to be reported on. This shall be
Only) Register
new cases only, does not include cases on
review

All OPD new cases that the that Clinician

Uncomplicated Consulting Room
8 Suspects to be Malaria (including pregnant
Malaria Suspected Register
women)

Uncomplicated Total number of suspected cases of malaria

Consulting Room
9 Malaria Suspected tested for malaria parasites (both RDTs and
Register
Tested Microscopy); including pregnant women
Total number of suspected cases of malaria
Uncomplicated
that tested positive for malaria parasites (both Consulting Room
10 Malaria Tested
RDTs and Microscopy); including pregnant Register
Positive
women

Uncomplicated Total number of Suspected cases of malaria

Consulting Room
11 Malaria not tested that were clinically diagnosed and treated
Register
but Treated without testing (including pregnant women)

Total number of Suspected cases of malaria

Uncomplicated
that tested negative for malaria parasites (both Consulting Room
12 Malaria tested
RDTs and Microscopy) but were treated as Register
negative but Treated
malaria

38
No. VARIABLE DEFINITION DATA SOURCE

Uncomplicated
All OPD new cases among Pregnant Women
Malaria In Consulting Room
13 that the Clinician Suspects to be Malaria
Pregnancy Register
Suspected
Uncomplicated
Total number of suspected cases of malaria
Malaria in Consulting Room
14 among Pregnant women tested for malaria
Pregnancy Register
parasites (both RDTs and Microscopy)
Suspected Tested
Uncomplicated Total number of suspected cases of malaria
Malaria in among Pregnant Women that tested positive Consulting Room
15
Pregnancy Tested for malaria parasites (both RDTs and Register
Positive Microscopy)
Uncomplicated
Total number of Suspected cases of malaria
Malaria in Consulting Room
16 among Pregnant women that were clinically
Pregnancy not tested Register
diagnosed and treated without testing
but Treated
17 Grouping the cases Male, Female under the various Age Groups
18 Total Totals for each strata
Disease that are not listed from 1-92 are all
19 All Other Diseases Consulting Register
counted as part of to this

20 Total New Cases Total of each column

21 Re-Attendance Conditions that came for review Consulting Register

Consulting Room
22 Referrals Condition that were referred out
Register
23 Signature Signature of In-charge of the facility reporting Facility Head

24 Rank Rank of the In-charge of the facility reporting Facility Head

25 Date Date of submission of the report Calendar

39
MONTHLY PHYSIOTHERAPY REPORTING FORM
VARIABL DATA
NO. DEFINITION
E SOURCE

Name of The name of the Health Facility e.g. Aboaso health

1 OPD Records
Facility centre etc.

The name of the district in which the Health

2 District OPD Records
Facility is located, e.g. Kwabre.

The name of the region in which the Health Facility

3 Region OPD Records
is located e.g. Ashanti.

4 Month Month in which the transaction took place e.g. July. Calendar
5 Year Write down the year the report was generated Calendar
OPD
6 Male Refers to all boys and men reporting at the facility
Register
Refers to all girls and women reporting at the OPD
7 Female
facility Register
OPD
8 Age group Age categorization of the client segregated by sex
Register
A count of the number of the individual service
requested by clinician/ prescriber for the clients. Consulting
Type of
21 Register/
Service
This is a List of the services that is conducted at the Ward register
physiotherapy unit

Number of all other services conducted by the Consulting

All Other
22 facility within the defined period other than what is Register/
Services
listed on the reporting form. Ward register

Name Of
23 Reporting Person completing the form Facility Head
Officer

24 Signature Signature of person completing the form Facility head

25 Date Date on which form was completed Calendar

40
MONTHLY PROSTHETICS AND ORTHOTICS REPORTING FORM
DATA
NO. VARIABLE DEFINITION
SOURCE
Name of The name of the Health Facility e.g. Aboaso
1 OPD Records
Institution health centre etc.

The type of the Health Facility e.g. public,

2 Type of facility OPD Records
private, quasi-government, faith-based etc.
The name of the sub-district in which the Health
3 Sub-District OPD Records
Facility is located, e.g. Asawasi
The name of the district in which the Health
4 District OPD Records
Facility is located, e.g. Kwabre.
The name of the region in which the Health
5 Region OPD Records
Facility is located e.g. Ashanti.
The month in which the transaction took place
6 Month Calendar
e.g. July.
7 Year Write down the year the report was generated Calendar
Indicate the sex of the attending client. M for
Sex OPD Register
Male and F for Female
Age categorization of the clients in days for the
10 Age group neonates, months for the post neonates and OPD Register
years from 1yr to adults
A count of the number of individual prosthetics
and orthotics conditions presented by clients.
Consulting
room Register/
23 Type of Service This is a list of the diseases to be reported on.
Ward Register
This shall be new cases only, does not include
cases on review
24 Signature Signature of In-charge of the facility reporting Facility Head
25 Rank Rank of the In-charge of the facility reporting Facility Head
26 Date Date of submission of the report Calendar

41
MONTHLY SPECIALIST OUTREACH SERVICES (FORM C)
No. VARIABLE DEFINITION DATA SOURCE
1 BP Blood pressure Readings

Body Mass Index: - This is calculated by dividing the

2 BMI body weight in kilograms by the height in meter Readings
squared (kg/m)

Fasting Plasma Glucose: -A fasting plasma glucose test

3 FPG is performed after the client has fasted or not eaten for Readings
at least 12 hours.

2 Hour Plasma Glucose: -

4 2HPG Readings
Is the blood glucose level measured 2 hours after meals

STATEMENT OF OUTPATIENTS
No. VARIABLE DEFINITION DATA SOURCE

The name of the Health Facility e.g. Aboaso Health Administrative

1 Institution
Centre etc. Records

The name of the district in which the Health Facility Administrative

2 District
is located, e.g. Kwabre. Records

The name of the region in which the Health Facility is Administrative

3 Region
located e.g. Ashanti. Records

The Month in which the transaction took place e.g.

4 Month Calendar
July

5 Year Year in which the transaction took place e.g. 2010 Calendar

Age categorization of the OPD attendants. in days for

6 Age Groups the neonates, months for the post neonates and years OPD Register
from 1yr to adults

42
No. VARIABLE DEFINITION DATA SOURCE

Insured OPD Patient

7 Insured New Male patients at OPD by all age group OPD Register
(M)

OPD Register
Insured OPD Patient
8 Insured New Female patient at OPD by all age group
(Female)

OPD Register
Insured OPD Patient
9 Insured Old Male patient at OPD by all age group
(Male)

OPD Register
Insured Patient
10 Insured Old Female patient at OPD by all age group
(Female)

OPD Register
Non-Insured OPD Non-Insured New Male patient at OPD by all age
11
Patient (Male) group

OPD Register
Non-Insured OPD Non-Insured New Female OPD patient at OPD by all
12
Patient (Female) age group

OPD Register
Non-Insured OPD
13 Non-Insured Old Male OPD patient by all age group
Patient (Male)

OPD Register
Non-Insured OPD Non-Insured Old Female OPD patient by all age
14
Patient (Female) group

15 Total All Ages Totals per column OPD Register

Medical Officer In- Name and signature/stamp of officer In-charge of the

16 Facility Head
Charge facility

43
 STATEMENT OF INPATIENT
No. VARIABLE DEFINITION DATA SOURCE
The name of the Health Facility e.g. Aboaso
1 INSTITUTION Records
Health Centre etc.
The name of the district in which SDP is
2 DISTRICT Records
located, e.g. Kwabre.
The name of the region in which the SDP is
3 REGION Records
located e.g. Ashanti.
The Month in which the transaction took place
4 MONTH Calendar
e.g. July
Year in which the transaction took place e.g.
5 YEAR Calendar
2010
Age categorization of the clients for the month
6 AGE GROUPS in days for the neonates, months for the post Ward Register
neonates and years from 1yr to adults
Insured Clients
7 Insured New Male clients on admission Ward Register
Admission (M)
Insured Clients Ward Register
8 Insured New Female clients on admission
Admission (Female)
Insured Clients Death Ward Register
9 Insured Old Male clients on admission
(Male)
Insured Clients Death Ward Register
10 Insured Old Female on admission
(Female)
Non-Insured Clients Ward Register
11 Non-Insured New Male clients on admission
Admission (Male)
Non-Insured Clients Ward Register
12 Non-Insured New Female clients on admission
Admission (Female)
Non-Insured Clients Ward Register
13 Non-Insured Old Male clients on admission
Death (Male)
Non-Insured Clients Ward Register
14 Non-Insured Old Female clients on admission
Death (Female)
15 Total All Ages Totals per column Ward Register
16 Summary of Inpatient Malaria Cases
Number of males patients below 5 years Ward Register
Malaria Admissions
17 admitted with malaria (Severe and
below 5 Years (Male)
uncomplicated)
Number of Female patients below 5 years Ward Register
Malaria Admission
18 admitted with malaria (Severe and
below 5 Years (Female)
uncomplicated)
Number of Female patients above 5 years Ward Register
Malaria Admission 5
19 admitted with malaria (Severe and
Years and Above (Male)
uncomplicated)
Malaria Admission 5 Number of Female patients above 5 years Ward Register
20 Years and Above admitted with malaria (Severe and
(Female) uncomplicated)
Number of Pregnant Ward Register
Number of pregnant women admitted with
21 Women Admitted with
malaria (Severe and uncomplicated)
Malaria

44
No. VARIABLE DEFINITION DATA SOURCE
Malaria Deaths Below 5 Number of male patients below under 5 dying Ward Register
22
Deaths (Male) of malaria
Malaria Deaths Below 5 Ward Register
23 Number of females under 5 dying of malaria
(Female)
Malaria Death 5 & Ward Register
24 Number of males 5 and above dying of malaria
Above (Male)
Malaria Death 5 & Number of females 5 and above dying of Ward Register
25
Above Female malaria
Number of Pregnant Ward Register
Number of pregnant women on admission dying
26 Women Dying of
of malaria.
Malaria
Severe Malaria Below 5 Number of male patients below five years Ward Register
27
Years Male admitted with diagnosis of severe malaria.
Severe Malaria 5 Years Number of male patients above five years Ward Register
28
and Above Male admitted with diagnosis of severe malaria.
Severe Malaria Below 5 Number of female patients below five years Ward Register
29
Years Female admitted with diagnosis of severe malaria.
Severe Malaria 5 Years Number of male patients above five years
30 Ward Register
and Above Female admitted with diagnosis of severe malaria
Medical Officer In- Name and signature/stamp of officer In-charge
31 Facility Head
Charge of the facility

45
 MONTHLY RETURNS ON SURGICAL OPERATIONS
No. VARIABLE DEFINITION DATA SOURCE
The name of the region in which the SDP is located e.g.
1 Region Records
Ashanti.
The name of the district in which SDP is located, e.g.
2 District Records
Kwabre.
The name of the Health Facility e.g. Aboaso Health
3 Hospital Records
Centre etc.

4 Month The Month in which the transaction took place e.g. July Calendar

Number of surgical procedures that involves respiratory

Major Surgical
5 assistance and anaesthesia including spinal anaesthesia Theatre Register
Operations
and pre-operative sedation.
Number of general surgeries done e.g. intestines
including oesophagus, stomach, small bowel, colon, liver,
6 General Surgery Theatre Register
pancreas, gallbladder and bile ducts, and often the thyroid
gland.
7 Orthopaedic Number of orthopaedic surgeries done. Theatre Register
8 Genito-Urinary Number of done on genito-urinary organs. Theatre Register
GLANDS & SPECIAL ORGANS
Obstetrics surgery: -relates to surgery and treatment of
women during pregnancy and childbirth,
Obstetrics &
Gynaecological operations: - refers to surgery on the
10 Gynaecological Theatre Register
female reproductive system.it includes procedures for
Operations
benign conditions, cancer, infertility, and incontinence,
and various other conditions.
TOTAL ALL MAJOR OPERATIONS
any surgical procedure that does not involve respiratory
Minor Surgical
12 assistance but have local anaesthesia with or without Theatre Register
Operations
sedation
Total All Minor
13 Total number of all minor operations Theatre Register
Operations
Total Minor And
14 Total number of all minor and major operations Theatre Register
Major Operations

15 Insured Clients Total number of insured clients who assessed this service Theatre Register

Total number of non-insured clients who assessed this

16 Non-Insured Clients Theatre Register
service
17 Total Refers to the total for insured and non-insured client. Theatre Register
18 Signature Person completing the form

MONTHLY MENTAL HEALTH INSTITUTIONAL REPORTING FORM

SN VARIABLE DEFINITION DATA SOURCE

1 Name of facility The name of the Health Facility e.g. Records

46
SN VARIABLE DEFINITION DATA SOURCE
Aboaso Health Centre etc.
The name of the district in which the
2 District Records
Health Facility is located, e.g. Kwabre.
The name of the region in which the
3 Region Records
Health Facility is located e.g. Ashanti.
The Month in which the transaction took
4 Month Calendar
place e.g. July
Year in which the transaction took place
5 Year Calendar
e.g. 2010
Age categorization of the OPD attendants.
in days for the neonates, months for the
6 Age Groups OPD Register
post neonates and years from 1yr to
adults.
7 Sex Biological sex of client (male or female)
8 Total (Male and Female) Total number of male clients per row Multiple sources
Indicates the sum of figures in each row
9 Grand Total OPD Register
and column
PSYCHIATRIC
DISORDERS
Schizophrenia, schizotypal disorder,
Schizophrenia, persistent delusional disorders, acute and
10 schizotypal and delusional transient psychotic disorders, induced F20 - F29
disorders delusional disorder, schizoaffective
disorders,
mild, moderate, severe, recurrent
11 Depression F32 and F33
depression
12 Bipolar Disorder Manic episode, bipolar affective disorder F30 and F31
Disorders associated with Peripartum, postpartum depression and
13 F53
childbirth psychosis
Generalised anxiety disorder, phobic
14 Anxiety Disorders anxiety disorders, Panic disorder, mixed F40, F41,
anxiety and depressive disorder
Obsessive Compulsive
15 see ICD 10 Codes F42
Disorder
Post-Traumatic Stress
16 see ICD 10 Codes F43. 1
Disorder
Dissociative (amnesia, fugue, stupor,
Conversion/Dissociative motor disorders, anaesthesia and sensory
17 F44
Disorders loss, mixed and other disorders), trance
and possession disorders
acute intoxication, harmful use,
Mental Disorders due to dependence syndrome, withdrawal state
18 F10.1 to F10.9
Alcohol use (including delirium), psychotic disorder,
amnesic syndrome, residual disorders
19 Mental Disorders due to acute intoxication, harmful use, F11. 1 to F19. 9
other psychoactive dependence syndrome, withdrawal state,
substance use psychotic disorder, amnesic syndrome,
residual disorders due opioids,
cannabinoids, sedatives or hypnotics,

47
SN VARIABLE DEFINITION DATA SOURCE
cocaine, other stimulants including
caffeine, hallucinogens, tobacco, volatile
solvents, multiple drug use, other
psychoactive substances
Attention Deficit
20 Hyperactive Disorder see ICD 10 Codes F90
(ADHA)
Foetal alcohol spectrum
21 see ICD 10 Codes
disorders (FASD)
Mixed disorders of conduct and emotion,
emotional disorders with onset specific to
Other Mental Disorders of
22 childhood, disorders of social functioning F92-F98
childhood origin
with onset specific to childhood and
adolescence, tic disorders, other
Conduct/Behavioural
23 see ICD 10 Codes F91
disorders
paranoid, schizoid, Dissocial, emotionally
24 Personality disorders unstable, histrionic, anankastic, anxious, F60
other specific personality disorders
specific developmental disorders of
language and speech, specific
Other developmental developmental disorders of scholastic
25 F80 - F83
disorders skills, specific developmental disorder of
motor function, mixed specific
developmental disorder
NEUROPSYCHIATRIC
DISORDERS
childhood autism, atypical autism, Rett's
syndrome, other childhood disintegrative
26 Autism F84
disorders, Asperger's, other pervasive
developmental disorder
mild, moderate, severe, profound, other
27 Mental Retardation F70 - F79
and unspecified mental retardation
28 Epilepsy/Seizures Generalized and focal seizures G40
see ICD 10 Codes. This excludes
29 Delirium delirium from psychoactive substance use F05
disorders
Alzheimer's dementia, vascular dementia,
30 Dementia dementia in diseases classified elsewhere, F00 - F03
unspecified dementia
All other mental disorders
31 see ICD 10 Codes
not specified above
A condition that treatment has begun at
Re-Attendances/ Re- the facility and the client is coming for Consulting room
32
visits/ Reviews review of the same condition after register
treatment has begun.
Total Attendance ( Ist Total number of visits to the facility Consulting room
33
visit + Re-Attendance) within a month register
34 Medical Officer In- Name and signature/stamp of officer In- Facility Head

48
SN VARIABLE DEFINITION DATA SOURCE
Charge charge of the facility

49
MONTHLY MENTAL HEALTH CLIENT STATUS FORM
SN VARIABLE DEFINITION DATA SOURCE
The name of the Health Facility e.g. Aboaso
1 Name of facility Records
Health Centre etc.
The name of the district in which the Health
2 District Records
Facility is located, e.g. Kwabre.
The name of the region in which the Health
3 Region Records
Facility is located e.g. Ashanti.
The Month in which the transaction took
4 Month Calendar
place e.g. July
Year in which the transaction took place e.g.
5 Year Calendar
2010
Indicates the sum of figures in each row and
6 Grand Total Multiple sources
column
7 Sex Biological sex of client (male or female) OPD Register
New Cases - Number of new episodes of disease conditions Consulting Room
9
Outpatients seen at the OPD in a month Register
New Cases - Number of new episodes of disease conditions
10
Inpatients admitted in a month Ward Register
New patients
Cases that are found through case search in the
11 through active case Active Case search
community among the new cases
search Register
Consulting room
Voluntary Number of clients receiving treatment Register (To be
12
treatment willingly at the facility OPD. included in the
remarks column)
Consulting room
Involuntary Number of clients receiving treatment through Register (To be
13
treatment a court of law or a certificate of urgency included in the
remarks column)
New insured clients counted as male and
14 Clients Insured
females. OPD Register
Clients Non- New non-insured clients counted as male and
15
insured females. OPD Register
Number of deaths of persons on admission
16 Deaths
who had mental illness Ward register
Number of clients diagnosed with a particular
mental health condition who during the
17 Relapsed
process of recovery and before full recovery Consulting Room
return to the acute state. Register
A client who misses a review two weeks after Consulting Room
18 Defaulters
the appointment date. Register
Number of clients diagnosed with a particular
19 Recurrence mental health condition who after recovery Consulting Room
return to the acute state Register
Pharmacovigilance
Clients with Form/Adverse Drug
20 Adverse Medicine Number of clients with adverse medicine Reaction
reaction reactions following the administration of Register/Incident
psychotropic and or anti-epileptic medications. Book
Clients Received Number of clients received from Traditional OPD Register (To be
21 from Traditional and Herbal centres. This includes medical included in the
and Herbal centres herbal centres. remarks column)
22 Clients Received Number of clients received from Faith based OPD Register (To be

50
 SN VARIABLE DEFINITION DATA SOURCE
from Faith-based included in the
healing centres. centres. remarks column)
Clients Received Number of clients received from other
from other alternative medical centres and these include OPD Register (To be
22
alternative medical centres for acupuncture, homeopathy, included in the
centres naturopathy, radionic medicine remarks column)
Patients brought to OPD Register (To be
Number of clients brought in chains or
22 the facility in included in the
shackles to the health facility.
chains or shackles remarks column)
Clients Received
from criminal
Number of Clients received from criminal
Justice system and Mental Health - OPD
23 Justice system and special institution (police
special institutions Register (To be
cells, security services)
(police cells, included in the
security services) remarks column)
Ward Register (To be
Voluntary Number of clients on admission receiving
24 included in the
Admissions treatment willingly at the facility.
remarks column)
Ward Register (To be
Involuntary Number of clients on admission through a
25 included in the
Admissions court order or a certificate of urgency
remarks column)
Ward Register (To be
Admissions by Number of clients on admission receiving
26 included in the
Court Order treatment based on a court order.
remarks column)
Number of admitted clients deemed to be a
Admissions by
risk to themselves or to others upon Ward Register (To be
27 certificate of
certification by a registered medical included in the
urgency
practitioner. remarks column)
Seclusions Number of admitted patients who are
(confinement of separated from others because they are a risk Ward Register (To be
28
mentally ill to themselves and others and tranquilization is included in the
persons) inappropriate or not readily available. remarks column)
Number of patients who leave the facility in an
Abscondees
unauthorised manner Ward Register
Number of patients released from facility after A&D / Ward
29 Discharges
admission Register
Ward Register (To be
Vagrants Treated - Number of persons with mental disorder found included in the
30
Facility in public places without a caregiver treated in remarks column) and
the health facility Activity book
Number of persons with mental disorder found
Vagrants Treated -
in public places without a caregiver treated by
Community
a trained staff in the community
Ward Register (To be
Number of abandoned clients from a Health
31 Repatriated clients included in the
facility reunited with their caregivers
remarks column)
Number of abandoned clients from the health
Repatriated clients
32 facility received by caregivers through
received
community mental health personnel Activity register
Clients with
physical Number of persons with mental illness and
33 disabilities (motor, physical disabilities (motor, vision, speech,
vision, speech, hearing) receiving treatment at the facility
hearing) OPD register

51
 SN VARIABLE DEFINITION DATA SOURCE
Number of persons who deliberately try to Consulting Room
34 Attempted suicide
take their own lives and fail. Register
Cause of death
Number of persons who deliberately take their
35 Suicides certificate/ Birth &
own lives.
Death Registry
Consulting room
Clients referred Number of clients received from another
36 register (check the
(in) facility
remarks)
Consulting room
Clients referred
37 Number of clients referred out of a facility register (check the
(out)
remarks)

52
MONTHLY COMMUNITY MENTAL HEALTH REPORTING FORM

SN VARIABLE DEFINITION DATA RATIONALE

SOURCE
1 Name of facilityThe name of the Health Facility Records To identify the facility
e.g. Aboaso Health Centre etc. from which service
was rendered
2 District The name of the district in which Records To know the district
the Health Facility is located, e.g. where the facility is
Kwabre. located
3 Region The name of the region in which Records To know the region
the Health Facility is located e.g. where the facility is
Ashanti. located
4 Month The Month in which the Calendar To the know the
transaction took place e.g. July month within which
the service was
rendered
5 Year Year in which the transaction took Calendar To the know the year
place e.g. 2010 within which the
service was rendered
6 Sex Biological sex of client (male or OPD Register To know the gender
female) distribution of cases
and attendances
7 Grand Total Indicates the sum of figures in Multiple To know the number
each row and column sources of cases or attendances
8 Community Number of community gatherings Health To promote
Durbars to discuss health related issues promotion community
including mental health. register / engagement in health-
Disaggregate audience or Community related issues
attendance in male and female. activity including mental
register health.
9 Number of Number of educational facilities in Health To know the number
educational which mental health programmes promotion of educational
institutions in were conducted in the catchment register facilities that were
which mental area. covered with mental
health health programmes.
programmes
were conducted
10 No. of mental Number of mental health Health To know the number
health programmes conducted in promotion of mental health
programmes educational institutions. register programmes
conducted in Disaggregate audience or conducted in
Educational attendance into male and female. educational institutions
health within a catchment
institutions area.
11 Home Visits Number of households visited and Home visit To know the number
conducted provided with mental health register of households visited
services. and provided with
mental health services.
12 Health Number of mental health Health To know the number
Education educational activities conducted in promotion of mental health
conducted the catchment area. register educational activities
conducted in the
catchment area.

53
SN VARIABLE DEFINITION DATA RATIONALE
SOURCE
13 Specialist Number of psychiatrist specialist Outreach To know the number
Outreach clinics conducted outside their Register of specialist Mental
Clinics normal place of work. Health outreach clinics
conducted conducted.
14 Routine Number of routine outreach clinics Outreach To know the number
Outreach conducted by other mental health Register of routine Mental
Clinics personnel. Health outreach clinics
conducted conducted.
15 Support group - Number of support groups (Groups Activity To know the number
Self Help of persons with similar conditions register of support groups
Groups (AA, coming together to support one available in a
NA, etc.) another). catchment area.
16 Service users’ Number of service users meetings Activity To know the number
fora held in the catchment area register of Service users' fora
held.
17 Support groups Number of clubs (people with Activity To know the level of
- Others (Clubs) similar interest, who are not register community support for
service users, coming together to mental health available
promote mental health). in a catchment area.
Membership disaggregated into
male and female
18 e- Support Number of different e- based Activity To know the extent of
Group support groups utilised in a register e- based support
catchment area (e.g. Social Media groups available and
Support Groups, Webinar) utilised in a catchment.
19 No. of Number of traditional and herbal District To know the number
Traditional and centres available. This includes Health Profile of traditional and
Herbal Centres medical herbal centres. herbal centers in a
catchment area.
20 No. of Number of traditional and herbal Daily activity To know the number
Traditional and centres visited to carry out mental register of traditional and
Herbal Centres health activities. This includes herbal centers visited
Visited medical herbal centres. to carry out mental
health programmes
21 No. of Faith Number of faith-based centres District To know the number
based Healing available in the catchment area. Health Profile of faith-based centres
centres in a catchment area.
22 No. of Faith Number of faith-based centres Activity To know the number
based Healing visited. register of faith-based centres
centres Visited visited
23 No. of other Number of other Alternative Activity To know the number
Alternative Medicine centres available in the register of Alternate Medicine
Medicine catchment area and these include centres available in the
Centres centres for acupuncture, catchment area for
homeopathy, naturopathy, radionic planning mental health
medicine activities.
24 No. of other Number of other Alternative Activity To know the number
Alternative Medicine centres visited to carry register of other Alternative
Medicine out mental health programmes in Medicine centres
Centres visited the catchment area and these visited and have
include centres for acupuncture, received mental health
homeopathy, naturopathy, radionic programmes
medicine

54
SN VARIABLE DEFINITION DATA RATIONALE
SOURCE
25 Clients found in Number of clients found in Activity To know the number
chains/shackles chains/shackles. This include register of clients found in
clients found in ropes and logs. chains/shackles to
initiate interventions to
stop human rights
abuses.
26 Number of Number of vagrants in the Activity To know the number
vagrants catchment area as at the last register of vagrants in the
vagrants census disaggregated into /district catchment area to plan
male and female health profile services and other
interventions

55
STATEMENT FOR MENTAL HEALTH OUTPATIENTS
SN VARIABLE DEFINITION DATA SOURCE
1 Institution The name of the Service Delivery Point (SDP) Records
e.g. Aboaso Health Centre etc.

2 District The name of the district in which SDP is located, Records

e.g. Kwabre.

3 Region The name of the region in which the SDP is Records

located e.g. Ashanti.

4 Month The Month in which the transaction took place Calendar

e.g. July
5 Year Year in which the transaction took place e.g. 2010 Calendar

6 Age Groups Age categorization of the OPD attendants. in days OPD Register
for the neonates, months for the post neonates and
years from 1yr to adults

7 Insured Clients New and old insured clients counted as male and OPD Register
females.

8 Non-Insured New and old non-insured clients counted as male OPD Register
Clients and females.

9 Total (Male Total number of male clients per row OPD Register
and Female)

10 Total Indicates the sum of figures in each row and OPD Register
column
11 Medical Name and signature/stamp of officer In-charge of Facility Head
Officer In- the facility
Charge

APPENDIX TWO

56
REGISTERS AND FORMS FOR FAMILY HEALTH DIVISION (FHD)
REGISTERS (FHD)

MATERNITY WARD REGISTER

No DATA RATIONALE
VARIABLE DEFINITION
. SOURCE
1 Serial The number on the row on Records Helps count the
Number which client record is written in number of clients
the register. been taken care of
within a particular
period, determines
client load,
determines target so
far & helps in
planning
2 Date of The date on which the Calendar Helps in record
Admission client was admitted OR keeping of events
transferred in from another for a particular
facility. period
3 Time of The time the client was Clock in Helps to track the
Admission admitted OR transferred in Maternity time of treatment
from another facility. Ward. initiation
4 Patient Client’s unique identification ANC It helps to identify
Number number issued on the first visit card/Folder and retrieve client
to the facility. records in case of
loss
5 Patient Name Name of client in full without ANC For easy
titles, avoid informal names card/Folder identification of
such as: Sister, Maame, Auntie, client & records
Wofa, etc.
6 Address The locality in which the client ANC For follow ups and
(Locality) resides but not the birth place card/Folder home visits
7 Age The exact age of the client in ANC Informs service
completed years e.g. 30 years. card/Folder providers on the full
details of the client
to provide
individualized care
8 Parity The number of times a ANC Provides
pregnancy has been carried card/Folder information to the
beyond 28 weeks, indicated by service provider for
the letter “P”. subsequent care
9 Duration of The age of the pregnancy at the ANC It informs the
Pregnancy time of admission in weeks card/Folder service provider on
the gestational age
to offer
individualized care
10 Partograph Use of Chart to monitor the ANC Provides
Use progress of active labour. card/Folder information on how
` effective labour was
managed

57
 No DATA RATIONALE
VARIABLE DEFINITION
. SOURCE
11 Foetal Heart Number of times the heart of ANC It provides
on Admission the foetus beats per minute card/Folder information on the
viability of the
foetus
12 Antenatal Medical conditions that can ANC Prompts the care
Risk Factors lead to complications in card/Folder provider on the need
pregnancy, labour and delivery for timely
intervention for
improved outcomes
13 Outcome of Number of baby or babies that ANC Provides
Delivery were delivered and their status card/Folder information on past
at the time of delivery; whether obstetric history and
alive or dead. informs decision for
individualized client
centred care
Provides
Date on which the woman and
information on
Date of baby or babies were discharged ANC
14 number of days
Discharge or transferred to another card/Folder
spent and the level
facility.
of quality of care
Provides
‘Difficult/Extreme/
information on the
Unexplained’ conditions that
Complication ANC extent of the need
15 required other medical
s of Delivery card/Folder for comprehensive
interventions or specialized
obstetric care for
care during/after delivery
necessary planning
The health insurance status of Provides
the client. This is limited only information on the
to the national health insurance proportion of clients
schemes. registered on the
health insurance
NHIS Status Write “YES”- if the client’s Insurance scheme and for
16 planning
(Yes or No) insurance card is valid or active Card
and has not expired.

Write “NO” if the client is not

insured at all or if the card is
not valid or active.

DELIVERY REGISTER
No VARIAB DATA RATIONALE
DEFINITION
. LE SOURCE
Provides information on
1 Place a serial number from Admissions & the number of clients
S/N (Serial
1 to the end of the month. Discharges been taken care of within
No.)
Each month starts with 1 Book a specified period & aids
in planning
Medical This is the number needed Records Helps in identification &
2 Record to locate client’s records retrieval of client records
No. from the facility. Write the

58
No VARIAB DATA RATIONALE
DEFINITION
. LE SOURCE
unique ID number assigned
to the client by the facility
National health insurance Provides information on
3 (NHIS) registration the proportion of clients
Insurance number. Write the number registered on the health
NHIS Card
No as it appears on client’s insurance scheme and for
NHIS card. If not covered planning
write NONE
Date and Time of Helps to keep track of
4 Admission to the labour the progress of labour
ward and for the initiation of
Delivery
a. Time: Record time as timely intervention for
Admission Room Clock &
in am/pm format (e.g. good outcomes
Calendar
3;00am) b. Date: write
date in the short date
format (dd/mm/yy)
Client Information
MCH Record For easy identification of
5 Name of Book & client and records
Write full name of client
mother confirmed
from client
Informs service
providers on the full
6 details of the client to
MCH Record
provide individualized
Mother’s Age. Write age Book &
Age care.
of the client in years confirmed
Also helps in
from client
identification of records
of clients with same
names.
Client’s location address. For follow ups & home
MCH Record
Include mobile number, visits
Contact Book &
7 community name,
Address confirmed
landlord’s name (where
from client
applicable) District etc.
Provides information on
the level of education of
Highest level of education MCH Record
8 women in a given
Level of attained. Write None, Book &
geographical area. Helps
Education Primary, secondary, confirmed
with the provision of
tertiary from client
client centred care and
for planning
Helps the service
This is the number of MCH record
9 provider to give
times the woman has ever Book &
Gravidity comprehensive care
been pregnant including confirmed
tailored to the needs of
current pregnancy from client
the client.
10 This indicates the number MCH Record Gives the service
of times the woman has Book & provider the appropriate
Parity
given birth (indicate the confirmed direction for subsequent
no. alive and no. dead) from client care
No of This is the number of MCH Record It provides information
11 ANC times the pregnant woman Book on the proportion of
Visits visited the ANC women getting the full
59
No VARIAB DATA RATIONALE
DEFINITION
. LE SOURCE
throughout the period of package of ANC services
pregnancy and helps in planning
MCH Record Provides information on
The age of the pregnancy Book the proportion of women
12 in weeks on the day of reporting in labour at
Gestationa admission to the delivery term and those with
l Age ward; estimated by LMP, preterm labour for timely
fundal height and or intervention to achieve
ultrasound scan the best outcomes and
for planning purposes
Provides information on
Intermittent Preventive
the number of women
Treatment/Sulphadoxine
13 MCH Record who received protection
IPT (SP) pyrimethamine. Write the
Book against malaria in
number of doses given to
pregnancy as per
client
protocol
This information helps
Haemoglobin in g/dl. identify the number of
14 Indicate the last Hb value women who report to
recorded in the maternal labour with anaemia in
Hb Lab Result
health record booklet. pregnancy, track their
Write NO if there are no antenatal records, plan to
records on that improve the quality of
ANC services
To plan & manage
Blood type of mother.
accordingly in case there
Write down the blood type
15 Blood is the need for blood
(A, B, AB, OR, O) AND Lab Result
group transfusion. Aids in
Rhesus factor (RH- or
prompt management to
RH+)
save lives.
Indicate whether any To track and ensure
ANC Client’s folder
16 corticosteroid was given or quality of management
Corticoster or MCH
not for gestational age 28- of preterm labour
oid Record Book
34 weeks
To track the number of
pregnant women
17 Random Diagnostic test for reporting with syphilis
Treponema pallidum. infection and plan
Syphilis Indicate positive(pos), Lab Result accordingly to prevent
Negative(Neg) or unknown the transmission to the
based on the test results babies and effective
management of the
mothers
To track the number of
pregnant women
Random Diagnostic test for reporting with hepatitis B
18 Hepatitis B virus. Indicate infection and plan
Hep. B positive(pos), Lab Result accordingly to prevent
Negative(Neg) or unknown the transmission to the
based on the test results babies and effective
management of the
babies
PMTCT Prevention of Mother to MCH Record To track the number of
Child Transmission of Book pregnant women positive
60
No VARIAB DATA RATIONALE
DEFINITION
. LE SOURCE
for HIV infection, plan
19 HIV. Select the appropriate accordingly to prevent
box to indicate whether the mother to child
client is positive (reactive) transmission and
or negative (non-reactive) effective management of
the mothers
Any intervention other Provides information on
than episiotomy such as the number of pregnant
ARM, induction of labour women receiving basic &
by misoprostol, comprehensive obstetric
20 augmentation of labour by care respectively
Other oxytocin, vacuum
interventio extraction, blood
Delivery notes
n transfusion, medications,
/Treatment etc. Write down any
intervention performed on
the client other than
episiotomy. Write the
indication for such
intervention
Mother’s Vital Signs ON Provides information on
BP, Pulse,
21 Admission. Write down the Partograph the mother’s health status
Temp
values on admission
FHR Write down the initial Provides information on
22 (Foetal foetal heart rate on Partograph the state of viability of
heart rate) admission. the foetus on admission
Write down the cervical Provides information on
Cervical
23 dilatation (in cm.) on Partograph the stage of labour on
dilatation
admission admission
Indication of the use of Provides information on
partograph in monitoring the level of quality care
24 the progress of active Client Record provision in labour
Partograph
labour. Write yes or no (if Card (ANC
use
No, indicate reason for not card or folder)
use e.g. Elective c/s,
imminent delivery, etc.)
Indicate the Lie of the Informs the decision of
foetus such as the care provider on the
Lie &
25 Longitudinal, Oblique or mode of delivery and
Presentatio ANC card
Transverse and the prompt referral where
n
presentation such as necessary
Cephalic, Breech, etc.
Condition of perineum. Provides information on
Tick if perineum is intact, the quality of the
Perineum Delivery notes
26 episiotomy given or management
whether a tear occurred of 2nd stage of labour
The date the new-born was Provides information on
delivered. Indicate by the age of the baby for
Date of
27 writing the date as Delivery notes appropriate care
delivery
appropriate (specify
dd/mm/yy)
Time Time baby fully delivered. Delivery notes Provides information on
28 the duration of labour

61
No VARIAB DATA RATIONALE
DEFINITION
. LE SOURCE
and quality of care
Provides information on
Did the baby CRY or the state of health of the
Breathing /
29 BREATH Delivery notes baby at birth and informs
Crying at
SPONTANOUSLY at baby form decision on both the
Birth
birth? Tick as appropriate. immediate & subsequent
care.
A measure of the physical Provides information on
condition of a new-born the physical condition of
infant. It is obtained by the new-born infant at
adding points (2, 1, or 0) 1minute & 5 minutes
for heart rate, respiratory after delivery. It informs
30 Apgar effort, muscle tone, decision for appropriate
Delivery notes
Score response to stimulation, care
and skin coloration; a score
of ten represents the best
possible condition. It is
measured at 1 minute & 5
minutes after delivery.
The respiration rate of the Provides information of
baby within the first 30 the health status of the
31 Resp. rate minutes of delivery. Write Postpartum baby in the immediate
within 30 the respiration rate monitoring postpartum period for
mins obtained after counting for chart timely intervention
one full minute in the where there is any
space provided. deviation
If it was possible to initiate Provides information on
skin to skin contact the proportion of babies
32 Initiated between the mother and the who receive skin to skin
Skin to new-born. There may be care at birth as per
Post-delivery
skin care extenuating circumstances protocol. A measure of
notes
within first under which this may not quality of care for
30 minutes occur. Indicate none in newborns.
such situations. Tick the
appropriate response
This indicates if the child
was provided some Provides information on
assistance to breathe on the quality of care for
delivery. Tick None if the new-borns who do not
baby required no assistance breathe or cry
33 to breathe. Tick stimulation spontaneously at birth
Resuscitati
and suction to start Post-delivery and informs decision for
on
breathing if the new-born notes planning
provided
required this only. If the
baby needed to be assisted
with either bag or mask or
with an endotracheal tube.
Tick as many steps as are
done.
Axillary The Axillary temperature Post-partum Provides information on
temperatur of the new-born within one observation the state of body warmth
e within and a half hours (90 form, of the new-born, the
34 the first 90 minutes) of delivery in quality of care for new-
mins centigrade. Must be borns and informs
62
No VARIAB DATA RATIONALE
DEFINITION
. LE SOURCE
measured with an decision for planning
appropriate thermometer.
Write the temperature
obtained for the new-born
in centigrade in the space
provided
If mother is able to/assisted Provides information on
to INITIATE breastfeeding the proportion of babies
within 30 minutes of put to breast within 30
35 Breastfeed delivery. There may be minutes of delivery as
Post-delivery
ing within extenuating circumstances per protocol. It is a
notes
30 min under which she may not measure of quality of
be able to. Indicate NO in care in the immediate
such situations. Tick the post-natal period.
appropriate response.
The status of the baby at Provides information on
36 the time of delivery. the number of still births
Alive/ Post-delivery
Indicate if the baby was recorded within a
Dead notes
born alive or dead and tick specified period
the appropriate response.
A foetal death in late
pregnancy. In Ghana, a Provides information on
stillbirth is defined as a late the quality of antenatal,
37 foetal death occurring after Post-delivery labour & delivery care
Stillbirth
at least 28 weeks’ notes
gestation. Indicate whether
fresh (FSB) or macerated
(MSB)
The birth of a dead baby
with no signs of
maceration/disintegration
Fresh Post-delivery
38 of the skin where the death Provides information on
stillbirth notes
is assumed to have taken the quality of the
place during labour and management of labour
process of delivery.
Includes all the changes
which occur in a foetus
39 retained in utero after
death. Provides information on
A “macerated” foetus the quality of antenatal
Macerated shows skin and soft-tissue Post-delivery care.
Stillbirth changes (skin discoloration notes
or darkening, redness,
peeling, and breakdown)
suggesting death was well
before onset of labour/
delivery (pre-partum)
Birth Defined as inability of Post-delivery Provides information on
Asphyxia baby to initiate or sustain notes and baby number of babies born
breathing. Indicate as: 1. form with asphyxia and aids in
No breathing or crying at planning to improve
birth. 2. APGAR score of 7 ANC labour and
40 or less at 5 minutes in a delivery, PNC refresher
baby. 3. Baby was training, procurement,
63
No VARIAB DATA RATIONALE
DEFINITION
. LE SOURCE
resuscitated (either by etc.
stimulation by rubbing the
baby’s back gently once or
twice OR/AND with bag
and mask ventilation).
Note that 1, 2 & 3 above
must be present before you
indicate that the baby has
asphyxia
The sex of the baby Provides information on
delivered (Male or female). proportion of male and
Ambiguous genitalia are if Labour notes/ female babies delivered
Sex
41 the sex of the baby cannot baby form in a specified place
be determined easily. within a specified period.
Indicate as appropriate. It helps in planning
The weight in kilograms of Provides information on
the baby on the day of proportion of
delivery. Write the weight underweight babies
42 of the baby in kilograms in delivered in a specified
Weight Labour notes/
the space provided place within a specified
(kg) baby form
period.
It also helps assess the
quality of ANC care &
helps with planning.
A valuable predictor
about a new-born’s
The length of the baby health, and also provides
measured from the occiput a suspected growth
Length Labour notes/
42 to the heel in centimetres. pattern to paediatricians.
(cm) baby form
Write the result in the box Concern for a smaller-
provided than-average baby can
come into play in the
case of premature births.
A valuable predictor
about a new-born’s
health, and also provide a
Head Circumference (cm).
suspected growth pattern
Write in the space provide Labour notes/
43 HC (cm) to paediatricians.
the head circumference of baby form
Concern for a smaller-
the new-born.
than-average baby can
come into play in the
case of premature births.
Provides information on
the number of new-borns
Write if vitamin K1
44 protected against
Vitamin injection was given or not Labour notes/
haemorrhagic disease of
K1 to the new-born on baby form
the new-born. An
delivery.
indicator for quality of
newborn care
Infant Antiretroviral Medications Client’s folder Provides information on
ARVs for HIV exposed babies. the number of HIV
45 Tick the appropriate box exposed new-borns put
on treatment against
mother to child
64
No VARIAB DATA RATIONALE
DEFINITION
. LE SOURCE
transmission.
Tetracycline ointment OR Provides information on
chloramphenicol eye drops the proportion of new-
for preventing eye borns protected against
46 infection given within Labour notes/ ophthalmia neonatorum
Eye care
90min of delivery. Note baby form as per protocol.
that only one antibiotic is
to be used, not both. Tick
the appropriate response
Methylated Spirit or Provides information on
Chlorhexidine used to the quality of cord care
47 dress the cord as part of the Postpartum as per protocol for the
Cord Care
essential care for the new- notes prevention of neonatal
born. Tick the appropriate sepsis likely to occur
response from cord sepsis.
Any abnormality detected Provides information on
in the new-born e.g. Extra the number of new-borns
Birth
48 digit. Write in the space Labour notes/ with congenital
Abnormali
provided as appropriate. baby form abnormalities, the quality
ties
Write None if there is no of ANC and helps in
abnormality planning.
3rd stage (AMSTL)
Medicine given to a Provides information on
woman usually by the quality of the
49 intramuscular injection management of the third
Oxytocin within one minute after Labour/deliver stage of labour, compare
delivery to aid uterine y notes with outcomes and aids
contraction and reduce the with planning.
risk of excessive bleeding
Provides information on
the quality of the
50 Indicate time oxytocin management of the third
Time Delivery notes
given; format (3:02 am) stage of labour, compare
with outcomes and aids
with planning.
Provides information on
the number of women
developing post-partum
51 Estimated blood loss (in Labour/ haemorrhage at delivery,
Blood loss
mls.) after delivery. delivery notes quality of the
management of the third
stage of labour, and aids
with planning
Provides information on
Any complication that the number of women
occur before or during developing
52 Complicati labour and after the Client’s complications in the
ons delivery of the baby e.g. records course of pregnancy,
PROM, PPH. Tick the quality of ANC, labour,
appropriate box. and delivery care, and
aids with planning
Mode of Mode of delivery such as Client’s Provides information on
Delivery spontaneous vaginal records the proportion of women
53 delivery (SVD), vacuum who needs
65
No VARIAB DATA RATIONALE
DEFINITION
. LE SOURCE
Extraction, Caesarean comprehensive obstetric
Section, etc. Tick the care services and aids in
appropriate box planning.
Time placenta and Provides information on
Time
membranes completely the quality of third stage
Placenta Delivery notes
54 delivered. Time: write in management and assists
Delivered
am/pm format with planning.
Provides information on
the quality of third stage
State of Indicate whether placenta
55 management, the number
Placenta and membranes were
of women with
and complete or any Delivery notes
abnormalities of the
membrane abnormalities detected.
placenta who needs
s Tick the appropriate box
further management and
aids in planning.
Discharge /Transferred/Referred (Mother)
This provides
56 Client’s Blood Pressure
information on the
Recorded at
BP Client Record proportion of mothers
Discharge/Transfer or
with hypertensive
referral
disorders.
Provides information on
57 deviation in the normal
Client’s pulse checked
Pulse Client Record body function for prompt
after delivery
decision making and
intervention
Provides information on
58 deviation in the normal
Client’s temperature
Temp Client Record body function for prompt
checked after delivery
decision making and
intervention
Provides information on
the client’s health status,
59 guides with detection of
Respiratio Client’s post-delivery
Client Record deviation in the normal
n respiration
body function for prompt
decision making and
intervention
Disch./ Indicate whether the client
61 Client Provides information on
Transf./ was discharged, transferred
Records level care at the facility
Ref. or referred
Provides information on
Indicate where client was number of clients
62 Transferre referred to Client referred from the facility,
d/Referred
Records the quality of services
To
available and aids in
planning.
Date The date of Discharge, Client Provides information on
Transfer or referral of the Records client’s length of stay,
mother number of clients
63 transferred or referred
from the facility, quality
of care and aids in

66
No VARIAB DATA RATIONALE
DEFINITION
. LE SOURCE
planning, resource
mobilization for quality
improvement
Provides information on
client’s length of stay,
64 number of clients
The time of
Client transferred or referred
Time Discharge/Transfer or
Records from the facility, quality
referral
of care and aids in
planning and resource
mobilization.
Indicate any additional
65 Provides holistic
information deemed Service
Comments information on the client
necessary in the space Provider
for future planning
provided
Discharge /Transferred/Referred (Baby)
Provides information on
Breath Count (Resp. rate) the baby’s health status,
66 in one full minute of the guides with detection of
Resp. baby at the time of Client Records deviation in the normal
discharge or referral. Write body function for prompt
the value obtained decision making and
intervention
Provides information on
Axillary Temperature in
the baby’s health status,
centigrade of the baby at
67 Post-natal guides with detection of
the time of discharge,
Temp ward deviation in the normal
transfer or referral. Write
thermometer body function for prompt
the value obtained in
decision making and
centigrade
intervention
Provides information on
Heart Rate (counted for a
the baby’s health status,
full minute by auscultation
68 Post-natal guides with detection of
of the new-born at the time
Heart Rate ward seconds deviation in the normal
of discharge/transfer or
hand clock body function for prompt
referral. Write the figure
decision making and
obtained
intervention
Indicate colour (pink, Provides information on
cyanosis, jaundice, pallor Observation by the baby’s health status,
69 etc.) at the time of the service guides with detection of
Colour discharge, transfer or provider, deviation in the normal
referral. Write the colour documents in body function for prompt
of the new-born in the client record decision making and
space provided intervention
Whether baby is being Provides information on
exclusively breastfed at the the number of babies
Breastfeed Client
70 time of discharge transfer exclusively breastfeeding
ing interview
or referral. Tick the at discharge transfer or
appropriate response referral
Disch/ Ref If new-born was Client records Provides information on
discharged from the labour the number of new-borns
71 ward OR transferred OR referred for higher care
referred elsewhere any and helps with planning
time after birth. Tick the
67
No VARIAB DATA RATIONALE
DEFINITION
. LE SOURCE
appropriate response
If the new-born was Provides information on
referred indicate the name the facilities receiving
72 Referred of the referral facility. referred new-borns and
Client Records
to Write the name of the helps with planning
facility the new-born was
referred to.
Date the mother was Provides information on
73 referred or discharged. Labour ward client’s length of stay
Date Write the date as calendar/Client and quality of care
appropriate (specify if records
dd/mm/yy)
Time the new-born was Provides information on
74 discharged, transferred or baby’s length of stay and
Labour ward
Time referred. Write the time in quality of care
clock
the space provided
(am/pm)
Relevant information Provides information on
related to the referral or the state of new-borns at
discharge. Indicate the discharge
state of the new-born at the
time of transfer, referral or
discharge. Alive and
75 satisfactory means the
new-born has signs of life
Client records /
and is not asphyxiated i.e.,
provider
Comments APGAR score is above 7 at
observation at
5 minutes. Dead means no
discharge
signs of life at time of
discharging the mother.
Asphyxiated means the
new-born is alive but at the
time of referral or transfer
from the labour ward, has:
An APGAR score of 7 or
less at 5 minutes
Provides information on
client load per service
76 provider, quality of care
Name of the service provided by the service
Delivered provider who conducted provider, for legal
Client Records purposes and helps in
by the delivery. Write down
the name planning

Provides information on
client load per service
77 provider, for legal
The Rank of the service
Designatio purposes and helps in
provider who conducted Client Records
n planning
the delivery.

68
No VARIAB DATA RATIONALE
DEFINITION
. LE SOURCE
Provides information on
client load per service
78
The service provider who provider, for legal
Service purposes and helps in
Signature conducted the delivery
Provider planning
appends a signature

69
POST-NATAL CARE REGISTER (MOTHER-24-48hours; 6-7days; 6 weeks)
DATA RATIONALE
No. VARIABLE DEFINITION
SOURCE
The name of the Service Delivery Point
1 Facility
(SDP) e.g. Aboaso Health Centre etc.
The name of the sub-district in which
2 Sub-District the Service Delivery Point is located,
e.g. Aboaso
The name of the district in which SDP
3 District
is located, e.g. Kwabre.
The name of the region in which the
4 Region
SDP is located e.g. Ashanti.
The Month in which the transaction
5 Month
took place e.g. July
Year in which the transaction took
6 Year
place e.g. 2010
The serial number is the sequential
Serial numbering of the rows in the register
7 Generated
Number but can be used to identify clients if
written on the client card.
MCH Record
Name of Write the name of the mother as Book and
8
Mother written in the MCH record book confirmed from
mother
MCH Record
Book and
9 Age of client in Years
Age confirmed from
mother
Medical
10 Record /ANC Number assigned by Records unit Records
Record No.
MCH Record
11 NHIS No. Unique number issued by NHIA
Book
Gives an indication of
A pregnant woman who makes contact
ANC MCH Record access and utilization
12 with a health professional/health
Attendant Book of services during
facility for antenatal care
pregnancy
Gives an indication of
Skilled Childbirth attended by a health MCH Record access and utilization
13
Delivery professional and/or in a health facility Book of services during
childbirth

70
 Gives an indication of
Client making a minimum of four ANC
ANC 4+ & clients following the
contacts as well as having childbirth MCH Record
14 Skilled continuum of care for
attended by a professional and/or in a Book
Delivery pregnancy and
health facility.
childbirth
Observation by Clinical sign of
Pale appearance of the conjunctiva, Service Provider anaemia, which must
15 Pallor
palms and nail beds be investigated and
treated.
Observation by May be an indication
Service Provider of an underlying
Yellow discolouration of the sclera of
16 Jaundice illness related to the
the eyes, palms and soles of the feet.
liver, gall bladder or
pancreas
Observation by Gives an indication of
Condition of the breast- whether soft or Service Provider engorgement and/or
17 Breast feels hard and tender with pain. Also abscess of the breast.
check for lumps. Presence of a lump
requires referral.
Observation by Distended abdomen
Service Provider may be a sign of an
Condition of the abdomen- whether
18 Abdomen underlying disease or
feels soft or tender with distension
dysfunction in the
body
Observation by Mild swelling may
Service Provider occur after childbirth
due to fluid retention
during pregnancy
Condition of the legs and feet- whether which usually clears
19 Lower Limbs
normal or swollen with pain up. Swelling of one
leg or both may be a
sign of a blood clot for
which immediate care
must be sought.
Observation by Following childbirth,
Service Provider the enlarged uterus
gradually reduces in
size until the sixth
week. Failure of the
Measurement of the uterus taken
Uterus Size uterus to shrink
20 abdominally from the fundus to the
(cm) gradually may be a
symphysis pubis
sign of retained
placental fragments,
inflammation of the
lining of the uterus or
fibroids.

71
 Observation by A wet perineal wound
Inspection of the perineum to see Service Provider could be the early
whether it is intact or there is a wound signs of an infection
due to an intentional cut (episiotomy) for which education
Condition of which has been sutured or a tear, which on frequent perineal
21 Perineum/woushould have been sutured. Appearance care must be
nd (if any) of the wound whether dry or wet emphasized.
should be noted. During second PNC Treatment must be
wound should again be inspected to see sought for a
whether it is dry or discharging. discharging perineal
wound.
Observation by Persistent red lochia is
Service Provider a sign of secondary
postpartum
Discharge from the vagina following haemorrhage and the
childbirth up to about 7-10 days, which cause must be
22 Lochia
progressively changes from red to pink determined and
and then colourless. treated. Offensive
smell of the lochia is a
sign of infection,
which must be treated.
MCH Record A mother infected
Book with HIV needs to be
Result of an HIV test on the mother treated on anti-
HIV Status of taken either during antenatal retroviral medicine to
23
mother care/labour & delivery or postpartum suppress viral load and
period also help to reduce
transmission of the
virus to her baby.

Treatment
MCH Record The anti-retroviral
Anti-retroviral medicine given as Book/Verbal medicine helps to
24 ARVs Given treatment to client who is HIV- suppress the viral load
infected. Check from client and keeps the client
healthy
MCH Record Iron and folic acid
Iron and folic acid supplements given Book/Verbal supplements helps to
25 Iron/Folate to mother to take for six weeks keep the mother’s
following childbirth. Check from client haemoglobin at an
optimal level

Family Planning
MCH Record Client obtains
Information given to client on family Book/Verbal information on return
Counselled on
26 planning following child birth. Indicate to fertility and how
FP
the appropriate response. she can prevent
unintended pregnancy

72
 MCH Record Family planning helps
Client who accepts to take a family
Book and Family to space childbirth and
Accept FP planning method within the postnatal
27 Planning Record enables the mother to
Method period in addition to breastfeeding.
Book regain her health and
Indicate the appropriate response
wellbeing
Any other significant observation or
28 Remarks service provided to client. Document
under remarks column
Observation by The uterus should
service provider have assumed its pre-
pregnant size and
The feel of the uterus on abdominal
Condition of position and should be
29 palpation at the 6th week postnatal visit.
Uterus observed to have
Document findings
involuted and not
easily measured
abdominally.

1st PNC Visit (24-48hours)

CHILD
Examination

Observation by Clinical sign of

Pale appearance of the conjunctiva, Service provider anaemia, which must
1 Pallor
palms and nail beds be investigated and
treated.
Observation by This is a sign that that
Service provider the newborn has too
much bilirubin in the
blood. The cause
Yellow discolouration of the sclera of
2 Jaundice must be investigated
the eyes, palms and soles of the feet.
and treated. Untreated
jaundice in the
newborn can led to
brain damage.
The set of typical movements and Observation by Absence of these
behaviours observed in the newborn Service provider movements or
3 Activity
such as reflexes, crying and movement behaviours may be an
of the limbs indication of illness.
Observation by Inability of a well-
Service provider positioned newborn to
latch onto mother’s
breast maybe an
Ability of the baby to latch onto the
4 Breastfeeding indication of illness,
mother’s breast and take in breastmilk
prematurity or a
congenital
abnormality such as
cleft palate or harelip.

73
 Observation by There may be mild
Service provider swellings on the
sutures of the baby’s
head as a result of
pressure on the head
during vaginal birth
and it normally
Detection of any abnormality on the
5 Head resolves within the
baby’s head e.g. swellings, injury etc
first few days. A
collection of blood
(haematoma), usually
on one side of the
head takes longer
(about two weeks) to
resolve
Observation by Abdominal distension
Service provider in a newborn may be
mild which may be
due to swallowing of
air during feeding and
resolves with burping
Appearance of the abdomen on the baby. A more
6 Abdomen
inspection and feel on palpation severe form of
abdominal distension
may be due to
congenital intestinal
obstruction, which
needs medical
attention.
Observation by Presence of an
Service provider abnormal growth
usually on the lower
Presence of an abnormal growth
7 Spina Bifida back of the baby is a
usually on the lower back of the baby.
congenital condition
of the spine and spinal
cord.
Appearance and feel of the skin on Observation by
8 Skin
inspection and palpation Service provider
Observation by Abnormal shape of the
Service provider feet are all forms of
Appearance of the arms, legs and feet congenital defects,
9 Limbs
of the baby which can be
surgically corrected
early in life.
Observation by Eyes discharging pus
Discharging Service provider is a sign of infection
10 Any fluid exuding from the baby’s eyes
Eyes which needs medical
attention
Appearance of the chest during Observation by Observation by
12 Chest
respiration Service provider Service provider

74
 MCH Record Failure of the term
Book/Verbal newborn to pass stools
from care giver within the first 24
hours in the presence
of a perforate anus
may be a sign of a
Report by mother of baby having problem with the
13 Passing stools
passed stool since birth bowels. Most preterm
infants will pass stools
within 24 hours of
birth even though
there may be a delay
up to 48 hours in a
few.
MCH Record The commonest cause
Report by mother of baby having
14 Passing Urine Book/ Verbal of failure to pass urine
passed urine since birth
from care giver is inadequate feeding.
MCH Record An HIV-exposed baby
Baby born to a mother who is HIV- Book needs to have anti-
15 HIV- Exposed
infected retroviral prophylactic
treatment
MCH Record Vaccinations given at
The required vaccination given usually
16 Immunization Book birth include BCG and
within the first 24 hours.
Polio
MCH Record A Hep B-exposed
Hep B Baby born to a mother who has tested Book baby is at risk of being
18
Exposed positive for Hepatitis B infected by the
mother.
MCH Record Hep B-exposed baby
Book needs to be vaccinated
Treatment given to protect a baby born
Hep B soon following birth
19 to a mother testing positive for
Treatment with Hepatitis B
Hepatitis B
immune globulin to
help fight the virus
Any other significant observation
20 Remarks and/or service provided for the baby.
Document under remarks column
Follow-up Visit (6-7days)
Examination
Blood sample taken through a prick of Procedure by The blood sample is
21 DBS Taken the big toe of a baby whose mother is Service Provider. screened to detect the
HIV-infected presence of the virus
PNC Visit at 6 weeks
Examination

75
 Obtained from A positive results
Result of a test to detect the presence of
Laboratory indicates that the baby
the virus in a baby whose mother is
is infected with the
22 EID Results HIV-infected. Document under
virus and will need
appropriate column as well as in MCH
life-long anti-
record book
retroviral therapy.

76
 FAMILY PLANNING REGISTER
DATA RATIONALE
No. VARIABLE DEFINITION
SOURCE
Serial number helps count
The serial number is the the number of clients within
sequential numbering of the a particular period. This
rows in the register which is helps the manager to
Family determine the client load,
Serial Number written on the client card and
1 Planning whether target is being met
(s/no) used to identify the client over a
Register/Card and plan the way forward.
one-year period. The client is
re-registered in every new year
and given a new serial number.

It helps to identify and

retrieve client records in
This is the number issued to the case of loss of Client card.
clients on the first encounter
with the service delivery point, Family
Client’s also known as the registration Planning
2
Registration No. number normally written in red Register/Client
ink if the client is a new client record book
to the service or other ink if the
client is a regular visitor.

It helps to keep record of

Family events throughout a
Indicate the date the visit was Planning particular period
3 Date made. All dates shall be Register/
recorded as Day/Month/Year. Client record
book

For easy identification of

Family client and records
Name of client in full without
Planning
titles, avoid informal names
4 Name Register/
such as: Sister, Maame, Auntie,
Client record
Wofa, etc.
book

77
 DATA RATIONALE
No. VARIABLE DEFINITION
SOURCE

For follow ups

Address is the location at which
a health worker would be able
Family
to track a client to. In most
Planning
Address cases, the format of the address
5 Register/
/Location includes a town, community,
Client record
landmark and/or the name of the
book
landlord. Include telephone
number

For follow ups

This is a sequence of digits
Family
assigned to a fixed-line
Planning
6 Phone No. telephone subscriber station or a
Client record
communication network
book
provided by the client

This aids in individualized

client centered care and also
This refers to the highest level provides information on the
of schooling that a person has Family level of education of
Level of reached. At the primary and Planning women seeking family
7
Education secondary school level, Client record planning services. Helps in
educational attainment refers to book planning
the number of years completed.

