PDP MONTHLY ACCOMPLISHMENT REPORT

Name of PDP:
Name of Health Facility:
Date of Visit:
Functions of PDP:
TASK 1: Oversee the overall Pharmaceutical Supply Chain Management (PSCM) of all Public Health Programs of the Department of Health providing essential medicines in
the Primary Healthcare Facilities (RHUs) and identified government Hospitals.
TASK 2: Conduct monthly visit and monitoring of all DOH Procured medicines and vaccines in the assigned Rural Health Units (RHUs), Health Centers and identified DOH
Retained Hospitals in terms of the following:
i. Monthly Inventory Management
TASK 3: Provide technical assistance to the local health facilities regarding the Supply Chain Management (SCM) and submit quarterly assessment using the tool provided;
i. Provide Technical assistance in Inventory Management
ii. Consolidate monthly inventory reports from the health facilities
ii. Validation
TASK of the
4: Conduct of receipt of delivery
education campaign in (e.g.
the health facilities
community tracking) in the Local Government Units (LGUs) of the following Information, Education, Communication (IEC)
iii. Facilitating
materials stockbe
that shall transfers
developedto other
by thehealth facilities Division
Pharmaceutical
iv. Gathering of all reports required for submission to the Pharmaceutical Division as scheduled including but not limited to Inventory, Utilization, Requisition Issuance Slip
TASK
(RIS), 5: Participates
complaints andincustomer
the implementation of health programs of DOH and the LGU in the community
feedback forms.
TASK 6: Assists in the conduct of DOH Pharmacovigilance activities and Post-Marketing Surveillance (PMS) of DOH program medicines
TASK 7: Conduct training to all identified Pharmacy Assistants for the Pharmacy Services National Certification III
TASK 8: Coordinates with the Public Health Associates to ensure timely data collection and reporting
TASK 9: Performs other related functions as may be assigned subject to the approval of the DOH

HEALTH FACILITY MONTHLY UTILIZATION/STOCK INVENTORY REPORT FORM

Ending
Deliveries Stock transfer Expired,
Lifestyle Related Disease Prevention and Control Inventory
from the
Monthly Losses and
Consumptio Damages
End of
Month
Program PREVIOUS
Month Quantity (B) Date Received
Transferred ns ( E) (if any) Stocks
(F) (G)
(A) (C ) (D)

Amlodipine 5mg, 30 Tablets/ TP

Losartan 50mg, 30 Tablets/ TP

Metformin 500mg, 90 Tablets/ TP

Gliclazide 30mg, 30 Tablets/ TP

Simvastatin 20mg, 30 Tablets/ TP

Regular Insulin 100 IU/mL, (SC, IV/IM)

Isophane Insulin Human 100 IU/Ml

Biphasic Isophane Human Insulin 100 IU/mL, 70/30 (SC)

Ending Expired,
Inventory Deliveries Stock transfer End of
from the Monthly Losses and Month
FAMILY PLANNING COMMODITIES PREVIOUS
Consumptio Damages
Received
Transferred ns ( E) (if any) Stocks
Month Quantity (B) Date (F) (G)
(A) (C )
(D)

Combined Oral Contraceptive Pills (COC)

Progestin Pills (POP)

Depo Medroxyprogesterong Acetate (DMPA) VIAL

Intra Uterine Device (IUD) TCU 380-A

Progestin Subdermal Implant (PSI)

Male Condoms

Cycle Beads

Etonogestrel/ Progestin Sub-dermal Implant (PSI)

Ending
Inventory Deliveries Stock transfer Expired, End of
from the Monthly Losses and Month
NTP COMMODITIES PREVIOUS
Consumptio Damages
Month Received Transferred ns ( E) (if any) Stocks (G)
Quantity (B) Date (C ) (F)
(A) (D)

Isoniazid 200mg/5mL Syrup

Rifampicin 200mg/5mL 120mL

Pyrazinamide 250mg/5ml

Ethambutol 400mg

Isoniazid 75mg + Rifampicin 150mg Tablet (FDC 2 Adult)

Isoniazid 75mg + Rifampicin 150mg + Pyrazinamide 400mg + Ethambutol

275mg Tablet (FDC 4 Adult)

Isoniazid 50mg + Rifampicin 75mg Tablet (FDC 2 Children)

Isoniazid 50mg + Rifampicin 75mg + Pyrazinamide 150mg Tablet (FDC 3

Children)

Bedaquiline 100mg

Purified Protein Derivative 2TU/0.1mL

MTB/RIF Cartridge
Ending Expired,
Inventory Deliveries Stock transfer End of
Monthly Losses and
from the Month
MICRONUTRIENTS PREVIOUS
Consumptio Damages
Transferred ns Stocks
Month Received ( E) (if any) (G)
Quantity (B) Date (F)
(A) (C )
(D)

