ANNEX E 2025 AOP Cost Matrices

AOP Form 1. Summary of Investment Cost by Health Systems Building Block and Fund Source

Region: REGION A
Province/HUC/ICC: PROVINCE Y
Municipality/Component City: _______________
AOP CY: 2025

Fund Sources (PhP)

LOCAL GOVERNMENT UNITS (LGU) DOH TOTAL per TOTAL per Building
Health Systems Building Blocks Province/HUC/ICC LGU Mun/CC LGU Building Block Unfunded % of Building Block Block
Remarks
Special Health Fund Trust Fund for (Funded) (PhP) to Grand Total (INCLUDING
(SHF*) BLGU Central Office CHD Others (PhP) Unfunded) (PhP)
General Fund Trust Fund for Health Total General Fund Health (SHF Sub Total
Separate Book of
Accounts sidiary Ledger)

1. Health Service Delivery 4,278,054 8,000,661 12,278,715 2,093,901 1,182,608 3,276,509 450,000 18,015,512 2,815,471 7,991,071 44,827,278 21,090,567 31% 65,917,845
Health Facility Development 2,569,071 6,789,341 9,358,412 1,590,432 500,000 2,090,432 250,000 9,780,426 0 3,567,132 25,046,402 15,000,000 40,046,402
Commodities 1,450,891 789,430 2,240,321 352,890 450,643 803,533 150,000 5,784,321 1,965,039 2,674,904 13,618,118 2,500,000 16,118,118
Other TA (for Service Delivery) 258,092 421,890 679,982 150,579 231,965 382,544 50,000 2,450,765 850,432 1,749,035 6,162,758 3,590,567 9,753,325
2. Health Workforce 25,789,320 2,525,790 28,315,110 7,842,053 1,784,501 9,626,554 2,578,432 24,789,321 0 2,675,982 67,985,399 5,869,345 47% 73,854,744
3. Health Information System 2,563,201 571,890 3,135,091 450,651 327,542 778,193 150,000 4,289,541 752,890 3,467,132 12,572,847 3,652,907 9% 16,225,754
4. Supply Chain & Logistics Management 589,532
and Health Regulation
5. Financing 1,890,432 432,860 2,323,292 325,970 250,729 576,699 150,000 2,550,890 957,005 1,678,431 8,236,317 2,500,000 6% 10,736,317
6. Leadership and Governance 1,300,774 1,469,000 2,769,774 550,875 325,890 876,765 150,000 1,890,432 1,567,430 2,890,468 10,144,869 575,245 7% 10,720,114
Total per Fund Source (PhP) 36,411,313 13,000,201 48,821,982 11,263,450 3,871,270 15,134,720 3,478,432 51,535,696 6,092,796 18,703,084 143,766,710 33,688,064 100% 177,454,774 -

As a Percentage of Total 25% 9% 34% 8% 3% 11% 2% 36% 4% 13% 100%

NOTES:
(1) Health Systems Building Blocks:
* Health Service Delivery; Health Workforce; Health Information System; Supply Chain & Logistics Mgt and Health Regulation (Medical products, vaccines and technology); Financing; Leadership and Governance
(2) Fund Sources in PhP: Identify specific Fund Source and amount in PhP assigned/proposed to implement the PPA
¨LGU – Cost in PhP assigned/proposed for funding ofbLocal Government Units: Province/HUC/ICC LGU (General Fund and Trust Fund for Health/Special Health Fund); Municipality/Component City LGU (General Fund and Trust Fund for Health); Barangay LGU
•General Fund - Fund which is available for any purpose and is composed of all receipts and revenues which are not otherwise accruing to other funds
•Trust Fund - Fund which accounts for the receipts by any agency of government or by a public officer acting as a trustee, agent, or administrator for the fulfillment of some obligations
•Special Health Fund - pool of financial resources at the P/CWHS (Province/HUC/ICC level) intended to finance population-based and individual health services, health system operating costs, capital investments, and remuneration of additional
health workers and incentives for all health workers. Specify which Fund Source/Book of Accounts: DOH; PhilHealth income; Development Partners/NGO/Faith-based Org; LGUs. Refer to JMC 2021-0001 on SHF for allowable expenses chargeable against SHF.
¨DOH – Cost in PhP assigned/proposed for funding of Central Office or Centers for Health Development;
¨Others - Cost in PhP assigned/proposed for funding of Other Fund Sources, such as Official Development Assistance (eg. UN Agencies, development partners); other national agencies; NGOs/CSOs; private and other sectors
(3) Total per Building Block - Sum in PhP of all funding sources for a particular Building Block (Columns E, H, I, J, K, L)
(4) Unfunded in PhP - Cost in PhP of PPAs with NO identified funding source
(5) % of Building Block to the Grand Total - Cost of Building Block OVER Total Cost of ALL Building Block x 100
(6) Total per Building Block (INCLUDING Unfunded) - Sum in PhP of Funded and Unfunded for the particular Building Block (Column M + Column N)
(7) Remarks - Notes or comments; may specify Other fund sources
ANNEX E 2025 AOP Cost Matrices
AOP Form 2. Cost Assumption by HS Building Block, PPAs, Quarter and Fund Source (AOP Mother Plan)

Region: REGION A
Province/HUC/ICC: PROVINCE Y
____________
Municipality/Component City:
___
AOP CY: 2025

Strategy/Program/ Target Resource Requirements (PhP) Fund Source (PhP)

Project/Activities (PPA)/
BUILDING BLOCK Province/HUC/ICC LGU Mun/CC LGU
Municipality/ Name of Total
Performance
SERVICE DELIVERY District Component Health Total Unfunded INCLUDING
Indicator Q1 Q2 Q3 Q4 Unit Cost Quantity Special Health BLGU CO CHD Others Remarks
City/ Barangay Facility Target Trust Fund for Health (PhP) Unfunded
Trust Fund Fund (SHF*)
General Fund Total General Fund (SHF Sub sidiary Total (PhP)
for Health Separate Book of Ledger)
Accounts

Health Facility Development

Strategy 1 Renovation of health facility
Santa Maria Sta. Maria RHU
Activity 1: Santa Fe Sta. Fe RHU Renovation
5 RHUs
Renovation of typhoon District III Santa Isabel Sta. Isabel RHU 3 2 5 expense CO 500,000.00 5 2,500,000 500,000 0 500,000 0 0 0 0 2,000,000 0 0 0 2,500,000
renovated Santa Barbara Sta. Barbara RHU
damaged RHUs Santa Catalina Sta. Catalina RHU
package

