Individual Performance Commitment Review (Ipcr) : Human Resources For Health Deployment Program (HRH-DP) 2018

INDIVIDUAL PERFORMANCE COMMITMENT REVIEW (IPCR)
HUMAN RESOURCES FOR HEALTH DEPLOYMENT PROGRAM (HRH-DP) 2018
I,AIMAN A. ALI,MEDICAL TECHNOLOGIST Deployment Program/UHCP, in Picong RHU, commit to deliver and agree to be rated on the attainment of the herein MFOs in accordan
their corresponding success indicators for the 1st semester (AUGUST- DECEMBER) of 2019.
AIMAN A. ALI.
Name and Signature of Ratee
8/13/2019
Date
Reviewed by: Approved by:
Name and signatureDR.

of Immediate
AMIRA B. BALINDONG
Supervisor Date Provincial Health Officer II / City Health Officer II
RURAL HEALTH PHYSICIAN
Accomplishment Rating
Major Final Output (MFO) Remarks
Target Actual Percent Q E T Ave
1. No. of meetings attended 10
2. No. of EQA participated 3
3. No. of eqa 6 assessment points with "Goo" results 600%

4. No. of DSSM 150
5. No. of routine
Support to Operation (STO) Remarks
NTBR NTBR NTBR
General Administrative Accomplishment Rating
Success Indicator (Target + Measure) Elementary Remarks
Support Services (GASS) Period Target Actual Percent Q E T Ave
1. Submitted Daily Time Record 6 NTBR NTBR
2. Submitted Accomplishment 6 NTBR NTBR
Final Average Rating:
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
MANCE COMMITMENT REVIEW (IPCR)
ALTH DEPLOYMENT PROGRAM (HRH-DP) 2018
HU, commit to deliver and agree to be rated on the attainment of the herein MFOs in accordance with
of 2019.
AIMAN A. ALI.
Date
Remarks
Remarks
Remarks
Final Rating
Date
I, ______________________________________(NAME), Universal Health Care Implementer (POSITION), _________________________ (AREA OF ASSIGNMENT), commit to deliver a
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.
Date
Name and signature of Immediate Supervisor Date Provincial Health Officer II / City Health Officer II Date
1. No. of activity reports for the health units prepared. 24
2. No. of health data analysis activities conducted. 6
3. No. health monitoring and evaluating activities conducted. 6
4. No. of programmatic and administratvie updates to deployed HRH disseminated. 2
5. No. of monthly accomplishment reports submitted. 6
6. % of proposed research study implemented. 100%
7. No. of Capability building projects / packages for health workers and other stakeholders 1
submitted.
8. No. of sustainability plan with monitoring and evaluation mechanism of the program/s or 1
project/s implemented.
9. No. of programs/projects developed. 6
10. No. of program / projects implemented. 6
12. No. of health related project proposals formulation assisted 1
13. No. of developed and implemented management systems assisted. 6
15. No. formulated and apodted local investment Plan for Health assisted. 1
16. No. of Philhealth reimbursement claims processing assisted. 2
17. No. of HRH monitoring and evaluation assisted. 1
18. No. of established and maintained SDN referaal system assisted. 1

NTBR (not to be rated) NTBR NTBR
General Administrative Support Success Indicator (Target + Elementary Accomplishment Rating

Remarks
Services (GASS) Measure) Period Target Actual Percent Q E T Ave
1. Submitted Daily Time Record (DTR) 6 NTBR NTBR
2. Submitted Accomplishment Report 6 NTBR NTBR

Signature of Rater Date Immediatce Supervisor Date Secretary of Health - ARMM / Authorized Representative Date
), commit to deliver and
ure of Ratee
Date
Remarks
Remarks
Remarks
Date
I, ______________________________________(NAME), Family Health Associates (POSITION), _________________________ (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.
Date
Name and signature of Immediate Supervisor Date Provincial Health Officer II / City Health Officer Date
Major Final Output (MFO) No. Of Remarks

targeted Actual Percent Q E T Ave
indicators
A. Demand Generation for Modern Family Planning (MFP)
A.1 % of WRA (15-19 years old) with unmet needs tracked. 100%
A.1 % of WRA (20-49 years old) with unmet needs tracked. 100%
A.2. Number of WRA actually reached and identified newly acceptors of MFP 60/qtr
B. Service Delivery on Modern Family Planning (MFP)
B.1. % of WRA with unmet needs counselled and voluntarily accepted MFP Actual No.
B.2. Number of New Acceptors of MFP methods provided in Regular Public Health Facilities Actual No.
C. Family Planning Acceptors
C.1. Total Number of New Acceptors for Modern Family Planning 12/qtr
D. ARMM HELPS
D.1. Number of consolidated Forms 1 & 2 report and submitted within the first 9 days of the succeeding 3/qtr
month
D.2. Percent of Household Profile updated 100%/Sem
D.3. Outreach Mission

