Download - Format ASHA Monthly Report
-
8/12/2019 Format ASHA Monthly Report
1/5
Target
Achievement
Target
Achievement
No.ofnew
ASHAwith
Drugkit
No.ofDrugkitReplished
TargetASHA
No.ofASHAPresentin
ASHADiwas
DistrictTrainerTeam
No.o
fASHA'sTrained
DistrictTrainerTeam
No.o
fASHA'sTrained
Target
Achievement
1
Best performance
award of Rs.1000/-
, Rs.500/- Rs.300/-
Rs.200/- Certificate
to ASHAs as BlockLevel
l No.
Status of Training Module
5,6 & 7
ASHABankA/C
Opened
StatusofIdentyCard
CapacityBuilding/Academicsupport
programmeNoofASHAenrolledinto10th
gradethroughopenSchool
ofIGNOU
ASHA Selection
ASHA
Facilitator
Selection
Drug kit Status ASHA Diwas
Monthly Physical Data Report of ASHA Programm for the Month of
ame of:- BCM/BHMName of :- Block
Phase-I Phase-II
-
8/12/2019 Format ASHA Monthly Report
2/5
NoofASHAEnrolle
d
Amounttobepaidfor
enrollment
Amountpaidforenrollm
ent
ASHAAwardedRs.10
00/-
ASHAAwardedRs.5
00/-
1
No.ofDrugKitReplishment
AmountforDurgkit
ReplishmentPaid
No.ofNew
DrugkitsProcured
Paidfornew
drugKit
No.ofSaree
Received
Monthly Financial Data/Report of ASHA Programm for the Month of ________________20
ame of:- BCM/BHM Name of :- Block
Sl
No.
Amount spent under the head of
Capacity Building/Academic
Support programme- no of ASHA
Enrolled into 10th gradehrough
open School or IGNOU
Best performance
ASHAs
Amounttobep
aidforsaree
No.ofASHADiwasOrganized
No.ofASHAPrese
ntinASHADiwas
AmountpaidtoASH
A'sinASHADiwas
AmounttobepaidtoA
SHAinModule5,
6,7
Train
ing
-
8/12/2019 Format ASHA Monthly Report
3/5
ASHAAwardedRs.3
00/-
ward to
-
8/12/2019 Format ASHA Monthly Report
4/5
Rural Area Urban Area
Janani Evam Bal Surakchha Yojana for Institutional
Dellivery and full Immunization of the new born400 200
* Registration 100 100
* BCG Immunization 300 100
5 to 10 Children 50
11 to 15 Children 100
16 to 20 Children 150
20 to above children 200
3 Providing DOTS under Tuberculosis Control Program250 per
patient
PB Case 300
MB Case 500
Training
D.A. Per Day 100
T.A. Per Day 100
6 ASHA Diwas 86
7 For Motivating for Sterilization 150
8 for Motivationg client for Vasectomy/NSV 200
9 Home visit under HBNC and IMNCI (After 6 visits) 250
10 National Blindness Control Programme 175
11 Kalazar 100
12 Social Marketing of Sanitary napkins 1 per pack
13 Facilitating monthly meeting with Adolescent at village 50
14
Reporting death of women (15 to 40 years) and
Children (0-1 years) by ASHA to the
Block,PHC,MO/ANM within 24 hours of occurrence of
death
50
No of newly married couple mobilized by asha to
have first child after two year of Marriage
500 per
couple
No of couple mobilized to have birth space of three
years between first and secound child
500 per
couple
No. of couples mobilized for vasectomy/tubectomy
after having two child
1000 per
couple
15
Sl
No.Program & Related Work
4
5
Mobilizing all the children of the village for Immunization (Under Muskan Ek Abhiyan) to be given to
For indentitying Patient of Leprosy and accompanying him/her to PHC
Incentive Details of ASHA Programe for the Month of ... 2Name of BCM/BHM:- BLOCK:- Date of Submissio
2
By CashBy
Whom
1
Incentives in Rs./- By
Cheque
Adarsh Dampati Yojana
-
8/12/2019 Format ASHA Monthly Report
5/5
Under RNTCP
Pruposed Under
HBNC( Part of
Child Health)Under NBCP
Under RNTCP
Undera ARSH
Programme
Under MDR
(Meternal Death
Review)
Under FP
Programme
SHA
Under National
Leprosy
Eradication
Programme
13:-
Under Universal
Immunization
Programme
Remarks
Under ASHA
Programme
Under Family
Planning &
Adarsh Dampati
Yojana
under JBSY
Programme