Activity 2
Activity 3
Sub-total
Strategy 2 _______
Activity 1
Activity 2
Activity 3
Sub-total
Strategy 3_______
Activity 1
Activity 2
Activity 3
Sub-total
Sub-total for Major/
Sub-Program 1
II. Major/Sub-Program 2
Strategy 1 _______
Activity 1
Activity 2
Activity 3
Sub-total
Strategy 2 _______
Activity 1
Activity 2
Activity 3
Sub-total
Strategy 3_______
Activity 1
Activity 2
Activity 3
Sub-total
Sub-total for Major/ Sub-Program 2
Total for (Building Block)
NOTES:
(1) Health Systems Building Block: Service Delivery; Health Workforce; Health Information Systems; Supply Chain & Logistics Mgt and Health Regulation (Medical products, vaccines and technology); Financing; Leadership & Governance
▪ Strategies - Identified priority interventions that address health needs and health inequities, such as:
- Construction; Repair/renovation/expansion of health facilities; Procurement/repair of equipment; Hiring of health workforce; Retention of health workforce; Capacity building/development; Procurement/provision of commodities, medical supplies;
- Establishing systems; Monitoring; Policy development; Sectoral collaboration/partnerships; Advocacy/awareness/health promotion campaigns; Research and development; Others
▪ Program/Project/Activity (PPA) activities to implement the Strategy
(2) Performance Indicator - Measurable value/performance measurement to evaluate the success of the PPA
(3) District - The legislative district where the PPA will be applied/conducted. In a province, this excludes the legislative districts covered by the HUC/ICC which will be reflected in the HUC/ICC’s respective plans
(4) Municipality/Component City/Barangay - Specific area where the PPA will be applied/conducted, indicate if area covers GIDA/IP/Urban poor and other vulnerable population
(5) Name of Health Facility - The exact name of the facility where the PPA will be applied/conducted
(6) Target - Quantifiable physical target in relation to the performance indicator of a particular PPA. Specify targets for Q1, Q2, Q3, Q4.
(7) Total Target - Sum of quarter targets
(8) Resource Requirement – Inputs needed to conduct/produce the PPA
§ Items Description - specific description of the items/units to be costed (eg. Capsules, tablets, meals, activity cost, etc.)
§ Expense Category: PS, MOOE, CO (Infrastructure, Equipment, Motor Vehicle, Others)
§ Unit Cost - Estimated Cost to produce/conduct the PPA
§ Quantity - Total Number of the Units to be costed, matched to Total Targets
(9) Fund Sources in PhP: Identify specific Fund Source and amount in PhP assigned/proposed to implement the PPA
§ LGU – Cost in PhP assigned /proposed for funding of specific Local Government Units: Province/HUC/ICC LGU (General Fund and Trust Fund for Health/Special Health Fund), Municipality/Component City LGU (General Fund and Trust Fund for Health); Barangay LGU
•General Fund - Fund which is available for any purpose and is composed of all receipts and revenues which are not otherwise accruing to other funds
•Trust Fund - Fund which accounts for the receipts by any agency of government or by a public officer acting as a trustee, agent, or administrator for the fulfillment of some obligations
•Special Health Fund - pool of financial resources at the P/CWHS (Province/HUC/ICC level) intended to finance population-based and individual health services, health system operating costs, capital investments, and remuneration of additional
health workers and incentives for all health workers. Specify which Fund Source/Book of Accounts: DOH; PhilHealth income; Development Partners/NGO/Faith-based Org; LGUs. Refer to JMC 2021-0001 on SHF for allowable expenses chargeable against SHF.
§ DOH – Cost in PhP assigned/proposed for funding of Central Office or Centers for Health Development;
§ Others - Cost in PhP assigned/proposed for funding of Other Fund, Sources such as Official Development Assistance (eg. UN Agencies, development partners); other national agencies; NGOs/CSOs; private and other sectors
(10) Unfunded - Cost in PhP of PPAs with NO identified funding source
(11) Total INCLUDING Unfunded - Sum in PhP of all funding sources including Unfunded
(12) Remarks - Notes or comments; may specify Other fund sources
ANNEX E 2025 AOP Cost Matrices
AOP Form 2. Cost Assumption by HS Building Block, PPAs, Quarter and Fund Source (AOP Mother Plan)

Region: REGION A
Province/HUC/ICC: PROVINCE Y
Municipality/Component ____________
City: ___
AOP CY: 2025

Strategy/Program/ Target Resource Requirements (PhP) Fund Source (PhP)

Project/Activities (PPA)/
BUILDING BLOCK Province/HUC/ICC LGU Mun/CC LGU
Municipality/ Name of Total
Performance
HEALTH WORKFORCE District Component Health Total Unfunded INCLUDING
Indicator Q1 Q2 Q3 Q4 Unit Cost Quantity Special Health BLGU CO CHD Others Remarks
City/ Barangay Facility Target Trust Fund for Health (PhP) Unfunded
Trust Fund Fund (SHF*)
General Fund Total General Fund (SHF Sub sidiary Total (PhP)
for Health Separate Book of Ledger)
Accounts

Activity 2
Activity 3
Sub-total
Strategy 2 _______
Activity 1
Activity 2
Activity 3
Sub-total
Strategy 3_______
Activity 1
Activity 2
Activity 3
Sub-total
Sub-total for Major/
Sub-Program 1
II. Major/Sub-Program 2
Strategy 1 _______
Activity 1
Activity 2
Activity 3
Sub-total
Strategy 2 _______
Activity 1
Activity 2
Activity 3
Sub-total
Strategy 3_______
Activity 1
Activity 2
Activity 3
Sub-total
Sub-total for Major/ Sub-Program 2
Total for (Building Block)
NOTES:
(1) Health Systems Building Block: Service Delivery; Health Workforce; Health Information Systems; Supply Chain & Logistics Mgt and Health Regulation (Medical products, vaccines and technology); Financing; Leadership & Governance
▪ Strategies - Identified priority interventions that address health needs and health inequities, such as:
- Construction; Repair/renovation/expansion of health facilities; Procurement/repair of equipment; Hiring of health workforce; Retention of health workforce; Capacity building/development; Procurement/provision of commodities, medical supplies;
- Establishing systems; Monitoring; Policy development; Sectoral collaboration/partnerships; Advocacy/awareness/health promotion campaigns; Research and development; Others
▪ Program/Project/Activity (PPA) activities to implement the Strategy
(2) Performance Indicator - Measurable value/performance measurement to evaluate the success of the PPA
(3) District - The legislative district where the PPA will be applied/conducted. In a province, this excludes the legislative districts covered by the HUC/ICC which will be reflected in the HUC/ICC’s respective plans
(4) Municipality/Component City/Barangay - Specific area where the PPA will be applied/conducted, indicate if area covers GIDA/IP/Urban poor and other vulnerable population
(5) Name of Health Facility - The exact name of the facility where the PPA will be applied/conducted
(6) Target - Quantifiable physical target in relation to the performance indicator of a particular PPA. Specify targets for Q1, Q2, Q3, Q4.
(7) Total Target - Sum of quarter targets
(8) Resource Requirement – Inputs needed to conduct/produce the PPA
§ Items Description - specific description of the items/units to be costed (eg. Capsules, tablets, meals, activity cost, etc.)
§ Expense Category: PS, MOOE, CO (Infrastructure, Equipment, Motor Vehicle, Others)
§ Unit Cost - Estimated Cost to produce/conduct the PPA
§ Quantity - Total Number of the Units to be costed, matched to Total Targets
(9) Fund Sources in PhP: Identify specific Fund Source and amount in PhP assigned/proposed to implement the PPA
§ LGU – Cost in PhP assigned /proposed for funding of specific Local Government Units: Province/HUC/ICC LGU (General Fund and Trust Fund for Health/Special Health Fund), Municipality/Component City LGU (General Fund and Trust Fund for Health); Barangay LGU
•General Fund - Fund which is available for any purpose and is composed of all receipts and revenues which are not otherwise accruing to other funds
•Trust Fund - Fund which accounts for the receipts by any agency of government or by a public officer acting as a trustee, agent, or administrator for the fulfillment of some obligations
•Special Health Fund - pool of financial resources at the P/CWHS (Province/HUC/ICC level) intended to finance population-based and individual health services, health system operating costs, capital investments, and remuneration of additional
health workers and incentives for all health workers. Specify which Fund Source/Book of Accounts: DOH; PhilHealth income; Development Partners/NGO/Faith-based Org; LGUs. Refer to JMC 2021-0001 on SHF for allowable expenses chargeable against SHF.
§ DOH – Cost in PhP assigned/proposed for funding of Central Office or Centers for Health Development;
§ Others - Cost in PhP assigned/proposed for funding of Other Fund, Sources such as Official Development Assistance (eg. UN Agencies, development partners); other national agencies; NGOs/CSOs; private and other sectors
(10) Unfunded - Cost in PhP of PPAs with NO identified funding source
(11) Total INCLUDING Unfunded - Sum in PhP of all funding sources including Unfunded
(12) Remarks - Notes or comments; may specify Other fund sources
ANNEX E 2025 AOP Cost Matrices
AOP Form 2. Cost Assumption by HS Building Block, PPAs, Quarter and Fund Source (AOP Mother Plan)

