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eline( Year )Indicator 4.Ithohegrated Hea/System (ity-wideSaTo be determinedTo be determinedbevetermineinedTo be determinedTo be determinedTo be determinedTo be determinedIndicator 5.Functional LocalHealth BoardIndicator 6.Organized P/CHO(filled plantillapositions)LGU TARGETMuni, ’HUC ’cc20,000 PopulationRHU/HC in the LGU.Municipal Health Center/City Health Center/RuralHealth Unit — types of primary care facilities thatprovide population-based and individual-basedprimary care health services that are accessible atthe time of need, continuous, comprehensive andcoordinated for all presenting conditions. It servesas the initial point of contact of the community to ahealth facility through its ability to navigate andcoordinate referrals to other health care providersand facilities within the health care providernetwork, when necessary. (Source: HFDB)Denominator: 2020!Projected PopulationLGUoftheiProvinceTOTo be.determined.Willnot be collected in ! he 2020LGU HSC implementationTobeTo bedeterminedWill not collected in the 2020LGU HSC implementationTo bedetermineddeterminedpending theofficial 2019LGU HSCresult1RHU/HCfor t.determined\beRHUMHCMultiplier: 20,000bedeterminedWill not be collected in the 2020LGU HSC implementationOBJECTIVE 3: IMPLEMENT COMPREHENSIVE DEVELOPMENT PLAN FOR SERVICE DELIVERY NETWORK:Accessible essential health services for all at the right place and timeTo beAtleastNumerator: Number ofRefers to the number of RHU/HC for everyIndicator 7. RuralHealth Unit (RHU)YHealth Center (HC)for every 20,000populationiccOfficialDataSourceLGU HealthOffice/FHSIS forthe numberof RHU/HCallofcomponentmunicipalities and citiesEBete d for2020populationOBJECTIVE 4: LOCALIZE HIGH IMPACT HEALTH POLICY REFORMSPage 2 0f 9

DefinitionIndicatorIndicator 8.Percentage ofnational healthpolicies translatedinto localpolicies/ordinancesLGUsbytheRefers to the number of local healthpolicies/ordinances issued by the LGUs among theof total number of national health policiesidentified by the DOH as needing localexpressed inadaptation,policies/ordinancespercentagerorofM eansla6VerificationNumerator: Number of localhealth policies/ordinancesissued.Baseline(Year)To bedeterminedLGU TARGETMuni,ccHUC,ICCProvinceJWill not be collected in the 2020LGU HSC implementationOfficialDataSourceSB Office/OfficeLCEof.Denominator: Total numberof national health policiesidentified by the DOH asneeding localpolicies/ordinanceMultiplier: 100OBJECTIVE 5: IMPROVE PERFORMANCE OF THE LGUsIndicator 9.Percentage of LGUhealth budget utilizedRefers to the proportion of budget allocated forhealth that was actually utilized for health,expressed in percentage9.1. Obligation Rate refers to the proportion of thebudget that was earmarked/committed out of thetotal budget allocated for health, expressed inpercentageNumerator: Total healthbudget Denominator: Total LGUbudget allocated for healthMultiplier: 1009.2. Disbursement Rate refers to the proportion ofbudget that was spent out of the total budgetallocated for health, expressed in percentageNumerator: Tota] healthbudget disbursedTo bedeterminedTo be determinedBudget/AccountingOfficeDenominator: Total LGUbudget obligated for healthMultiplier: 100Indicator 10, Health Service Coverage target metPage 3 of 9

DefinitionIndicator10.1. ModemContraceptivePrevalence Rate(mCPR)to the proportion of women of reproductiveage (15-49 years old) who are using or whosepartner is using any modern FP method at a givenReferspoint in time.Modern FP methods include the following:Bilateral Tubal Ligation or Female Sterilization2. Male Sterilization/ No Scalpel Vasectomy3. Intrauterine Devices (IUD)3.1 [UD-interval3:2 [UD-post partum4. Oral Contraceptive Pills4.1 Progestin-Only Pill (POP)4.2 Combined Oral Contraceptive (COC)5. Injectables6. Implants7. NFP Methods7.1 Cervical Mucus Method (CMM)7.2 Basal Body Temperature (BBT)7.3 Symptothermal Method (STM)7.4Standard Days Method (SDM)7.5Lactational Amenorrhea Method (LAM)numberbirths to females aged 15-19 years per1.Indicator 10.2.Adolescent BirthRateof1000 females in the same age grouprorv usVerificationM eansiofMuni,24.9%mCPR amongall 9/1,00069.9%(NDHS,2017)95%95%Numerator: No. of womenof reproductive age (WRA)who are using (or whoseusing) a modern FPpartnermethod at a given rceFHSISDenominator: No. of WRAwho are eligible to practicecontraception (TotalPopulatiopulation x 5.854%%)20.Multiplier: 100Numerator: Total number oflivebirths to femalesyears old15 - 19 39/1,000FHSISDenominator: Totalpopulation X LGU multiplier(women 15- 19 years old)Indicator 10.3.Percentage of FullyImmunized ChildRefers to the proportion of infants and childrenwho are fully immunized among the total estimatedinfants and children in the population, expressed inpercentageMultiplier: 1000Numerator: No. of FullyImmunized ChildrenDenominator: Total95%FHSISPopulation x LGU multiplierPage 4 of 9

