REPUBLIC OF THE PHILIPPINES

DEPARTMENT OF HEALTH
Western Visayas Center for Health Development
 CHAPTER 4.3
Child Care & Services

MICHAEL JOHN P. SABIDO

Statistician II, RESU/FHSIS Cluster
Newborn Care (0-28 days)

● Immunization at birth (BCG & Hepatitis B within 24 hours)

● Protection at birth from neonatal tetanus
● Initiation of breastfeeding lasting for at least 90 minutes
Infant Care (29 days-11 months old)

● Immunization of BCG, DPT-HiB-Hep B dose 1, 2 and 3, Pneumococcal

Conjugate Vaccine (PCV) dose 1,2, and 3, Oral Polio Vaccine (OPV) dose
1, 2, and 3, Inactivated Polio Vaccine (dose 1 and 2), Measles Containing
Vaccine (MCV) at 9 months
● Exclusive breastfeeding
● Complementary feeding initiation with continuous breastfeeding
starting at 6 months old
● Low birth weight infants, ages 1-3 months, seen and given iron
supplementation
● Micronutrient Supplementation: Vitamin A and Micronutrient Powder
(MNP)
Under-five Children Care (1-4 years old)

● Immunization of MCV at 12 months

● Micronutrient Supplementation, Vitamin A and Micronutrient Powder
(MNP)
● Deworming, 2 doses, six months apart

School-Aged Children (5-9 years old)

● School-Aged Children (5-9 years old)

● Deworming, 2 doses, six months apart
● School-based Immunization of Td & MR (Grade 1)
Adolescents (10-19 years old)

● Deworming, 2 doses, six months apart

● School-based Immunization of Td & MR (Grade 7 children)

Management of Sick Infants and Children

● School-Aged Children (5-9 years old)

● Deworming, 2 doses, six months apart
● School-based Immunization of Td & MR (Grade 1)
 Indicator
Immunization Services for Infants and Children
1. Proportion of newborn /
infants vaccinated with BCG
antigen disaggregated by sex
 
 
Definition Formula
Refers to the proportion of Numerator:
newborns / infants who were Number of newborn / infants
vaccinated with BCG antigen vaccinated with BCG antigen
among the total estimated  
infants in the population. Denominator:
  Population Under 1
Note: It is recommended that  
BCG is given immediately after Multiplier: 100
birth. But may consider before
discharge from the birthing Target: 95%
facility or within the neonatal
period (0-28 days). Those infants
given BCG after 28 days within
one year can still be added as
part of the numerator.
 Indicator
Immunization Services for Infants and Children
2. Proportion of newborn
vaccinated with Hepatitis B
antigen within 24 hours after
birth
Definition Formula
Refers to the proportion of Numerator:
newborns vaccinated with the Number of newborn vaccinated
birth dose of Hepatitis B antigen with birth dose of HepB antigen
within 24 hours after birth within 24 hours
among the total estimated  
infants in the population. Denominator:
Population Under 1
Multiplier: 100
Target: 95%
 Indicator
Immunization Services for Infants and Children
3. Proportion of children
protected at birth (CPAB) from
neonatal tetanus
disaggregated by sex
Definition
Refers to the proportion of
newborns whose mothers
pregnant for the first time have
received at least 2 doses of
Tetanus Toxoid (TT) or Tetanus
diphtheria toxoid (Td)
vaccination at least a month
prior to delivery AND newborns
whose mothers pregnant for
the 2nd or more times have
received at least 3 doses of
TT/Td.
Formula
Numerator:
Number of newborns whose
mothers pregnant for the first
time who have received at least
2 doses of TT/Td vaccination at
least a month prior to delivery
  PLUS
Number of newborns whose
mothers pregnant for the 2nd
or more times have received
at least 3 doses of TT/Td.
 Denominator:
Population Under 1
 Multiplier: 100
Target: 95%
 Indicator Definition Formula

Immunization Services for Infants and Children

4. Proportion of Infants who Refers to the proportion of Numerator:

completed 3 doses of DPT- infants who completed 3 doses
HiB-HepB antigen of DPT-HiB-HepB within one
year among the total estimated
infants in the population.
 