Provides information on
Family whether client is in a stable
The client’s situation with
Planning relationship or not. It
regard to whether being single,
8 Marital Status Register/ influences the family
married, separated, divorced, or
Client record planning method
widowed.
book

Informs service providers

The age of the client in on the age of the client for
Family
completed years, circle age if it age appropriate care.
Planning
is less than 20 or more than
9 Age Register/
35years circle the age. This
Client record
helps you to keep an eye on this
book
person

78
 DATA RATIONALE
No. VARIABLE DEFINITION
SOURCE
Provides information on the
number of children client
This column records more than Family
has for appropriate
4 deliveries, both live and Planning
education and care.
10 Parity stillbirths delivered by the client Register/
seeking family planning service. Client record
Circle number if more than 4 book

It provides information on
Indicate in this column whether the number of clients
the client is using modern Family accepting a family planning
11 1st Ever Use family planning method for the Planning method for the first time
first time in her life with a Yes Register/Card
or No

Family This enables the service

Any modern method of Family Planning provider to determine the
Last Method
12 Planning the client ever used to Register/ status of the client as being
Used
prevent pregnancy. Client record new or continuing acceptor.
book
Provides information on the
Family methods commonly used
The preferred method chosen by Planning
Current Method
13 the client and the date the Register/
and Date Started
method was given. Client record
book

Provides information on the

Family number of post-partum
This refers to the initiation and planning mothers accepting a family
PPFP (0-12
14 use of contraceptives during the Register/ planning method
months)
first year after delivery Client record
book

Provides information on the

Family availability of family
Record dates for which Family
Planning planning services for clients
Planning services will be
15 Subsequent visits Register/
provided for subsequent visits in
Client record
the year.
book

Provides information on the

Family compliance of clients with
This refers to the particular date
Planning regards to a particular
the client came for removal of a
16 Date of Removal Register/ method
method in the case of implants
Client record
and IUD.
book

79
 DATA RATIONALE
No. VARIABLE DEFINITION
SOURCE
It informs service providers
on the most effective
This refers to the sources of channel for health education
information that led the client to
the service delivery point. The
sources are provided in a legend
Sources of Family
at the bottom of the register.
17 Family Planning Planning
The sources must be represented
Information Register
with the numbering codes
assigned to them. However, the
client could have more sources
mentioned.

This is the count of other It informs services

sources of Family Planning Other sources providers about alternative
No. of other services within the catchment of family sources of family planning
sources of Family area of the facility, obtained planning services and supplies in the
18
Planning services through community scanning. services and community
and supplies (excluding the health facilities supplies
offering family planning register
services
It provides information
Total number of This is the count of abortion Comprehensiv about abortions carried out
abortions managed using medication as e Abortion with medication as against
19
managed using captured in the abortion register Care Daily surgical interventions
medication done within the facility. log/Form A
Provides information on
Family relevant issues for care and
Indicate anything of interest that planning aids with future planning
20 Remarks
is important for continuous care register

80
 ANTENATAL CARE REGISTER (ANC REGISTER)
DATA
No VARIABLE DEFINITION RATIONALE
SOURCE
Serial number helps count the
number of clients been taken
care of within a particular
Serial Number The sequential numbering
1 Generated period. This helps the manager
(S/N) of the rows in the register.
to determine the client load,
whether target is being met and
plan the way forward.
Indicate the date the visit It helps to keep record of events
was made to the service throughout a particular period
2 Date delivery point. All dates Calendar
shall be recorded as
DD/MM/YYYY.
This is the client’s It helps to identify and retrieve
registration /identification client records in case of loss of
number on the Ante Natal Client card.
card. If the client is
MCH Record
3 Reg. No. registered at a different
Book
facility before visiting you,
then use the same number
obtained from the previous
facility.
Name of client in full MCH Record For easy identification of client
Name of Mother
without titles, avoid Book and records
5 (First name, middle
informal names such as:
name, last name)
Sister, Maame, Auntie, etc.
The residence of the client For follow-ups and home visits
but not the birthplace. This
should include where the
house is located, the name
of the community and the
Full Residential MCH Record
6 house number. This
Address Book
address is very useful for
home visits so it is
important to get the correct
directions from the client.
include telephone number
Informs service providers on the
The age of the client in MCH Record
7 AGE full details of the client to
completed years. Book
provide individualized care
The number of times a It provides information to the
female has given birth. service provider for appropriate
MCH Record
8 PARITY Therefore, you shall direction on the subsequent care
Book
indicate the number of
births (alive and dead).
9 BP The Blood Pressure of the MCH Record For early detection of any
client measured with a Book deviation and appropriate action.

81
 DATA
No VARIABLE DEFINITION RATIONALE
SOURCE
sphygmomanometer.
Gives information about the
The height of the client MCH Record
10 HT (cm) level of stunting in a specific
measured centimetres. Book
area
For early detection of any
Weight of the client MCH Record
11 WT (kg) deviation in foetal growth and
measured in kilograms. Book
appropriate action taken
The age of the pregnancy To keep track, monitor the
in weeks on the day of the growth of foetus for timely
visit. This can be estimated intervention where necessary
by asking about the last
MCH Record
12 Gestation menstrual day LMP, the
Book
height of the fundus,
and /or ultrasound scan.
NB: Avoid using early
pregnancy
The date on which an To keep track, monitor the
infant is expected to be growth of foetus for timely
Expected Date of MCH Record
13 born, calculated from the intervention where necessary
Delivery (EDD) Book
first day of the last
menstrual period.
These are routine iron and To boost the pregnant woman’s
folic acid supplements haemoglobin level and maintain
Folic Acid & Iron MCH Record
14 given to the client the growth and development of
Supplements Book
throughout the pregnancy the foetus. It also serves for
and postpartum period. planning purposes.
It is a measure of the size To keep track and monitor the
of the uterus used to growth of foetus. It also aids in
assess foetal growth and diagnosis of intra-uterine
development conditions such as
MCH Record
15 Fundal Height (cm) during pregnancy. It is oligohydramnios,
Book
measured from the fundus polyhydramnios etc. for
of the uterus to the appropriate intervention
mother's pubic bone in
centimetres.
The heartbeat of the foetus To check the viability of the
counted for 60 seconds MCH Record foetus and detect foetal distress
16 Foetal Heart Rate
using the foetal Book for early intervention
stethoscope.
Hb The pregnant woman’s For early detection of anaemia in
17 Hb at MCH Record
haemoglobin level at the pregnancy and appropriate
Reg. Book
time of registration management.
To identify pregnant women at
The pregnant woman’s
Hb at MCH Record 28 weeks with low Hb. levels for
haemoglobin level at 28
28 wks. Book appropriate management before
weeks of gestation
labour
Hb at The pregnant woman’s MCH Record To identify pregnant women at
36 wks. haemoglobin level at 36 Book 36 weeks with low Hb. levels for

82
 DATA
No VARIABLE DEFINITION RATIONALE
SOURCE
appropriate management before
weeks of gestation
labour.
The blood group of the To plan and manage accordingly
Blood Group MCH Record
18 pregnant woman e.g. A, B, when the need arises for blood
(ABO) Book
AB, O infusion
To identify number of pregnant
This indicates the sickle
Status women with sickle cell disease,
cell test result of the Lab Result
(+/-) plan and manage them
pregnant woman.
appropriately.
Type is the result obtained To identify number of pregnant
19 Sickling
from the HB women with sickle cell disease,
electrophoresis. For plan and manage them
TYPE Lab Result
positive sickling status: appropriately.
indicate the type e.g. AS,
SS, SC or CC
Indicate here whether the To know the number of pregnant
pregnant woman was MCH Record women who have received ITNs
20 ITN Given
given an ITN or not for Book for use and plan accordingly.
malaria prevention
It is an investigation done MCH Record To identify pregnant women
Status
to indicate whether the Book reporting with syphilis for
(+/-)
pregnant woman has appropriate management
Syphilis
syphilis at registration
21 Screenin
Treatm It is an indication to MCH Record To identify pregnant women
g
ent determine whether the Book reporting with syphilis for
(Yes/ pregnant woman was on appropriate management.
No) treatment or being treated.
Lab Result To identify pregnant women
It is an investigation done
reporting with HIV for
Status to indicate whether the
appropriate management and
(+/-) pregnant woman has HIV
prevention of mother to child
in the blood at registration
transmission.
22 PMTCT
ARV To identify the number of
It is an indication to
Treatm pregnant women receiving
determine whether the MCH Record
ent ARVs for treatment and plan
pregnant woman was on Book
(Yes/N accordingly.
treatment or being treated.
o)
23 TB Screene This indicates whether the To know the number of pregnant
Screenin d pregnant woman has been Lab Result women screened for
g (Yes/N screened for TB at Tuberculosis infection at
o) registration. registration
It is an investigation done To identify pregnant women
Status to indicate whether the Lab Result infected with Tuberculosis at
(+/-) pregnant woman has TB at registration
registration
Treatm This indicates whether or MCH Record To know the number of TB
ent not a TB positive pregnant Book positive pregnant women on
(Yes/N woman has been put on treatment and plan accordingly

83
 DATA
No VARIABLE DEFINITION RATIONALE
SOURCE
o) treatment or not. with the information
SUBSEQUENT VISITS (2-12)
24 DATE Indicate the date the visit Calendar It helps to keep record of events
was made to the service throughout a particular period
delivery point. All dates
shall be recorded as
DD/MM/YYYY.
The Blood Pressure of the Sphygmoman For early detection of any
BP client measured with a ometer deviation and appropriate action.
sphygmomanometer. Reading
Weight of the client MCH Record For early detection of any
WT measured in kilograms. Book deviation in foetal growth and
appropriate action taken.
It is a measure of the size MCH Record To keep track and monitor the
of the uterus used to assess Book growth of foetus. It also aids in
foetal growth and diagnosis of intra-uterine
Fundal development during conditions such as
Height pregnancy. It is measured oligohydramnios,
from the fundus of the polyhydramnios etc. for
uterus to the mother's appropriate intervention
Subsequent Visits (2-12)

pubic bone in centimetres.

This is an investigation to
detect the presence of
Urine
protein, glucose and pus
Test
cells in the pregnant
woman's urine
Outcom Lab / RDT For early identification of
e of Result complications in pregnancy such
Pregna as pre-eclampsia and timely
ncy management
The heartbeat of the foetus For determining how healthy
Foetal counted for 60 seconds the foetus is and identifying
Heart using the foetal foetal distress.
Rate stethoscope or foetal
Doppler.
Folic It is a B vitamin MCH Record To know the number of
acid supplement needed for the Book pregnant women receiving folic
growth and development acid supplementation within a
of the foetus specified period for planning
purposes. To facilitate normal
development of the foetus and
ensure healthy haemoglobin
levels in women.

84
 DATA
No VARIABLE DEFINITION RATIONALE
SOURCE
An essential component of MCH Record To know the number of pregnant
haemoglobin for Book women receiving iron
preventing anaemia in supplementation within a
pregnancy specified period for planning
purposes. To ensure healthy
Iron
haemoglobin levels for women
and babies.

The number of Tetanus To know the number of pregnant

Diphtheria vaccines given women given TD to protect their
in the course of a babies from neonatal tetanus
pregnancy. In the duration within a specified period for
of a pregnancy a planning purposes.
maximum of 3 doses can
be given. To keep track of the number of
pregnant women completing the
Number of TD doses taken recommended schedule for TD
during the pregnancy not MCH Record
Tetanus Diphtheria- the number of routine Book /
25 TD (1-5) doses that should be taken. vaccination
So, for any dose given Card
during the pregnancy the
actual number continuing
from the yellow card
should be used in
recording. E.g. the first
dose may actually be TT4
if the woman had
previously taken up to TT3
in the yellow card.
To know the number of pregnant
women receiving Sulphadoxine
This represents the
pyrimethamine for malaria
intermittent preventive
Intermittent prevention
treatment for malaria given
Preventive MCH
26
to pregnant women in the
Treatment IPT- (1- Record Book
form of SP. Indicate the
5)
date and the dose of IPT
given

It gives information on
Provider notes written at Service initiatives taken based on
27 REMARKS services provided.
the end of the session. provider

85
86
 ADOLESCENT HEALTH CORNER REGISTER

DATA RATION
No VARIABLE DEFINITION
SOURCE ALE
The numbering of clients in the order of
attendance. This is done in sequence to know
the number of clients registered over a given
Serial Number
1 period. Generated
(S/No.)
Write the number of the client in the space
provided
This is the identification number issued to the
clients on the first encounter with the service
delivery point.
2 Registration No. Generated
Write the number of the client in the space
provided
This is the valid NHIS number of the client.
3 Insurance No. NHIS Card
Write the number of the client in the space
provided
This includes adolescents accessing service(s)
first-time
4 Attendant (New) ADH Register
Tick the corresponding box
This includes adolescents accessing services
subsequently/ subsequent visits
5 Attendant (Old) ADH Register
Tick the corresponding box
Refers to which day and the month within the
year of reporting that client visited the service
6 delivery point.
Date Calendar
Write all dates using the format: Day/Month/
Year
Name of the client in full without titles (e.g.
Miss, Mrs., Mr., Sister, Brother, Auntie, Uncle ,
7 etc.)
Name Verbal
Write the exact name of the client as
mentioned in the space provided
This could be the regular mobile number or a
functional landline if available
8 Verbal
Phone Number
Write the number in the box provided
The age of the client in completed years.
9
Age Verbal
Tick the appropriate age group of the client

87
10 Verbal/Service
Sex (M/F) Tick the appropriate gender of the client
provider
The location to which the health worker
could trace a client . The address should include
the name of the community, a house number , or
Residential
a landmark if the house number cannot be Verbal
11 Address
obtained or the name of the landlord if possible

Write per the description given by the client

The civil status in relation to marriage laws or
customs
12 Marital Status Verbal
Tick the corresponding marital status

The employment status of the client

13 Occupation (Student,Tick the corresponding

Employed, Unemployed,occupation
Apprentice) Verbal

The faith the client identifies with

14 Religion (Christian, Muslim, Traditional Verbal

Tick the corresponding religion

15

The highest level of education attained by

the
client.
15
Educational Level Verbal
Indicate by ticking the box beside the level of
education that applies to the client
Refers to the primary reason(s) why the
16 Reasons for adolescent is accessing services
Verbal
visit
Tick as appropriate
ADOLESCENT
DEVELOPMEN
T PROBLEMS
Girls who have not developed breast buds by
Verbal/Physical
Delayed puberty age 13. Boys whose testicles have not enlarged
Examination
by age 14
Precocious puberty Pubertal development occurring much earlier
than usual. Identified by testicular or penile
enlargement and genital or facial hair growth
before age 9 in boys.

Identified by breast development, menarche and

pubic and underarm hair growth at age 7 or 8 in

88
 girls.

Tick the corresponding box

NUTRITION
SERVICES
A condition characterized by low haemoglobin
levels. Screening can be through identification
of pallor by examining the palms, conjunctiva
or tongue. It can also be through laboratory
tests.

Reference values
Normal
10 to 11 years (both sexes)- 11.5 g/dl or higher
12 to 14 years (both sexes)-12.0 g/dl or higher
15 years and above (boys)- 13.0 g/dl or higher
Physical
15 years and above (non-pregnant girls and
Anaemia examination/Lab
women)- 12 g/dl or higher oratory Report
Anaemia
10 to 11 years (both sexes)- 8.0 g/dl to 11.4 g/dl
12 to 14 years (both sexes)- 8.0 g/dl to 11.9g/dl
15 years and above (boys)- 8.0 g/dl to 12.9 g/dl
15 years and above (non-pregnant girls and
women)- 8.0 g/dl to 11.9 g/dl
Severe Anaemia
Below 8.0 g/dl
The BMI is an attempt to quantify the amount Calculated
of tissue mass (muscle, fat, and bone) in an
individual to classify as being underweight,
normal weight, overweight, or obese based on
the value obtained.

It is calculated using the mass (weight in

kilograms) and height (in metres) of the
individual. The weight is divided by the square
Nutrition Status of the individual’s height and is universally
Assessment using expressed in kg/m2 .
Body Mass Index
(BMI at age) Calculate and tick the appropriate category
based on results from calculation.

Reference values
Underweight- below 18.50

89
 Normal range- 18.50 to 24.99
Pre-obese- 25.00 to 29.99
Obese – 30.00 and above
Adolescent girls are to be on Iron (60 mg) and
Iron Folic Acid Folic acid (2800 mg or 400 micrograms)
(IFA) Supplement weekly. Verbal

Give IFA and tick appropriately.

MATERNAL
HEALTH
SERVICES
This is an intervention to make pregnancy,
childbirth, and post-delivery services more
accessible to adolescents and more responsive
to their needs.
Safety Net Program Safety Net Register

All pregnant adolescents who opt to keep their pregnancies are enrolled on the safety ne

This refers to scheduled visits to the residence of pregnant girls on the Safety Net Progra
Home Visit Safety Net Register

Tick the number of times client has been

visited
This refers to monthly support group meetings
organized for girls on the Safety Net Program
Support Group Meeting Safety Net Register
Tick the number of times the client has
attended support group meeting(s).
This refers to what the adolescent pregnant client intends to do after delivery.
After Pregnancy Plan Verbal/Safety Net Register
Tick as appropriated

90
 NUTRITION AND CHILD HEALTH REGISTER

NUTRITION AND CHILD HEALTH REGISTER

N DATA
VARIABLE DEFINITION RATIONALE
o SOURCE
The numbering of clients Helps count the number of
as they attend the facility, clients seen within a
it is done sequentially to particular period, determines
1 Serial No. Generated
know the number of client load, whether target is
clients registered at a being met and helps in
given period planning
The registration number
Child
2 given to the child on first Generated Helps in identification and
Registration No.
visit to clinic. retrieval of client records
Record official name For easy identification of
given to child. If child is Birth client records and for follow
3 Child's Name not yet named, indicate Certificate. / ups
with a dash and record MCHRB
once it is provided
Write the date of birth of Helps in age calculation for
Birth
the baby it should be quality care
4 Date of Birth Certificate/
written as
MCHRB
DD/MM/YYYY
Date when baby is first Provides information on the
seen at health facility. level of awareness of clients
5 Date First Seen Could be same as that MCHRB on the CWC services
when the child was first
registered
This is sex of baby. Helps with easy retrieval of
Indicate M for Male and F records and also provides
Verbal/
for Female information on the gender
6 Sex MCHRB -
distribution of children
Delivery
within the particular area
over a specified period
Birth weight is the body To detect overweight and
weight of a baby at its underweight and faltering
birth. Record it from the MCHRB growth potentially due to
7 Birth Weight
MCHRB if available. Card underlying medical
problems. It can also provide
reassurance about normality.
Birth length is the body To detect short stature and
length of a baby at its birth faltering growth potentially
MCHRB
8 Birth Length due to underlying medical
Card
problems. It can also provide
reassurance about normality
9 Birth Birth registration number Birth Provides information on the
Registration No. given the baby Certificate. / number of births within the
MCHRB specified period in the
Card specified area and helps with

91
 NUTRITION AND CHILD HEALTH REGISTER
N DATA
VARIABLE DEFINITION RATIONALE
o SOURCE
planning
It is important to know such
Indicate the sickling status that appropriate care
10 Sickling Status MCHRB
of the child required can be given to the
child.
Indicate the name of the For easy identification
11 Mother’s Name MCHRB
mother
Indicate the Telephone
number and the residence For follow ups and home
of the client but not the visits
birth place. (This should
include where the house is
Telephone
located, the name of the
9 No. /Traceable Verbal
community and the house
Address
number. This address is
very useful for home visits
so it is important to get the
correct directions from the
client.)
Ask mother how the child To find out how many
is being fed. Indicate EBF children are being fed
if baby is being according to national
exclusively breastfed and recommendations.
Feeding status at Verbal -
10 Other if not. Ask caregiver Helps to assess breastfeeding
3 months caregiver
for this information during programmes.
the 14 weeks visit, which More children should be
coincides with the time for exclusively breastfeeding at
PENTA 3 this time
Ask mother how the child To find out how many
is being fed. Indicate YES children have been
for introduction to introduced to solids/semi-
solids/semi-solid foods or solid foods at the right age.
Feeding status at
Other, if NO. Verbal -
11 6 months
Ask caregiver for this caregiver More children should have
(CF Started-Y/N)
information during the been introduced to
visit for Vitamin A solid/semi-solid foods at this
supplementation at 6 age
months up to 8 months
Ask mother when she Continued Breastfeeding
comes at 1 year whether after the introduction of
Is child child is breastfeeding. complementary foods up to 2
Breastfeeding Indicate Y for yes if Verbal- years or more is
12
(Y/N) mother is still Caregiver recommended for mothers.
breastfeeding the child,
otherwise indicate N for
No
13 Month Weight Weight of child Readings To assess the growth of the

92
 NUTRITION AND CHILD HEALTH REGISTER
N DATA
VARIABLE DEFINITION RATIONALE
o SOURCE
(Kilogram) from child and provide the
weighing necessary support.
scale
A point of intersection of Growth Chart
the weight in kgs and age in the
Z-score in completed months MCHRB
plotted on the growth
1 - 59
chart.
month
Indicate the nutritional
s
status of the child
according to the z-score
with the key
Classify
Indicate:
S – severe (< -3SD),
M-Moderate (≥-3 to <-2
SD) N-Normal (≥- 2 )
Measurement of child’s To assess onset of stunting
linear growth in cm. and provide the necessary
Child Health
Length/ length: children less than 2 intervention. Measures are
and Nutrition
Height years taken every 3 months in the
Register
height: children 2 years first year and every 6 months
and above from the second year to 59
A point of intersection of months.
the length/height in cms
Month Growth Chart
Z-score and age in completed
1 - 59 in MCHRB
14 months plotted on the
month
growth chart.
s
Indicate the nutritional
status of the child
according to the z-score
Child Health
with the key
Classify and Nutrition
Reference:
Register
S – severe (< -3SD),
M-Moderate (≥-3 to <-2
SD) N-Normal (≥- 2 )
15 Check to know mothers This variable track early
HIV status. If she is infant diagnosis for HIV
Child Health
positive, indicate Y (Yes) exposed babies as well as
HIV Exposed and Nutrition
for child exposed; track prophylaxis for them.
Register
otherwise indicate N for
No If children test positive,
16 Ask caregiver or mother initiate care
If YES, Child Health
of HIV exposed baby
Prophylaxis and Nutrition
whether they are currently
given Register
on co-trimoxazole
17 If YES, EID If child is HIV exposed, Child Health
Done? ask mother or caregiver if and Nutrition

93
 NUTRITION AND CHILD HEALTH REGISTER
N DATA
VARIABLE DEFINITION RATIONALE
o SOURCE
samples have been taken
and send for early infant
diagnosis. Indicate Y Register
(Yes) if test has been done
and N (No) if not
18 Indicate P for positive if
results are positive and N Report from
EID test results
for negative if results are Laboratory
negative
19 Perform HIV antibody test
for all HIV exposed
children (enumerated at
Antibody
6weeks) and indicate
evaluation at Test results To inform next line of care
results. All children
18months
should be enumerated
even if initial EID results
at 6 weeks was positive
20 BCG; Polio
0,1,2,3; Penta
1,2,3;
Pneumococcal These are the dates on
1,2,3; Rotavirus which each of these
MCHRB/ Provides information on the
1 and 2; Yellow vaccines is given. Write
Child Health number of children receiving
Fever; Measles- the date on which each of
and Nutrition required vaccinations as per
Rubella 1; these is given. It should be
Register protocol
Vitamin A from recorded as
6 – 59months; DD/MM/YYYY
Measles-Rubella
2; MEN A;
Others

94
 MATERNAL, INFANT AND YOUNG CHILD COUNSELING (IYCF)- REGISTER
FOR HEALTH WORKERS
DATA
No VARIABLE DEFINITION RATIONALE
SOURCE
1 The serial number is the Identify clients and to
sequential numbering of the keep records of the
Serial
rows in the register but can be Generated number of clients on the
Number(S/N)
used to identify clients if written programme.
on the client card.
2 Name of child in full without For identification
titles. Use mothers name if child MCHRB/
Name of Child
has not been given a formal Verbal
name.
3 This is sex of baby, M for Male To know the sex of the
and F for Female child. The nutritional
status of children
MCHRB/ especially under 5 years
Sex (M/F)
Observation (0-59months) is
determined relative to
their sex on the child
growth chart.
4 The date of birth of the To know the date on
baby/babies. which the child was born
in order to get the actual
MCHRB/
Date of Birth age of the child in
Verbal
completed months
especially during CWC
session for plotting.
5 The weight of the baby/babies at To detect overweight and
birth in kilograms underweight and
faltering growth
Birth Weight potentially due to
MCHRB
(Kg) underlying medical
problems. It can also
provide reassurance
about normality.
6 The length of the baby/babies at To detect short stature
birth in Centimetres and faltering growth
potentially due to
Birth Length MCHRB/
underlying medical
(Cm) Record
problems. It can also
provide reassurance
about normality
7 Mothers Indicate the Telephone number To enable tracing or
Telephone/Tracea and the residence of the client follow-ups.
ble but not the birth place. (This
MCHRB
Address (include should include where the house
Landmarks) is located, the name of the
community and the house

95
 DATA
No VARIABLE DEFINITION RATIONALE
SOURCE
RECORD OF INITIAL VISIT
8 Date when baby/mother is first To know when the
seen by health worker and person has started
Date Enrolled Calendar
registered on the IYCF benefiting from the
programme. programme.
9 Indicate on the z-scores the Counselling of the
weight baby/babies during the mother are based on the
initial visit as Either, Normal, weight of the child as
moderately Underweight, Severe well as its z-scores.
Weight underweight, possibly This shows the
MCHRB/
indicate z-score overweight or possibly obese. nutritional status of the
Record
(N, U, S, PO) child (weight-for-age)
severe, moderate,
normal, and
overweight/obese of the
child weighed.
10 Write down the Key challenges To be able to counsel the
Key challenges Verbal/
you identified during the initial mother on the key
identified observation
visit with the care taker/mother. challenges identified.
11 Small doable actions that both For follow-up
the health worker and the care
Agreed upon taker agreed upon to manage the
Verbal/
actions key challenges identified. Write
observation
down all the agreed upon actions
for follow-up.
FOLLOW-UP VISIT 1
12 An appointment date that the To assess the
child is coming back to the effectiveness/impact of
health worker or the health the treatment or actions
Follow-up visits
worker going to see the child on Calendar that both the client and
(date)
the agreed upon actions. Write the worker agreed upon.
down the date agreed for follow-
up on the mother/baby.
13 Weigh and indicates as in the To know the nutritional
first visit status of the child at a
Weight
giving age.
indicate z-score MCHRB
To know whether the
(N, U, S, PO)
child is growing well or
not
14 Key problems identified during To identify
Key challenges Verbal/
the first visit should also be
identified observations
written as the initial visits
15
Agreed upon Agreed upon actions should also
Verbal
actions be documented as in the initial
visit.
FOLLOW-UP VISIT 2
16 Follow-up visits An appointment date that the Calendar

96
 DATA
No VARIABLE DEFINITION RATIONALE
SOURCE
child is coming back to the
health worker or the health
worker going to see the child on
(date)
the agreed upon actions. Write
down the date agreed for follow-
up on the mother/baby.
17 Weight Weigh and indicates as in the
indicate z-score first visit MCHRB
(N, U, S, PO)
18 Key problems identified during
Key challenges Verbal/
the first visit should also be
identified observations
written as the initial visits
19
Agreed upon Agreed upon actions should also
Verbal
actions be documented as in the initial
visit.
FOLLOW-UP VISIT 3
20 An appointment date that the
child is coming back to the
health worker or the health
follow-up visits
worker going to see the child on Calendar
(date)
the agreed upon actions. Write
down the date agreed for follow-
up on the mother/baby.
21 Weight indicate Weigh and indicates as in the
z-score (N, U, S, first visit MCHRB
PO)
22 Key problems identified during
Key challenges the first visit should also be Verbal/
identified written as it was done during the Observation
initial visits
23
Agreed upon Agreed upon actions should also
Verbal
actions be documented as in the initial
visit.
24 Outcome and date Record the status of the child Observation/
of discharge during discharge based on the MCHRB/
weight /z-scores (normal or not) Verbal
& write down the date of
discharge as DD/MM/YYYY

97
COMMUNITY BASED MANAGEMENT OF ACUTE MALNUTRITION (CMAM)
REGISTER

No VARIABLE DEFINATION DATA SOURCE RATIONALE

The serial number

To easily
is the sequential
identify the
numbering of the
number of
rows in the
children
1 Serial Number register but can be Generated
admitted on
used to identify
the
clients if written
programme in
on the client
that facility
treatment card
It’s a unique
number giving to
each child
admitted to the
CMAM
programme in
each treatment
site. It is made up To easily
of the facility code identify the
2 OPC Number and the 3 digits Generated children on
number. E.g. the
PML/002/OPC. programme
PML is the facility
code, 002 is the
number and then
the OPC indicated
that the child is
managed through
outpatient care
The date on which
To be able to
the child is put on
determine to
a programme. This
3 Admission Date Calendar length of stay
date should be
of each client
written on full as
at discharged.
DD/MM/YYYY
Name of child in To easily
full without titles, identification
avoid informal of the child
4 Child’s Name MCHRB
names such as: on the
Sister, Maame, programme
Auntie, etc. by Name.
The age of the To determine
5 Age (Months) child admitted on Birth certificate/MCHRB whether the
the programme child is

98
No VARIABLE DEFINATION DATA SOURCE RATIONALE

qualified per
age under the
should be written
programme or
in completed
not and the
months.
type of care
(IPC/OPC)
Indicates if the
child admitted is
6 Sex (M/F) Verbal/Observation
male (M) and
Female (F)
Indicate the
Telephone number
and the residence
This is to
of the client but
enable easy
not the birth place.
follow-up at
7 Community/Address (This should Verbal/Record
the
include where the
community
house is located,
level
the name of the
community and
the house)
This is to
indicate
where the
This is to indicate
child was
where the child
seen or
was seen or
identified and
identified and
referred to the
referred to the
OPC for
OPC for further
further
management.
Referred by (HW, management.
Indicates if the
Volunteer, Indicates if
child was
8 Traditional Healer, Verbal the child was
identified by
Caregiver, identified by
Volunteer,
Other[specify]) Volunteer,
Traditional Healer,
Traditional
any other place or
Healer, any
person who
other place or
identified the case
person who
and referred it to
identified the
the facility for
case and
treatment.
referred it to
the facility for
treatment
Indicates the This helps to
Admission Criteria
criterion on which know the
9 (MUAC, Oedema + Measurement/assessment
the child is basis of
++, Others)
admitted on to the admission of

99
No VARIABLE DEFINATION DATA SOURCE RATIONALE

programme.
Indicate if the
child is admitted
on MUAC
(<11.5cm),
Oedema (+, ++) or the child.
any other criterion
that might have
been used as the
basis for the
admission.
To know the
level of
wasting on
The Mid Upper admission
Arm and to
Circumference monitor the
(MUAC) of the progress of
child should be the recovery
measured and via the used
MUAC on Indicated during of the
10 Measurement
Admission admission. This therapeutic
should be food. (RUTF)
indicated whether This enables
the child is the health
admitted on the worker to
basis of MUAC or know if the
not. child is
responding to
treatment or
not
This is to
At discharged know the
indicate the basis state at which
Discharge Outcome of the discharged. the child is
(Cured, Defaulted, Indicates whether discharged
11 Assessment/measurement
Died &Non- the child is from the
Recovered) discharged cured, programme.
defaulted, died & These
Non-recovered. variables will
also
The Mid Upper Children are
Arm discharged on
Circumference the
12 MUAC at Discharge (MUAC) of the Measurement programme
child should be through
measured and MUAC
Indicated during (≥12.5cm

100
No VARIABLE DEFINATION DATA SOURCE RATIONALE

continuous).
The MUAC
discharged. This at discharged
should be done & tells whether
indicated for each the child had
and every child met the
during discharged. discharged
criteria cured
or not
Write the
To determine
discharged date of
the length of
the child. This
13 Discharge Date Calendar stay of the
should be written
child at
as
discharged
DD/MM/YYYY
Write any other
comments or
For follow-up
information that
14 Comments Generated and further
will be beneficial
actions
to the client and
the health worker.

101
 GIRLS IRON FOLATE TABLETS SUPPPMENTATION PROGRAMME (OUT-OF-
SCHOOL)
No Variable Definition Data Source Rationale
.
Serial Number The serial number is the Generated To easily identify the
sequential numbering of the number of Adolescents
rows in the register. admitted on the
programme in that
facility
Name Name of the adolescent girl Generated For easy identification
10-19years registered for the of the beneficiary
GIFTS out-of-school
programme. Write the full
name of the adolescents who
is registered for the
programme
Age The age of the adolescent Verbal To determine the
girl at her last birth date. eligibility of the
Write the age in years. beneficiary adolescents
and to know when
adolescents is exiting
from the free IFA
Screened for Indicate if adolescent is Generated To identify adolescents
Anaemia (Y/N) screen for anaemia. Indicate who are severely
Y for adolescent girls who is anaemic such that they
screened and N for can be transferred for
adolescent girls who is not further diagnosis and
screened treatment before they
Results of This the physical screening Generated are put on the
Anaemia done for the presence of programme.
Screening anaemia. Write the screening
results by indicating A for
anaemia and NA not
anaemia
Date IFA given Indicate the day in each Calendar To know when the
month that the adolescents /Generated adolescents is qualified
come for IFA. Write indicate for other doses and to
only the day of the month. know when to do a
(e.g. 4th, 29th, etc) follow-up for default
adolescents
FORMS (FHD)

MONTHLY MIDWIFE’S RETURNS (FORM A)

DATA
No. VARIABLE DEFINITION
SOURCE
Name of Institution/ The name of the Service Delivery Point (SDP) e.g.
1 Records
Maternity Home Aboaso Health Centre etc.
Type of SDP reporting.eg hospital, health centre, clinic,
2 Type of Facility Records
maternity home, CHPS

102
 DATA
No. VARIABLE DEFINITION
SOURCE
The name of the sub-district in which the Service
3 Sub-District Records
Delivery Point is located, e.g. Aboaso.
The name of the district in which SDP is located, e.g.
4 District Records
Kwabre.
The name of the region in which the SDP is located e.g.
5 Region Records
Ashanti.
6 Month The Month in which the transaction took place e.g. July Calendar
7 Year Year in which the transaction took place e.g. 2010 Calendar
EMONC Services
Indicate whether Emergency obstetric care for new
8 (Basic or ANC register
born done in the SDP is Basic or Comprehensive.
Comprehensive)
Blood Transfusion
9 Indicate whether facility does blood transfusion or not ANC register
Services
Prevention of Mother
to Child Indicate whether SDP does PMTCT services or not EID
10 ANC register
Transmission Services
(PMTCT)
11 Conduct Delivery Indicate whether SDP conducts delivery or not ANC register
Baby Friendly Indicate whether SDP renders baby friendly services or
12 ANC register
Services not
ANTENATAL
Number of pregnant women reporting for antenatal care
13 Registrants for the first time to any health facility with their current ANC register
pregnancy.
14 Attendances Total number of all ANC visits for the period ANC register
Number of pregnant women making their 4th antenatal
15 Making 4th Visit ANC register
visit for the period.
Number of pregnant women making their 8th antenatal
16 Making 8th Visit ANC Register
visit for the period.
Pregnant women seen Number of pregnant women reporting for care at 36
17 ANC Register
at 36 weeks weeks’ gestation
Number of pregnant women who have had two doses of
TD for their current pregnancy OR require only one
18 TD2+ dose for their current pregnancy OR have completed ANC Register
their TD schedule and therefore do not require any dose
for their current pregnancy.

103
 DATA
No. VARIABLE DEFINITION
SOURCE
Age of Mother at Age of the pregnant woman as at the time of first ANC
19 ANC register
Registration visit with the current pregnancy
SYPHILIS SCREENING
Total number of pregnant women who were screened
20 No. Screened ANC register
for syphilis
Number of pregnant women with a positive syphilis test
21 No. Positive ANC Register
result
Number of pregnant women with a positive syphilis test
22 No. Treated ANC Register
result treated with benzathine penicillin injection
TB SCREENING
Total number of pregnant women who were tested for
23 No. Tested ANC Register
TB using sputum sample
Number of pregnant women who had positive sputum
24 No. Positive ANC Register
test result
25 No. Treated Number with positive sputum test result treated ANC Register
26 Parity Number of deliveries prior to the current pregnancy ANC register
Duration of Pregnancy at Registration (Trimester)
27 1ST Trimester ANC Registrants reporting within the first 3months ANC Register
ANC Registrants reporting between the 4th and 6th
28 2ND Trimester ANC Register
month of pregnancy
ANC Registrants reporting between the 7th and 9th
29 3RD Trimester ANC Register
month of pregnancy
ANAEMIA AT REGISTRATION & AT 36 WEEKS
Hb Checked at Number of pregnant women whose HB were checked at
30 ANC register
Registration ANC registration
Hb < 11gm/Dl at Number of pregnant women with HB less than 11gm/dl
31 ANC register
Registration at the time of registration
Hb < 7gm/Dl at Number of pregnant women with HB less than 7gm/dl
32 ANC register
Registration at ANC registration
Hb Checked at 36 Number of pregnant women whose HB were checked,
33 ANC register
Weeks at 36 weeks
Hb < 11gm/Dl at 36 Number of pregnant women with HB less than11gm/dl
34 ANC register
Weeks at 36 weeks
Hb <7gm/Dl at 36 Number of pregnant women with HB less than7gm/dl
35 ANC register
Weeks at 36 weeks

104
 DATA
No. VARIABLE DEFINITION
SOURCE
Primigravidae With
Number of pregnant women who are pregnant for the
36 Hb Checked at 36 ANC register
first time who had their HB checked at 36wks
weeks
Primigravidae With Number of pregnant women who are pregnant for the
37 ANC register
Hb< 7gm/dl at 36wks first time with HB less than7gm/dl at 36 weeks
INTERMITTENT PREVENTIVE TREATMENT (IPT)
Number of pregnant women given their first dose of SP
38 IPT1 ANC register
at ANC
Number of pregnant women given their second dose of
39 IPT 2 ANC register
SP at ANC
Number of pregnant women given their third dose of
40 IPT 3 ANC register
SP at ANC
Number of pregnant women given their fourth dose of
41 IPT 4 ANC register
SP at ANC
Number of pregnant women given their fifth dose of SP
42 IPT 5 ANC register
at ANC
Pregnant Women
Number of pregnant women who had adverse reaction ANC register,
43 with Adverse
after taking SP. AERF
Reaction
Number of women who have been given 3 monthly
44 IFA 3 ANC Register
Supplements of IFA.
Number of women who has been given 6 or more
45 IFA 6 ANC Register
monthly Supplements of IFA
46 ITN Given Number of pregnant women who were given ITN. ANC register
PMTCT
Number of known
HIV positive before This refers to all pregnant women who were positive
ANC register
current pregnancy prior to their current pregnancy

Number on ARV
This refers to all pregnant women who were on ART
treatment before ANC register
treatment before their current pregnancy
current pregnancy
Number of known
HIV Positives before This refers to all pregnant women who have been
current pregnancy known to be HIV positive and newly put on treatment ANC register
newly put on during their current pregnancy
treatment

105
 DATA
No. VARIABLE DEFINITION
SOURCE
This refers to all pregnant women having their first HIV
Number initially
test irrespective of gestational age during current ANC register
tested
pregnancy
This refers to all pregnant women testing positive at
Number positive at
their first HIV test irrespective of gestational age during ANC register
initial testing
current pregnancy
Number of negatives This refers to all initially HIV negative pregnant
ANC register
retested at 34 weeks women provided repeated test at 34 weeks of gestation
Number positive after This refers to all initially HIV negative pregnant
ANC register
retesting at 34 weeks women retested HIV positive at 34 weeks of gestation
This refers to pregnant women tested HIV positive at
New HIV Positives initial testing plus those retested HIV positive at 34 ANC register
weeks
This refers to all newly diagnosed HIV positive
Number of new pregnant women (initial positive + retested HIV
ANC register
positives put on ARV positive at 34 weeks) put on ARVs during current
pregnancy
Number of Babies on This refers to all babies born to HIV positive mothers
ANC register
ARV Prophylaxis receiving ARV prophylaxis from birth
This refers to all pregnant women both newly tested
HIV positive at current pregnancy put on ARVs and
Total on ARVs those who were tested HIV positive in their previous ANC register
pregnancy and were put on ARVs and are still on
ARVs before current pregnancy
DELIVERIES
PRIMIGRAVIDAE OUTCOMES
Age of Mother at Age groups of mothers who are pregnant for the first
54 ANC register
Delivery time
Live Birth To
Number of babies delivered by primigravidae by sex
55 Primigravidae (Male ANC register
(male and female)
And Female)
Primigravidae Still
56 Total number of still births by primigravidae ANC register
Birth
Total number of deliveries
57 TOTAL BIRTHS
Delivery Register
LIVE BIRTH
Delivery
58 Male Number of Male babies
Register

106
 DATA
No. VARIABLE DEFINITION
SOURCE
Delivery
59 Female Number of Female babies
Register
Delivery
60 Total Live births Total number of babies born alive
Register
STILL BIRTHS
Total number of babies who died in the process of Delivery
61 Fresh
labour Register
Total number of babies who died in utero more than 12 Delivery
62 Macerated
hours before delivery with signs of maceration Register
Total number of babies who were delivered without Delivery
63 Total Still Births
signs of life Register
BIRTH WEIGHT
Below 2.5kg Number of babies born weighing less than 2.5kg to Delivery
64
Primipara women with first delivery Register
Below 2.5kg Number of babies born weighing less than 2.5kg to Delivery
65
Multipara women previous deliveries Register
Total number of babies weighing less than 2.5kg Delivery
66 Total
(PRIMIPARA + MULTIPARA) Register
Delivery
67 2.5kg & Above Number of babies born weighing 2.5kg and above
Register
TYPE OF DELIVERY
Delivery
68 Normal Number of mothers with spontaneous vaginal deliveries
Register
Number of mothers with deliveries through caesarean Delivery
69 C/Section
section Register
Number of mothers with vaginal deliveries assisted Delivery
70 Vacuum
with vacuum extractor Register
Number of mothers with vaginal deliveries assisted Delivery
71 Forceps
with forceps Register
Mother Infant Baby
Pairs Exclusively Total number of postpartum mothers discharged with
72 PNC Register
Breastfeeding at their babies exclusively breastfeeding as per protocol
Discharge
OUTCOME OF DELIVERY

107
 DATA
No. VARIABLE DEFINITION
SOURCE
Number of Mothers
Total Number of Mothers who gave birth to Single Delivery
73 who gave birth to
babies Register
Single babies
Number of Mothers
Total Number of Mothers who gave birth to Twin Delivery
74 who gave birth to
babies Register
Twin babies
Number of Mothers
Total Number of Mothers who gave birth to Triplet Delivery
75 who gave birth to
babies Register
Triplet babies
Number of Mothers
Total Number of Mothers who gave birth to other sets Delivery
76 who gave birth to
of babies Register
other sets of babies
Total Mothers who Total Number of Mothers who gave birth in a specified Delivery
77
gave birth period Register
Number of Single
Delivery
78 babies born to Total Number of Single babies born to Mothers
Register
Mothers
Number of Twin
Delivery
79 babies born to Total Number of Twin babies born to Mothers
Register
Mothers
Number of Triplet
Delivery
80 babies born to Total Number of Triplet babies born to Mothers
Register
Mothers
Number of other set
Delivery
81 of babies born to Total Number of other set of babies born to Mothers
Register
Mothers
Total No. of babies Delivery
82 Total No. of babies born
born Register
Number Eligible
Total number of pregnant women with preterm labour Maternity
Mothers Receiving
83 at between 28-34 weeks who received corticosteroids Ward/Delivery
Corticosteroids at 28-
for foetal lung maturation as per protocol Register
34wks
Number of Babies
receiving
Number of Babies receiving Delivery
84 Chloramphenicol/Tet
Chloramphenicol/Tetracycline Eye drops at Birth Register
racycline Eye drops
at Birth
Number of Babies
Number of Babies receiving cord care with Delivery
85 receiving cord care
Chlorhexidine Register
with Chlorhexidine

108
 DATA
No. VARIABLE DEFINITION
SOURCE
Number of Babies
receiving cord care Number of Babies receiving cord care with Methylated Delivery
86
with Methylated Spirit Register
Spirit
MORTALITIES
Ward Registers
(Maternity,
Number of deaths due to pregnancy and child birth Female and
Maternal Deaths by
87 related issues by age groups 10-14yrs, 15-19yrs, 20- Emergency
Age Groups
24yrs, 25-29yrs, 30-34yrs,>=35yrs) Ward
Registers)/MCC
D
Female/
Maternity
Total Maternal Total number of pregnancy and child birth- related
88 Ward/Delivery/
Deaths deaths
Theatre/OPD
Register
Death Audit
Maternal Deaths
89 Maternal deaths that are audited and reported. Register/Log
Audited
Book
Ward Registers
(Maternity,
Neonatal
Intensive Care
90 Neonatal Deaths Babies dying before 28 days of life Unit, Children
and Emergency
Ward
Registers)/MCC
D
Ward Registers
(Maternity,
Neonatal
Intensive Care
91 Post-Neonatal Deaths Babies dying between 28 days and 1 year of life Unit, Children
and Emergency
Ward
Registers)/MCC
D
MORBIDITIES

109
 DATA
No. VARIABLE DEFINITION
SOURCE
PNC Register/
Vesico-Vaginal Theatre/Female
92 Fistula (VVF) Number of VVF cases seen Ward/Gynae
number seen Ward A & D
Log Book
Theatre/Gynae
VVF Number
93 Number of VVF cases repaired Ward/Female
Repaired
Ward Log Book
VVF Number LWR / CR
94 Number of VVF cases referred
Referred Register
PNC
95 Drop Foot Cases Number of DROP FOOT CASES seen Register/OPD
Log Book
Consulting,
ANC, female
96 Puerperal Psychosis Number of cases of puerperal psychosis ward register,
Delivery
Register
Maternity
97 Endometritis Infection of the Uterus Ward/Female
Ward Log Book
Maternity
98 Mastitis Infection of the Breast Ward/Female
Ward Log Book
BABY FRIENDLY HOSPITAL INITIATIVE
Number of Mother- PNC
99 Infant Pairs Number of mother/infant pairs discharged after delivery Register/Matern
Discharged ity Ward
Number of Mother-
Infant Pairs PNC
Number of mother/infant pairs exclusively
100 Exclusively Register/Matern
breastfeeding at discharge
Breastfeeding at ity Ward
Discharge
Breastfeeding within Number of mothers initiating breastfeeding within first Delivery/PNC
101
first 1 hour 1 hour after delivery Register
Number of active mother support groups to which
Number of Active
lactating mothers are referred to for support in the care
102 Mother Support Records
of their babies after discharge from the health facility
Groups
within the catchment area of the facility.
POSTNATAL

110
 DATA
No. VARIABLE DEFINITION
SOURCE
103 Registrants Mothers accessing PNC for the first time after delivery PNC Register
No. Receiving 1st Mothers visiting clinic in the first or second day after
104 PNC Register
PNC on Day 1 Or 2 delivery for their first PNC
Number receiving 1st All client attending 1st PNC between days 3-7 after
105 PNC Register
PNC on day 3-7 delivery.
No. Receiving 1st
Mothers visiting clinic from DAY 8 after delivery for
106 PNC from Day 8 And PNC Register
their first PNC
Above
Age Group (Years) of The age-bracket into which a woman attending PNC
107 PNC Register
PNC Registrants falls.
108 Site of Delivery A place where the woman delivered. PNC Register
Family
Number of post-natal mothers accepting and using a
109 Post-Partum FP planning, PNC
modern family planning method
register,
Number with IFA Number of women given IFA for six weeks following
110 PNC Register
given delivery
Baby’s Weight Number of babies weighed within 6-10day grouped into
111 PNC Register
(Within 6-10 Days) below and above 2.5kg
REFERRALS (IN/OUT)
Number of pregnant women referred either into the Admission and
112 ANTENATAL facility or out of the facility for further management discharge
during ANC register
Admission and
Number of women in labour referred either into the
113 LABOUR discharge
facility or out of the facility for further management
register
Admission and
Number of postnatal mothers referred either into the
114 POSTNATAL discharge
facility or out of the facility for further management
register
BIRTH
115 Number and type of birth abnormalities seen Labour ward
ABNORMALITIES
ABORTIONS
Number of elective abortions done or recorded in the FP /theatre
116 Elective
SDP for the period register
Gynaecology or
117 Spontaneous Number of spontaneous abortions recorded female ward
register

111
 DATA
No. VARIABLE DEFINITION
SOURCE
Gynaecology or
118 Induced Number of pregnancies terminated by self. female ward
register
Electronic/ Manual
FP/theatre
119 Vacuum Aspirations Number of manual vacuum aspiration procedures done
register
Done
theatre
120 D&CS DONE Number of dilatation and curettage procedures done register/CAC
Log book
MEDICAL Number of abortions done using medical methods
121 CAC Log book
ABORTION according to the protocol.
Theatre
Age Group
122 Age of women having abortions in completed years register /CAC
Performing Abortion
Log book
Number of
123 Number of post abortion bleeding cases reported CAC Log book
Haemorrhage
124 Number of Sepsis number of post abortion sepsis/infection cases reported CAC Log book
Number Of
125 Number of post abortion perforations cases reported CAC Log book
Perforations
Deaths from Post Number of deaths resulting from post abortion CAC Log
126 Abortion complication(s) book/Gynae
Complications Register
POST ABORTION FAMILY PLANNING
Number of persons counselled on family planning
127 Counselled FP register
following abortion care
128 Accepting Number accepting family planning following abortion FP register
Number of women being accompanied by their male Various
129 Male Involvement
partners at ANC, DELIVERY, PNC, FP, CWC Registers
Completed by
130 Signature Signature of person who completed the form Facility Head
131 Name Name of person who completed the form Facility Head
132 Authorized by
133 Name
134 Signature Name and rank of officer receiving at next level Facility Head

112
 FAMILY PLANNING RETURNS (FORM B)
No. VARIABLE DEFINITION DATA SOURCE
The name of the Service Delivery Point (SDP) e.g.
1 Facility FP Register
Aboaso Health Centre etc.
The name of the sub-district in which the Service
2 Sub-District FP Register
Delivery Point is located, e.g. Aboaso
The name of the district in which SDP is located, e.g.
3 District FP Register
Kwabre.
The name of the region in which the SDP is located
4 Region FP Register
e.g. Ashanti.
The Month in which the transaction took place e.g.
5 Month FP Register
July
6 Year Year in which the transaction took place e.g. 2010
The number of persons who are accepting modern
Total New
7 form of contraception for the first time in their lives FP Register
Acceptors
(registrants). Split by the age range on the form
The total count of usable commodities available in
Beginning Inventory control
8 stock or on hand at a particular point in time or at the
Balance card
beginning of a reporting period.
Quantity of FP commodities that was taken delivery
Inventory control
9 Received of in the course of the period from the supply point
card
(Regional Medical Stores/Implementing partners
The total count of commodities that are given to
Inventory control
10 Issued /Dispensed clients for the purpose of family planning from the
card
stock in store at the facility.
It is the count of commodity moved out from your
stock to another facility or private practitioner or
Transferred Inventory control
11 implementing partner. This is mostly termed as a
card
negative adjustment, which means that stock must be
deducted from your stock on hand
The total count of commodities that were lost due to
Loss / Expired Inventory control
12 expiry dates, breakages or damages, or stolen or used
/Demonstration card
for demonstration purposes.
It is the total count of usable commodities that is left
Ending Inventory control
13 in store at the end of the reporting period calculated
Balance card
using columns [(1+2c) -(3c+4+5)]
STOCK REQUIRED
The quantity of commodity required for a given
period. It is calculated by multiplying the quantity
Number of Months
14 Issued/Dispensed[col3] by the number of months for Work Sheet
Required
which the commodity is required depending on the
level of the facility

113
No. VARIABLE DEFINITION DATA SOURCE
The quantity of commodity required for 3 months.
Quantity
Calculated by subtracting column 6 from column 7.
15 Required Work Sheet
This is because the quantity required is needed to top
up the ending balance to make it last for 3 months
The unit cost of each commodity used for service
16 Unit Price FHD
delivery. This information is supplied by FHD
The total amount of Cedis collected by multiplying
17 Cedis Collected Records
the quantity issued/dispensed by the Unit Price.
The amount of Cedis retained of the total amount of
Cedis collected by level of service delivery point:
18 Cedis Retained The SDHMT is to retain 50% of what is collected Records
The DHMT is to retain 10% of what is collected
The RHMT is to retain 10% of what is collected
Each level is to submit a specified percentage of
Cedis collected to the next level:
The SDHMT is to submit 50% of total amount of
Cedis collected to the DHMT (after retaining 50% at
the SDHMT)
19 The DHMT is to submit 40% of total amount of Records
Cedis collected to the RHMT (after retaining 10% at
Cedis Submitted the DHMT)
The RHMT is to submit 30% of total amount of
Cedis collected to central account (after retaining
10% at the RHMT)
The Total number of persons who have accepted to
use a family planning method. This number includes
the

New Acceptor: (First Ever Use): -Any female of

reproductive age who accepts any modern family
planning commodity for the first time in her life.
This has been split according to the age groupings
(10-14, 15-19, 20-24, 25-29, 30-34 and 35 & Above)
.
Continuing Acceptor: -Any female of reproductive
age who is using modern family planning commodity
20 and in a new year continues to use the modern family FP Register
planning method or decides to use/switch/swap to
Acceptors any other commodity of modern family planning
during her first visit in the new year.
This has been split according to the age groupings
(10-14, 15-19, 20-24, 25-29, 30-34 and 35 & Above)

Total Acceptors: Total count of female of

reproductive age who are using modern family
planning method per a specified period. Total
Acceptors = New Acceptors + Continuing Acceptors

114
No. VARIABLE DEFINITION DATA SOURCE
The trade name of a commodity, e.g. Copper-T,
21 Brand Name Records
Protector Condom etc.
The Scientific name of a commodity, e.g. Depo
Generic Name
Medroxy Progesterone Acetate (DMPA)
It is the count of clients who are using a family
planning method and comes for a re-supply or
subsequent dose (in short term) or comes for removal
or changes to a method in the course of the period
22 Total Visits under review (within a particular year). This has Tally Sheet
been split according to the age groupings (10-14, 15-
19, 20-24, 25-29, 30-34 and 35 & Above)

The estimated protection provided by family

Couple Year planning services during a one-year period, based on
23 Records
Protection the volume of all contraceptives sold or distributed
free of charge to clients during that period
Any individual and /couple who come to a family
planning clinic solely for information and education
without taken any method irrespective of whether he
Total Number or she is an acceptor. This has been split according to FP Daily log
24
Counselled Only the age groupings (10-14, 15-19, 20-24, 25-29, 30-34
and 35 & Above)

Mention whether the client has never married, co-

25 Marital Status FP Client Register
habiting, divorced or widowed
26 Age Age of FP client in Years FP Client Register

115
 ADOLESCENT HEALTH CORNER MONTHLY FORM

No. VARIABLE DEFINITION DATA SOURCE

Region The name of the region in which the SDP is ADH Register
1
located e.g. Ashanti.
District The name of the district in which SDP is located, ADH Register
2
e.g. Kwabre.
Sub-District The name of the sub-district in which the Service ADH Register
3
Delivery Point is located, e.g. Aboaso
Facility The name of the Service Delivery Point (SDP) ADH Register
4
e.g. Aboaso Health Centre , etc.
Month The Month in which the transaction took place Calendar
5
e.g. July
Year in which the transaction took place e.g.
6 Year Calendar
2016
New Attendants These are adolescents who visited the facility for ADH Register
7
the first time
10 – 14 years It is the total count of adolescents between 10 - ADH Register
8 14 years who visited the facility for the first
time
15 – 19 years It is the total count of adolescents between 15 - ADH Register
9 19 years who visited the facility for the first
time
20-24- years It is the total count of young persons between 20- ADH Register
10
24 years who visited the facility for the first time
Old Attendan ts These includes d adolescent ADH Register
11 making subsequent visits to the facility. That is
for old adolescent clients only.
10 – 14 years It is the total count of adolescents between 10 - ADH Register
12 14 years who are making a subsequent visit
to the facility
15 – 19 years It is the total count of adolescents between 15 - ADH Register
13 19 years who are making a subsequent visit
to the facility
20-24 years It is the total count of young persons between 20- ADHD Register
14 24 years who are making a subsequent visit
to the facility
15 Highest It is the total count of adolescents who has ADH Register
Educational Level (Primary,
attained aJHS,
specified
SHS,educational
Tertiary) level according

116
 to their age and sex who visited the facility
within the given period

16 Graduates(Primary,itJHS,
is the
SHS,
totalTertiary)
count of the adolescent who is currently not in school but has complete

Dropouts
17 it is the total count of adolescents who has dropped out of school or has never been

Marital Status It is the total count of adolescents who fall under

married or unmarried according to their age and
18 ADH Register
sex who visited the facility within the given
period
Occupation
It is the total count of adolescents who fall under
(Student,
the various occupational status according to their
19 Employed, ADH Register
age and sex who visited the facility within the
Unemployed,
given period
Apprentice)

20 Religion( Christian,itMuslim, traditionalist,

is the total Other ) who associate with
count of adolescents ADH Register
either being a Christian, Musl

REASONS FOR VISIT

ADOLESCENT DEVELOPMENT PROBLEMS
21 Delayed Puberty
22 Precocious Puberty
Counselling for It is the total count of Female adolescents who
23 developmental reported to the facility with any of the listed
problem ADHD Register
reasons according to their age within the given
period
Referred for
24 developmental
problem

SEXUAL AND REPRODUCTIVE HEALTH SERVICES

Counselled on It is the total count of female adolescents who ADH Register
received counselling on family planning options
25 family planning
options within the given period

26 Referred for family It is the total count of female adolescents who

were referred for family planning services within
planning services
a given period

117
 It is the total count of female adolescents who
Option counselling were given option counselling after testing
after testing positive for pregnancy.
27
positive for
pregnancy

Enrolled on Safety
28 Net Program after It is the total count of pregnant adolescents who
option counselling has been enrolled on the safety net program

Referred for CAC It is the total count of pregnant adolescents who

29 services after have opted for CAC services after option
option counselling counselling.