Indicator 10.4.Percentage of adults20 years old andabove who were riskassessed using thePhilPEN protocolrorM eans ofDefinitionIndicatorFully Immunized Child (FIC) is an infant whoreceived 1 dose of BCG, 3 doses of OPV, 3 dosesof DPT-HiBHepB vaccines, and 2 doses of measlescontaining vaccine by [2 monthsRefers to the number of adults age 20 years old andabove who were risk assessed using the PhilippinePackage of Essential NCD Interventions (PhilPEN)adults 20 yearsprotocol among the total numberold and above in the total population expressed inpercentageof(populationbelow)12ue 6VerificationccMecc13%(Programdata, 2018)15%15%15%LGU TBCaseNotificationRate based on2018 ,CHD TBReport/ITIS90%90% orhigher90% orhigher90% orhigherFHSIS,CHD cline(Year)months andMuni,HLiProvinceEeSourceMultiplier: 100Numerator: Number ofadults (20 years old andabove) who were riskassessed using PhilPENFHSISDenominator: Totalpopulation X LGU multiplier(adults age 20 years old andabove)of notifiedIndicator 10.5. TBNumberCase NotificationRatepopulationTB,allformsfor every 100,000Multiplier: 100Numerator: Total number ofnotified TB cases, all formsDenominator: TotalPopulation of the LGUIndicator 10.6. TBTreatment SuccessRateIndicator 10.7.Percentage ofhouseholds usingsafely managedNumber of all forms of TB that were cured orcompleted treatment out of all those that werestarted on treatment.Refers to the proportion of households usingimproved water sources/services, meeting therequired criteria among the total projected numberof households for the given year expressed inMultiplier: 100,000Numerator: Number of allforms of TB that were curedor completed treatmentDenominator: All registeredTB casesMultiplier: 100Numerator: Number ofhouseholds using safelymanaged drinking-waterservicesPage 50f 9

itiefinitionStunting amongunder 5 childrenBaseline(Year)percentage Criteria for safely-managed drinking-water services:Denominator: Projectedlocated inside the household or within itspremises;2. available at least 12 hours per day; and3. water supplied should be free of fecalcontaminationThe percentage of children under-five categorizedwith height-for-age below minus 2 standarddeviations from the median WHO Child GrowthStandards.number of households for thegiven year1.Indicator 10.8.Prevalence ofioFormula/Means of VerificationLGU TARGETMunicc HUC.OnetalcoProvince.ataSourceMultiplier: 100Numerator: Total number ofstunted children aged 0-59monthsTo bedetermined30.3%30.3%30.3%FHSISTo bedeterminedTo bedeterminedTo bedetermineddeterminedTobeCHD-Denominator: Totalpopulation X LGU multiplier(children aged 0-59 months)Indicator11.Percentage offacilities with nostock out of thefollowingcommodities: (1)Family Planning Pill(COC), (2) DPTHiB-HepB vaccine;(3) Losartan; (4)Metformin; (5)Category [ TB DrugsIndicator12. WithOrganizedEpidemiologyNo stock-out means that the facility has anavailable one (1) month buffer stock of the tracercommodities during the reporting year; ultiplier: 100Numerator: Number ofrecipient public healthfacilities (e.g., RHU, MHC,HC) within the LGU with noreport of stock-outs of any ofthe specified tracercommoditiespp aceuti*count onlyhealthfacilitiesaneofthecal rnmentDenominator: Total numberrecipient public healthfacilities within the sameLGUofRefers to the presence of the six (6) ESUcomponents1. DirectionMultiplier: 100MOV for the ESUcomponentsTo bedeterminedpending thePresence of6/6 ESUPresence of6/6 ESU6/6 e 6 of 9

