INDIVIDUAL PERFORMANCE COMMITMENT REVIEW (IPCR)

HUMAN RESOURCES FOR HEALTH DEPLOYMENT PROGRAM (HRH-DP) 2018

I, ALIBASHER DEREPOSUN MACALNAS (NAME), Nurse Deployment Program (POSITION), DITSAAN RAMAIN (AREA OF ASSIGNMENT), commit to deliver and agree to be rated
on the attainment of the herein MFOs in accordance with their corresponding success indicators for the 1st semester (January - June) of 2018.

ALIBASHER D. MACALNAS, RN, RM, MAN

Name and Signature of Ratee
7/8/2018
Date
Reviewed by: Approved by:
DR. NORMALLAH M. DIMALOTANG-ALONTO, CFP 7/8/2018
Name and Signature of Immediate Supervisor Date Provincial Health Officer II / City Health Officer II Date

Accomplishment Rating

No. of Target
Major Final Output (MFO) Health Remarks
Indicators/ Actual Percent Q E T Ave
Reports

1. No. of household health education conducted. 360 331 91.90% 4 5 4 4.5

2. % of under 5 children with Diarrhea referred to health facilities. 100% 0 100% 4 4 4 4 DIARRHEA CASES ARE OUTSIDE THE TARGET
AGE

3. % of 12-59 months old moderately acute malnutrition (MAM) referred to health facility. 100% 1 100% 5 5 5 5

4. % of 12-59 months old severe acute malnutrition (SAM) referred to health facility. 100% 1 100% 5 5 5 5

5. % of eligible (6- 59 months old) children given Vitamin A capsule per household visited. 100% 234 88.64% 4 4 4 4 DUE TO LIMITED NUMBER OF VITAMIN A
SUPPLY

6. % of EPI defaulter (12- 24 months old) per antigen followed-up and referred to health facility for
immunization. 100% 3 100% 5 5 4 5 3 DEFAULTERS ARE DUE TO UNAVAILABILITY
OF PENTA VACCINE

a. Penta 100% 50 100% 5 5 4 5

b. OPV 100% 47 100% 5 5 5 5

c. PCV 100% 47 100% 5 5 5 5

d. MMR 100% 27 100% 5 5 5 5 MR SIA ACCOMPLISHMENT ( ) WERE NOT

INCLUDED IN THIS REPORT

7. % of under 5 children with Respiratory Tract problems referred to health facilities. 100% 5 100% 5 5 5 5

8. % of patients with more than 2 weeks of cough referred for sputum exam. 100% 3 100% 4 5 4 4.5 ALL 3 PATIENTS WITH MORE THAN 2 WEEKS
COUGH WERE COLLECTED WITH SPUTUM

9. % of TB patient lost to follow up and referred to health facilities. 100% 0 0% 5 NTBR 5 5 NO TB PATIENT LOST TO FOLLOW-UP CASES

10. No. of women of reproductive age screened for VIA / Pap Smear in a health facility. 6 0 0% 4 NTBR 4 4 NO VIA/ PAP SMEAR IN THE COMMUNITY

11. % of hypertensive clients age 25 yrs and above in a barangay screened. 3% 51 2.34% 4 5 5 4.6

12. % of diabetic clients age 25 yrs and above in a barangay screened. 1% 17 0.78% 4 5 5 4.6

13. No. of smoker counselled 1 2 200% 5 5 5 5

Accomplishment Rating
Support to Operation (STO) Remarks
Target Actual Percent Q E T Ave

1. % of Maternal Deaths reported. 0 0 0% 5 5 5 5 NO MATERNAL DEATH IN THE COMMUNITY

2. % of Neonatal Deaths reported. 0 0 0% 5 5 5 5 NO NEONATAL DEATH IN THE COMMUNITY

3. % of Infant Deaths reported. 0 0 0% 5 5 5 5 NO INFANT DEATH IN THE COMMUNITY

3. % of Under 5 years old Deaths reported. 0 0 0% 5 5 5 5 NO UNDER 5 YEARS OLD DEATH IN THE
COMMUNITY

Success Indicator Elementary Accomplishment Rating

General Administrative Support Services (GASS) Remarks
(Target + Measure) Period Target Actual Percent Q E T Ave

1. Submitted Daily Time Record (DTR) 6 6 100% NTBR NTBR 5 5

2. Submitted Accomplishment Report 6 6 100% NTBR NTBR 5 5

Final Average Rating: 4.8

Comments and Recommendation for Development purposes:

Discussed with: Assessed by: Final Rating

Signature of Rate Date Immediatce Supervisor Date Secretary of Health - ARMM / Authorized Representative Date
Legend: 1- Quality, 2-Efficiency, 3-Timeliness, 4-Average