It is the total count of pregnant adolescents who

30 STI services has received counselling and were managed for
STIs
Emergency It is the total number of adolescents who received
31 contraception
emergency contraception

SCREENING AND TESTING SERVICES

Pregnancy Testing It is the total count of Female adolescents who ADHD Register
32 tested positive for pregnancy according to
their age within the given period
HIV Testing It is the total count of adolescents who tested HTC Forms
33 positive for HIV according to their age and
sex within the given period (Link to HCT field)

ALHIVs HTC Form

34 psychosocial ADH Register
support
It is the total count of adolescents who are on
35 ARV Therapy ARV therapy according to their age and sex ADH Register
within the given period
Referred for ARV ADH Register
36 therapy

ALHIVs referred ADH Register

37 for specialized care

OTHER SRH SERVICES

Testicular
38 examination

118
39 Breast examination

Sexual-Based
Violence
40 management
It is the total count of adolescents who had
(SBV)
examined and or received services by a service ADHD Register
provider according to their age within the given
Counselled as part period
41 of SBV
management

Referred to
42 DoVVSU as part
of SBV

Referred for
43 specialist services
as part of SBV

NUTRITION SERVICES
Screened for It is the total count of adolescents who have been ADH Register
44 Anaemia screened for anaemia according to their age and
sex within the given period
Signs of Pallor It is the total count of adolescent who have been ADH Register
45 assessed on the signs of pallor according to their
age and sex within the given period
BMI at Age It is the total count of adolescents who fall under ADH Register
Underweight-- the different BMI ranges according to their age
<18.50 and sex who visited the facility within the given
Normal-- 18.50 to period
21 46
24.99
Pre-obese--25.00
to 29.99
Obese – 30.00
Hb Level (Low It is the total count of adolescents who fall under ADH Register
and Normal) the Hb level according to their age and sex who
47 visited the facility within the given period

IFA It is the total count of adolescents who had School Health

supplementation received IFA supplementation by a serviceRegister
48
provider according to their age within the given ADH Register
period
49 Nutrition It is the total count of adolescents who hadSchool Health

119
 counselling received by a service provider according to theirRegister
age within the given period ADH Register
Referred to It is the total count of adolescents referred to a School Health
50 clinician/dietician clinician/dietician according to their age within Register
the given period ADH Register
MATERNAL HEALTH SERVICES/SAFETY NET PROGRAM
Girls registered on It is the total count of adolescents pregnant girls Safety Net
50 safety net program registered on the safety net program according to Register
for tracking their age within the given period
Visited 1 to 3 timesIt is the count of adolescent’s pregnant girls whoSafety Net
51 (Home Visit) have been visited 1 to 3 times by a service Register
provider within the given period.
Visited 4 to 5 timesIt is the total count of adolescent pregnant girlsSafety Net
52 (Home Visit who have been visited 4 to 5 times by a service Register
provider within the given period.
Visited 6 times It is the total count of adolescent pregnant girlsSafety Net
53 (Home Visit who have been visited 6 times by a service Register
provider within the given period.
Support group It is the total count of adolescent pregnant girlsSafety Net
54 meeting who has attended a number support group Register
meeting within the given period.
Counselling on It is the total count of adolescent girls who has Safety Net
55 Postpartum FP received counselling on postpartum family Register
planning within the given period
Education on MCHIt is the total count of adolescent girls who has Safety Net
56 services received education on MCH services within the Register
given period
Person/Adequate It is the total count of adolescent girls who has a Safety Net
57 support system person/adequate support system available withinRegister
the given period
Develop Birth It is the total count of adolescent girls who has a Safety Net
58 Preparedness plan birth preparedness plan developed within theRegister
given period
After Pregnancy It is the total count of adolescent girls who has an
59
Plan after pregnancy plan either to return back to
school, learn a trade or vocation or undecided
60 Return to School within the given period Safety Net
Learn a Trade or Register
61
Vocation
62 Still Undecided
63 Referred to It is the total count of adolescent girls who hasSafety Net

120
 specialist Obstetric been referred to specialist obstetric servicesRegister
services according to their age and sex within the given
period
Referred to It is the total count of adolescent girls who has Safety Net
64 DoVVSU been referred to DoVVSU according to their ageRegister
and sex within the given period
Linked to GES It is the total count of adolescent girls who has Safety Net
Girls Officer been linked to GES girls education officer Register
65
according to their age and sex within the given
period
Referred to DSW It is the total count of adolescent girls who has Safety Net
66 been referred to DSW according to their age and Register
sex within the given period
PREVENTION OF NON COMMUNICABLE DISEASES
Counselled on
healthy lifestyle ADH Register
67
and physical
activity
Risk factor It is the total count of adolescent assessed or
68 screening/medical received services by a service provider with any
screening of the listed according to their age within the
Education on given period
69
Cervical Cancer
70 HPV Vaccination
Referred as part of
71
NCD services
MENTAL HEALTH SERVICES
Counselled after
72
BMSE
Educated on
73 coping strategies
and life skills ADH Register
Referred to the It is the total count of adolescent assessed or
74 received services by a service provider with any
psychiatrist
of the listed according to their age within the
75 Eating Disorders given period
Drug and
76
substance abuse
77 Alcohol abuse
78 Self-harm/suicide

121
 MONTHLY NUTRITION AND CHILD HEALTH FORM

No VARIABLE DEFINITION DATA SOURCE

GROWTH MONITORING AND PROMOTION
REGISTRANTS (first ever visit to the site on the day of registration)
1. 0-11months It is the total count of Male children between 0 - 11 Child Health and
(Male) months weighed at their first ever visit to the CWC site. Nutrition
Register
2. 12-23 months It is the total count of Male children between 12 - 23 Child Health and
(Male) months weighed at their first ever visit to the CWC site Nutrition
Register
3. 24-59 months It is the total count of Male children between 24 - 59 Child Health and
(Male) months weighed at their first ever visit to the CWC site Nutrition
Register
4. Total (Column, It is the total count of all male children 0 - 59 months Child Health and
Male) weighed at the CWC site during their first ever visit Nutrition
Register
5. 0-11 months It is the total count of Female children between 0 - 11 Child Health and
(Female) months or below one (1) year weighed at their first ever Nutrition
visit to the CWC site Register
6. 12-23 months It is the total count of female children between 12 - 23 Child Health and
(Female) months weighed at their first ever visit to the CWC site Nutrition
Register
7. 24-59 months It is the total count of female children between 24 - 59 Child Health and
(Female) months weighed at their first ever visit to the CWC site Nutrition
Register
8. Total (Column, It is the total count of all Female children 0 - 59 months Child Health and
Female) weighed at the CWC site during their first ever visit Nutrition
Register
9. Total children It is the total count of all children 0 - 11 months both male Child Health and
weighed (Row, and female weighed at the CWC site during their first ever Nutrition
Male and female) visit. Register
0-11 months
10. Total children It is the total count of all children 12 - 23 months both Child Health and
weighed (Row, male and female weighed at the CWC site during their Nutrition
Male and female) first ever visit Register
12-23 months
11. Total children It is the total count of all children 24 - 59 months both Child Health and
weighed (Row, male and female weighed at the CWC site during their Nutrition
Male and female) first ever visit. Register
24-59 months

122
No VARIABLE DEFINITION DATA SOURCE
WEIGHT FOR AGE
< -3SD SEVERE UNDERWEIGHT (below -3 standard
(Registrants) deviation)
12. Total (Row, It is the total count of all children 0 - 11 months weighed Child Health and
Male & Female) at the CWC site during their first ever visit and had their Nutrition
0-11 months weights falling below -3SD Register
13. Total (Row, It is the total count of all children 11 - 23 months weighed Child Health and
Male & Female) at the CWC site during their first ever visit and had their Nutrition
12-23 months weights falling below -3SD Register
14. Total (Row, It is the total count of all children 24 - 59 months weighed Child Health and
Male & Female) at the CWC site during their first ever visit and had their Nutrition
24-59 months weights falling below -3SD Register
15. Total (Column) It is the total count of all children 0 - 59 months weighed Child Health and
0-59 months at the CWC site during their first ever visit and had their Nutrition
weights falling below -3SD Register
MODERATE UNDERWEIGHT (equal to or greater
≥-3 to <-2 SD
than -3 & less than -2 standard deviations)
16. Total (Row, It is the total count of all children 0 - 11 months weighed Child Health and
Male & Female) at the CWC site during their first ever visit and had their Nutrition
0-11 months weights equal to or greater than -3SD but less than -2SD Register
17. Total (Row, It is the total count of all children 12 - 23 months weighed Child Health and
Male & Female) at the CWC site during their first ever visit and had their Nutrition
12-23 months weights equal to or greater than -3SD but less than -2SD Register
18. Total (Row, It is the total count of all children 24 - 59 months weighed Child Health and
Male & Female) at the CWC site during their first ever visit and had their Nutrition
24-59 months weights equal to or greater than -3SD but less than -2SD Register
19. 2 Total (Column) It is the total count of all children 0 - 59 months weighed Child Health and
0-59 months at the CWC site during their first ever visit and had their Nutrition
weights falling ≥3SD but >-2SD Register
≥-2 NORMAL WEIGHT (equal to or greater than -2
standard deviations)
20. Total (Row, It is the total count of all children 0 - 11 months weighed Child Health and
Male & Female) at the CWC site during their first ever visit and had their Nutrition
0-11 months weights equal to or greater than -2SD Register
21. Total (Row, It is the total count of all children 12 - 23 months weighed Child Health and
Male & Female) at the CWC site during their first ever visit and had their Nutrition
12-23 months weights equal to or greater than -2SD Register
22. Total (Row, It is the total count of all children 24 - 59 months weighed Child Health and
Male & Female) at the CWC site during their first ever visit and had their Nutrition
24-59 months weights equal to or greater than -2SD Register

123
No VARIABLE DEFINITION DATA SOURCE
ATTENDANCE (includes the first-time registrants and those making subsequent visits to the
weighing centre to be weighed) i.e., new and old clients attending for the day
23. 0-11 months It is the total count of Male children between 0 - 11 Child Health and
(Male) months or below one (1) year weighed at the CWC site Nutrition
Register
24. 12-23 months It is the total count of Male children between 12 - 23 Child Health and
(Male) months weighed at the CWC site Nutrition
Register
25. 24-59 months It is the total count of Male children between 24 - 59 Child Health and
(Male) months or below five (5) years weighed at the CWC site Nutrition
Register
26. Total (Column, It is the total count of all male children 0 - 59 months Child Health and
Male) weighed at the CWC site Nutrition
Register
27. 0-11 months It is the total count of Female children between 0 - 11 Child Health and
(Female) months or below one (1) year weighed at the CWC site Nutrition
Register
28. 12-23 months It is the total count of Female children between 12 - 23 Child Health and
(Female) months weighed at the CWC site Nutrition
Register
29. 24-59 months It is the total count of Female children between 24 - 59 Child Health and
(Female) months weighed at the CWC site Nutrition
Register
30. Total (Column, It is the total count of all Female children 0 - 59 months Child Health and
Female) weighed at the CWC site Nutrition
Register
31. Total children It is the total count of all children 0 - 11 months both male Child Health and
weighed (Row, and female weighed at the CWC site Nutrition
Male and female) Register
0-11 months
32. Total children It is the total count of all children 12 - 23 months both Child Health and
weighed (Row, male and female weighed at the CWC site Nutrition
Male and female) Register
12-23 months
33. Total children It is the total count of all children 24 - 59 months both Child Health and
weighed (Row, male and female weighed at the CWC site Nutrition
Male and female) Register
24-59 months
WEIGHT FOR AGE

124
No VARIABLE DEFINITION DATA SOURCE
< -3SD SEVERE UNDERWEIGHT (below -3 standard
(Attendants) deviation)
34. Total (Row, It is the total count of all children 0 - 11 months weighed Child Health and
Male & Female) at the CWC site and had their weights falling below -3SD Nutrition
0-11 months Register
35. Total (Row, It is the total count of all children 12 - 23 months weighed Child Health and
Male & Female) at the CWC site and had their weights falling below -3SD Nutrition
12-23 months Register
36. Total (Row, It is the total count of all children 24 - 59 months weighed Child Health and
Male & Female) at the CWC site and had their weights falling below -3SD Nutrition
24-59 months Register
37. ≥-3 to <-2 SD MODERATE UNDERWEIGHT (equal to or greater than
-3 & less than -2 standard deviations)
38. Total (Row, It is the total count of all children 0 - 11 months weighed Child Health and
Male & Female) at the CWC site and had their weights equal to or greater Nutrition
0-11 months than -3SD but less than -2SD Register
39. Total (Row, It is the total count of all children 12 - 23 months weighed Child Health and
Male & Female) at the CWC site and had their weights equal to or greater Nutrition
12-23 months than -3SD but less than -2SD Register
40. Total (Row, It is the total count of all children 24 - 59 months weighed Child Health and
Male & Female) at the CWC site and had their weights equal to or greater Nutrition
24-59 months than -3SD but less than -2SD Register
NORMAL WEIGHT (equal to or greater than -2SD standard deviations)
41. Total (Row, It is the total count of all children 0 - 11 months weighed Child Health and
Male & Female) at the CWC site and had their weights equal to or greater Nutrition
0-11 months than -2SD Register
42. Total (Row, It is the total count of all children 12 - 23 months weighed Child Health and
Male & Female) at the CWC site and had their weights equal to or greater Nutrition
12-23 months than -2SD Register
43. Total (Row, It is the total count of all children 24 - 59 months weighed Child Health and
Male & Female) at the CWC site and had their weights equal to or greater Nutrition
24-59 months than -2SD Register
LENGTH MEASUREMENT
44. 0-11 months It is the total count of Male children between 0 - 11 Child Health and
(Male) months or below one (1) year whose length is measured at Nutrition
the CWC or outreach point Register
45. 12-23 months It is the total count of Male children between 12-23 Child Health and
(Male) months or below one (1) year whose length is measured at Nutrition
the CWC or outreach point Register

125
No VARIABLE DEFINITION DATA SOURCE
46. 24-59 months It is the total count of Male children between 24-59 Child Health and
(Male) months or below one (1) year whose height is measured at Nutrition
the CWC or outreach point Register
47. Total (Column, It is the total count of Male children between 0 - 59 Child Health and
Male) months or below one (1) year whose length/height is Nutrition
measured at the CWC or outreach point Register
48. 0-11 months It is the total count of female children between 0 - 11 Child Health and
(Female) months or below one (1) year whose length is measured at Nutrition
the CWC or outreach point Register
49. 12-23 months It is the total count of female children between 12-23 Child Health and
(Female) months whose length is measured at the CWC or outreach Nutrition
point Register
50. 24-59 months It is the total count of female children between 24-59 Child Health and
(Female) months whose height is measured at the CWC or outreach Nutrition
point Register
51. Total (Column, It is the total count of female children between 0-59 Child Health and
Female) months whose length is measured at the CWC or outreach Nutrition
point Register
52. Total children It is the total count of children between 0 - 11 months or Child Health and
weighed (Row, below one (1) year whose length is measured at the CWC Nutrition
Male and female) or outreach point Register
0-11 months
53. Total children It is the total count of children between 12-23 months’ Child Health and
weighed (Row, year whose length is measured at the CWC or outreach Nutrition
Male and female) point Register
12-23 months
54. Total children It is the total count of children between 24-59 months Child Health and
weighed (Row, whose length is measured at the CWC or outreach point Nutrition
Male and female) Register
24-59 months
LENGTH FOR AGE (STUNTING)
SEVERE STUNTING (below -3 standard deviation)
55. Total (Row, It is the total count of all children 0 - 11 months whose Child Health and
Male & Female) length fell below -3SD when plotted Nutrition
0-11 months Register
56. Total (Row, It is the total count of all children 12-23 months whose Child Health and
Male & Female) length fell below -3SD when plotted Nutrition
12-23 months Register

126
No VARIABLE DEFINITION DATA SOURCE
57. Total (Row, It is the total count of all children 24-59 months whose Child Health and
Male & Female) length fell below -3SD when plotted Nutrition
24-59 months Register
MODERATE STUNTING (equal to or greater than -3 & less than -2 standard deviations)
58. Total (Row, It is the total count of all children 0 - 11 months whose Child Health and
Male & Female) length falls on the -3SD line or is greater than -3SD but Nutrition
0-11 months less than -2SD when plotted Register
59. Total (Row, It is the total count of all children 12-23 months whose Child Health and
Male & Female) length falls on the -3SD line or is greater than -3SD but Nutrition
12-23 months less than -2SD when plotted Register
60. Total (Row, It is the total count of all children 24-59 months whose Child Health and
Male & Female) length falls on the -3SD line or is greater than -3SD but Nutrition
24-59 months less than -2SD when plotted Register
NORMAL LENGTH/HEIGHT (equal to or greater than -2SD)
61. Total (Row, It is the total count of all children 0 - 11 months weighed Child Health and
Male & Female) at the CWC site and had their weights equal to or greater Nutrition
0-11 months than -2SD Register
62. Total (Row, It is the total count of all children 12 - 23 months weighed Child Health and
Male & Female) at the CWC site and had their weights equal to or greater Nutrition
12-23 months than -2SD Register
63. Total (Row, It is the total count of all children 24 - 59 months weighed Child Health and
Male & Female) at the CWC site and had their weights equal to or greater Nutrition
24-59 months than -2SD Register
FEEDING STATUS OF CHILD AT 3 MONTH
64. Exclusive Total count of children (male and female) who are Child Health and
Breastfeeding receiving only breastmilk at the time of visit Nutrition
Register
65. Total count of children (male and female) who are
Other receiving other solids or fluids in addition to breast milk at
the time of their visit to CWC to at age 3 months which Child Health and
coincide with PENTA 3 or at 14 weeks visits. Nutrition
Register
FEEDING STATUS OF CHILD AT MONTH 6 (Ask during Vitamin A Supplementation visit)
66. Exclusive Total count of children (male and female) who are
breastfeeding breastfeeding only at the time of their visit to CWC for Child Health and
Vitamin A Supplementation Nutrition
Register

127
No VARIABLE DEFINITION DATA SOURCE
67. Introduced to Total count of children (male and female) who are
Solids and other receiving other liquids and solids in addition to
foods in addition breastfeeding at the time of their visit for Vitamin A
to breastfeeding supplementation. This question can be asked among
infants from 6-8 months. This variable is to be collected
during the 6-months Vitamin A supplementation visit.
Continued Total number of children who are still breastfeeding at 1 Child Health and
breastfeeding at 1years or more Nutrition
yr. Register
NUTRITION REHABILITATION (CMAM)
Outpatient Care (OPC)
68. Total No. of Total count of all SAM cases of children 6-59 months who CMAM
cases at start of met admission criteria at the end of the previous month Register/CMAM
Month Reporting Form
69. Total No. of Total count of all severe acute malnourished children CMAM
Cases (New (either by MUAC or oedema or other) admitted onto the Register/CMAM
Admissions) CMAM programme at the Outpatient care site during the Reporting Form
month of reporting
70. No. Cured It is total count of all severe acute malnourished cases CMAM
admitted onto the programme at the OPC for treatment Register/CMAM
and discharged cured Reporting Form
71. No. Died It is total count of all severe acute malnourished cases CMAM
admitted onto the programme at the OPC for treatment Register/CMAM
and discharged dead Reporting Form
72. No. defaulted It is total count of all severe acute malnourished cases CMAM
admitted onto the programme at the OPC for treatment but Register/CMAM
were absent on three continuous visits and therefore were Reporting Form
discharged defaulted
73. No. Non- It is total count of all severe acute malnourished cases CMAM
recovered admitted onto the programme at the OPC for treatment Register/CMAM
and discharged non-recovered or not responding to Reporting Form
treatment after 4 months (16 continuous weeks) in
treatment (medical investigation previously done)
74. Total Discharged It is total count of all severe acute malnourished cases CMAM
admitted onto the programme at the OPC for treatment Register/CMAM
and discharged died, defaulted, cured and non-recovered. Reporting Form
Inpatient Care (IPC)
75. Total No. of Total count of all SAM cases of children 0-59 months who CMAM
cases at start of met admission criteria including those who relapsed after Register/CMAM
Month cure at the end of the previous month Reporting Form

128
No VARIABLE DEFINITION DATA SOURCE
76. Total No. of Total count of all severe acute malnourished children CMAM
Cases (New (either by MUAC or oedema or other) admitted onto the Register/CMAM
Admissions) CMAM programme at the Outpatient care site during the Reporting Form
month of reporting
77. Total Cases It is the total count of all cases formally at the Inpatient CMAM
referred from care site and due to their progress to treatment are now Register/CMAM
IPC to OPC referred to the OPC site for continuation of the treatment Reporting Form
78. No. Cured It is total count of all cases admitted onto the programme CMAM
at the IPC for treatment and discharged cured Register/CMAM
Reporting Form
79. No. Died It is total count of all cases admitted onto the programme CMAM
at the IPC for treatment and discharged dead Register/CMAM
Reporting Form
80. No. defaulted It is total count of all cases admitted onto the programme CMAM
at the IPC for treatment but were absent on three Register/CMAM
continuous days and therefore were discharged defaulter Reporting Form
81. No. Non- It is total count of all cases admitted onto the programme CMAM
recovered at the IPC for treatment and discharged non-recovered Register/CMAM
after 4 months or 16 continuous weeks in treatment with Reporting Form
all medical investigations previously done
82. Total Discharged It is total count of all cases admitted onto the programme CMAM
at the IPC for treatment and discharged died, defaulted, Register/CMAM
cured and non-recovered. Reporting Form
COMMUNITY INFANT AND YOUNG CHILD FEEDING
83. No. of new at- Count of children who have been newly registered in the C-IYCF Register
risk registrants in C-IYCF register for the management of a difficulty
the C-IYCF
Register
84. Total number of Is the total count of all children registered in the C-IYCF C-IYCF Register
at-risk children inRegister, both old and new cases requiring follow-up
C-IYCF Register
(old + new)
85. Total no. of at- Count of all children (old + new) visited at least once in C-IYCF Register
risk children the month of reporting. Visits could be more than once per
visited at least in child but reporting should be done for only one visit in the
a month month
86. Total no. of Count of children who no longer need home visits and C-IYCF Register
children have been discharged in the home visit books
discharged from
home visits
GIRLS IRON AND FOLATE TABLET SUPPLEMENTATION (GIFTS) PROGRAMME-OUT-OF SCHOOL

129
No VARIABLE DEFINITION DATA SOURCE
87. Total number of The total count of 10-19years old girls whose names have GIFTS Out-of-
girls (10-19yrs) been written in the out-of-school register (old and new) School Register
in register
88. Total number of Total count of all adolescent girls (10-19 years) registered GIFTS Out-of-
New registrants by the health workers at the facility or service delivery School Register
for the month point for the provision of the IFA tablets for the month
(New)
89. Total number of Total count of all girls 10-19years who are given IFA GIFTS Out-of-
girls (10-19yrs) tablets in a month (It consist both old and new in any School Register
supplied IFA this particular month who received their monthly supply of
month IFA (x 4 tablets per girl))
90. Number of girls Total number of girls 10-19years on the GIFTS GIFTS register
who exited programme who attained 20years in the months
ANAEMIA IN PREGNANCY
91. New Pregnancy Count of all pregnancies registered for the first time at ANC Register
Registrants (no.) ANC in the month
92. No. with Hb Is the total count of all new pregnancies whose Hb was
Checked checked upon registration
93. No. with anaemiaTotal count of all new pregnancies with Hb checked less
than 7g/dl or 11g/dl.
94. Pregnancies 36 Is the total count of all pregnancies which are 36 weeks
weeks old old coming to access ANC services in the month
95. No. with Hb Is the total count of all pregnancies at 36 weeks whose Hb
Checked was checked upon their visit
96. No. with anaemiaTotal count of all pregnancies at 36 weeks with Hb less
than 7g/dl or 11g/dl.
97. No. of women Total count of pregnant women who have received 3
receiving IFA on monthly doses of IFA
3 visits
98. No. of women Total count of pregnant women who have received 6
receiving IFA on monthly doses of IFA
6 visits
99. No. of women Total count of women who are given IFA when they PNC Register
receiving IFA at attend the postnatal clinic (delivery up to 6 weeks)
the Postnatal
clinic
PREVENTION OF MOTHER TO CHILD TRANSMISSION OF HIV
100. HIV exposed Total count of children whose mothers are HIV positive Verbal/Maternal
Record Book

130
No VARIABLE DEFINITION DATA SOURCE
101. No. given co- Total count of children who are receiving cotrimoxazole
trimoxazole prophylaxis for the ART clinic
prophylaxis
102. No. with EID Total count of HIV exposed infants whose samples have
done been taken for early infant diagnosis
103. No. with positive Total count of HIV exposed children who have EID done
results and their results are positive for HIV
VITAMIN A SUPPLEMENTATION
No Data Element Definition Source
1 6-11months Number of children 6-11 months who were dosed EPI Tally book
100,000iu
2 12-59months Number of children 12-59 months who were dosed EPI Tally book
200,000iu
3 Total Number of children from 6-59 months (6-11months + EPI Tally book
12-59 months) who were dosed with Vitamin A
Supplement
School Health Services
164 Number of
Number of schools within catchment area for SDP SHR
Schools
165 Number of Number of schools visited within catchment area for the
SHR
Schools Visited period
166 Number of
Schools Number of schools that have received at least 3 health
SHR
Receiving 3+ educational talks
Health Talks
167 Enrolled Number of children within a specified class SHR
168 Examined Number of children examined by care giver SHR
169 Of Children Number of children with health problems who were
SHR
Referred referred for further management
170 Number of
Environmental Number of environmental certificates awarded to the
SHR
Certificates schools in the catchment area
Awarded
171 Number of schools in catchment area with type A
Type A SHR
certificate
172 Number of schools in catchment area with type B
Type B SHR
certificate

131
No VARIABLE DEFINITION DATA SOURCE
173 None Number of schools without certificate SHR
174 Number of pupils referred for the following problems:
Ear Problems, Eye Problems, Oral Health Problems, Skin
Referrals SH register
Problems Undescended Testis, Hernia and those with
BMI>25kg/m2
NUTRITION COMMODITIES
RUTF
104. Quantity at the Total amount of RUTF (sachets) available at the facility at Tally / Bin /
beginning of the the beginning of the month Inventory cards
month
105. Quantity Total amount of RUTF (sachets) received at the facility in Tally / Bin /
Received the month Inventory cards
106. Quantity Used Total amount of RUTF (sachets) used at the facility during Tally / Bin /
the month Inventory cards
107. Wastage Total amount of RUTF (sachets) wasted at the facility Tally / Bin /
during the month Inventory cards
108. Expired Total amount of RUTF (sachets) expired at the facility Tally / Bin /
during the month Inventory cards
109. Balance Total amount of RUTF (sachets) available at the facility at Tally / Bin /
the end of the month Inventory cards
F-100
110. Quantity at the Total amount of F-100 (sachets) available at the facility at Tally / Bin /
beginning of the the beginning of the month Inventory cards
month
111. Quantity Total amount of F-100 (sachets) received at the facility in Tally / Bin /
Received the month Inventory cards
112. Quantity Used Total amount of F-100 (sachets) used at the facility during Tally / Bin /
the month Inventory cards
113. Wastage Total amount of F-100 (sachets) wasted at the facility Tally / Bin /
during the month Inventory cards
114. Expired Total amount of F-100 (sachets) expired at the facility Tally / Bin /
during the month Inventory cards
115. Balance Total amount of F-100 (sachets) available at the facility at Tally / Bin /
the end of the month Inventory cards
F-75

132
No VARIABLE DEFINITION DATA SOURCE
116. Quantity at the Total amount of F-75 (sachets) available at the facility at Tally / Bin /
beginning of the the beginning of the month Inventory cards
month
117. Quantity Total amount of F-75 (sachets) received at the facility in Tally / Bin /
Received the month Inventory cards
118. Quantity Used Total amount of F-75 (sachets) used at the facility during Tally / Bin /
the month Inventory cards
119. Wastage Total amount of F-75 (sachets) wasted at the facility Tally / Bin /
during the month Inventory cards
120. Expired Total amount of F-75 (sachets) expired at the facility Tally / Bin /
during the month Inventory cards
121. Balance Total amount of F-75 (sachets) available at the facility at Tally / Bin /
the end of the month Inventory cards
VITAMIN A
100,000iU
122. Received Number of capsules (100,000iu) received at the facility Tally / Bin /
Inventory cards
123. Used Number of capsules (100,000iu) used Tally / Bin /
Inventory cards
124. Expired Number of capsules (100,000iu) wasted Tally / Bin /
Inventory cards
125. Wastage Number of capsules (100,000iu) expired Tally / Bin /
Inventory cards
126. Balance Number of capsules (100,000iu) left Tally / Bin /
Inventory cards
200,000iU

127. Received Number of capsules (200,000iu) received at the facility Tally / Bin /
Inventory cards
128. Used Number of capsules (200,000iu) used Tally / Bin /
Inventory cards
129. Wastage Total number of capsules (200,000iu) wasted Tally / Bin /
Inventory cards
130. Expired Total number of capsules (200,000iu) expired Tally / Bin /
Inventory cards
131. Balance Number of capsules (200,000iu) left Tally / Bin /
Inventory cards

133
No VARIABLE DEFINITION DATA SOURCE
Resomal

132. Quantity at the Total amount of Resomal (sachets) available at the facility Tally / Bin /
beginning of the at the beginning of the month Inventory cards
month
133. Quantity Total amount of Resomal (sachets) received at the facility Tally / Bin /
1 Received in the month Inventory cards
134. Quantity Used Total amount of Resomal (sachets) used at the facility Tally / Bin /
1 during the month Inventory cards
135. Wastage Total amount of Resomal (sachets) wasted at the facility Tally / Bin /
during the month Inventory cards
136. Expired Total amount of Resomal (sachets) expired at the facility Tally / Bin /
during the month Inventory cards
137. Balance Total amount of Resomal (sachets) available at the facility Tally / Bin /
1 at the end of the month Inventory cards
IFA
138. Quantity of IFA It is the total number of IFA tablets at the start of the GIFTS Out-of-
1 tablets at the month School
beginning of the Register/Tally
month (A) Sheet
139. Quantity of IFA It is the total number of IFA tablets received by the facility GIFTS Out-of-
1 tablets received within a month School
this month(B) Register/Tally
140. Quantity of IFA It is the total number of IFA tablets issued to adolescents GIFTS Out-of-
1 tablets used this within the month (x4 tablets per girl) School
month -(C) Register/Tally
Card
141. Quantity of IFA It is the total number of IFA tablets wasted (Spilled off, GIFTS Out-of-
tablets Wasted destroy, etc) within the month School
this month (D) Register/Tally
Card
142. Quantity of IFA It is the total number of IFA tablets expired at the facility GIFTS Out-of-
tablets Expired within the month School
this month(E) Register/Tally
Card
143. Quantity of IFA It is the total number of IFA tablets remining in-stock at GIFTS Out-of-
1 tablets the end of the month (F=A+B-C-D-E) School
Remaining Register/Tally
(Balance) this Card
month (F)

134
135
APPENDIX THREE
REGISTERS AND FORMS FOR HEALTH PROMOTION DIVISION (HPD)

REGISTERS (HPD)

HEALTH WORKER REGISTER FOR HEALTH PROMOTION ACTIVITIES

NO
VARIABLE DEFINITION DATA SOURCE RATIONALE
1 The name of the region in which the service delivery point (SDP) is Records Geographical location
REGION
located e.g. Ashanti.
2 Records Geographical location
DISTRICT The name of the district in which service delivery point (SDP) is
located, e.g. Kwabre.
3 The name of the sub-district in which service delivery point (SDP) Records Geographical location
SUB-DISTRICT
is located, e.g. Kwabre.
4 The name of the Service Delivery Point (SDP) under which the Records Service Delivery Point
FACILITY
activity is taking place e.g. Aboaso Health Centre etc.
5 Measure the time the
DATE The Date on which the activity is taking place Calendar
activity took place
6 The name of the Community in which the Health Promotion activity Records Geographical location
NAME OF COMMUNITY
is taking place e.g. Aboaso etc.
7 To know the particular
Subject or topic which was discussed during the health promotion Plan of Work (POW) / subject or topic that
HEALTH TOPIC / ISSUES
activity. It shall be noted that it is one topic per row Action plan was discussed
 NO
VARIABLE DEFINITION DATA SOURCE RATIONALE
8 To identify the
The type of topic that was discussed by ticking the appropriate
category for each
column.
specific topic
(Communicable Disease, Non-Communicable Disease,
CATEGORY OF HEALTH Plan of Work (POW) /
Reproductive Health, Nutrition, Adolescent Health, Child Health,
TOPICS Action plan
Personal/ Environmental Hygiene, Mental Health). If the topic
discussed is not listed, the said topic shall be written at "Other
Specify" column.
9 Indicate whether the session or activity was an advocacy or To know the type of
Educational (Advocacy - Meeting held to solicit session held
TYPE OF SESSION support/sponsorship from key decision-makers and partners.
Service Provider
(ADVOCACY, EDUCATION) Education - Meeting held to explain any health issue to
participants). Note that each session shall either be an advocacy or
educational session.
10 To know
Indicate whether the session was in collaboration or partnership
COLLABORATION AND events/programs
with key stakeholders by writing the name(s) of the partner(s) Service Provider
PARTNERSHIP jointly held with
involved in the activity.
partners
11 The medium used in communicating the message at the session to It enables us to know
the audience- (Group meetings /Durbar, Radio, One-on-One, the type of
CHANNEL USED Drama/Role Play, Community information centre (CIC), Video Service Provider communication
show, TV, Social Media, Public Address System), Tick all that channel that was used
apply for each session.
12 It enables us to know
TYPE OF SOCIAL The type of SBCC material(s) used for the activity or interaction. the type of SBCC
BEHAVIOUR CHANGE (Leaflet/flyers, Poster, Booklet, Flipchart, Games, Banner, material that was used
Service Provider
COMMUNICATION (SBCC) Counselling Cards, Audio , Audio Visual ). Tick all that apply for
MATERIALS USED each session.

137
 NO
VARIABLE DEFINITION DATA SOURCE RATIONALE
13 To know the number
of people reached and
The number of people who participated in the session or activity. If whether they are males
NUMBER OF
the audience are Adolescent, School Children or Opinion Leader, or females
AUDIENCE/PARTICIPANTS Service Provider
they shall be segregated into males and females and numbers
REACHED
recorded.

14 This will enable us to

Indicate the place the activity was carried out. If it was at the
know the exact
community level then it shall be one of the following (School,
VENUE (COMMUNITY, location or place
Community Centers, Outreach CWC, Church, Mosque, Home,
HEALTH FACILITY, (Tick one Service Provider
Market, specify if not in the list). If it was at the health facility level
for each category)
then it shall be one of the following (Static CWC, OPD, RCH
(ANC, FP, PNC), specify if not in the list).
15 Indicate any important point worthy of notes. This is to help you For comments or
REMARKS Provider’s notes clarifications
have a better session next time.
NOTE For all items, not listed, write in the other specify column.

138
MASTER REGISTRY FOR TRAINING (REGIONAL/DISTRICT)
NO. VARIABLE DEFINITION DATA SOURCE RATIONALE
Participant / Training
1 REGION The name of the region where the training is taking place Geographical location
Registration sheet
Indicate the district that the participant came from. Note.
When training is happening in a district and participants are Participant / Training
2 DISTRICT Geographical location
all from the same district, this will not be necessary since the Registration sheet
District register will be used
The name of the sub-district in which service delivery point
3 SUB-DISTRICT Records Geographical location
(SDP) is located, e.g. Kwabre.
The name of the Service Delivery Point (SDP) under which
4 FACILITY Records Service Delivery Point
the activity is taking place e.g. Aboaso Health Centre etc.
Participant / Training Measure the period the
5 MONTH Indicate the reporting month
Registration sheet activity took place
Participant / Training Measure the period the
6 YEAR Indicate the reporting year
Registration sheet activity took place
Participant / Training Measure the time the
7 DATE The Date on which the training took place
Registration sheet activity took place
Participant / Training
To know the type of
8 TITLE OF TRAINING Indicate the title of the training. Registration sheet/Activity
training organised
plan
To know the total
Indicate the Serial number of training organized in a month Participant / Training
9 NO. number of training
(District or Region) Registration sheet
organized in a month
Participant/Training To be able to identify
10 NAME Name of the participant
Registration sheet participants
To identify whether a
Participant / Training
11 SEX (male / female) Indicate the total number participant/cadre/sex participant is male or
Registration sheet
female

139
 NO. VARIABLE DEFINITION DATA SOURCE RATIONALE
TOTAL NUMBER OF Indicate the total number of participants by cadre District-
Participant / Training To know the category
12 PARTICIPANTS BY (HPTO, CHOs, FT, ENs, TO, CHN, Volunteers, HI, DCO)
Registration sheet or staff been trained
CADRE Region-(HPMs, HPTOs, CHOs, CHNs, PHNs, others)
SOURCE OF Indicate the source of funding or support for the training (e.g. To know the funding
13 Approved budget/POW
FUNDING/SUPPORT UNICEF, C4H etc.), agency.
Participant / Training To know the period the
14 DURATION (in Days) Indicate the duration in days of the particular training session
Registration sheet activity took place
TYPE OF TRAINING
Indicate the type of training that was organized, whether it Participant / Training To know the type of
15 (FORMAL,
was formal or internship Registration sheet training been organised
INTERNSHIP)
Indicate the total number of participants who have been newly To know whether a
Participant / Training
16 NEWLY TRAINED trained on the specific training title in question been participant is a first-
Registration sheet
summarized time trainee
Indicate the total number of participants who have ever been To identify participants
EVER BEEN Participant / Training
17 trained on the specific training title in question been who have been trained
TRAINED Registration sheet
summarized before

140
 FORMS (HPD)
MONTHLY HEALTH PROMOTION VOLUNTEER REPORTING FORM
NO. RATIONALE
VARIABLE DEFINITION DATA SOURCE
1 Geographical location
Write the name of the region in which the service delivery point
REGION Volunteer register
(SDP) is located e.g. Ashanti.
2 Volunteer register Geographical location
DISTRICT Write the name of the district in which service delivery point (SDP)
is located, e.g. Ga West.
3 Volunteer register Geographical location
SUB-DISTRICT Write the name of the sub-district in which service delivery point
(SDP) is located, e.g. Aboaso
4 Volunteer register Service Delivery Point
Health Facility Write the name of the Service Delivery Point (SDP) e.g. Aboaso
Health Centre
5 Volunteer register Geographical location
NAME OF Write the name of the Community in which the Health Promotion
COMMUNITY activity took place e.g. Amasaman etc.

6 Calendar/ Volunteer Measure the period the

MONTH Write the month in which the activity took place e.g. July
Register activity took place
7 Calendar/Volunteer Measure the period the
YEAR Write the Year in which the activity took place e.g. 2010
register activity took place
8 To identify topics
Topic which was discussed (Communicable disease, Non-
discussed
communicable, Reproductive Health, Nutrition, Adolescent Health,
TOPICS Child Health, Personal/Environmental hygiene, mental health). All Volunteer Register
topics listed under ‘’other specify” shall be recorded under
“Others”

141
NO. RATIONALE
VARIABLE DEFINITION DATA SOURCE
9 The number of people who participated in the session or activity To know the number of
from the volunteer register at the various venues in the community. people reached and
AUDIENCE/ If the audience are Adolescents, School Children or Opinion whether they were male
PARTICIPANT Leaders, they shall be disaggregated into males and females and Volunteer Register or females
REACHED numbers recorded. For Pregnant women, Nursing mothers, Other
women and Men their sex is known. On the reporting form, this can
be found at the category of people column
10 SBCC MATERIALS It enables us to know the
The number of times each SBCC material(s) was used. (FLIP number of times each
USED
CHART, POSTER, COUNSELLING CARD), for the activities or Volunteer Register type of SBCC material
(social behaviour change
interaction was used.
communication )
11 This is to know the total
number of times an
The number of times activities are carried out at each of the
activity occurs at each
venues. If it was at the community level then it shall be one of the
specific venue
following (School, Community Centres, Outreach CWC, church,
VENUE mosque, home, market, specify if not in the list) if it was at the Volunteer Register
health facility level then it shall be one of the following (Static
CWC, OPD, RCH (ANC, FP, PNC), specify if not in the list.

142
MONTHLY (HEALTH WORKER) REPORTING FORM FOR HEALTH PROMOTION ACTIVITIES
No. Variable Definition Data Source RATIONALE
Write the name of the region in which the service delivery point Geographic location
1REGION Records
(SDP) is located e.g. Ashanti.
Write the name of the district in which service delivery point Geographic location
2DISTRICT Records
(SDP) is located, e.g. Kwabre.
Write the name of the sub-district in which service delivery point Geographic location
3SUB-DISTRICT Records
(SDP) is located, e.g. Kwabre.
Write the name of the Service Delivery Point (SDP) e.g. Aboaso Service Delivery point
4FACILITY Records
Health Centre
Measure the period the
5MONTH Write the month in which the activity took place e.g. July. Calendar
activity took place
Measure the period the
6YEAR Write the year in which the activity took place e.g. 2010. Calendar
activity took place
The number of times each topic was discussed. To identify the number of
(Communicable Disease, Non-Communicable Disease, times each topic was
Health
CATEGORY OF HEALTH Reproductive Health, Nutrition, Adolescent Health, Child discussed
7 Worker
TOPICS Health, Personal / Environmental Hygiene, Mental Health). All
Register
topics listed under "Other Specify" shall be counted and recorded
under "Others".
The number of times each channel was used as a medium in It enables us to know the
communicating the message at the session to the audience- number of times each
Health communication channel was
(Group meetings(Durbar), Radio, One-on-One, Drama/Role
8CHANNELS Worker used
Play, Community information centre (CIC), Video show, TV,
Register
Social Media, Public Address System). All channels listed under
"Other Specify" shall be counted and recorded under "Others".

143
No. Variable Definition Data Source RATIONALE
The number of people who participated in the session or activity. To know the number of
If the audience are Adolescent, School Children or Opinion Health people reached and whether
AUDIENCE/PARTICIPANTS
9 Leader, they shall be segregated into males and females and Worker they are males or females.
REACHED
numbers recorded. (Pregnant women, Nursing mothers, Other Register
women, Men, Adolescent, School Children, Opinion Leaders)
The number of SBCC material(s) used for the activity. It enables us to know the
Categorise them using the following total number of times each
(PRINT - Leaflet/flyers, Poster, Booklet, Banner, Flipchart, type of SBCC materials was
Counselling Cards GAMES - All forms of Games, Health used
TYPE OF SBCC MATERIALS
10 Audio Visual - Video. Worker
USED
Audio - Audio Recordings Register
All SBCC materials written under "Other Specify" shall be
counted against its type (Print, Games, Audio and Audi-Visual)
and recorded.
The number of times activities are carried out at each of the This is to know the total
venues. If it was at the community level then it shall be one of number of times an activity
the following (School, Community Centers, Outreach CWC, Health occurred at each specific
11VENUE Church, Mosque, Home, Market, specify if not in the list). If it Worker venue.
was at the health facility level then it shall be one of the Register
following (Static CWC, OPD, RCH(ANC, FP, PNC), specify if
not in the list).
Health To know the total number for
Indicate the number of types of session or activity held
12TYPE OF SESSIONS HELD Worker each type of session held
(Advocacy or Education)
Register
NUMBER OF Health To know the number of
13 COLLABORATIVE Indicate the number of collaborative or partnership session held Worker events /Programmes jointly
ACTIVITIES Register held with partners

144
QUARTERLY HEALTH PROMOTION REPORTING FORM
NO DATA RATIONALE
VARIABLE DEFINITION
SOURCE
1 Geographic Location
DISTRICT Indicate the District that is filling the form for reporting Records
2 REGION Indicate the Region that is filling the form for reporting Records Geographic Location

3 Measure the period the

QUARTER Indicate the quarter of the year that the data is being reported for Calendar
activity took place
4 Indicate the year in which the work took place for which you are Measure the period the
YEAR Calendar
reporting activity took place
HEALTH PROMOTION SERVICE

5 The number of Health Promotion Officers at post categorised To know the number of
according to the cadre of staff at post carrying out Health Human health promotion officers at
HUMAN RESOURCES
Promotion activities and also segregated by Males and Females Resource Data post by cadre and sex.
including volunteers.
6 Master To know the number of staff
Indicate whether the trainees are first-time trainee or had been
TYPE OF TRAINEE Registry/Train being newly trained or have
trained in Health Promotion-related activity before
ing Register ever been trained
To know the number of
Indicate the number of people trained according to the type of people trained according to
Master
7 training and the material used. Those who are being trained for the type of training
Registry
TRAINING each category for the first time and those who are receiving the
/Training
training more than once will be indicated under Newly Trained
Register
and Ever Trained respectively

145
NO DATA RATIONALE
VARIABLE DEFINITION
SOURCE
To know the number of
8 The number of Health Promotion training that was carried out in Master training that was supported
TRAINING RECEIVED BY
the quarter which was supported by other GHS Programs such as Registry by other GHS programs and
HEALTH PROMOTION UNIT
NMPC, EPI etc, and all the other training that were supported by /Training Partners
FROM EXTERNAL SOURCE
external partners such as USAID, UNICEF etc. Register

9 Training CONDUCTED BY To know the number of

Number of training planned and the number carried out in the Program of
HEALTH PROMOTION UNIT training that was organized
quarter by HPU Work
INTERNAL by the Health Promotion Unit
10 Number of monitoring and supervisory visits planned for the To conduct an assessment of
MONITORING AND period, Number carried out in the same period and Number of Program of key Health behaviours
EVALUATION Health Promotion Evaluation/Assessments of key behaviours Work
conducted for the same period
11 The number of Health Promotion Champions identified in the To assess the contribution of
district or region or National, Number that is active, the number active Health Promotion
of planned activities in their action plan and the total activities Program of Champions
Champions
that were carried out for the reporting period NB: Champions are Work
recognized individuals or group undertaking advocacy activities
for Health promotion e.g. influential people, satisfied clients. etc

HEALTHIER COMMUNITIES

12 To assess activities carried

The number of media houses engaged to carry out planned health out with engaged media
promotion activities in the district or region. Indicate the number Program of houses
MEDIA HOUSE
of activities planned and carried out by the type of media house Work
e.g. Print, Radio, TV, Internet (Mail, Social Media)

COLLABORATIONS AND PARTNERSHIP

146
NO DATA RATIONALE
VARIABLE DEFINITION
SOURCE

13 To know the type of partners

Indicate the type of partners that you collaborate with, in terms of Program of
TYPE OF PARTNERS working with HPU whether
internal (GHS) or external (outside GHS) Work
internal or external
14 To know the number of
Indicate the type of activity that you collaborated with the partner Program of activities that were jointly
TYPE OF ACTIVITY
e.g. Meetings, Training etc. Work organized with implementing
partners.
Note: This quarterly reporting form is to be filled by districts and regional offices and not by facilities

147
APPENDIX FOUR
REGISTERS AND FORMS FOR PUBLIC HEALTH DIVISION (PHD)

DISEASE SURVEILLANCE DEPARTMENT

COVID 19 MONTHLY REPORTING DATA DEFINITION

Variable Definition Data Source Rationale
REGION: The name of the region in which reporting facility is Records To know the name of the region in
located. (e.g. Ashanti) which reporting facility is located.
(e.g. Ashanti)

DISTRICT: The name of the district in which reporting facility is Records To know the name of the district in
located. (e.g. Bekwai) which reporting facility is located.
(e.g. Bekwai)

SUB DISTRICT: The name of the sub district in which reporting facility Records To know the name of the sub district
is located. (e.g. ) in which reporting facility is located.
(e.g.)
FACILITY: The name of health facility reporting COVID-19 cases Records To know the name of health facility
for the month reporting COVID-19 cases for the
month
MONTH: The month in which the report is generated. (e.g. July) Calendar To know the month in which the
report is generated. (e.g. July)

YEAR: The year in which the report is generated. (e.g. 2020) Calendar To know the year in which the report
is generated. (e.g. 2020)

148
Variable Definition Data Source Rationale
Age Group The number of COVID-19 cases within a specified age All consulting rooms To know the number of COVID-19
group and OPD registers cases within a specified age group

0-1 Number of persons with COVID-19 who are less than 2 All consulting rooms To know the number of persons with
years of age (e.g. 1) and OPD registers COVID-19 who are less than 2 years
of age (e.g. 1)

2-4 Number of persons with COVID-19 who are 2 years of All consulting rooms To know the number of persons with
age more but less than 5 Yrs (e.g. 3) and OPD registers COVID-19 who are 2 years of age
more but less than 5 Yrs (e.g. 3)

5-14 Number of persons with COVID-19 who are 5 years of All consulting rooms To know the number of persons with
age or more but less than15 Yrs (e.g. 11) and OPD registers COVID-19 who are 5 years of age or
more but less than 15 Yrs (e.g. 11)

15-49 Number of persons with COVID-19 who are 15 years of All consulting rooms To know the number of persons with
age or more but less than 50 Yrs (e.g. 47) and OPD registers COVID-19 who are 15 years of age
or more but less than 50 Yrs (e.g. 47)

50-64 Number of persons with COVID-19 who are 50 years of All consulting rooms To know the number of persons with
age or more but less than 65 Yrs and OPD registers COVID-19 who are 50 years of age
or more but less than 65 Yrs

65-79 Number of persons with COVID-19 who are 65 years of All consulting rooms To know the number of persons with
age or more but less than 80 Yrs and OPD registers COVID-19 who are 65 years of age
or more but less than 80 Yrs

149
Variable Definition Data Source Rationale
80+ Number of persons with COVID-19 who are 80 years of All consulting rooms To know the number of persons with
age or more and OPD registers COVID-19 who are 80 years of age
or more
Number of new Number of newly suspected cases of COVID-19 in the All consulting rooms To know the number of newly
Suspected cases month for which the report is made and OPD registers suspected cases of COVID-19 in the
month for which the report is made

Number of new Number of newly confirmed cases of COVID-19 in the All consulting rooms To know the number of newly
confirmed cases month for which the report is made and OPD registers confirmed cases of COVID-19 in the
month for which the report is made

Number of Number of newly recovered cases of COVID-19 in the All consulting rooms To know the number of newly
recovered cases month for which the report is made and OPD registers recovered cases of COVID-19 in the
month for which the report is made

Number of new Number of new COVID-19 deaths in the month for Admission and To know the number of new
deaths which the report is made discharge register COVID-19 deaths in the month for
which the report is made
Number of cases Number of cases of COVID-19 in the month for which All consulting rooms To know the number of cases of
tested the report is made and OPD registers, Line COVID-19 in the month for which
list, Feedback from the report is made
Laboratory, Sormas
Number of new Number of new COVID-19 patients that we admitted Admission and To know the number of new
cases hospitalised (hospitalised) in the month for which the report is made discharge register COVID-19 patients that we admitted
(hospitalised) in the month for which
the report is made

New cases by
treatment type

150
Variable Definition Data Source Rationale
Mechanical Number of new cases put on ventilator machines to Admission and To know the number of new cases
ventilation assist or replace spontaneous breathing discharge register put on ventilator machines to assist
or replace spontaneous breathing

ECMO Number of new cases put on Extracorporeal Membrane Admission and To know the number of new cases
Oxygenation life support machine discharge register put on Extracorporeal Membrane
Oxygenation life support machine

Admitted into ICU Number of new cases admitted to intensive care units Admission and To know the number of new cases
discharge register admitted to intensive care units

Suspected cases by
transmission
classification
Imported Number of persons meeting the suspected case Line list To know the number of persons
definition with a history of returning to Ghana from meeting the suspected case definition
another country within 14 days prior to their symptom with a history of returning to Ghana
onset from another country within 14 days
prior to their symptom onset

Known cluster Number of suspected cases from areas experiencing Line list To know the number of suspected
cases, clustered in time, geographic location and/or by cases from areas experiencing cases,
common exposures clustered in time, geographic
location and/or by common
exposures

151
Variable Definition Data Source Rationale
Community Number of suspected cases from areas experiencing Line list To know the number of suspected
Transmission larger outbreaks of local transmission defined through cases from areas experiencing larger
an assessment of factors including, but not limited to: outbreaks of local transmission
defined through an assessment of
factors including, but not limited to:

- Large numbers of cases not linkable to transmission To know the Large numbers of cases
chains not linkable to transmission chains

- Large numbers of cases from sentinel lab surveillance To know Large numbers of cases
from sentinel lab surveillance

- Multiple unrelated clusters in several areas of an area To know Multiple unrelated clusters
or country experiencing cases, clustered in time, in several areas of an area or country
geographic location and/or by common exposures experiencing cases, clustered in time,
geographic location and/or by
common exposures

Unknown Number of suspected cases with unknown transmission Line list To know the number of suspected
classification cases with unknown transmission
classification

Confirmed cases
by transmission
classification

152
Variable Definition Data Source Rationale
Imported Number of confirmed cases among persons who Line list To know the number of confirmed
returned to Ghana from another country within 14 days cases among persons who returned to
prior to symptoms onset or before collection of samples Ghana from another country within
14 days prior to symptoms onset or
before collection of samples

Known cluster Number of confirmed cases from areas experiencing Line list To know the number of confirmed
cases, clustered in time, geographic location and/or by cases from areas experiencing cases,
common exposures clustered in time, geographic
location and/or by common
exposures

Community Number of confirmed cases from areas experiencing Line list To know the number of confirmed
Transmission larger outbreaks of local transmission defined through cases from areas experiencing larger
an assessment of factors including, but not limited to: outbreaks of local transmission
defined through an assessment of
factors including, but not limited to:

- Large numbers of cases not linkable to transmission To know Large numbers of cases not
chains linkable to transmission chains

- Large numbers of cases from sentinel lab surveillance To know Large numbers of cases
from sentinel lab surveillance

153
Variable Definition Data Source Rationale
- Multiple unrelated clusters in several areas of an area To know Multiple unrelated clusters
or country experiencing cases, clustered in time, in several areas of an area or country
geographic location and/or by common exposures experiencing cases, clustered in time,
geographic location and/or by
common exposures

Unknown Number of confirmed cases with unknown transmission Line list To know the number of confirmed
classification cases with unknown transmission
classification

Laboratory details
Total Laboratory Total number COVID-19 cases for which laboratory Laboratory feedback, To know the total number COVID-
results received results are received in the month SORMAS 19 cases for which laboratory results
are received in the month

Total laboratory Total number COVID-19 cases for which laboratory Laboratory feedback, To know the total number COVID-
results pending results are pending (not received) in the month SORMAS 19 cases for which laboratory results
are pending (not received) in the
month

154
WEEKLY REPORTING DATA DEFINITIONS
Variable Definition Data Source Rationale
Sentinel Site Name of sentinel site/facility (e.g. Ridge Hospital) Records To know the name of sentinel
site/facility (e.g. Ridge Hospital)

Region The name of the region in which reporting facility is Records To know the name of the region in
located. (e.g. Ashanti) which reporting facility is located.
(e.g. Ashanti)

District The name of the district in which reporting facility is Records To know the name of the district
located. (e.g. Bekwai) in which reporting facility is
located. (e.g. Bekwai)

Year The year in which the report is generated. (e.g. 2016) Calendar To know the year in which the
report is generated. (e.g. 2016)

Reporting Week # The number of the week for which reporting data is Epidemiological Calendar To know number of the week for
recorded. (e g. 01) which reporting data is recorded.
(e g. 01)

Week Beginning The date of the Monday that begins the epidemiological Epidemiological Calendar To know the date of the Monday
Monday week for which data is reported (e.g. 02/01/2017) that begins the epidemiological
week for which data is reported
(e.g. 02/01/2017)

155
Variable Definition Data Source Rationale
Week Ending Sunday The date of the Sunday that ends the epidemiological Epidemiological Calendar To know the date of the Sunday
week for which data is reported (e.g. 08/01/2017) that ends the epidemiological
week for which data is reported
(e.g. 08/01/2017)

Number of new ILI The number of new ILI cases recorded for the period for All consulting rooms To know the number of new ILI
cases which data is reported. (e.g. 100) register cases recorded for the period for
which data is reported. (e.g. 100)

Number of new ILI The number of new ILI cases recorded which throat or Flu register To know the number of new ILI
cases sampled nasal swab (sample) was collected and sent to the cases recorded which throat or
reference laboratory for the period for which data is nasal swab (sample) was collected
reported. (e.g. 08) and sent to the reference
laboratory for the period for
which data is reported. (e.g. 08)

Number of total The total number of persons who used the OPD services OPD register To know the total number of
outpatients visits in the period for which data is reported. (e.g. 254) persons who used the OPD
services in the period for which
data is reported. (e.g. 254)

0-1 years Number of persons who are less than 2 years of age (e.g. All consulting rooms To know the number of persons
1) register and OPD registers who are less than 2 years of age
(e.g. 1)

156
Variable Definition Data Source Rationale
2-4 years Number of persons who are 2 years of age more but less All consulting rooms Number of persons who are 2
than 5 Yrs (e.g. 3) register years of age more but less than 5
Yrs (e.g. 3)

5 to 14 years Number of persons 5 years of age or more but less Consulting room register To know the number of persons 5
than15 Yrs (e.g. 11) and OPD register years of age or more but less
than15 Yrs (e.g. 11)
15 to 49 years Number of persons 15 years of age or more but less than Consulting room register To know the number of persons
50 Yrs (e.g. 47) and OPD register 15 years of age or more but less
than 50 Yrs (e.g. 47)

50 to 64 years Number of persons 50 years of age or more but less than Consulting room register Number of persons 50 years of
65 Yrs and OPD register age or more but less than 65 Yrs

= > 65 years Number of persons who are 65 Yrs or more Consulting room register To know the number of persons
and OPD register who are 65 Yrs or more

Geographical spread Geographical spread refers to the number and Flu register To know the geographical spread
distribution of communities reporting influenza activity. refers to the number and
Option for selection will indicate “No activity”, distribution of communities
“Localized”, “Regional”, “Widespread” and “No reporting influenza activity.
information available” Option for selection will indicate
“No activity”, “Localized”,
“Regional”, “Widespread” and
“No information available”

157
Variable Definition Data Source Rationale
No activity "No activity" denotes where there are no laboratory- Records To know the "No activity" which
confirmed case(s) of influenza, or evidence of increased denotes where there are no
or unusual respiratory disease activity laboratory-confirmed case(s) of
influenza, or evidence of
increased or unusual respiratory
disease activity

Localized "Localized" denotes where reported cases are limited to Flu register, all consulting To know the "Localized" which
one sub district (or reporting site) only room registers or spot map denotes where reported cases are
limited to one sub district (or
reporting site) only
Regional "Regional" denotes ILI appearing in multiple but <50% Flu register or spot map To know the "Regional" which
of the administrative units of the Sub district (or denotes ILI appearing in multiple
reporting sites). but <50% of the administrative
units of the Sub district (or
reporting sites).
Widespread "Widespread" denotes ILI appearing in ≥50% of the Flu register or spot map To know the "Widespread" which
administrative units of the country (or reporting sites). denotes the ILI appearing in
≥50% of the administrative units
of the country (or reporting sites).
No information No information available: no information available for All consulting room To know where no information
available the previous 1-week period. registers available: no information
available for the previous 1-week
period.

158
Variable Definition Data Source Rationale
Trend in the activity Trend refers to changes in the level of respiratory All consulting room To know the trend which refers to
disease activity compared with the previous week registers changes in the level of respiratory
disease activity compared with the
previous week

Increasing Evidence that the level of respiratory disease activity is All consulting room To know the evidence that the
increasing compared with the previous week registers level of respiratory disease
activity is increasing compared
with the previous week

Unchanged Evidence that the level of respiratory disease activity is All consulting room To know the evidence that the
unchanged compared with the previous week. registers level of respiratory disease
activity is unchanged compared
with the previous week.

Decreasing Evidence that the level of respiratory disease activity is All consulting room To know the evidence that the
decreasing compared with the previous week. registers level of respiratory disease
activity is decreasing compared
with the previous week.

159
Variable Definition Data Source Rationale
No information No information available Records To know the no information
available available

The intensity of An estimate of the proportion of the population with All consulting room To know an estimate of the
acute respiratory acute respiratory disease, covering the spectrum of registers and records proportion of the population with
disease disease from influenza -like illness to pneumonia. acute respiratory disease, covering
Option for selection will indicate “Low or moderate”, the spectrum of disease from
“high”, “very high” and “no information available” influenza -like illness to
pneumonia. Option for selection
will indicate “Low or moderate”,
“high”, “very high” and “no
information available”

Low or moderate A normal or slightly increased proportion of the All consulting room To know a normal or slightly
population is currently affected by respiratory illness. registers and records increased proportion of the
population is currently affected by
respiratory illness.
High A large proportion of the population is currently All consulting room To know a large proportion of the
affected by respiratory illness registers and records population is currently affected by
respiratory illness

Very high A very large proportion of the population is currently All consulting room To know a very large proportion
affected by respiratory illness. registers and records of the population is currently
affected by respiratory illness.

160
Variable Definition Data Source Rationale
No information No information available All consulting room To know where no information
available registers and records available

The impact on the The degree of disruption of health-care services as a All consulting room To know the degree of disruption
health care system result of acute respiratory disease. registers and records of health-care services as a result
of acute respiratory disease.

