ABCDEFGHIJKLMNOPQRSTUVWXYZAAABACADAEAFAGAHAIAJAKALAMANAOAPAQARASATAUAVAWAXAYAZBABBBCBDBEBFBGBHBIBJBKBLBMBNBOBPBQBRBSBTBUBVBW
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Government of India
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Ministry of Health and Family Welfare
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(Child Health Division)
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 Home Based Care for Young Children (HBYC) Home Visit: Quarterly Reporting format-National Level (For Compilation of data from States/UTs)
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Name of State/UT:
Reporting Quarter and Year:
QTR-4 (January - March 2024)
Date of reporting:
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Sl No.Name of the
District		1.
Total no. of young children visited by ASHA		2.
No. of young children received ORS packet from ASHA		3.
No. of young children received IFA syrup from ASHA		4.
No. of young children received age appropriate immunization		5.
No. of sick children identified by ASHA		6.
No. of sick children referred to nearest facility		7.
No. of children received adequate complementary feeding		8.
No. of young children who are Underweight (Yellow)		9.
No. of young children who are Severe Underweight (Red)		10.
No. of young children identified with any development delay		11.
No. of young children identified with any development delay referred to ANM/ Health Fcaility		12
No. of ASHA received supervisory visits by ANM
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3 months6 months9 months12 months15 monthsTOTAL3 months6 months9 months12 months15 monthsTotal3 months6 months9 months12 months15 monthsTotal3 months6 months9 months12 months15 monthsTotal3 months6 months9 months12 months15 monthsTotal3 months6 months9 months12 months15 monthsTotal3 months6 months9 months12 months15 monthsTotal3 months6 months9 months12 months15 monthsTotal3 months6 months9 months12 months15 monthsTotal3 months6 months9 months12 months15 monthsTotal3 months6 months9 months12 months15 monthsTotal3 months6 months9 months12 months15 monthsTotal
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1Trivandrum












000000x00000x00000000000000000000000x00000000000000000000000000000000000
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2Kollam000000x00000x00000000000000000000000x00000000000000000000000000000000000
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3Pathanamthitta000000x00000x00000000000000000000000x00000000000000000000000000000000000
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4Alappuzha7316566415876653280x00000x00000000000000000000000x00000000000000000000000000000000000
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5Kottayam3132533181832071274x00000x00000000000000000000000x00000000000000000000000000000000000
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6Idukki7566553855123122620x00000x00000000000000000000000x00000000000000000000000000000000000
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7Ernakulam158713981544137217467647x00000x00000000000000000000000x00000000000000000000000000000000000
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8Thrissur15514515811081649x00000x00000000000000000000000x00000000000000000000000000000000000
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9Palakkad1031111179181503x00000x00000000000000000000000x00000000000000000000000000000000000
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10Malappuram2874261425932185225212518x00000x00000000000000000000000x00000000000000000000000000000000000
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11Kozhikode3773202602451991401x00000x00000000000000000000000x00000000000000000000000000000000000
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12Waynad9327357705586303625x00000x00000000000000000000000x00000000000000000000000000000000000
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13Kannur17212812775117619x00000x00000000000000000000000x00000000000000000000000000000000000
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14Kasargod5365026204174892564x00000x00000000000000000000000x00000000000000000000000000000000000
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State Total8536751775336335677936700000000000000000000000000000000000000000000000000000000000000000
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Source: Indicators 1‐11 will be compiled from the ASHA HBYC card and indicator 12 will be compiled from HBYC supervisor's checklist
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Note: 1. Home visit report to be submitted quarterly only
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2. At National level, District wise data is required from the State/UT.
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3. At National Level, Block wise data is not required however State and district may collect/compile data individual block wise.
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