Region: REGION A
Province/HUC/ICC: PROVINCE Y
Municipality/Component ____________
City: ___
AOP CY: 2025

Strategy/Program/ Target Resource Requirements (PhP) Fund Source (PhP)

Project/Activities (PPA)/
BUILDING BLOCK Province/HUC/ICC LGU Mun/CC LGU
Municipality/ Name of Total
Performance
HEALTH INFORMATION District Component Health Total Unfunded INCLUDING
Indicator Q1 Q2 Q3 Q4 Unit Cost Quantity Special Health BLGU CO CHD Others Remarks
SYSTEM City/ Barangay Facility Target Trust Fund for Health (PhP) Unfunded
Trust Fund Fund (SHF*)
General Fund Total General Fund (SHF Sub sidiary Total (PhP)
for Health Separate Book of Ledger)
Accounts

Activity 2
Activity 3
Sub-total
Strategy 2 _______
Activity 1
Activity 2
Activity 3
Sub-total
Strategy 3_______
Activity 1
Activity 2
Activity 3
Sub-total
Sub-total for Major/
Sub-Program 1
II. Major/Sub-Program 2
Strategy 1 _______
Activity 1
Activity 2
Activity 3
Sub-total
Strategy 2 _______
Activity 1
Activity 2
Activity 3
Sub-total
Strategy 3_______
Activity 1
Activity 2
Activity 3
Sub-total
Sub-total for Major/ Sub-Program 2
Total for (Building Block)
NOTES:
(1) Health Systems Building Block: Service Delivery; Health Workforce; Health Information Systems; Supply Chain & Logistics Mgt and Health Regulation (Medical products, vaccines and technology); Financing; Leadership & Governance
▪ Strategies - Identified priority interventions that address health needs and health inequities, such as:
- Construction; Repair/renovation/expansion of health facilities; Procurement/repair of equipment; Hiring of health workforce; Retention of health workforce; Capacity building/development; Procurement/provision of commodities, medical supplies;
- Establishing systems; Monitoring; Policy development; Sectoral collaboration/partnerships; Advocacy/awareness/health promotion campaigns; Research and development; Others
▪ Program/Project/Activity (PPA) activities to implement the Strategy
(2) Performance Indicator - Measurable value/performance measurement to evaluate the success of the PPA
(3) District - The legislative district where the PPA will be applied/conducted. In a province, this excludes the legislative districts covered by the HUC/ICC which will be reflected in the HUC/ICC’s respective plans
(4) Municipality/Component City/Barangay - Specific area where the PPA will be applied/conducted, indicate if area covers GIDA/IP/Urban poor and other vulnerable population
(5) Name of Health Facility - The exact name of the facility where the PPA will be applied/conducted
(6) Target - Quantifiable physical target in relation to the performance indicator of a particular PPA. Specify targets for Q1, Q2, Q3, Q4.
(7) Total Target - Sum of quarter targets
(8) Resource Requirement – Inputs needed to conduct/produce the PPA
§ Items Description - specific description of the items/units to be costed (eg. Capsules, tablets, meals, activity cost, etc.)
§ Expense Category: PS, MOOE, CO (Infrastructure, Equipment, Motor Vehicle, Others)
§ Unit Cost - Estimated Cost to produce/conduct the PPA
§ Quantity - Total Number of the Units to be costed, matched to Total Targets
(9) Fund Sources in PhP: Identify specific Fund Source and amount in PhP assigned/proposed to implement the PPA
§ LGU – Cost in PhP assigned /proposed for funding of specific Local Government Units: Province/HUC/ICC LGU (General Fund and Trust Fund for Health/Special Health Fund), Municipality/Component City LGU (General Fund and Trust Fund for Health); Barangay LGU
•General Fund - Fund which is available for any purpose and is composed of all receipts and revenues which are not otherwise accruing to other funds
•Trust Fund - Fund which accounts for the receipts by any agency of government or by a public officer acting as a trustee, agent, or administrator for the fulfillment of some obligations
•Special Health Fund - pool of financial resources at the P/CWHS (Province/HUC/ICC level) intended to finance population-based and individual health services, health system operating costs, capital investments, and remuneration of additional
health workers and incentives for all health workers. Specify which Fund Source/Book of Accounts: DOH; PhilHealth income; Development Partners/NGO/Faith-based Org; LGUs. Refer to JMC 2021-0001 on SHF for allowable expenses chargeable against SHF.
§ DOH – Cost in PhP assigned/proposed for funding of Central Office or Centers for Health Development;
§ Others - Cost in PhP assigned/proposed for funding of Other Fund, Sources such as Official Development Assistance (eg. UN Agencies, development partners); other national agencies; NGOs/CSOs; private and other sectors
(10) Unfunded - Cost in PhP of PPAs with NO identified funding source
(11) Total INCLUDING Unfunded - Sum in PhP of all funding sources including Unfunded
(12) Remarks - Notes or comments; may specify Other fund sources
ANNEX E 2025 AOP Cost Matrices
AOP Form 2. Cost Assumption by HS Building Block, PPAs, Quarter and Fund Source (AOP Mother Plan)

Region: REGION A
Province/HUC/ICC: PROVINCE Y
Municipality/Component ____________
City: ___
AOP CY: 2025

Strategy/Program/ Target Resource Requirements (PhP) Fund Source (PhP)

Project/Activities (PPA)/
BUILDING BLOCK Province/HUC/ICC LGU Mun/CC LGU
Municipality/ Name of Total
Performance
SUPPLY CHAIN AND District Component Health Total Unfunded INCLUDING
Indicator Q1 Q2 Q3 Q4 Unit Cost Quantity Special Health BLGU CO CHD Others Remarks
LOGISTICS City/ Barangay Facility Target Trust Fund for Health (PhP) Unfunded
Trust Fund Fund (SHF*)
MANAGEMENT General Fund Total General Fund (SHF Sub sidiary Total (PhP)
for Health Separate Book of Ledger)
Accounts