Low Demands on health-care services are not above usual All consulting room To know the demands on health-
levels registers and records care services are not above usual
levels

Moderate Demands on health-care services are above the usual All consulting room To know demands on health-care
demand levels but still below the maximum capacity of registers and records services are above the usual
those services demand levels but still below the
maximum capacity of those
services
Severe Demands on health care services exceed the capacity of All consulting room To know demands on health care
those services. registers and records services exceed the capacity of
those services.
No information No information available. All consulting room
available registers and records

161
SARI WEEKLY REPORTING DATA DEFINITION
Variable Definition Data Source Rationale
Sentinel Site Name of sentinel site/facility (e.g. Ridge Hospital) Records To know the name of sentinel site/facility
(e.g. Ridge Hospital)

Region The name of the region in which reporting facility Records To know the name of the region in which
is located. (e.g. Ashanti) reporting facility is located. (e.g. Ashanti)

District The name of the district in which reporting facility Records To know the name of the district in which
is located. (e.g. Bekwai) reporting facility is located. (e.g. Bekwai)

Year The year in which the report is generated. (e.g. Calendar To know the year in which the report is
2016) generated. (e.g. 2016)

Reporting Week # The number of the week for which reporting data is Epidemiological To know number of the week for which
recorded. (e g. 01) Calendar reporting data is recorded. (e g. 01)

Week Beginning The date of the Monday that begins the Epidemiological To know the date of the Monday that begins
Monday epidemiological week for which data is reported Calendar the epidemiological week for which data is
(e.g. 02/01/2017) reported (e.g. 02/01/2017)

Week Ending The date of the Sunday that ends the Epidemiological To know the date of the Sunday that ends
Sunday epidemiological week for which data is reported Calendar the epidemiological week for which data is
(e.g. 08/01/2017) reported (e.g. 08/01/2017)

162
 Variable Definition Data Source Rationale
Number of new Number of patients who meet the SARI case Admission and To know the number of patients who meet
SARI cases definition and admitted for first time during the discharge register the SARI case definition and admitted for
week first time during the week

Number of new Number of SARI patients from whom samples were Flu register To know the number of SARI patients from
SARI cases sampled collected whom samples were collected

Number of total Total number of admissions at the health facility Admission and To know the total number of admissions at
hospital admissions discharge register the health facility

Number of SARI Total number of deaths of patients who met the case Admission and To know the total number of deaths of
deaths this week definition for SARI discharge register patients who met the case definition for
SARI

Proportion of SARI
(%) (=A/C)

0-1 years Number of persons who are less than 2 years of age Admission and To know the number of persons who are less
(e.g. 1) discharge register than 2 years of age (e.g. 1)

2-4 years Number of persons who are 2 years of age more but Admission and To know the number of persons who are 2
less than 5 Yrs (e.g. 3) discharge register years of age more but less than 5 Yrs (e.g. 3)

163
 Variable Definition Data Source Rationale
5 to 14 years Number of persons 5 years of age or more but less Admission and To know the number of persons 5 years of
than15 Yrs (e.g. 11) discharge register age or more but less than15 Yrs (e.g. 11)

15 to 49 years Number of persons 15 years of age or more but less Admission and To know the number of persons 15 years of
than 50 Yrs (e.g. 47) discharge register age or more but less than 50 Yrs (e.g. 47)

50 to 64 years Number of persons 50 years of age or more but less Admission and To know the number of persons 50 years of
than 65 Yrs discharge register age or more but less than 65 Yrs

= > 65 years Number of persons who are 65 Yrs or more Admission and To know the number of persons who are 65
discharge register Yrs or more

Geographical spread Geographical spread refers to the number and Admission and To know the geographical spread refers to
distribution of communities reporting influenza discharge register the number and distribution of communities
activity. Option for selection will indicate “No reporting influenza activity. Option for
activity”, “Localized”, “Regional”, “Widespread” selection will indicate “No activity”,
and “No information available” “Localized”, “Regional”, “Widespread” and
“No information available”
No activity "No activity" denotes where there are no laboratory- Admission and To know the "No activity" which denotes
confirmed case(s) of influenza, or evidence of discharge register where there are no laboratory-confirmed
increased or unusual respiratory disease activity case(s) of influenza, or evidence of
increased or unusual respiratory disease
activity

164
 Variable Definition Data Source Rationale
Localized "Localized" denotes where reported cases are Admission and To know the "Localized" which denotes
limited to one sub district (or reporting site) only discharge register where reported cases are limited to one sub
district (or reporting site) only

Regional "Regional" denotes SARI appearing in multiple but Admission and To know the "Regional" which denotes
<50% of the administrative units of the Sub district discharge register SARI appearing in multiple but <50% of the
(or reporting sites). administrative units of the Sub district (or
reporting sites).
Widespread "Widespread" denotes SARI appearing in ≥50% of Admission and To know the "Widespread" which denotes
the administrative units of the country (or reporting discharge register the SARI appearing in ≥50% of the
sites). administrative units of the country (or
reporting sites).
No information No information available: no information available Admission and To know where no information available: no
available for the previous 1-week period. discharge register information available for the previous 1-
week period.

Trend in the activity Trend refers to changes in the level of respiratory Admission and To know the trend which refers to changes
disease activity compared with the previous week discharge register in the level of respiratory disease activity
compared with the previous week

Increasing Evidence that the level of respiratory disease Admission and To know the evidence that the level of
activity is increasing compared with the previous discharge register respiratory disease activity is increasing
week compared with the previous week

Unchanged Evidence that the level of respiratory disease Admission and To know the evidence that the level of
activity is unchanged compared with the previous discharge register respiratory disease activity is unchanged
week. compared with the previous week.

165
 Variable Definition Data Source Rationale
Decreasing Evidence that the level of respiratory disease Admission and To know the evidence that the level of
activity is decreasing compared with the previous discharge register respiratory disease activity is decreasing
week. compared with the previous week.

No information No information available Admission and To know the no information available

available discharge register

The intensity of An estimate of the proportion of the population with Admission and To know an estimate of the proportion of the
acute respiratory acute respiratory disease, covering the spectrum of discharge register population with acute respiratory disease,
disease disease from influenza -like illness to pneumonia. covering the spectrum of disease from
Option for selection will indicate “Low or influenza -like illness to pneumonia. Option
moderate”, “high”, “very high” and “no information for selection will indicate “Low or
available” moderate”, “high”, “very high” and “no
information available”
Low or moderate A normal or slightly increased proportion of the Admission and To know a normal or slightly increased
population is currently affected by respiratory discharge register proportion of the population is currently
illness. affected by respiratory illness.

High A large proportion of the population is currently Admission and To know a large proportion of the
affected by respiratory illness discharge register population is currently affected by
respiratory illness

Very high A very large proportion of the population is Admission and To know a very large proportion of the
currently affected by respiratory illness. discharge register population is currently affected by
respiratory illness.

166
 Variable Definition Data Source Rationale
No information No information available Admission and To know where no information available
available discharge register

The impact on the The degree of disruption of health-care services as a Admission and To know the degree of disruption of health-
health care system result of acute respiratory disease. discharge register care services as a result of acute respiratory
disease.

Low Demands on health-care services are not above Admission and To know the demands on health-care
usual levels discharge register services are not above usual levels

Moderate Demands on health-care services are above the Admission and To know demands on health-care services
usual demand levels but still below the maximum discharge register are above the usual demand levels but still
capacity of those services below the maximum capacity of those
services
Severe Demands on health care services exceed the Admission and To know demands on health care services
capacity of those services. discharge register exceed the capacity of those services.

No information No information available. Admission and No information available.

available discharge register

167
IDSR REPORTING
No. VARIABLE DEFINITION DATA RATIONALE
SOURCE
1 Year Year in which the transaction took place e.g. 2010 Calendar To know the year in
which the report is
generated.
2 Month The month in which the transaction took place e.g. July Calendar To know the month in
which the report is
generated.

3 Health Facility The name of the Health Facility e.g. Aboaso Health Records To know the name of
Centre etc. the Health Facility

4 Sub-District The name of the sub-district in which the Service Records The name of the sub-
Delivery Point is located, e.g. Aboaso. district in which the
Service Delivery Point
is located.
5 District The name of the district in which SDP is located, e.g. Records The name of the district
Kwabre. in which SDP is located.

6 Region The name of the region in which the SDP is located e.g. Records The name of the region
Ashanti. in which the SDP is
located
7 Notifiable Diseases and Events These are the list of the disease conditions or events of Consulting To know the list of the
public health importance that occurred in the locality room register disease conditions or
that are being reported-e.g. cholera, typhoid, SARS and events of public health
so on importance that
occurred in the locality
that are being reported-
e.g. cholera, typhoid,

168
No. VARIABLE DEFINITION DATA RATIONALE
SOURCE
SARS and so on
8 Suspected cases The number of the disease condition or events that is Consulting To know the number of
being reported before they were actually tested to Register the disease condition or
confirm it events that is being
reported before they
were actually tested to
confirm it
9 Death Number of deaths as a result of the occurrence of the MCCD To know the number of
event in the locality deaths as a result of the
occurrence of the event
in the locality
10 Lab Confirmed Cases Number of the conditions or events that have been Lab Register Number of the
confirmed using laboratory investigations conditions or events that
have been confirmed
using laboratory
investigations
11 Comments Any information of importance that will help in
managing the condition

12 NB: All cases that show the signs and symptoms of AFP but Consulting
not limited to poliomyelitis only Register, Lab
Registers,
a. Acute Flaccid Paralysis Reference lab
results

b. Poliomyelitis This are limited to flaccid paralysis limited to

poliomyelitis only

169
No. VARIABLE DEFINITION DATA RATIONALE
SOURCE
b. Poliomyelitis

13 Analysis, Interpretation, Decision, Action and Recommendations

14 Epidemiological Comments All comments that will help professionals to understand

the situation better- e.g. who, what, where, when, why,
how etc.
15 Decisions and Actions Taken List the decisions and action under taken in dealing
with the occurrence in question

16 Recommendation What action you recommend to be taken

17 Report Date: Date of reporting to the district in the form dd/mm/yyyy Calendar To know the Date of
reporting to the district
in the form dd/mm/yyyy
18 Person Reporting The officer filling the form, this will include the name, To know the officer
telephone number and email address of the officer. filling the form, this will
include the name,
telephone number and
email address of the
officer.
19 Date Received Date that the report was received at the district level Calendar To know the Date that
the report was received
at the district level

170
No. VARIABLE DEFINITION DATA RATIONALE
SOURCE
20 Person Receiving Details of the officer receiving the report at the district Details of the officer
level receiving the report at
the district level

171
EXPANDED PROGRAMME ON IMMUNISATION (EPI)
EPI MONTHLY VACCINATION REGIONAL STORES STOCKS REPORTS

Code Variable Definition Data Source

A Region The name of the region in which reporting facility is located. e.g. Volta Records

B District The name of the district in which reporting facility is located. e.g. Adaklu Records

C Month The month in which the report was generated. e.g. January Calendar

D Year The year in which the report was generated. e.g. 2015 Calendar
Quantity of a specified vaccine/commodity available at the beginning of the
1.1* Beginning Vaccine ledger/tally card
reporting period

1.2* Received Quantity of a specified vaccine/commodity received within the reporting period Vaccine ledger/tally card

Total doses opened for Quantity in doses of a specified vaccine opened for vaccine administration within
1.3* Vaccine ledger/tally card
vaccination the reporting period

Quantity in doses of a specified vaccine with VVM status in stages 3 or 4 within

1.4* VVM status change (3 or 4) Vaccine ledger/tally card
the reporting period

Quantity of a specified vaccine/commodity which expired within the reporting

1.5* Expired Vaccine ledger/tally card
period

172
Code Variable Definition Data Source

Quantity of a specified vaccine/commodity which were lost due to other reasons

1.6* Other losses Vaccine ledger/tally card
other than VVM and expiry within the reporting period

Quantity of a specified vaccine/commodity available at the end of the reporting

1.7* Stock at end Vaccine ledger/tally card
period

Number of days of stock Number of days for which a specified vaccine/commodity run out-of-stock at the
1.8* Vaccine ledger/tally card
outs facility within the reporting period

Maximum temperature The maximum (highest/warmest) temperature recorded within the reporting
2.1 Fridge tag
recorded period

Minimum temperature
2.2 The minimum (lowest/coolest) temperature recorded within the reporting period Fridge tag
recorded

Number of days with high Number of days on which high temperature alarms were recorded within the
2.3 Fridge tag
temperature alarms reporting period

Number of days with low Number of days on which low temperature alarms were recorded within the
2.4 Fridge tag
temperature alarms reporting period

Number of refrigerators Absolute number of vaccine refrigerators available at the reporting facility within
2.5 Cold chain inventory
available the reporting period

173
Code Variable Definition Data Source

Number of functional Absolute number of functional vaccine refrigerators available at the reporting
2.6 Cold chain inventory
refrigerators facility within the reporting period

Remarks Other information worth sharing to the next high level on the report NA

Compiled by Name of the officer who completed the report Records

Designation The official position of the officer who completed the report Records

Date The date on which the report was completed Calendar

Contact Number The phone number of the officer who completed the report Records

174
MONTHLY VACCINATION FACILITY REPORT

Code Variable Definition Data Source

A Region The name of the region in which reporting facility is located. e.g. Volta Records

B District The name of the district in which reporting facility is located. e.g. Adaklu Records

The reporting facility from where the report is generated. e.g. Ahunda Health
C Name of Reporting Facility Records
Center
D Month The month the report was generated. e.g. January Calendar

E Sub-district The name of the sub-district in which reporting facility is located. e.g. Helekpe Records

F Year The year the report was generated. e.g. 2015 Calendar
The total population of all persons living the geographic areas for which the
1.1 Total population PPMED-GHS
report represents. E.g. 100,000
Infants 0-11 months:
1.2 The number of children aged 0-11 months old targeted in a year. e.g. 4,000 PPMED-GHS
annual
Infants 0-11 months:
1.2 The number of children aged 0-11 months old targeted in a month. e.g. 333 PPMED-GHS
monthly
Children 12 - 23 months:
1.3 The number of children aged 12-23 months old targeted in a year. e.g. 4,000 PPMED-GHS
annual
Children 12 - 23 months:
1.3 The number of children aged 12-23 months old targeted in a month. e.g. 333 PPMED-GHS
monthly
Expected Pregnancy:
1.4 The number of women expected to be pregnant in a year. e.g. 4,000 PPMED-GHS
annual

175
Code Variable Definition Data Source

Expected Pregnancy:
1.4 The number of women expected to be pregnant in a month. e.g. 333 PPMED-GHS
monthly
No. of fixed vaccination Facility micro-plan
2.1 Number of fixed vaccination sessions planned by the facility for the month
sessions planned
No. of fixed vaccination Facility micro-plan
2.1 Number of fixed vaccination sessions conducted by the facility for the month
sessions conducted
No. of outreach vaccination Facility micro-plan
2.2 Number of outreach vaccination sessions planned by the facility for the month
sessions planned
No. of outreach vaccination Number of outreach vaccination sessions conducted by the facility for the Facility micro-plan
2.2
sessions conducted month
No. of school vaccination Facility micro-plan
2.3 Number of school vaccination sessions planned by the facility for the month
sessions; planned
No. of school vaccination Facility micro-plan
2.3 Number of school vaccination sessions conducted by the facility for the month
sessions conducted
Monthly vaccination Number of children vaccinated with a specific vaccine dose in a month divided
3.1 Immunization Tally Sheet
coverage by the monthly target population
Number of children vaccinated with a specific vaccine dose from the beginning
3.2 Cumulative coverage Immunization Tally Sheet
of the year to the current month divided by the annual target population
The difference between the number of children vaccinated with the first and the
3.2 Dropout rate (Penta) third doses of the pentavalent vaccine divided by the number of children Immunization Tally Sheet
vaccinated with the first dose of the pentavalent vaccine multiplied by 100
The difference between the number of children vaccinated with BCG and MR-
3.2 Dropout rate (BCG/MR) Immunization Tally Sheet
1 divided by the number of children vaccinated with BCG multiplied by 100

176
Code Variable Definition Data Source

Monthly vaccinations by Number of children aged 0 - 11 months vaccinated or provided with a specific
4.1 Immunization Tally Sheet
age; 0 - 11 months dose of a vaccine or service
Monthly vaccinations by Number of children aged 12 - 23 months vaccinated or provided with a specific
4.2 Immunization Tally Sheet
age; 12 - 23 months dose of a vaccine or service
Monthly vaccinations by Number of children aged 24 months and above vaccinated or provided with a
4.3 Immunization Tally Sheet
age; >=24 months specific dose of a vaccine or service
Monthly vaccinations by Total number of children vaccinated or provided with a specific dose of a
4.4 Immunization Tally Sheet
age; total vaccinated vaccine or service
Number girls aged 9 years vaccinated with the first dose of HPV vaccine in
5.1 HPV1; in-school Immunization Tally Sheet
school
Number girls aged 9 years vaccinated with the first dose of HPV vaccine out-
5.1 HPV1; out-of-school Immunization Tally Sheet
of-school
Total number of girls aged 9 years vaccinated with the first dose of HPV
5.1 HPV1; total Immunization Tally Sheet
vaccine (both in-school & out-of-school)
Number girls aged 9 years vaccinated with the second dose of HPV vaccine in
5.2 HPV2; in-school Immunization Tally Sheet
school
Number girls aged 9 years vaccinated with the second dose of HPV vaccine
5.2 HPV2; out-of-school Immunization Tally Sheet
out-of-school
Total number of girls aged 9 years vaccinated with the second dose of HPV
5.2 HPV2; total Immunization Tally Sheet
vaccine (both in-school & out-of-school)
Number of children aged 6-11 months receiving vitamin A within the reporting
6.1 Vitamin A; 6-11 months Immunization Tally Sheet
period
Number of children aged 12-59 months receiving vitamin A within the
6.1 Vitamin A; 12-59 months Immunization Tally Sheet
reporting period

177
Code Variable Definition Data Source

Number of post-partum mothers receiving vitamin A within the reporting

6.1 Vitamin A; Post-partum Immunization Tally Sheet
period
No. of AEFI cases Number of non-serious adverse events following immunization (AEFI)
7.1 Immunization Tally Sheet
reported; non-serious reported within the reporting period
No. of AEFI cases Number of serious adverse events following immunization (AEFI) reported
7.1 Immunization Tally Sheet
reported; serious within the reporting period

8.1 No. of safety boxes used Number of safety boxes used within the reporting period Immunization Tally Sheet

No. of safety boxes

8.2 Number of safety boxes disposed within the reporting period Immunization Tally Sheet
disposed
Maximum temperature The maximum (highest/warmest) temperature recorded within the reporting
9.1 Fridge tag
recorded period
Minimum temperature The minimum (lowest/coolest) temperature recorded within the reporting
9.2 Fridge tag
recorded period
Number of days with high Number of days on which high temperature alarms were recorded within the
9.3 Fridge tag
temperature alarms reporting period
Number of days with low Number of days on which low temperature alarms were recorded within the
9.4 Fridge tag
temperature alarms reporting period
Number of refrigerators Absolute number of vaccine refrigerators available at the reporting facility
9.5 Cold chain inventory
available within the reporting period
Number of functional Absolute number of functional vaccine refrigerators available at the reporting
9.6 Cold chain inventory
refrigerators facility within the reporting period
No. of IEC sessions; Number of information, education and communication (social mobilization)
10.1 Micro-plan
planned activities planned within the reporting period

178
Code Variable Definition Data Source

No. of IEC sessions: Number of information, education and communication (social mobilization)
10.1 Activity report
conducted activities conducted within the reporting period
No. of participants: Number of participants that were present at the IEC activities conducted within
10.2 Activity report
conducted the reporting period
No. of home visit sessions;
10.3 Number of home visits planned within the reporting period Micro plan
planned
No. of home visit sessions:
10.3 Number of home visits conducted within the reporting period Activity report
conducted
Quantity of a specified vaccine/commodity available at the beginning of the
11.1* Beginning Vaccine ledger/tally card
reporting period

11.2* Received Quantity of a specified vaccine/commodity received within the reporting period Vaccine ledger/tally card

Total doses opened for Quantity in doses of a specified vaccine opened for vaccine administration
11.3* Vaccine ledger/tally card
vaccination within the reporting period
Quantity in doses of a specified vaccine with VVM status in stages 3 or 4
11.4* VVM status change (3 or 4) Vaccine ledger/tally card
within the reporting period
Quantity of a specified vaccine/commodity which expired within the reporting
11.5* Expired Vaccine ledger/tally card
period
Quantity of a specified vaccine/commodity which were lost due to other
11.6* Other losses Vaccine ledger/tally card
reasons other than VVM and expiry within the reporting period
Quantity of a specified vaccine/commodity available at the end of the reporting
11.7* Stock at end Vaccine ledger/tally card
period
Number of days of stock Number of days for which a specified vaccine/commodity run out-of-stock at
11.8* Vaccine ledger/tally card
outs the facility within the reporting period

179
Code Variable Definition Data Source

Remarks Other information worth sharing to the next high level on the report NA

Compiled by Name of the officer who completed the report Records

Designation The official position of the officer who completed the report Records

Date The date on which the report was completed Calendar

Contact Number The phone number of the officer who completed the report Records

NATIONAL AIDS CONTROL PROGRAMME

HTC REG

VARIABLE DESCRIPTION
NO.
Chronological numbering starting from 1
DATE
Date of client visit to the Health facility (dd/mm/yyyy)
NAME
Name of client/Patient
ADDRESS AND TELEPONE
NUMBERS
Traceable Address and Telephone Numbers

180
 VARIABLE DESCRIPTION
AGE
How old is the client/Patient
SEX
Whether client/patient is (Male/Female)

PRE-TEST INFOR. Whether Primary Information is provided on HIV/AIDS before test is conducted ( Yes/No)

Unit of facility where HIV test was conducted, Whether test was conducted at (OPD / IPD/ CWC/ FP/
TESTING POINT OTHERS)

The category/Population the client/Patient belongs to; either Partner of an Index Client (PIC), Child of
an Index Client ( CIC), STI Client (STI), High Risk ( HR), MSM, FSW, Prisoners, Persons who Inject
TYPE OF CLIENT/POPULATION Drugs (PWID),TB Patients (TB), Other Population (Others)Diagnostic Testing (DT)

FIRST RESPONSE Test kit for initial screening with either of the following outcomes; RI, RII, RI & II, Non-reactive

ORAQUICK Test kit for reactive test confirmation with either of the following outcomes; Reactive / Non-reactive

Test kit for positive test confirmation/tie breaker with either of the following outcomes HIV I, HIV II,
SD BIOLINE HIV I&II, Non-Reactive
FINAL TEST RESULT Outcome of test which is either (Positive/Negative)

POST TEST C. Whether information is provided on HIV/AIDS after test is conducted either (Yes/No)

181
 VARIABLE DESCRIPTION

PREVIOUSLY TESTED POSITIVE Whether client/patient have ever tested positive for HIV at in the past (Yes/No)

Whether client/patient have been handed over to care givers for care and support services (Yes/No) If
LINKED TO HIV CARE Yes, Provide Folder Number
COMMENTS Additional comments by service providers - Further Actions/ Clarification
SERVICE PROVIDER Full name of Service provider

182
HTC MONTHLY SUMMARY
INDICATOR DEFINITION SOURCE RELEVANCE
This refers to the number of males and non- To determine access to HIV
Number tested for HIV HTC Register
pregnant females tested for HIV. (Antibody test) testing
Number of males and non-pregnant females tested
Number HIV positive HIV positive. (Antibody test) (Includes previously HTC Register To know the disease burden
tested positive and actual positive)
This refers to the number of males and non-
Number Previously tested To know the extent of retesting
pregnant females who have ever tested HIV HTC Register
Positive among positives
positive
This refers to the number of males and non-
Actual Positive pregnant females who have tested HIV positive HTC Register To know the actual positive
after accounting for repeat testing.
This refers to the number of males and non-
Number linked into HIV care pregnant females HIV positive clients escorted to HTC Register Access to care
ART clinic and seen by a Health Care Worker
To promote index contacts and
This refers to types of persons/individuals targeted
Populations HTC Register high-risk groups HIV testing
for HIV testing services
services
This refers to health service delivery units/sites
within health facilities where HIV testing and To increase access to HIV
Entry Points HTC Register
counselling services are to be provided or are testing services
provided

183
ANC (PMTCT) REG

VARIABLE DESCRIPTION
This refers to all pregnant women who were positive prior to their
Known HIV Positive before current pregnancy
current pregnancy (Yes/No)

This refers to whether pregnant women were on ART treatment before

ARV Treatment before current pregnancy
their current pregnancy (Yes/No)

This refers to the HIV status of the pregnant woman during her first test
HIV status at Initial Testing for the current preg.
in the pregnancy, (Positive/ Negative)

This refers to the status of HIV negative pregnant women retested at 34

HIV Status of Negatives retested at 34wks for the current preg.
weeks of gestation, (Positive/ Negative)

This refers to whether diagnosed HIV positive pregnant women were put
ARV Treatment for the current preg.
on ARVs during current pregnancy, (Yes/No)

184
FORM A (PMTCT) MONTHLY SUMMARY
INDICATOR DEFINITION SOURCE RELEVANCE
To determine pregnant women
Number of known HIV positive This refers to all pregnant women who were
ANC Register who are already HIV positive
before current pregnancy positive prior to their current pregnancy
before current pregnancy.
To determine HIV positive
Number on ARV treatment before This refers to all pregnant women who were on pregnant who are already on ART
ANC Register
current pregnancy ART treatment before their current pregnancy treatment before current
pregnancy.
To determine HIV positive
Number of known HIV Positives This refers to all pregnant women who have been pregnant women not previously
before current pregnancy newly put known to be HIV positive and newly put on ANC Register initiated on ART treatment but
on treatment treatment during their current pregnancy newly initiated on ART treatment
in the current pregnancy
This refers to all pregnant women having their first
To determine access to HIV
Number initially tested HIV test irrespective of gestational age during ANC Register
testing among pregnant women
current pregnancy
To identify positive women and
This refers to all pregnant women testing positive
put in intervention to prevent
Number positive at initial testing at their first HIV test irrespective of gestational ANC Register
mother to child transmission of
age during current pregnancy
HIV
This refers to all initially HIV negative pregnant
Number of negatives retested at 34 To identify all those who might
women provided repeated test at 34 weeks of ANC Register
weeks have sero converted
gestation
To identify positive women and
This refers to all initially HIV negative pregnant
Number positive after retesting at put in intervention to prevent
women retested HIV positive at 34 weeks of ANC Register
34 weeks mother to child transmission of
gestation
HIV
This refers to pregnant women tested HIV To know the total number of
New HIV Positives positive at initial testing plus those retested HIV ANC Register HIV positive pregnant women
positive at 34 weeks and put in intervention to

185
 INDICATOR DEFINITION SOURCE RELEVANCE
prevent mother to child
transmission of HIV
This refers to all newly diagnosed HIV positive
Number of new positives put on pregnant women (initial positive + retested HIV To prevent Mother to child
ANC Register
ARV positive at 34 weeks) put on ARVs during current transmission of HIV
pregnancy
Number of Babies on ARV This refers to all babies born to HIV positive To prevent Mother to child
ANC Register
Prophylaxis mothers receiving ARV prophylaxis from birth transmission of HIV
This refers to all pregnant women both newly To know the total number of HIV
tested HIV positive at current pregnancy put on positive pregnant women who are
Total on ARVs ARVs and those who were tested HIV positive in ANC Register receiving ARV intervention to
their previous pregnancy and were put on ARVs prevent mother to child
and are still on ARVs before current pregnancy transmission of HIV

186
ART REGISTER

No VARIABLE DESCRIPTION
1 Visit No Sequential number of the visit, starting from 1
2 Date of Visit Date of client visit to the Health facility (dd/mm/yyyy)
Type of Visit This explains the type of visit of the client; whether 1. A client is being newly enrolled into HIV
Care 2. A Client has come for follow up visit, 3. A client has been transferred from one facility
3 to another
4 Client Name Name of client
5 Registration Number Registration Number of Client
6 NHIS Number National Health Insurance Scheme Number
7 Sex The sex of the client (Male/Female)
Refers to Client's Date of Birth at First Visit and Client's Age in years at subsequent visits.
8 Date of Birth/ Age (note** For babies <1yrs, Age = 0)
This refers to whether the client has ever taken some ARV in the past (whether full course or
9 Past ARV Experience prophylaxis) choose (Yes/No)
If yes, For Prophylaxis or Treatment Indicate if the past ARV medication was P for prophylaxis (PMTCT, PrEP, PEP, HIV exposed
10 (P/T) infant) or T for Treatment
11 Client on Cotrimoxazole Prophylaxis Refers to whether client has been offered Cotrimoxazole prophylaxis? (Yes/No)
ARV Status The ARV status of the client at each visit. START ART-A client who has been initiated on
treatment. Each client is initiated only once. START LATER-This is the Pre-ART client who
has never been initiated on ART. CONTINUE ART-This is an active client who has been
asked to continue on the current regimen. CHANGE REGIMEN-This is a client whose
regimen has been substituted or switched. STOP-This is a client who has been asked to stop or
has stopped ART. RESTART-This is a client who is being re-initiated on treatment after being
lost to follow up or stopped ART. RESTART LATER-This is the client who has been lost to
12 follow up OR stopped ART and undergoing counselling prior to re-starting ART.

187
 No VARIABLE DESCRIPTION
13 Drug Regimen Refers to drug regimen or combination or the set of drugs dispensed to the client
14 Regimen Type Refers to the type of regimen, whether its first, second, third or other line
15 Days Drug dispensed Number of days of regimen that is dispensed to the client

State the reasons for which a client's regimen has been changed. Reasons could be Drug
16 Reasons for Change in Regimen Toxicity, Treatment Failure, TB Diagnosis, Drug Stockout, Policy, Pregnancy, Others

Whether the client has any adverse clinical events due to Immune Reconstitution Two to
Twelve Weeks After ART Initiation? These could be presented in the following forms;
Does client have Adverse clinical Tuberculosis (Pulmonary), TB Meningitis, Cryptococcal Meningitis, CMV Retinitis, Herpes
17 events? (Immune Reconstitution) Zoster, Cerebral Toxoplasmosis, Pneumocystis jeroveci pneumonia (PJP), (Indicate -Yes/No)

Whether the client has any adverse clinical events due to the Appearance of New Ois?, These
Does client have Adverse clinical events could present in the following forms; Oral Candidiasis, Esophageal Candidiasis,
18 events? (Appearance of New Ois) Pneumocystis jeroveci pneumonia (PJP), Cerebral Toxoplasmosis (Indicate Yes/No)
Whether the client has any new adverse drug reactions due to the regimen , presented in the
following forms; Anaemia, Hepatotoxicity, Depression, Rash, Weight Gain, Weight Loss,
Does Client have New Adverse Drug Hyperglycemia, Bone dysfunction, Renal Impairment/Kidney dysfunction, Diarrhoea > 3days,
19 Reactions Pain/numbness/tingling in extremeties (Indicate Yes/No)
20 Has Client Been Screened for TB Whether the client has been screened for TB on a particular visit (Indicate Yes/No)
21 Is Client diagnosed with TB Whether the client has been diagnosed with TB (Indicate Yes/No)
22 Is Client on TB Treatment Whether the client is being treated for TB (Indicate Yes/No)
Is Client eligible for TB Preventive
23 Therapy (TPT) Whether client is eligible for TB Preventive Therapy at Initial Assessment (Indicate Yes/No)
24 Has Client Started TPT Whether client has been started on TPT? (Indicate Yes/No)
What is the outcome of the client's TPT status; Completed, Died, Stopped due to adverse
25 Outcome of TPT events, stopped due to development of active TB, stopped due to clinician decision, Loss to

188
 No VARIABLE DESCRIPTION
Follow-up
26 Is Client Pregnant? Whether client is pregnant; (Indicate Yes/No) ( applicable to female clients only)
Refers to the outcome of the pregnancy; Live Term birth, Pre-Term, Still Birth, Miscarriage,
27 Outcome of Pregnancy Spontaneous Abortion, Induced Abortion
Whether client has been switched from first line to second line or second line to third line,
28 Has Client Switched Regimen (Indicate Y1/Y2/N)
29 Has Client done VL Test Whether the client has done the Viral Load test (Indicate Yes/No)

30 VL @6 Months After Initiation The result of the viral load test done 6 months after initiating ART measured in (copies/ml)

31 VL @12 Months after Initiation The result of the viral load test done 12 months after initiating ART measured in (copies/ml)
The result of the viral load test done at repeat 12 months after initiating ART measured in
32 VL @ Repeat 12 Months (copies/ml)
33 Client Outcome Whether client is alive or dead (Alive/Dead)
34 Date of Death The date of death of clients who have passed away (dd/mm/yyyy)
35 Next Visit Date The next date of appointment for the client (dd/mm/yyyy)

189
ART MONTHLY SUMMARY
ART INDICATORS DEFINITION / DESCRIPTION SOURCE RELEVANCE
To determine the extent to which
All PLHIV who have never been initiated on HTC Register, Facility
Pre-ART Clients the treat all protocol is being
ART. This is cumulative Records, ART Folder
adhered to
New clients on Total number of new PLHIV given co- To determine the number of clients
ART Register, ART Folder
cotrimoxazole prophylaxis trimoxazole prophylaxis who are given co-trimoxazole

Total number of HIV positive clients initiated

on ART. Patients who are eligible to be
initiated on ART include (1) treatment-naive
patients with no prior use of ART; (2)
patients who have previously received only
Newly on ART ART Register, ART Folder Measures overall scale-up of ART
PEP or PrEP; (3) non-naïve patients with or
without records who received ART from
sources outside the formal health-care system
and have not been counted as new in the
national health system.

HIV positives screened for Total number of PLHIV screened for TB at To determine the TB status of
ART Register, ART Folder
TB the ART clinic. clients
to determine if service providers are
No of times ART clients Number of times/Episodes PLHIV are
ART Register, ART Folder adhering to the HIV/TB Screening
screened for TB screened for TB at the ART clinic.
protocol (screening at every visit)
HIV Positive clients with Total number of PLHIV who also have TB To know the number of co-infected
ART Register, ART Folder
TB on ART and are given ARVs TB clients on ART
New Clients eligible for Total number of HIV positive clients who are to determine the number of clients
ART Register, ART Folder
TPT eligible for TPT to be given TPT
New Clients started TPT Total number of HIV positive clients who ART Register, ART Folder

190
 ART INDICATORS DEFINITION / DESCRIPTION SOURCE RELEVANCE
have started TPT
Total number of PLHIV on ARVs who had to track the number of clients with
ART clients with adverse
adverse clinical events (Immune ART Register, ART Folder adverse clinical events for
clinical events
Reconstitution or New OIs etc ) pharmaco-vigilance

Total number of PLHIV on ARVs who had

ART clients with new
adverse drug symptoms (e.g. anaemia, rash, ART Register, ART Folder for pharma-covigilance reporting
adverse drug reactions
diarrhoea, hepatoxicity, etc )
ART clients with change Total number of PLHIV on ARVs who
of regimen due to drug changed their ARV regimen as a result of ART Register, ART Folder for pharma-covigilance reporting
toxicity drug toxicity.
to provide information on patient
ART clients with change All PLHIV on ARVs whose ARV regimen
drug management and
of regimen due to was changed by the Health Care Worker as a ART Register, ART Folder
quantification and procurement of
treatment failure result of Virological failure (VL >1000cp/ml)
ARVs
Number of clients who
All PLHIV on ARVs who died whiles on To monitor mortality among
stopped treatment due to ART Register, ART Folder
treatment PLHIVs
death
Number of clients who All PLHIV on ARVs who stopped taking
stopped treatment due to ARVs as a result of adverse clinical To know the number of PLHIVs
ART Register, ART Folder
adverse clinical status/events (e.g. Pulmonary TB, Kaposi who have failed treatment
status/events Sarcoma, chronic diarrhea etc ).

All PLHIV on ARVs who have missed their

Number of clients who scheduled appointments continuously for
To know the defaulter rate among
stopped treatment due to more than 90 days, who are not dead, ART Register, ART Folder
clients on treatment
loss to follow up transferred out or stopped treatment. This
cummulative
No of Clients who are All PLHIV who are pregnant ART Register, ART Folder to know the number of PLHIVs who

191
 ART INDICATORS DEFINITION / DESCRIPTION SOURCE RELEVANCE
are pregnant in order to target the
pregnant HIV exposed infants for
intervention
All PLHIV on first line ARV regimen (Refer for clinical management and
Clients on First Line ART Register, ART Folder
to ART Guidelines). procurement

All PLHIV on second line ARV regimen for clinical management and
Clients on Second Line ART Register, ART Folder
(Refer to ART Guidelines). procurement

All PLHIV on third line ARV regimen (Refer for clinical management and
Clients on Third line ART Register, ART Folder
to ART Guidelines). procurement

All PLHIVs on non-standard treatment

for clinical management and
Clients on Other Line regimen. These are clients who are not on ART Register, ART Folder
procurement
First, Second or Third Lines.
Cumulative number of PLHIV who are on to provide information on active
Currently on ART ARVs (treatment) and are active. This is ART Register, ART Folder clients on treatment at any point in
cummulative time
Number of Clients who
All PLHIV clients who have been tested for
have been tested for Viral
Viral Load @ 6 - 11 months after ART ART Register, ART Folder To monitor the third 90
load @ 6 months after
initiation
ART initiation
Number of Clients Virally
All PLHIV clients whose Viral load is <
suppressed @ 6 Months ART Register, ART Folder To monitor the third 90
1000cp/ml @ 6 - 11 of ART initiation
after ART initiation
Number of Clients who
All PLHIV clients who have been tested for
have been tested for Viral
Viral Load @ 12 - 23 months after ART ART Register, ART Folder To monitor the third 90
load @ 12 months after
initiation
ART initiation
Number of Clients Virally All PLHIV clients whose Viral load is < ART Register, ART Folder To monitor the third 90

192
 ART INDICATORS DEFINITION / DESCRIPTION SOURCE RELEVANCE
suppressed @ 12 Months
1000cp/ml @12 - 23 of ART initiation
after ART initiation
Number of Clients who
All PLHIV clients who have been tested for
have been tested for Viral
Viral Load @ 24 months or more after ART ART Register, ART Folder To monitor the third 90
load @ Repeat 12 months
initiation
after ART initiation
Number of Clients Virally
All PLHIV clients whose Viral load is <
suppressed @ Repeat 12
1000cp/ml @24 months or more of ART ART Register, ART Folder To monitor the third 90
Months after ART
initiation
initiation
Proportion of Clients on
Proportion of clients on treatment whose
treatment who are Virally
Viral load is < 1000cp/ml @12 of ART ART Register, ART Folder To monitor the third 90
suppressed @ 12 Months
initiation
after ART initiation
Proportion of Clients who
have been tested and are
Proportion of clients tested whose Viral
Virally suppressed @ 12 ART Register, ART Folder To monitor the third 90
load is < 1000cp/ml @12 of ART initiation
Months after ART
initiation

193
EID MONTHLY SUMMARY

INDICATOR DEFINITION SOURCE RELEVANCE

Number of HIV exposed This refers to all infants born to HIV positive Delivery Register, CWC To know the number of HIV
infants mothers Register exposed infants
Number of HIV exposed
This refers to all infants born to HIV positive To ensure that HIV prophylaxis
infants given ARV ANC Card, CWC Register
mothers given ARV prophylaxis is given to all exposed infants
prophylaxis
Number of HIV exposed
This refers to all infants born to HIV positive Ensure that Septrin is given to
infants given septrin ANC Card, CWC Register
mothers given Septrin from 6 weeks all HIV exposed infants
prophylaxis
Number of HIV exposed To determine the number of
This refers to all infants born to HIV positive
Infants tested by DNA ANC Card, CWC Register infants who have access to DNA
mothers tested for HIV by DNA PCR
PCR PCR test
Number of HIV exposed
This refers to all infants born to HIV positive To determine the effectiveness
Infants tested positive by ANC Card, CWC Register
mothers tested HIV positive by DNA PCR of the PMTCT intervention.
DNA PCR
Negative infants retested This refers to all infants initially tested HIV
To determine transmission
at 9 months by DNA negative by DNA PCR retested at 9 months by ANC Card, CWC Register
through Breast Feeding
PCR DNA PCR
Number of HIV exposed
Infants retested positive This refers to all HIV negative infants retested HIV To determine transmission
ANC Card, CWC Register
by DNA PCR at 9 positive at 9 months by DNA PCR through Breast Feeding
months
Number of exposed
This refers to all children previously tested for HIV
children tested by To confirm HIV status of the
(both positive and negative) by DNA PCR being ANC Card, CWC Register
antibody test at 18 exposed children
tested for HIV using antibody test from 18 months
months
Number tested positive This refers to all children previously tested for HIV To confirm HIV status of the
ANC Card, CWC Register
using antibody test at 18 (both positive and negative) by DNA PCR who exposed children

194
 INDICATOR DEFINITION SOURCE RELEVANCE
tested HIV positive using antibody test from 18
months
months
Number of DNA PCR
This refers to all infants tested HIV positive by To promote and improve HIV
HIV positive Infants ANC Card, CWC Register
DNA PCR before 18 months and enrolled into care positive clients linkage to care
enrolled into HIV care
ANC Card, CWC
Number of Antibody To promote, improve & track
This refers to all infants tested HIV positive by Register, ART Register,
Tested positive Infants HIV positive clients linkage to
Antibody test from 18 months and enrolled into care ART Client Folder, E-
enrolled into HIV care care
tracker

195
EID REGISTER

Data element Description

Name of Mother
Refers to the name of Client’s mother (Surname, first name, & aliases/Nickname)

Mother's Surname Refers to the Client's mother’s Surname

Mother's First name Refers to the Client's mother’s first name
Mother's Nick name Refers to the Client's mother’s Nickname
Address of Client
Refers to a traceable address of the Client, house address/street name

Tel No. of Client Refers to telephone (Fixed line) or mobile number of Client
Email address Refers to the Email address of Client
Date of delivery
This indicates the Date the baby was born
Sex
Refers to the Sex of the child born to HIV positive mother, indicate whether Male or Female

Type of ARVs given at Birth

Indicates the ARV given to the child, whether AZT (syrup) or NVP (syrup)

Septrin at 6 Wks
Indicate whether the child was given Septrin, state Yes (Y) or No (N)

DNA-PCR Tested at 6Wks

Indicate DNA PCR tested at week 6, indicate Yes (Y) or No (N)

DNA-PCR After 6Wks - 18 Months

This Indicates DNA PCR tested after 6 weeks to 18 months , State in Weeks or Months)

196
 Data element Description
EID Results
This Indicate the child DNA/PCR results whether Positive (POS) or Negative (NEG)

Antibody Test at 18 Months

This refers to the antibody test results for all HIV exposed infants including those tested negative
for DNA/PCR, indicate whether Positive (POS) or Negative (NEG). This determines the HIV
result of the exposed infants at 18 months.

Antibody Test Results

This refers to the antibody test results for all HIV exposed infants including those tested negative
for DNA/PCR, indicate whether Positive (POS) or Negative (NEG). This determines the HIV
result of the exposed infants after 18 months.

Referred into Care

This indicates whether the client has been referred into care for further management, (indicate Yes
or No)
Comments
This refers to Actions/Clarification or any other comment on service provided.

Name Refers to the counsellor's details (name and other details)

197
EARLY WARNING INDICATORS

Data element Description

The name of the Health Facility e.g. Holy family Hospital, Techiman
Facility

The name of the district in which the Health Facility is located, e.g. Techiman North Sub District
Sub District

The name of the district in which the Health Facility is located, e.g. Techiman Municipal.
District

The name of the region in which the Health Facility is located e.g. Bono East.
Region
Quarter The month in which the transaction took place e.g. May.

Year The year the report is being generated

Male All boys and men reporting at the facility

Female All girls and women reporting at the facility

Age Group Age categorization of clients/Patients

Percentage of ART patients picking up all prescribed ARV drugs on time (Baseline + 1 pick-up)
On time ARV pill pickup (Numerator/Denominator)

Percentage of adults and children known to be alive and on treatment 12 months after initiation of ART
(Numerator/Denominator)
Retention on ART at 12 Months

198
 Data element Description
Percentage of months in a designated year in which there were no ARV drug stock-outs
ARV Drug Supply Continuity (Numerator/Denominator)

Percentage of patients with confirmed virological failure switched to second line ART within three months of
Appropriate Switch to Second making a diagnosis of failure. (Numerator/Denominator)
Line

Percentage of patients receiving ART at the site after the first 12 months of ART whose viral load is <1000
Virological Suppression at 12 copies/ml (Numerator/Denominator)
Months
DATE
COMPLETED BY
APPROVED BY

199
POST EXPOSURE PROP (PEP)
Data element Description
Risk Level This refers to the severity or otherwise of the exposure. It is measured as; (Very Low, Low, High,
Rape)
Outcome This refers to the HIV Status After Giving Prophylaxis and Testing for HIV. It is either (Positive /
Negative)
Age Band Refers to the age aggregation of patients Paediatric Male (0-14) Adult, (15+)
Very Low Exposure of potentially infectious material to intact skin
Exposure to a small volume of blood or body fluids contaminated with blood from asymptomatic
Low HIV-positive patients. 2. An injury with a solid needle. 3. Any superficial injury or mucocutaneous
exposure
Exposure to a large volume of blood or potentially infectious fluids. Exposure to blood or body fluids
contaminated with blood from a patient with a high viral load. i.e. patients in the AIDS phase or early
sero-conversion phase of HIV infection. Injury with a hollow bore needle. Deep and extensive injury
High from a contaminated sharp instrument. Exposure to blood from an HIV Drug resistant patient.

Anybody who reports of an unlawful sexual intercourse or any other sexual penetration of any form
Rape (vagina, anus, mouth) of another person, with or without force, by a sex organ, other body part, or
foreign object, without the victim's consent.

200
OTHER INDICATORS
PROGRAMME INDICATOR DEFINITION NUMERATOR DENOMINATOR REMARKS
Number of health
Percentage of health Proportion of health This is to measure
facilities providing Total number of
facilities providing facilities providing access to PMTCT
PMTCT integrated package of health facilities in a
integrated package of integrated package of services within the
PMTCT services in given period
PMTCT services PMTCT services catchment area
period a given
Number of HIV
Percentage of HIV Proportion of HIV Total number of
exposed infants who
exposed infants who exposed infants who infants born to HIV
are breastfeeding and
PMTCT are breastfeeding and are breastfeeding and positive women
covered by ARV
covered by ARV covered by ARV within the specified
prophylaxis in a given
prophylaxis prophylaxis time period
period
Percentage of new Proportion of new Total number of Total number of
HIV positive pregnant HIV positive (all newly diagnosed newly diagnosed HIV
women who newly newly diagnosed HIV (initial positive + positive (initial
received positive pregnant retested HIV positive positive + retested
Antiretrovirals to women (initial at 34 weeks) HIV HIV positive at 34
reduce the risk of positive + retested positive pregnant weeks) pregnant
mother-to-child HIV positive at 34 women within the women within the
transmission of HIV weeks)) who newly current period who current period
(New) received were newly given
Antiretrovirals to Antiretrovirals to
reduce the risk of reduce the risk of
mother-to-child mother-to-child
PMTCT transmission. transmission
Percentage of Known Number of Known
HIV positive pregnant Proportion of Known Number of Known HIV Positive pregnant
women who newly HIV Positive pregnant HIV Positive pregnant women (from the
received women who are not women (from the previous period) who
PMTCT on ARVs but were previous period) who

201
PROGRAMME INDICATOR DEFINITION NUMERATOR DENOMINATOR REMARKS
Antiretrovirals to are not on ARVs but are not on ARVs
reduce the risk of were newly given before the current
mother-to-child newly given Antiretrovirals to period.
transmission (New) in Antiretrovirals to reduce the risk of
the current period reduce the risk of mother-to-child
mother-to-child transmission of HIV
transmission of HIV in the current period
Percentage of Known Number of known Number of Known
HIV positive pregnant HIV Positive pregnant HIV Positive pregnant
women who are Proportion of Known women (from the women (from the
already on ARVs HIV Positive pregnant previous period) who previous period) who
before the current women already on are already on ARVs are visiting for
period Antiretrovirals before prior to the current services within the
PMTCT current period period current period
Proportion of all HIV
positive (including
positives from HTC Number of HIV This is to the access to
and PMTCT) who positive clients (both ART treatment
Linkage to ART were given ART in HTC+ PMTCT) who services to determine
treatment (Linkage to line with the "treat all were initiated on ART the extent of the "treat
ART treatment) policy" during the period all policy" of HIV
Proportion of all HIV
Percentage of HIV Exposed Infants
Exposed Infants (HEI) who tested for
(HEI) who had Early HIV using DNA PCR
Infant Diagnosis of (for ages 0 to less than
EID HIV done via PCR 18 months)
CONSOLIDATED HIV REFERENCE SHEET

202
 Item Indicator Name (Short Disaggregation/Comments/
Short Description Numerator Denominator
# Name) Source

Number of respondents Population (Gen Pop, MSM,

% of people who used condoms Number of respondents who say they used a condom who report having had sex FSW) ; Gender (male, female)
Condom use (KP & Gen
during their last high-risk sex the last time they had sex with a non-marital, non- with a non-marital, non- Age (<25, 25+). This is usually
1

pop)
act* in the last 12 months cohabitating (non-regular) partner in the last 12 months cohabitating partner in the integrated in national surveys
last 12 months such as DHS and IBSS.

Condom type (male, female)

• Distribution type (commercial
Total number of condoms sector, social marketing, public
Number of condoms distributed and sold during the
Condoms distributed distributed during the reporting NA sector). Data for the health
2

reporting period
period facility distribution is available
on the Monthly Family
Planning Form B.

Gender (male, female)

• Age (15–19, 20–24, 25–49
and 50+)
• Experience with PrEP (first-
time users, repeat users)
• Populations (MSM, FSW,
% of eligible people who Number of people who discordant couples)
initiated Number of people who initiated oral PrEP during the were newly offered PrEP • Dosing (daily oral PrEP,
PrEP uptake
3

oral PrEP during the reporting reporting period during the reporting event-driven PrEP (for MSM)).
period period Data collection tools recently
developed as part of PreP
implementation guidelines.
Further discussion needed to
have system for national level
reporting e.g. in DHIMS/tracker
or GKPIUS.

203
 Item Indicator Name (Short Disaggregation/Comments/
Short Description Numerator Denominator
# Name) Source

Gender (male, female)

• Age (15–19, 20–24, 25–49
and 50+)
• Experience with PrEP (first-
time users, repeat users)
% of PrEP users who continued • Populations (MSM, FSW,
oral discordant couples)
Number of people who continued PrEP for 3 Number of people who
PrEP continuation PrEP for 3 consecutive months • Dosing (daily oral PrEP,
consecutive months after having initiated PrEP during initiated oral PrEP during
4

(at 3 months) after event-driven PrEP (for MSM)).

the reporting period the reporting period
having initiated PrEP during the Data collection tools recently
reporting period developed as part of PreP
implementation guidelines.
Further discussion needed to
have system for national level
reporting e.g. in DHIMS/tracker
or GKPIUS

Gender (male, female)

• Age (15–19, 20–24, 25–49
and 50+)
• Experience with PrEP (first-
time users, repeat users)
• Populations (MSM, FSW,
Number of people who received discordant couples)
oral PrEP at least once during Number of people who received oral PrEP at least once • Dosing (daily oral PrEP,
Currently on PrEP NA
5

the during the reporting period event-driven PrEP (for MSM)).

reporting period Data collection tools recently
developed as part of PreP
implementation guidelines.
Further discussion needed to
have system for national level
reporting e.g. in DHIMS/tracker
or GKPIUS

204
 Item Indicator Name (Short Disaggregation/Comments/
Short Description Numerator Denominator
# Name) Source

• Gender (male, female)

• Age (0–4, 5–9, 10–14, 15–19,
20–24, 25–49, 50+)
• Key populations (MSM, FSW)
• ANC attendees.
This will be obtained using
PLHIV who know their Number and % of PLHIV who Number of people living with HIV who have received
NA UNAIDS SPECTRUM
6

status (first 95) know their status their diagnosis and are still alive
SOFTWARE, there is need to
discuss further disaggregation
of this indicator for KP (full
functionality of GKPIUS is first
consideration) and ANC
attendees.
• Gender (male, female
• Age (0–4, 5–9, 10–14, 15–19,
20–24, 25–29, 30–34, 35–39,
40–44, 45–49, 50+)
• Key populations (MSM, FSW)
• TB status (presumptive TB,
diagnosed TB, none)
Number of HIV tests conducted Number of tests • Testing entry point
(testing volume) and the % of Number of tests conducted in which a new HIV- performed where results (Community, facility).
HTS testing volume and
HIV positive results returned to positive result or diagnosis was returned to a person were returned to a person This is separate in data
7

positivity
people during the reporting period (positivity) during the reporting collection tools but should be
(positivity) period (testing volume) reported together as one
indicator using the following
format #Tested (#positive) in
DHIMS2

Action: Community level and

TB Status disaggregation need
further work

205
 Item Indicator Name (Short Disaggregation/Comments/
Short Description Numerator Denominator
# Name) Source

• Gender (male, female

• Age (0–4, 5–9, 10–14, 15–19,
20–24, 25–29, 30–34, 35–39,
40–44, 45–49, 50+)
• Key populations (MSM, FSW)
• TB status (presumptive TB,
diagnosed TB, none)
• Testing entry point
(Community, facility) •Time
to start ART (within 14, 30 or
Number of people newly 90 days of diagnosis). This
% of people newly diagnosed
Number of people newly diagnosed with HIV and diagnosed with HIV indicator is not currently
Linkage to ART with
8

started ART during the reporting period during the reporting reported with denominator from
HIV initiated on ART
period DHIMS and numerator from e-
tracker, this is not optimal, the
process for resolving it will
include:
•Short Term - Improve
programmatic arrangements for
ensuring all positive clients
initiated are captured in e-
tracker.
•Long term - full deployment of
the HIV Surveillance System.

206
 Item Indicator Name (Short Disaggregation/Comments/
Short Description Numerator Denominator
# Name) Source

• Index case gender (male,

female)
• Age (0–4, 5–9, 10–14, 15–19,
20–24, 25–49, 50+)
Number of elicited partners of people diagnosed with
• HIV status of partner or
HIV who received HTS. Additional cascade data
contact (already knew positive,
should be collected:
newly diagnosed positive,
Number of people who were • Number of people diagnosed with HIV (index cases)
negative)
HTS index and partner identified and tested using index offered partner services
NA • Key populations (MSM,
9

notification testing services and received • Number of people diagnosed with HIV (index cases)
FSW).
their results accepting partner services
HTC Summary tool includes
• Number of contacts/partners of people living with
index testing
HIV whose information is elicited from
Disaggregation by population
people diagnosed with HIV (index cases).
age contacted HIV status
currently not available
Information available in
DHIMS2 on testing and results

207
 Item Indicator Name (Short Disaggregation/Comments/
Short Description Numerator Denominator
# Name) Source

• Gender (male, female)

• Age (10–14, 15–19, 20–24,
25–29, 30–34, 35–39, 40–44,
45–49, 50+) •
Key populations (MSM FSW)
•HIVST approach (community-
based,
facility-based, secondary
Number of individual HIVST
HIVST distribution Number of individual HIVST kits distributed NA distribution )
10

kits distributed
• HIVST distribution by type of
sites (community outreach,
mobile, workplace, antenatal
clinic, primary care,
outpatient department, STI
clinic, family planning clinic)
• HIVST distributed for use
by(self, sex partner, other)

208
 Item Indicator Name (Short Disaggregation/Comments/
Short Description Numerator Denominator
# Name) Source

Number of respondents who know that they are living

with HIV (Q3 = a) or number of respondents who
report having tested for HIV in last 12 months (Q1 = b
• Gender (male, female)
% of key population members & Q2= a or b) AND the result was negative (Q3 = b)
• Age (<25, 25+)
who tested for HIV in the past Q1. Do you know your HIV status from an HIV test?
Know their status (KP) Number of respondents • Key populations (MSM FSW).
11

12 months or who know their a. No, I have never been tested; b. Yes, I have been
Survey - IBBSS for FSW and
current HIV status tested Q2. If yes, when were you last tested? a. In the
MSM Available
past 6 months; b. 6–12 months ago; c. More than 12
months ago Q3. Was the result of your last test: a.
Positive; b. Negative; c. Inconclusive

1. To determine treatment
coverage: Estimated
number of people living
• Gender (male, female, )
with HIV (from models,
Number and % of people on • Age (0–4, 5–9, 10–14, 15–19,
Number of people on ART at the end of the reporting such as Spectrum AIM)
ART among all people living 20–24, 25–29, 30–34, 35–39,
PLHIV on ART period (programme data). For key populations survey 2. To gauge progress
12

with HIV at the end of the 40–44, 45–49, 50+)

data may be required. toward the second 95
reporting period • Key populations (MSM,
target, number of people
FSW).
living with HIV who
know their HIV status
(from surveys, models)

209
 Item Indicator Name (Short Disaggregation/Comments/
Short Description Numerator Denominator
# Name) Source

Gender, Age, by KP Type,

Treatment Outcome.
Number of people living with HIV reported on ART at
To track at Community Cadre
Number and % of people living the end of the last reporting period who were not on
Initiatives : Community cadres
with HIV reported on ART at treatment at the end of the current reporting period Number of people
bringing people back to care -
the end of the last reporting (including those who died, stopped treatment and were reported on ART at the
"percentage of defaulters track
period and/or newly initiating lost to follow-up). plus end of the last reporting
Total attrition from ART back into treatment. To serve a
13

ART during the current Number of people living with HIV newly initiated on period plus new on ART
programmatic need (missed /
reporting period who were not ART during the current reporting period during the current
defaulter - agree on the
on ART at the end of the who were not on treatment at the end of the current reporting period
nomenclature to address our
reporting period reporting period (including those who
special indicator)
died, stopped treatment or were lost to follow-up).
The source of the information
shall be the ART e-tracker

Number of people living

with HIV on ART at least
Number of people living with HIV on ART for at least
% of PLHIV on ART (for at 6 months with at least one Gender, Age, by KP Type. Data
PLHIV who have 6 months and with at least one routine VL test result
least 6 months) who have routine VL result in a elements available - ART e-
14

suppressed VL who have virological suppression (<1000 copies/mL)

virological suppression medical or lab record tracker
during the reporting period
during the reporting
period

Gender, Age, by KP Type,

Number of people living with HIV who initiated ART
Number of PLHIV who initiated Pregnant or breastfeeding
New ART patients in accordance with national treatment guidelines NA
15

ART women. Data elements available

during the reporting period
– e-Tracker/GKPUIS.

210
 Item Indicator Name (Short Disaggregation/Comments/
Short Description Numerator Denominator
# Name) Source

Gender, Age, by KP Type .