DefinitionIndicatorSurveillance Unit(ESU)5.ESU Staff ComplementESU Staff CompetencyPlan and BudgetCoordination6.Report2.3.4.Formula / .MeansVerificationofDirection: ExecutiveOrder or Ordinance onestablishment of theEpidemiology andSurveillance UnitESUComplement:a. Team Leader(preferably an MD)b. Disease SurveillanceOfficer (Public HealthNurse)c. Registered Medical.Baseline(Year)official 2019LGU HSCresultLGU ffTechnologistEncoderESU Staff Competency:Basic Epidemiology,Disease Surveillance, andEvent-based SurveillancePlan and Budget:Approved planningdocuments with budgetaryallotment from the localbudget (AIP/AOP/WFP)Coordination: link withProvincial Hospital andother Health Facilitieswithin the locality(MOA/SLA)Report: Disease andEvent Surveillancesubmitted in theprescribed timeline.d.Page 7 of 9

IndicatorIndicator 13. WithinstitutionalizedDisaster1815ascr RiskReduction andManagementinHealth (DRRM-H)SystemFormula/.Means of VerificationDefinitionRefersto the presence the four (4)componentsof an institutionalized DRMM-H System:DRRM-H Plan S shall be unifiedcomprehensive and coherent.2. Health emergency response teams forpublic health and hospitals shall beorganized, trained and self sufficient3. Essential health emergency commoditiesshall be available and accessible4. Functional Health Operations Center1.of:MOVs for the DRMM-HComponents’RXApproved, updated,integrated, disseminatedand tested DRRM-H Plan2. Organized and trainedHealth EmergencyResponse Team (HERT)on minimum requiredtrainings: Basic LifeSupport and StandardFirst Aid3. Available and accessible(24 hrs post impact ofemergency or disaster)essential healthemergency commoditiese.g. medicines such ascotrimoxazole,amoxicillin, mefenamicacid, paracetamol, oresol,lagundi, vitamin A andskin ointment; withequipped, servicingambulance or patienttransport vehicle; witharrangement for fieldimplementation facility4. Health/EmergencyOperations Center withfunctional (1) Commandand Control, (2)1.Baseline(Year)Tobedeterminedpending theofficial 2019LGU HSC resultLGU TARGETiMoaIndicator isnotapplicableat theheProvincePresence of4/4DRMM-HPresence mergencyManagementUnitmunicipal/componentcity levelPage 8 of 9

IndicatorDefinitionFormula/Means of VerificationBaseline(Year)LGU dination, (3) andCommunicationPage 9 of 9

Annex B. LGU Information SheetLGU HEALTH SCORECARDINFORMATION SHEET(Province)(Name of Province)(Region)GENERAL INFORMATIONName of LCE:Years in Position:Health Governance Training: Yes( ) No() If Yes,specifyName of PHO/Designate:Years in Position:Health Governance Training: Yes()No (}If Yes, specifyLGU Income Class:MORTALITY2QCurrent Yearous YearDiseasesDiseasesActual CountActual CountEITCIEISNCIEIRIENTotalMORBIDITY2 Current Yearevious YearCasesActual Count n afwShee]Note: Affix your signature above printed name.Date Validated:CasesActual Count

LeLGU HEALTH SCORECARDINFORMATION SHEET(Highly Urbanized Cities/Independent Component Cities)(Name of HUC/ICC)(Region)GENERAL INFORMATIONName of LCE:Years in Position:Health Governance Training: Yes()No() If Yes,specifyName of CHO/Designate:Health Governance Training: YesYears in Position:()No() If Yes,specifyLGU Income Class:MORTALITY24Current Yearous YearActual CountDiseasesDiseasesActual Countbam W] u a enOoo10TotalMORBIDITYZzCurrent Year)us Year,Actual Count[Wr[Un] I enOoo—oNote: Affix your signature above printed name.Date Validated:CasesActual Count

LGU HEALTH SCORECARDINFORMATION SHEET(Municipalities/Component Cities)(Province)(Region)(Municipality)GENERAL INFORMATIONName of LCE:Years in Position:Health Governance Training: Yes()No() If Yes, specifyName of MHO/Designate:Health Governance Training: YesYears in Position:()No() If Yes,specifyLGU Income Class:MORTALITYZCurrent YearDiseasesDiseasesActualActualo eol afa[n a] wlpf-] @TotalMORBIDITYZ Current YearActual win] ns anSefNote: Affix your signature above printed name.Date Validated:CasesActual