Activity 2
Activity 3
Sub-total
Strategy 2 _______
Activity 1
Activity 2
Activity 3
Sub-total
Strategy 3_______
Activity 1
Activity 2
Activity 3
Sub-total
Sub-total for Major/
Sub-Program 1
II. Major/Sub-Program 2
Strategy 1 _______
Activity 1
Activity 2
Activity 3
Sub-total
Strategy 2 _______
Activity 1
Activity 2
Activity 3
Sub-total
Strategy 3_______
Activity 1
Activity 2
Activity 3
Sub-total
Sub-total for Major/ Sub-Program 2
Total for (Building Block)
NOTES:
(1) Health Systems Building Block: Service Delivery; Health Workforce; Health Information Systems; Supply Chain & Logistics Mgt and Health Regulation (Medical products, vaccines and technology); Financing; Leadership & Governance
▪ Strategies - Identified priority interventions that address health needs and health inequities, such as:
- Construction; Repair/renovation/expansion of health facilities; Procurement/repair of equipment; Hiring of health workforce; Retention of health workforce; Capacity building/development; Procurement/provision of commodities, medical supplies;
- Establishing systems; Monitoring; Policy development; Sectoral collaboration/partnerships; Advocacy/awareness/health promotion campaigns; Research and development; Others
▪ Program/Project/Activity (PPA) activities to implement the Strategy
(2) Performance Indicator - Measurable value/performance measurement to evaluate the success of the PPA
(3) District - The legislative district where the PPA will be applied/conducted. In a province, this excludes the legislative districts covered by the HUC/ICC which will be reflected in the HUC/ICC’s respective plans
(4) Municipality/Component City/Barangay - Specific area where the PPA will be applied/conducted, indicate if area covers GIDA/IP/Urban poor and other vulnerable population
(5) Name of Health Facility - The exact name of the facility where the PPA will be applied/conducted
(6) Target - Quantifiable physical target in relation to the performance indicator of a particular PPA. Specify targets for Q1, Q2, Q3, Q4.
(7) Total Target - Sum of quarter targets
(8) Resource Requirement – Inputs needed to conduct/produce the PPA
§ Items Description - specific description of the items/units to be costed (eg. Capsules, tablets, meals, activity cost, etc.)
§ Expense Category: PS, MOOE, CO (Infrastructure, Equipment, Motor Vehicle, Others)
§ Unit Cost - Estimated Cost to produce/conduct the PPA
§ Quantity - Total Number of the Units to be costed, matched to Total Targets
(9) Fund Sources in PhP: Identify specific Fund Source and amount in PhP assigned/proposed to implement the PPA
§ LGU – Cost in PhP assigned /proposed for funding of specific Local Government Units: Province/HUC/ICC LGU (General Fund and Trust Fund for Health/Special Health Fund), Municipality/Component City LGU (General Fund and Trust Fund for Health); Barangay LGU
•General Fund - Fund which is available for any purpose and is composed of all receipts and revenues which are not otherwise accruing to other funds
•Trust Fund - Fund which accounts for the receipts by any agency of government or by a public officer acting as a trustee, agent, or administrator for the fulfillment of some obligations
•Special Health Fund - pool of financial resources at the P/CWHS (Province/HUC/ICC level) intended to finance population-based and individual health services, health system operating costs, capital investments, and remuneration of additional
health workers and incentives for all health workers. Specify which Fund Source/Book of Accounts: DOH; PhilHealth income; Development Partners/NGO/Faith-based Org; LGUs. Refer to JMC 2021-0001 on SHF for allowable expenses chargeable against SHF.
§ DOH – Cost in PhP assigned/proposed for funding of Central Office or Centers for Health Development;
§ Others - Cost in PhP assigned/proposed for funding of Other Fund, Sources such as Official Development Assistance (eg. UN Agencies, development partners); other national agencies; NGOs/CSOs; private and other sectors
(10) Unfunded - Cost in PhP of PPAs with NO identified funding source
(11) Total INCLUDING Unfunded - Sum in PhP of all funding sources including Unfunded
(12) Remarks - Notes or comments; may specify Other fund sources
ANNEX E 2025 AOP Cost Matrices
AOP Form 2. Cost Assumption by HS Building Block, PPAs, Quarter and Fund Source (AOP Mother Plan)

Region: REGION A
Province/HUC/ICC: PROVINCE Y
Municipality/Component ____________
City: ___
AOP CY: 2025

Strategy/Program/ Target Resource Requirements (PhP) Fund Source (PhP)

Project/Activities (PPA)/
BUILDING BLOCK Province/HUC/ICC LGU Mun/CC LGU
Municipality/ Name of Total
Performance
FINANCING District Component Health Total Unfunded INCLUDING
Indicator Q1 Q2 Q3 Q4 Unit Cost Quantity Special Health BLGU CO CHD Others Remarks
City/ Barangay Facility Target Trust Fund for Health (PhP) Unfunded
Trust Fund Fund (SHF*)
General Fund Total General Fund (SHF Sub sidiary Total (PhP)
for Health Separate Book of Ledger)
Accounts