Vitamin A 100,000IU

Vitamin A 200,000IU

Ferrous with Folic Acid

Micronutrient Powder
MUAC Tape for Adult

MUAC Tape for Children

Ending Expired,
Inventory Deliveries Stock transfer End of
Monthly Losses and
from the Month
NATIONAL IMMUNIZATION PROGRAM PREVIOUS Consumptio Damages
Transferred ns Stocks
Received ( E) (if any)
Month Quantity (B) Date (F) (G)
(A) (C ) (D)

BCG Vaccine

Hepatitis B Vaccine

Pentavalent Vaccine (DPT-Hepatitis B-HiB)

Bivalent Oral Polio Vaccine (bOPV)

Inactivated Polio Vaccine(IPV)

Pneumococcal Conjugate Vaccine (PCV13)

Measles Mumps and Rubella (MMR)

Measles Rubella Vaccine (MR)

Measles Vaccine

Tetanus Diphtheria (TD) Toxoid Vaccine

Human Papillomavirus Vaccine (HPV)

Influenza Vaccine (Flu)

Polysaccharide Polyvalent Vaccine (PPV23)

Ending Expired,
Inventory Deliveries Stock transfer End of
Monthly Losses and
from the Month
INTEGRATED HELMINTH CONTROL PROGRAM PREVIOUS
Consumptio Damages
Month Received
Transferred ns ( E) (if any) Stocks (G)
Quantity (B) Date (C ) (F)
(A) (D)

Albendazole 400 mg chewable tablet

Albendazole 400 mg tablet

Mebendazole 500mg

Albendazole 200mg tablet

Ending Expired,
Inventory Deliveries Stock transfer End of
Monthly Losses and
from the Month
NATIONAL LEPROSY PREVENTION AND CONTROL PROGRAM PREVIOUS Consumptio Damages
Month Received Transferred ns ( E) (if any) Stocks (G)
Quantity (B) Date (F)
(A) (C ) (D)

Betamethasone 5g

Prednisone 10mg

Fusidate Sodium/Acid Ointment 2% 15g

Ascorbic Acid

Itraconazole 100mg

Ferrous Sulfate + Folic Acid

Vitamin B Complex

Ending Deliveries Stock transfer Expired,

Inventory Monthly Losses and End of
from the Month
Integrated Management of Childhood Illness (IMCI) PREVIOUS Consumptio Damages
Transferred ns Stocks
Month Received ( E) (if any) (G)
Quantity (B) Date (F)
(A) (C )
(D)

Amoxicillin Trihydrate 250mg/5mL Powder for Suspension, 60 mL amber

bottle

Zinc sulfate 55mg/5ml syrup

Zinc Sulfate 22mg/5ml syrup

Ending Deliveries Stock transfer Expired,
Inventory End of
from the Monthly Losses and Month
ORAL HEALTH PROGRAM PREVIOUS
Consumptio Damages
Stocks
ns ( E) (if any)
Month (G)
 Ending
Inventory Expired, End of
from the Monthly Losses and Month
ORAL HEALTH PROGRAM PREVIOUS Consumptio Damages
Transferred ns Stocks
Month Received ( E) (if any) (G)
Quantity (B) Date (F)
(A) (C ) (D)

Essential Health Care Package 1 (EHCP-1)

Portable Ultrasonic Scaler with Mini Water Tank and Accessorie

Light Curing Unit

High Speed Handpiece bundled with burs 0 0 N/A 0 0 0 0 0

Oral Health Family Package 0 0 N/A 0 0 0 0 0

Ending Deliveries Stock transfer Expired,
Inventory End of
from the Monthly Losses and Month
FOOD AND WATERBORNE DISEASE PROGRAM (FAWDP) PREVIOUS Consumptio Damages
Transferred ns ( E) (if any)
Stocks
Month Quantity (B) Date Received (G)
(C ) (F)
(A) (D)