% of people on ART (for at least Number of ART patients with at least one routine VL Number of ART patients Need to improve programmatic
VL testing coverage
17

6 months) with VL test results test result during the reporting period on ART at least 6 months systems to enable reporting of
this from e-tracker

Number of ART patients

Number of ART patients who were eligible for VL eligible for VL Gender, Age, by KP Type .
Number and % of PLHIV on
Early VL testing (at 6 monitoring at 6 months after initiation of ART during monitoring at 6 months Need to improve programmatic
ART who had VL monitoring at
18

months) the reporting period and who had VL monitoring at 6 after initiation of ART systems to enable reporting of
6 months after initiation of ART
months1 and received their results during the reporting this from e-tracker
period

Gender, Age, by KP Type,

Number of people living
% of people receiving ART with Number of people living with HIV on ART who ARV regimen, receipt of
with HIV on ART with
Appropriate second VL VL ≥1000 copies/mL who received a follow-up VL test within 6 months after a adherence counselling. Need to
VL ≥1000 copies/ml
19

test received a follow-up VL test VL test result of ≥1000 copies/ml during the reporting improve programmatic systems
during the reporting
within 6 months period to enable reporting of this from
period.
e-tracker

Gender, Age, by KP Type,

Number of ART patients who have stopped treatment Pregnant or breastfeeding
% of ART patients with Number of ART patients
ART toxicity prevalence or switched regimen due to toxicity in the reporting women. Need to improve
20

treatment limiting* toxicity in the reporting period

period programmatic systems to enable
reporting of this from e-tracker

211
 Item Indicator Name (Short Disaggregation/Comments/
Short Description Numerator Denominator
# Name) Source

• Gender (male, female)

• Age (<5; 5–15; 15+)
Number and % of eligible
Number of ART patients • Type of TPT regimen
PLHIV
Number of ART patients who initiated TPT during the who are eligible for TPT • ART initiation (new on ART
TPT initiation on ART who initiated TB
21

reporting period during the reporting in the last 12 months, on ART

preventive
period >12 months). Data Available in
treatment
the ART Register and the ART
e-tracker

• Gender (male, female)

• Age (<5; 5–15; 15+)
% of PLHIV on ART who
Number of ART patients • Type of TPT regimen
completed
Number of ART patients who completed a course* of who initiated any course • ART initiation (new on ART
TPT completion a course of TB preventive
22

TPT during the reporting period of TPT during the in the last 12 months, on ART
treatment
previous reporting period >12 months). Data Available in
among those who initiated TPT
the ART Register and the ART
e-tracker

•Gender (male, female)

Number of people living • Age (0–4, 5–14, 15–19, 20–
% of PLHIV with TB symptoms Number of people living with HIV and having TB with HIV and who are 24, 25–49, 50+.)
TB diagnostic testing who receive a rapid molecular symptoms who were tested using a rapid molecular test screened for TB and • Key populations (MSM, FSW)
23

type test as a first test for diagnosis of (for example, Xpert MTB/RIF) as a first test during the found to have symptoms • Pregnant or breastfeeding
TB reporting period during the reporting women.
period Data Available in the ART
Register and the ART e-tracker

212
 Item Indicator Name (Short Disaggregation/Comments/
Short Description Numerator Denominator
# Name) Source

•Gender (male, female)

• Age (0–4, 5–14, 15–19, 20–
24, 25–49, 50+.)
Number of people living • Key populations (MSM, FSW)
% of PLHIV newly initiated on Number of people living with HIV newly initiated on
PLHIV with active TB with HIV new on ART • Pregnant or breastfeeding
ART who have active TB ART during the reporting period who have active TB
24

disease during the reporting women. Data available in

disease disease
period register - Update in the ART e-
Tracker, disaggregation by KP
and pregnant or breastfeeding
needs further work

Number of HIV-positive • Age (<15, 15–19, 20–24,

% of HIV-positive pregnant pregnant women on ART 25+)
women Number of HIV-positive pregnant women on ART during pregnancy who • Timing of ART initiation
Viral suppression at
who are virally suppressed at during pregnancy and delivery at a facility during the deliver at a facility during (during pregnancy, on ART at
25

labour and delivery

labour reporting period and who were virally suppressed (VL the reporting period and first ANC visit). The
and delivery had a VL test during information source shall the
delivery ART e=tracker
• Test result (HIV-positive,
% of HIV-exposed infants who
Estimated number of HIV-negative, indeterminate,
receive Number of HIV-exposed infants born during the
HIV-positive women who other) • •Age of infant (<2
EID coverage a virological test for HIV within reporting period who received a virological HIV test
26

delivered during the months, 2–12 months). The

2 within 2 months (and 12 months) of birth
reporting period source of the information is the
months (and 12 months) of birth
DHIMS2

213
 Item Indicator Name (Short Disaggregation/Comments/
Short Description Numerator Denominator
# Name) Source

Population-based
denominator Number of
HIV-positive women who
delivered within the past Information source is from the
Number of HIV-exposed infants born within the past
Infant ARV % of HIV-exposed infants who 12 months population (the UNAIDS
tHE

12 months who were started on ARV prophylaxis at

prophylaxis coverage initiated ARV prophylaxis Programme-based SEPETRUM and the
birth
denominator Number of programme (DHIMS2)
HIV-positive women who
delivered in a facility
within the past 12 months

Population-based
denominator Number of
HIV-positive pregnant
•Age (<15, 15–19, 20–24, 25+)
women who delivered
•Timing
during the reporting
% of HIV-positive pregnant of ART initiation (1. already on
period
women Number of HIV-positive pregnant women who ART at first ANC visit, 2.
ART coverage in pregnant Programme-based
who received ART during delivered during the reporting period and received newly on ART during
28

women denominator Number of

pregnancy ART during pregnancy and/or labour and delivery pregnancy,
HIV-positive pregnant
and/or at labour and delivery 3. newly on ART during labour
women who delivered
and delivery, 4. on non-
during the reporting
recommended ART regimen)
period and attended ANC
or had a facility-based
delivery

Number of HIV-exposed
% of HIV-exposed breastfeeding Number of HIV-exposed breastfeeding infants whose
infants attending MCH
infants whose mothers are mothers are receiving ART at 12 months (and 24
ART coverage in services for a 12-month
receiving months*) postpartum.
29

breastfeeding mothers visit (and 24-month visit

ART at 12 (and 24 months) * Or a timeframe matched to median duration of
or first visit after the end
postpartum breastfeeding in the country
of breastfeeding)

214
 Item Indicator Name (Short Disaggregation/Comments/
Short Description Numerator Denominator
# Name) Source

Population-based
denominator Estimated
number of HIV-positive
women who delivered
within the past 12 months
(or 24 months in
breastfeeding settings)
% of HIV-exposed infants HIV-exposed infants born within the past 12 months Outcome status (HIV-positive,
Programme-based
Final outcome of PMTCT whose (or 24 months in breastfeeding settings) with known HIV-negative, no longer
30

denominator Number of
final outcome status is known final outcome status breastfeeding).
HIV-exposed infants who
were born within the 12
months (or 24 months in
breastfeeding settings)
prior to the reporting
period and registered in
the birth cohort

Number of women
Age (<15, 15–19, 20–24, 25+).
Syphilis screening % of ANC attendees tested for Number of women attending ANC services during the attending ANC services
Available in Form A in the
31

coverage (in ANC) syphilis reporting period who were tested for syphilis during the reporting
DHIMS2
period

Number of syphilis seropositive ANC attendees within Number of syphilis

% of ANC attendees testing
Syphilis treatment the past 12 months who received treatment with at seropositive ANC Age (<15, 15–19, 20–24, 25+).
seropositive for syphilis who are
32

coverage (in ANC) least one dose of benzathine penicillin 2.4 MU attendees within the past Available in Form A
treated
intramuscularly 12 months

% of women living with HIV Number of survey respondents who report ever having
Cervical cancer
who have a screening test for cervical cancer using any of these Number of survey Not in the guidelines might be
screening among
33

been screened for cervical methods: visual inspection with acetic acid (VIA), pap respondents considered at a later date.
women living with HIV
cancer smear or HPV test

215
 Item Indicator Name (Short Disaggregation/Comments/
Short Description Numerator Denominator
# Name) Source

Number of survey respondents who answer “yes” to

any of the following: “Have you ever avoided
seeking… A. any health care B. HIV testing C. HIV
Avoidance of health care % of key population members medical care or D. HIV treatment in the last 12 months Age (<25, 25+)
Number of survey
due to stigma and who avoid health care because …due to any of the following: 1. fear of or concern • Key populations (MSM,FSW).
34

respondents
discrimination (KP) of stigma and discrimination about stigma 2.fear or concern that someone may learn Available in survey.
you were a [insert KP type] 3.fear of or concern about
or experience of violence 4.fear of or concern about or
experiencing harassment or arrest by police?

Number of survey respondents who answer “yes” to

any of the following: Have you ever avoided seeking…
A. health-care B. HIV testing C. HIV medical care or
Avoidance of health care % of PLHIV who avoid health
D. HIV treatment in the last 12 months …due to any of Number of survey • Age (<25, 25+). Available in
due to stigma and carebecause of
35

the following: 1. fear of or concern about stigma 2. fear respondents Survey

discrimination (PLHIV) stigma and discrimination
or concern that someone may learn that you are HIV-
positive 3. fear of or concern about or experience of
violence?

216
 Item Indicator Name (Short Disaggregation/Comments/
Short Description Numerator Denominator
# Name) Source

A. Survey-based Numerator Number of surveyed

people in a key population who have received a
defined, evidence-based package of HIV prevention
interventions (consistent with WHO guidelines) within
a defined timeframe Consistent with GAM guidance,
the numerator is measured as follows: Number of
respondents of key population surveys who report A. Survey-based
receiving at least two of the following prevention Denominator Number of
services from an NGO, healthcare provider or other people in a key population
sources: • In the past 3 months, have you been given responding to the survey.
condoms and lubricant (for example, through an B. Programme-based Gender (male, female)
% of KP members reached with outreach service, drop-in centre or sexual health Denominator • Age (<25, 25+ years).
Coverage of HIV HIV prevention programmes clinic)? • In the past 3 months, have you received Estimated size of key Reached - Program based -
37

prevention (KP) with a defined package of counselling on condom use and safe sex (for example, population group . Available (GKPUIS), need to
services through an outreach service, drop-in centre or sexual For the denominator. have full reporting in GKPIUS
health clinic)? • Have you been tested for sexually Validated population Syrvey based using IBBSS
transmitted infections in the last 3 months? (only for size estimate for area
sex workers, transgender people and men who have relevant to the
sex with men) • Have you received new, clean needles programme
and syringes in the past 3 months? (only for people of interest
who inject drugs).
B. Programme-based
Numerator
Number of people in a key population who have
received a defined, evidence-based package of
HIV prevention interventions

217
 Item Indicator Name (Short Disaggregation/Comments/
Short Description Numerator Denominator
# Name) Source

Number of survey respondents who answer “yes” to

any of the following: “Have you ever avoided Gender (male, female)
seeking… A. any health care B. HIV testing C. HIV • Age (<25, 25+ years).
Avoidance of health % of KP members who avoid medical care or D. HIV treatment in the last 12 months Available in survey - IBBSS,
Number of survey
care due to stigma and health care because of stigma …due to any of the following: 1. fear of or concern with full reporting of GKPIUS
39

respondents
discrimination (KP) and discrimination about stigma 2.fear or concern that someone may learn programmatic reporting of this
you were a [insert KP type] 3.fear of or concern about indicator can be achieved as
or experience of violence 4.fear of or concern about or well
experiencing harassment or arrest by police?

Number of opioid-
Number of people who inject drugs and who are on
Coverage of OST % of PWID receiving OST dependent people in the
40

OST at a specified date during the reporting period

country who inject drugs

Numerator Number of survey respondents who answer

% of PWID reporting using “yes” to both questions: 1. Have you injected drugs at
Safe injecting practices Number of survey
sterile injecting equipment the any time in the past month? If yes, 2. The last time you
41

(PWID) respondents
last time they injected injected drugs, did you use a sterile needle and
syringe?

218
 Item Indicator Name (Short Disaggregation/Comments/
Short Description Numerator Denominator
# Name) Source

Number of adolescent
% of AGYW seeking Number of adolescent girls and women seeking
AGYW HIV/SRH girls and women seeking
contraception/family planning contraception/family planning services who were
43

integration contraception/family
who received an HIV test tested for HIV
planning services

Number of VMMCs performed Number of voluntary medical male circumcisions

VMMC scale-up according to the national during the reporting period performed according to the NA
44

standard national standard

Number of males experiencing at least one moderate or Number of men

Number and % of circumcised severe adverse event (that is, complications resulting in undergoing voluntary
VMMC adverse events males death or hospitalization within 30 days or permanent medical male
45

experiencing adverse events disability) during or following circumcision surgery in circumcision during the
the reporting period reporting period

% of healthcare facilities where

all therapeutic injections are Number of sampled healthcare facilities where all
Facility-level injection Number of facilities
given with new, disposable, therapeutic injections are given with new, disposable,
46

safety sampled
single-use injection single-use injection equipment
equipment

Number of survey
Rate of unsafe Number of unsafe healthcare Average number of unsafe healthcare injections during
respondents who answer
47

injections per person injections per person per year one year among survey respondents
the question

219
 Item Indicator Name (Short Disaggregation/Comments/
Short Description Numerator Denominator
# Name) Source

% of health facilities providing

Number of health facilities providing blood transfusion
blood transfusion that meet Number of surveyed
with tracer items on the day of the assessment by the To be considered as part of an
Facility-level blood safety requirements for safe and health facilities providing
48

Service Availability and Readiness Assessment ongoing survey

sufficient blood blood transfusion
(SARA) survey indicators index
transfusion

% of blood units that are

Quality-assured blood screened for blood borne Number of donated blood units tested in a quality- Number of donated blood To be considered as part of an
49

testing diseases in a quality assured assured manner for HIV, HBV, HCV and syphilis units ongoing survey
manner

Number of people living with HIV on ART who were

% of PLHIV on ART who were screened for hepatitis C (with HCV antibody (Ab)
Number of people living
HCV screening* screened for hepatitis C during testing followed by confirmatory testing with either
with HIV on ART during
50

coverage the HCV RNA (viral load) or HCV core antigen testing
the reporting period
reporting period among those HCV Ab-positive) during the reporting
period

Number of people living

with HIV on ART who
were diagnosed with
chronic viraemic hepatitis
Number of people living with HIV on ART diagnosed
% of PLHIV on ART and C infection (defined as
with chronic viraemic hepatitis C infection (defined as
diagnosed positive HCV antibody
positive HCV antibody (Ab) testing followed by
HCV treatment with chronic HCV infection who (Ab) testing followed by
confirmatory testing with either HCV RNA (viral load)
51

coverage initiated HCV treatment during confirmatory testing with

or HCV core antigen testing among those HCV Ab-
the either HCV RNA (viral
positive) and who initiated HCV treatment during the
reporting period load) or HCV core
reporting period
antigen testing among
those HCV Ab-positive)
during the reporting
period

220
 Item Indicator Name (Short Disaggregation/Comments/
Short Description Numerator Denominator
# Name) Source

Number of people living

TB screening coverage % of PLHIV newly initiated on Number of people living with HIV newly initiated on • Gender (male, female)
with HIV who newly
among new ART ART ART who were screened for TB during the reporting • Age (<15, 15+). Data points
52

initiated ART during the

patients who were screened for TB period available in ART e-tracker
reporting period
Number of people living
% of PLHIV newly initiated on
with HIV newly initiated
TB symptom-screened ART • Gender (male, female)
Number of people living with HIV newly initiated on on ART during the
positive among new who were screened for TB • Age (<15, 15+).
53

ART who screened positive for TB symptoms reporting period who

ART patients symptoms Data available in Register
were screened for TB
and who screened positive
symptoms
% of people living with HIV Number of people living
newly with HIV newly initiated
TB testing among Number of people living with HIV newly initiated on
initiated on ART and screened on ART and screened • Gender (male, female)
those symptom screened ART who are investigated for active TB disease with
54

positive for TB symptoms who positive for TB symptoms • Age (<15, 15+).
positive appropriate diagnostic testing
then during the reporting
are tested for TB period
Number of people living
with HIV who newly
% of PLHIV newly initiated on initiated ART and
• Gender (male, female)
TB diagnosis among ART and tested for TB who are Number of people living with HIV newly initiated on screened positive for TB
• Age (<15, 15+).
55

those tested for TB diagnosed with active TB ART who were diagnosed as having active TB disease symptoms who had
Data available in Register
disease appropriate diagnostic
testing during the
reporting period
Number of people living
TB treatment % of PLHIV newly initiated on Number of people living with HIV newly initiated on with HIV newly initiated • Gender (male, female)
initiation among ART and diagnosed with active ART who were diagnosed with TB and who started on ART who were • Age (<15, 15+).
56

diagnosed TB who initiated TB treatment treatment for active TB disease diagnosed with active TB Data available in Register
disease

• Gender (male, female)

• Age (0–4, 5–9, 10–14, 15–19,
People living Estimated number of people Estimated number of people infected with HIV and
NA 20–24, 25–49, 50+)
57

with HIV living with HIV who are alive

• Key populations (MSM,FSW).
Data Available in SPECRUM

221
 Item Indicator Name (Short Disaggregation/Comments/
Short Description Numerator Denominator
# Name) Source

Key populations (MSM,FSW)

• Gender (male, female)
• Age (<25, 25+)
• Duration of engaging in key
population-defining behaviour
Number of people in a (for example, <1 year, >1 year
HIV prevalence % of specific key populations Number of people in a specific key population group
specific key population of
58

among KP living with HIV who test positive for HIV

group tested for HIV doing sex work/having sex with
men).
IBBSS Surveys, may need some
revision for disaggregation by
duration of engaging in KP
defining behaviour

• Gender (male, female)

Estimated number of people Total number of
New HIV infections Estimated number of people newly infected during the • Age (0–4, 5–9, 10–14, 15–19,
newly infected with HIV per uninfected population (or
59

(per 1000 population) reporting period 20–24, 25–49, 50+)

1000 uninfected population person-years exposed)
• Key populations (MSM,FSW)

Estimated % of children newly

infected with HIV from mother- Estimated number of
Estimated number of children newly infected with HIV
to-child transmission among women living with HIV
Final MTCT rate via mother-to-child transmission among women living Data available in SPECTRUM
60

women living delivering in the past 12

with HIV delivering in the past 12 months
with HIV delivering in the past months
12 months

222
 Item Indicator Name (Short Disaggregation/Comments/
Short Description Numerator Denominator
# Name) Source

• Gender (male, female)

Total number of people who • Age (0–4, 5–9, 10–14, 15–19,
Estimated number of people dying from AIDS-related Total population,
AIDS mortality have died from AIDS-related 20–24, 25–49, 50+)
61

causes during the calendar year regardless of HIV status

causes per 100 000 population • Key populations (MSM,FSW).
Data Available in SPECRUM

223
NATIONAL MALARIA CONTROL PROGRAMME (NMCP)

PHD/NMCP/OPD Indicators
Indicator_Group_Name Indicator_Name Numerator_Description Denominator_Description Source

Malaria Indicators Number of OPD Suspected Number of OPD Suspected OPD morbidity form
Malaria Cases Uncomplicated Malaria Cases
Malaria Indicators Number of OPD Malaria Uncomplicated malaria cases OPD morbidity form
cases tested positive+Uncomplicated
malaria cases not tested but
treated
Malaria Indicators Number of OPD Malaria cases Total number of OPD Malaria OPD morbidity form
- children under 5 years cases among children under 5
years (<28days, 1-11 months
& 1-4 years)
Malaria Indicators Number of OPD Malaria cases Total number of OPD Malaria OPD morbidity form
- 5 years and above cases for person aged 5 years
and above
Malaria Indicators Number of OPD Malaria cases Total number of OPD Malaria OPD morbidity form
- pregnant women cases among Pregnant women
Malaria Indicators OPD Malaria cases per 1000 Total OPD Malaria cases Annual population OPD morbidity form/
population (multiplied by 1000) Census Data
Malaria Indicators OPD Confirmed Malaria cases Total Number of Annual population OPD morbidity form/
per 1000 population Uncomplicated Malaria cases (multiplied by 1000) Census Data
Tested positive
Malaria Indicators Proportion of OPD Malaria Number of OPD Suspected Total Number of OPD New
cases Tested Uncomplicated Malaria Cases Suspected Uncomplicated
Tested Malaria Cases (multiplied
by 100)

224
Indicator_Group_Name Indicator_Name Numerator_Description Denominator_Description Source

Malaria Indicators Number of Confirmed Malaria Number of OPD Malaria Monthly

Cases Put on ACTs Cases tested positive treated Antimalarial
with ACTs Reporting Form
Malaria Indicators Proportion of OPD Malaria Number of OPD Malaria Total Number of OPD OPD morbidity form/
Cases Treated with ACTs Cases given ACTs Malaria Cases (multiplied Antimalarial Form
by 100)
Malaria Indicators Proportion of OPD cases Total OPD Malaria Cases Total OPD Cases OPD morbidity form
attributable to Malaria
Test Positivity Rate (Sentinel Number of malaria cases Number of malaria cases
Sites) tested positive using RDT tested using RDT (from
(from sentinel sites) sentinel sites)
Slide Positity Rate (Sentinel Number of malaria cases Number of malaria cases
Sites) tested positive using tested using Microscopy
Microscopy (from sentinel (from sentinel sites)
sites)

225
PHD/NMCP/IPD Indicators
Indicator_Group_Nam Indicator_Name Numerator_Description Denominator_Description Source
e
Malaria Indicators Number of Admitted Number of confirmed malaria cases
Malaria Cases admitted

Malaria Indicators Percentage of Inpatient Number of admitted malaria cases Total Number of Hospital Statement
Admissions attributable Admissions of Inpatient
to Malaria
Malaria Indicators Inpatient malaria cases Number of Inpatient malaria cases Annual Population of the country Delete
per 1000 population per
year
Malaria Indicators Number of malaria Number of inpatient deaths due to Statement
reported deaths (<5 year, malaria, segregated into <5 years and 5 of Inpatient
>=5 years) years and above

Malaria Indicators Percentage of inpatient Number of Inpatient malaria deaths (all Total hospital deaths (all age Statement
deaths attributable to age groups) groups) of Inpatient
malaria
Malaria Indicators Under 5 Malaria Case Number of Children under years dying Total Number of Children Under Statement
Fatality Rate of Malaria five admitted with Malaria of Inpatient

Inpatient malaria deaths Number of Inpatient malaria deaths (all Annual Population (multiplied by Statement
per 100,000 population age groups) 100,000) of Inpatient
per year

226
PHD/NMCP/IPTp Indicators

Indicator_Group_Nam Indicator_Name Numerator_Description Denominator_Descriptio Source

e n
Malaria Indicators Percentage of Pregnant women Number of pregnant women Total number of ANC Monthly Midwifery
taking IPT1 given IPT1 registrants Returns

Malaria Indicators Percentage of Pregnant women Number of pregnant women Total number of ANC Monthly Midwifery
taking IPT2 given IPT 2 registrants Returns

Malaria Indicators Percentage of Pregnant women Number of pregnant women Total number of ANC Monthly Midwifery
taking IPT3 given IPT 3 registrants Returns

Malaria Indicators Percentage of Pregnant women Number of pregnant women Total number of ANC Monthly Midwifery
taking IPT4 given IPT4 registrants Returns

Malaria Indicators Percentage of Pregnant women Number of pregnant women Total number of ANC Monthly Midwifery
taking IPT5 given IPT5 registrants Returns

Malaria Indicators IPTp3 Dropout rate Number of pregnant women Number of pregnant Monthly Midwifery
given IPT1 - Number of women given IPTp1 Returns
pregnant women given IPTp3

227
PHD/NMCP/LLIN Indicators

Indicator_Group_Name Indicator_Name Numerator_Description Denominator_Description Source

Malaria Indicators Proportion of Children due for Number of Children 18+ months Total number of children Monthly Vaccination
Measles 2 dose given LLINs given LLINs 18+ months given measles Form
2 doses (multiplied by 100)

Malaria Indicators Proportion of ANC registrants Number of ANC registrants Total number of ANC Monthly Midwifery
given LLINs given LLINs registrants (multiplied by Returns
100)

228
NATIONAL TB CONTROL PROGRAMME (NTP)

MONTHLY SUMMARY OF TUBERCULOSIS SCREENING RESULTS

Data Element Description Purpose Data Source

Number Screened For

Number of persons responding yes to cough or in contact This is to help determine the
TB Symptom Based Screening
with index TB case who have been recorded on the TB number of OPD attendees who
(recorded on the TB Tool
screening tool at the various OPDs in the facility are at risk of TB
Screening Tool)

These are patients who responded yes to cough or in This reflects the number of
Symptom Based Screening
Number Presumed TB contact with index TB case and presented with two or patients eligible to undertake
Tool
more TB symptoms TB test

This will help determine the

The number of persons with presumed TB who were
Number Tested for TB number of persons loss to TB Lab Register
tested for TB in the laboratory
diagnosis (drop-out)

This is the number of persons tested for TB in the lab This reflects the yield of TB
Number Diagnosed who were either bacteriologically confirmed or clinically cases from the screening Health Facility TB
with TB diagnosed. This includes Smear negative and Extra process and a proxy for quality Register
Pulmonary TB patients of care
Number initiated on The number of persons diagnosed with TB and enrolled This will help measure initial Health Facility TB
TB Treatment on TB treatment loss to treatment Register

229
TUBERCULOSIS TREATMENT CARD (new)

Data element/attribute Description Purpose Source

Cover Page
Folder number as recorded on the treatment For ease of Patient ID issued
OPD Number
card identification by facility
For ease of patient
Unique unit TB number generated for a Facility
identification and
Unique Patient ID (e.g.: KP/01) -considering it to be client number. TB eTracker
tracking for
This is generated by the TB eTracker
services
Patient or ID card
Provide patient name in full and include popular For ease of patient
Name issued by state
names as known in the community identification
institution
To aid appropriate
Age Provide the age of patient at last birthday Any formal ID
management
Sex of the patient, indicate whether Male or To provide the
Sex (M / F Ask and Observe
Female appropriate care
Provide the Health Insurance Number whether
NHIS Number NHIS card
active or dormant
GP address, house number and landmark. A
To facilitate
Address (in full) traceable address of the patient, house Patient
patient follow up
address/street name
Provide tell number of patient or any close To facilitate
Tel No Patient
relative or associate patient follow up
To know the date
Provide the date on which patient was
Date of registration of registration for Patient
registered in the Institutional register
Patient
Name & address of Treatment supporter Provide name, GP address, house number and To facilitate Patient
landmark of person the patient holds in trust, and patient follow up/

230
 Data element/attribute Description Purpose Source

can be contacted in case of emergency. A

traceable address of the contact, house
To help trace
address/street name. Copy Name, address and
patient by address
phone number of treatment supporter from “TB
Treatment Card”.
To facilitate Treatment
Tel No of treatment supporter Provide telephone number of treatment supporter
patient follow up supporter or patient
To estimate
Region Region in which service is being provided Health worker
disease burden
District in which the facility providing service is To estimate
District Health worker
being provided disease burden
For ease of patient
Unique unit TB number generated for a Facility
identification and
District TB Number (e.g.: KP/01) -considering it to be client number. TB eTracker
tracking for
This is generated by the TB eTracker
services
For ease of patient
identification and
Health Facility Name of facility providing TB services
tracking for
services
The marital status of the patient, may help
Marital status
determine contacts of patient
Educational Status The level of education of the patient
Occupation The type of work engaged in by the patient
Facility from which patient was referred or
Referred or transferred from:
transferred
Inner Side
Type of patient Could be new, relapse, return after lost to follow Help categorise Determined from

231
 Data element/attribute Description Purpose Source

patient for
up, return after failure etc patient history
reporting
Tick under column “Pulmonary” if patient has
pulmonary tuberculosis and “Extrapulmonary” in Help determine
case of extra-pulmonary TB. A patient with both appropriate
Site of disease Laboratory result
pulmonary and extrapulmonary TB should be treatment
accounted as a case of PTB during reporting monitoring tests
notification and treatment outcome data
Refers to various types of laboratory Determine tests
Diagnostic Tests Laboratory result
investigations conducted to arrive at diagnosis done
Record the results of the X-ray as given by the
Medical officer: e.g. “Suggestive” or “Abnormal”
depending on the type of X-ray, normal Chest X- To support patient
X-ray results X-ray report
rays can be recorded as “Not suggestive” or diagnosis
“Normal” and “Not done” in case chest X-ray
was not preformed
Determine date of
examination and
Date Date X-ray was taken X-ray report
approximate
waiting time
To screen for TB
Indicate if there is any person(s) in close contact
Any known TB Contact in order to protect Patient/home visit
with patient e.g. spouse, children, neighbours
contacts and patient
To determine if
child had been By examination of
Indicate the presence of BCG Scar if the Patient
BCG Scar immunized, help in patient lefter
is within 0-59 months (under 5 years)
interpreting shoulder
laboratory results

232
 Data element/attribute Description Purpose Source

Counselling & Testing

Date Date on which patient was tested for HIV Lab request form
Results HIV test results Lab request form
Date of counselling Date on which patient was counselled for HIV Patient folder
CPT start date Date on which Co-Triomozazole was started Patient folder
HIV Clinic No Reference number for the ART clinic Patient folder
To estimate
waiting time
Date of registration Date patient was registered for ARV between diagnosis Patient folder
and treatment
initiation
To estimate
waiting time
ART start date Date on which patient was initiated on ARV between diagnosis Patient folder
and treatment
initiation
Indicate the ARV regimen on which patient is
ART Regimen Patient folder
initiated
Initial Phase – Prescribed regimen and dosage
To monitor patient
response to
Weight Band Weight of the patient in Kilogram (Kg) treatment, could be
used to alter dose in
children
Month Day and Month TB treatment was started To assist in

233
 Data element/attribute Description Purpose Source

treatment
monitoring
Height of the patient in meter (m) To assist in
Height treatment
monitoring
To assist in
The patients BMI calculated from the weight
BMI treatment
and height: Weight/H2
monitoring
Provide the laboratory number for the test
Lab No To identify patient Lab request form
(eg:0001/2015)
Provide the smear result for the patient at month To help in
Sputum smear results zero or before treatment starts. Indicate Neg, treatment Lab request form
Scanty, 1+, 2+, 3+ monitoring
Provide the Xpert results for the patient at
month zero or before treatment starts. To determine
Xpert MTB/RIF Results Pos/RS= MTB detected; rifampicin resistance not susceptibility to Lab request form
detected Rifampicin

234
TB INSTITUTIONAL REGISTER

No Data element/attribute Description Purpose

Unit TB No./ Facility Unique unit TB number generated for a Facility (e.g.: KP/01) -
1 To uniquely identify a facility
Name considering it to be client number
To know the date of registration for
2 Date Registered Date of Patient registration
Patient
3 District TB No. Unique unit TB number generated for a District (e.g.: AMD/KP/01) To uniquely identify a District
To identify a patient by his/her
5 Patient's Surname Provide the patient's Surname
Surname
To identify a patient by his/her first
6 Name of patient Provide the patient's Last name
name)
7 Provide the patient's Nickname To identify a patient by nickname
To know the patient age as at the last
8 Age Age of the patient in complete month and year in months and years
birthday
Indicate the presence of BCG Scar if the Patient is within 0-59
9
months (under 5 years)
10 Sex (M/F) Sex of the patient, indicate whether Male or Female To know the sex of the patient

11 Weight of the patient in Kilogram (Kg)

12 Height Height of the patient in meter (m)

13 BMI The patients BMI calculated from the weight and height: Weight/H2

235
 No Data element/attribute Description Purpose

14 Occupation The occupation of patient

15 Educational status The educational status of the patient

16 Marital status The marital status of the patient

GP address, house number and landmark. A traceable address of the
17 Address of patient To help trace patient by address
patient, house address/street name
To help trace patient by the telephone
18 Tel No. of Patient Telephone or mobile number of patient
or mobile number
19 Email address of patient To help trace patient
Name of person the patient holds in trust, and can be contacted in
Name, Tel No & address case of emergency. A traceable address of the contact, house Persons identified by the patient to be
20
of contact person address/street name. Copy Name, address and phone number of contacted in case of emergency
treatment supporter from “TB Treatment Card”.
New: A patient who has received no or less than one month of anti-
TB treatment
Relapse: A patient who was previously treated for TB and whose
most recent treatment outcome was Cured or Treatment completed,
and who is subsequently diagnosed with a recurrent episode of TB
(either a true relapse or a new episode of TB caused by reinfection).
History of previous Return after Loss to Follow-up: A patient who had previously been This is to help categorise the patient
22 treatment (choose one treated for TB and was declared lost to follow-up at the end of the appropriately for the necessary
only)one of the following most recent course of treatment. (This was previously known as treatment
treatment after default
Other Previously treated: A previously treated TB patient whose
outcome after the most recent course of treatment is unknown or
undocumented
Unknown: It is unknown whether the patient was previously treated
for TB

236
 No Data element/attribute Description Purpose
Patient has been transferred from another TB register to continue
This is to help avoid double counting
23 Transferred in treatment. Exclude from monthly reports of case registrations and
of TB patients
treatment outcomes
Tick under column “Pulmonary” if patient has pulmonary
tuberculosis and “Extrapulmonary” in case of extra-pulmonary TB. A
Provides estimates of site of disease
24 Disease site patient with both pulmonary and extrapulmonary TB should be
for planning interventions
accounted as a case of PTB during reporting notification and
treatment outcome data
Record the results of the X-ray as given by the Medical officer: e.g.
“Suggestive” or “Abnormal” depending on the type of X-ray, normal This may be classified as part of
25 Chest X-ray
Chest X-rays can be recorded as “Not suggestive” or “Normal” and screening to help diagnosis
“Not done” in case chest X-ray was not preformed
Stage 1: Before
Treatment
Provide the smear result for the patient at month zero or before
Smear Results To help in treatment monitoring
treatment starts. Indicate Neg, Scanty, 1+, 2+, 3+
Provide the Xpert results for the patient at month zero or before
treatment starts.
Pos/RS= MTB detected; rifampicin resistance not detected
Xpert MTB/Rif To determine resistance to Rifampicin
Pos/RR= MTB detected; rifampicin resistance detected
Pos = MTB detected; rifampicin resistance indeterminate
Neg = MTB not detected
Culture results reported as follows:
Pos= culture growth, MTB detected Help to determine appropriate
Culture/DST Neg=No growth treatment

13 Lab Number Provide the laboratory number for the test (eg:0001/2015) To identify patient

14 Date of Lab Result Provide the date the laboratory investigation was done

237
 No Data element/attribute Description Purpose

15 Stage 2: 2 or 3 Months

Provide the smear result for the patient at month 2 or 3. Indicate Neg,
17 Smear Results To help in treatment monitoring
Scanty, 1+, 2+, 3+
Should only be done before TB treatment is initiated necessary at
19 Xpert MTB/Rif
this stage
Culture results reported as follows:
Pos= culture growth, MTB detected
20 Culture/DST Neg=No growth

22 Lab Number Provide the laboratory number for the Patient (eg:0001/2015)

23 Date of Lab Result Provide the date the laboratory investigation was done

24 Stage 3: 5 Months
Provide the smear result for the patient at month 5. Indicate Neg,
26 Smear Results
Scanty, 1+, 2+, 3+
27 Xpert MTB/Rif Should only be done before TB treatment is initiated
Culture results reported as follows:
29 Culture/DST Pos= culture growth, MTB detected
Neg=No growth
30 Other tests Not necessary at this stage

31 Lab Number Provide the laboratory number for the Patient (eg:0001/2015)

238
 No Data element/attribute Description Purpose

32 Date of Lab Result Provide the date the laboratory investigation was done

33 Stage 4: End of treatment

Provide the smear result for the patient at month 6 or 8/End of
35 Smear Results
treatment. Indicate Neg, Scanty, 1+, 2+, 3+
37 Xpert MTB/Rif Should only be done before TB treatment is initiated
Culture results reported as follows:
38 Culture/DST Pos= culture growth, MTB detected
Neg=No growth
40 Lab Number Provide the laboratory number for the Patient (eg:0001/2015)

41 Date of Lab Result Provide the date the laboratory investigation was done

Treatment Outcome

Date Indicate date treatment was completed

Outcome Cured: A pulmonary TB patient with bacteriologically confirmed
TB at the beginning of treatment who was smear- or culture-negative
in the last month of treatment and on at least one previous occasion
Treatment Completed: A TB patient who completed treatment
without evidence of failure BUT with no record to show that sputum
smear or culture results in the last month of treatment and on at least
one previous occasion were negative, either because tests were not
done or because results are unavailable
Treatment Failed: A TB patient whose sputum smear or culture is
positive at month 5 or later during treatment. Treatment will also be
considered to have failed if a clinical decision has been made to

239
 No Data element/attribute Description Purpose
terminate treatment early because of poor clinical or radiological
response or adverse events, or identified with RR-TB, but did not
start second-line treatment.
Died: A TB patient who dies for any reason before starting or during
treatment
Lost to follow-up: A TB patient who did not start treatment or
whose treatment was interrupted for 2 consecutive months or more.
Not evaluated: A TB patient for whom no treatment outcome
is assigned. This includes cases “transferred out” to another
treatment unit as well as cases for whom the treatment outcome is
unknown to the reporting
HIV Infection Indicate Yes if HIV+ And No if HIV Neg
On ART Yes, if HIV positive and on ARV and No if not
On CPT Indicate ‘Y’ if patient is on CPT and ‘N’ if not

240
TB DISTRICT REGISTER (new)

No Data element/attribute Description Purpose

Unique unit TB number generated for a Facility (e.g.: KP/01)
1 Unit TB No./ Facility Name To uniquely identify a facility
-considering it to be client number
2 Date Registered Date of Patient registration To know the date of registration for Patient
Unique unit TB number generated for a District (e.g.:
3 District TB No. To uniquely identify a District
AMD/KP/01)
This is the name of the facility within the district where the This ensures that each patient can be
4 Facility Name
patient has been registered and being managed followed up
5 Patient's Surname Provide the patient's Surname To identify a patient by his/her Surname
6 Name of patient Provide the patient's Last name To identify a patient by his/her first name)
7 Provide the patient's Nickname To identify a patient by nickname
Age of the patient in complete month and year in months and To know the patient age as at the last
8 Age
years birthday
Indicate the presence of BCG Scar if the Patient is within 0-59
9
months (under 5 years)
10 Sex (M/F) Sex of the patient, indicate whether Male or Female To know the sex of the patient
11 Weight of the patient in Kilogram (Kg)
12 Height of the patient in meter (m)
13 The patients BMI calculated from the weight and height
14 The occupation of patient
15 The educational status of the patient
16 The marital status of the patient

241
No Data element/attribute Description Purpose
17 Address of patient A traceable address of the patient, house address/street name
To help trace patient by address
18 Tel No. of Patient Telephone or mobile number of patient To help trace patient by the telephone or
mobile number
19 Email address of patient To help trace patient
20 Name, Tel No & address of Name of person the patient holds in trust, and can be Persons identified by the patient to be
contact person contacted in case of emergency. A traceable address of the contacted in case of emergency
contact, house address/street name. Copy Name, address and
phone number of treatment supporter from “TB Treatment
Card”.
22 History of previous New: A patient who has received no or less than one month This is to help categorise the patient
treatment (choose one of anti-TB treatment appropriately for the necessary treatment
only)one of the following Relapse: A patient who was previously treated for TB and
whose most recent treatment outcome was Cured or
Treatment completed, and who is subsequently diagnosed
with a recurrent episode of TB (either a true relapse or a new
episode of TB caused by reinfection).
Return after Loss to Follow-up: A patient who had
previously been treated for TB and was declared lost to
follow-up at the end of the most recent course of treatment.
(This was previously known as treatment after default
Other Previously treated: A previously treated TB patient
whose outcome after the most recent course of treatment is
unknown or undocumented
Unknown: It is unknown whether the patient was previously
treated for TB
23 Transferred in Patient has been transferred from another TB register to This is to help avoid double counting of TB
continue treatment. Exclude from monthly reports of case patients
registrations and treatment outcomes
24 Disease site Tick under column “Pulmonary” if patient has pulmonary Provides estimates of site of disease for
tuberculosis and “Extrapulmonary” in case of extra- planning interventions
pulmonary TB. A patient with both pulmonary and

242
No Data element/attribute Description Purpose
extrapulmonary TB should be accounted as a case of PTB
during reporting notification and treatment outcome data
25 Chest X-ray Record the results of the X-ray as given by the Medical This may be classified as part of screening
officer: e.g. “Suggestive” or “Abnormal” depending on the to help diagnosis
type of X-ray, normal Chest X-rays can be recorded as “Not
suggestive” or “Normal” and “Not done” in case chest X-ray
was not preformed
Stage 1: Before Treatment
Provide the smear result for the patient at month zero or
Smear Results To help in treatment monitoring
before treatment starts. Indicate Neg, Scanty, 1+, 2+, 3+
Provide the Xpert results for the patient at month zero or
before treatment starts.
Pos/RS= MTB detected; rifampicin resistance not detected
Xpert MTB/Rif To determine resistance to Rifampicin
Pos/RR= MTB detected; rifampicin resistance detected
Pos = MTB detected; rifampicin resistance indeterminate
Neg = MTB not detected
Culture results reported as follows:
Pos= culture growth, MTB detected
Culture/DST Help to determine appropriate treatment
Neg=No growth

13 Lab Number Provide the laboratory number for the test (eg:0001/2015) To identify patient

14 Date of Lab Result Provide the date the laboratory investigation was done

15 Stage 2: 2 or 3 Months

243
No Data element/attribute Description Purpose
Provide the smear result for the patient at month 2 or 3.
17 Smear Results To help in treatment monitoring
Indicate Neg, Scanty, 1+, 2+, 3+
Should only be done before TB treatment is initiated
19 Xpert MTB/Rif
necessary at this stage
Culture results reported as follows:
Pos= culture growth, MTB detected
20 Culture/DST
Neg=No growth

22 Lab Number Provide the laboratory number for the Patient (eg:0001/2015)

23 Date of Lab Result Provide the date the laboratory investigation was done

24 Stage 3: 5 Months
Provide the smear result for the patient at month 5. Indicate
26 Smear Results
Neg, Scanty, 1+, 2+, 3+
27 Xpert MTB/Rif Should only be done before TB treatment is initiated
Culture results reported as follows:
29 Culture/DST Pos= culture growth, MTB detected
Neg=No growth
30 Other tests Not necessary at this stage

31 Lab Number Provide the laboratory number for the Patient (eg:0001/2015)

32 Date of Lab Result Provide the date the laboratory investigation was done

244
No Data element/attribute Description Purpose

33 Stage 4: End of treatment

Provide the smear result for the patient at month 6 or 8/End of
35 Smear Results
treatment. Indicate Neg, Scanty, 1+, 2+, 3+
37 Xpert MTB/Rif Should only be done before TB treatment is initiated
Culture results reported as follows:
38 Culture/DST Pos= culture growth, MTB detected
Neg=No growth
40 Lab Number Provide the laboratory number for the Patient (eg:0001/2015)

41 Date of Lab Result Provide the date the laboratory investigation was done
Treatment Outcome
Date Indicate date treatment was completed
Outcome Cured: A pulmonary TB patient with bacteriologically confirmed
TB at the beginning of treatment who was smear- or culture-
negative in the last month of treatment and on at least one previous
occasion
Treatment Completed: A TB patient who completed treatment
without evidence of failure BUT with no record to show that
sputum smear or culture results in the last month of treatment and
on at least one previous occasion were negative, either because tests
were not done or because results are unavailable
Treatment Failed: A TB patient whose sputum smear or culture
is positive at month 5 or later during treatment. Treatment will also
be considered to have failed if a clinical decision has been made to
terminate treatment early because of poor clinical or radiological
response or adverse events, or identified with RR-TB, but did not

245
No Data element/attribute Description Purpose
start second-line treatment.
Died: A TB patient who dies for any reason before starting or
during treatment
Lost to follow-up: A TB patient who did not start treatment or
whose treatment was interrupted for 2 consecutive months or more.
Not evaluated: A TB patient for whom no treatment outcome is
assigned. This includes cases “transferred out” to another treatment
unit as well as cases for whom the treatment outcome is unknown to
the reporting
HIV Infection Indicate Yes if HIV+ And No if HIV Neg
On ART Yes, if HIV positive and on ARV and No if not
On CPT Indicate ‘Y’ if patient is on CPT and ‘N’ if not
42 Treatment Outcome

246
MONTHLY REPORT ON TB CASE REGISTRATION TB07 (new)
Data Element Description Purpose Data Source
To monitor number of cases registered in
Name of district Name of district in which services are provided TB01 & Facility TB Register
each district
To monitor number of cases registered in
Facility Name of facility managing the TB patient TB 01 & Facility TB Register
each facility
Patient registered To monitor number of cases registered in
Month for which the report cover TB01 & Facility TB Register
during month each facility
Name of This is the name of the designated Institutional To ensure that an officer is accountable
TB01 & Facility TB Register
Coordinator TB Coordinator (ITC) for TB recording and reporting
Signature Signature of the ITC This authenticates report
Date form was
Date on which the report was completed Determine timeliness of reports
completed
All TB Cases registered during month
Pulmonary, These are patients who had TB of the lungs and To determine pulmonary TB patients that TB01 & Facility TB Register
bacteriologically are confirmed through lab tests were confirmed through lab tests
confirmed
Pulmonary, These are patients who had TB of the lungs but To determine number of pulmonary TB TB01 & Facility TB Register
clinically diagnosed not confirmed by the lab test patients that were diagnosed by clinical
examination
Extrapulmonary, These are patients who had TB outside the To determine number of patients that had TB01 & Facility TB Register
bacteriologically lungs and were either confirmed by lab tests or TB outside the lungs who were either
confirmed or by other means confirmed through lab tests or by clinical
clinically diagnosed examination
New A patient who has received no or less than one To help determine incident TB cases TB01 & Facility TB Register
month of anti-TB treatment.
Relapse A patient who was previously treated for TB Provides estimates of patients who had TB01 & Facility TB Register
and whose most recent treatment outcome was reactivated TB or with new episode of
Cured or Treatment completed, and who is TB
subsequently diagnosed with a recurrent

247
 Data Element Description Purpose Data Source
episode of TB (either a true relapse or a new
episode of TB caused by reinfection).
Previously treated These are patients who Returned after Loss to Provides estimates about quality of care TB01 & Facility TB Register
(excluding relapse) Follow-up, Returned After treatment Failure, and risk of drug resistance TB
and Other previously treated
Patient treatment It is unknown whether the patient was Helps to assess risk of drug resistance TB TB01 & Facility TB Register
history unknown previously treated for TB
All new and relapse cases (bacteriologically confirmed or clinically diagnosed) registered during the month by age and sex: BLOCK 2 presents the
sex and age specific data on new and relapse cases from first two columns of Block 1. The age groups used in Block 2 are internationally recognized
age groups. When the report is completed, the total number in the BLOCK 2 column TOTAL should correspond to the sum of all cells of in Block 1
under the heading “New” and “Relapse”.

Patients aged 0 to 4 years who received To determine the number of patients aged
0-4yrs Health Facility Register
treatment for TB in the period by sex 0 to 4years
Patients aged 5 to 14 years who received To determine the number of patients aged
5-14yrs Health Facility Register
treatment for TB in the period by sex 5 to 14years
Patients aged 15 to 24 years who received To determine the number of patients aged
15-24yrs Health Facility Register
treatment for TB in the period by sex 15 to 24years
Patients aged 25 to 34 years who received To determine the number of patients aged
25-34yrs Health Facility Register
treatment for TB in the period by sex 25 to 34years
Patients aged 35 to 44 years who received To determine the number of patients aged
35-44yrs Health Facility Register
treatment for TB in the period by sex 35 to 44years
Patient aged 45 to 54 years who received To determine the number of patients aged
45-54yrs Health Facility Register
treatment for TB in the period by sex 45 to 54years
Patients aged 55 to 64 years receiving TB To determine the number of patients aged
55-64yrs Health Facility Register
treatment in the period by sex 55 to 64years
Patients aged 65years and above receiving TB To determine the number of patients aged
65yrs+ Health Facility Register
treatment in the period by sex 65years and above
BLOCK 3: Laboratory Diagnostic Activity
Patients with Presumed TB patients that were tested for TB To determine number of presumed TB Health Facility Register

248
 Data Element Description Purpose Data Source
presumptive TB
tested by microscopy and/or Xpert
undergoing by smear microscopy and/or Xpert MTB/RIF
MTB/RIF by sex patients with confirmed
bacteriological by sex
TB
examination
Patients with
presumptive TB Presumed TB cases with positive smear
To determine proportion of TB patients
with positive microscopy and/or Xpert MTB/RIF result by Health Facility Register
who were bacteriologically diagnosed
bacteriological sex
examination results
Block 4: TB/HIV activities: all new and relapse TB cases registered during the month
Patients tested for
HIV at the time of
diagnosis or with
TB patients who were tested for HIV by sex To provide comprehensive care Health facility register
known HIV status at
the time of TB
diagnosis
HIV positive TB
TB patients who tested HIV positive by sex To provide comprehensive care Health facility register
patients
HIV positive TB TB patients who tested HIV positive and were To ensure that all HIV & TB coinfected
Health facility register
patients on ART on ARVs by sex patients who are on ARVs
HIV positive TB TB patients who tested HIV positive and were To ensure that all HIV & TB coinfected
Health facility register
patients on CPT on CPT by sex patients who are on CPT

249
MONTHLY REPORT ON TB TREATMENT OUTCOMES – TB08

Data elements Description Purpose

it helps to know Patient category by type
evaluated among cases notified 12 months
The total number of TB patients by category registered in the period are
earlier
recorded in this column; such as bacteriologically confirmed and
clinically diagnosed new and relapse cases, new and relapse HIV
positive cases, new and relapse child TB cases, new and relapse females
and retreated cases. NB. Cases that were transferred from another
facility are not accounted.
Number of Cases
Registered in Period

The total number of TB patients by category transferred to second line

treatment are recorded in this column, those cases should not be
included into cohort analysis. NB; the cohort size is equals to the
difference between TB patients by category registered and cases moved it help to measure total TB patients by
to SLD. category that moved to 2nd line during
Moved to SLD treatment: treatment of 1st line medicines

The total number of TB patients by category that Initially were

bacteriologically confirmed who has completed the treatment and is
smear/culture negative in the last 2months of treatment. NB; Clinically it help to measure total TB patients by
diagnosed cases do not fall in this category. category with initially sputum positive that
Cured: were cured at 6 months of treatment

250
Data elements Description Purpose

The total number of TB patients by category who completed their

treatment without evidence of failure, BUT with no record to show that
sputum smear results in the last month of treatment or at least one it help to measure TB smear negative cases
previous occasion were negative, either because tests were not done or and clinically diagnosed cases by patient
because results are unavailable. category that completed treatment at
Treatment completed: 6months

The total number of TB patients by category whose sputum smear or it help to measure TB patients by category
culture is positive at month 5 or later during treatment who failed to respond after 2 or more
Treatment failed: months of treatment

The total number of TB patients by category who dies for any reason This help to measure TB patients by
before starting or during the course of treatment. category who died before or during
Died: treatment

The total number of TB patients by category who did not start

treatment or whose treatment was interrupted consecutive for 2 or more This help to measure TB patients by
months category who stop/ interrupted treatment
Lost to follow-up: consecutive for 2 or more months

The total number of TB patients by category whom treatment outcome This help to measure TB patients by
is not assigned/ unknown to the reporting unit. category whose outcome is not known or
was not assigned before or at 6months of
Not evaluated: treatment

251
Data elements Description Purpose

Treatment outcome of all new and relapse cases, both bacteriologically

Bateriologically confirmed and clinically diagnosed, adults and children, pulmonary and This help to measure TB new and relapse
confirmed and clinically extrapulmonary, HIV positives, HIV negatives and HIV unknown. cases, including treatment history unknown
diagnosed new and who were bacteriologically or clinically
relapse: diagnosed
This help to measure TB new and relapse
cases, including treatment history unknown
This is a subset of Bateriologically confirmed and clinically diagnosed
who are HIV+ before or during treatment
new and relapse, and it includes new and relapse HIV/TB cases
regardless of the timing of the documentation of HIV status, sex, age
groups and site of the disease. Patients who at the registration refused
HIV testing but were over the course of treatment were identified with
HIV status, should be accounted among HIV/TB at the treatment
outcome reporting.
New and relapse HIV
positive cases:

This is a subset of Bateriologically confirmed and clinically diagnosed

new and relapse, and it Includes all new and relapse female cases, both This help to measure TB new and relapse
New and relapse adults and children, HIV positives/negatives/unknown. cases, including treatment history unknown
Females: who are females

This help to measure outcome of cases who

has previously been treated for TB more
Retreatment cases Treatment outcome of all previously treated classified as “return after than 2 or more months but were not cured or
(excluding relapse): lost to follow-up”, and “Return after failure” treatment completed

252
MONTHLY REPORT ON RR-TB DETECTION

BLOCK 1. Surveillance of drug resistance

Data elements Purpose Source

Description
Tested by Gene Calculate total number of records with completed Xpert The help to monitor the total number
Xpert: MTB/RIF test in the facility TB register for the given of GeneXpert test performed in the
month regardless of test results disaggregated by Risk period/ reporting month
category such as; “New”, “Previously treated” and
“Unknown treatment history” NB; Calculation should
include all four possible options of results (“Pos/RR”,
“Pos/RS”, “Pos” and “Neg”) performed during the
reporting month, before or after starting the treatment.
Confirmed MTB: This is a subset of Xpert MTB/RIF test results, Calculate This help to monitor the total number
and record here the cases with confirmed Mycobacteria of confirmed Mycobacteria
Tuberculosis: cases with following results: “Pos/RR”, Tuberculosis among the completed
“Pos/RS” and “Pos” disaggregated by Risk category such Xpert MTB/RIF test in the reporting
as; “New”, “Previously treated” and “Unknown treatment period
history”.
Confirmed RR-TB: This is a subset of confirmed Mycobacterial Tuberculosis This help to monitor the total number
results, Calculate the number of cases with “Pos/RR” of Confirmed RR-TB among the
results disaggregated by Risk category such as “New”, confirmed Mycobacteria
“Previously treated” and “Unknown treatment history”. Tuberculosis in the reporting period
Number of cases Calculate total number of RR-TB cases with test results This help to monitor the total number
with SLD DST for any fluoroquinolone (FQ) and any second-line of RR-TB cases that came with DST
results: injectable agent (2LI) that were received during the results in the reporting period
reporting month regardless of test results in the MDR-TB
Facility Register . NB; This might include the cases
notified several months ago and is not the subset of
Confirmed RR-TB as it is unlikely to receive the first- and

253
Data elements Purpose Source
Description
second-line DST result within the same month.
Pre-XDR: This help to monitor of the number
Among patients that reported with DST results , Calculate of patients with DST results, number
the number of patients with any resistance to FQ only or with any resistance to FQ only or any
any resistance to 2LI only. resistance to 2LI only.
XDR: This help to monitor of the number
Among patients that reported with DST results, Calculate
of patients with DST results, number
number of patients with any resistance to both FQ and
with any resistance to both FQ and
2LI.
2LI.
TOTAL: This help to monitor total number of
Calculate the sum of above three rows for each of column. Xpert done, confirmed and detected
with RR-TB
HIV positive cases: This is a subset of the totals, Calculate the total number of This help to monitor the total number
TB/HIV co infected patients that during the reporting of TB/HIV positive patients in the
month were tested for Xpert/MTB RIF, before or after reporting period
starting the treatment regardless of GeneXpert results,
number with confirmed M. Tuberculosis and number with
confirmed RR. NB; Data should include all forms of TB,
all age groups and both males and females.
HIV positive on This help to monitor TB/HIV Co
This is subset of HIV positive cases: HIV/TB cases that
ART: infected patients on ART
are on ART.
Children <15: This is a subset of totals, Calculate total number of This help to monitor the total number
children <15 years that during the reporting month were of children in the reporting period
tested for Xpert/MTB RIF, before or after starting the
treatment regardless of GeneXpert results, number with
confirmed M. Tuberculosis and number with confirmed
RR. NB; Data should include all forms of TB and both
males and females.

254
Data elements Purpose Source
Description
Females including This is a subset of totals, Calculate total number of female This help to monitor the total number
children: TB cases that during the reporting month were tested for of Females in the reporting period
Xpert/MTB RIF, before or after starting the treatment
regardless of GeneXpert results, number with confirmed
M. Tuberculosis and number with confirmed RR. NB;
Data should include all forms of TB and all age groups.
Contact of confirmed This is a subset of totals, Calculate total number of clients This help to monitor the total number
RR cases: who are contacts of known RR cases that during the of Cases that are contacts of TB in
reporting month were tested for Xpert/MTB RIF, the reporting period
regardless of GeneXpert results, number with confirmed
M. Tuberculosis and number with confirmed RR. NB;
Data should include all forms of TB, all age groups and
both males and females.
Treatment failure This is a subset of totals, Calculate total number of TB This help to monitor the number of
using first line drugs: cases who were sputum smear positive at 5th month of patients who were sputum positive at
treatment and later were tested for drug resistance for R, month 2, 5 or 6 during treatment of
regardless of GeneXpert results, number with confirmed 1st line regimen
M. Tuberculosis and number with confirmed RR. NB;
Data should include all forms of TB, all age groups and
both males and females.

255
BLOCK 2. Number of RR/MDR-TB patients detected during the period of assessment and enrolled into second-line treatment
Data Elements Purpose Source
Description
All Patients eligible for Calculate from Facility TB register the number of all This help to monitor total
treatment: patients that during the reporting month were MDR cases notified through
diagnosed/confirmed as RR-TB, as well as those who confirmation or by
by local MDR-TB steering committee (clinicians Clinicians discretion and
discretion) were identified as eligible to start MDR- enrolled into treatment
TB treatment but had no laboratory confirmation desegregated into; started on
(presumed MDR-TB cases). The data should be shorter regimen, Delamanid
desegregated into; “Total cases notified”, and “Total and on Bedaquiline.
enrolled into MDR Treatment “columns obtained
from the Facility MDR Register. NB; Patients with
laboratory confirmed Pre-XDR TB and XDR TB
should be excluded.
children < 15 years: This is subset of all patients eligible for treatment and This help to monitor total
it includes all children below 15 years laboratory MDR cases <15years
confirmed and clinically diagnosed, eligible for notified through
MDR-TB treatment, both males and females. NB; confirmation or by
Children <15 notified and enrolled into SLD Clinicians discretion and
treatment is obtained from Facility MDR Register. enrolled into treatment.
Females (including This is subset of all patients eligible for treatment and This help to monitor total
children) it includes all females laboratory confirmed and MDR female cases notified
clinically diagnosed, eligible for MDR TB treatment, through confirmation or by
both adults and children. NB; Females enrolled into Clinicians discretion and
SLD treatment is obtained from Facility SLD register. enrolled into treatment.
Confirmed RR-TB or This is subset of all patients eligible for treatment and This help to monitor total
MDR-TB it includes all laboratory confirmed RR-TB cases MDR cases notified through
identified, eligible for MDR TB treatment during the confirmation and enrolled
reporting month. NB; Number of Confirmed RR-TB into treatment.
enrolled into MDR Treatment is obtained from

256
Data Elements Purpose Source
Description
Facility MDR Registe.
Confirmed RR-TB or This is subset of Confirmed RR-TB or MDR-TB and This help to monitor total
MDR-TB, HIV+: it includes laboratory confirmed RR-TB cases MDR HIV co infected cases
identified during the reporting months that are HIV notified through
positive. NB; The number of RR-TB/HIV co infected confirmation and enrolled
cases enrolled into MDR treatment is calculated from into treatment.
Facility MDR Registe.
Confirmed RR-TB or This is subset of Confirmed RR-TB or MDR-TB and This help to monitor total
MDR-TB, HIV+ on ART: it includes laboratory confirmed RR-TB cases MDR HIV co infected cases
identified during the reporting months that are HIV notified through
positive and on ART. NB; The number of confirmation, enrolled into
RR-TB/HIV on ART enrolled into MDR treatment is treatment and on ART.
calculated from Facility SLD register.
Confirmed Pre-XDR-TB: This help to monitor MDR
From Facility MDR Register and facility MDR
cases that are identify with
steering committee meeting resolution (Clinicians
Pre-XDR TB (number of
Discretion), calculate total number of cases identified
patients with any resistance
with Pre-XDR TB (number of patients with any
to FQ only or any resistance
resistance to FQ only or any resistance to 2LI only)
to 2LI only) and those
and those enrolled into SLD based on Facility MDR
enrolled into SLD based on
Registe.
Facility SLD Register
Confirmed XDR-TB: This help to monitor MDR
From SLD register and facility MDR steering
cases identified with XDR
committee meeting resolution (Clinicians Discretion),
TB (number of patients with
calculate total number of cases identified with XDR
resistance to both FQ and
TB (number of patients with resistance to both FQ
2LI) and those enrolled into
and 2LI) and those enrolled into XDR treatment based
XDR treatment based on
on Facility MDR Registe.
Facility SLD Register
Number started on From the Facility MDR Register calculate the This help to monitor MDR
Shorter Regimen number of patients enrolled into shorter MDR-TB cases identified and enrolled

257
Data Elements Purpose Source
Description
treatment during the reporting months. NB; A shorter into shorter regimen
MDR-TB treatment regimen is a standardised regimen
lasting 12 months or less,. Data source is Facility
MDR Register.
Patients started on This help to monitor
Delamanid. From the Facility SLD Register calculate the number patients identified and
of patients enrolled into SLD treatment during the enrolled into SLD treatment
reporting months that started the treatment with with Delamanid as part of
Delamanid as part of expanded access, compassionate expanded access,
use or under normal programmatic use. compassionate use or under
normal programmatic use.
Patients started on This help to monitor
Bedaquilin From the Facility MDR Registe calculate the number patients identified and
of patients enrolled into SLD treatment during the enrolled into SLD treatment
reporting months that started the treatment with with Bedaquilin as part of
Bedaquilin as part of expanded access, compassionate expanded access,
use or under normal programmatic use. compassionate use or under
normal programmatic use.
BLOCK 3: Delay in start of second-line treatment

Reasons for Delay in start Provides detailed information on reasons for not This help to monitor
of second-line treatment enrolling eligible patients into SLD treatment. patients not enrolled on
Possible reasons might include: Death before the start treatment for some reason
of treatment, stock-out of second-line drugs, not being
eligible to start the treatment, Refusal to start SLD
treatment, Referral to higher level, or awaiting
baseline tests. The source of such information might

258
Data Elements Purpose Source
Description
be the comments of Facility TB register or Individual
Treatment Card.

259
QUARTERLY REPORTING ON DR-TB TREATMENT OUTCOMES

Data elements Description Purpose Source

This help to measure the treatment
This includes only laboratory confirmed RR/MDR-TB cases, outcome of all laboratory confirmed
excluding those that are HIV positive and Pre-XDR and XDR RR-TB and MDR-TB (excluding
cases registered in the period disaggregated by "cure", "died", Pre/XDR and HIV+ patients) registered
"Treatment failure", Treatment completed”, “Loss to follow up in the period.
All laboratory confirmed RR-TB and Non Evaluated".
and MDR-TB (excluding Pre/XDR)
This help to measure the treatment
This includes only treatment outcome of presumptive RR/MDR- outcome of all presumptive RR/MDR-
TB (clinically diagnosed) cases registered in the period TB (clinically diagnosed) cases
disaggregated by “treatment completed", "died", "Treatment registered in the period.
failure", "Loss to follow up and Non Evaluated”.
Presumed RR/MDR
This help to measure the treatment
This includes only treatment outcome of laboratory confirmed outcome of all laboratory confirmed
RR/MDR TB cases that are HIV positive registered in the period RR/MDR TB cases that are HIV
disaggregated by "cure", "died", "Treatment failure", Treatment positive registered in the period.
RR/MDR-TB cases with HIV+ completed”, “Loss to follow up and Non Evaluated".
(bacteriologically confirmed)
This help to measure the treatment
This includes only treatment outcome of only RR/MDR-TB cases outcome of only RR/MDR-TB cases
All children (0-14yrs) with that are children both laboratories confirmed and clinically that are children both laboratories
laboratory confirmed and diagnosed disaggregated by "cure", "died", "Treatment failure", confirmed and clinically diagnosed.
Presumptive RR-TB/MDR-TB Treatment completed”, “Loss to follow up and Non Evaluated".
(excluding Pre/XDR)
Final treatment outcome of Pre-XDR and XDR TB cases is
Pre-XDR and XDR TB reported separately, after 36 months of enrollment.