NTBR NTBR
General Administrative Support Services (GASS) Success Indicator (Target + Measure) Elementary Period Remarks
1. Submitted Daily Time Record (DTR) 6 NTBRNTBR
2. Submitted Accomplishment Report 6 NTBRNTBR

I, ______________________________________(NAME), Dentist Deployment Program (POSITION), _________________________ (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.
Date
No. of
Major Final Output (MFO) Target Remarks
Health Actual Percent Q E T Ave
Indicators/
Reports
1. Basic Oral Health Care (BOHC)
1.1 12- 71 Months Old (Orally Fit Child)
a. No. of Orally Fit Male children 12- 71 months old examined. 45/qtr.
b. No. of Orally Fit Female children 12- 71 months old examined. 45/qtr.
1.2 12-71 months old with BOHC
a. No. of male children 12- 71 months old provided with Basic Oral Health Care (BOHC). 180/qtr.
b. No. of female children 12- 71 months old provided with Basic Oral Health Care (BOHC). 180/qtr.
1.3 Adolescent and Youth (10-24 years old) provided with Basic Oral Health Care (BOHC)
a. No. of Male Adolescent and Youth (10-24 years old) provided with Basic Oral Health Care (BOHC) 500/qtr.
b. No. of Female Adolescent and Youth (10-24 years old) provided with Basic Oral Health Care (BOHC) 500/qtr.
1.4 No. of Pregnant Women provided with Basic Oral Health Care (BOHC) 30/qtr.
1.5. Older Persons (60 years old and above) provided with Basic Oral Health Care (BOHC)
a. No. of Male Older Persons (60 years old and above) provided with Basic Oral Health Care (BOHC) 150/qtr.
b. No. of Female Older Persons (60 years old and above) provided with Basic Oral Health Care (BOHC) 150/qtr.
1.6 Other ages (6-9 years old and 25-59 years old) provided with any Basic Oral Health Care (BOHC) Services
a. No. of Male (6-9 years old) provided with any Basic Oral Health Care (BOHC) Services 500/qtr.
b. No. of Female (6-9 years old)provided with any Basic Oral Health Care (BOHC) Services 500/qtr.
c. No. of Male (25-59 years old) provided with any Basic Oral Health Care (BOHC) Services 500/qtr. NTBR
d. No. of Female (25-59 years old) provided with any Basic Oral Health Care (BOHC) Services 500/qtr.
NTBR NTBR NTBR
General Administrative Support Services (GASS) Success Indicator (Target + Measure) Elementary Period Remarks

I, AIMAN A. ALI,MEDICAL TECHNOLOGIST Deployment Program/UHCP, in Picong RHU, commit to deliver and agree to be rated on the
on the attainment of the herein MFOs in accordance with their corresponding success indicators for (AUGUST-DECEMBER) of 2019.
AIMAN A. ALI

AMIRA B. BALINDONG M.D. Aug- 13-2019
No. of Target
Major Final Output (MFO) Health Remarks
Indicators/ Actual Percent Q E T Ave
Reports
1. No. of meetings attended 10

2. No. of EQA participated 3
3. No. of eqa 6 assessment points with "GooD" results 6
4. No. of DSSM performed 150
5. No. of routine laboratory performed
6. No. of TB related activities conducted 10
7. No. of plan prepared 4
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) 10
2. Submitted Accomplishment Report 10
AIMAN A. ALI AUGUST 13 , 2019 DR. AMIRA B. BALINDONG AUGUST 13, 2019
Signature of Ratee Date Immediatce Supervisor Date Secretary of Health - ARMM / Authorized Representative Date
I, ______________________________________(NAME), Provincial Public Health Associate (POSITION), _________________________ (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.
Date
No. of Target
Major Final Output (MFO) Health Remarks
Actual Percent Q E T Ave
Indicators/Re
ports
Module 2: Data Collection Form at the Provincial Civil Registry
a. No. of quarterly health indicators submitted within the second week of the succeeding 10/qtr. NTBR
quarter.
b. % of under-five death reported within the second week of the succeeding quarter. 100%/qtr. NTBR
c. % of maternal death reported within the second week of the succeeding quarter. 100%/qtr. NTBR
Module 3: Data Collection Form in All Government Hospital
a. No. of quarterly health indicators consolidated and submitted within the second week of 37/qtr. NTBR
the succeeding quarter.
Module 4: Data Collection Form at the Provincial Level
a. No. of quarterly health indicators consolidated and submitted within the second week of the 1/qtr.
succeeding quarter.
Module A: Provincial Consolidation of Health Indicators and reports

