Republic of the Philippines

Department of Health
WESTERN VISAYAS
Center for Health Development

2023-2025 LIPH APPRAISAL CHECKLIST RATING SCALE

PARAMETERS FOR MEANS OF RATING SCALE
DETAILS Points
EVALUATION VERIFICATION RATING REMARKS

I. COMPLETENESS OF THE DOCUMENT

Indicate the presence of:
Executive Summary Executive Summary Section
I. Plan development Plan Development Section
II. Health situation of the Province/City Health Situation Secton
III. Local priorities/Major thrusts of the LIPH Local Priorities Section
IV. Monitoring & Evaluation M&E Section
V. Cost Matrices
a. LIPH Form 1: Summary of Investment Cost by Health
A. Content/Parts Accomplished Form
Systems Building Block and Fund Source

b. LIPH Form 2: Cost Assumptions by Health Systems

Building Block, Strategies and Fund Source Accomplished Form

Documents Attached
VI. Other attachments, specify:
_____________________________________________
1. Data are entered in the appropriate columns
(eg. If equipment, entered in the equipment column and not Accomplished Form
in Entries
2. the infracorrespond
or total column)
to the appropriate data required
B. Properly Filled-up (eg. If the column requires funds, amount in PhP should be
Accomplished Form
Forms entered; if column requires quantity, numbers are entered
3. Columns and rows which need data entries are filled up (No
empty column /rows unless filling-up is not applicable) Accomplished Form
(No empty column/rows unless filling-up is not appplicable)

C. Endorsement of
Reviewed LIPH from
1. Endorsement Letter/Email from PHO/CHO Letter or email
LGU Planning Team to
CHD

D. LIPH Information Generated Forms from the

Encoded LIPH in the LIPH-IS
System System

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 PARAMETERS FOR MEANS OF RATING SCALE
DETAILS Points
EVALUATION VERIFICATION RATING REMARKS
II. PLAN DEVELOPMENT PROCESS 30
0 = not stated
1 = Stated in the plan but no EO/PO/SO attached 3
A. Organization of years)
1. Organized LGU Planning Team as per AO 2020-0022 EO/ Personnel Order/SO 2
Planning Team
2 = Stated in the plan with EO/ PO/ SO attached
AO/PO/SO
1. Incorporation of lower level plans a. Consulation /workshop / 0 = No documented Consultations / Workshop /
For the province: meetings documentation Meetings
a. Incorporation of Barangay Health Plans into the 2 = With documented Consultations / Workshop /
Municipal/ Component City LIPH Meetings
b. Incorporation of Municipal and Component City Health
b. Elements of lower level plans Actual component city/ municipality health plans
Plans into the Province-wide LIPH;
reflected/ included in the included
Provincial Plan 0 = 0%-49%
2 = 50%-74%
8 4 = 75%-99%
6 = 100%

With actual barangay health plans and other plans

c. Actual Mun/CC IPH, Brgy. as bases
For the HUC/ICC: Incorporation of Barangay Health Plans Health Plans and other Plans as 0 = 0%-24%
B. Consideration of into the HUC/ICC City-wide AOP bases (these plans do not need 2 = 25%-49%
health situation and needs to be submitted to BLHSD) 4 = 50%-74%
of different levels 6 = 75%-100%
Consideration of other plans such as but not limited to: Score 1 point if each plan is considered
a.DRRM-H plan 1 = with DRRM-H Plan
b. Health Facility Development Plan c. Elements of these plans 1 = with Health Facility Development Plan
Human Resources for Health Plan d. reflected / included in the 6 1 = with Human Resource for Health Plan
ICT Development Plan Prov/HUC/ ICC plan 1 = with ICT Development Plan
e. Devolution Transition Plan 1 = with Devolution Transition Plan
f. GAD plan 1 = with GAD Plan