The word “Pentavalent” refers
to the preparation of the
combination of 5 vaccines and
does not refer to the antigen(s)
Disaggregation: being given.
• By sex  
Number of infants vaccinated
with
a. DPT-HiB-HepB 1 antigen
b. DPT-HiB-HepB 2 antigen
c. DPT-HiB-HepB 3 antigen
 
Denominator:
Population Under 1
 
Multiplier: 100

Target: 95%
 Indicator Definition Formula

Immunization Services for Infants and Children

5. Proportion of Infants who Refers to the proportion of Numerator:

completed 3 doses of Oral infants who completed 3 doses Number of infants vaccinated
Polio Vaccine (OPV) of specific OPV antigens within with
one year among the total a. OPV1 antigen
disaggregated by sex estimated infants in the b. OPV2 antigen
population. c. OPV3 antigen
 
Denominator:
Population Under 1

 
Multiplier: 100

Target: 95%
 Indicator Definition Formula

Immunization Services for Infants and Children

6. Proportion of Infants who Refers to the number of infants Numerator:

completed two (2) doses of
IPV disaggregated by sex
who were vaccinated with 2
doses of IPV antigen within one
year among the total estimated
infants in the population
Number of infants vaccinated
with IPV 1 and IPV 2 antigen
 
Denominator:
Population Under 1

 
Multiplier: 100
Target: 95%
 Indicator Definition Formula

Immunization Services for Infants and Children

7. Proportion of Infants who Refers to the proportion of Numerator:

completed 3 doses of
Pneumococcal Conjugate
Vaccine (PCV) disaggregated
by sex
infants who completed 3 doses Number of infants vaccinated
of Pneumococcal Conjugate with
Vaccine (PCV) antigen within one a. PCV1 antigen
year among the total estimated b. PCV2 antigen
infants in the population. c. PCV3 antigen
Denominator:
Population Under 1

 
Multiplier: 100
Target: 95%
 Indicator Definition Formula

Immunization Services for Infants and Children

8. Proportion of Children Refers to the proportion of Numerator:

vaccinated with 2 doses of
MMR antigen disaggregated
by sex
children from 9-12 months of Number of children given 2
age who were vaccinated with 2 doses of MMR
doses of MMR antigen among  
the total estimated infants in the Denominator:
population. Population Under 1
Recommended ideal age to be  
given: Multiplier: 100
MMR1 at 9 months,
MMR2 at 12 months Target: 95%
Note: The minimum interval  
from MMR1 and MMR2 is at
least 4 weeks since it is a live-
attenuated vaccine.
 Indicator
Immunization Services for Infants and Children
9. Proportion of Fully-
Immunized Children (FIC)
disaggregated by sex
Definition Formula
Refers to the proportion of Numerator:
infants and children who are No. of Fully
Fully Immunized Child among Immunized Children
the total estimated infants and  
children in the population. Denominator:
  Population Under 1
FIC is an infant who received: (previously)
1 dose of BCG, 3 doses of OPV, 3 0-1 yo (starting 2022)
doses of DPT-HiB-HepB vaccines
and 2 doses of MMR vaccine by  
12 months. MMR1 at 9 months Multiplier: 100
and MMR2 at 12 months
Target: 95%
 Indicator
Immunization Services for Infants and Children
10. Proportion of Completely
Immunized Children (CIC)
disaggregated by sex
Definition Formula
Refers to the proportion of Numerator:
children 13 to 23 months of age No. of completely immunized
who are completely immunized child
among the total estimated  
infants in the population. Denominator:
  Population Under 1
CIC is a child 13 to 23 months of
age who received 1 dose of BCG,  
3 doses each of OPV, 3 doses Multiplier: 100
each of DPT-HiB-HepB vaccines,
and 2 doses of MMR. No target
 Indicator
Immunization Services for School-Aged Children
11. Proportion of Grade 1 and
Grade 7 learners given one
dose of Tetanus diphtheria
toxoid (Td) vaccine
Disaggregation:
• By sex
Definition Formula
Refers to the proportion of Grade Numerator 1:
1 and Grade 7 learners who Number of Grade 1 learners given
received one dose of Td among Td 
the total Grade 1 and Grade 7 Denominator 1:
learners enrolled. Number of enrolled Grade 1
  learners
(To be submitted on November by  
RHU to PHO) Numerator 2:
Number of Grade 7 learners given
For Grade 1 learners who have Td
already received complete doses  
of DPT-HiB hepB or DPT 1,2,3, Td Denominator 2:
immunization is not mandatory Number of enrolled Grade 7
learners
For Grade 7 learners, regard-less  
of status of DPT-HiB-HepB or DPT Multiplier: 100
and Td immunization, Td must still Target: 95%
be given Source: Masterlist of Grade 1
And Grade 7 Learners from
Schools
 Indicator Definition Formula

