Kab : Hulu Sungai Tengah Lampiran :

Bulan : Maret Tahun : 2023

Form 5 (KB)

JUMLAH
JUMLAH PUS
JUMLAH PUS WANITA
JUMLAH PUS PROYEKS YANG
NO. PUSKESMAS JUMLAH JUMLAH JUMLAH DILAKUKA
PENDUDU AWAL I 17 % * KB AKTIF KB PASCA SALIN KB PASCA KEGUGURAN
BULIN PUS 4 T PUS ALKI N
K TAHUN JLH
RIIL PENDUDU SKRINING
LAYAK
K HAMIL
BLN LALU MARET DO ABS % BLN LALU MARET ABS % BLN LALU

1 Anduhum 22 1,463 293 249 142 111 1 0 4 0 283 113.79 0 4 4 18.18 0

2 Birayang 1 1,352 196 230 83 13 1 0 0 0 161 70.05 0 0 1 100.00 0
3 Birayang Surapati 13 831 144 141 79 12 - 0 0 1 131 92.73 0 0 2 15.38 0
4 Birayang Timur 12 775 124 132 61 27 - 0 0 1 125 94.88 0 0 1 8.33 0
5 Cukan Lipai 24 1,534 293 261 70 76 - 1 2 0 221 84.75 1 2 2 8.33 0
6 Labuhan 14 936 133 159 68 66 - 0 0 0 116 72.90 0 0 0 - 0
7 Limbar 12 870 128 148 72 7 - 1 1 0 109 73.70 1 1 3 25.00 0
8 Lok Besar 1 1,059 175 180 53 12 - 2 2 0 120 66.67 2 2 5 500.00 0
9 Mahela 11 744 116 387 56 32 - 3 0 0 109 28.17 3 0 4 36.36 0
10 Rangas 20 1,337 203 227 78 6 - 1 1 0 164 72.15 1 1 2 10.00 0
11 Wawai 19 1,323 185 235 109 17 2 0 0 1 159 67.66 0 0 1 5.26 0
12 Wawai Gardu 26 1,346 232 229 94 30 - 2 0 1 201 87.77 2 0 6 23.08 0
JUMLAH 195 1,337 2,222 2,578 965 409 4 10 10 4 1,899 73.67 10 10 31 15.90 0
KB PASCA KEGUGURAN PUS 4 T BER KB PUS ALKI BER KB KOMPLIKASI EFEK SAMPING KEGAGALAN

MARET ABS % BLN LALU MARET ABS % BLN LALU MARET ABS % BLN LALU MAR ABS % BLN LALU MAR ABS % BLN LALU

0 0 0 0 253 178.17 - - 111.00 100.00 0 0 0 - 0 0 0 - 0

0 0 0 0 96 115.66 - - 13.00 100.00 0 0 0 - 0 0 0 - 0
0 0 0 0 91 115.19 - - 12.00 100.00 0 0 0 - 0 0 0 - 0
0 0 0 0 88 144.26 - - 27.00 100.00 0 0 0 - 0 0 0 - 0
0 0 0 0 145 207.14 - - 76.00 100.00 0 0 0 - 0 0 0 - 0
0 0 0 0 51 75.00 - - 66.00 100.00 0 0 0 - 0 0 0 - 0
0 0 0 0 78 108.33 - - 7.00 100.00 0 0 0 - 0 0 0 - 0
0 0 0 0 63 118.87 - - 7.00 58.33 0 0 0 - 0 0 0 - 0
0 0 0 0 80 142.86 4 - 36.00 112.50 0 0 0 - 0 0 0 - 0
0 0 0 0 83 106.41 - - 6.00 100.00 0 0 0 - 0 0 0 - 0
0 0 0 0 126 115.60 - - 17.00 100.00 0 0 0 - 0 0 0 - 0
0 0 1 0 123 130.85 - - 30.00 100.00 0 0 0 - 0 0 0 - 0
- 0 1 - 1,277 132.33 4 - 408.00 99.76 0 - 0 - 0 - 0 - 0
1,277
KEGAGALAN DROP OUT KB BARU
KONDOM PIL