Activity 2
Activity 3
Sub-total
Strategy 2 _______
Activity 1
Activity 2
Activity 3
Sub-total
Strategy 3_______
Activity 1
Activity 2
Activity 3
Sub-total
Sub-total for Major/
Sub-Program 1
II. Major/Sub-Program 2
Strategy 1 _______
Activity 1
Activity 2
Activity 3
Sub-total
Strategy 2 _______
Activity 1
Activity 2
Activity 3
Sub-total
Strategy 3_______
Activity 1
Activity 2
Activity 3
Sub-total
Sub-total for Major/ Sub-Program 2
Total for (Building Block)
NOTES:
(1) Health Systems Building Block: Service Delivery; Health Workforce; Health Information Systems; Supply Chain & Logistics Mgt and Health Regulation (Medical products, vaccines and technology); Financing; Leadership & Governance
▪ Strategies - Identified priority interventions that address health needs and health inequities, such as:
- Construction; Repair/renovation/expansion of health facilities; Procurement/repair of equipment; Hiring of health workforce; Retention of health workforce; Capacity building/development; Procurement/provision of commodities, medical supplies;
- Establishing systems; Monitoring; Policy development; Sectoral collaboration/partnerships; Advocacy/awareness/health promotion campaigns; Research and development; Others
▪ Program/Project/Activity (PPA) activities to implement the Strategy
(2) Performance Indicator - Measurable value/performance measurement to evaluate the success of the PPA
(3) District - The legislative district where the PPA will be applied/conducted. In a province, this excludes the legislative districts covered by the HUC/ICC which will be reflected in the HUC/ICC’s respective plans
(4) Municipality/Component City/Barangay - Specific area where the PPA will be applied/conducted, indicate if area covers GIDA/IP/Urban poor and other vulnerable population
(5) Name of Health Facility - The exact name of the facility where the PPA will be applied/conducted
(6) Target - Quantifiable physical target in relation to the performance indicator of a particular PPA. Specify targets for Q1, Q2, Q3, Q4.
(7) Total Target - Sum of quarter targets
(8) Resource Requirement – Inputs needed to conduct/produce the PPA
§ Items Description - specific description of the items/units to be costed (eg. Capsules, tablets, meals, activity cost, etc.)
§ Expense Category: PS, MOOE, CO (Infrastructure, Equipment, Motor Vehicle, Others)
§ Unit Cost - Estimated Cost to produce/conduct the PPA
§ Quantity - Total Number of the Units to be costed, matched to Total Targets
(9) Fund Sources in PhP: Identify specific Fund Source and amount in PhP assigned/proposed to implement the PPA
§ LGU – Cost in PhP assigned /proposed for funding of specific Local Government Units: Province/HUC/ICC LGU (General Fund and Trust Fund for Health/Special Health Fund), Municipality/Component City LGU (General Fund and Trust Fund for Health); Barangay LGU
•General Fund - Fund which is available for any purpose and is composed of all receipts and revenues which are not otherwise accruing to other funds
•Trust Fund - Fund which accounts for the receipts by any agency of government or by a public officer acting as a trustee, agent, or administrator for the fulfillment of some obligations
•Special Health Fund - pool of financial resources at the P/CWHS (Province/HUC/ICC level) intended to finance population-based and individual health services, health system operating costs, capital investments, and remuneration of additional
health workers and incentives for all health workers. Specify which Fund Source/Book of Accounts: DOH; PhilHealth income; Development Partners/NGO/Faith-based Org; LGUs. Refer to JMC 2021-0001 on SHF for allowable expenses chargeable against SHF.
§ DOH – Cost in PhP assigned/proposed for funding of Central Office or Centers for Health Development;
§ Others - Cost in PhP assigned/proposed for funding of Other Fund, Sources such as Official Development Assistance (eg. UN Agencies, development partners); other national agencies; NGOs/CSOs; private and other sectors
(10) Unfunded - Cost in PhP of PPAs with NO identified funding source
(11) Total INCLUDING Unfunded - Sum in PhP of all funding sources including Unfunded
(12) Remarks - Notes or comments; may specify Other fund sources
ANNEX E 2025 AOP Cost Matrices
AOP Form 2. Cost Assumption by HS Building Block, PPAs, Quarter and Fund Source (AOP Mother Plan)

Region: REGION A
Province/HUC/ICC: PROVINCE Y
Municipality/Component ____________
City: ___
AOP CY: 2025

Strategy/Program/ Target Resource Requirements (PhP) Fund Source (PhP)

Project/Activities (PPA)/
BUILDING BLOCK Province/HUC/ICC LGU Mun/CC LGU
Municipality/ Name of Total
Performance
LEADERSHIP AND District Component Health Total Unfunded INCLUDING
Indicator Q1 Q2 Q3 Q4 Unit Cost Quantity Special Health BLGU CO CHD Others Remarks
GOVERNANCE City/ Barangay Facility Target Trust Fund for Health (PhP) Unfunded
Trust Fund Fund (SHF*)
General Fund Total General Fund (SHF Sub sidiary Total (PhP)
for Health Separate Book of Ledger)
Accounts

Activity 2
Activity 3
Sub-total
Strategy 2 _______
Activity 1
Activity 2
Activity 3
Sub-total
Strategy 3_______
Activity 1
Activity 2
Activity 3
Sub-total
Sub-total for Major/
Sub-Program 1
II. Major/Sub-Program 2
Strategy 1 _______
Activity 1
Activity 2
Activity 3
Sub-total
Strategy 2 _______
Activity 1
Activity 2
Activity 3
Sub-total
Strategy 3_______
Activity 1
Activity 2
Activity 3
Sub-total
Sub-total for Major/ Sub-Program 2
Total for (Building Block)
NOTES:
(1) Health Systems Building Block: Service Delivery; Health Workforce; Health Information Systems; Supply Chain & Logistics Mgt and Health Regulation (Medical products, vaccines and technology); Financing; Leadership & Governance
▪ Strategies - Identified priority interventions that address health needs and health inequities, such as:
- Construction; Repair/renovation/expansion of health facilities; Procurement/repair of equipment; Hiring of health workforce; Retention of health workforce; Capacity building/development; Procurement/provision of commodities, medical supplies;
- Establishing systems; Monitoring; Policy development; Sectoral collaboration/partnerships; Advocacy/awareness/health promotion campaigns; Research and development; Others
▪ Program/Project/Activity (PPA) activities to implement the Strategy
(2) Performance Indicator - Measurable value/performance measurement to evaluate the success of the PPA
(3) District - The legislative district where the PPA will be applied/conducted. In a province, this excludes the legislative districts covered by the HUC/ICC which will be reflected in the HUC/ICC’s respective plans
(4) Municipality/Component City/Barangay - Specific area where the PPA will be applied/conducted, indicate if area covers GIDA/IP/Urban poor and other vulnerable population
(5) Name of Health Facility - The exact name of the facility where the PPA will be applied/conducted
(6) Target - Quantifiable physical target in relation to the performance indicator of a particular PPA. Specify targets for Q1, Q2, Q3, Q4.
(7) Total Target - Sum of quarter targets
(8) Resource Requirement – Inputs needed to conduct/produce the PPA
§ Items Description - specific description of the items/units to be costed (eg. Capsules, tablets, meals, activity cost, etc.)
§ Expense Category: PS, MOOE, CO (Infrastructure, Equipment, Motor Vehicle, Others)
§ Unit Cost - Estimated Cost to produce/conduct the PPA
§ Quantity - Total Number of the Units to be costed, matched to Total Targets
(9) Fund Sources in PhP: Identify specific Fund Source and amount in PhP assigned/proposed to implement the PPA
§ LGU – Cost in PhP assigned /proposed for funding of specific Local Government Units: Province/HUC/ICC LGU (General Fund and Trust Fund for Health/Special Health Fund), Municipality/Component City LGU (General Fund and Trust Fund for Health); Barangay LGU
•General Fund - Fund which is available for any purpose and is composed of all receipts and revenues which are not otherwise accruing to other funds
•Trust Fund - Fund which accounts for the receipts by any agency of government or by a public officer acting as a trustee, agent, or administrator for the fulfillment of some obligations
•Special Health Fund - pool of financial resources at the P/CWHS (Province/HUC/ICC level) intended to finance population-based and individual health services, health system operating costs, capital investments, and remuneration of additional
health workers and incentives for all health workers. Specify which Fund Source/Book of Accounts: DOH; PhilHealth income; Development Partners/NGO/Faith-based Org; LGUs. Refer to JMC 2021-0001 on SHF for allowable expenses chargeable against SHF.
§ DOH – Cost in PhP assigned/proposed for funding of Central Office or Centers for Health Development;
§ Others - Cost in PhP assigned/proposed for funding of Other Fund, Sources such as Official Development Assistance (eg. UN Agencies, development partners); other national agencies; NGOs/CSOs; private and other sectors
(10) Unfunded - Cost in PhP of PPAs with NO identified funding source
(11) Total INCLUDING Unfunded - Sum in PhP of all funding sources including Unfunded
(12) Remarks - Notes or comments; may specify Other fund sources
ANNEX E 2025 AOP Cost Matrices
AOP Form 3. Summary of LGU Investment Needs

