Republic of the Philippines

Region IX – Zamboanga Peninsula

LGU Logo
Province of ________________________
Municipality/City of _________________
BNS MONTHLY ACCOMPLISHMENT REPORT
As of Month _________________ 20___
Name of BNS: _________________________________ Date Prepared: ________________, 20____
Barangay: ____________________________________

Target No.
NEW cases reached/activities conducted/targets served this MONTH Noted by:
ACTIVITIES as stated in
BNS Action
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
TOTAL _________
Plan Signature o
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15)
A. ANTHROPOMETRIC MEASUREMENT ACTIVITIES
1. Anthropometric Measurement of all
0-59 months old PSC (OPT Plus)
2. Ff-up Measurement of 0-23 mos old
a. Weight for Age (WFA) (monthly)
 Normal (N)
 Underweight (UW)
 Severely Underweight (SUW)
 Overweight (OW)
b. Length for Age (LFA) (monthly)
 Normal (N)
 Stunted (St)
 Severely Stunted (SSt)
 Tall (T)
c. Weight for Length (WFL) (monthly)
 Normal (N)
 Wasted (W)
 Severely Wasted (SW)
 Overweight (OW) Validated b
 Obese (Ob) _________
3. Ff-up Measurement of 24-59 mos old Signature
a. Weight for Age (WFA)
 Normal (semesterly)
 Underweight (monthly)
 Sev. Underweight (monthly)
 Overweight (monthly)
b. Height for Age (HFA)
 Normal (semesterly)
 Stunted (monthly)
 Sev. Stunted (monthly)
 Tall (quarterly)
c. Weight for Height (WFH)
 Normal (semesterly)
 Wasted (monthly)
 Severely Wasted (monthly)
 Overweight (monthly)
 Obese (monthly)
B. DELIVERY OF BASIC SERVICES
1. Provision of Basic Nutrition Information Prepared b
a. Home Visit/Individual Counselling _________
 Mothers/Parents of MN PSC & SC Signat
 Pregnant Women (PW)
 Normal
 Nutritionally at-risk PW
 Lactating Mothers
b. Conduct of Nutrition, Sanitation & Health Education Classes
 Household of 0-59 mos. old PSC
 Household with malnourished
60-71mos & SC
 Pregnant Women
 Lactating Mothers
 Organization of Mothers/Parents’
12
Classes (write topic if applicable)
-
c. Distribution of IEC Materials
 Target No.
NEW cases conducted/reached/served this MONTH
ACTIVITIES as stated in
BNS Action
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
TOTAL
Plan
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15)
2. Home and Community Food Production
a. HH w/ established backyard garden
b. HH distributed with seeds/seedlings
c. HH dispersed with small animals
d. Established Community Gardens Noted by:
3. Assisted in the distribution of Micronutrient Supplements _________
a. Undernourished PSC Signature o
b. Undernourished SC
c. Pregnant Women
d. Lactating Mother
4. Promotion on the utilization of Fortified Foods
a. Iodized Salt
 Sale/Distribution of Iodized Salt
 Iodized Salt Testing
b. Consumption of Sangkap Pinoy
Seal (SPS) products
5. Conduct of Complementary/Supplemental Feeding
a. Undernourished 6-59 mos old PSC
b. Undernourished 60-71mos not
enrolled in DCC
c. All pregnant women
6. Provision of Food Commodities (RUTF / RUSF)
a. SAM PSC
b. MAM PSC
c. Pregnant Women
d. Lactating Mother
C. ENVIRONMENTAL SANITATION Validated b
1. Families referred to Sanitary Inspector for: _________
a. Construction of Sanitary Toilets Signature
b. Proper Garbage Disposal
D. NUTRITION AND HEALTH SERVICES
1. Referral to Nutrition and Health Services
a. UW & SUW 0-59 mos old PSC
b. St & SSt 0-59 mos old PSC
c. W & SW 0-59 mos old PSC
d. MN 60-71mos not enrolled in DCC
e. Pregnant Women
f. Lactating Mother
E. OTHER ACTIVITIES
1. BNC Organized/Reorganized 1
2. Nutrition Advocacy Activities Initiated
3. Assistance and referral of concerned individual/s to Health Center activities
a. Micronutrient Supplementation 12
b. Campaign for Breastfeeding 12
c. Promotion of Iodized Salt 12
d. Deworming 2
e. Immunization 12 Prepared b
f. Pre-/Postnatal Care/Check-up 12 _________
g. PIMAM & IMCI Signat
h. Adolescent Health
4. No. of GOs & CSOs linked to address
malnutrition
5. Attendance to Capacity & Manpower
Development Activity
6. BNS Monthly Meetings attended 12
7. Participation in other nutrition-
sensitive projects/activity in the brgy
8. 0-59 mos old PSC & ECCD F1KD/DSP
beneficiaries’ masterlisted, updated 12
and monitored
9. Local Nutrition Planning attended
10. No. of Resource Generation
Activities
11. Others, pls specify:
Noted by:
_________
Signature o

Validated b
_________
Signature

Prepared b
_________
Signat