Immunization Services for School-Aged Children

12. Proportion of Refers to the proportion of Grade 1 and Grade 7 Numerator 1:

Grade 1 and Grade learners who received one dose of Measles Rubella Number of Grade 1 learners
7 learners given (MR) provided that the learners have no history of given MR
previous immunization of Measles-Mumps-Rubella  
one dose of (MMR) Vaccine. Denominator 1:
Measles Rubella   Number of eligible Grade 1
(MR) Note: learners enrolled
Follow recommended schedule as per SBI Guidelines.   
(To be submitted on November by RHU to PHO) Numerator 2:
  Number of Grade 7 learners
For Grade 1 learners who have already received 1 or 2 given MR
doses of MMR, no need to give MR.  
  Denominator 2:
All Grade 7 learners should be given MR regardless if Number of eligible Grade 7
Disaggregation: they have previously received MMR. learners enrolled
•  
By sex Multiplier: 100
Target: 95%
 Indicator Definition Formula

Nutrition Services for Infants and Children

13. Proportion of newborns who Refers to the proportion of Numerator:

were initiated on newborns who were initiated on Number of newborns who were
breastfeeding immediately breastfeeding immediately after initiated on breastfeeding
birth lasting for at least 90 immediately after birth lasting
after birth lasting for at least minutes among the total for at least 90 minutes
90 minutes number of live births in the  
population. Denominator:
  Total No. of Live births
Breastfeeding initiation refers  
to the 4-time bound Multiplier: 100
interventions that consist of
Disaggregation: immediate and thorough Target: 95%
• By sex drying, early skin-to-skin
contact, properly timed cord
clamping and cutting, and non-
separation of the newborn
from the mother
 Indicator
Nutrition Services for Infants and Children
15. Proportion of infants
exclusively breastfed until 6th
month disaggregated by sex
Definition Formula
Refers to the proportion of infants Numerator:
6 months old who have been Total no. of infants age 6 months
exclusively breastfed from birth up old who have been exclusively
to 6th month among the total breastfed from birth until 6 months
estimated number of 6 months old of age
infants in the population.  
  Denominator:
Exclusive breastfeeding means no Population 6 months old
other food (including water) other  
than breast milk. Multiplier: 100
Drops of prescribed vitamins and Target: At least 50%
medications with indication given
with breast feeding is still
“exclusively breastfed” during
sickness, low birth weight or
anemia.
 Indicator Definition Formula

Nutrition Services for Infants and Children

14. Proportion of infants born Refers to the proportion of low Numerator:

preterm or with low birth
weight given iron supplements
 
Disaggregation:
• By sex
birth weight (LBW) and/or
preterm infants whose weight at
birth is less than 2.5 kilograms and
was given iron supplementation
starting at 1 month and completed
at 3 months old regardless of the
source.
 
Dosage: 0.3 ml once a day to start
at one (1) month of age until three
(3) months.
Preparation: 15 mg elemental
iron/0.6 ml).
No. of preterm infants and/or
infants with low birth weight (less
than 2500 grams) given iron
supplement starting 1 month until
3 months
 
Denominator:
Total No. of live births with
low birth weight
(taken from Maternal Care
TCL)
Multiplier: 100

Target: 95%
 Indicator Definition Formula

Nutrition Services for Infants and Children

16. Proportion of infants who Refers to the proportion of infants Numerator:

continued breastfeeding and
were introduced to
complementary feeding
beginning at 6 months of age
Disaggregation:
• By sex
who continued breastfeeding and No. of infants who continued
were introduced to breastfeeding and were
complementary feeding beginning introduced to complementary
at 6 months of age among the feeding beginning at 6 months of
total estimated number of infants age
in the population.  
  Denominator:
Complementary foods: Based on Population Under 1
the IYCF guidelines
Multiplier: 100
Target: 95%
 Indicator
Nutrition Services for Infants and Children
17. Proportion of infants /
children who completed
Vitamin A supplementation
Disaggregation:
• By sex
Definition
Refers to the proportion of
Infants/children who completed
Vitamin A supplementation among the
total estimated number of
infants/children in the population.
 