MAR ABS % BLN LALU MARET ABS % BLN LALU MARET ABS % BLN LALU MAR DO ABS % BLN LALU MARET DO ABS

- 0 - 0 - 0 - 0 4 4 1.61 0 - - 0 - 0 2 - 2
- 0 - 0 - 0 - 1 - 1 0.44 0 - - 0 - 0 - - 0
- 0 - 1 1 3 2 2 - 2 1.42 0 - - 0 - 0 - - 0
- 0 - 0 1 1 1 1 - 1 0.76 0 - - 0 - 1 - - 1
- 0 - 0 - 0 - 1 2 3 1.15 0 - - 0 - 2 1 - 3
- 0 - 0 - 1 1 0 - 0 - 0 - - 0 - 0 - - 0
- 0 - 0 - 0 - 0 1 1 0.68 0 - - 0 - 0 - - 0
- 0 - 0 - 0 - 0 2 2 1.11 0 - - 0 - 1 1 - 2
- 0 - 0 - 0 - 5 - 5 1.29 0 - - 0 - 1 - - 1
- 0 - 0 - 0 - 1 1 2 0.88 0 - - 0 - 1 - - 1
- 0 - 0 1 1 1 0 - 0 - 0 - - 0 - 2 - 1 1
- 0 - 0 1 3 1 6 - 6 2.62 0 - - 0 - 0 - - 0
- 0 - 1 4 9 0 17 10 27 1.05 0 - - 0 - 8 4 1 11
 PELAYANAN KB

Jml Peserta KB Aktif Menurut Metode Kontrasepsi Cara Modern

L SUNTIK AKDR IMPLANT MOW

% BLN LALU MARET DO ABS % BLN LALU MAR DO ABS % BLN LALU MAR DO ABS % BLN LALU MAR DO ABS

0.71 0 2 - 2 0.71 0 - - 0 - 0 - - 0 - 0 - - 0
- 0 - - 1 0.62 0 - - 0 - 0 - - 0 - 0 - - 0
- 0 - - 2 1.53 0 - - 0 - 0 - - 0 - 0 - - 0
0.80 0 - - 0 - 0 - - 0 - 0 - - 0 - 0 - - 0
1.36 0 1 - 1 0.45 0 - - 0 - 0 - - 0 - 0 - - 0
- 1 - - 1 0.86 0 - - 0 - 0 - - 0 - 0 - - 0
- 0 1 - 1 0.92 0 - - 0 - 0 - - 0 - 0 - - 0
1.67 1 1 - 2 1.67 0 - - 0 - 0 - - 0 - 0 - - 0
0.92 3 - - 3 2.75 0 - - 0 - 0 - - 0 - 0 - - 0
0.61 0 - - 0 - 0 - - 0 - 0 1 - 1 0.61 0 - - 0
0.63 1 - - 1 0.63 0 - - 0 - 0 - - 0 0 - - 0
- 6 - 1 5 2.49 0 - - 0 - 0 - - 0 - 0 - - 0
0.58 12 5 1 16 0.84 0 - - 0 - 0 1 - 1 0.05 0 - - 0
 PELAYANAN KB