AnnexC.Data Capture FormsRegion:LGUName:Date Accomplished:— —Instructions:Fill-up the form with the required data (e.g., numerator, denominator). Round-off the final valuesinto two decimal points (e.g., xx.xx). In case an indicator is not applicable to the LGU, please putN.A and write a brief explanation in the remarks portion.N Countersign any erasures on the DCF3. For all indicators with accomplishment rate of at least 20% higher than the target, or at least 20%lower than the baseline values, write a corresponding explanation on the remarks sectionincluding the sources of initiative/efforts, whether from DOH or LGU, or both, as applicable. Theinformation shall be used to aid data analysis, and as evidence for national and local planning.4. LGU report will be deemed official ONLY when submitted together with a signed certification page.iThis is to establishaccountability in the submission and review of LGU data reflected in this DCF.1.\LTioIndicator 1. “Percentage ofLGUandthe ‘efficient:and qitable. use-of resotirces’HEALTH FINANCING -budget allocated for health;.-For data collection but LGUs will not be rated pending the result of the Local Health Accounts study *refers to the proportion ofpercentageLGUbudget earmarked ta health, nutritionTotal LGU budget allocated forhealth, nutrition & environmentB. Total LGU budget&environment, expressedA.Expense ClassinNoX100LGUPersonnel Service (PS) Data Total LGU BudgetBudget for HealthAmount (in PhP)Maintenance and OtherOperating Expenses (MOOE)Capital Outlay (CO)TOTAL:Notes:eebudget - refers to a financial plan embodying the estimates of income including IRA and otherlocally-generated sources, and expenditures for Personnel Services, Maintenance & Other OperatingExpense (MOOE), and Capital Outlay for a given fiscal yearLGU income includes Philthealth paymentsLGU

-AnnexoeC.Data Capture FormsInclude the LGU budget allocated for health, nutrition & environment programs, activities, andprojects (PAPs) whose primary purpose is to improve the health status of the population.Refer to the list of PAPs in the Local Health Account (LHA) manual.Remarks (include a short explanation for accomplishments 20% or higher than the target, or 20% orlower than the baseline values, or any implementation issue encountered).Indicator 2. With Municipal/City Investment Plan for Health (MIPH/CIPH) endorsed by the MayorPHO*DMLIPHto the2018-0386 require LGUs, including Municipalities and Component Cities, to develop their respectivebased on rational and realistic planning.YESNOScoring System (external benchmark):Green: Yeseo*NoRed:Remarks (any implementation issue encountered):Indicator 3. Provision of FULL hazard pay, subsistence and laundry allowances to permanent publichealth workers under the Magna Carta for Public Health Workers*Does the LGU provide full hazard pay, subsistence, and laundry allowances to its health workers(Physician, Nurse & Midwife) in accordance with RA 7305 (Magna Carta of Public Health Workers)?YESMagna Carta BenefitsHazard PaySubsistenceLaundry AllowanceNOYESNO

AnnexC.Data Capture FormsNote: An LGU must have provided all the three incentives (hazard pay, subsistence, and laundryallowance) following the provisions of RA 7305 (Magna Carta of Public Health Workers), computedusing the current salary to be able to answer YES. Otherwise, the target is not metScoring System (external benchmark):*Green: Yes»Red:NoRemarks (any implementation issue encountered).Indicator 4. Presence of an Integrated Health SystemNot for data collectionwaiting operational guidelineIndicator 5. Functional Local Health BoardNot far data collection*A*Awaiting operational guideline*Adequate RHU/HC to Population Ratio is defined as having at leastpopulationA.B.RHU/HC for every 20,000NoTotal PopulationTotal number of RHU/HC1 DataNotes:e«Municipal Health Center/City Health Center/Rural Health Unit a health facility which provides basicclinical, preventive, promotive, curative, and rehabilitative services for the municipality/city.Barangay Health Stations shall not be included in the count.Remarks (include a short explanation for accomplishments 20% or higher than the target, or 20% orlower than the baseline values, or any implementation issue encountered):

AnnexC.Data Capture FormsIndicator 7. Percentage of national health policies translated into local policies by the LGUsNot for data collection*A waitingguideline on Integrated HealthPolicyAgendaoy mIndicator 8. Percentage of LGU health budget utilizedo 2a x,mITIndicator 8.a. Obligation Rate*Obligation Rate refers to the proportion of the budget that was earmarked/committed out of the totalbudget allocated for health, expressed in percentage[A.B.Total health budget obligatedTotal health budget allocatedfor healthNote: Report the obligation rate as of DecemberJ]X10031,Benchmark:*2020 National Target: 95%) -NoiData 2020.Scoring System (external benchmark):Green: 95% and aboveeooeYellow: 80 to 95%Red:below 80%Remarks (include a short explanation for accomplishments 20% or higher than the target, or 20% orlower than the b

Scorecard CHD October— December Attached arethefollowingas annexes for dissemination anduseofCHDs and LGUs: Shwe ANNEX A— LGU Health Scorecard Metadata ANNEX B— Information Sheet (Municipality/CC, Province, HUC/ICC) ANNEX C-Data Capture Form (Municipality/CC, Province, HUC/ICC) ANNEX D Data QualityAssessmentTool ANNEX E— Regional .