260
TB Symptoms Based Screening Tool (Chest Infection) Register

Item Description

Region: Refers to the part of the country where the screening activity is being undertaken e.g. Greater
Accra Region

District:
Refers to an area within the Region defined by local government as an administrative area

Health Facility Name:

Refers to the Name of the health care delivery centre where the screening is being done

NGO/Community Name: Refers to the name of the NGO undertaking the screening and the community in which they are
operating
Month/Year: Refers to the month and year the screening is being done
Screening Date:
Refers to the date the screening activity is being carried out

Consultation (1X): Provides options of different units where TB screening can be undertaken N.B. Only one
option can be selected in this section (1 - 7).

Symptoms and signs Could check more than 1 symptom (X) as appropriate): Provides options of various symptoms and
signs of TB a client is likely to present with N.B. More than one option can be selected in this
section (8 - 17)

261
 Item Description

Lab Screening Eligibility (Check only 1

X):
Refers to decision made based on the presenting symptoms and signs of the clients as well as the
case definition N.B. Only one option can be selected in this section (18 – 20)

Investigation Requested/action taken (

Could check more than 1 request or action as appropriate): Refers to laboratory investigation
requested after a decision of eligibility is made N.B. More than one option can be selected in this
section (21 – 30)

Screening case definition:

Defines criteria for eligibility i.e. Any Client responding “YES” to cough or contact with a known
TB case in addition to two or more other symptoms and signs OR Any client responding to cough
for more than 2 weeks irrespective of presence or absence of other symptoms

Name: Refers to the name of the client who responded “YES” to having a cough or having come into
contact with a known TB case
Age: Refers to Age in years (Written in figures)
Sex: Refers to the gender of the client either Male (M) or Female (F)
Tel# / Remark:
Refers to the phone number or any additional information useful in contacting the client

262
DRUG RESISTANCE REGISTER
TO BE COMPLETED

Element Description Purpose Data Source

263
TB STOCKS LEVEL REGISTER
Data
Description Purpose Data Source
Element
To know the quantity of
Opening Quantity of useable medicines available at the health Report Requisition Issue
1 medicines available for use at the
Balance facility at the beginning of the reporting period i.e. month Voucher on TB Medicines
beginning of the month
To know the quantity of
Quantity Quantity of medicines received from the RMS/CMS Report Requisition Issue
2 medicines received within the
Received during the reporting period Voucher on TB Medicines
month
Losses are the quantities removed from your stock for
Helps to account for all inventory
anything other than dispensing to patients e.g. expiry,
Losses& in stock. This informs stock Report Requisition Issue
3 theft, damage. Adjustments are the quantities received
Adjustments managers to take decisions Voucher on TB Medicines
from any source other than the RMS/CMS or given to
concerning safety of stock
another facility
To indicate the number of days
the facility was without a
Number of
Number of days in the month that the health facility did particular medicine. This Report Requisition Issue
4 days out-of-
not have a particular medicine in stock information is used by the higher Voucher on TB Medicines
stock
levels to monitor the logistics
system
Usable Stock
To identify the quantity of useable
on Hand at Quantity of useable medicines available at the health
medicines in order to determine Report Requisition Issue
5 the Pharmacy facility at the end of the reporting period. Quantities must
the exact quantities of additional Voucher on TB Medicines
& DOTs be obtained thorough physical count
medicines to reorder
centre
6 Consumption Quantity of medicines dispensed to patients in the month To record and track the number of Report Requisition Issue
(from TB for which report is generated. TB medicines dispensed to Voucher on TB Medicines
Dispensing patients in the period. This
Register) information helps to determine the
Average Monthly Consumption of

264
 Data
Description Purpose Data Source
Element
the facility
To establish the stock quantities
The maximum quantity of medicine that a facility must that will be used for inventory
Maximum
stock at any time. This is obtained by multiplying the control and in calculating order Report Requisition Issue
7 Stock
AMC for the facility by 2. This must be recalculated quantity. It ensures that the Voucher on TB Medicines
Quantity
every six months facility stocks just the quantities it
needs in order to avoid expiries
This is the quantity to request from the RMS. It is To determine additional quantities
Quantity to Report Requisition Issue
8 obtained by subtracting the useable stock on hand from needed to bring stock back to
Order Voucher on TB Medicines
the Maximum stock quantity maximum stock quantity
To indicate if facility was
Quantity to Report Requisition Issue
9 Quantity issued by the RMS to the requesting facility resupplied with required
Issue Voucher on TB Medicines
quantities.

265
MONTHLY TB CASE REGISTRATION

INSERT TABLE

266
QUARTERLY REPORTING ON TREATMENT RESULTS: ALL PATIENTS (ADULTS + CHILDREN)

Data Element Description

Total No. registered in quarter1 Number of cases registered in the period

HIV status HIV test results of the Patient i.e. HIV+, HIV- or HIV ND/NA
Number of new Sputum smear positive (+) patients who were sputum smear negative (–) in the last month of
Cure (1)
treatment and at least once before
Number of new patients who have completed treatment but who do not meet the criteria to be classified as a
Treatment completed (2)
cure or a failure
Died (3) Number of new patients who die from any cause during the course of treatment
Number of New patients who are sputum smear positive (+) at 5 months or later during treatment, or who is
Treatment Failure (4)
switched to Category IV treatment because sputum turned out to be MDRTB.

Default (5) Number of New patients whose treatment was interrupted for 2 consecutive months or more

Number of Patients who have been transferred to another recording and reporting unit and for whom treatment
Transferred out (6)
outcome is not known
Total Evaluated for outcomes Number of patients for which treatment outcomes was provided

267
REGISTERS AND FORMS FOR NON-COMMUNICABLE DISEASES (NCD)

REVISED CONSULTING ROOM REGISTER

No Variables Definitions Data Sources

The numbering of clients as they attend the facility, it is done serially to know
1 Serial Number Generated
the number of clients registered at a given period

Date on which the client is visiting the facility and shall be in the form
2 Date Calendar
DD/MM/YYYY

Client’s unique identification issued on the first visit to the facility and retained
3 Patient Number for life. If the client is not a new client in the facility, then steps shall be taken to Patient ID Card
search for the number assigned on the first visit.

Name of client in full without titles, avoid informal names such as: Sister,
4 Name of Patient Insurance card, Verbal
Maame, Auntie, Wofa, etc.

5 Address (Locality ) The locality in which the client resides but not the birthplace. Verbal

6 Phone number Contact number(s) of client or close relative Client/Relative

National Health
7 Insurance number The unique insurance identification number of the client Insurance Registration
Card

268
 No Variables Definitions Data Sources

The exact age of the client in completed years e.g. 30 years. If the child A
NEONATE WRITE THE AGE IN DAYS, but from the first month to the first
8 Age Verbal, insurance card
birthday (POST NEONATE) state the age in completed months followed by the
word ‘months’, e.g. 9 months

9 Sex Indicate the sex of the client. M for Male and F for Female Observation / Verbal

10 Weight (Kg) Indicate the weight in kilograms of the client Measure/client folder

11 Height (m) Indicate the height in meters of the client Measure/client folder

Indicate the body mass index (BMI) of the client. Its calculated by dividing the
12 BMI (kg/m2) Calculate/client folder
weight in kg by the height in meters squared

13 Blood pressure Indicate the blood pressure of the client Measure/client folder

14 Provisional Diagnosis The suspected morbidity condition that the patient is presenting Clinician

Laboratory Request
15 Referred for Testing (Tick) This is the laboratory investigation(s) requested by the clinician/prescriber
Form

This is the result(s) from the lab investigation requested by the

16 Test Result Lab result sheet
clinician/prescriber

17 Principal Diagnosis The main morbidity condition for which the patient is being treated Attending Clinician

269
 No Variables Definitions Data Sources

A CONDITION that is seen at the facility for the first time for which the client
is beginning treatment. This is referring to the diagnosis only and it is not the
Status of Principal
same as a New Client in the OPD register. It is the new cases that are counted
18 Diagnosis (New Case Attending Clinician
and reported on the Monthly OPD Morbidity Reporting Form as individual
Tick)
cases. If it is a chronic condition and there is evidence of contact with any
health facility it is then recorded as an old case. e.g. hypertension, diabetes

A condition that treatment has begun at the facility and the client is coming for
review of the same condition after treatment has begun. This condition will
Status of Principal
19 remain old until it is cured. All old cases are added to the re-attendance on the Attending Clinician
Diagnosis (Old Case Tick)
Monthly OPD Morbidity reporting form. The principle is to ensure that no
diagnosis is counted more than once.

Any other diagnosis that the client is confirmed by the clinician to have in
20 Additional Diagnosis Attending Clinician
addition to the principal diagnosis

Status of Additional
Attending Clinician /
21 Diagnosis ( New Case Tick if additional diagnosis is a new case as defined in row 19 above.
Records
Tick)

Status of Additional Tick if additional diagnosis is an old case, all old cases are added to the re- Attending Clinician /
22
Diagnosis (Old Case Tick) attendance on the OPD Morbidity report. As defined in row 21 above. Records

270
 No Variables Definitions Data Sources

If the patient has been diagnosed as hypertensive as the principal or additional

diagnosis, indicate if the blood pressure is controlled. Controlled hypertension is
defined as blood pressure below 140/90 mm Hg or, if the subject had diabetes or
Controlled blood pressure Attending Clinician /
23 CRD, below 130/80 mm Hg and are being treated with medicines. If the client
(Y/N/NA) Records
has controlled BP, then write “Y” and “N” if the client's hypertension is not
controlled. Write NA if not applicable. This should be checked over the last
three months

Patient on hypertension If the client with any NCD is on medication, then write “Y” and “N” if the Attending Clinician /
24
medication (Y/N/NA) client's hypertension is not controlled. Write NA if not applicable. Records

Attending
25 Referred Indicate condition for which patient is referred
Clinician/Records

This is to indicate if female clients visiting the consulting room are pregnant or Lab result / Verbal /
26 Pregnant woman (Y/N)
not. If the client is pregnant then, write “Y” and “N” if the client is not pregnant observation

The health insurance status of the client. This is limited only to the national
health insurance schemes. Write “YES”- if the client’s insurance card is valid or
active and has not expired. If ‘YES’, indicate if the patient is under
27 NHIS Patient (Y/N) CAPITATION OR DIAGNOSIS RELATED GROUP (DRG). Write “NO” if Insurance ID Card
the client is not insured at all or if the card is not valid or active. If the health
insurance card indicates that the insurance has expired then it means the client is
not insured, treat as non-insured.

271
REPORTABLE NON-COMMUNICABLE DISEASES AND ACTIVITIES

No Variables Definitions Data Sources Rational REMARKS

Cardiovascular diseases and risk factors
This will give the burden of the
Total new and old hypertensive Aggregate data from disease. This will help data
patients. It counts the total number NCD monthly form users including the facility to
1 Hypertension-Total Good
of both old and new cases of counted from know the burden of
hypertension. consulting room hypertension cases within the
reporting unit.
This gives the incidence of
Aggregate data from
hypertension within the
Newly diagnosed patients with NCD monthly form
2 Hypertension-New reporting period which helps Good
blood pressure ≥140/90 mmHg counted from
evaluate the public health
consulting room
interventions.
This gives an idea of the
Number of hypertensive (old and Aggregate data from
number of patients who are in
Hypertension- new) with associated organ NCD monthly form
3 the late stages of hypertension Revise to good
Complicated (TOD) damage (heart disease, eye, stroke, counted from
and those likely to develop fatal
and kidney disease) consulting room
outcomes
Aggregate from
Newly diagnosed hypertensives This indicates adherent of
Hypertension- New put NCD monthly form
4 who were put on blood pressure health practitioners to Revise to good
on treatment counted from
medications hypertension guidelines.
consulting room
Hypertensive patients who are This indicates the number of
Hypertension- Aggregate from
compliant with medication or patients who are compliant with
Continuing treatment NCD monthly form
5 continuing with prescribed treatment. It helps determine Revise to good
(Review cases – old counted from
medications and have come for patients who are likely to have a
cases) consulting room
review – This is old cases controlled blood pressure.

272
 No Variables Definitions Data Sources Rational REMARKS
This indicates those patients
less likely to develop
Old hypertensive patients who
complications that could be NCD register –
Hypertension- have their blood pressure ≤ NCD register – yet
6 fatal. It is also a proxy to yet to be
Controlled 140/90 mmHg in the last three to be implemented
determine the effectiveness of implemented
months
the treatment regimen given to
the patients.
Number of blood pressure Aggregate from
Hypertension-Number medications being taken to control NCD monthly form This indicates pill burden and
7 Good
of medications hypertension or daily hypertension counted from the likelihood of defaulting.
pill burden(number) pharmacy
The likelihood of people
Patients with blood sugar above Aggregate from developing diabetes is
normal but below the diabetic cut- NCD monthly form determined by knowing their
8 Prediabetes Good
off value ( RBS 7.8-11.1mm/l or counted from prediabetes status. Having such
FBS 6.1-7.0mm/l) consulting room data helps better management
and planning.
This will give the burden of the
Aggregate from disease. This will help data
Total number of patients (both
Diabetes mellitus- NCD monthly form users including the facility to
9 new and old) diagnosed with Good
Total counted from know the burden of diabetes
diabetes
consulting room mellitus cases within the
reporting unit.
This gives the incidence of
Newly diagnosed patients with Aggregate from
diabetes mellitus within the
Diabetes mellitus- blood sugar of RBS > 11.1mmol/l, NCD monthly form
10 reporting period which helps Good
New FBS >7.0mmol/l or 2HPPG >11.1 counted from
evaluate the public health
mmol/l consulting room
interventions.
Diabetes mellitus- Diabetic patients with Aggregate from This gives an idea of the
11 Good
Complicated (TOD) microvascular or macrovascular NCD monthly form number of patients who are in

273
 No Variables Definitions Data Sources Rational REMARKS
complications such as retinopathy,
neuropathy, nephropathy, leg
ulcers, amputations, erectile the late stages of diabetes
counted from
dysfunction, stroke and heart mellitus and those likely to
consulting room
diseases either develop fatal outcomes
clinical/symptomatic or
subclinical/asymptomatic

Patients with high cholesterol with

fasting lipid levels of :Intermediate
High
Aggregate from This indicates the burden of
Dyslipidaemia(high Tchol >6.2 NCD monthly form patients who are likely to
12 Good
cholesterol) LDL >4.11 counted from develop atherosclerotic
HDL <1.03 consulting room cardiovascular diseases.
Triglyceride >2.25
Non-HDL >4.1
TG/HDL ratio >1.68

Key
Currently not
recommendation
available to be This indicates the proportion of
to add to
13 Obesity: Mild Patients with BMI 30-34.9 reported from the patients with metabolic
consulting room
consulting room syndrome.
register for
register
reporting
14 Obesity- Moderate Patients with BMI 35-39.9 Currently not This indicates the proportion of Key
available to be patients with metabolic recommendation
reported from the syndrome. to add to
consulting room consulting room
register register for

274
 No Variables Definitions Data Sources Rational REMARKS
reporting
Key
Currently not
recommendation
available to be This indicates the proportion of
to add to
15 Obesity- Severe Patients with BMI≥40 reported from the patients with metabolic
consulting room
consulting room syndrome.
register for
register
reporting
This indicates the number of Patient folder
Patient with current cigarette patients with risk factors for review to
16 Cigarette smoking Community survey
smoking history or active smoking developing cancers, COPD, determine the
CVDs etc. sample frame
This indicates the number of Patient folder
History of current significant
patients with risk factors for review to
17 Alcohol intake alcohol intake: 14 units/week for Community survey
developing cancers, liver determine the
women and 21 unit/week for men
disease, CVDs etc. sample frame
This shows the proportion of This should not
Patients with symptoms and signs
In-patient Morbidity patients with embolic or be added.
18 Stroke- Infarctive of stroke who have head CT scan
and Mortality atherosclerotic cerebrovascular available through
showing an infarctive stroke
disease. inpatient
About 90% of hemorrhagic This should not
Patients with symptoms and signs
In-patient Morbidity stroke are due to hypertension be added.
19 Stroke-Haemorrhagic of stroke who have head CT scan
and Mortality and they are with a higher case available through
showing haemorrhagic stroke
fatalities. inpatient
This indicates the proportion of
This should not
Patients with symptoms and signs patients with no cause of stroke
In-patient Morbidity be added.
20 Stroke-Unconfirmed of probable stroke with no CT or identified. This is usually
and Mortality available through
MRI confirmation common in the lower levels of
inpatient
care.
Cardiac Diseases- Patients with dyspnea, fatigue, and Aggregate from These are patients with
21 Good
Presenting as Heart signs of volume overload, which NCD monthly form symptoms of the heart disease.

275
 No Variables Definitions Data Sources Rational REMARKS
may include peripheral edema and counted from
failure
pulmonary rales consulting room
Patients with hypertension with This measures the proportion of
Aggregate from
Cardiac Diseases- ECG or Echocardiogram features heart diseases due to
NCD monthly form
22 Hypertensive heart suggestive cardiac remodeling hypertension. It is the Good
counted from
diseases (arrhythmia, hypertrophy, diastolic commonest type in sub-Sahara
consulting room
or systolic dysfunction or both) Africa.
Patients with symptoms of angina,
history of myocardial infarction or
Aggregate from
ECG and Echocardiogram changes This is the proportion of Access control to
Cardiac Diseases- NCD monthly form
23 suggestive of myocardial patients with ischemic heart data element by
MI/IHD/CAD counted from
ischaemia/infarction or coronary diseases. levels
consulting room
angiogram
confirmation(invasive/CT/MRI)
OPD and emergency
room register
Cardiac Diseases- A patient with heart diseases with Number of patients with Access control to
Aggregate from
24 Rheumatic /valvular clinical or echocardiogram rheumatic / degenerative data element by
NCD monthly form
heart diseases features of valvular heart disease valvular heart disease. levels
counted from
consulting room
Access control to
OPD and emergency
data element by
room register
Patients with cardiac disease with levels – and will
Cardiac Diseases- Aggregate from These are people with heart
25 imaging(echocardiogram/CT/MRI) be implemented
Cardiomyopathy NCD monthly form disease of unknown cause.
diagnosis of cardiomyopathy when
counted from
incorporated in
consulting room
the NCD register
OPD and emergency To detect patients who are Access control to
Patient with rate or rhythm
26 Cardiac arrhythmia room register likely to have an explanation for data element by
abnormalities.
Aggregate from palpitation and syncope. levels – and will

276
 No Variables Definitions Data Sources Rational REMARKS
be implemented
NCD monthly form
when
counted from
incorporated in
consulting room
the NCD register
Access control to
data element by
Patients with other cardiac Aggregate from
levels – and will
Cardiac Disease- diseases such as congenital, NCD monthly form All other relevant heart
27 be implemented
Others pericardial and endocardial counted from diseases.
when
diseases. consulting room
incorporated in
the NCD register
Patients with symptoms and signs Aggregate from
Proportion of patients with clot
of Deep Vein Thrombosis NCD monthly form
28 Deep vein thrombosis formation usually in the deep Good
confirmed by either a doppler scan counted from
veins of the lower limbs.
or D-Dimer consulting room
Patients with symptoms and signs Aggregate from
of Pulmonary embolism confirmed NCD monthly form Patients with dislodged clots in
29 Pulmonary Embolism Good
by D-Dimer, Echocardiogram or counted from the lungs.
CT-Pulmonary angiogram consulting room
Sudden reduction of kidney
function within 48 hours
These are patients who develop
characterized by reduction in urine Aggregate from
sudden deterioration in their
output and increase in serum NCD monthly form
30 Acute kidney diseases kidney function with 48 hours. Good
creatinine. 25% reduction in counted from
This also indicates acute kidney
eGRR, >1.5x increase in serum consulting room
injury.
Creatinine or urine out
<0.5ml/kg/hr
Clinical features of chronic kidney Aggregate from These are patients with chronic
Chronic kidney
31 disease with vomiting, anaemia, NCD monthly form kidney dysfunction most of Good
diseases
oedema, hypertension as well as counted from which are due to hypertension,

277
 No Variables Definitions Data Sources Rational REMARKS
proteinuria/haematuria with or
diabetes, medication (eg
without reduction in eGFR (Stage consulting room
herbal).
1-5)
Aggregate from
Patients with asthma seen with
NCD monthly form This is the proportion of
32 Asthma(bronchial) acute symptoms of dyspnoea, Good
counted from patients with bronchospasm.
cough or wheezing
consulting room
Patients with sickle cell disease Aggregate from
who presents with acute symptoms NCD monthly form Proportion of patients with the
33 Sickle cell disease Good
such chest pain, bone pain, fever, counted from SS or SC hemoglobinopathy
etc. consulting room
A traffic collision, also called a
motor vehicle collision, car
Aggregate from
accident, or car crash vehicle
NCD monthly form Injuries sustained due to road
34 Injuries: RTA collides with another vehicle, Good
counted from traffic accidents
pedestrian, animal, road debris, or
consulting room
other stationary obstruction, such
as a tree, pole or building
Acute exposures to mechanical, Significant injuries sustained
Aggregate from
thermal, electrical or chemical within the domestic
NCD monthly form
35 Injuries: Domestic energy resulting in harm at home environment. Eg injuries that Good
counted from
which includes domestic violence, would require a hospital
consulting room
abuse and rape visitation.
36 Injuries: Occupational injuries result from Aggregate from Significant injuries sustained Good
Occupational/Industria physical, biological, chemical, or NCD monthly form within the work environment
l psychosocial hazards such as counted from and indicates those without
noise, temperature, insect or consulting room protective equipment. Eg. A
animal bites, aerosols, blood-borne child getting injured at the farm.
pathogens, hazardous chemicals,
radiation, and occupational

278
 No Variables Definitions Data Sources Rational REMARKS
burnout
Cancers (Adult +Children)
Access control to
Burkitt lymphoma- OPD and emergency This shows the incidence of
37 Newly Diagnosed Patients data element by
New room register Burkitt Lymphoma
levels
Aggregate from
This shows the proportion of
Burkitt Lymphoma- NCD monthly form
38 diagnosed patients that have
On Treatment counted from
accessed treatment
consulting room
Aggregate from
Access control to
Acute Lymphoblastic Patients with new diagnosis of NCD monthly form This indicates the incidence of
39 data element by
leukemia - New Acute Lymphoblastic Leukemia counted from Acute Lymphoblastic Leukemia
levels
consulting room
Aggregate from
Acute Lymphoblastic The proportion of diagnosed
Patients with Acute Lymphoblastic NCD monthly form
40 Leukemia- On Acute Lymphoblastic Leukemia
Leukemia receiving treatment counted from
Treatment patients on treatment
consulting room
Aggregate from
Access control to
Hodgkin lymphoma - Patients with new diagnosis of NCD monthly form Indicates incidence of Hodgkin
41 data element by
New Hodgkin Lymphoma counted from Lymphoma
levels
consulting room
Aggregate from
Proportion of patients diagnosed
Hodgkin Lymphoma – Patients with Hodgkin Lymphoma NCD monthly form
42 with Hodgkin Lymphoma on
On treatment receiving treatment counted from
treatment
consulting room
Aggregate from Indicates Incidence of
Access control to
Patients with new diagnosis of NCD monthly form retinoblastoma and
43 Retinoblastoma- New data element by
Retinoblastoma counted from effectiveness of screening
levels
consulting room programs for retinoblastoma
44 Retinoblastoma – On Patients with retinoblastoma Aggregate from Proportion of patients with

279
 No Variables Definitions Data Sources Rational REMARKS
NCD monthly form
diagnosed retinoblastoma
Treatment receiving treatment counted from
receiving treatment.
consulting room
Aggregate from
Access control to
Patients with new diagnosis of NCD monthly form Indicates the incidence of
45 Wilms tumor - New data element by
Wilm’s Tumor counted from Wilms Tumor
levels
consulting room
Aggregate from
Wilm’s Tumor- On Patients with Wilm’s tumor on NCD monthly form Proportion of patients diagnosed
46
Treatment treatment counted from with Wilm’s tumor on treatment
consulting room
Aggregate from
Access control to
Low grade glioma- Patient with new diagnosis of Low NCD monthly form
47 Incidence of Low Grade Glioma data element by
New Grade Glioma counted from
levels
consulting room
Aggregate from
Proportion of patients diagnosed
Low Grade Glioma – Patient with Low Grade Glioma on NCD monthly form
48 with Low Grade Glioma on
On Treatment treatment counted from
treatment.
consulting room
Aggregate from
Patients with new diagnosis of NCD monthly form Indicates the incidence of breast
49 Breast cancer- new Good
breast cancer counted from cancer
consulting room
Aggregate from
Indicates the proportion of
Breast cancer- on Patients with breast cancer who NCD monthly form
50 diagnosed breast cancer cases Good
treatment are on treatment counted from
on treatment
consulting room
Aggregate from
Patients with new diagnosis of Indicates the incidence of
51 Cervical cancer-new NCD monthly form Good
cervical cancer cervical cancer
counted from

280
 No Variables Definitions Data Sources Rational REMARKS
consulting room
Aggregate from
Indicates the proportion of
Cervical cancer- on Patients with cervical cancer who NCD monthly form
52 diagnosed cervical cancer cases Good
treatment are on treatment counted from
on treatment
consulting room
Aggregate from
Patients with newly diagnosis of NCD monthly form Indicates the incidence of
53 Lymphoma-New Good
lymphoma counted from lymphoma cases.
consulting room
Aggregate from
Indicates the proportion of
Lymphoma-on Patients with lymphoma who are NCD monthly form
54 diagnosed lymphoma cases on Good
treatment on treatment counted from
treatment
consulting room
Aggregate from
Patients with new diagnosis of NCD monthly form Indicates the incidence of
55 Leukaemia- New Good
leukemia counted from Leukemia
consulting room
Aggregate from
Indicates the proportion of
Leukaemia- on Patients with leukaemia who are NCD monthly form
56 diagnosed leukemia patients on Good
treatment on treatment counted from
treatment
consulting room
Aggregate from
Patients with new diagnosis of NCD monthly form Indicates the incidence of
57 Prostate cancer-New Good
prostate cancer counted from Prostate cancer
consulting room
Aggregate from
Indicates the proportion of
Prostate Cancer-on Patients with prostate cancer who NCD monthly form
58 diagnosed prostate cancer Good
treatment are put on medication counted from
patients on treatment
consulting room
59 Liver cancer Patients with new diagnosis of Aggregate from Indicates the incidence of liver Good

281
 No Variables Definitions Data Sources Rational REMARKS
NCD monthly form
(Hepatocellular
liver cancer counted from cancer
carcinoma) -New
consulting room
Liver cancer Aggregate from
Indicates the proportion of
(Hepatocellular Patients with liver cancer who are NCD monthly form
60 diagnosed hepatocellular cancer Good
carcinoma)- on put on medication counted from
patients on treatment
treatment consulting room
Screening services
Number of people who were Helps in early case detection,
Screening services for OPD and Wellness
61 identified as newly diagnosed treatment and/or prompt referral
CVD: Hypertension Clinic register
hypertensives from screening for management
Number of people who were Helps in early case detection,
Screening services OPD and Wellness
62 identified as newly diagnosed treatment and/or prompt referral
CVD: Diabetes Clinic register
diabetics for management
Number of people who were Helps in early case detection,
Screening services OPD and Wellness
63 identified as newly diagnosed treatment and/or prompt referral
CVD: High cholesterol Clinic register
with high cholesterol for management
OPD register/
Screening services for Helps in early case detection,
Number of people screened family planning
64 cervical cancer (VIA treatment and/or prompt referral
cervical cancer returns/annual
PAP) for management
reports
OPD register/
Screening services for Proportion of women between the Helps in early case detection,
family planning
65 cervical cancer (VIA ages 30-49 screened for cervical treatment and/or prompt referral
returns/annual
PAP cancer at least once for management
reports
OPD register/
Screening services for Helps in early case detection,
Number positive for cervical family planning
66 cervical cancers (VIA treatment and/or prompt referral
cancer returns/annual
PAP) for management
reports

282
 No Variables Definitions Data Sources Rational REMARKS
OPD register/
Screening services for Number positive for cervical Helps in early case detection,
family planning
67 cervical cancers (VIA cancer who were referred to a treatment and/or prompt referral
returns/annual
PAP) gynaecologist for management
reports
screening services for
OPD register/
breast cancers Helps in early case detection,
Number of screened for breast family planning
68 (physical exams, treatment and/or prompt referral
cancer returns/annual
ultrasound and for management
reports
mammogram)
screening services for
OPD register/
breast cancers Helps in early case detection,
family planning
69 (physical exams, Number positive for breast cancer treatment and/or prompt referral
returns/annual
ultrasound and for management
reports
mammogram)
Screening services for
OPD register/
breast cancers Helps in early case detection,
Number referred account of breast family planning
70 (physical exams, treatment and/or prompt referral
cancer returns/annual
ultrasound and for management
reports
mammogram)
Functional Wellness Clinics
71 Criteria:

1. Dedicated space or clinic for (Blood pressure, diabetes, BMI, Breast, Cervical, etc.) Please define this ,
develop new form to
2. Dedicated staff assigned, capture this at the
district level , quarterly
3. Generate monthly reports that will be added to the facility reports report recommended.
There should be policy
4. Have basic equipment for screening (including BP apparatus, weighing scale, heightometer, tape measure,
or guidelines to support
glocumeter with strips (or access to laboratory),

283
 No Variables Definitions Data Sources Rational REMARKS
5. Capacity to provide counselling services and intra-referral
this tool.

284
NCD SCREENING REGISTER

# Serial No. The numbering of clients as they attend the facility, it is done generated
serially to know the number of clients registered at a given
period
Name of client in full without titles, avoid informal names
1 Name of Client Insurance card, Verbal
such as: Sister, Maame, Auntie, Wofa, etc.

The exact age of the client in completed years e.g. 30 years.

If the child A NEONATE WRITE THE AGE IN DAYS, but
2 Age from the first month to the first birthday (POST NEONATE) Verbal, insurance card
state the age in completed months followed by the word
‘months’, e.g. 9 months

3 Sex Indicate the sex of the client. M for Male and F for Female Observation / Verbal

4 Address (Locality ) The locality in which the client resides but not the birthplace. Verbal
5 Phone number Contact number(s) of client or close relative Client/Relative

Indicate the NCD condition for which the client is screened

6 Condition screened for Clinician/Attendant
for E.g. Hypertension

Clinician/Attendant/Lab
7 Screening result Indicate the results (outcome) of the condition screened for.
results

Indicate 'Yes' OR 'No' if client is a known patient for the

8 Known Patient Verbal
condition screened for

285
 # Serial No. The numbering of clients as they attend the facility, it is done generated
serially to know the number of clients registered at a given
period

9 Taking any medicine Indicate 'Yes' OR 'No' if client is already on medication Verbal

10 Height Indicate the height in meters of the client Measure / Verbal

11 Weight Indicate the weight in kilograms of the client Measure / Verbal
Women who consume eight or more bottle of alcoholic
drinks per week are considered excessive drinkers. And for
12 Alcohol
men, excess is defined as 15 or more bottles of alcoholic
drinks a week. Verbal

Never Smokers – Adults who have never smoked a cigarette

or who smoked fewer than 100 cigarettes in their entire
lifetime. Former Smokers – Adults who have smoked at
least 100 cigarettes in their lifetime, but say they currently do
13 Smoker not smoke. Nonsmokers – Adults who currently do not
smoke cigarettes, including both former smokers and never
smokers. Current Smokers – Adults who have smoked 100
cigarettes in their lifetime and currently smoke cigarettes
every day (daily) or some days (nondaily).
Verbal
14 Diabetic Indicate 'Yes' OR 'No' OR No Idea if client is diabetic Verbal
15 Referred Indicate 'Yes' OR 'No' if client is referred Clinician/Attendant

286
 # Serial No. The numbering of clients as they attend the facility, it is done generated
serially to know the number of clients registered at a given
period
Comments ( Institution
Any comments or additional information or indicate
16 conducting screening/ any Clinician/Attendant
institution/organization carrying out the screening
other information

287
MONTHLY NCD REPORTING FORM
No. VARIABLE DEFINITION DATA SOURCE
1 Name of Facility The name of the Health Facility e.g. Aboaso Health Centre etc. Records
The name of the district in which the Health Facility is located,
2 District Records
e.g. Kwabre.
3 Location Town in which the Health Facility is situated Records
4 Region The name of the region in which the SDP is located e.g. Ashanti. Records
5 Month The Month in which the transaction took place e.g. July Records
6 Year Year in which the transaction took place e.g. 2010 Calendar
A count of the number of the individual conditions presented by
7 Disease (New Cases Only) clients. This is List of the diseases to be reported on. This shall Consulting Room Register
be new cases only, does not include cases on review
Patients with blood sugar above normal but below the diabetic
8 Pre diabetes Consulting Room Register
cut-off value ( RBS 7.8-11.1mm/l or FBS 6.1-7.0mm/l)
Number of hypertensives (old and new) with associated organ
9 Complicated hypertension Consulting Room Register
damage (heart disease, eye, stroke, and kidney disease)
Diabetic patients with microvascular or macrovascular
complications such as retinopathy, neuropathy, nephropathy, leg
12 Complicated diabetes Consulting Room Register
ulcers, amputations, erectile dysfunction, stroke and heart
diseases either clinical/symptomatic or subclinical/asymptomatic
13 Grouping the cases Male, Female under the various Age Groups
14 Total Totals for each strata
15 Total New Cases Total of each column
16 Re-Attendance Conditions that came for review Consulting Register
17 Signature Signature of In-charge of the facility reporting Facility Head
18 Rank Rank of the In-charge of the facility reporting Facility Head
19 Date Date of submission of the report Calendar

288
MONTHLY NCD SCREENING REPORTING FORM
No. VARIABLE DEFINITION DATA SOURCE

1 Name of Facility The name of the Health Facility e.g. Aboaso Health Centre etc. Records

The name of the district in which the Health Facility is located,

2 District Records
e.g. Kwabre.

3 Location Town in which the Health Facility is situated Records

4 Region The name of the region in which the SDP is located e.g. Ashanti. Records

5 Month The Month in which the transaction took place e.g. July Records

6 Year Year in which the transaction took place e.g. 2010 Calendar

The total number of people screened within the reporting period.

7 Number screened This includes outreaches, and those organized by partners Screening Register
(NGOs, CSOs etc.)

13 Grouping the cases Male, Female under the various Age Groups

14 Total Totals for each strata

17 Signature Signature of In-charge of the facility reporting Facility Head

18 Rank Rank of the In-charge of the facility reporting Facility Head

19 Date Date of submission of the report Calendar

289
MONTHLY NCD REFERRAL REPORT
No. VARIABLE DEFINITION DATA SOURCE

1 Name of Facility The name of the Health Facility e.g. Aboaso Health Centre etc. Records

The name of the district in which the Health Facility is located,

2 District Records
e.g. Kwabre.

3 Location Town in which the Health Facility is situated Records

4 Region The name of the region in which the SDP is located e.g. Ashanti. Records

5 Month The Month in which the transaction took place e.g. July Records

6 Year Year in which the transaction took place e.g. 2010 Calendar

A count of the number of the individual conditions presented by Consulting

7 Disease / Condition
clients. This is List of the diseases to be reported on. Room/Screening Register

13 Grouping the cases Male, Female under the various Age Groups

14 Total Totals for each strata

17 Signature Signature of In-charge of the facility reporting Facility Head

18 Rank Rank of the In-charge of the facility reporting Facility Head

19 Date Date of submission of the report Calendar

290
QUARTERLY REPORTING FORM FOR WELLNESS CLINIC SERVICES

No. VARIABLE DEFINITION DATA SOURCE

1 District The name of the district reporting on the wellness clinic services Records
The name of the region in which the district is located e.g.
2 Region Records
Ashanti.
3 Month The Month in which the transaction took place e.g. July Records
4 Year Year in which the transaction took place e.g. 2020 Calendar

Availability of a The presence/absence of wellness clinic services in the district.

5 functioning wellness clinic Indicate Yes if only one or more facilities provide the services or Records
in district 'No' if it does not happen at all.

Number of facilities with

6 functional wellness clinic Facilities that provide wellness clinic services Records
services

Number of staff assigned to

7 Allocated staff in district to provide wellness clinic services Records
wellness clinic

8 Signature Signature of In-charge of the facility reporting Facility Head

9 Rank Rank of the In-charge of the facility reporting Facility Head
10 Date Date of submission of the report Calendar

291
NATIONAL VIRAL HEPATITIS CONTROL PROGRAMME

MONTHLY VIRAL HEPATITIS REPORTING FORM

Data Element/Variable Description/Definition Data Source Relevance
Records Identifies facility from which data is
Name of facility The name of the Health Facility e.g. Aboaso Health Centre etc
generated
Identifies town in which data is generated
Location Town in which the Health Facility is situated Records
The name of the sub district in which the Health Facility is Records Identifies sub district from which data is
Sub District
located, generated
Records Identifies district from which data is
District The name of the district in which the sub district is located generated
To know the name of the region in which
The name of the region in which the district is located e.g. reporting facility is located. (e.g.
Region Records
Ashanti. Ashanti)

Calendar month in which service delivery

Month The Month in which the transaction took place e.g. July Calendar took place

Year Year in which the transaction took place e.g. 2020 Calendar Year in which service delivery took place
Disease (New Cases Only)A count of the number of the individual conditions presented Consulting Room Important to identify new cases that were
by clients. This is List of the diseases to be reported on. This Register identified in the year and month
shall be new cases only, does not include cases on review

Laboratory Confirmed A case of acute hepatitis with biomarker (IgM anti-HAV or Consulting Room For monitoring types of virus causing
acute HAV HAV RNA) positivity, OR a case of acute hepatitis with Register acute infections
epidemiological link to a case confirmed with biomarker
positivity, by sex and age

292
Data Element/Variable Description/Definition Data Source Relevance
Laboratory Confirmed A case of acute hepatitis with biomarker (anti-HBc IgM) Consulting Room For monitoring types of virus causing
acute HBV positivity, by sex and age Register acute infections
Laboratory Confirmed A case of acute hepatitis with positivity of one of the three Consulting Room For monitoring types of virus causing
acute HCV biomarker criteria: Register acute infections
-detectable HCV RNA and negative for anti-HCV antibodies,
-sero-conversion to anti-HCV antibodies,
-positive for anti-HCV AND negative for IgM anti-HBc, IgM
anti-HAV and IgM anti-HEV, by sex and age
A case of acute hepatitis that is laboratory confirmed by virus Consulting Room For monitoring types of virus causing
Laboratory Confirmed specific biomarkers IgM anti-HBc positive plus anti-HDV Register acute infections
acute HDV positive (only as co-infection or super-infection of hepatitis
B) by sex and age
A case of acute hepatitis that tests positive for the biomarker Consulting Room For monitoring types of virus causing
Laboratory Confirmed Register acute infections
IgM anti-HEV OR a case of acute hepatitis with an
acute HEV
epidemiological link to a confirmed case, by sex and age
A case defined clinically by the discrete onset of an acute Consulting Room Sydromic definition and relevant in the
illness with signs/ symptoms of an infectious illness (e.g. Register absence of laboratory setting to do type-
fever, malaise, fatigue) and liver damage (e.g. anorexia, specific diagnosis, especially lower level
Unconfirmed/Unspecified
nausea, jaundice, dark urine, right upper quadrant tenderness, facilities. This covers any of the hepatitis
acute viral hepatitis cases
AND/OR levels of alanine aminotransferase [ALT] raised viruses.
more than ten times the upper limit of normal of the
laboratory), by sex and age
Chronic Viral Hepatitis B A person having chronic inflammation of the liver of more Consulting Room Very useful for tracking chronic hepatitis
infection than six months’ duration with persistently elevated liver Register B burden
function tests, characterised by persistence of hepatitis B
surface antigen (HBsAg) for six months or more, by sex and
age OR A person not meeting the case definition of acute
hepatitis and testing positive for HbsAg, by sex and age

293
Data Element/Variable Description/Definition Data Source Relevance
A person not meeting the case definition for acute hepatitis Consulting Room Very useful for tracking chronic hepatitis
but having serological evidence of past or present infection: Register C burden
Chronic Viral Hepatitis C (anti-HCV positive) and/ OR detectable HCV RNA or HCV
infection core antigen positive, by sex or age.
Any person with persistence of anti HCV and/or RNA
positivity for more than six months duration, by sex and age
A complication of many liver diseases including viral Consulting Room Very useful for tracking disease sequelae
Liver cirrhosis hepatitis B and C, characterized by abnormal structure and Register
function of the liver, by sex and age
Consulting Room Very useful for tracking disease sequelae
Hepatocellular carcinoma A cancer arising from the liver cells, by sex and age Register

294
MONTHLY CHRONIC VIRAL HEPATITIS B AND C TREATMENT FORM
PROG DATA ELEMENT DESCRIPTION SOURCE RELEVANCE
NVHCP Region Specify region where chronic care and Provider To know the name of the region in
treatment site is located which reporting facility is located. (e.g.
Ashanti)

NVHCP District Specify district where chronic care and Provider identifies district from which data is
treatment site is located generated

NVHCP Health Facility Specify Health Facility name where chronic Provider Identifies facility from which data is
care and treatment site is located generated

NVHCP Month Specify month for which this report applies Calendar Calendar month in which service
delivery took place

NVHCP Year Specify Year for which this report applies Calendar Year in which service delivery took
place

NVHCP Chronic Hepatitis B Specify total number of males accepted into Provider To analyse differential access to care
(Males) chronic care by age and sex by males

NVHCP Chronic Hepatitis B Specify total number of females accepted into Provider To analyse differential access to care
(Females) chronic care by age and sex by females

NVHCP Total chronic HBV Add males and females accepted into chronic Provider Indicates total new persons in care for
care, by age and sex chronic hepatitis B

295
PROG DATA ELEMENT DESCRIPTION SOURCE RELEVANCE
NVHCP Chronic Hepatitis C Specify total number of males accepted for Provider To analyse differential access to
(males) curative care of chronic HCV by age and sex treatment by males

NVHCP Chronic Hepatitis C Specify total number of females accepted for Provider To analyse differential access to
(Females) curative care of chronic HCV by age and sex treatment by females

NVHCP Total chronic HCV Add males and females accepted for curative Provider Indicates total new persons in care for
care of chronic HCV, by age and sex chronic hepatitis C

NVHCP Persons who inject Indicate by age and sex, the number of Treatment Register Useful for planning interventions for
drugs (within last 12 persons who injected drugs within the last 12 IVDU
months) months

NVHCP Experienced stigma Indicate by age and sex, the number of Treatment Register Necessary to assess level of stigma and
and or discrimination persons with chronic HBV and HCV who discrimination against persons with
experienced stigma and discrimination during chronic hepatitis
the month

296
Monthly Chronic HBV and HCV Treatment Outcome Form SOP
PROG DATA ELEMENT DESCRIPTION SOURCE RATIONALE
NVHC Region Specify region where chronic care and Provider To know the name of the region in
P treatment site is located which reporting facility is located. (e.g.
Ashanti)
NVHC District Specify district where chronic care Provider identifies district from which data is
P and treatment site is located generated
NVHC Health Facility Specify Health Facility where chronic Provider Identifies health facility from which
P care and treatment site is located data is generated

NVHC Month and Year Specify month and year for which this Calendar Calendar month and year in which
P report applies service delivery took place

NVHC Disease Applies to chronic hepatitis B and Treatment Register To limit conditions that can be reported
P chronic hepatitis C respectively on here
NVHC Prevalent cases (Hep B) Number of infected HBV people Treatment Register Reflects caseload for previous year
P already identified before year (treated
or not)
NVHC Hep B Testing Number of people tested with serology Screening For statistical analysis
P this month for Hep B register/Laboratory
reports
NVHC Diagnosis Hep B # HBsAg positive (diagnosed) this Screening For planning intervention
P month register/Laboratory
reports
NVHC Prevalent cases (Hep C) Number of infected HCV people Treatment Register Reflects caseload from previous year
P already identified before year (treated
or not). Remains the same value from
month to month in the year
NVHC Hep C Testing Number of people tested with serology Screening For statistical analysis
P this month for Hep C register/Laboratory

297
PROG DATA ELEMENT DESCRIPTION SOURCE RATIONALE
reports
NVHC Diagnosis Hep C # anti-HCV or HCV RNA or HCV Screening For planning intervention
P core antigen positive (diagnosed) this register/Laboratory
month reports
NVHC Treatment
P coverage/Initiation
NVHC CHB Continuing # continuing specific treatment for Treatment Register For planning intervention
P Treatment HBV started last year
NVHC New CHB Treatment # newly starting HBV treatment this Treatment Register For planning intervention
P month
NVHC PWID (People Who Inject # newly starting treatment among Treatment Register Measures access to treatment for PWID
P Drugs) starting CHB people who injected drugs in the past community
treatment 12 months
NVHC New CHC treatment # newly starting HCV treatment this Treatment Register For planning intervention
P month
NVHC PWID (People Who Inject # newly starting treatment among Treatment Register Measures access to treatment for PWID
P Drugs) starting CHC people who injected drugs in the past community
treatment 12 months
NVHC Treatment
P effectiveness/Completion
NVHC HBV Treatment # on HBV treatment assessed for Treatment Register Useful for programme evaluation
P Effectiveness Assessed treatment effectiveness
NVHC HB Viral suppression # with effective treatment among Treatment Register Useful for programme evaluation
P achieved those assessed for HBV treatment
effectiveness
NVHC Completing HCV # completing HCV treatment Treatment Register Useful for programme evaluation
P treatment
NVHC HCV Treatment # on HCV treatment assessed for Treatment Register Useful for programme evaluation
P Effectiveness Assessed treatment effectiveness
NVHC HCV Cured # with effective treatment (cure) Treatment Register Useful for programme evaluation

298
PROG DATA ELEMENT DESCRIPTION SOURCE RATIONALE
P among those assessed for HCV
treatment effectiveness
NVHC Treatment impact
P
NVHC HBV positive cirrhosis Total deaths with cirrhosis having COD Certificates
P deaths HBV positive
NVHC All Cirrhosis deaths Total deaths from cirrhosis COD Certificates
P
NVHC Cirrhosis mortality Proportion of people dying from Provider calculated Useful for programme evaluation
P attributed to HBV cirrhosis who had hepatitis B, (best proportion
generated with annual data)
NVHC HBV positive Total deaths with HCC having HBV COD Certificates Useful for programme evaluation
P hepatocellular carcinoma positive
(HCC) deaths
NVHC All hepatocellular Total deaths from HCC COD Certificates Useful for programme evaluation
P carcinoma deaths Cancer registry
NVHC HCC mortality attributed Proportion of people dying from HCC Provider calculated Useful for programme evaluation
P to HBV who had hepatitis C, (best generated proportion
with annual data)
NVHC HCV positive cirrhosis Total deaths with cirrhosis having COD Certificates Useful for programme evaluation
P deaths HCV positive
NVHC All Cirrhosis deaths Total deaths from cirrhosis COD Certificates Useful for programme evaluation
P
NVHC Cirrhosis mortality Proportion of people dying from Provider calculated Useful for programme evaluation
P attributed to HCV cirrhosis who had hepatitis C, (best proportion
generated with annual data)
NVHC HCV positive Total deaths with HCC having HCV COD Certificates Useful for programme evaluation
P hepatocellular carcinoma positive
(HCC) deaths

299
PROG DATA ELEMENT DESCRIPTION SOURCE RATIONALE
NVHC All hepatocellular cancer Total deaths from HCC COD Certificates Useful for programme evaluation
P deaths Cancer registry
NVHC HCC mortality attributed Proportion of people dying from HCC Provider calculated Useful for programme evaluation
P to HCV who had hepatitis C, (best generated proportion
with annual data)

300
PMTCH_HEP B REGISTER
PROG Data Element Description Source Relevance
NVHCP Date Date of Client registration Calendar Date of service
provision/encounter
NVHCP Serial Number Count of clients registered in the year Provider For statistical purposes

NVHCP ANC Registration Number Unique number assigned from ANC Maternal Health Record For unique identification of
clinic mother/ baby

NVHCP Name of pregnant women Name of Client (Surname, Last name Maternal Health Record For Identification/tracing
& aliases)
NVHCP House Address A traceable address of the Client, Maternal Health Record For Identification/tracing
house address/street name
NVHCP Workplace address A traceable address of the Client Client For Identification/tracing
workplace/street name
NVHCP Telephone number Telephone (Fixed line) or mobile Client For Identification/tracing
number of Client
NVHCP Gestational age Most reliable duration of pregnancy Maternal Health Record To determine when treatment
today in completed weeks by USG or accurate LMP can begin
NVHCP Pre-test information Indicate if Pregnant woman received Maternal Health To assess understanding and
basic information of Hep B before Record /ANC Register cooperation of client
testing
NVHCP Tested Indicated yes to confirm if pregnant Maternal Health Confirm Hep B testing
woman was tested for HBsAg in the Record /ANC Register
ANC clinic
NVHCP Result positive Indicate pregnant woman tested Maternal Health To confirm the result of test
HBsAg +ve at ANC clinic Record /ANC
Register/Lab Report

301
PROG Data Element Description Source Relevance
NVHCP Post-test counselling Indicate if pregnant woman received Maternal Health To assess understanding and
Hep B test results and counselling to Record /ANC Register cooperation of client
cope with results
NVHCP Tested for HBV DNA or Indicate if HBsAg positive pregnant ANC Register To confirm if viral load testing
HBeAg woman was tested for HBV DNA or done
HBeAg
NVHCP Eligibility of HBsAg + Indicate HBV DNA or HBeAg results Lab report/ANC register To confirm the result of test
women for antiviral and highlight if eligible or meets
prophylaxis criteria for antivirals
NVHCP Date antiviral prophylaxis to Day on which prophylactic treatment Maternal Health Record To indicate date treatment to
start/started was started (at/after 28 weeks’ start/started
gestation)
NVHCP Treatment regimen and Indicate treatment name and dosage Maternal Health Record Adequacy of prophylaxis
dosage and duration
NVHCP Date of delivery Date on which client delivers live birth Maternal Health Record Indicates when interventions
for baby was started

NVHCP Birth dose hepatitis B vaccine Indicate if birth dose Hepatitis B Delivery Register Indicates whether baby
vaccine within 24 hours of birth was received birth dose
given
NVHCP HBIG Indicate if exposed newborn was given Delivery Register Indicates whether baby
hepatitis B immune globulin on birth received HBIG
NVHCP Infant testing at 7-12 months Indicate if Hepatitis B exposed infant Child Health Record Indicates date baby received
of age was tested from 7-12 months for testing at 7-12 months
HBsAg
NVHCP Result of post-vaccination Indicate result of Hepatitis B exposed Laboratory report Indicates result of test
serological testing for HBsAg infants at 7-12 months of age who
were tested using antigen test

302
PROG Data Element Description Source Relevance
NVHCP Cumulative incidence of Number of children 5 years of age Biomarker survey Result of a sample of children
HBsAg in children 5 years of testing positive to HBsAg five years old are tested in
age location

303
CHRONIC VIRAL HEPATITIS B AND C SCREENING REGISTER
PROGRAMME DATA DESCRIPTION SOURCE RELEVANCE
ELEMENT
NVHCP Region Region where screening team is Records To know the name of the region in which
located reporting facility is located. (e.g. Ashanti)

NVHCP District District where screening team is Records Identifies source of data
located
NVHCP Health Facility Name of health facility where Records Identifies source of data
screening team is located
NVHCP Date This refers to the day, the month and Calendar Defines date of service for future reference
the year that the client accessed
services (DD/MM/YYYY)
NVHCP Serial No This refers to the serial numbers given Records For counting clients
to clients
NVHCP Name The unique identity of the client Client To identify client
without title e.g. Dr., Mr., Mrs
NVHCP Name of The unique identity of the Client To identify client
parent/caretaker if parent/caretaker of child under 12
child under 12 years without title e.g. Dr., Mr., Mrs
NVHCP DOB, or age if Refers to date of birth of client in Client To know the date of birth or age
DOB unknown DD/MM/YYYY format OR Age in
complete years or months
NVHCP Sex Gender of the Client, indicate whether Observation For counting of sex of clients
Male or Female

304
PROGRAMME DATA DESCRIPTION SOURCE RELEVANCE
ELEMENT
NVHCP Location Address This refers to the exact physical Client To locate client in community
address/location of the client/how to
contact client
NVHCP District of District which client lives in Client To locate client in community
residence
NVHCP Sub district of Sub district which client lives in Client To locate client in community
residence
NVHCP Telephone/Email Telephone or email of client Client To contact client
NVHCP Occupation The occupation of client Client For risk level analysis

NVHCP Marital status Indicate if single, married, widowed, Client For risk level analysis
separated or divorced or NA for child
NVHCP Screening site Name of site where this screening is Provider For record purposes
being undertaken, health facility or
community location e.g. specific
church or prison
NVHCP Individual/Group Indicate or categorize if individual Provider To indicate level of individual and group
screening walk in (IWI) or group screening (G) interest/access
NVHCP Categorization of Voluntary or mandatory Client For determine relative proportions
individual
NVHCP Categorization of Specify group name as : CSW, PWID, Client/Provider For record and to determine access to
group MSM, Prison, Church, Health different groups/sub populations
Workers, School, Household,
Corporate, Church group, Others

NVHCP Previous Indicate if client had received Client To help with interpreting profile results
vaccination hepatitis B vaccination previously

305
PROGRAMME DATA DESCRIPTION SOURCE RELEVANCE
ELEMENT
received? Specify with doses received
type & no of doses
NVHCP Pre-test counselling Refers to clients given basic Provider To access preparation of clients
information on Hepatitis before
testing is done
NVHCP Result of Hepatitis Indicate result of Hepatitis B test Lab report For interpretation and management
B test
NVHCP Result of Hepatitis Indicate result of Hepatitis C test Lab report For interpretation and management
C test
NVHCP Post-test Indicate Yes or No whether the client Provider To access preparation of clients
counselling had a post-test counselling after
receiving results.

NVHCP Given Hep B Indicate Yes and date if client testing Provider Indicates service continuity
vaccine (first dose) negative for Hep B received first dose
of hepatitis B vaccine, Otherwise No
NVHCP Referral for Indicate if client testing positive for Provider Indicates service continuity
confirmation/ Hep B or C is referred for
chronic care and confirmation and enrolment on
treatment chronic care/treatment register

306
CHRONIC VIRAL HEPATITIS B AND C SCREENING FORM
PROG DATA ELEMENT DESCRIPTION SOURCE RATIONALE
NVHCP Region Region where screening team is located Provider To know the name of the region in which
reporting facility is located. (e.g.
Ashanti)

NVHCP District District where screening team is located Provider To identify district location of the team

NVHCP Sub district Sub district where screening team is Provider To identify sub district location of the
located team
NVHCP Health Facility Name of health facility where screening Provider To identify health facility location of the
team is located team
NVHCP Month and Year This is the month and year covered by Calendar To identify month and year report
report pertains to
NVHCP # individuals received Number of individuals received for Screening Register To indicate uptake by individuals
for screening screening during the month by disease
type as distinct from groups
NVHCP Group numbers Specify total numbers screened for each Screening Register To indicate workload generated by
of these CSW, PWID, MSM, Prison, groups
Health Workers, School, Household,
Corporate, Church group, Others
NVHCP Total persons screened Add individuals and group numbers Screening Register To know numbers screened
NVHCP # Groups received for Indicate different numbers of groups Screening Register To indicate level of group interest
screening received for screen during month
NVHCP Total receiving pre-test Specify total persons counselled prior to Screening Register Reflects on acceptance of results
counselling testing
NVHCP Total receiving post-test Specify total persons counselled after Screening Register Reflects on acceptance of results
counselling receiving results
NVHCP Total tested for Hep B Specify total tested for Hepatitis B Screening Register To know the proportion positive

307
PROG DATA ELEMENT DESCRIPTION SOURCE RATIONALE
NVHCP Total positive for Hep B Specify total testing positive for Screening Register For planning intervention
Hepatitis B
NVHCP Total tested for Hep C Specify total tested for Hepatitis C Screening Register To know the proportion positive

NVHCP Total positive for Hep C Specify total testing positive for Screening Register For planning intervention
Hepatitis C
NVHCP Total Negative for Hep Specify total testing Negative for Screening Register For planning vaccination need
B Hepatitis B
NVHCP Total vaccinated (first Specify total vaccinated with first dose Screening Register To know those who accessed vaccination
dose) Hep B for Hep B
NVHCP Total referred for Specify total referred for confirmation Screening Register For follow up through treatment
confirmation and and chronic care for Hep B
chronic care for Hep B
NVHCP Total referred for Specify total referred for treatment for Screening Register For follow up through treatment
treatment for Hep C Hep C

308
APPENDIX FIVE
REGISTERS AND FORMS FOR NON-SERVICE DELIVERY DIVISIONS
POLICY PLANNING MONITORING AND EVALUATION

INSERT PPME REGISTERS AND FORMS

309
FINANCE DIVISION
MONTHLY FACILITY IGF REVENUE FORM
Variable Definition Data Source Rationale for collecting data
Budget This is the approved revenue Approved monthly revenue 1. To ascertain the revenue budget for the month for
budget for the month. Budgets are budget as recorded in each revenue generating facility.
supposed to be approved by the Departmental Journal
Regional Director in line with Voucher and entered in the 2.To help generate monthly revenue budget of the
ATF Revenue Budget Ledger Service and also provide information for budgeting in
ensuing periods

This is the cash and carry revenue Revenue Budget Ledger 1.To track revenue performance of the facilities
Revenue Collected collected in the relevant month
(cash & carry) 2. To examine trends and mix of IGF revenue over the
period
This is the revenue generated from
Corporate (Deferred corporate clients/deferred 3. To assist in the implementation of approved
Payment) payment clients (apart from NHI revenue budgets
clients) for the relevant month Revenue Budget Ledger

This is the revenue generated from

only NHI clients for the relevant
month

NHI revenue This is the difference between the

Budget and Total actual Revenue Budget Ledger
revenue(cash & carry plus
Corporate client plus NHI) for the
relevant period

Variance Revenue Budget Ledger

310
CLAIMS SUBMITTED FORM (This form is to track NHI submissions)
Variable Definition Data Source Rationale for collecting data
Amount Submitted This is the value of NHI claims submitted Facility signed/approved NHI Rational
for the relevant month. For e.g. the bill for relevant month bill submitted to This form is to enable Management to
May be submitted in June. In this case the NHIA for payment on facility track the timeliness of claims
template to be filled would be May. But the NHI file. This must also submission by health facilities. This is
date submitted would be the date in June correspond to monthly NHI bills important because it has an impact on
when the May bill was submitted in the revenue budget ledger the timing of reimbursements and the
amounts reimbursed
Medicine & This is the total value of NHI bills for Facility signed/approved NHI
Pharmacy Medicines and Pharmaceuticals for the relevant month bill for Medicines
relevant month submitted by the facility to and pharmaceuticals submitted to
the NHIA for payment NHIA for payment on facility
NHI file. This figure must also
correspond to monthly NHI bills
in the revenue budget ledger
Services This is the total value of NHI bills for Non- Facility signed/approved NHI
drug consumables for the relevant month relevant month bill for Non-drug
submitted by the facility to the NHIA for consumables submitted to NHIA
payment for payment on facility NHI file.
This figure must also correspond
to monthly NHI bills in the
revenue budget ledger
Total Submission This is the addition of the monthly NHI The monthly NHI Medicines and
Medicines and Pharmaceuticals and the Pharmaceuticals and the Monthly
Monthly NHI Services submitted for the NHI Services submitted for the
relevant month relevant month as appropriately
sourced
Date of Submission This is the date of submission of the NHI NHIA stamped received Cover
bill for the relevant bill. letter of health facilities and the
In this case the template to be filled would receipt acknowledgement e-mail

311
Variable Definition Data Source Rationale for collecting data
be May. But the date submitted would be for electronic submissions.
the date in June when the May bill was Facilities must get NHIA to stamp
submitted received date of bill on the facility
cover letter for the bill for the
relevant month and Date of
submission of bill to NHIA as
appropriately received or
acknowledged.