W MOP MAL KONDOM PIL SUNTIK

% BLN LALU MAR DO ABS % BLN LALU MAR DO ABS % BLN LALU MAR ABS % BLN LALU MAR ABS % BLN LALU

- 0 - - 0 - 0 - - 0 - 0 - 0 - 0 2 2 50.00 0
- 0 - - 0 - 0 - - 0 - 0 - 0 - 0 - 0 - 1
- 0 - - 0 - 0 - - 0 - 0 - 0 - 0 - 0 - 2
- 0 - - 0 - 0 - - 0 - 0 - 0 - 1 - 1 100.00 0
- 0 - - 0 - 0 - - 0 - 0 - 0 - 1 1 2 100.00 1
- 0 - - 0 - 0 - - 0 - 0 - 0 - 0 - 0 - 1
- 0 - - 0 - 0 - - 0 - 0 - 0 - 0 - 0 - 1
- 0 - - 0 - 0 - - 0 - 0 - 0 - 1 1 2 40.00 3
- 0 - - 0 - 0 - - 0 - 0 - 0 - 1 - 1 25.00 0
- 0 - - 0 - 0 - - 0 - 0 - 0 - 1 - 1 50.00 0
- 0 - - 0 - 0 - - 0 - 0 - 0 - 0 - 0 - 1
- 0 - - 0 - 0 - - 0 - 0 - 0 - 0 - 0 - 6
- 0 - - 0 - 0 - - 0 - 0 0 0 - 5 4 9 29.0 16
 Jml Peserta KB Pasca Persalinan Menurut Metode Kontrasepsi Cara Modern

SUNTIK AKDR IMPLANT MOW MOP MAL

MAR ABS % BLN LALU MAR ABS % BLN LALU MARET ABS % BLN LALU MAR ABS % BLN LALU MAR ABS % BLN LALU

2 2 50.00 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 0 0
- 1 100.00 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 0 0
- 2 100.00 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 0 0
- 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 0 0
1 2 100.00 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 0 0
- 1 #DIV/0! 0 - 0 #DIV/0! 0 - 0 - 0 - 0 0 - 0 0 0
1 2 66.67 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 0 0
1 4 80.00 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 0 0
- 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 0 0
- 0 - 0 - 0 - 0 1 1 50.00 0 - 0 - 0 - 0 0 0
- 1 100.00 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 0 0
- 6 100.00 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 0 0
5 21 67.7 0 0 0 - 0 1 1 3.2 0 0 0 - 0 0 0 0 0
 Jml Peserta KB Pasca Abortus Menurut Metode Kontrasepsi Cara Modern

MAL KONDOM PIL SUNTIK AKDR IMPLANT

MAR ABS % BLN LALU MAR ABS % BLN LALU MAR ABS % BLN LALU MAR ABS % BLN LALU MAR ABS % BLN LALU

- 0 0 0 - 0 #DIV/0! 0 - 0 #DIV/0! - - 0 #DIV/0! 0 - 0 #DIV/0! 0

- 0 0 0 - 0 #DIV/0! 0 - 0 #DIV/0! - - 0 #DIV/0! 0 - 0 #DIV/0! 0
- 0 0 0 - 0 #DIV/0! 0 - 0 #DIV/0! - - 0 #DIV/0! 0 - 0 #DIV/0! 0
- 0 0 0 - 0 #DIV/0! 0 - 0 #DIV/0! - - 0 #DIV/0! 0 - 0 #DIV/0! 0
- 0 0 0 - 0 #DIV/0! 0 - 0 #DIV/0! ABS - 0 #DIV/0! 0 - 0 #DIV/0! 0
- 0 0 0 - 0 #DIV/0! 0 - 0 #DIV/0! - - 0 #DIV/0! 0 - 0 #DIV/0! 0
- 0 0 0 - 0 #DIV/0! 0 - 0 #DIV/0! - - 0 #DIV/0! 0 - 0 #DIV/0! 0
- 0 0 0 - 0 #DIV/0! 0 - 0 #DIV/0! - 0 #DIV/0! 0 - 0 #DIV/0! 0
- 0 0 0 - 0 #DIV/0! 0 - 0 #DIV/0! - - 0 #DIV/0! 0 - 0 #DIV/0! 0
- 0 0 0 - 0 #DIV/0! 0 - 0 #DIV/0! - - 0 #DIV/0! 0 - 0 #DIV/0! 0
- 0 0 0 - 0 #DIV/0! 0 - 0 #DIV/0! - 0 #DIV/0! 0 1 1 #DIV/0! 0
- 0 0 0 - 0 #DIV/0! 0 - 0 #DIV/0! - - 0 #DIV/0! 0 - 0 #DIV/0! 0
0 0 0 0 0 0 - 0 0 0 - - - - #DIV/0! 0 1 1 #DIV/0! 0
asepsi Cara Modern