Region: REGION A
Province/HUC/ICC: PROVINCE Y
Municipality/Component City: ____________
AOP Year: 2025

Cost per Fund Source (PhP)

LOCAL GOVERNMENT UNITS (LGU) DOH
Province/HUC/ICC LGU Mun/CC LGU Total Total
Categories of EXCLUDING Unfunded INCLUDING Remarks
Special Health Others
Investment Needs Trust Fund for Trust Fund for Health Barangay Central Office CHD unfunded (PhP) Unfunded
General Fund Fund (SHF) Total General Fund (SHF Sub sidiary Total
Health Separate Book of Ledger) (PhP) (PhP)
Accounts

1. Health Facility Development

New Construction
a. LGU Hospital
b. RHU
c. BHS
d. Other facilities (please specify)
Repair/Improvement/Upgrading
a. LGU Hospital
b. RHU
c. BHS
d. Other facilities (please specify)
Equipment
a. LGU Hospital
b. RHU
c. BHS
d. Other facilities (please specify)
Motor Vehicle
a. LGU Hospital
b. RHU
c. BHS
d. Other facilities (please specify)
MOOE (including operations cost)
a. LGU Hospital
b. RHU
c. BHS
d. Other facilities (please specify)
2. Information & Communication Technology
a. LGU Hospital
b. RHU
c. BHS
d. Other facilities (please specify)
Sub-Total

3.*Human Resource for Health

I. HRH Deployment
Please indicate the quantity and amount per cadre.
a. Physician (specify)
b. Nurse
c. Midwife
d. Medical Technologist
e. Dentist
f. Pharmacist
g. Nutritionist-Dietician
h. Physical Therapist
i. Other HRH, please specify
II. LGU
a. Needemployment
for New Plantilla Items
(itemized)
b. Existing Plantilla Items
(Lumped)
c. Request for New Job
Order/Casual
d. Existing Job(Lumped
Order/Casual
(Lumped)
Sub-Total

4. Commodities (Drugs/Vaccines/Med. Supplies)

Please indicate commodities/ drugs/ vaccine under each program. Commodities cited in this template are EXAMPLES only.
Family Health, Nutrition and
Responsible Parenting
Family Planning & Reproductive
Health
a. DMPA
b. Pills
c. Condoms
d. Sub-dermal Implant
Oral Health
a. Flouride
b. Lidocaine
Nutrition
a. Micronutrient powder
b. Vitamin A
c. Iron
Others
National Immunization
a. IPV
b. OPV
c. DPT-HEPB-HIB
d. MR
Elimination of Infectious Diseases
Malaria Control and Elimination
Schistosomiasis
Leprosy
Filariasis
Rabies Prevention and Control
Prevention and Control of
infectious Diseases
TB
Dengue Prevention and Control
HIV/STI Prevention and Control
Other Infectious Diseases
Non-communicable Diseases
Hypertension
Diabetes
Mental Health
CVD
Cancer
Environmental and Occupational
Health
Health Emergency Management
Other Commodities

Sub-total

5. Other Technical Assistance

A. Leadership
Local and Governance
Health Systems integration
activities
LIPH/AOP development and monitoring
LGU Health Scorecard activities
including
GIDA, advocacy
ICC/IPS, Urban Poorand recognition
activities/projects
of those with exemplary practices
Leadership and Governance strengthening activities
Data collection for health equity
assessment, measurement and
intervention for HUCs/ICCs
Barangay Health Workers (BHWs) activities
Documentation of best practices
Others

B. Financing
C. Health Workforce
D. Information
E. Supply
F. ServiceChain and(Programs
Delivery Logistics Management & Health Regulation
indicated are not
Family Health, exhaustive)
Nutrition and
Responsible Parenting
National Immunization
Elimination of Infectious Diseases
Rabies Prevention and Control
Prevention and control of Infectious Diseases
TB
Dengue Prevention and Control
HIV/STI Prevention and Control
Other Infectious Diseases
Non-communicable Diseases
Environmental and Occupational Health
Health Emergency Management
Others (specify)

Sub-total

Total
NOTES:
(1) Fund Sources in PhP: Identify specific Fund Source and amount in PhP assigned/proposed to implement the PPA
§ LGU – Cost in PhP assigned /proposed for funding of specific Local Government Units: Province/HUC/ICC LGU (General Fund and Trust Fund for Health/Special Health Fund), Municipality/Component City LGU (General Fund and Trust Fund for Health); Barangay LGU
•General Fund - Fund which is available for any purpose and is composed of all receipts and revenues which are not otherwise accruing to other funds
•Trust Fund - Fund which accounts for the receipts by any agency of government or by a public officer acting as a trustee, agent, or administrator for the fulfillment of some obligations
•Special Health Fund - pool of financial resources at the P/CWHS (Province/HUC/ICC level) intended to finance population-based and individual health services, health system operating costs, capital investments, and remuneration of additional
health workers and incentives for all health workers. Specify which Fund Source/Book of Accounts: DOH; PhilHealth income; Development Partners/NGO/Faith-based Org; LGUs. Refer to JMC 2021-0001 on SHF for allowable expenses chargeable against SHF.
§ DOH – Cost in PhP assigned/proposed for funding of Central Office or Centers for Health Development;
§ Others - Cost in PhP assigned/proposed for funding of Other Fund, Sources such as Official Development Assistance (eg. UN Agencies, development partners); other national agencies; NGOs/CSOs; private and other sectors
(2) Total (EXCLUDING Unfunded) - Sum in PhP of all funding sources excluding Unfunded
(3) Unfunded - Cost in PhP of PPAs with NO identified funding source
(4) Total INCLUDING Unfunded - Sum in PhP of all funding sources including Unfunded
(5) Remarks - Notes or comments; may specify Other fund sources
ANNEX E 2025 AOP Cost Matrices
AOP Form 3.1. LGU Investment Need for Health Facility Development, Information & Communication Technology and Operations Cost

Region: REGION A
Province/HUC/
ICC: PROVINCE Y

Municipality/
Component City: ______________
AOP CY: 2025

Facility Investment Need (PhP) Cost per Fund Source (PhP)

LOCAL GOVERNMENT UNITS (LGU) DOH

Municipality/ Climate Change intervention Province/HUC/ICC LGU Mun/CC LGU Total

District Name of Health Project
Component City/ Category Bed Increase (Structural, Non-structural, Medical Total Cost/ Unfunded INCLUDING
Facility Description Infrastructure Motor Vehicle ICT Equipment Others Others Remarks
Barangay Energy, WSH, HCWM) Equipment Facility Barangay Central Office CHD/MOH (PhP) Unfunded
Special Health Fund
Trust Fund for Trust Fund for Health (PhP)
General Fund (SHF) Total General Fund Total
Health Separate Book of (SHF Sub sidiary Ledger)
Accounts

