Attachment E - Peer Counselor Monthly Report.pdf
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- Attached to
- Breastfeeding Peer Counseling Services
- Solicitation number
- 25RFP-25-0904004-005
- Issued by
- Kingsbury County, South Dakota
About this file
This document is a monthly report template for Breastfeeding Peer Counselors in the South Dakota Department of Health's Special Supplemental Nutrition Program for Women, Infants and Children (WIC) Program. The report details caseload information, breastfeeding participant graduation, breastfeeding classes and support groups led, total contacts via various channels, and outreach impact. The key purpose of the Breastfeeding Peer Counseling program is to provide mother-to-mother support and education to increase breastfeeding initiation and duration among WIC participants.
The related state and local contract opportunity is for the management and administration of the Breastfeeding Peer Counseling Program within the South Dakota WIC program. The selected subrecipient will be responsible for all program operations, supervision, fiscal management, and coordination with the Breastfeeding Coordinator. The goal is to increase breastfeeding rates and duration among WIC participants through one-on-one support, group education, and overall promotion of breastfeeding.
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Text version
Breastfeeding Peer Counselor
(Month, year) Monthly Report
(Peer Counselor Name)
The below chart indicates the clients on your caseload for the month reporting. Participants that have closed throughout the month are included for this month.
The total number of participants in the chart should match the months end caseload.
Organize by Region & County in alphabetical order.
PG Women BF Women Total
Central Region
West Region
Butte (Belle Fourche)
Butte (Newell)
Lawrence (Deadwood)
Lawrence (Spearfish)
Totals
Caseload
151 (month start caseload)
+17 new referrals
+/- transfers
=168 (month end caseload)
-9 drops
=159 (next month start caseload)
Breastfeeding Participants Graduating from Program – report how many participants that are closed out due to their child reaching 1 year of age during the reporting period.
Breastfeeding Classes – identify how many classes you assisted the Breastfeeding Specialist and identify how many classes you lead
Support Group -- identify how many classes you assisted the Breastfeeding Specialist and identify how many classes you lead
Total Contacts – total of the below categories
Zendesk – total of all individual text messages, phone calls and emails
Face to Face – total of all in-person consultations at WIC Clinic or hospital
Zoom Consultations – total of all video consultations, identify number of consultations you attended with Breastfeeding Specialist and identify number of consultations you had individually with your participants
Mailed Information – total number of mailings sent
Announcements – total of all sent through month identified below
Attachment E
Identify what the announcement was for and how many prenatal and breastfeeding participants it was sent to. Include the number of participants it was sent to in your
Total Contacts. For example, if you send a National Breastfeeding Month announcement to 100 people. Add 100 to your total contacts broken down by prenatal or breastfeeding.
Outreach
Impact on Area/Participants
Trainings Peer Counselor Attended
Miscellaneous
File details come from the government source that posted it. Updated .