IMPLANT MOW MOP DATA KONTROL

MARET ABS % BLN LALU MAR ABS % BLN LALU MAR ABS %
KB AKTIF KB PS KB PG

- 0 #DIV/0! 0 - 0 #DIV/0! 0 - 0 #DIV/0! 4 4 0

- 0 #DIV/0! 0 - 0 #DIV/0! 0 - 0 #DIV/0! 1 1 0
- 0 #DIV/0! 0 - 0 #DIV/0! 0 - 0 #DIV/0! 2 2 0
- 0 #DIV/0! 0 - 0 #DIV/0! 0 - 0 #DIV/0! 1 1 0
- 0 #DIV/0! 0 - 0 #DIV/0! 0 - 0 #DIV/0! 4 4 0
- 0 #DIV/0! 0 - 0 #DIV/0! 0 - 0 #DIV/0! 1 1 0
- 0 #DIV/0! 0 - 0 #DIV/0! 0 - 0 #DIV/0! 1 2 0
- 0 #DIV/0! 0 - 0 #DIV/0! 0 - 0 #DIV/0! 4 6 0
- 0 #DIV/0! 0 - 0 #DIV/0! 0 - 0 #DIV/0! 4 1 0
- 0 #DIV/0! 0 - 0 #DIV/0! 0 - 0 #DIV/0! 2 2 0
3 3 #DIV/0! 0 - 0 #DIV/0! 0 - 0 #DIV/0! 2 1 4
- 0 #DIV/0! 0 - 0 #DIV/0! 0 - 0 #DIV/0! 5 6 0
3 3 #DIV/0! 0 0 0 #DIV/0! 0 0 0 #DIV/0! 28 31 4
DATA SUBDIT USIA KESEHATAN REPRODUKSI
Kabupaten : Hulu Sungai Tengah
Tahun : 2023
BLN
Pelayanan Keluarga Berencana Peserta KB Aktif Jumlah Peserta KB Pasca Salin
NO DESA PUS 4T Komplikas Efek Kegagalan Drop Out Kondom Jml Jml KB
PIL Suntik AKDR Implan MOW MOP Kondom PIL Suntik AKDR Implan MOW MOP
ber KB i Samping Peserta Pasca

ANDUHUM
1 142 0 0 0 0 0 2 2 0 0 0 0 253 0 2 2 0 0 0 0 4

BIRAYANG
2 83 0 0 0 0 0 - - 0 0 0 0 96 0 0 0 0 0 0 0 0

BIRAYANG SURAPATI
3 79 0 0 0 1 0 - - 0 0 0 0 91 0 0 0 0 0 0 0 0

BIRAYANG TIMUR
4 61 0 0 0 1 0 - - 0 0 0 0 88 0 0 0 0 0 0 0 0

CUKAN LIPAI
5 70 0 0 0 0 0 1 1 0 0 0 0 146 0 1 1 0 0 0 0 2

LABUHAN
6 68 0 0 0 0 0 - - 0 0 0 0 68 0 0 0 0 0 0 0 0

LIMBAR
7 72 0 0 0 0 0 - 1 0 0 0 0 79 0 0 1 0 0 0 0 1

LOK BESAR
8 53 0 0 0 0 0 1 1 0 0 0 0 65 0 1 1 0 0 0 0 2

MAHELA
9 56 0 0 0 0 0 - - 0 0 0 0 91 0 0 0 0 0 0 0 0

RANGAS
10 78 0 0 0 0 0 - - 0 1 0 0 85 0 0 0 0 1 0 0 1

WAWAI
11 109 0 0 0 1 0 - - 0 0 0 0 126 0 0 0 0 0 0 0 0

WAWAI GARDU
12 94 0 0 0 1 0 - - 0 0 0 0 124 0 0 0 0 0 0 0 0

TOTAL 965 0 0 0 4 0 4 5 0 0 0 0 1,312 0 0 0 0 0 0 0 10

Birayang, Maret 2023

Pengelola KB

Seri Yuliani, Am.Keb

NIP.19780225 200604 2 023