Recommended Dosage:
6-11 months old - 1 dose of 100,000
I.U. One capsule is given at 6 months
or any time before reaching 12
months.
Children between 12-59 months old
given two doses of 1 capsule of
Vitamin A 200,000 international
units/capsule with 6 months interval in Multiplier 1,2: 100
a given year.
Formula
Numerator 1:
No. of Infant 6-11 months old who
completed 1 dose of Vitamin A
supplementation
 
Denominator 1:
Population 6-11 months old
 
Numerator 2:
Total no. of children with ages 12-
59 months old who completed 2
doses Vitamin A Supplementation
Denominator 2:
Population 12-59 months old
Target: 95%
 Indicator Definition Formula

Nutrition Services for Infants and Children

18. Proportion of infants 6-11
months old and children
12-23 months old who
completed Micronutrient
Powder (MNP)
supplementation
Disaggregation:
• By sex
Refers to the proportion of infants 6-11 Numerator 1:
months old and children 12-23 months old No. of infants 6-11 months
who completed micronutrient powder old who completed MNP
(MNP) supplementation among the total supplementation
estimated number of infants and children in  
the population. Denominator 1:
  Population 6-11 months old
Micronutrient Powder (MNP) refers to  
premix vitamins and minerals in powder Numerator 2:
form No. of children 12-23 months
  old who completed MNP
For children 6-11 months old: A total of 90 supplementation
sachets over a period of 6 months  
  Denominator 2:
For children 12-23 months old: A total of 90 Population 12-23 months
sachets every 6 months for a total of 180 old
sachets in a year
Multiplier: 100
Target: 95%
 Indicator Definition Formula

19. Proportion of 0-59 Stunted children refers to number of Numerator 1:

months old who are children aged 0-59 months old whose
length/height for age are less than 2
∙ Stunted standard deviation (less than minus 2 SD)
∙ Wasted - MAM from the median length/height for age of
∙ Wasted - SAM the WHO Child Growth Standard.
∙ Overweight/ Obese  
∙ Normal Wasted children refers to number of
children aged 0-59 months old whose
weight for length/height for age are less
than 2 standard deviations (less than
minus 2 SD) from the median weight for
length/height of the WHO Child Growth
Standard.
Disaggregation: This shall include infants and children
• By sex with moderate and severe acute
malnutrition (MAM and SAM
respectively)
No. of infants and children 0-59
months old who are stunted
 
Numerator 2A
No. of infants and children 0-59
mos old who have moderate
acute malnutrition (MAM)
Numerator 2B
No. of infants and children 0-59
mos old who have severe acute
malnutrition (SAM)
Numerator 3:
No. of infants and children 0-59
months old who are
overweight/obese
 Indicator Definition Formula

Nutrition Services for Infants and Children

Acute Malnutrition (or Wasting Numerator 4: No. of infants

and/or edema) – occurs when an and children 0-59 months old
individual suffers from current, who have
severe nutritional restrictions, a normal weight for length/height
recent bout of illness, inappropriate for age measurement
childcare practices or their
combination resulting to sudden Denominator 1,2, 3 and 4:
weight loss or the Population 0-59 months old
development of bilateral pitting
edema. This can be reversed with Multiplier: 100
appropriate treatment.
Target: To reduce the number
Moderate Acute Malnutrition of
(MAM) or Wasting – Low weight-for- stunted children 0-59 mos. old
length/height for age defined as by:
between 2 and 3 SD below the 2019: 26.7%
median (<-2 and ≥-3 SD) of the 2022: 21.4%
WHO growth
standards or a MUAC measurement Source: TCL
of <125mm and ≥115mm (<12.5cm
and ≥11.5cm).
 Indicator Definition

Nutrition Services for Infants and Children

Severe Acute Malnutrition (SAM) or Severe Wasting – Very low

weight-forlength/ height for age defined as less than 3 standard
deviations below the median (<-3SD) of the WHO growth standards,
characterized by visible severe wasting, or by the presence of bipedal
pitting edema (WHO), or a Mid-Upper Arm Circumference (MUAC)
measurement of <115 millimeters (<11.5 cm)
Overweight/Obese children refers to number of children aged 0-59
months old whose weight for length/height are more than plus two
standard deviation (>+2 SD) from the median weight for length/height
of the WHO Child Growth Standard.