2. When available, consideration of health needs contained a. Elements of lower level plans NA = if LGU has no ADIPH/ ADSDPP
in the Ancestral Domain Investment Plan for Health reflected/ included in the
(ADIPH) / Ancestral Domain Sustainable Development and Prov/HUC/ICC plan
2 2 = Plans available; Health needs of ICCs/IPs
Protection Plan (ADSDPP)
NOTE: If not available, item should not be part of the b. Actual ADIPH/ADSDPP as from the ADIPH/ADSDPP are reflected
denominator. bases

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 PARAMETERS FOR MEANS OF RATING SCALE
DETAILS Points
EVALUATION VERIFICATION RATING REMARKS
0 = Not stated in the plan
1. Non-health sector, specify: Consulations/workshops/meetin
2
______________________________________________ gs documentation 2 = stated in the plan, with documentation

2. Special population groups, eg. GIDA, Indigenous Peoples, 0 = Not stated in the plan
Urban Poor, PWDs, seniors, other vulnerable/marginalized Consulations/workshops/meetin
2
C. Consultation with/ groups, specify: gs documentation 2 = stated in the plan, with documentation
involvement of key _________________________________________
stakeholders 0 = Not stated in the plan
3. Plan harmonization, integration, and synchronization by Consulations/workshops/meetin
2
LGU, DOH-CHD and other partners gs documentation 2 = stated in the plan, with documentation

Consulations/workshops/meetin 0 = Not stated in the plan

4. Office of the District Representative/ Legislator 1
gs documentation 1= stated in the plan, with documentation
0 = Not stated in the plan

a. Planning workshops, PIR 2 = Stated in the plan but without documentation

1. Revisit/Review of processes, outputs and outcomes of the
documentation 4
previous LIPH/ AOP period
D. Review of previous b. AOP monitoring Report
4 = stated in the plan, with documentation and
LIPH/AOP period and monitoring reports
other LGU plans
0 = Not stated in the plan
2. Other LGU plans reviewed, specify: Planning workshops, PIR
2 2 = stated in the plan; other plans reviewed; with
__________________________________________ documentation
documentation

III. TECHNICAL
CONTENT
With reference to LIPH Content Outline
Part II. Health Situation of the Province/City Cited/indicated: 50
Check for the presence of the following elements
and give corresponding score:
Citation of latest status, reports,
records with verifiable &
2 = Health System Presented by Building Blocks
validated data sources such as
FHSIS, LGU scorecard,
surveillance unit reports, annual
1. Health, health systems and health-related threats/concerns statistical reports, AOP 1 = Updated and Latest Data
6
and situations backed up by appropriate data/evidence monitoring report, health
indices, emerging and re-
emerging diseases (if any), 1 = Verifiable Data Sources
hospital reports, equity
statistics, best practices, non-
2 = Compared with external and internal
health sources, others
benchmarks

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 PARAMETERS FOR MEANS OF RATING SCALE
DETAILS Points
EVALUATION VERIFICATION RATING REMARKS
Citation of latest status, reports, Check for the inclusion of the following elements
records with verifiable & and give corresponding score:
validated data sources such as
FHSIS, LGU scorecard,
surveillance unit reports, annual
statistical reports, AOP 3 = Updated and latest data on health status
monitoring report, health
2. Health status of IPs/ICCs, GIDA, Urban Poor and other indices, emerging and re- 4
vulnerable populations, as applicable emerging diseases (if any),
hospital reports, equity
statistics, best practices, non-
health sources, others 1 = Verifiable Data Sources

3. Status/Gaps on:
2
a. Human resources for health a. Citation of latest status,
reports, records with verifiable
b. Infrastructure and equipment 2
A. Description and & validated data sources, if any,
analysis of health and such as annual statistical
health-related threats and c. Service capabilities (status of DOH licensing and reports, health indices, non-
2
situations, and health PhilHeath accreditation) of health facilities and services health sources, others

d. Management support systems:

1. Human resources for health management and b. Brief narrative on the status
2
development of each management system
2. Information management/EMR 2
3. Procurement and supply chain management 2
4. Referral system 2
5. DRRM-H system 2
6. Epidemiologic surveillance system 2

7. Proactive and effective health promotion programs/ 2

campaigns

a. Citation of latest report, if any 0 = report reflected not updated

2 = latest report reflected

4. Status of P/CWHS integration (as applicable) 5 Discussion on UHC Characteristics

0 = No discussion on any characteristic
b. Brief narrative on P/CWHS
1 = 1-4 characteristics
integration
2 = 5- 9 characteristics
3 = 10 characteristics

5. Levels of analysis:
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PARAMETERS FOR MEANS OF
DETAILS
EVALUATION VERIFICATION
a. Citation of latest statistics
a. Clear and logical description of data/information
b. Use of tables and diagrams
b. Comparison against standards, trends, benchmarks,
targets
1. National Objectives for Health
Citation of latest NOH, F1 plus
and LGU SC targets vis-a-vis
latest health situation
2 LGU Scorecard
Causes/factors for the
c. Causes and contributing factors identified high/low/equal trend compared
to standards/benchmarks
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RATING SCALE
Points
RATING REMARKS
1 = Updated and latest data
Elements of Rating:
1 pts = tables and
Tables and diagrams: diagram with no
3
1 = presented but without description description
2 = presented with description 2 pts = tables and
diagram with
description
0= No citation of data from NOH/ F1 Plus
1 = Citation of not updated data of NOH/ F1 Plus
without comparison to the latest health situation
3
2 = Citation of updated data of NOH/ F1 Plus
without comparison to the latest health situation
3 = Citation of latest/updated data of NOH/ F1
Plus in comparison to latest health situation
0= if no citation of data of LGU SC
1 = Citation of not updated data of LGU SC
without comparison to the latest health situation
3 2 = Citation of updated data of LGU SC without
comparison to the latest health situation
3 = Citation of latest/updated data of LGU SC in
comparison to latest health situation
1 = Citation of major gaps without identified
causes and contributing factors and without
comparison to standards/benchmarks
2 = Citation of major gaps with identified causes
3 and contributing factors without comparison to
standards/benchmarks
3 = Citation of major gaps with identified causes
and contributing factors with comparison to
standards/benchmarks
 PARAMETERS FOR MEANS OF
DETAILS Points
EVALUATION VERIFICATION
Narrative on how the gaps
d. Linking of related gaps with health outcomes and
identified will affect the health 3
indicators
outcomes nd indicators
Part III. Local Priorities/Major Thrusts of the LIPH 18
1. Local Priorities/Major Thrusts consistent with gaps
7
problems/concerns identified in the Health Situation Section
List of Local Priorities/Major
Thrusts
2. Integration of Health Systems as priority (as applicable) 4
A. Goals and objectives,
priorities/thrusts, targets
and indicators for the year
a. Specific contributions cited
3. Aligned with/contribute to Universal Health Care Act, b. Specific provisions of UHC
Fourmula One Plus for Health, National Objectives for Act, F1 Plus, etc that the 7
Health, Sustainable Development Goals, Ambisyon 2040 priorities/thrusts are aligned
with
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RATING SCALE
RATING REMARKS
1 = Citation of major gaps without discussion of
the identified health outcomes and indicators in the
Situational Analysis
3 = Citation of major gaps, how it affects the
identified health outcomes and indicators in the
Situational Analysis
0 = No list of local priorities/major thrusts
3 = Incomplete and / or inconsistent with gaps
problems/concerns identified in the Health
Situation Section
7 = Complete and consistent list of Local
Priorities/Major Thrusts consistent with gaps
problems/concerns identified in the Health
Situation Section
2 = incomplete list of local priorities and PPAs
based on identified gaps on a particular level (LHS
ML)
4 = complete list of local priorities and PPAs based
on identified gaps on a particular level (LHS ML)
Check alignment with:
- UHC
- NOH
- F1 Plus
- SDG
- Ambisyon Natin
0 = Not Stated in the plan
3 = Aligned to at least 3 health plans/goals
5 = Aligned to at least 4 health plans/goals
7 = Aligned to at least 5 health plans/goals
 PARAMETERS FOR MEANS OF RATING SCALE
DETAILS Points
EVALUATION VERIFICATION RATING REMARKS
Part IV Monitoring & Evaluation Cited/indicated: 10
0 = No M&E Team, No Issuance(s)
1= With M & E Team but No Issuance(s)
EO, Personnel Order, other
1.a. Organization of LIPH/AOP Monitoring Team 3
issuance 3 = With M & E Team; supported by Issuance (s),
Issuance should be updated; at least every 3 years