I. Health Facility Development

A. Construction/ Completion/ Repair/ Upgrading/ Equipping

B. Maintenance and Other Operating Expenses

Sub-total

II. Information and Communication Technology

Sub-total

III. Others (including operations/overhead cost)

A. Capital Outlay

B. Maintenance and Other Operating Expenses

Sub-total
Total
NOTES:
(1) District - The legislative district where the PPA will be applied/conducted. In a province, this excludes the legislative districts covered by the HUC/ICC which will be reflected in the HUC/ICC’s respective plans
(2) Municipality/Component City/Barangay - Specific area where the PPA will be applied/conducted, indicate if area covers GIDA/IP/Urban poor and other vulnerable population
(3) Category -
(4) Name of Health Facility - The exact name of the facility where the PPA will be applied/conducted
(5) Project Description
(6) Bed Increase - The requested increase # of beds

(7) Climate Change Intervention: Project being proposed for health facility development. Indicate type: Structural, Non-structural, Energy, Water, Sanitation, and Hygiene (WSH), Health Care Waste Management (HCWM)
(8) Infrastructure - Refers to the cost in PhP of construction, repair, rehabilitation, upgrading of facilities
(9) Medical Equipment - The cost in PhP of specific equipment needed for the facility
(10) Motor Vehicle - The cost in PhP of specific vehicle needed for the facility
(11) Information, Communication & Technology Equipment - The cost of ICT, such as hardware; software; databases; registries; capacity building
(12) Others - The cost in PhP of non-medical equipment, non-ICT items and operations/overhead costs to cover day-to-day requirements of facilities
to carry out their regular operationssuch as water utilities, electricity, regular office supplies, rents, gasoline, other maintenance and operating expenses
(13) Total Cost/Facility - Cost in PhP of all interventions for the facility
(14) Fund Sources in PhP: Identify specific Fund Source and amount in PhP assigned/proposed to implement the PPA
§ LGU – Cost in PhP assigned /proposed for funding of specific Local Government Units: Province/HUC/ICC LGU (General Fund and Trust Fund for Health/Special Health Fund), Municipality/Component City LGU (General Fund and Trust Fund for Health); Barangay LGU
•General Fund - Fund which is available for any purpose and is composed of all receipts and revenues which are not otherwise accruing to other funds
•Trust Fund - Fund which accounts for the receipts by any agency of government or by a public officer acting as a trustee, agent, or administrator for the fulfillment of some obligations
•Special Health Fund - pool of financial resources at the P/CWHS (Province/HUC/ICC level) intended to finance population-based and individual health services, health system operating costs, capital investments, and remuneration of additional
health workers and incentives for all health workers. Specify which Fund Source/Book of Accounts: DOH; PhilHealth income; Development Partners/NGO/Faith-based Org; LGUs. Refer to JMC 2021-0001 on SHF for allowable expenses chargeable against SHF.
§ DOH – Cost in PhP assigned/proposed for funding of Central Office or Centers for Health Development;
§ Others - Cost in PhP assigned/proposed for funding of Other Fund, Sources such as Official Development Assistance (eg. UN Agencies, development partners); other national agencies; NGOs/CSOs; private and other sectors
(9) Unfunded - Cost in PhP of PPAs with NO identified funding source
(10) Total INCLUDING Unfunded - Sum in PhP of all funding sources including Unfunded
(11) Remarks - Notes or comments; may specify Other fund sources
ANNEX E 2025 AOP Cost Matrices
AOP Form 3.2. LGU Investment Need for Human Resource for Health

Region: REGION A
Province/HUC/
PROVINCE Y
ICC:
Municipality/ ______________
Component City: _
AOP CY: 2025

Cost per Fund Source (PhP)

LOCAL GOVERNMENT UNITS (LGU) DOH

District Municipality/ Province/HUC/ICC LGU Mun/CC LGU Total

Name of Health Salary Total Salaries
Component City/ HRH/ Cadre Number Unfunded INCLUDING Remarks
Facility Grade and Benefits Special Health Others
Barangay Trust Fund Trust Fund for Barangay CO CHD (PhP) Unfunded
General Fund (SHF) General (PhP)
for Health Total Health (SHF Sub Total
Fund Separate Book of Fund sidiary Ledger)
Accounts

I.a.HRH Deployment
Physician
(specify)
b. Nurse
c. Midwife
d. Medical
Technologist
e. Dentist
f. Pharmacist
g. Nutritionist-
Dietician
h. Physical
Therapist
i. Other HRH,
please specify
Sub-total
II. LGU Employment
a. Need for New Plantilla Items* (summary per facility)

b. Existing Plantilla Items

c. Request for New Job Order/Casual

d. Existing Job Order/Casual

Sub-total
Total
NOTES:
(1) District - The legislative district where the PPA will be applied/conducted. In a province, this excludes the legislative districts covered by the HUC/ICC which will be reflected in the HUC/ICC’s respective plans
(2) Municipality/Component City/Barangay - Specific area where the PPA will be applied/conducted, indicate if area covers GIDA/IP/Urban poor and other vulnerable population
(3) Name of Health Facility - The exact name of the facility where the PPA will be applied/conducted
(4) HRH/Cadre - Specific item/type of the Human Resources for Health needed/requested
(5) Number - # of specific HRH /Cadre requested
(6) Salary Grade - Predetermined compensation level for a given position or cadre
(7) Total Salaries and Benefits - Sum in PhP of salaries and benefits of a specific HRH/Cadre
(8) Fund Sources in PhP: Identify specific Fund Source and amount in PhP assigned/proposed to implement the PPA
§ LGU – Cost in PhP assigned /proposed for funding of specific Local Government Units: Province/HUC/ICC LGU (General Fund and Trust Fund for Health/Special Health Fund), Municipality/Component City LGU (General Fund and Trust Fund for Health); Barangay LGU
•General Fund - Fund which is available for any purpose and is composed of all receipts and revenues which are not otherwise accruing to other funds
•Trust Fund - Fund which accounts for the receipts by any agency of government or by a public officer acting as a trustee, agent, or administrator for the fulfillment of some obligations
•Special Health Fund - pool of financial resources at the P/CWHS (Province/HUC/ICC level) intended to finance population-based and individual health services, health system operating costs, capital investments, and remuneration of additional
health workers and incentives for all health workers. Specify which Fund Source/Book of Accounts: DOH; PhilHealth income; Development Partners/NGO/Faith-based Org; LGUs. Refer to JMC 2021-0001 on SHF for allowable expenses chargeable against SHF.
§ DOH – Cost in PhP assigned/proposed for funding of Central Office or Centers for Health Development;
§ Others - Cost in PhP assigned/proposed for funding of Other Fund, Sources such as Official Development Assistance (eg. UN Agencies, development partners); other national agencies; NGOs/CSOs; private and other sectors
(9) Unfunded - Cost in PhP of PPAs with NO identified funding source
(10) Total INCLUDING Unfunded - Sum in PhP of all funding sources including Unfunded
(11) Remarks - Notes or comments; may specify Other fund sources
ANNEX E 2025 AOP Cost Matrices
AOP Form 3.3. LGU Investment Need for Commodities

Region: REGION A
Province/HUC/ICC: PROVINCE Y
Municipality/
____________
Component City:
AOP CY: 2025

Cost per Fund Source (PhP)

