The performance - Score Card

RBSK Nurse
Name of RBSK Nurse KARTHIKA .NK Date of joining duty 03.0
Health Block POOKKOTTUR Name of PHC
Item April May June July Aug Sep Oct Nov Dec Jan Feb Mar
Sl no 2018 2018 2018 2018 2018 2018 2018 2018 2018 2019 2019 2019 Total

1 Number of children Screened 410 384 404 409 421 580 480 456 398 413 356 397 5108
0-6 yrs, 6-18 yrs
percentage of AWC visited minimum twice in their 95.00% 90% 86% 78.20% 70% 82.35% 76.30% 79.20% 80% 84% 75% 89%
allotted area in the last 12 months. ( Total number of
2 AWC visited twice/Total number of AWC in their 98.4
allotted area)*100

Health Education RBSK Nurse 16 13 15 14 13 14 16 15 14 13 14 15

given /organised
3 by RBSK Nurse 172

MOs 1 1 1 1 1 1
4 6

Block cordinator PRO Cum 1 1 1 1 1

LO/ Health Supervisiors
5 5

49 63 97 56 55 50 69 78 35 31 41 20
6 Number of positive cases identified and refered 644

7 Number of referals to DEIC attended OPD 10 11 12 9 11 10 10 11 12 11 13 11 131

Total No.of Immunisation in session 100% 100% 100% 100% 100% 100% 100% 100% 100% 99% 100% 98%
attended,screened children and % of children
8 screened 100

Total number of training attended as part of skill 1 1 1 1 1 1 1 2

9 development & knowledge sharing 9

2 1 3 2 1 1 1
10 Substance abuse / smoking / pan chewing / alcohol 11
use etc identified and referred to referal centers
 1 1 1 1 1 1 1 1 1 1 1 1
11 Monthly report submited on or before block Mos 12
conference
percentage consumption of IFA as part of WIFS 80% 82% 90% 92% 90% 89% 88% 95% 96% 92% 90% 91%
12 program in schools attended by RBSK Nurse 97%

95% 85% 92.80% 94.14% 90% 88.20% 82.60% 95.20% 82% 83% 92% 89.30%
Percentage of under five children screened for 6' Ds
out of the total children registered in AWC
13 concerned/ visited/allotted. ( Total children under 98.00
five screened/ total under five registered in their
allotted AWC)*100

* Above mentioned items to be verified by Block Cordinator of the concerned Health Block

Name : Date :

Designation : Signature :

District :
uty 03.04.2018
PHC ANAKKAYAM

Remarks

Minimum 3 AWC
visit/month for 12
months(April & May will
cover all)

10 classes/month for 10
months
65

once in two months

once in three months

30 referrals/month

10 referrals/month

Activities done other

than routine activity
with self initiative
 Avrage for 10 months
will be taken

Cumulative average for

12 months will be taken
 School Health Programme
Performa for evaluating the perfomance of SHNs by Block & District Officials
Name of RBSK Nurse: KARTHIKA.NK Date of Joi03.04.2018
Health Block: POOKKOTTUR Name of P PHC ANAKKAYAM

Total
activities Score
by Score maximum
after Total
Sl no Item SHN(colu verificatio Weightage calculatio Score score
mn Total n allowed
n
in SHNs
form)

Number of children Screened

1 0-6 yrs, 6-18 yrs 5108 Total Divided by 175 0 20

percentage of AWC visited minimum twice in their allotted area in

the last 12 months. ( Total number of AWC visited twice/Total
2 number of AWC in their allotted area)*100 98.4 % Divided by 10 0 10

Health RBSK Nurse

3 Education 172 Divided by 200 0 5
given
4 /organise MOs 6 1 point for 1 class 0 5
5 d Block cordinator PRO Cum LO/ Health Supervisiors 5 1 point for 1 class 0 3
by RBSK
Nurse
6 Number of positive cases identified and refered 644 Divided by 60 0 5

7 Number of referals to DEIC attended OPD 131 Divided by 10 0 7

Total No.of Immunisation in session attended and screened

children and % of children screened Total Number of
8 100 0 10
activities divided by 3
Total number of training attended as part of skill development &
knowledge sharing 1point for one
9 9 0 5
training
 Substance abuse / smoking / pan chewing / alcohol use etc 0.25 point for 1
10 11 0 5
identified and referred to referal centers detection

0.5 point for 1 month

11 Monthly report submited on or before block Mos conference 12 0 5
report

percentage consumption of IFA as part of WIFS program in schools

12 attended by RBSK Nurse 97 % divided by 10 10

Percentage of under five children screened for 6' Ds out of the total
children registered in AWC concerned/ visited/allotted. ( Total
13 98 % divided by 10 10
children under five screened/ total under five registered in their
allotted AWC)*100

100

To be verified by District coordinator SH & AH

Name of the Employee : KARTHIKA.NK Designation : RBSK NURSE

District : MALAPPURAM

Name and signature of District co ordinator SH & AH :

Remarks of the DPM :

Name :

Singnature : Date :
 Remarks

350 students/month(20
students /day - *17 school days)

Minimum 3 AWC visit/month for

12 months(April & May will cover
all)

10 classes/month for 10 months

once in two months

once in three months
30 referral /month and details to
be verified by PRO Cum Los

6 referral/ month and evidences

to be certified through DEIC
Activities done other than routine
activity with self initiative

Report should be collected

through PRO Cum Los and
verified by RBSK Manager
Validated by RBSK Manage
through PRO Cum Los by
checking stock and supply.r
Checked by PRO Cum Los in
consultation with ICDS
Supervisors