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0-370840Dakshata0DakshataMonthly reporting format Facility:District:State: Provider name (If applicable): Month and year:S.NoData elementNumbers in the reporting monthAObstetric ServicesA1Total number of normal deliveries in the facility A2Total number of assisted deliveries in the facility (Vacuum/ forceps)A3Total number of caesarean deliveries in the facilityA4Number of live births in the facilityA5Number of still births in the facilityA6Number of Intrauterine deaths in the facilityA7Number of maternal deaths in facility in the monthA8Number of new born deaths in facility in the reported monthBComplicated deliveriesManaged at facilityReferred to higher centerB1Mothers with post-partum hemorrhageB2Mothers with SepsisB3Mothers with Severe Pre-eclampsia/ EclampsiaB4Mothers with Prolonged labor B5Mothers with Obstructed laborB6Newborn with asphyxiaB7Number of newborn with sepsisB8Number of pre term births (<34 weeks)CPracticesC1Number of deliveries where partographs were used for monitoring of laborC2Number of deliveries where mother’s Blood pressure was recorded at admissionC3Number of deliveries where mother’s temperature was recorded at admissionC4Number of deliveries where oxytocin was given as uterotonic for Active management of third stage of labor immediately after birthC5Number of livebirths where baby was breast feed within 1 hour of deliveryC6Number of deliveries where mothers temperature was recorded at dischargeC7Number of deliveries where Baby’s birth weight was recorded after birthC8Number of deliveries where Safe child birth checklist was usedC9Number of livebirths where Baby’s Temperature was recorded at dischargeC10Number of preterm births (<34 weeks) where antenatal corticosteroids were administered C11C11.1C11.2C11.3C11.4C11.5Number of mothers who adopted a post-partum family planning methodPPIUCDLAMPost-partum sterilizationCondomsOthers (specify) ................
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