312
PAYMENT OF CLAIMS FORM
Variable Definition Data Source Rationale for collecting data
Payment of Claim This is the claims paid by NHIA for the Amount in Bank statement This is to help management track
Amount Paid relevant month. So, for example if the and/or NHI Payment 1. The average time between when claims are
MAY Bill submitted was paid in advice submitted and when they are paid to aid
December, the information would be management decisions and advocacy
entered in the December Month payment of 2. The quantum and percentage of Claims that
claim template/form. The date of are rejected and hence gauge the efficiency
submission would show when the bill that and quality of claims submitted by facilities
has been paid was submitted 3. The quantum of Med & Pharmacy and
Services claims paid and rejected
Medicine & This is the total value of NHI payments for Amount in Bank statement
Pharmacy Medicines and Pharmaceuticals in the and/or NHI Payment
relevant month paid by the NHIA to the advice
facility
Services This is the total value of NHI payments for Amount in Bank statement
Non-drug consumables in the relevant and/or NHI Payment
month paid by the NHIA to the facility advice
Rejected Claims This is the value of Medicines and Amount in Bank statement
Medicine & pharmaceuticals claims for the relevant and/or NHI Payment
Pharmacy month that was rejected by the NHIA. advice

Rejected Claims This is the value of Services claims for the Amount in Bank statement
Services relevant month that was rejected by the and/or NHI Payment
NHIA advice
Date of Submission/ This is the date of Submission/ Payment of Amount in Bank statement
Payment the NHI bill for the relevant bill. and/or NHI Payment
In this case the template to be filled would advice
be May. But the date submitted would be
the date in June when the May bill was
submitted For example, if the May bill

313
Variable Definition Data Source Rationale for collecting data
was submitted in June and paid in July,
the payment date is July and not May or
June

314
TRANSPORT DEPARTMENT
LOGBOOK/FILE
Variable Name Definition Source
Region where the vehicle is allocated to (e.g.
VEHICLE Region Ashanti Region) Generated
BASE District where the vehicle is allocated to (e.g.
District Accra Metro) Generated
Sub-district where the vehicle is allocated to (e.g.
Sub-District Ashiedu Keteke) Generated
Facility where the vehicle is allocated to (e.g.
Facility Ridge Hospital) Generated
Brand name and type of the vehicle (e.g. Toyota
Vehicle Make/Type Pick-up) Front and rear of the vehicle
The DVLA registration number of the vehicle (e.g.
Vehicle Reg. No GV 419-19) Vehicle Number Plate
Date of movement or usage of the vehicle. It
Date should be written as DD/MM/YYYY Generated
For calculation of
The days at which the vehicle is used for service operational
Service Days delivery. Tick on each day that the vehicle is used Generated utilization
The days at which the vehicle is not in good For calculation of
VEHICLE
condition for use. Tick for each day that the vehicle operational
USE
Workshop Days is faulty. Generated utilization
The days at which the vehicle is in good condition For calculation of
but not being used. Tick for each day that the operational
Idle vehicle is idle Generated utilization
For calculation of
KILOMETE The vehicle Kilometre reading before the operational
R Start beginning of the day usage Vehicle Odometer utilization
REDADING End The vehicle kilometre at the end of the day usage Vehicle Odometer For calculation of

315
 Variable Name Definition Source
operational
utilization
Official source of fuel allocated for vehicle use To determine the source
Service Indicate quantity in litres Vehicle/Fuel request form of the fuel
FUEL USE To determine the source
Non-official source of fuel allocated for vehicle use
Non-Service Indicate quantity in litres Vehicle/Fuel request form of the fuel
Top-up engine oils to the vehicle aside the usual Fuel ledger Determine quantity of
Engine Oil Added routine servicing. Indicate quantity in litres top-up engine oil
Description of purpose of vehicle usage and Track vehicle
Activity & Destination destination Vehicle/Fuel request form movement usage
To identify the
driver of the vehicle
in case of any
Driver Full name and signature of the driving the vehicle Generated incident
To identify the officer
Full name and Signature of Officer that the Vehicle vehicle assigned to in
Officer is assigned to Generated case any incident
Maintenance expenses incurred on the vehicle (e.g. For calculation of
Routine servicing, replacement of tyres, batteries operational
Maintenance Cost etc) Maintenance file cost
The occurrence of any incident or accident that
results in the injury of officers/damage to the
vehicle or property. Indicate Y for accident and N
Accident/Incident for No accident within the period of report. Incident/Accident File
Number Injured Total Count of people injured due to the accident. Incident/Accident File
Number Died Total count of people died from the accident Incident/Accident File
Damage cause to the vehicle. Indicate Y for
Vehicle Damage damage and N for no damage Incident/Accident File
For calculation of
The cost of replacing or repairing the damage operational
Repairs/replacement Cost vehicle due to the accident. Indicate in GHc. Incident/Accident File cost

316
 Variable Name Definition Source

317
TRANSPORT MONTHLY REPORT FORM
Name of Data Element Definition Source Purpose
No. of Vehicles Total number of vehicles owned Vehicle Asset Register For calculation of operational
utilization

Total Kilometres Travelled Total number of kilometres covered Transport Logbook/File For calculation of operational
by all vehicles in a month utilization

Total Fuel Used Total official and non-official fuel Transport Logbook/File For calculation of operational
used by all vehicles in a month

Total Days Used Total number of Use Days by all Transport Logbook/File utilization
vehicles in a month

Total Days Idled Total number of Idle Days by all Transport Logbook/File For calculation of operational
vehicles in a month

Total Workshop Days Total number of Days spent at Transport Logbook/File For calculation of operational
workshops by all vehicles in a
month

Total Maintenance Cost Total maintenance cost incurred on Transport Logbook/File utilization
all vehicles in a month (e.g. Routine
servicing, corrective and accident
repairs)

318
Name of Data Element Definition Source Purpose
No. of Vehicle request Total number of approved vehicle Vehicle Request file For calculation of operational
request received in a month

No. of vehicle request Total number of approved vehicle Vehicle request file utilization
honored request honored in a month

No. of Accident/Incident Total number of vehicle Transport Logbook/File Basis for calculating Collision Frequency
occurred accident/Incident recorded in a Rate
month

No. of Injuries Total number of Injuries recorded Transport Logbook/File

in a month due to vehicle accident

No. of Deaths Total number of Deaths recorded in Transport Logbook/File

a month due to vehicle accident

319
STORES SUPPLIES AND DRUG MANAGEMENT (SSDM)

INSERT REGISTERS AND FORMS FOR SSDM

320
HUMAN RESOURCE DEVELOPMENT DIVISION (HRDD)

INSERT REGISTERS AND FORMS FOR HRDD

321
GLOSSARY
NON COMMUNICABLE DISEASE CONTROL PROGRAMME INDICATORS

# Indicator Definition Numerator Denominator Remarks

definition definition
This refers to the number of cases of
hypertension present in the population at a Number of Total population
Prevalence of given time and demonstrates the burden of hypertension in catchment area expressed in
1
hypertension hypertension among the population within a cases (old and in reporting 100,000 pop
particular geography. new combined) period

This refers to the number of cases of diabetes

Number of Total population
present in the population at a given time and
diabetes cases in catchment area expressed in
2 Prevalence of diabetes demonstrates the burden of diabetes among the
(old and new in reporting 100,000 pop
population within a particular geography.
combined) period
This refers to the number of cases of breast
cancer present in the population at a given time Number of Total population
Prevalence of breast and demonstrates the burden of breast cancer breast cancer in catchment area expressed in
3
cancer among the population within a particular cases(old and in reporting 100,000 pop
geography. new) period

This refers to the number of cases of cervical

Total population
cancer present in the population at a given time
Number of of women(14-
Prevalence of cervical and demonstrates the burden of cervical cancer expressed in
4 cervical cancer 65yers) in
cancer among the population within a particular 100,000 pop
cases catchment area in
geography.
reporting period
This refers to the number of cases of childhood number of all 6 Total population
Prevalence of childhood expressed in
5 present in the population at a given time and main childhood of under 20 year
cancers 100,000 pop
demonstrates the burden of childhood cancers cancers old’s in

322
 # Indicator Definition Numerator Denominator Remarks
definition definition
among the population within a particular
geography. Childhood cancers are the different catchment area in
combined
cancers that affect children. reporting period

Total population
New cases of
Proportion of Proportion of population diagnosed with in catchment area expressed in
6 reported
Hypertension cases hypertension in reporting 100,000 pop
hypertension
period
New cases of
Total
Percent of Hypertension Proportion of total hypertension cases hypertension in expressed as
7 hypertension
in children occurring in children 1-19 years. children (1-19 a percentage
cases
years)
New cases of
Proportion of Diabetes Total population expressed in
8 Proportion of population diagnosed diabetic diabetes
cases in catchment area 100,000 pop
reported
New cases of
Percent of Diabetes in Proportion of total hypertension cases diabetes in Total diabetes expressed as
9
children occurring in children 1-19 years. children (1-19 cases a percentage
years)
Total cancers Total population
Proportion of population among children 0-19 diagnosed in among children expressed in
10 Childhood cancers rate
years diagnosed with cancers children (0-19 (0-19 years) in 100,000 pop
years) catchment area
This measures the new cases among people at
New cases of Population at
Incidence of Cervical risk. It gives indication of the etiology or cause expressed in
11 cervical cancers risk ( females 14-
Cancers of a disease and its outcome. 100,000 pop
reported 65years)
Proportion of women Among women aged 30-49 years who were Women 30-49 Population of expressed as
12
screened for cervical screened at least once for cervical cancer years screened women 30-49 a percentage

323
 # Indicator Definition Numerator Denominator Remarks
definition definition
years in
cancer at least once catchment
population
Children (school
going age and
Proportion of total obese cases occurring in Total obesity expressed as
13 Obesity in children adolescent with
children 1-19 years. reported a percentage
BMI 30+
reported
Newly
Proportion of male population 20 years and Population at expressed in
14 Prostate Cancer rate diagnosed
above diagnosed with prostate cancer risk ( males 20+) 100,000 pop
prostates cases
All injuries
Proportion of total population suffering from reported (RTA, expressed in
15 Rate of Injuries Total population
all forms of injuries (RTA, Home, occupation) Home, percentage
Occupation)
Newly screened
for High
Incidence of High This measures the new cases among people at Total population
cholesterol expressed in
16 cholesterol levels in risk. It gives indication of the etiology or cause of children under
levels among percentage
children of a disease and its outcome. 20
children under
20 years
Newly
Percentage of Dental Proportion of total population suffering from expressed in
17 diagnosed dental Total population
Caries dental caries percentage
caries
Newly
Proportion of total population suffering from diagnosed expressed in
18 Periodontal diseases Total population
periodontal diseases periodontal percentage
diseases

324
 # Indicator Definition Numerator Denominator Remarks
definition definition
Newly
diagnosed oral
health ( cleft
Proportion of total population suffering all
lip/palate, other expressed in
19 Percentage of oral health forms of oral health conditions (dental caries, Total population
oral health, percentage
periodontal, others etc.)
dental caries,
periodontal
diseases)
This measures the incidence of breast cancer
among women who are at risk. It gives New cases of Population at
expressed in
20 Breast Cancer incidence indication of the etiology or cause of a disease breast cancers risk ( females
100,000 pop
and its outcome. reported 10+ years)

Proportion of population dying as a result of All deaths due to Total population expressed in
21 Mortalities due to NCD
NCDs NCDs in catchment area 100,000 pop
Number of
Proportion of facilities Total number of
Facilities providing wellness clinics out of all facilities with expressed in
22 with functional wellness facilities in
facilities in the geographic area functional percentage
clinic geographic area
wellness clinics

325
REVISED CONSULTING ROOM REGISTER

326
 Controlle
Test Status of Principal Status of Additional d Blood
Referred
Serial Provisiona Result Diagnosis Diagnosis pressure Patient on
Insurance BMI Blood for Principal Additional
Date Patient Number Name of Patient Address (Locality ) Phone number Age Sex Weight (Kg) Height (m) l in last treatment
Number number (kg/m2) pressure Testing Diagnosis Diagnosis

(Y/N)
Diagnosis three (Y/N/NA)

Referred

NHIS Patient (Y/N)

Pregnant woman
(Tick) New Case Old Case New Case Old Case months
(+ or -)
(Tick) (Tick) (Tick) (Tick) (Y/N/NA)

327
NCD SCREENING REGISTER
Sex Taking any Comments (
Known Patient Height Weight Alcohol Smoker Diabetic Referred
Serial No. Name of Client Age Address (Locality ) Phone number Condition screened for Screening result medicine Institution conducting
M/F Y/N Y/N m kg Y/N Y/N Y/N/NI Y/N screening/ any other

328
MONTHLY NCD MORBIDITY REPORTING FORM

329
Region District Subdistrict
Facility Date

Male Female
Diseases/Condition (New cases only) Total Total Grand
>28 days 1-11mths 1-4yrs 5-9yrs 10-14yrs 15-17yrs 18-19yrs 20-34yrs 35-49yrs 50-59yrs 60-69yrs 70+ >28 days 1-11mths 1-4yrs 5-9yrs 10-14yrs 15-17yrs 18-19yrs 20-34yrs 35-49yrs 50-59yrs 60-69yrs 70+ total
Complicated hypetension
Pre Diabetes
Complicated diabetes
Dyslipidaemia(high cholesterol)
Acute Kidney Disease
Chronic Kidney Disease
Heart Failure
Heart Attack
Rheumatic / Valvular Heart Disease
Cardiac Arrhythmia
Deep Vein Thrombosis
Pulmonary Embolism
Congenital Heart Disease
Leukemia
Brain and spinal cord tumors
Neuroblastoma
Rhabdomyosarcoma
Retinoblastoma
Bone cancer
Lung cancer
Stomach cancer
Colorectal cancer
Liver cancer
Eczema
Celebral palsy
Re-attendances

Signature Rank Date

330
MONTHLY NCD REFERRAL REPORTING FORM

331
Region District Subdistrict

Facility Date
Number Referred
Disease/Condition Male Female Grand
Total Total
>28 days 1-11mths 1-4yrs 5-9yrs 10-14yrs 15-17yrs 18-19yrs 20-34yrs 35-49yrs 50-59yrs 60-69yrs 70+ >28 days 1-11mths 1-4yrs 5-9yrs 10-14yrs 15-17yrs 18-19yrs 20-34yrs 35-49yrs 50-59yrs 60-69yrs 70+ total
Hypertension
Complicated hypetension
Diabetes
Complicated diabetes
Chronic Obstructed Pulmonary Disease
Asthma
Dyslipidaemia(high cholesterol)
Acute Kidney Disease
Chronic Kidney Disease
Heart Failure
Heart Attack
Cardiac diseases
Cardiac arrhythmia
Stroke
Deep Vein Thrombosis
Pulmonary Embolism
Congenital Heart Disease
Leukemia
Brain and spinal cord tumors
Neuroblastoma
Childhood cancer
Lymphoma
Rhabdomyosarcoma
Retinoblastoma
Bone cancer
Lung cancer
Stomach cancer
Colorectal cancer
Breast cancer
Cervical cancer
Prostate cancer
Liver cancer
Other cancers
Home injuries - Domestic
Road Traffic Accidents -RTA
Occupational & Industrial Injuries
Sickel Cell Diseases
Anaemia
Malnutrition
Arthritis
Dental Caries
Peridontal diseases
Eczema
Celebral palsy
Autism
Other NCDs

Signature Rank Date

332
MONTHLY NCD SCREENING REPORTING FORM

333
Region District Subdistrict

Facility Date
Number Screened
Disease/Condition Male Female Grand
Total Total
>28 days 1-11mths 1-4yrs 5-9yrs 10-14yrs 15-17yrs 18-19yrs 20-34yrs 35-49yrs 50-59yrs 60-69yrs 70+ >28 days 1-11mths 1-4yrs 5-9yrs 10-14yrs 15-17yrs 18-19yrs 20-34yrs 35-49yrs 50-59yrs 60-69yrs 70+ total

Hypertension

Complicated hypetension

Pre Diabetes

Diabetes

Complicated diabetes

Dyslipidaemia(high cholesterol)

Chronic Kidney Disease

Cardiac diseases

Obesity

Congenital Heart Disease

Leukemia

Brain and spinal cord tumors

Neuroblastoma

Lung cancer

Colorectal cancer

Breast cancer

Cervical cancer

Prostate cancer

Liver cancer

Other cancers

Sickel Cell Diseases

Anaemia

Malnutrition

Dental Caries

Peridontal diseases

Signature Rank Date

334
MONTHLY NCD SCREENING REPORTING FORM

District Region

Month Year

Serial No Variable Response

Availability of a functioning wellness clinic in district
1 Yes No
Number of facilities with fuctional wellness clinic services
2
Number of staff assigned to wellness clinic
3

Signature Rank

Date

335
FAMILY HEALTH DIVISION DATA DICTIONARY
FAMILY HEALTH INDICATORS
PROGRAMME INDICATOR DEFINITION NUMERATOR DENOMINATOR REMARKS
This indicator is used to
Proportion of pregnant Total number of
Antenatal Care Coverage assess the coverage of
SAFE women receiving Total number of expected pregnancies
antenatal services and to
MOTHERHOO antenatal care during antenatal registrants in a of the catchment area
decide when and where
D -to be measured as per 100 pregnancy (at least specified period within the specified
to begin interventions to
once). period
improve low coverage
+
ANC 4 Visit Number of pregnant Total number of Measures proportion of
SAFE Proportion of Women
women in a specified antenatal registrants pregnant women making
MOTHERHOO making at least 4 ANC
period making at least 4 within the specified adequate number of
D -to be measured as per 100 visits
ANC visits period antenatal visits.
This indicator is used to
Average number of
Average ANC Visit per client Total number of assess the utilisation of
SAFE ANC visits made by all Total number of
antenatal attendances antenatal services helps
MOTHERHOO of women delivering in antenatal registrants in
(all ANC clients) within to plan for the resources
D -to be measured as per 100 the specified time a specified period
the specified period needed for effective
period l
service delivery
Proportion of ANC attendants by Proportion of ANC Total number of
Number of ANC
SAFE TBAs expected pregnancies
clients attended by a attendants seen or TBA contribution to
MOTHERHOO of the catchment area
trained traditional birth attended to by TBAs in ANC
D within the specified
-to be measured as per 100 attendant a specified period
period
Number of pregnant
proportion of pregnant
SAFE Percentage 1st trimester registration women making their women making their Total number of ANC This is to assess the care
first ever visit to the
MOTHERHOO first ever visit to the registrants within the seeking behaviour of
ANC in their 1st
D -to be measured as per 100 ANC in their 1st specified period clients
trimester of gestation in
trimester
a specified period
SAFE Percentage 3rd trimester registration Proportion of pregnant Number of pregnant Total number of ANC This is to assess the care
MOTHERHOO women making their women making their registrants within the seeking behaviour of
D -to be measured as per 100 first ever visit during first ever visit to the specified period clients
their 3rd trimester of ANC in their 3rd

336
PROGRAMME INDICATOR DEFINITION NUMERATOR DENOMINATOR REMARKS
gestation in a specified trimester of gestation in
period. a specified period
Percentage Pregnant Women with Proportion of Pregnant Number of pregnant
SAFE parity 5+ women with parity 5+ at Total number of
Women with parity 5+ This is to assess
MOTHERHOO the time of ANC registrants within the
at the time of ANC pregnant women at risk
D registration in a specified period
-to be measured as per 100 registration
specified period
Percentage Pregnant Women less Proportion of Pregnant Number of pregnant
SAFE than 5 feet Total number of
Women less than 5 feet women with height less This is to assess pregnant
MOTHERHOO registrants within the
at the time of than 5 feet in a specified women at risk
D specified period
-to be measured as per 100 registration period.
Percentage Pregnant Women 35yrs Number of pregnant
SAFE and above Proportion of Pregnant women aged 35years Total number of This is to assess
MOTHERHOO Women 35yrs and and above at the time of registrants within the percentage pregnant
D above registration in a specified period women at risk
-to be measured as per 100 specified period
Number of women Measures whether
Proportion of pregnant
ANC Syphilis Screening Coverage women who were delivering in the pregnant women are
SAFE Total Number of
specified time period being screened for
MOTHERHOO screened for syphilis at Registrants in the
who had been tested for syphilis. * This indicator
D -to be measured as per 100 the ANC clinic in a specified time period
syphilis during the is measured at the time of
specified period of time
pregnancy birth.
Measures how common
syphilis infection is
Proportion of pregnant among pregnant women,
Syphilis infection among pregnant women who were Number of pregnant Number of pregnant
and the potential for
SAFE women women screened for women who were
screened for syphilis congenital syphilis. There
MOTHERHOO syphilis in the specified tested for syphilis in
and tested positive at is a possible bias if
D time period who tested the specified time
-to be measured as per 100 the ANC clinic in a syphilis testing is not
positive for syphilis period
specified period of time systematic. Is only valid
if all pregnant women are
tested.
SAFE Tetanus Diphtheria Vaccination Proportion of pregnant Number of women Total number of Measures whether
MOTHERHOO coverage women receiving at delivering in a specified Registrants in the women of reproductive

337
PROGRAMME INDICATOR DEFINITION NUMERATOR DENOMINATOR REMARKS
age are being vaccinated
with Tetanus Diphtheria
least 2 doses of Tetanus
time period who had to protect the newborn
Diphtheria vaccination
been vaccinated with from tetanus. This
D before delivery specified time
-to be measured as per 100 tetanus Diphtheria indicator is measured at
including those fully
toxoid (at least 2 doses) the time of birth.
immunised
Neonatal tetanus cases
should also be reported.
Number of women who This is a measure to
SAFE Proportion of ANC Total number of ANC
Percentage ANC clients with 1st had their 1st IPT dose assess the protection of
MOTHERHOO registrants who had registrants within the
IPT dose st during their ANC visit pregnant women against
D their 1 IPT dose specified period
in a specified period malaria.
Number of ANC
SAFE Proportion of ANC registrants who had their Total number of ANC Number of women
Percentage ANC clients with 3rd
MOTHERHOO registrants who had 3rd IPT dose during their registrants within the adequately protected
IPT dose
D their 3rd IPT dose ANC visit in a specified specified period against Malaria
period
Percentage Hb checked at Proportion of pregnant Number of pregnant
SAFE registration Total number of ANC
women who had their women with Hb checked This is a measure of
MOTHERHOO registrants within the
Hb checked at the time at registration in a access to Hb assessment
D specified period
-to be measured as per 100 of registration specified period
Percentage Hb checked at term Proportion of pregnant Number of pregnant
SAFE Total number of ANC
women who had their women with Hb checked Measures the health of
MOTHERHOO registration within the
Hb checked at term of at term in a specified women prior to delivery
D -to be measured as per 100 specified period
gestation period
Number of pregnant Total number of ANC
SAFE Percentage Anaemic at registration Proportion of pregnant women with Hb less clients whose Hb were Measures the health of
women who were
MOTHERHOO than (11g/dl) at the time checked at registration women prior to
found anaemic at the
D -to be measured as per 100 of registration in a within the specified pregnancy
time of registration
specified period period
SAFE Percentage Anaemic at term Proportion of pregnant Number of pregnant Total number of Hb Measures the health
MOTHERHOO women who were women found anaemic checked at term within Status of women before
D -to be measured as per 100 found anaemic (less at term in a specified the specified period delivery
than 11g/dl) at term of period

338
PROGRAMME INDICATOR DEFINITION NUMERATOR DENOMINATOR REMARKS
gestation
Percentage Registered Deliveries Total number of
SAFE Proportion of deliveries Number of deliveries
expected deliveries Measures fertility rate
MOTHERHOO conducted in a conducted reported in a
within the specified within a specified period.
D -to be measured as per 100 specified time period specified time period
period
Percentage obstetric emergencies Measures the quality of
Proportion of women Number of women with Total number of
SAFE managed obstetric care. Case
with obstetric obstetric emergencies expected obstetric
MOTHERHOO definitions for various
emergencies managed who are managed in a emergencies within the
D obstetric emergencies
-to be measured as per 100 in health facilities. specified time period specified time period
need to be developed.
Proportion of women Measures whether
Percentage knowledge of danger of reproductive age Number of women of
women can identify
SAFE signs of obstetric complications reproductive age who
with Number of women of danger signs of obstetric
MOTHERHOO can name at least two
knowledge on at least reproductive age complications, which can
D danger signs of obstetric
-to be measured as per 100 two danger signs of facilitate referral for
complications
obstetric complications proper care
Percentage Caesarean Section Number of women
SAFE Proportion of deliveries Total number of Measures access to
delivered by Caesarean
MOTHERHOO performed by deliveries within the emergency surgical
section in the specified
D -to be measured as per 100 Caesarean section specified time period obstetric services.
time period
Number of unsafe and Measures effectiveness
Rate of pregnancies spontaneous abortions of antenatal care in
SAFE Number of live births
Incidence of unsafe and loss due to spontaneous before 28 weeks of preventing early
MOTHERHOO in the specified time
spontaneous abortions abortion before 28 gestation or below 500g pregnancy loss. Also is
D period
weeks of gestation in the specified time measure of women’s
period general health
Proportion of women
Total number of
Management of complications due with complications due Number of women with women with Measures the quality of
SAFE to abortions to unsafe and complications due to
complications due to care for complications
MOTHERHOO spontaneous abortions spontaneous abortions
spontaneous abortions due to unsafe and
D treated in a timely and who are treated in the
-to be measured as per 100 within the specified spontaneous abortion.
appropriate manner specified time period
time period
according to protocol
SAFE Postnatal Care Coverage Proportion of women Number of women who Total number of Measures whether

339
PROGRAMME INDICATOR DEFINITION NUMERATOR DENOMINATOR REMARKS
women receive
postpartum care. Time
period can be up to 42
days following delivery.
This indicator is used to
received postnatal care
who received postnatal expected deliveries in assess the use of
MOTHERHOO within 6 weeks after
care within 6 weeks the specified time postnatal and by
D -to be measured as per 100 delivery in a specified
after delivery period extension well-baby
time period
services. Low coverage
can prompt health
workers to adopt new
strategies to increase
coverage.
Proportion of women Number of women who
Total number of
who received their first received their first This is to assess women
Percentage Postnatal care coverage expected deliveries in
postnatal care within postnatal care within the who delivered and had
(Early) the specified time
the first 7 days after first 7days after delivery early postnatal.
period
delivery in a specified period
Number of women in a
Proportion of women
specified time period Total number of
who received their first This is to assess women
Percentage Postnatal care coverage who received their first expected deliveries in
postnatal care from the who delivered and had
(Late) postnatal care from the the specified time
8th to 42nd day after th nd early postnatal.
8 to 42 day after period
delivery
delivery
Number of postnatal
Percentage Postnatal care mothers Proportion of postnatal mothers with no Total number of
SAFE with no previous ANC visit care mothers who did previous antenatal care postnatal registrants
MOTHERHOO
not make any antenatal visit to the time of within the specified
D
-to be measured as per 100 visit till delivery delivery in a specified period
period
SAFE Percentage Maternal Deaths Proportion of reported Number of reported Total number of Measures the
MOTHERHOO Audited maternal deaths that are maternal deaths which reported maternal programmes capacity to
D investigated according are investigated deaths within the identify all maternal
-to be measured as per 100 to established according to established specified period deaths and to determine

340
PROGRAMME INDICATOR DEFINITION NUMERATOR DENOMINATOR REMARKS
the factors contributing to
guidelines, and the
guidelines, and the those deaths. Assumes
results of which are
results are disseminated that: a) both indirect and
disseminated to health
to health staff direct maternal mortality
staff
events are examined.
Maternal death represents
the death of a woman
while pregnant or within
Number of maternal 42 days of termination of
SAFE Number of maternal
Maternal Mortality Ratio-to be deaths for every Total live births in a pregnancy irrespective of
MOTHERHOO deaths reported in a
measured as per 100,000 100,000 live births specified period the duration and the site
D specified time period
during the year of the pregnancy, from
any cause related to the
pregnancy or its
management
Total number of
Percentage TBA deliveries Proportion of total Number of deliveries This indicator measures
SAFE expected pregnancies
deliveries conducted by conducted by traditional access to maternal health
MOTHERHOO of the catchment area
traditional birth birth attendants in a services by a trained
D -to be measured as per 100 within the specified
attendants specified period skilled attendant
period
Measures the health
status of pregnant women
Percentage Low Birth Weight Proportion of babies Number of live infants Total number of live
SAFE and the adequacy of
born who weighed less weighing <2,500 grams births (with birth
MOTHERHOO antenatal care. Birth
than 2,500 gm at birth at birth in a specified weight recorded) in the
D -to be measured as per 100 weights also identify
in a specified period time period specified time period
infants at higher risk who
may need special care
Percentage of Very Low Birth Measures the health and
Proportion of babies Number of live infants Total number of live
SAFE Weight nutritional status of
who weighed less than weighing <1,500 gm at births (with birth
MOTHERHOO pregnant women, and
1,500 gm at birth in a birth in the specified weight recorded) in the
D identifies babies in need
-to be measured as per 100 specified period time period specified period
of specialized care

341
PROGRAMME INDICATOR DEFINITION NUMERATOR DENOMINATOR REMARKS
Percentage of health facilities Number of health
providing integrated package of Proportion of health Total number of health
facilities providing This is to measure access
PMTCT services facilities providing facilities providing
PMTCT integrated package of to PMTCT services
integrated package of antenatal services in a
PMTCT services in within the catchment area
PMTCT services given period
-to be measured as per 100 period a given

Percentage of health facilities Total number of health

Proportion of health Number of health
providing EID services using DBS facilities providing EID facilities providing EID facilities providing
PMTCT maternal health
services using DBS services using DBS in a
services in a given
-to be measured as per 100 (Dry Blood Spot) specified period
period
Percentage of pregnant women Number of ANC clients Total number of ANC
tested for HIV and received results Proportion of pregnant who were tested for HIV clients who were tested
PMTCT women tested for HIV
and received result in for HIV in the specified
and received results
-to be measured as per 100 the specified time period period of time
Proportion of HIV
Percentage of HIV negative negative women Total number of
Number of HIV
women counselled counselled and pregnant women who
negative women
PMTCT provided information tested negative for HIV
counselled in a specified
on HIV and STI within the specified
-to be measured as per 100 time period
prevention, and how to period
remain HIV free
Proportion of negative
women who initially Total number of HIV
Percentage of HIV Negative Number of HIV positive
tested at registration negative women
PMTCT women retested positive at 34 women identified during
but were found to be identified negative at
weeks of gestation testing at 34weeks
positive during registration
retesting at 34weeks
Number of HIV positive Total number of HIV
Proportion of infected
Percentage of infected women who pregnant women put on positive women within
PMTCT women who received
received ARVs for PMTCT ARV within a specified the specified time
ARVs for PMTCT
period period
PMTCT Percentage of infected women Proportion of infected Number of infected Total number of HIV
provided counselling and support. women provided with pregnant women who positive women within

342
PROGRAMME INDICATOR DEFINITION NUMERATOR DENOMINATOR REMARKS
received nutrition
nutrition counselling the specified time
counselling and support
-to be measured as per 100 and support. feeding period
in a specified period
Percentage of HIV infected Number of HIV infected
pregnant women counselled on Proportion of HIV
pregnant women who Total number of HIV
infant feeding by a trained infected pregnant
received counselling on positive women within
PMTCT counsellor women counselled on
infant feeding by a the specified time
infant feeding by a
trained counsellor in a period
trained counsellor
-to be measured as per 100 given period
Percentage of HIV infected Number of HIV infected
pregnant women provided with Proportion of HIV
pregnant women Total number of HIV
family planning services after infected pregnant
provided with family positive women within
PMTCT delivery women provided with
planning services after the specified time
family planning
delivery in a given period
services after delivery
-to be measured as per 100 period
Percentage of exposed infants
receiving ARV prophylaxis for Proportion of exposed Number of infants Total number of infants
PMTCT infants receiving ARV receiving ARV born to HIV positive
PMTCT
prophylaxis for prophylaxis for PMTCT women within the
PMTCT in a given period specified time period
-to be measured as per 100
Number of infants born
Percentage of exposed infants Proportion of exposed to HIV positive mothers
started on co-trimoxazole Total number of infants
infants started on co- who started receiving
prophylaxis within 2 months of age trimoxazole born to HIV positive
PMTCT co-trimoxazole
women within the
prophylaxis within 2 prophylaxis within 2
specified time period
-to be measured as per 100 months of age months of age in a given
period
Percentage of exposed infants Number of infants born
receiving first HIV virological test Proportion of exposed to HIV positive mothers Total number of infants
within two months age infants received first who received first born to HIV positive
PMTCT
HIV virological test virological test within 2 women within the
within two months age months of age in a given specified time period
-to be measured as per 100 period

343
PROGRAMME INDICATOR DEFINITION NUMERATOR DENOMINATOR REMARKS
Percentage of HIV exposed infants Proportion of HIV Number of HIV exposed
who are on EBF, RF or mixed Total number of infants
exposed infants who infants who are on EBF,
feeding at Penta 3 visit born to HIV positive
PMTCT are on EBF, RF or RF or mixed feeding at
women within the
mixed feeding at Penta Penta 3 visit in a given
specified time period
-to be measured as per 100 3 visit period

Percentage of HIV exposed infants Proportion of HIV Number of HIV exposed

who are breastfeeding and covered exposed infants who infants who are Total number of infants
by ARV prophylaxis breastfeeding and born to HIV positive
PMTCT are breastfeeding and
covered by ARV women within the
covered by ARV
prophylaxis in a given specified time period
-to be measured as per 100 prophylaxis
period
Proportion of new HIV Total number of newly
positive (all newly diagnosed (initial
diagnosed HIV positive positive + retested HIV Total number of newly
Percentage of new HIV positive pregnant women (initial positive at 34 weeks) diagnosed HIV positive
pregnant women who newly positive + retested HIV HIV positive pregnant (initial positive +
received Antiretrovirals to reduce positive at 34 weeks)) women within the retested HIV positive at
PMTCT the risk of mother-to-child who newly received current period who 34 weeks) pregnant
transmission of HIV (New) Antiretrovirals to were newly given women within the
reduce the risk of Antiretrovirals to reduce current period
mother-to-child the risk of mother-to-
transmission. child transmission

PMTCT Percentage of Known HIV positive Proportion of Known Number of Known HIV Number of Known HIV
pregnant women who newly HIV Positive pregnant Positive pregnant Positive pregnant
received Antiretrovirals to reduce women who are not on women (from the women (from the
the risk of mother-to-child ARVs but were newly previous period) who previous period) who
transmission (New) in the current given Antiretrovirals to are not on ARVs but are not on ARVs before
period reduce the risk of were newly given the current period.
mother-to-child Antiretrovirals to reduce
transmission of HIV the risk of mother-to-
child transmission of
HIV in the current

344
PROGRAMME INDICATOR DEFINITION NUMERATOR DENOMINATOR REMARKS
period

Proportion of Known Number of known HIV Number of Known HIV

Percentage of Known HIV positive HIV Positive pregnant Positive pregnant Positive pregnant
pregnant women who are already women already on women (from the women (from the
PMTCT on ARVs before the current period Antiretrovirals before previous period) who previous period) who
current period are already on ARVs are visiting for services
prior to the current within the current
period period
Proportion of all HIV
Number of HIV positive
positive (including
clients (both HTC+
Linkage to ART treatment positives from HTC
ART PMTCT) who were
(Linkage to treatment) and PMTCT) who were
initiated on ART during
given ART in line with
the period
the "treat all policy"

Proportion of all HIV

Exposed Infants (HEI)
Percentage of HIV Exposed Infants who tested for HIV
EID (HEI) who had Early Infant using DNA PCR (for
Diagnosis of HIV done via PCR ages 0 to less than 18
months)

Percentage of HIV exposed

children who test positive by DNA Proportion of HIV Number of HIV exposed Total number of infants
PCR exposed children who children who test born to HIV positive
PMTCT
test positive by DNA positive by DNA PCR women within the
PCR in a given period specified time period
-to be measured as per 100
Proportion HIV
Number of infants who Total number of
exposed infants who
Percentage of HIV exposed tested HIV negative at exposed babies who
PMTCT tuned out to be negative
negative infants at 18months 18months using were followed up to
at the final testing
antibody test 18months
(18months)

345
PROGRAMME INDICATOR DEFINITION NUMERATOR DENOMINATOR REMARKS
Percentage of infected children (0- Number of HIV positive
14weeks) receiving Antiretroviral Proportion of infected children (0-14) Total number of infants
treatment (ART) children (0-14) born to HIV positive
PMTCT receiving ARV
receiving Antiretroviral women within the
treatment in a given
treatment (ART) specified time period
-to be measured as per 100 period

Percentage of male partners

counselled and tested for HIV in Proportion of male Total number of male Total number of
ANC setting partners counselled and partners counselled and antenatal registrants
PMTCT
tested for HIV in ANC tested for HIV in ANC within the specified
setting setting in a given period time period
-to be measured as per 100
Measures access to
reproductive health
Proportion of women services that are essential
Contraceptive Prevalence of reproductive age for meeting many of the
Total number of family Target population
FAMILY who are using (or Millennium Development
planning acceptors in a within the specified
PLANNING whose partner is using) Goals (MDG)s,
-to be measured as per 100 given period period
a contraceptive method especially the Child
at a given point in time Mortality, Maternal
Health HIV/AIDS, and
Gender related goals
Contraceptive Acceptor Proportion of the
To estimate or assess a
rate/Family Planning Coverage women in fertile age Number of family
FAMILY Total number of WIFA percentage of the
(WIFA) using family planning acceptors in a
PLANNING specified period population using family
planning method in a specified period
-to be measured as per 100 planning methods
specified period
Contraceptive Method Preference The measure to Number of
Total number of family
Identifies the most
FAMILY contraceptive method contraceptive acceptors preferred methods and
planning acceptors
PLANNING use and uptake in a to a specific method in a less preferred methods
-to be measured as per 100 within the given period
given period given period for program planning.
FAMILY Percentage Postnatal care mothers Proportion of mothers Number of mothers who Total number of
PLANNING counselled on family planning who were counselled received counselling on postnatal registrants
on family planning family planning during

346
PROGRAMME INDICATOR DEFINITION NUMERATOR DENOMINATOR REMARKS
during the postnatal their postnatal visit in a
-to be measured as per 100
period specified period
Proportion of mothers
Percentage Postnatal care mothers who were given
accepting family planning counselling and Number of family Total number of
FAMILY
accepted to use a planning acceptors in a postnatal care
PLANNING
family planning method specified period registrants
-to be measured as per 100 during their postnatal
visit
The estimated
protection provided by
Family Planning Couple Years of contraceptive methods
Protection (CYP) for a couple during a * All Short Acting
FAMILY one-year period based contraceptives sold or
upon the volume of all distributed free of
PLANNING contraceptives sold or charge to clients during
-to be measured as per factor distributed free of a specified period
outlined charge to clients during
that period divided by
the CYP factor.
Commodity CYP Factor
Short Term Methods Short Acting Methods
Oral Contraceptives Oral Contraceptives 13 cycles
FAMILY Condoms Condoms 120 pieces
PLANNING Depo Provera Depo Provera 4 doses
Norigynon Norigynon 12 doses
LAM LAM 0.25
FAMILY Long Acting Methods CYP Long Term Methods
PLANNING Jadelle Jadelle 3.5
Sino Implants Sino Implants 3.2
Implanon Implanon 2.5
Copper T Copper T 3.5
Vasectomy Vasectomy 10
Female Sterilization Female Sterilization 11

347
PROGRAMME INDICATOR DEFINITION NUMERATOR DENOMINATOR REMARKS
Natural FP Natural FP 2

Indicator Definition Numerator Denominator Rational

Adolescent Birth Rate Proportion of births by Number of births by girls within the Total adolescent population
adolescents in a specified period ages of 10 - 19 years in a specified (10-19) from projected census
period
% Early adolescent Proportion of early (10 to 14 Number of pregnant girls within the Total number of adolescent
pregnancy years) adolescents who reported age group of 10 to 14 years at the ANC registrants within the
as pregnant in a specified period time of registration in a specified specified period
period
% Late adolescent Proportion of late (15 to 19 Number of pregnant girls within the Total number of adolescent
pregnancy years) adolescents who reported age group of 15 to 19 years at the ANC registrants within the
as pregnant in a specified period time of registration in a specified specified period
period
% Adolescent pregnancy Proportion of pregnant girls Number of pregnant girls within the Total number of ANC
within the age group 10 to 19 age group of 10 to 19 years at the registrants within the specified
years who reported as pregnant time of registration in a specified period
in a specified period period
% Early adolescent new Proportion of FP new acceptors Number of early adolescents Total new adolescent FP
acceptors of FP who are early (10 to 14 years) accepting FP for the very first time acceptors
adolescents in a specified period
% Late adolescent new Proportion of FP new acceptors Number of late adolescents Total new adolescent FP
acceptors of FP who are late (15 to 19 years) accepting FP for the very first time acceptors
adolescents in a specified period
% Adolescent (10-19) new Proportion of FP new acceptors Number of adolescents accepting FP Total new FP acceptors

348
Indicator Definition Numerator Denominator Rational
acceptors of FP who are adolescents for the very first time in a specified
period
% Adolescent screening for Proportion of adolescents Number of adolescents testing for Total number of adolescents
HIV screening for HIV testing HIV in a specified period visiting the adolescent health
corner in a specified period
% Adolescent accessing Proportion of adolescents Number of adolescents accessing Total number of adolescents
STI/HIV Counselling accessing STI/HIV Counselling STI/HIV Counselling services in a visiting the adolescent health
services in a specified period specified period corner in a specified period
% Adolescent accessing Proportion of adolescents Number of adolescents accessing Total number of adolescents
Family Planning accessing Family Planning Family Planning counselling visiting the adolescent health
Counselling counselling services in a services in a specified period corner in a specified period
specified period
% Adolescent accessing Proportion of adolescents Number of adolescents accessing Total number of adolescents
Abortion Counselling accessing Abortion counselling Abortion counselling services in a visiting the adolescent health
services in a specified period specified period corner in a specified period
% Young people (10-24 Proportion of young people Number of young people accessing Total number of young people
years) accessing Nutrition accessing Nutrition counselling Nutrition counselling services in a visiting the adolescent health
counselling services in a specified period specified period corner in a specified period
% Adolescent (10-19 years) Proportion of adolescents Number of adolescents accessing Total number of adolescents
accessing Drug and accessing drug and substance drug and substance abuse support in visiting the adolescent health
substance abuse support abuse support in a specified a specified period corner in a specified period
period
% Early adolescent (10-14 Proportion of early adolescent Number of early adolescents Total number of early
years) accessing Drug and accessing drug and substance accessing drug and substance abuse adolescents visiting the
substance abuse support abuse support in a specified support in a specified period adolescent health corner in a
period specified period

349
Indicator Definition Numerator Denominator Rational
% Late adolescent (15-19 Proportion of late adolescent Number of late adolescents Total number of late
years) accessing Drug and accessing drug and substance accessing drug and substance abuse adolescents visiting the
substance abuse support abuse support in a specified support in a specified period adolescent health corner in a
period specified period
% Young people (10-24 Proportion of young people Number of young people accessing Total number of young people
years) accessing Drug and accessing drug and substance drug and substance abuse support in visiting the adolescent health
substance abuse support abuse support in a specified a specified period corner in a specified period
period
% Young people (10-24 Proportion of young people Number of young people accessing Total number of young people
years) accessing Gender and accessing Gender and sexual Gender and sexual based violence visiting the adolescent health
sexual based violence based violence Support in a Support in a specified period corner in a specified period
Support specified period
% Adolescent (10-19 years) Proportion of adolescent Number of adolescents accessing Total number of adolescent
and youth accessing Gender accessing Gender and sexual Gender and sexual based violence visiting the adolescent health
and sexual based violence based violence Support in a Support in a specified period corner in a specified period
Support specified period
% Early (10 to 14 years) Proportion of early adolescent Number of early adolescents Total number of early
adolescent accessing accessing Gender and sexual accessing Gender and sexual based adolescents visiting the
Gender and sexual based based violence Support in a violence Support in a specified adolescent health corner in a
violence Support given period period specified period
% Late (15 to 19 years) Proportion of late adolescents Number of late adolescents Total number of late
adolescents accessing accessing Gender and sexual accessing Gender and sexual based adolescents visiting the
Gender and sexual based based violence Support in a violence Support in a specified adolescent health corner in a
violence Support specified period period specified period
% Adolescent (10-19 years) Proportion of adolescents Number of adolescents accessing Total number of adolescents
accessing support to address accessing support to address support to address suicidal visiting the adolescent health

350
Indicator Definition Numerator Denominator Rational
suicidal tendencies suicidal tendencies tendencies corner in a specified period
% Early (10 to 14 years) Proportion of early adolescents Number of early adolescents Total number early of
adolescent accessing accessing support to address accessing support to address adolescents visiting the
support to address suicidal suicidal tendencies suicidal tendencies adolescent health corner in a
tendencies specified period
% Late (15 to 19 years) Proportion of late adolescents Number of late adolescents Total number late of
adolescents accessing accessing support to address accessing support to address adolescents visiting the
support to address suicidal suicidal tendencies suicidal tendencies adolescent health corner in a
tendencies specified period
% Young people (10 to 24 Proportion of young people Number of young people accessing Total number of young people
years) accessing support to accessing support to address support to address suicidal visiting the adolescent health
address suicidal tendencies suicidal tendencies tendencies corner in a specified period
% Adolescent (10 to 19 Proportion of adolescents given Number of adolescents given Total number of adolescents
years) given Emergency emergency contraception in a visiting the adolescent health
contraception specified period corner in a specified period
% Early adolescent (10 to Proportion of early adolescents Number of early adolescents given Total number of early
14 years) given Emergency given emergency contraception Emergency Contraception adolescents visiting the
contraception in a specified period adolescent health corner in a
specified period
% Late (15 to 19 years) Proportion of late adolescents Number of late adolescents given Total number of late
given Emergency given emergency contraception Emergency Contraception adolescents visiting the
contraception in a specified period adolescent health corner in a
specified period
% Young people (10 to 24 Proportion of young people Number of young people given Total number of young people
years) given Emergency given emergency contraception Emergency Contraception visiting the adolescent health
contraception in a specified period corner in a specified period

351
Indicator Definition Numerator Denominator Rational
% Adolescent given Proportion of adolescents given Number of adolescents given Total number of adolescents
condoms condoms in a specified period condom visiting the adolescent health
corner in a specified period
% Married adolescents Proportion of adolescents Number of adolescents married or Total number of adolescents
visiting the ADHD corner married or in union or living union or living together visiting the adolescent health
together corner in a specified period
% Employed adolescents Proportion of adolescents Number of adolescents engage in Total number of adolescents
visiting the corner engage in economic ventures to economic ventures to make a living visiting the adolescent health
make a living corner in a specified period
% Adolescents students Proportion of adolescent’s Number of adolescent students who Total number of adolescents
visiting the adolescent students who visited the visited the adolescent health corner visiting the adolescent health
health corner adolescent health corner in a in a specified period corner in a specified period
specified period
% Adolescents given IE&C Proportion of adolescents given Number of adolescents given IE&C Total number of adolescents
material IE&C materials at the materials visiting the adolescent health
adolescent health corner corner in a specified period

352
NUTRITION AND CHILD HEALTH INDICATORS

N Indicato Definition Numerator Denominator Source Rationale

o. r
UNDERWEIGHT AMONG REGISTRANTS
1 Child Proportion of children 0- Total no. of children 0-59 Total number of children 0- Nutrition and Child Health This indicator measures children’s
Underwe 59 months with months Weight for age 59 months weighed in a Register growth adequacy with weight as a
ight weight-for-age < –2 below -2SD in a given given period proxy. Evidence has shown that the
standard deviations (SD) period (also explained at (Total Registrant) mortality risk of children who are
moderate + severe even mildly underweight is
underweight) increased, and severely underweight
2 Moderat Proportion of children 0- Total no. of children 0-59 Total number of children 0- Nutrition and Child Health children are at even greater risk.
e 59-month Weight for age months Weight for age ≥- 59 months weighed in a Register (summarized)
Underwe ≥-3 but <-2SD 3<-2SD in a given period given period The rate of underweight at this stage
ight (Total Registrant) could be a reflection of poor infant
3 Severe Proportion of children 0- Total no. of children 0-59 Total number children 0-59 Nutrition and Child Health feeding support both at the facility
Underwe 59 months Weight for months Weight for age <- months weighed in a given Register and within the community, leading to
ight age <- 3SD 3SD in a given period period (Total Registrant) poor infant feeding practices. This
data to improve upon their infant
feeding program.
UNDERWEIGHT AMONG ATTENDANCE
1 Underwe Proportion of children 0- Total no. of children 0-59 Total number of children of Nutrition and Child Health This indicator for measuring of
ight 59 months with months Weight for age 0-59 months weighed in a Register underweight rate among children is
weight-for-age < –2 below -2SD in a given given period (Total not cumulative. The indicator is
standard deviations (SD) period attendance) calculated per month and the rate for
2 Moderat Proportion of children 0- Total no. of children 0-59 Total a number of children Nutrition and Child Health December for each year is taken as
e 59 months Weight for months Weight for age ≥- 0-59 months weighed in a Register the point prevalence of underweight
Underwe age below ≥-3<-2SD 3<-2SD in a given period given period (Total for the total attendance at CWC for
ight attendance) the year.
3 Severe Proportion of children 0- Total no. of children 0-59 Total number children 0-59 Nutrition and Child Health
Underwe 59 months Weight for months Weight for age <- months weighed in a given Register
ight age <-3SD 3SD in a given period period (Total attendance)
STUNTING AMONG CHILDREN
1 Stunting Proportion of children 0- Total no. of children 0-59 Total number of children 0- Nutrition and Child Health
59 months with months with length/height 59 months whose Register
Length/height-for-age < for age below -2SD in a length/height measured in a
–2 standard deviations given period given period
(SD)
2 Moderat Proportion of children 0- Total no. of children 0-59 Total number of children 0- Nutrition and Child Health
e 59 months length/height months length/height for 59 months with Register
Stunting for age below ≥-3<-2SD age ≥-3<-2SD in a given length/height for age
N Indicato Definition Numerator Denominator Source Rationale
o. r
period measured in a given period
3 Severe Proportion of children 0-
Total no. of children 0-59 Total number of children 0- Nutrition and Child Health
Stunting 59 months Weight for months length/height for 59 months with Register
age <-3SD age <-3SD in a given length/height for age
period measured in a given period
INFANT AND YOUNG CHILD FEEDING
1 % of Proportion of health Total number of health Total number of health Nutrition Biannual All health facilities with maternity
health facilities designated as facilities designated as facilities conducting Surveillance form/FHD services are to sign on to the national
facilities Baby Friendly facilities Baby Friendly health deliveries Form D BFHI policy. This indicator looks at
designat facilities uptake of the Baby Friendly
ed as initiative
Baby
Friendly
facilities
2 Early Proportion of new born Total # of live births put Total # of live births in a RCH Form A This indicator measures when infants
initiation put to breast within 30 to breast within given period were put to breast early after
of Minutes of birth 30minutes of birth in a delivery. In Ghana, the BF policy
breastfee given period looks at 30 mins but globally it is 1
ding hour. Early initiation of
Rate breastfeeding within 1 hour of
delivery has been shown to reduce
neonatal deaths, increase success of
lactation and improve exclusive
breastfeeding rates.
3 Exclusiv Proportion of mother Total # of mother infant Total # of live births in a RCH form A Health staff who deliver pregnant
e infant pair practicing pairs practicing exclusive given period women are expected to initiate the
Breastfe EBF at discharge bf on discharge in a given process of breastfeeding, refuse to
eding period give pre-lacteal feeds and ensure that
Rate at breastfeeding has started off well
discharg before mother/infant are discharged
e
4 Low Birth Proportion of babies Total # of live births with Total # of live births in a RCH form A This indicator gives an idea of
with weight. less than
Weight Rate weight. less than 2.5kg in given period maternal malnutrition, especially
2.5kg a given period during pregnancy and other maternal
health issues if poorly managed.
LBW should be reduced to the barest
minimum if maternal nutrition before
and during pregnancy is
appropriately addressed.
5 Percenta Proportion of children 0- Total number of children Total number of children Nutrition and Child Health This indicator is to be collected

1
N Indicato Definition Numerator Denominator Source Rationale
o. r
ge of 3 months exclusively 0-3 months exclusively enumerated they come for Register during the PENTA 3 or
infants breastfed breastfeeding at the time GMP at 3 months which ROTAVIRUS 2 immunization visit.
o- they come for GMP at 3 also coincides with the It measures exclusive breastfeeding
3months months which also PENTA 3 immunization rate at month 3: a proxy for how well
exclusiv coincides with PENTA 3 visit (EBF + OTHER) the breastfeeding programme is
ely or ROTAVIRUS 2 doing, especially after discharge
breastfee immunization visit from the facility. This data can be
ding cumulated at the end of the quarter,
half-year or annual to find out how
the children are doing.
6 Timely Proportion of children Total number of children Total number of children EPI/ Nutrition and Child This indicator is to be collected
introduct receiving other family receiving other family enumerated at the Vitamin Health Register/RCH Form during the 6-months Vitamin A
ion of foods at month 6-8 foods at the time they A supplementation visit 6-8 A supplementation visit. It measures
comple come for Vitamin A months/in a given period. whether the caregivers have
mentary supplementation visit 6-8 introduced complementary foods or
feeding months in a given not; which is usually expected to be.
This indicator would show whether
caregivers are introducing
complementary foods or not for the
necessary action to be taken
7 Proportion of children Total number of children Total population of 12-23 Nutrition and Child Health This indictor tracks continued
Percenta seen at 1 years who are who are still breastfeeding months children attending Register breastfeeding which is a national
ge still breastfeeding. This at 1 year in a given period CWC in a given period feeding recommendation
Continue should be calculated
Breastfe annually.
eding at
1 year.
VITAMIN A SUPPLEMENTATION PROGRAMME
1 Routine Proportion of children Total Number of children Total # of children within 6- EPI Report Routine coverages are expected to be
Vit A (6- aged 6-59months dosed 6-59 months dosed with 59months in a given period. above 80% for each indicator to
59MTH with Vitamin A within Vit A within 6 months achieve national targets of reducing
S) 6months interval Vitamin A deficiency
coverage Calculate this indicator for the first
and second semesters (January to
June; and July to December)
2 Routine Proportion of children Total Number of children Total # of children within 6- EPI report Routine coverages are expected to be
Vitamin aged 6-11months dosed 6-11 months dosed with 11months in a given period. above 80% for each indicator to
A with Vitamin A within Vit A within 6 months achieve national targets of reducing
Coverag 6months interval Vitamin A deficiency
e 6- Calculate this indicator for the first

2
N Indicato Definition Numerator Denominator Source Rationale
o. r
11month and second semesters (January to
s June; and July to December)
3 Routine Proportion of children Total Number of children Total # of children within EPI report Routine coverages are expected to be
Vitamin aged 12-59months dosed 12-59months dosed with 12-59months in a given above 80% for each indicator to
A with Vitamin A within Vit A within 6 months period. achieve national targets of reducing
Coverag 6months interval Vitamin A deficiency
e 12- Calculate this indicator for the first
59month and second semesters (January to
s June; and July to December)
ANAEMIA CONTROL
4 Percenta Proportion of children 6- Total # f children 6-59 Total under 5 years seen at OPD Morbidity form Trends of this indictor would point to
ge of 59months diagnosed months diagnosed with OPD in a given period. the deficiency of iron in the children
children anaemic at OPD anaemia at OPD in a and WIFA.
6-59 given period.
months
diagnose
d
anaemic
1 % of Proportion of women 15- Total # of women 15-49 Total WIFA OPD Statement of Outpatients
women 49 years (WIFA) years (WIFA) diagnosed Attendance in a given
15-49 Diagnosed anaemic at anaemic at OPD in a period.
years OPD given period.
(WIFA)
diagnose
d
anaemic
2 % of Proportion of pregnant Total # of pregnant Total Number of pregnant RCH form A/ Nutrition and
pregnant women anaemic at women anaemic (below women with HB checked at Child Health Register
women registration 11g/dl) at registration in a registration in a given
anaemic given period. period.
at
registrati
on
3 % of Proportion of pregnant Total # of pregnant Total Number of pregnant RCH form A/ Nutrition and
pregnant women anaemic at women anaemic at women with HB checked at Child Health Register
women 36wks 36weeks in a given 36weeks in a given period.
anaemic period.
at 36
weeks
4 % of Proportion of pregnant Total number of pregnant Total ANC registrants in a RCH form A/ Nutrition and To track IFA supplementation

3
N Indicato Definition Numerator Denominator Source Rationale
o. r
ANC women receiving IFA women receiving IFA for given period. Child Health Register programme for pregnant and
registran for 3 months or for 90 3 months in a given lactating women
ts days period.
receivin
g IFA
for
3months
5 % of Proportion of pregnant Total number of pregnant Total ANC registrants in a RCH form A Nutrition and
ANC women receiving IFA women receiving IFA for given period. Child Health Register
registran for at least 6 months or 6 or more months in a
ts for 180mdays given period.
receivin
g IFS for
6 or
more
months
6 % of Proportion of lactating Total number of lactating PNC Registrants in a given RCH form A/ Nutrition and
PNC women who receive at women given IFA at least period. Child Health Register
clients least 1-month supply of once at PNC in a given
receivin IFA at postnatal care period.
g IFA visit
during
their
PNC
visit
Percent It’s the proportion of Total number of Total number of health GIFTS Out-of-School To know the geographical
age of health facilities that are health facilities facilities in the Monthly Report coverage of the programme. It
currently implementing
Health the GIFTS programme
Implementing GIFTS District/region helps in planning and decision
facilitie expressed in percentage. Programme in the /Country making. It’s useful in
s district/Region/countr assessing the access to the
implem y GIFTS services by
enting adolescents.
GIFTS
progra
mme
Percent The proportion of out- Total number of out Estimated number of GIFTS Out-of-School This to determine the out-of-
age of of-school adolescent of –school girls out-of-school girls in a Register school beneficiary coverage
girls who are covered
Out-of- registered on the given catchment area. It’s to determine the
4
N Indicato Definition Numerator Denominator Source Rationale
o. r
school under GIFTS programme GIFTS programme in (Facility/CHPS acceptability and the demand
girls on expressed in percentage a given catchment Zone/Sub-district/Distri of the GIFTS services by the
the area. (Facility/CHPS ct/Region/Country adolescents
GIFTS Zone/Sub-district/Dis
progra trict/Region/Country
mme
NUTRITION REHABILITATION (CMAM)
1 CMAM Proportion of SAM Total # of SAM cases Total number discharges Nutrition and Child Health These set of indicators shows how
Cure rate children 6-59 months Discharged cured in a (cured + defaulter +died + Register/CMAM Register well children with severe acute
discharged cured given period. non recovered) in a given malnutrition are identified and
period. treated. Treatment success is
2 CMAM Proportion of SAM Total number of SAM Total number discharges Nutrition and Child Health determined by a high cure rate of
Death children 6-59 discharged children discharged dead (cured + defaulter +died + Register/CMAM Register more than 75%.
rate died in a given period. non recovered) in a given Some validity checks for CMAM,
period. NACS and Supplementary Feeding
3 CMAM Proportion of SAM Total number of SAM Total number discharges Nutrition and Child Health data is that the total discharges must
Defaulte children 6-59months children discharged (cured + defaulter +died + Register/CMAM Register be equal to (numbers cured + died
r rate discharged defaulted defaulted in a given non recovered) in a given +defaulted and non-recovered)
period. period. and never be more than that.
4 CMAM Proportion of SAM Total # of children not Total number discharges Nutrition and Child Health
Non –children 6-59months recovered after 16 weeks (cured + defaulter +died + Register/CMAM Register
recovery
discharged non of continuous treatment in non recovered) in a given
rate recovered after 16 a given period. period.
continuous weeks of
treatment
COMMUNITY INFANT AND YOUNG CHILD FEEDING
1 % of Proportion of children Total number of children Total number of children in C-IYCF Register
children with nutrition –related visited at home (0-24 the Register (old + new) in a
receivin difficulties registered in months) in a given period. given period.
g at least the C-IYCF register who
1 visit in are visited at home
a month
from a
health
worker
2 % of Proportion of schools Number of schools with Total number of schools Nutrition Report
schools with school feeding SFP visited monthly in a with School Feeding
with program visited by given period. Programme in a given

5
N Indicato Definition Numerator Denominator Source Rationale
o. r
School nutrition staff period.
feeding
program
visited
CHILD HEALTH INDICATORS
1 OPV1 Proportion of children Number of children under Number of children under 1 EPI Returns This indicator is used to assess the
Coverag under 1 year receiving 1 year receiving the year (estimated as 4% of the performance of the immunization
e Oral polio (OPV1) OPV1 vaccine in the year population) and infant health programmes
vaccine
-to be
measure
d as per
100
2 OPV 3 Proportion of children Number of children under Number of children under 1 EPI Returns This indicator is used to assess the
Coverag under 1 year receiving 1 year receiving the OPV year (estimated as 4% of the performance of the immunization
e Oral polio (OPV 3) 3 vaccine in the year population) and infant health programmes
vaccine during the year
-to be
measure
d as per
100
3 PENTA Proportion of children Number of children under Number of children under 1 EPI Returns This indicator is used to assess the
1 under 1 year receiving 1 year receiving the Penta year (estimated as 4% of the performance of the immunization
Coverag Penta1 vaccine during 1 vaccine in the year population) services, and to determine the drop-
e the year out rate between PENTA 1 and
PENTA 3.
-to be
measure
d as per
100
4 PENTA Proportion of children Number of children under Number of children under 1 EPI Returns This indicator is used to assess the
3 under 1 year receiving 1 year receiving the Penta year (estimated as 4% of the performance of the immunization
Coverag Penta3 vaccine during 3 vaccine in the year population) services, and to determine the drop-
e the year out rate between PENTA 1 and
PENTA 3. Low coverage can prompt
-to be health workers to adopt strategies to
measure increase coverage
d as per
100
5 Immuniz Proportion of children Number of children 0-11 Number of children 0-11 EPI Returns This indicator is used to assess the