a. No. of quarterly health indicators consolidated and submitted within the second week of the 37/qtr.
succeeding quarter.
b. No. of semi-annual health indicators consolidated and submitted within the second week of 37/ sem.
the succeeding semester.
1. Assisted the Municipal Health Officer/Universal Health Care implementers in the installation
of effective monitoring and evaluation systems for UHC programs for health sector 100% NTBR
performance.
2. Assisted in the collection, validation, analysis and evaluation program indicators 100% NTBR
3. Participated in the analysis of health related data/information 100% NTBR

4. Assisted in the encoding /Updating of Data/Information in the established DOH information
systems and submits health reports/data/information to Department Of Health Regional Office 100% NTBR
and Central Office
General Administrative Support Services Success Indicator (Target + Reglementary Accomplishment Rating
Remarks
(GASS) Measure) Period Target Actual Percent Q E T Ave

I, ______________________________________(NAME), Municipal Public Health Associate (POSITION), _________________________ (AREA OF ASSIGNMENT), commit to deliver and
agree to be ratedon the attainment of the herein MFOs in accordance with their corresponding success indicators for the 1st semester (January - June) of 2018.
Date
Name and signature of Immediate Supervisor Date Provincial Health Officer II / City Health Officer I Date
No. of
Major Final Output (MFO) Target Remarks
Health Actual Percent Q E T Ave
Indicators/R
eports
Module 1: Data Collection Form at the RHU/ MHC
a. No. of monthly health indicators submitted within the first week of the succeeding month. 11/ mo. NTBR
b. No. of quarterly health indicators submitted within the first week of the succeeding quarter. 2/ qtr. NTBR
c. No. of semi-annual health indicators submitted within the first week of the succeeding semester. 1/ sem. NTBR
Module 2: Data Collection Form at the Municipal Civil Registry
a. No. of monthly health indicators submitted within the first week of the succeeding month. 10/mo. NTBR
b. % of under-five death reported. 100%/mo. NTBR
c. % of maternal death reported. 100%/mo. NTBR

Module 3: Data Collection Form in All Municipal and District Hospitals
a. No. of monthly health indicators submitted within the first week of the succeeding month. 4/mo. NTBR
1. Assisted the Municipal Health Officer/Universal Health Care implementers in the installation of 100% NTBR
effective monitoring and evaluation systems for UHC programs for health sector performance.
2. Assisted in the collection, validation, analysis and evaluation program indicators 100% NTBR
3. Participated in the analysis of health related data/information 100% NTBR
4. Assisted in the encoding /Updating of Data/Information in the established DOH information systems 100% NTBR
and submits health reports/data/information to Department Of Health Regional Office and Central Office
Reglementary Accomplishment Rating
General Administrative Support Services (GASS) Success Indicator (Target + Measure) Remarks
Period Target Actual Percent Q E T Ave

I, ______________________________________(NAME), Rural Health Midwife Placement Program (POSITION), _________________________ (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.
Date
1. Maternal Health Care