0 = No non-health stakeholders in the existing M

1.b. Participation of other stakeholders (non-PHO/CHO List of other stakeholders not & E Team; none to be invited.
staff) in M&E activities, specify: included in the Monitoring team 2 2 = Existing M & E Team with or without non-
_______________________________________________ that the LGU plans to invite health stakeholders; with intent to invite non-
health stakeholdere
A. M&E Process
2.a. M&E process/activities (eg. systems or program-based, 0 = Not stated in the plan
PIR, PBUR, quarterly or semi-annual AOP monitoring, 2 = M&E processes/activities clearly stated in the
2
progress monitoring report), specify: plan
_______________________________________________ List of M&E activities and
coverage to be conducted with
0 = Coverage of monitoring activities not stated in
2.b. Coverage of Monitoring activities include: target timelines
the plan
i. Status of physical accomplishment
ii. DOH assistance 1 = Coverage of monitoring activities stated but
3 covers 2 items or less
iii. LGU counterpart in the AIP
iv. Other areas, specify: 3 = Monitoring activities stated covers 4 items
________________________________________

Part V. Cost Matrices Cited/indicated: 52

0 = No strategies resulted from the Situational and

Gap Analysis reflected in the cost matrices

2 = Some strategies resulted from the Situational

1. Address gaps/problems/concerns and priorities listed in
A. Strategies/ activities
Situational and Gap analysis and Baseline Assessments
and Gap Analysis; Some strategies are reflected in
the correct Cost Matrix (per building block)
Forms reflecting:
Strategies resulted from the
6
Situational and Gap Analysis
are reflected in the LIPH Forms 4 = Most strategies resulted from the Situational
and Gap Analysis; Most strategies are reflected in
the correct Cost Matrix (per building block)

6 = All strategies resulted from the Situational and

Gap Analysis; All strategies are reflected in the
correct Cost Matrix (per building block)