6
N Indicato Definition Numerator Denominator Source Rationale
o. r
ation under 1 year who do not months who have months who have received extent to which children fail to
Drop complete their received PENTA 1 minus PENTA 1 complete their immunization
Out Rate immunization schedule the number of children 0- schedule. It is also used to assess the
11 months who have continuity of service and quality of
-to be received PENTA 3 care provided. This indicator is a
measure measure of continuity of service and
d as per quality of care. It is most useful to
100 make a year-to-date cumulative
calculation of the indicator
throughout the year.
6 Proportion of children Number of children Number of children under 1 EPI Returns This indicator is used to assess the
Measles under 1 year receiving under 1 year receiving the year within the specified performance of the immunization
Coverag Measles Vaccine during Measles vaccine in the period and infant health programmes
e the year year

-to be
measure
d as per
100
7 Early Proportion of newborn Number of live born Total number of live births This indicator is a measure of the
Neonatal deaths occurring infants who died from 0 - within the specified period Form A general health status of the
Mortalit between 0 - 6 days of life 6 days of life population and the performance of
y rate the infant health programmes

-to be
measure
d as per
1,000
8 Perinatal Proportion of deaths of Number of newborn Total number of live births Form A This indicator is a measure of the
mortality a newborn occurring deaths occurring during or within the specified period general health status of the
rate during or pertaining to pertaining to the phase population and the performance of
the phase surrounding surrounding the time of the infant health programmes
-to be the time of birth, from birth, from the 20th week
measure the 20th week of of gestation to the 28th
d as per gestation to the 28th day day of newborn life
1,000 of newborn life
9 Neonatal Proportion of newborn Number of live born Total number of live births Form A
mortality deaths occurring infants who die from 0 - in the specified time period
-to be between 0 - 28 days of 28 days of life in a
measure life specified period

7
N Indicato Definition Numerator Denominator Source Rationale
o. r
d as per
1,000
10 Late Proportion of newborn Number of live born Total number of live births Form A This indicator is a measure of the
Neonatal deaths from the first 7 infants who die from the in the specified time period general health status of the
mortality days to the 28 days of first 7 days to the 28 days population and the performance of
rate life of life in the specified the infant health programmes
-to be time period
measure
d as per
1,000
11 Post Proportion of infant Number of infant deaths Total number of live births Form A This indicator is a measure of the
neonatal deaths occurring occurring between 28 in the specified time period general health status of the
mortality between 28 days and 11 days and 11 months of population and the performance of
rate months (29-364 days) of life in a specified period the infant health programmes
-to be life
measure
d as per
1,000
12 Stillbirth Proportion of babies Number of baby born Total number of live births Form A A general measure of pregnancy
Rate born with no signs of life with no signs of life at or in the specified time period outcome and quality of ANC, labour
-to be at or after 28 weeks' after 28 weeks' gestation and delivery services
measure gestation in the specified time
d as per period
1,000
13 Child Proportion of child Number of infant deaths Total number of live births Form A
mortality deaths occurring occurring between 1 - 4 in the specified time period
-to be between 1 - 4years of years of life in a specified
measure life period
d as per
1,000
14 Under- Proportion of infant Number of children Total number of live births Form A To determine the health survival of
Five deaths occurring <5 deaths occurring between in the specified time period children
Mortalit years (0 - 59 months) of 0 - 59 months of life in a
y Rate-to life specified period
be
measure
d as per
1,000
SCHOOL HEALTH

8
N Indicato Definition Numerator Denominator Source Rationale
o. r
15 Percenta Proportion of schools Number of schools visited Total number of schools Nutrition And Child Health
ge of within the catchment in a catchment area in a within a catchment area in a Form
schools area visited or reached specified period specified period
visited by outreach teams
-to be
measure
d as per
100
16 Percenta Proportion of schools Number of schools with Total number of schools Nutrition And Child Health
ge of within the catchment current environmental within a catchment area in a Form
schools area with currently certificate within a specified period
with approved environmental catchment area in a
current certificate specified period
Environ
mental
Certifica
te
-to be
measure
d as per
100
17 Percenta Proportion of school Number of School Total number of school Nutrition And Child Health
ge of children enrolled children examined within children enrolled within a Form
Schools examined within the a catchment area in catchment area in a
Children catchment area within a specified period specified period
Examine specified period
d
-to be
measure
d as per
100
18 Percenta Proportion of School Number of school Total number of School Nutrition And Child Health
ge of children who were children examined children examined within a Form
School examined referred for referred within a catchment area in specified
Children treatment catchment area in period
referred specified period
-to be
measure
d as per
100

9
N Indicato Definition Numerator Denominator Source Rationale
o. r
19 Percenta Proportion of Schools Number of schools Total number of schools Nutrition And Child Health
ge of receiving at least 3 receiving at least 3 health within a catchment area in a Form
Schools health Educational talks educational talks within a specified period
Receivin catchment area in a
g 3+ specified period
Health
Educatio
nal Talks

-to be
measure
d as per
100
NUTRITION RELATED NON- COMMUNICABLE DISEASES
1 Percentage of Proportion of OPD Total number of OPD Total consulting room Consulting room register This data is important to document
OPD attendants who are attendants who are attendance in a given the trends of incidence of NR-NCDs
attendants diagnosed hypertensive diagnosed hypertensive in period. as an indicator of healthy lifestyles.
who are a given period. The trends would inform staff
diagnosed distribution and in-service training
hypertensive needs to ensure appropriate care. It
also offers districts/facilities of
2 Percentage of Proportion of OPD Total number of OPD Total OPD attendance in a Consulting room register which areas to provide more
OPD attendants who are attendants who are given period. preventive services.
attendants diagnosed diabetic diagnosed diabetic in a
who are given period.
diagnosed
diabetic

NUTRITION COMMODITIES
Commodity Quantity at the Quantity received Quantity used (sachets) in a Balance(sachets) The main rationale for providing this
beginning of the month (sachets) in a given given period. data is to inform appropriate stocks
(sachets) period. management and improve forecast.
1 RUTF N/A N/A N/A
2 F-100
3 F-75
4 Resomal
5 IFA NA NA NA
6 Vit A N/A N/A N/A N/A
100000IU
7 Vit A

10
N Indicato Definition Numerator Denominator Source Rationale
o. r
200000IU

11
HEALTH PROMOTION DIVISION DATA DICTIONARY
HEALTH PROMOTION INDICATORS

No. Indicator Definition Numerator Denominator Source Remark/Rationale

Number of clients (internal and

external) who are satisfied with the Number of
Percentage of
services provided by health promotion. clients
clients satisfied Total number of Use to improve the
Internal clients include GHS programs satisfied
1. with health clients Survey report quality of health
e.g. Nutrition, FP, NMCP etc. with health
promotion interviewed promotion services
External clients include community promotion
services
members, NGOs and other services
development partners

To ensure
HP documents developed e.g. adherence to health
Number of
Guidelines on material development promotion policies,
Health
and usage, media, advertising, policy Resource legal framework,
2. Promotion (HP) NA NA
on advocacy lobbying and networking, Centre reports guidelines and
documents
resource mobilization plan/ strategy and standards by health
developed
SBCC materials workers and
partners

Of all training planned by HP for or To strengthen

Proportion of Number of
with lower levels, programs and Total number of Quarterly human resource
3. training training
external partners, the number that were planned training reporting form capacity for Health
conducted by HP conducted
conducted Promotion
All designated staff undertaking HP
activities who have ever or newly Number
Proportion of HP
received any sensitization or training in trained on To strengthen
Personnel/Focal Total number of
the use and adherence of HP protocols HP Quarterly human resource
4. Persons trained HP designated
and guidelines at all levels. These could protocols reporting form capacity for health
On HP protocols personnel.
include HP managers, HPTOs, CHNs, and promotion
and guidelines
Midwife, FTs. The training will include guidelines
internships

12
 No. Indicator Definition Numerator Denominator Source Remark/Rationale

Total number of HP Managers, HP

Number of HP
Technical Officers, focal persons who
personnel/focal
have ever or newly received training in To strengthen
persons trained Quarterly
5. the effective use of SBCC materials. NA NA human resource
in the utilization reporting form
Focal persons include staff at the lowest capacity for HP
of SBCC
levels of health delivery. E.g. CHNs,
materials
FTs, enrolled nurses, volunteers

Total number of HP Managers, HP

Number of HP
Technical Officers, focal persons who
personnel/focal To strengthen
have ever or newly received training in Quarterly
6. persons trained NA NA human resource
interpersonal communication. Focal reporting form
in interpersonal capacity for HP
persons include CHNs, FTs, enrolled
communication.
nurses, volunteers
Total number of HP Managers, HP
Number of HP
Technical Officers, focal persons who
personnel/focal To strengthen
have ever or newly received training in Quarterly
7. persons trained NA NA human resource
risk communication. Focal persons reporting form
on risk capacity for HP
include CHNs, FTs, enrolled nurses,
communication
volunteers
Total number of HP Managers, HP
Technical Officers, focal persons who
Number of HP have ever or newly received training in
To strengthen
personnel/focal topics other than HP protocols and Quarterly
8. NA NA human resource
persons trained guidelines, utilization of SBCC reporting form
capacity for HP
on other topics materials, and risk communication.
Focal persons include CHNs, FTs,
enrolled nurses, volunteers
The total number of staff engaged and
To strengthen
Number of HPOs posted to the various levels (National, Quarterly
9. NA NA human resource
at post Regional, Districts and facilities) and reporting form
capacity for HP
currently undertaking HP activities

13
 No. Indicator Definition Numerator Denominator Source Remark/Rationale

Number of
proposals To improve
Number of proposals submitted for
10. submitted for NA NA Proposal file resource
support (funding) of HP activities
funding HP mobilization for HP
activities

Number of
meetings
Number of meetings organised to Meeting To operationalize a
organised to
11. specifically assess HPD performance at NA NA reports/ results-based M&E
review HPD
all levels minutes system
performance
indicators

Number of
verification and To operationalize a
Number of meetings held to verify and Meeting
12. validation NA NA results-based M&E
validate data. reports
meetings for system
HPD data
The total number of
monitoring/supervisory conducted.
Visits should include those to address
Number of
the following activities - adherence to Monitoring/ To operationalize
monitoring/
13. SOPs, protocols, guidelines, and NA NA supervisory robust results-based
supervisory visits
compliance to campaigns and its report M & E system
conducted
programmatic implications in the field
(this includes regional, district,
community, etc.)
No. of
Number of assessments conducted by
evaluations Assess/Measure the
HPD to measure the outcome/impact of Quarterly
14. conducted by NA NA effectiveness of HP
HP interventions. These include rapid report
HPD for key interventions
assessments, desk reviews, etc.
health behaviors

14
 No. Indicator Definition Numerator Denominator Source Remark/Rationale

Resource To ensure
No of SBCC
Total number of educational materials centre report, availability and
15. materials NA NA
developed to change behavior. Material Dev.t access to SBCC
developed
Unit report materials

Total number of SBCC materials

developed, the number that has been Resource To ensure
No of SBCC
disseminated. centre report, availability and
16. materials NA
Dissemination refers to training and Material Devt access to SBCC
disseminated
distribution of materials for their Unit report materials
intended purpose.

Total number of SBCC

materials disseminated[1]
Number of T This is to assess the
Proportion of Of the quantities of SBCC materials Monitoring
SBCC otal number of usage of SBCC
17. SBCC materials disseminated, the quantity that has been visit reports
materials SBCC materials for their
used utilized for their intended purpose. Survey report
used materials intended purpose
disseminated[1
]
Number of The establishment
SBCC resource centre refers to a
SBCC resource of the SBCC
repository of electronic and print
centres resource centre’s is
materials on health where people can Resource
18. (E.g. Library, NA NA to make available
easily have access e.g. Section of a Centre Report
electronic and assessable,
regional library, cabinet in the RHD,
catalogue, portal) SBCC tools and
approved HPD online library
established materials.

Total number of SBCC materials disseminated[1]

15
 No. Indicator Definition Numerator Denominator Source Remark/Rationale

Schedule,
Number of media The number of media houses (TV,
Accounts, To know media
houses engaged Print, radio, social media) contacted
programme houses who are
19. to undertake (through contract, reaching agreements) NA NA
and actively involved in
health promotion by HPD to air/publish health promotion
Procurement HP activities
activities messages
records

To assess the
Number of Media
promotion of health
programmes and The number of health messages/ Monitoring
messages on media
20. messages programmes aired/published on media NA NA Report,
platforms of the
aired/published platforms Transmission
media houses
by media houses. certificate
engaged by HPD

Total number of Health programs used

during health promotion activities.
Programs include Communicable
Diseases (TB, Malaria, HIV/AIDS,
cholera, etc.), Non-Communicable
Diseases (Hypertension, Cancer,
To ensure that
asthma, etc.), Reproductive
Number of health SBCC interventions
Health (ANC attendance, skilled
programs of the various
21. delivery, family planning and NA NA Monthly report
covered during programs are
awareness on fistula etc.), Nutrition
HP activities effectively
(early initiation of breastfeeding,
implemented
exclusive breastfeeding and
complementary feeding) and
Regenerative Health, Child health
(ORS and Zinc for diarrhoea, newborn
care, CWC attendance, etc.), Personal
Environmental hygiene, Mental Health

16
 No. Indicator Definition Numerator Denominator Source Remark/Rationale

Number of times various channels were

used for communicating HP messages
To assess the use
Number of times during HP activities/sessions.
and effectiveness of
channels were Channels include group meetings, Monthly
22. NA NA the communication
used for HP radio, One-on-One, drama/role play, reporting form
channels used for
activities community information centre, video,
HP activities
television, social media, public address
system, others
Total number of times SBCC material
were used to support HP activities.
SBCC materials include print, audio,
Number of times audio-visual and games. Print SBCC To assess the
SBCC materials materials include posters, flipcharts, Monthly effective use of
23. NA NA
were used during counselling cards, flyers, banners, reporting form SBCC materials for
HP activities booklet, leaflets etc. Audio includes HP activities
recorded radio adverts (discussions and
jingles), Audiovisual include video
CDs.
Total number of times activities were
carried out in various venues. Venues To know which
Number of times
include Community level (school, Monthly venues were used in
24. venues were used NA NA
community, CWC outreach, church, reporting form carrying out HP
for HP activities
mosque, market, home), Facility level activities
(static CWC, OPD, RCH )
The number of people who participated To ensure that all
Number of target
in HP activities/sessions. Participants target audience are
audience reached Monthly
25. include pregnant women, nursing NA NA engaged and
with SBCC reporting form
mothers, other women, adolescents, actively involved in
activities
school children, and opinion leaders SBCC interventions

17
 No. Indicator Definition Numerator Denominator Source Remark/Rationale

Number of the
target audience
Number of
Percentage of in the general To assess the
community
community Percentage of community members population adoption of positive
members DHIMS2,
members practicing desired behaviors in health Number of health behaviour
26. practicing rapid
practicing areas CH, FP, RH, Nutrition, ARH, community and lifestyles by
desired assessment
desired health Mental health, etc.) members community
health
behaviors interviewed members
behaviors.
(rapid
assessment).

To assess the output

of the HP activities
Number of Total number of advocacy and
27. NA NA Monthly report (to know the total
sessions held educational sessions conducted
number and type of
sessions held)

Number of HP The number of health promotion To assess the level

events/ programs events/ programs planned with internal Quarterly of collaboration
28. NA NA
jointly planned (within GHS) and external (outside report with other
with partners GHS) partners. stakeholders

Number of HP
The number of health promotion To assess the level
events/ programs
events/ programs conducted with Quarterly of collaboration
29. jointly NA NA
internal (within GHS) and external Report with other
held/organised
(outside GHS) partners. stakeholders
with partners

18
 No. Indicator Definition Numerator Denominator Source Remark/Rationale

To assess the output

Number of of the HP activities
The number of meetings held by ICC-
advocacy (to know the total
for -HP with MOH, GHS Council, ICC-HP
sessions held number of
30. HRD, RHMT to support the provision NA NA Meeting
with key advocacy sessions
of health promotion resources at all reports
decision-makers held with key
levels (national, regional, district)
and partners decision-makers
and partners

To increase
A functional district health committee
Number of DHMT collaboration,
refers to a group of stakeholders who
functional district minutes/distric coordination and
31. have an action plan and meet regularly NA NA
health t monitoring partnership among
to discuss health issues affecting their
committees checklist stakeholders in the
district
district
Number of
HPC refers to recognized people
Health
undertaking advocacy activities for Quarterly Increase Advocacy
32. Promotion NA NA
health promotion which includes Report and support for HP
Champions
influential people, satisfied clients, etc.
(HPC) identified

Number of active
Measure the active
Health An active HPC is one who implements
Quarterly involvement of HP
33. Promotion activities according to the terms of NA NA
Report Champions in HP
Champions reference (TOR).
activities
(HPC)

Proportion of Number of
Number of Measure the
activities in the planned Work plan,
The number of completed activities as activities implementation of
34. action plan activities in the activity report,
per TOR/ action plan implemented planned activities
implemented by action plan of TOR
by HPC by Champions
HPC HPC.

19
PUBLIC HEALTH DIVISION DATA DICTIONARY
NATIONAL VIRAL HEPATITIS CONTROL PROGRAMME INDICATORS
Programm
Indicator Definition Numerator Denominator Data source Justification
e
National ANC Proportion of Number of pregnant Number of Lab report/ANC register
Viral Seroprevalence pregnant women women testing positive pregnant Relevant for programming
Hepatitis of Hepatitis B testing positive for HBsAg during women interventions for
Control for HBsAg routine ANC screening screened at preventing mother to child
Programme during routine ANC transmission
ANC screening
National Coverage of Proportion of Number of eligible Delivery Measures access of
Viral eligible mothers eligible mothers HBsAg + women Number of register/PMTCT_Hep B women in need to
Hepatitis with peripartum receiving receiving Tenofovir HBsAg positive register prophylaxis
Control prophylaxis peripartum antiviral (or other pregnant
Programme prophylaxis drug, according to women with
according to national policy) high viral load
policy treatment from 28 according to
weeks of gestation HBV DNA or
onwards HBeAg results
National Timely hepatitis Proportion of Number of exposed Number of Delivery Measures effective use of
Viral B birth dose exposed newborns receiving newborns born register/Immunization birth dose to protect
Hepatitis coverage newborns hepatitis B vaccine to HBsAg register/PMTCT-Hep B newborns
Control (exposed receiving a within 24 hours of life positive register
Programme newborns) timely birth dose mothers
National HBIG coverage Proportion of Number of newborns Number of Delivery register/ Measures exposed
Viral exposed receiving HBIG newborns born PMTCT_Hep B register newborns given maximum
Hepatitis newborns to HBsAg protection at birth
Control receiving HBIG positive
Programme mothers
National Timely hepatitis Proportion of all Number of newborns Number of Delivery Indicates access of all
Viral B birth dose newborns receiving hepatitis B newborns registers/Immunization newborns to timely birth
Hepatitis coverage (all receiving a vaccine within 24 hours register dose
Control newborns) timely birth dose of life
Programme

20
Programm
Indicator Definition Numerator Denominator Data source Justification
e
National Post-vaccination Proportion of Number of infants Number of PMTCT_Hep B register Measures coverage of
Viral serological infants tested for tested at 7–12 months infants born to post-vaccination
Hepatitis testing coverage infection at 7-12 of age HBsAg positive serological testing at 7-12
Control (exposed months of age mothers months among exposed
Programme newborns) newborns
National Rate of mother Incidence of Number of HBsAg Number of Follow up of infants Measures effectiveness of
Viral to child HBV infection in positive infants at post- infants tested at born to HBsAg positive preventive measures
Hepatitis transmission children born to vaccination serological 7-12 months of mothers in PMTCT_Hep against Hep B among the
Control HBsAg positive testing age B register exposed
Programme mothers
National Treatment Proportion of Number of chronic Total number of Treatment Register Measures access to care
Viral coverage/initiati chronic HBV HBV affected persons chronic HBV
Hepatitis on affected persons starting treatment affected persons
Control starting chronic
Programme care
Proportion of Number of chronic Treatment Register
Total number of
chronic HCV HCV affected persons
chronic HCV
affected persons starting treatment
affected persons
starting treatment
National Treatment Proportion of Number of HBV with Treatment Register Indicates if treatment is
Total number
Viral completion/ chronic HBV viral suppression after working to suppress virus
assessed for
Hepatitis effectiveness affected persons treatment
treatment
Control achieving viral
effectiveness
Programme suppression
Proportion of Total number Treatment Register Indicates cure rate
chronic HCV Number of HCV with assessed who
affected persons cure completed
achieving cure treatment
National Cumulative Cumulative Number of HBsAg Number of Biomarker survey Useful for tracking
Viral incidence in incidence of positive children children tested Mathematical modelling elimination targets
Hepatitis children five(5) HBV infection in
Control years of age children five (5)
Programme years of age

21
Programm
Indicator Definition Numerator Denominator Data source Justification
e
Incidence of New HCV Ongoing systematic
HCV infection infections reviews of biomarker
survey data
Mortality Proportion (%) of Total deaths in persons Total deaths COD Certificates
attributable to people dying with cirrhosis who from cirrhosis
HBV and HCV from cirrhosis tested positive for
who were chronic HBV
positive for viral
hepatitis B
infection
Proportion (%) of Total deaths in persons Total deaths COD Certificates
people dying with cirrhosis who from cirrhosis
from cirrhosis tested positive for
who were chronic HCV
positive for viral
hepatitis C
infection
Proportion (%) of Total deaths in persons Total deaths COD Certificates and
people dying with hepatocellular from Cancer registries
from carcinoma who tested hepatocellular
hepatocellular positive for chronic carcinoma
carcinoma who HBV
were positive for
viral hepatitis B
infection
Proportion (%) of Total deaths in persons Total deaths COD Certificates and
people dying with hepatocellular from Cancer registries
from carcinoma who tested hepatocellular
hepatocellular positive for chronic carcinoma
carcinoma who HCV
were positive for
viral hepatitis C
infection

22
MICROBIOLOGY DATA FORM
HAEMATOLOGY DATA FORM

1
BIOCHEMISTRY DATA FORM

2
NON-SERVICE DELIVERY DATA DICTIONARY
POLICY PLANNING MONITORING AND EVALUATION INDICATORS

FUNCTIONAL E-TRACKER INDICATORS

Stage Steps/Attribute Definition Data Source Rationale/Reason
CHPS zone ID The CHPS zone code as entered in DHIMS2 To uniquely Identify each zone on
DHIMS2 the system
Name of CHPS zone The Official name of the CHPS Zone Profile For the purposes on identification
zone
Electoral area The Electoral area within which Zone profile To be able to determine the
CHPS zone CHPS zone is located distribution of zones across electoral
Profile areas
Population The Current Estimated population Zone profile To determine the total population
served by the CHPS zone covered by CHPs zones
No. of communities The Number of communities in Zone profile To measure the number of
the CHPS zone communities covered by CHPS
zones
Background Trained CHOs The Number of Trained CHOs Master Training Log To measure number of Functional
Information assigned and serving in the CHPS books zones with trained CHOS
zone
Number of other health The Number of other health staff Master Training Log To measure the number of other
staff assigned to zone who are not trained CHOs but books categories of staff assigned to CHPS
assigned and serving in the CHPS
zone
Total Staff Deployed to The Total Staff strength of the Master Training Log To measure the staffing numbers
CHPS Zone CHPS zone books across CHPS zones
Active CHMC with A Community Health Activity Report/Zone To measure the support level CHOs
meeting since last 3 Management Committee that has profile receive from CHMCs and if they are
months held a least one meeting in the last functioning effectively
3 months
Number of Active The Number of Active Activity Report/Zone To measure the Number of active

3
Stage Steps/Attribute Definition Data Source Rationale/Reason
Community Health Community Health Volunteers in profile volunteers supporting the CHOs their
Volunteers in CHPS CHPS zone that are reporting. daily duties
zone
Number of Households The total Number of Households Activity Report/Zone To determine the number of
under CHPS Zone under CHPS Zone profile households to be covered by each
CHO
CHAP Status in Last 3 The status of Implementation on Activity Report/Zone To measure the progress of CHAP
months Community Health Action Plan profile implementation in the zone
(CHAP) in the CHPS zone
1 Planning & Indicate the period in which Calendar To measure the time the activity was
community planning with community leaders performed
Milestone selection, zone on selecting communities, zone
One demarcation demarcation, including effective
community entry and mobilisation
took place.
2 Dialogue with Indicate whether discussions have Activity Report To hold discussions with health
health workers been held with health workers workers
3 Dialogue with Indicate whether discussions Activity Report To hold discussions with
communities in involving community members in communities in zones
Planning & zone zone have been conducted
Community 4 Community Indicate whether community Activity Report To know whether durbars have been
Entry information durbar leaders have been informed about held to inform community members
CHPS implementation during about plans to establish a CHPS in
durbars the community
5a CHO Selection & Indicate whether Community Master Training Log To know whether CHOs have been
training Health Officers (CHOs) have been books selected and given the pre-requisite
selected and given CHMC minutes book training
orientation/training to become
community-based front-line health
Milestone workers who visit households,
Two organise community health
4
Stage Steps/Attribute Definition Data Source Rationale/Reason
services, and conduct CHMC
meetings
5b CHO deployed to Indicate the period in which Calendar To measure the time the activity was
serve zone: but Community Health Nurses were performed
Staffing NOT resident in provided with further training and
(CHO) zone designated Community Health
Officers (CHOs) as non-resident
health care providers in a CHPS
zone
5c CHO deployed to Indicate the period in which Calendar To measure the time the activity was
serve zone: Community Health Nurses were carried out
RESIDENT in provided further training and
zone designated Community Health
Officers (CHOs) as resident health
care providers in a CHPS zone
6a Selection of Indicate whether committee Activity Report To know whether committee
committee members have been selected by members have been selected
Milestone members the community leaders
Three 6b Orientation of Indicate whether committee Activity Report To know if committee members have
committee members are reoriented on their been educated on the role they are to
members roles perform
Local 7 Community profile Indicate whether community District To enable CHOs know their
Leadership & CHO work profile consisting of the Assembly/DHMT community profile and their
areas delineated population, boundaries, ethnicity, respective catchment areas.
main occupation, etc. and the
CHO’s work areas are well
defined and explained to them
8a Facility Indicate whether Community District To know if the community has
Milestone construction members have been mobilised to Assembly/DHMT started constructing community
Four started construct CHPS with their health centres.
involvement.
5
Stage Steps/Attribute Definition Data Source Rationale/Reason
8b Facility Indicate whether a CHPS District To know the period within which the
Facility construction compound comprising CHO Assembly/DHMT community completed building the
Construction completed accommodation and a service community health centres.
(includes work & delivery point has been
living quarters) constructed
9a Procure medical Indicate whether medical supplies Ledger Book To determine if the facility has
supplies & and equipment have been medical supplies and equipment.
equipment procured for the day to day
Milestone running of the facilities
Five 9b Procure motorbike Indicate whether motorbikes, as Ledger Book To determine if the facility has a
means of transportation, have motorbike for outreach services
been procured for the day to day
running of the facilities
9c CHOs complete Indicate if CHOs have been Master Training Log To know if CHOs have been given
Logistics* motorbike training trained on the use of motorbikes books requisite training to ride motorbikes.
Mobilization 9d Procure bicycles Indicate whether bicycles, as Ledger Book To determine if the facility has
for volunteers means of transportation, have procured bicycles for volunteers to
been procured for the volunteers. aid them in performing their duties
10 CHO/CHPS Indicate if DHMT, in consultation Activity report To create awareness about the take-
launching durbar with community leaders, have off of the CHPS in the community
organised durbar to introduce the and the need for their participation.
CHO to the community and
CHPS programme launched.
11 Select volunteers Indicate whether community Activity report To know if volunteers have been
leaders have selected volunteers to selected by the community leaders to
Milestone Six support the CHO support the CHO
12 Volunteer Indicate whether community Activity report To formally present the volunteers to
introduction leaders have organised durbars to the community members
durbar introduce volunteers to the
community.
Volunteer 13 Volunteer training Indicate whether volunteers have Master Training Log To build volunteers capacity on what
6
Stage Steps/Attribute Definition Data Source Rationale/Reason
Mobilization been trained on basic health issues books they are expected to do
and serving mainly as agents of
referral services and community
social mobilization through home
visits
14 Provide volunteer The volunteers are provided with Ledger To ensure that community volunteers
supplies equipment and other medical (Stock/Equipment) have been provided with enough
supplies to work with medical supplies and equipment
15 Final durbar for Indicate the period in which the Calendar To measure the time the activity was
volunteers volunteers are finally introduced performed
to the community members at the
durbar grounds

PBMIS DATA DICTIONARY

7
IGF REVENUE BUDGET

Table Variable Definition Data Source

This refers to the facility code as defined by
the Government of Ghana Chart of
BMC Code Accounts Automatically generated
BMC Name This refers to the facility name Automatically generated
This refers to specific department under the
Department BMC Automatically generated
This refers to the ensuing year for which the
IGF Revenue Set Up Budget Year budget is being prepared Automatically generated
This refers to the year within which the
Current Year budget is being prepared Automatically generated
Last Year This refers to the past year Automatically generated
IGF Revenue Type This refers to the type of IGF you are going
to budget for i.e. Services ,
Medicine/Pharmaceuticals or Support Fund
(from IGF Guidelines)
Source of Fund
Total Budget
Prior Year Average for Non-Insured
Rate of Projection (Non-Insured) %
IGF Budgeting Projected Monthly Average (Non-Insured) Automatically generated
Approved Tariff (Non-Insured)
Annual IGF Budget (Non-Insured) Automatically generated
Prior Year Average for Insured (NHIS)
Rate of Projection (NHIS) %

8
Table Variable Definition Data Source
Projected Monthly Average (NHIS) Automatically generated
Approved Tariff (NHIS)
Annual IGF Budget (NHIS) Automatically generated
Month
Previous Years Amount or Figures
Primary Non-Insured
Primary Insured (NHIS)
Primary Total
Referral Non-Insured
Referral Insured (NHIS)
Referral Total

GOODS AND SERVICES BUDGET

9
Table Variable Definition Data Source
Automatically generated using
BMC This refers to the facility name
login credentials
This refers to the ensuing year for which the budget is
Budget Year Automatically generated
being prepared
This refers to the number of activities that have been
Total Budget Lines Automatically generated
budgeted for

This refers to the identification generated automatically for

Budget ID Automatically generated
which activity
This refers to the total budget inputted for each BMC
Total Budget for BMC according to the activities. Automatically generated

This defines the services or operations which contribute to

Automatically set to Primary and
Sub-Program the achievement of the objective(s) of the program of
Secondary Health Services
which it forms a part.
Budget Header
This refers to all known activities that are planned to
Project
achieve specific objective for the budget year
This is where you type in the activity you plan to
Planned Activity
undertake
Refers to all sources of funding that will be used during
Source of Fund
the budget capture

Refers to the nature of the activity i.e. meeting, training

Activity Type
workshop, monitoring, etc

Refers to the results you hope to achieve immediately after

implementing an activity.
Activity Output/Target
You must be able to measure the results in terms of
quantity, quality and timeliness

10
Table Variable Definition Data Source
Activity Frequency Number of times the activity will be carried out

Refers to the level of importance of the activity. On a scale

Activity Prioritization of 1-10, with 1 being the lowest priority and 10 being the
highest

This explains why each item is needed and its purpose,

Budget Justification
and how the total amount was arrived at.

This refers to specific interventions that are linked to the

GHS Core Intervention
national intervention packages defined in the HSMTDP
This refers to all the proven interventions that addresses Automatically generated
the Health Sector Medium Term Development Plan
Intervention Package according to the intervention
(HSMTDP) Objectives. selected.

This refers to the Health Sector Medium Term

HSMTDP Objective Development Plan (HSMTDP) Objectives that a budget
will be aligned to under the Program Based Budget

The Operations is used to link activities and budget to

National Operations Broad Operations of Government. This is automatically
generated as it is linked to the Core Intervention selected

Refers to the type of item you are budgeting for, i.e.

Budget Details Item Type
goods or services

11
Table Variable Definition Data Source

This is where you select the code for Goods you require to
undertake your activity.
Item Number
For Services, the code needs to be entered manually,
starting from 1.

This displays the description of the codes selected. When

Goods are selected , PPA approved rates for Goods will
Item Description be displayed

For Services, this description must be entered manually

This refers to the unit of measure that the selected Item is

Unit of Measure
supplied in

Unit Cost/Rate Refers to the cost of a single Item selected

Quantity Refers to the quantity of the Item selected

Refers to the number of days you intend to carry out

Number of Days
activity

This is automatically populated from the Frequency

Activity Frequency
entered in the Budget Header section

This refers to the total budget for the activity. It is

Budget Amount
computed automatically
GIFMIS Natural Account This refers to GIFMIS Chart of Account

CAPITAL EXPENDITURE BUDGET

12
Table Variable Definition Data Source
Serial Number Automatically generated

This is where you select the Project description which could

Project either be GOG, IGF or Development Partner Project

Contract Number This refers to the approved Contract Number

Refers to who is providing financial and technical resources for
Source of Fund the activity
Description This refers to the Project Name
Project Category

Refers to the period within which the Project is expected to be

Contract Period completed (in months)

Contracts This refers to the exact location the Project will be implemented
Project Location (Region, District, Community )

Refers to the name of the name of the person or firm contracted to

Contractor undertake project

Award Date This refers to the actual date the contract was signed

Start Date This refers to the actual date the contractor started work on the site
This refers to the agreed completion date at the time the contract
Initial Completion date
was signed

Revised Completion date This refers to the new agreed date for completion after evaluation

Actual Completion date This refers to the actual date the contractor completed the project

13
Table Variable Definition Data Source
This refers to the percentage completeness with reference to the
Status
agreed scope of work

This refers to the agreed amount to be paid to the consultant upon

Initial Contract Sum
start and completion of project
This refers to the agreed currency which payment will be made to
Currency the contractor

This refers to the difference between the initial contract amount

Variation and amount needed to complete the project

This refers to the change in contract sum due to price changes to

specified items over the duration of the project.

This usually happens when the contractor tenders based on the

current prices (prices at an agreed base date)
Fluctuation
This refers to the interest accrued when payments to contractors
Interest on delayed payment are delayed

This refers to total contract amount after it has been revised either
upwards or downwards after evaluation of project implementation
Revised Contract Sum status
This refers to the total contract amount that has been released for
payment to the contractor
YTD Releases
This refers to the remaining contract balance
YTD Outstanding

14
Table Variable Definition Data Source

This refers to the total amount that has been guaranteed and set
aside to pay contractor upon completion of the project
YTD Certified Commitment
This refers to total payments made to contractor
YTD Payment
This refers to the amount of funds committed that have not yet
been paid
YTD Outstanding Commitment
This is where you specify if there are any peculiar challenges
Remarks

EXPENDITURE FORM (IGF)

15
Variable Definition Data Source Rationale for collecting data
EXPENDITURE This is the approved expenditure budget Approved monthly 1. To ascertain the expenditure budget for the
ITEM BUDGET – A for the month. Budgets are supposed to expenditure budget as month for each revenue generating facility.
be approved by the Regional Director in recorded in Departmental 2. To help generate monthly expenditure
line with ATF Journal Voucher and budget of the Service and also provide
entered in the expenditure information for budgeting in ensuing periods
Budget Ledger 3. To assist in the implementation of
approved expenditure budgets

COMMITMENTS/ This is the cumulative commitments of Expenditure Budget 1. Track the budget execution of funds from
EXPENDITURE the facility as at the month of entry. For Ledger(LPOs, Contracts, IGF of the facilities
ITEM – B example, the cumulative commitments Approved Memos) 2. Obtain information on IGF expenditure to
for June 2020 would be the total make budget estimates for ensuing fiscal year
commitments of the facility from January 3. Determine the budget variance trends over
2020 to June 2020. This is captured using periods
the expenditure item for the Government 4. Determine the outstanding obligations for
of Ghana Chart of Account accurate Accumulated Fund Balance analysis

AVAILABLE This is the difference between the Approved monthly

BUDGETA-B approved budget and the cumulative expenditure budget as
commitment or expenditure recorded in Departmental
Journal Voucher and
entered in the expenditure
Budget Ledger

16
Variable Definition Data Source Rationale for collecting data
PAYMENT OF This is total commitments paid by the Expenditure Budget
COMMITMENTS - C facility as at the month of entry. For Ledger(LPOs, Contracts,
example, cumulative payments for June Approved Memos)
2020 would be the total payments of
commitments of the facility from January
2020 to June 2020

OUTSTANDING This is the difference between the Creditors Ledger Control

COMMITMENT B - cumulative commitment and the payment
C of commitment

FINANCE DIVISION DATA DICTIONARY

17
INSERT FINANCE DATA DICTIONARY

TRANSPORT DEPARTMENT DATA DICTIONARY

18
TRANSPORT DEPARTMENT INDICATORS
INDICATOR DEFINITION NUMERATOR DENUMENATOR SOURCE PURPOSE
Kilometre Total distance covered Vehicle logbooks Serve as basis for
travelled from one point to another calculating operational
by a vehicle. utilization
Speedometer reading at
the end of the month
minus speedometer
reading at the beginning
of the month
How far a vehicle can Total Kilometre Total fuel used Vehicle Basis for calculating
Fuel travel with one litre of travelled logbooks/files operational cost
Utilization fuel expressed in -Evaluate vehicle
kilometre per litre (km/l) performance
- Serve as a guide for fuel
allocation.
Maintenance Average sum of Total Total Km travelled Vehicle - To serves as
Cost/Km maintenance expenses for maintenance logbooks/files measurement of vehicle
every km travelled cost performance
- basis for disposal
Fuel Cost Average fuel cost of Cost of fuel per Total Kilometre Vehicle -Basis for calculating
per Kilometre moving vehicle for a litre as the time Travelled divided logbooks/files/fuel operational cost
kilometre, express in of entering for a by Total Fuel used books -Evaluate vehicle
Ghana cedis quarter of a year for a quarter of a performance
year - Serve as a guide for fuel
allocation.
-basis for disposal
Running cost The total cost incurred in Vehicle logbook/fuel -Cost of operation,
per moving a Vehicle for one ledger/maintenance Input for budgeting
kilometre) kilometre in a quarter of a ledger and basis for disposal
19
INDICATOR DEFINITION NUMERATOR DENUMENATOR SOURCE PURPOSE
year. Maintenance cost
per kilometre plus (+)
Fuel cost per kilometre
Availability Proportion of days in the No of days in Total days in the Vehicle logbook To determine vehicle
(%) month were the vehicle the month month condition and
available for use minus basis for replacement
expressed in percentage workshop days

Vehicle Proportion of days No of days No of days vehicle Vehicle logbook To measure institutional
Utilization vehicle used for service vehicle was was available for performance and
(%) delivery when it was used in a month use in a month need for additional vehicle
available

Fleet Refers to the average age Sum of ages of Total number of Vehicles Asset Determine the quality of
Average Age of the total Transport all vehicles vehicles Register Transport in terms of age
fleet.
Performance The proportion of No of approved No of Approved Vehicle Request To assess the effectiveness
(Needs approved transport Requests Requests received Forms of the Transport Unit in
Satisfaction) requests that were met, honored meeting transport demand
expressed in percentage
Fleet Proportion of days in a Total No. of Total days in a Vehicle Logbook and To Determine vehicle
Downtime month that vehicle was Workshop days month maintenance ledger condition and basis for
not in good condition for replacement
use expressed in
percentage
Collision No. of Fleet crashes per No. of accidents Total kilometre Accident/Incident Measure Safety
Frequency specified kilometre recorded in a travelled in a month forms performance
Rate month

20
21
STORES SUPPLIES AND DRUG MANAGEMENT (SSDM) DATA DICTIONARY

SSDM LMIS DICTIONARY FOR NATIONAL DATA AGGREGATION

VARIABLE DIFINITION SOURCE (PRIMARY) PURPOSE

Region facility operates or is To determine the location of the

REGION Regional Health Directorate
located facility
District under the Region the To determine the location of the
DISTRICT District Health Directorate
Facility operates or is located facility
Name given to the facility GHS-HQ/PPMED/
To determine the identity of the
FACILITY NAME according to the records of the Regional/District Health
Facility
Ghana Health Service Directorate
Kind of Facility you are
To determine the kind and
FACILITY TYPE operating from (CHPS, HEALTH Health Directorate
operations of the facility
CENTER, HOSPITAL, etc.)
The Year the transaction is To determine the period of
YEAR Year under review
carried out. operation
The Month the transaction is To determine the period of
MONTH Month under review
carried out. operation
Item Number is the unique
Ghana Integrated Logistics
number assigned to the
ITEM NUMBER Management Information System To make it unique and uniform
commodity as found in the
(GhiLMIS)
GhiLMIS

Ghana Integrated Logistics

The Commodity Name is the
COMMODITY NAME Management Information System To make it unique and uniform
generic name of the Commodity.
(GhiLMIS)

State whether Commodity is a To differentiate between

COMMODITY TYPE Commodity Type under review
syrup, capsule, injection, etc. commodities

22
VARIABLE DIFINITION SOURCE (PRIMARY) PURPOSE

Under which Programme does

the commodity belong to. i.e. Ghana Integrated Logistics To categorize the Commodities
PROGRAMME ( NACP, FH, NMCP, Covid-19, Management Information System according to the Programmes
EPI, NTD, Psychotropics, (GhiLMIS) they belong
Others).
Write the dosage form, strength Ghana Integrated Logistics
To get the exact description of
DESCRIPTION and individual unit of the Management Information System
the commodity
commodity. (GhiLMIS)
To determine the actual quantity
CLOSING STOCK FOR Quantity of items left in stock for of a particular commodity
Bin Card/Ledger
LAST MONTH the previous month available at the end of a given
month
Expiries, damaged, destroyed
To determine the quantity of
commodities of commodities Bin Card/Ledger Report in
LOSSES/ADJUSTMENTS commodities either expired,
issued out to other facilities due GhiLMIS
damaged or destroyed
to near expiry
Quantity of Commodity Received To determine the quantity of
Bin Card/Ledger Report in
QUANTITY RECEIVED from collection point i.e.( RMS, commodities received from your
GhiLMIS
DHD) into the Stock collection point
To determine the quantity given
Quantity of Commodities Issued Bin Card/Ledger Report in
QUANTITY ISSUED or issued out of stock (e.g.. to the
out of the Stock GhiLMIS
pharmacy, DOT, Clinic)
To determine the quantity
Quantity of Commodities
consumed out of stock dispensed
QUANTITY CONSUMED consumed out of the Stock issued Consumption Report in GhiLMIS
(e.g.. to the Patient, user
at a given time
department)
The usable quantity/amount of
USABLE STOCK AT Bin Card/Ledger Report in To determine the balance of
commodity on hand at a given
HAND GhiLMIS commodity in stock
time.

23
VARIABLE DIFINITION SOURCE (PRIMARY) PURPOSE

Write how many months quantity Bin Card/Ledger Report in To determine the period the
MONTH OF STOCK
of a commodity is available GhiLMIS commodities available can last.

NUMBER OF DAYS Write how many days product Bin Card/Ledger Report in To determine the period the
STOCK OUT was not available GhiLMIS commodities were not available.

Ghana Integrated Logistics

Unit Price multiplied by the To determine the actual value of
TOTAL SALES Management Information System
Quantity Issued sales at the end of a given month
(GhiLMIS)
The average stock level of the
facility for a month ( Divide the
total dispensed or issued for the
past six (6) months by six (6) and
write the figure. if the number
of months of data on the Bin card
is five (5) months, divide the total
of the five months consumption To determine how much of stock
AVERAGE MONTLY
by five (5), again if you have Bin Card/Ledger have been consumed/issued
CONSUMPTION/ISSUE
three (3) months of data on the within a given period
tally card you divide the total by
three (3). Example, total
consumption for 6months :
3000/6 =500 If you have a
decimal, round up to the nearest
number. Example: 139/6 = 23.16
write 24 in the column

HUMAN RESOURCE FOR DEVELOPMENT DIVISION (HRDD) DATA DICTIONARY

24
HUMAN RESOURCE INDICATORS
No. Variable Definition Primary source
1 Category
These are employees who are payed through the Controller and Accountant General’s Payroll data or Data from
Mechanised - male or
2 Department (CAGD). In other words, employees whose monthly salary and SSNIT the Facility Nominal
female
contributions are payed by the Government of Ghana and at post working. Roll/HRIMS
3 Total mechanised Total mechanised male and female
These are employees whose monthly salary and SSNIT contributions are not paid by
the Controller and Accountant General’s Department (CAGD). They comprise of two
categories namely;
Non-Mechanised - IGF Nominal Roll of the
4 1. Casual Staff: - These are employees that are engaged by the various health facilities
& Projects (B) facility or HRIMS
on contract basis and are paid with the Internally Generated Funds of the facility.
2. Project Staff: - This comprise of employees who are engaged on contract basis by
donor organizations (e.g. GAVI, DFID, Global Fund, UNICEF, etc.).
5 Total non-mechanised Total of all IGF (casual) and Project/contract staff
These are employees who are granted approval to pursue further studies for an
approved period of time and are required to return to post after the completion of
course. It can be grouped into two main types namely;
1. Study Leave with Pay: - Employees are paid their monthly salaries even though they
are not physically at post to provide service delivery. However, they are required to Facility nominal roll or
6 Study leave ( C )
serve for some number of years after completion of course. HRIMS
2. Study Leave without Pay: - The monthly salaries of these employees are temporarily
blocked for the time he/she will be away and reactivated when the officer completes
the course and assume duty. This is applied when officer does not meet the
requirements for study leave with pay
Total Number on study
7 leave Total Number of staff on study leave with or without pay
(D)
Total No of staff needed This is number of the various categories of staff that are needed to be at post at the
8 Staffing Norms/HRIMS
(E) various health facilities in order to achieve optimum service delivery at the facility.
25
No. Variable Definition Primary source
These staffing needs of a facility are determined by the staffing norm.
Facility nominal roll or
9 Total number at post (F) Number of the various categories of staff currently at post
HRIMS
Total Gap (G)= (F-E) This is the difference between the number of various categories of staff
needed/required as per the staffing norms and the number currently at post. This
10 difference can either be excess, optimum or shortage.
1. Shortage: - The number of staff currently at post is less than the required number as
per the staffing norm, hence recruitment or redistribution from other facilities that have
excess is required to fill the existing gap.
2. Optimum: - The number of staff currently at post is tallies with the required number
as per the staffing norm.
3. Excess: - The number of staff currently at post is more than the required number as
per the staffing norm, hence redistribution to other facilities that have shortage is
required in order to attain optimum service delivery.

26
ACCESS TO HEALTH SERVICES INDICATORS

NUMBER OF COMMUNITY RESIDENT NURSE PER DISTRICT

Definition of the indicator: This shows the trend in the deployment of community health officer
(CHO) under the CHPS programme. Over the years, the indicator has been presented to show
communities which have completed all the stages of the programme which include the completion of
residential units or CHPS compounds and the provision of other essential equipment and amenities.

A functional CHPS compound represents communities where the compound is completed and the
community health officer is at post. The definition is currently being considered for modification to
indicate the provision of service rather than the completion of structures. For now, it will be taken as
communities where the community health nurses have started working with the communities in the
area of community mobilization, provision of essential primary health services.

Definition of key terms: Total number of communities with resident trained nurse

Data sources: CHPS monitoring data at the district level

Use: The indicator assess the extent of the deployment of the CHPS programme to communities and by
extension a measure of access to health care services to communities.

NUMBER OF OUTREACH SERVICES CARRIED OUT BY SPECIALIST FROM

TERTIARY, SECONDARY AND DISTRICT HOSPITAL
Definition of the indicator: Number of clinics held by specialists from outside the Region or District
during the year.
Definition of key terms: Specialist outreach services are organized by the national level and they
involve the use of specialists mainly from the teaching (tertiary) facilities. However, region may also
organize specialists from the regional hospital or district hospitals and may request the use of
specialists from other areas including the private sector. A specialist service provided by a specialist(s)
in a facility that is also his or her normal place of work is not counted as an outreach service. Specialist
outreach services may include any of the recognized specialties such as Obstetrics and Gynaecology;
Surgery; Ophthalmology; Ear Nose and Throat; Dermatology; etc. Clinics may include outpatient
services and other operations carried out by the specialist.
Data sources: Routine registers kept by the specialist outreach services coordinator at the national
level. Registers kept by the regional and district health administrations and individual facilities where
services were provided.
Information on specialist outreach services may be presented as Total number of clinics, Total number
of clinics by specialty, Number of clients seen at outpatient, Number of operations undertaken.

Use: The indicator is a measure of access to specialized health care services at the local level.

POPULATION TO DOCTOR AND NURSE RATIO BY REGION

Definition of the indicator: Number of people to one doctor/nurse in a defined geographical area.
Definition of key terms:
1. Numerator: Total number of doctors/nurses in the region.
2. Denominator: Total population of the region

Data sources: Number of doctors/nurses may be obtained from the personnel unit of the regional
health administration. At the district level the district health administration will compile list of all
Doctors and Nurses including those in the private sector. Population figures for regions and districts
may be obtained from the Ghana Statistical Services. This has been compiled and will be found in the
annex. It is based on the 2000 population census and the district projections are based on the regional
growth rates.

Use: The indicator measures the availability of health staff at various levels and also the equity in staff
distribution patterns.

OUTPATIENT VISIT PER CAPITA BY REGION

Definition of the indicator: Number of outpatient (OPD) visits in a region per person per year.
Definition of key terms:
1. Numerator: Total number of outpatient visits in the year
2. Denominator: Total population of the region
Data sources: The data obtained from the outpatient attendance recorded per facility and summed for
all the facilities in the region per year.
1
Use: The indicator measures the use of outpatient services. In a population with a low OPD per capita
but with a high morbidity of acute and preventable diseases, the indicator is a prompt to health staff to
adopt strategies to make health services more accessible and available to the population.

DISTRICT HOSPITAL ADMISSION RATE

2
Definition of the indicator: The hospital admission rate is the average number of hospital admissions
per 1000 population per year.
Definition of key terms:
1. Numerator: Total number of district hospital admissions in the year

2. Denominator: Total population of the district.

Data sources: In-patient register summed for all the hospitals in a district (if there is more than one
hospital in the district) per year.
Use: This is an indicator of the use of inpatient services reflecting the level of accessibility of hospital
services to the population. It indicates the level of utilization of hospital services despite the traditional
barriers such as distance, user charges and quality of care.

3
INDICATORS ON MEASURES OF EFFICIENCY AND SERVICE QUALITY

BED OCCUPANCY RATE (BOR)

Definition of the indicator: Bed Occupancy Rate measures the percentage of beds occupied by clients
in a given period.
Definition of key terms:
1. Numerator: Number of client-days.

2. Denominator: Number of beds multiplied by number of days in the period.

Data sources: The number of client-days is obtained from the Monthly Bed State Returns compiled at
each hospital.
Use: This is an indicator of the efficiency of hospital resource use. In general, health facilities are
designed to operate most efficiently at a level of about 80-90 percent occupancy; lower bed occupancy
rates indicate inefficient use of hospital resources. Conversely, high occupancy rate may reflect an
efficient use of hospital resources and poor quality of care when it is related to inappropriate pattern of
admissions and length of stay that is too long.

AVERAGE LENGTH OF STAY (ALOS)

Definition of the indicator: The average length of stay is a measure of the average duration of
inpatient hospital admissions (mean number of days from admission to discharge).
Definition of key terms:
1. Numerator: Number of client-days.

2. Denominator: Number of inpatients.

Data sources: Monthly Bed State Returns compiled at each hospital. The number of inpatients
obtained from the inpatient register.
Use: This is another indicator of the efficiency of hospital resource utilization. Short average length of
stay generally indicate good efficiency, enabling turnover rates to increase, and allowing the extension
of hospital services to a greater number of clients. An excessively long average length of stay for a
given condition may reflect inefficient hospital resource use, inflating demand for hospital beds and
increasing hospital costs.

4
BED TURNOVER RATE (BTR)
Definition of the indicator: Bed Turnover Rate is the average number of inpatients admitted per each
hospital bed.
Definition of key terms:
1. Numerator: Number of clients admitted.

2. Denominator: Number of hospital beds.

Data sources: The number of inpatients is obtained from the inpatient register. The number of beds is
obtained from the ward state returns.
Use: Bed Turnover rate (BTR) is an indicator of the efficiency of hospital resource use. High bed
turnover rate implies that a greater number of clients may be admitted, improving hospital productivity
and decreasing average cost per admission. Alternatively, excessively low bed turnover rate reflects
inefficiency in the use of hospital resources leading to high average costs per admission.

PERCENTAGE TRACER DRUG AVAILABILITY

Definition of the indicator: A snap shot assessment of the availability of essential drugs. A list of
tracer drugs is provided and at a given time the proportion of those that are available on the shelves is
taken.
Definition of key terms:
1. Numerator: Proportion of tracer drugs available at the time of survey.

2. Denominator: Total number of tracer drugs on the list.

Data sources: Pharmacy stores records.

Use: This indicator is used to assess the quality of care of the services provided. If the tracer drug
availability is 100 percent it indicates that all essential drugs required to provide treatment for clients
are made available at all times. A low value indicates that the facility is not stocking all essential drugs
required to provide treatment to clients and this may impact on the quality of care provided and client
outcomes.

ADA DECLARATION ON DHIMS2 DATA LOCK

5
Introduction
The third edition of the GHS Health Management Information System (HMIS) Standard Operating
Procedures (SOPs) indicates that facility heads should set up the facility data validation teams and
verify the data monthly before transmission. The teams are to check for the accuracy and completeness
of data. The chairperson of the validation team is also required to sign off the validated reports. In
situations where errors occur, all errors detected after the submission of the reports can be changed
upon submission of a completed data change request form to the DDHS for approval before data is
changed. All entry fields are locked 90days after it has been entered after which they cannot be altered.

There has been a series of request from Divisions, Programmes, Service Providers and Donor Partners
for the national level to consider locking the DHIMS2 data 60days instead of the 90 days after data
entry to align the locking date with the date of authorization of data use. This is thought to be essential
to permit early usability of data. This proposal was tabled for discussion at the fourth Health
Information Management System (HIMS) SOP Review workshop held at the Aqua Safari, Ada from
15th to 18th September 2020.

Participants of the HIMS SOP Review workshop, including the Deputy Director General of the GHS,
the Director of PPMED, representatives from GHS Divisions and Programmes as well as some donor
partners including USAID-funded Accelerator project, PATH and UNAIDS, exhaustively discussed the
data verification, validation and the locking of data in DHIMS 2. Outlined below is a summary of the
discussions.

Discussions
 The Service is committed to continuously update the HMIS SOPs towards achieving the
requisite standards for improved data management practices at all levels. This fourth edition of
the GHS HIMS SOP reflects the current changes and realities of the Service in the capturing,
collation and analysis of data in the Service.
 With regards to the reduction of the allowed window period for data change from the current 90
days, three options were proposed: Reduction to 60 days, 40 days or 25 days.
 After an exhaustive brainstorming, the meeting unanimously agreed that a 60-day window
period prior to restriction of data change was the best, to begin with. The 40-days or 25-day
window were perceived to be too drastic to allow for adequate sensitization at the Regional and
District level.
 Additionally, the current service infrastructure cannot support the 40 days or 25 days window as
there are still hard-to-reach facilities who still submit their reports to the districts for entries.

6
  With the current 90-day window, the Service has witnessed over 90% success, hence, achieving
the same or greater level of success with the 60-day window period will require maximum
commitment at all levels
 A reduction to a 40-day or 25-day window period could be tabled for discussion in the next
HMIS SOP review meeting.
 Locking the data at 60 days:
o Should not go against the guiding principles for data verification and validation as
stipulated in the SOPs.
o Should not affect the district data validations
o Should not affect the monthly regional feedback process
o Should not affect the quarterly data validations at the national level.

 As stipulated in the SOPs the 60 days starts from the 1st day of the ensuing month
 There is a need for full commitment from all levels of the Service and stakeholders.
 There should be full compliance at all levels to maintain the integrity of data
 There is no luxury of time hence, all quality checks should be done at the stipulated time
 Managers should look at the data more frequently
 All the data should be collated and be visible to national level managers on the 25 th of the
ensuing month
 The data change request forms can only be used within the 60 days period

Conclusion and Proposal for Approval

THE SYSTEM SHOULD BE LOCKED AT 60 DAYS AFTER WHICH DATA CANNOT BE
ALTERED.

Find attached the approved memo for the 60-day DHIMS2 data lock

7
8
GUIDELINES AND FEES FOR THE RELEASE HEALTH SERVICE DATA
INTRODUCTION
The Ghana Health Service (GHS) is the largest autonomous national executive body responsible for
implementing all national health policies in Ghana. It was established in 1996 through Parliamentary
Act 525 and works in liaison with the Ministry of Health (MOH). Together, GHS and MOH are
committed to bringing quality health care and services to every doorstep and household, and to
achieving optimum quality of life in every community in Ghana.
GHS due to its unique position and presence in all 216 districts, is authorized by MOH to collect,
collate and report on all routine health services including health service data from Mission, Private and
Quasi-government health facilities everywhere in the country.
GHS operates a decentralized system at five levels: National, Regional, District, sub- District and
Community. GHS provides preventive, promotive and curative/restorative services as well as
rehabilitative and occupational therapy through its various service delivery points across the country,
reaching down to the community level.
All service delivery points generate essential data on health service utilization, morbidity and disease
patterns. Such data are very useful to health managers at all levels for planning, budgeting and
decision-making. Routine service data also feed into the Health Sectors’ monitoring and evaluation
system for analysis and dissemination of results. Thus, helping to reflect and judge performance, and
highlighting weak areas for strengthening intervention programmes.

OVERVIEW OF GUIDE LINES

Data collected by the GHS for the Ministry of Health Ghana, represent a valuable source of
information, and requests for data from qualified requesters will be given serious consideration.
GHS data are the property of the GHS and the Ministry of Health, and are derived and worked on
through considerable time and expense. As such, requests for data will be evaluated with careful
consideration, and the GHS reserves the right to deny any request that it deems an inappropriate use of
its data.
GHS/MOH data may be used only for the purposes requested and specified.
In addition, in recognition of the intrinsic value of the data as well as the costs incurred by GHS/MOH
collecting and processing data, the GHS charges a fee for the use of the data.

9
REQUESTING FOR DHIMS2 DATA

a) The person seeking health aggregated data from a health facility, sub district, district, regional
or at the national level begins by expressing his request, in writing, to the director of health
services of the BMC the data is being requested from for approval copied to the head of the
BMC.

b) If the request is for district, municipal or metropolitan aggregated level data then the then the
approval will be given by the Regional Director of Health Service.
c) If the request if for national level data, then the approval will be given by the Director General
of the GHS and the respective programme and divisional head will be mandated to provide
such information as requested.
d) The request shall be in a form of a letter
e) The letter (hardcopy or scanned softcopy) should include:
I. The person/ institution requesting the data
II. The reason why the data is being requested (e.g. research purpose, production of report,
monitoring, etc)
III. A Standardized GHS data request form will have to be completed attached to request
letter for review and approval by Head of BMCs .
f) Data variables required and the period of coverage for the data, indicating:
I. Specific area like maternal deaths, number of live births, number of DPT3
II. Disaggregation by year and or month (Jan, Feb, March, etc),
III. By sex and geographical coverage (can be the entire country or it may be for list
of districts).

g) This applies to only health facility aggregated data at all levels.

Individual Client Data is Confidential.

10
FEES FOR DATA REQUEST FOR PAID AND SPONSORED RESEARCH WORK.
No Type of data Fees
1 Facility level aggregated data between 5-20 indicators over a period of 1000 GHC
3months -3 years
2 Facility level aggregated data between 20 -50 indicators over a period of 3 2000 GHC
months – 3years
3 Facility level aggregated data indicators for periods more than 3 years and 3000 GHC
over
4 District, municipal and metropolitan level aggregated data between 5-20 2000 GHC
indicators over a period of 3months -3 years
6 District, municipal and metropolitan aggregated data between 20 -50 3000 GHC
indicators over a period of 3 months – 3years
7 District, municipal and metropolitan aggregated data indicators for periods 4000 GHC
more than 3 years and over
8 Regional level aggregated data between 5-20 indicators over a period of 3000 GHC
3months -3 years
9 Regional level aggregated data between 20 -50 indicators over a period of 3 4000 GHC
months – 3years
10 Regional level aggregated data indicators for periods more than 3 years and 5000 GHC
over
11 National level aggregated data between 5-20 indicators over a period of 3000 GHC
3months -3 years
12 National level aggregated data between 20 -50 indicators over a period of 3 4000 GHC
months – 3years
13 National level aggregated data indicators for periods more than 3 years and 5000 GHC
over
Rates Applies To Data Request From Individual, Organisations And Institutional Funded And
Sponsored Projects And Research Work

ALL PAYMENTS WILL BE RECEIVED BY THE ACCOUNTS DEPARTMENTS OF

RESPECTIVE BMC FOR DHIMS2 SUPPORT DEDICATED ACCOUNTS

11
12