LOCAL GOVERNMENT UNITS (LGU) DOH
Total
Commodities Municipality/ Total Cost Province/HUC/ICC LGU Mun/CC LGU
Name of Health Target Estimated Unit INCLUDING
District Component Items/ Description Quantity (Unit Cost x Quantity) Unfunded Remarks
Facility Population Cost (PhP) Special Health Others Unfunded
City/ Barangay (PhP) Trust Fund for Health Barangay Central Office CHD (PhP)
Trust Fund for Fund (SHF) (PhP)
General Fund Total General Fund (SHF Sub sidiary Total
Health Separate Book of Ledger)
Accounts

Major Program 1
Sub Program 1
Commodities 1
Commodities 2
Sub-Total

Sub Program 2
Commodities 1
Commodities 2
Sub-Total

Sub-total Major Program 1

Major Program 2
Sub Program 1
Commodities 1
Commodities 2
Sub-Total

Sub Program 2
Commodities 1
Commodities 2
Sub-Total

Sub-total Major Program 2

Total
NOTES:
(1) Commodities - Drugs, vaccines and their corresponding medical supplies
(2) District - The legislative district where the PPA will be applied/conducted. In a province, this excludes the legislative districts covered by the HUC/ICC which will be reflected in the HUC/ICC’s respective plans
(3) Municipality/Component City/Barangay - Specific area where the PPA will be applied/conducted, indicate if area covers GIDA/IP/Urban poor and other vulnerable population
(4) Name of Health Facility - The exact name of the facility where the PPA will be applied/conducted
(5) Target Population - Specific group of people who are recipients or beneficiaries of the identified commodity
(6) Items/Description - Specific description of the commodity
(7) Quantity - Number of commodities needed/requested
(8) Estimated Unit Cost - Cost in PhP of a unit of commodity
(9) Total Cost - Unit cost in PhP multiplied by the Quantity
(10) Fund Sources in PhP: Identify specific Fund Source and amount in PhP assigned/proposed to implement the PPA
§ LGU – Cost in PhP assigned /proposed for funding of specific Local Government Units: Province/HUC/ICC LGU (General Fund and Trust Fund for Health/Special Health Fund), Municipality/Component City LGU (General Fund and Trust Fund for Health); Barangay LGU
•General Fund - Fund which is available for any purpose and is composed of all receipts and revenues which are not otherwise accruing to other funds
•Trust Fund - Fund which accounts for the receipts by any agency of government or by a public officer acting as a trustee, agent, or administrator for the fulfillment of some obligations
•Special Health Fund - pool of financial resources at the P/CWHS (Province/HUC/ICC level) intended to finance population-based and individual health services, health system operating costs, capital investments, and remuneration of additional
health workers and incentives for all health workers. Specify which Fund Source/Book of Accounts: DOH; PhilHealth income; Development Partners/NGO/Faith-based Org; LGUs. Refer to JMC 2021-0001 on SHF for allowable expenses chargeable against SHF.
§ DOH – Cost in PhP assigned/proposed for funding of Central Office or Centers for Health Development;
§ Others - Cost in PhP assigned/proposed for funding of Other Fund, Sources such as Official Development Assistance (eg. UN Agencies, development partners); other national agencies; NGOs/CSOs; private and other sectors
(11) Unfunded - Cost in PhP of PPAs with NO identified funding source
(12) Total INCLUDING Unfunded - Sum in PhP of all funding sources including Unfunded
(13) Remarks - Notes or comments; may specify Other fund sources
ANNEX E 2025 AOP Cost Matrices
AOP Form 3.4. LGU Investment Need for Other Technical Assistance

Region: REGION A
Province/HUC/ICC: PROVINCE Y
Municipality/
______________
Component City:
AOP CY: 2025

Resource Requirements (PhP) Fund Source (PhP)

Target
LOCAL GOVERNMENT UNITS (LGU) DOH
Activities Province/HUC/ICC LGU Mun/CC LGU Total
Municipality/ Total Cost INCLUDING
Component City/ (Unit Cost x Unfunded Remarks
Items Description Unit Cost Quantity Special Health Central Others Unfunded
Barangay Q1 Q2 Q3 Q4 Total Target Quantity) Trust Fund for Barangay CHD (PhP)
General Fund
Trust Fund Fund (SHF) Total General Fund Total Office (PhP)
(PhP) for Health
Health (SHF Sub
Separate Book of sidiary Ledger)
Accounts

A. Leadership and Governance

Major Program 1
Sub-Program 1
Activity 1
Activity 2

Sub-Program 2
Activity 1
Activity 2
Sub-total Leadership and Governance
B. Financing
Major Program 1
Activity 1
Activity 2
Sub-total Financing
C. Health Worksforce
Major Program 1
Sub-Program 1
Activity 1
Activity 2

Sub-Program 2
Activity 1
Activity 2
Sub-total Health Workforce
D. Information
Major Program 1 `
Sub-Program 1
Activity 1
Activity 2

Sub-Program 2
Activity 1
Activity 2
Sub-total Information
E. Supply Chain & Logistics Management (Health Regulation)
Major/Sub-Program 1
Activity 1
Activity 2
Sub-total Supply Chain & Logistics Management (Health Regulation)
F. Service Delivery
Major Program 1
Sub-Program 1
Activity 1
Activity 2

Sub-Program 2
Activity 1
Activity 2

Major Program 2
Sub-Program 1
Activity 1
Activity 2

Sub-Program 2
Activity 1
Activity 2
Sub-total Service Delivery
Total
NOTES:
(1) Activities - Specific action/intervention to be undertaken
(2) Municipality/Component City/Barangay - Specific area where the PPA will be applied/conducted, indicate if area covers GIDA/IP/Urban poor and other vulnerable population
(3) Target - Quantifiable physical target in relation to the performance indicator of a particular PPA. Specify targets for Q1, Q2, Q3, Q4.
(4) Total Target - Sum in PhP of cost of fund sources, including Unfunded
(2) Fund Sources in PhP: Identify specific Fund Source and amount in PhP assigned/proposed to implement the PPA
§ LGU – Cost in PhP assigned /proposed for funding of specific Local Government Units: Province/HUC/ICC LGU (General Fund and Trust Fund for Health/Special Health Fund), Municipality/Component City LGU (General Fund and Trust Fund for Health); Barangay LGU
•General Fund - Fund which is available for any purpose and is composed of all receipts and revenues which are not otherwise accruing to other funds
•Trust Fund - Fund which accounts for the receipts by any agency of government or by a public officer acting as a trustee, agent, or administrator for the fulfillment of some obligations
•Special Health Fund - pool of financial resources at the P/CWHS (Province/HUC/ICC level) intended to finance population-based and individual health services, health system operating costs, capital investments, and remuneration of additional
health workers and incentives for all health workers. Specify which Fund Source/Book of Accounts: DOH; PhilHealth income; Development Partners/NGO/Faith-based Org; LGUs. Refer to JMC 2021-0001 on SHF for allowable expenses chargeable against SHF.
§ DOH – Cost in PhP assigned/proposed for funding of Central Office or Centers for Health Development;
§ Others - Cost in PhP assigned/proposed for funding of Other Fund, Sources such as Official Development Assistance (eg. UN Agencies, development partners); other national agencies; NGOs/CSOs; private and other sectors
(9) Unfunded - Cost in PhP of PPAs with NO identified funding source
(10) Total INCLUDING Unfunded - Sum in PhP of all funding sources including Unfunded
(11) Remarks - Notes or comments; may specify Other fund sources