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PARAMETERS FOR MEANS OF
DETAILS
EVALUATION VERIFICATION
Forms reflecting strategies are:
2. Strategies listed realistic, reasonable and implementable -based on SA
in time frame given -doable within three years
-appropriate to the area
3. Strategies are aligned with the Devolution Transition Plan/
Accomplished Forms
DOH Menu of Assistance
Forms indicating that all
1. Strategies are costed strategies have corressponding
costs
LIHP Froms indicating
strategies costed based on Menu
2. Costing of strategies realistic, reasonable, and appropriate
of Assistance, population
to locality
projection, previous year's
allocation, site of PPA
LIPH Forms indicating that all
B. Costing of Strategies have corresponding
fund source as follows:
interventions
-DOH fund source based on
menu
3. Fund sourcing of activities realistic, reasonable and -Outside the menu to be funded
appropriate by LGU or other sources
-Strategies with no specific
source will fall under Unfunded
4. Strategies for GIDA barangays costed
LIPH Forms reflecting
NOTE: If not applicable, item should not be part of the
strategies/actvities for GIDA
denominator.
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RATING SCALE
Points
RATING REMARKS
Check for the presence of the following elements
and give corresponding score:
6 2 = Based on SA
2 = Doable within 3 Years
2 = If appropriate to the area
Check for the alignment of strategies with :
1 = HFEP
5 1 = HRH Deployment
2 = Commodities
1 = Epidemiology and surveillance
2 = Some strategies with corresponding costs
4 3 = Most strategies with corresponding costs
4 = All strategies with corresponding costs
Costing of strategies based on the following:
- Menu of assistance
- population projection,
- previous year's allocation
4 - site of PPA
2 = Costing of strategies based on 2 out of 4
3 =Costing of strategies based on 3 out of 4
4 = Costing of strategies based on all items
0 = Strategies do not have funding source reflected
Check for the presence of the following elements
and give corresponding score:
2 = DOH Fund source based on Menu
1 = Outside the menu to be funded by LGU or
other sources
4
1 = Strategies with no specific source reflected
0 = No strategies for GIDA barangays reflected
1 = Strategies for GIDA barangays reflected but
2 some are not costed
2 = Strategies for GIDA barangays reflected and
completely costed.
 PARAMETERS FOR MEANS OF RATING SCALE
DETAILS Points
EVALUATION VERIFICATION RATING REMARKS
N/A = No ADIPH/ADSDPP available
Strategies/activities from ADIPH/ADSDPP costed LIPH Forms reflecting 0 = Plans are present but no strategies from
C. Costing of
NOTE: If not available, item should not be part of the strategies/actvities from 2 ADIPH/ADSDPP reflected
interventions (con't)
denominator. ADIPH/ADSDPP 2 = Specific strategies/activities from
ADIPH/ADSDPP are all reflected and costed

Check the inclusion of LGU counterpart (reflected

in the LIPH) in the following LGU Plans:
- CDP
1. Specified LGU counterpart are reflected in the LGU Copy of the CDP/ ELA/ LDIP/ - ELA
(Province/HUC/ICC) Comprehensive Development Plan/ AIP reflecting the counterpart 5 - LDIP
ELA/ LDIP/ AIP fund of LGU on LIPH - AIP

D. LGU ownership of and 2 = if reflected in atleast 2 out of 4 LGU Plans

accountability for health
operations and reforms 5 = if reflected in atleast 4 out of 4 LGU Plans
0 = No increase reflected
3 = The increase is 10% or more
Accomplished Forms (LGU
2. Health budget for Year 1 is higher than the previous year's
Counterpart) vs. LGU share in 5
AOP 5 = The increase is more than 10%. Year one (1) of
2022 AOP
the 2023 - 2025 LIPH should be Higher than the
2022 AOP

E. Special Health Fund

Strategies to be funded through SHF Accomplished Forms 3 N/A
(SHF), if applicable

0 = No M&E strategies reflected in the cost

matrices as indicated in the narrative

1. M&E activities costed are consistent with the planned 1 = M&E strategies are costed but NOT consistent
2 with the M&E activities in the narrative
M&E activities in the narrative

2 = M&E strategies are costed and consistent with

LIPH Forms reflecting the M&E the M&E activities in the narrative
F. M&E component
activities as per Part IV of LIPH 0 = Without Budget Allocation for M&E
2. Budget allocation 2
2 = With Budget Allocation for M&E
0 = M&E strategies without timelines/schedule

1 = M&E strategies with timelines/schedule but

3. Timelines/schedule 2
not doable
2 = M&E strategies with timelines/schedule and
doable
TOTAL 160
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 PARAMETERS FOR MEANS OF RATING SCALE
DETAILS Points
EVALUATION VERIFICATION RATING REMARKS
Percentage 100%

 85% or Better PASSED  For CHD Concurrence

RESULT OF CHD
 84-75% PASSED with minor correction, For Enhancement
APPRAISAL
 74% and Below LIPH For Revision, PDOHO/CHD to provide special Technical Assistance
Other Comments: ____________________________________________________________________________

Prepared by:

MARIA CLARISSA JUANICO

Head, HSIMEC

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