Metronidazole 125mg/5 ml, 60 ml bottle 0 0 N/A 0 0 0 0 0

Metronidazole 250mg suspension 0 0 N/A 0 0 0 0 0
Metronidazole 250mg Tablet 0 0 N/A 0 0 0 0 0
Metronidazole 500mg Tablet 0 0 N/A 0 0 0 0 0
Oral Rehydration Salts (75 replacement) 0 0 N/A 0 0 0 0 0
Ciprofloxacin 0 0 N/A 0 0 0 0 0
Ciprofloxacin 250mg tablet 0 0 N/A 0 0 0 0 0
Zinc sulfate 27.5mg/ml 0 0 N/A 0 0 0 0 0
Diloxanide 500mg tablet (as furoate) 0 0 N/A 0 0 0 0 0
Zinc 0 0 N/A 0 0 0 0 0
Ending
Deliveries Stock transfer Expired,
Inventory Monthly Losses and End of
from the Month
DOH PROCURED PREVIOUS
Consumptio Damages
Transferred ns Stocks
Received ( E) (if any)
Month Quantity (B) Date (F) (G)
(A) (C ) (D)

Ascorbic Acid 100mg?5ml syrup, 120mL Bottle 0 0 N/A 0 0 0 0 0

Amlodipine 10mg 0 0 N/A 0 0 0 0 0
Amlodipine 5mg 0 0 N/A 0 0 0 0 0
Atorvastatin 10mg Tablet 0 0 N/A 0 0 0 0 0
Mefenamic Acid 500mg 0 0 N/A 0 0 0 0 0
Paracetamol 500mg Tablet 0 0 N/A 0 0 0 0 0
Salbutamol (as sulfate) 1mg/mL, 2.5mL (unit dose) nebule 0 0 N/A 0 0 0 0 0
Salbutamol 100mcg/dose MDI 0 0 N/A 0 0 0 0 0
Ending Expired,
Inventory Deliveries Stock transfer Monthly Losses and End of
from the Month
SENIOR CITIZEN PROGRAM PREVIOUS Transferred
Consumptio Damages Stocks
Received ns ( E) (if any)
Month Quantity (B) Date (F) (G)
(A) (C )
(D)

Ascorbic Acid 500mg Tablet 0 0 N/A 0 0 0 0 0

Multivitamins + minerals capsule 0 0 N/A 0 0 0 0 0

Ending
Inventory Deliveries Stock transfer Expired, End of
Monthly Losses and
from the Month
COVID-19 RESPONSE PREVIOUS
Consumptio Damages
Month Received Transferred ns ( E) (if any) Stocks (G)
Quantity (B) Date (C ) (F)
(A) (D)

Cetirizine 5mg/5mL syrup

0 0 N/A 0 0 0 0 0

Diphenhydramine 50mg 0 0 N/A 0 0 0 0 0

Paracetamol 500mg Tablet 0 0 N/A 0 0 0 0 0

Paracetamol 250mg/5mL 0 0 N/A 0 0 0 0 0

Zinc sulfate 20mg/5ml Syrup 0 0 N/A 0 0 0 0 0

Celecoxib 200mg tablet 0 0 N/A 0 0 0 0 0

Doxycycline 100mg capsule 0 0 N/A 0 0 0 0 0

Oseltamivir Phosphate 75mg Capsule 0 0 N/A 0 0 0 0 0

Submitted By: Approved By:

KISSEL C. DANO __________________________________________

Name and Signature Name and Signature
(PDP) (Municipal Health Officer/Public Health Nurse)
 Noted By:

______________________________________________________________________________
Name and Signature
(DMO IV)
 PDP MONTHLY ACCOMPLISHMENT REPORT
Name of PDP:
Name of Health Facility:
Date of Visit:
Functions of PDP:
TASK 1: Oversee the overall Pharmaceutical Supply Chain Management (PSCM) of all Public Health Programs of the Department of Health providing essential medicines in
the Primary Healthcare Facilities (RHUs) and identified government Hospitals.
TASK 2: Conduct monthly visit and monitoring of all DOH Procured medicines and vaccines in the assigned Rural Health Units (RHUs), Health Centers and identified DOH
Retained Hospitals in terms of the following:
i. Monthly Inventory Management
i.TASK 3: Provide
Provide technical
Technical assistance
assistance to the local
in Inventory health facilities regarding the Supply Chain Management (SCM) and submit quarterly assessment using the tool provided;
Management
ii. Consolidate monthly inventory reports from the health facilities
ii. Validation
TASK of the
4: Conduct of receipt of delivery
education campaign in (e.g.
the health facilities
community tracking) in the Local Government Units (LGUs) of the following Information, Education, Communication (IEC)
iii. Facilitating
materials stockbe
that shall transfers
developedto other
by thehealth facilities Division
Pharmaceutical
iv. Gathering of all reports required for submission to the Pharmaceutical Division as scheduled including but not limited to Inventory, Utilization, Requisition Issuance Slip
TASK
(RIS), 5: Participates
complaints andincustomer
the implementation of health programs of DOH and the LGU in the community
feedback forms.
TASK 6: Assists in the conduct of DOH Pharmacovigilance activities and Post-Marketing Surveillance (PMS) of DOH program medicines
TASK 7: Conduct training to all identified Pharmacy Assistants for the Pharmacy Services National Certification III
TASK 8: Coordinates with the Public Health Associates to ensure timely data collection and reporting
TASK 9: Performs other related functions as may be assigned subject to the approval of the DOH