Normal – refers to number of children aged 0-59 months old

whose weight for length/height for age are within 2 SD
(Reference: A.O. No. 2015-0055)
Updates for the Nutritional Status indicator
(MAM/SAM)
Updates for the Nutritional Status indicator
(MAM/SAM)
 Indicator Definition Formula

Deworming Services for Children and Adolescents

20. Proportion of Refers to the proportion of Numerator 1:

Children/Adolescents who children ages 1-4 years old / 5-9 No. of children 1-4 years old given
years old / 10-19 years old given 1 2 doses of deworming drugs
completed 2 doses of deworming tablet twice a year Denominator 1:
deworming tablet with 6 months interval among the Population 1-4 years old
a. Pre-school Aged children total estimated children in the  
(PSAC): 1-4 years old or 12-59 population. Numerator 2:
mos. No. of children 5-9 years old given
Completed 2 doses of deworming 2 doses of deworming drugs
b. School-Aged Children (SAC): 5- tablet within the same year Denominator 2:
9 years old   Population 5-9 years old
c. Adolescents: 10-19 years old
Numerator 3:
No. of adolescents 10-19 years
old given 2 doses of deworming
drugs
Disaggregation: Denominator 3:
Target:• 95%
By sex Population x 10-19 years old
Source: TCL  
Multiplier: 100
 Indicator
Management of Sick Infants and Children
21. Proportion of high risk
infants and children with
measles and/or persistent
diarrhea who received
Vitamin A capsule aside from
routine supplementation
Disaggregation:
• By sex
Definition
Refers to the proportion of high
risk infants and children with
measles and/or persistent
diarrhea who received Vitamin A
capsule aside from routine
supplementation among the
total number of sick infants/
children seen.
 
Vitamin A dose for 6-11
months-old sick infants:
100,000 IU
 
Vitamin A dose for 12-59
month-old sick children:
200,000 IU (1 capsule)
Formula
Numerator 1:
Number of sick infants 6-11
months old who received
Vitamin A capsule aside from
routine supplementation
 
Denominator 1:
Total Number of sick infants 6-
11 months old seen
 
Numerator 2:
Number of sick children 12-59
months old who received
Vitamin A capsule aside from
routine supplementation
 Indicator Definition Formula

Management of Sick Infants and Children

Conditions: Denominator 2:
a. measles Number of sick children 12-59
b. persistent diarrhea months old seen
   
Persistent diarrhea: diarrhea of Multiplier 1,2: 100
14 days or more.
  Target: 100%
Note: If the child has had a dose
of Vitamin A within the past
month or is on RUTF for
treatment of Severe Acute
Malnutrition (SAM), DO NOT
GIVE VITAMIN A.
 Indicator Definition Formula

22. Proportion of Refers to the number of children 0-59 months old with Numerator:
diarrhea cases diarrhea who received oral rehydration salt solution (ORS) No. of diarrhea
0-59 months and ORS with zinc drops/syrup among the total number of cases 0-59
0-59 months old infants and children seen with acute months old who
old who received oral
received oral diarrhea (gastroenteritis). rehydration salt
rehydration salt solution (ORS)
Dosage for children less than 6 months: 10 mg elemental
solution (ORS) with oral zinc
Zn/day drops or syrup
with oral zinc
 
drops or syrup  
Dosage for children more than 6 months: 20 mg elemental Denominator:
Zinc/day x 10-14 days. No. of acute
  diarrhea cases 0-
Note: The term “oral rehydration therapy” (ORT), that was 59 months old
used or has appeared before in older documents, refers to seen
increase in fluid intake and continuous feeding. This
Disaggregation: encompasses as well the administration of ORS, oral zinc, in Multiplier: 100
addition to the continuation of breastfeeding, and/or provision
• By sex of complementary feeding for infants 6 months and above
during the period of illness. Target: 100%
 Indicator
Management of Sick Infants and Children
23. Proportion of pneumonia
cases among children 0-59
months old who received
treatment disaggregated by
sex
Disaggregation:
• By sex
Definition Formula
Refers to the number of Numerator:
children 0-59 months old who No. of pneumonia cases 0-59
received antibiotic treatment months old who received
among the total number of 0-59 treatment
 
months pneumonia cases seen
Denominator:
No. of pneumonia cases 0-59
months old seen
Multiplier: 100
Target: 100%
Part 1. Immunization and Nutrition Services
for Infants Age 0-11 Months Old and
Children Age 12 Months Old
Part 2. Nutrition and Deworming Services
for Children Age 12-59 Months Old
Part 3. Deworming Services for Children
Age 5-9 Years Old
Part 4. Deworming Services for Children
Age 10-19 Years Old
Part 5. Services Rendered for Sick Children
F1
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