a. No. of household health education conducted. 360
b. % of pregnant women tracked.
- below 15 years old 100%
- 15-19 years old 100%
-20- 49 years old 100%
c. % of pregnant women with four antenatal care examined. 100%
d. % of pregnant women given 2 TT immunization. 100%
e. No. of facility based deliveries handled. 18
f. % of postpartum mothers initiated exclusive breastfeeding. 100%
g. % of mothers with two postpartum follow up visits done. 100% NTBR
h. % of high risk pregnant mothers referred. 100% NTBR
i.% of pregnant women with birth plan. 100%
2. Neonatal Health Care NTBR
a. No. of babies screened/ referred for newborn screening. 18
b. No. of babies given BCG vaccine. 18
b. No. of babies given Hepa- B vaccine. 18
c. % of eligible (6- 59 months old) children given Vitamin A capsule per household visited. 100%
d. % of EPI defaulter (0-11 months old) per antigen followed-up and referred to health
facility for immunization.
- BCG 100%
- Hepa-b 100%
- Penta 100%
- OPV 100%
- PCV 100%
- MMR 100%
f. % of Newborn Screening done or referred. 100%
3. Infant Health Care
a. No. of infant given OPV dose. 54/ sem.
b. No. of infant given Hepa B dose. 54/ sem.
c. No. of infant given Measles dose. 54/ sem.
4. Infant Nutrition
a. No. of 7 months old infant started complementary feeding. 100%
b. Percent of infant with moderately acute malnutrition (MAM) referred to health facility. 100%
c. Percent of infant with severe acute malnutrition (SAM) referred to health facility. 100%
Support to Operation (STO) Target Actual Percent Q E T Ave Remarks
NTBR NTBR NTBR
General Administrative Support Accomplishment Rating
Success Indicator (Target + Measure) Elementary Target Actual Percent Q E T Ave Remarks
Services (GASS) Period

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Individual Performance Commitment Review (Ipcr) : Human Resources For Health Deployment Program (HRH-DP) 2018

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INDIVIDUAL PERFORMANCE COMMITMENT REVIEW (IPCR)

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

Name and signatureDR.

1. No. of meetings attended 10

2. No. of EQA participated 3

3. No. of eqa 6 assessment points with "Goo" results 600%

Name and Signature of Ratee

1. No. of activity reports for the health units prepared. 24

2. No. of health data analysis activities conducted. 6

3. No. health monitoring and evaluating activities conducted. 6

4. No. of programmatic and administratvie updates to deployed HRH disseminated. 2

5. No. of monthly accomplishment reports submitted. 6

6. % of proposed research study implemented. 100%

10. No. of program / projects implemented. 6

12. No. of health related project proposals formulation assisted 1

13. No. of developed and implemented management systems assisted. 6

16. No. of Philhealth reimbursement claims processing assisted. 2

17. No. of HRH monitoring and evaluation assisted. 1

18. No. of established and maintained SDN referaal system assisted. 1

NTBR (not to be rated) NTBR NTBR

General Administrative Support Success Indicator (Target + Elementary Accomplishment Rating

1. Submitted Daily Time Record (DTR) 6 NTBR NTBR

2. Submitted Accomplishment Report 6 NTBR NTBR

Final Average Rating:

Discussed with: Assessed by: Final Rating

Name and Signature of Ratee

Major Final Output (MFO) No. Of Remarks

A. Demand Generation for Modern Family Planning (MFP)

B. Service Delivery on Modern Family Planning (MFP)

C. Family Planning Acceptors

D.2. Percent of Household Profile updated 100%/Sem

D.3. Outreach Mission

1. Submitted Daily Time Record (DTR) 6 NTBRNTBR

2. Submitted Accomplishment Report 6 NTBRNTBR

Final Average Rating:

Discussed with: Assessed by: Final Rating

Name and Signature of Ratee

1. Basic Oral Health Care (BOHC)

1.1 12- 71 Months Old (Orally Fit Child)

1.2 12-71 months old with BOHC

NTBR NTBR NTBR

1. Submitted Daily Time Record (DTR) 6 NTBR NTBR

2. Submitted Accomplishment Report 6 NTBR NTBR

Final Average Rating:

Discussed with: Assessed by: Final Rating

Reviewed by: Approved by:

1. No. of meetings attended 10

Success Indicator Elementary Accomplishment Rating

Discussed with: Assessed by: Final Rating

Name and Signature of Ratee

Module 2: Data Collection Form at the Provincial Civil Registry

Module 3: Data Collection Form in All Government Hospital

Module 4: Data Collection Form at the Provincial Level

Module A: Provincial Consolidation of Health Indicators and reports

3. Participated in the analysis of health related data/information 100% NTBR

1. Submitted Daily Time Record (DTR) 6 NTBR NTBR

2. Submitted Accomplishment Report 6 NTBR NTBR

Final Average Rating:

Discussed with: Assessed by: Final Rating

Name and Signature of Ratee

Module 2: Data Collection Form at the Municipal Civil Registry

b. % of under-five death reported. 100%/mo. NTBR

c. % of maternal death reported. 100%/mo. NTBR