HEALTH FACILITY MONTHLY UTILIZATION/STOCK INVENTORY REPORT FORM

Ending Expired,
Inventory Deliveries Stock transfer End of
from the Monthly Losses and Month
DOH MAINTENANCE MEDICINES (COMPACK) PREVIOUS Consumptio Damages
Transferred ns Stocks
Month Received ( E) (if any) (G)
Quantity (B) Date (C ) (F)
(A) (D)

Amlodipine 5mg, 30 Tablets/ TP

Losartan 50mg, 30 Tablets/ TP
Metformin 500mg, 90 Tablets/ TP
Gliclazide 30mg, 30 Tablets/ TP
Simvastatin 20mg, 30 Tablets/ TP
Regular Insulin 100 IU/mL, (SC, IV/IM)
Isophane Insulin Human 100 IU/Ml
Biphasic Isophane Human Insulin 100 IU/mL, 70/30 (SC)
Ending Expired,
Inventory Deliveries Stock transfer End of
Monthly Losses and
from the Month
RABIES PROGRAM PREVIOUS
Consumptio Damages
Transferred ns ( E) (if any) Stocks
Month Quantity (B) Date Received (G)
(C ) (F)
(A) (D)

Purified Chick Embryo Cell Rabies Vaccine 2.5 IU/mL

Anti-Rabies Serum (Equine) 200 IU/mL (1,000 IU/5mL)

Purified Chick Embry Cell (PCEC) Rabies Vaccine 2.5IU/mL Lyophilized
Powder for Injection
Inactivated Rabies Vaccine: Wistar Strain Rabies 2.5 IU / 0.5 mL

Inactivated Purified Verocell Rabies Vaccine

Ending Expired,
Inventory Deliveries Stock transfer End of
Monthly Losses and
from the Month
National HIV Aids / STI Prevention and Control Program PREVIOUS
Consumptio Damages
Transferred ns ( E) (if any) Stocks
Month Quantity (B) Date Received (G)
(C ) (F)
(A) (D)

Efavirenz 600mg

Lamivudine 150mg

Nevirapine 200mg

Tenofovir 300mg

Abacavir 300mg

Nevirapine 10mg/mL

Lamivudine 10mg/mL

Zidovudine 150mg/mL

Lamivudine 150mg + Zidovudine 300mg

Lamivudine 300mg+ Tenofovir 300mg

Lamivudine 300mg + Tenofovir 300mg + Efavirenz 600mg

Lopinavir 200mg + Ritonavir 50mg

Azithromycin 500 mg

Efavirenz 200mg

Fluconazole 200mg

Zidovudine 50mg/5mL

Ceftriaxone 1g vial

Isoniazid 300mg

Nevirapine 50mg/5mL, 240mL suspension

Penicillin G Benzathine Vial

Cefixime 400mg Capsule

Ending Expired,
Inventory Deliveries Stock transfer End of
Monthly Losses and
from the Month
COVID-19 RESPONSE PREVIOUS
Consumptio Damages
Transferred ns ( E) (if any) Stocks
Month Quantity (B) Date Received (G)
(C ) (F)
(A) (D)

Cetirizine 5mg/5mL syrup

Diphenhydramine 50mg

Paracetamol 500mg Tablet

Paracetamol 250mg/5mL

Zinc sulfate 20mg/5ml Syrup

Celecoxib 200mg tablet

Doxycycline 100mg capsule

Oseltamivir Phosphate 75mg Capsule

Ending
Inventory Deliveries Stock transfer Expired, End of
from the Monthly Losses and Month
MENTAL HEALTH MEDICINE ACCESS PROGRAM PREVIOUS Consumptio Damages
Transferred ns Stocks
Month Received ( E) (if any) (G)
Quantity (B) Date (C ) (F)
(A) (D)

Haloperidol 5mg

Haloperidol 5mg/mL, 1 mL

Carbamazepine 200mg

Diphenhydramine 50mg/mL, 1mL

Valproate Disodium + Valproic Acid 250mg

Submitted By: Approved By:

KISSEL C. DANO __________________________________________

Name and Signature Name and Signature

(PDP) (Municipal Health Officer/Public Health Nurse)

Noted By:

MARY JANE MOHAMMAD SALI

Name and Signature

(DMO IV)