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Tanzania HIV/AIDS and Malaria Indicator Survey ... - Measure DHS

Tanzania HIV/AIDS and Malaria Indicator Survey ... - Measure DHS

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LAST BIRTH NEXT-TO-LAST BIRTH SECOND-FROM-LAST BIRTHNO. QUESTIONS AND FILTERS NAME ________________ NAME ________________ NAME _________________319 Now I would like to know how much(NAME) was given to drink (includingbreastmilk) during the illness witha fever. Was he/she given less thanusual to drink, about the same MUCH LESS . . . . . 1 MUCH LESS . . . . . 1 MUCH LESS . . . . . 1amount, or more than usual to SOMEWHAT LESS . 2 SOMEWHAT LESS . 2 SOMEWHAT LESS . 2drink? ABOUT THE SAME . 3 ABOUT THE SAME . 3 ABOUT THE SAME . 3IF LESS, PROBE: Was he/she MORE . . . . . . . . . . . . 4 MORE . . . . . . . . . . . . 4 MORE . . . . . . . . . . . . 4given much less than usual to NOTHING TO DRINK 5 NOTHING TO DRINK 5 NOTHING TO DRINK 5drink or somewhat less? DON'T KNOW . . . . . 8 DON'T KNOW . . . . . 8 DON'T KNOW . . . . . 8320 When (NAME) had a fever, washe/she given less than usual to eat, MUCH LESS . . . . . 1 MUCH LESS . . . . . 1 MUCH LESS . . . . . 1about the same amount, more SOMEWHAT LESS . 2 SOMEWHAT LESS . 2 SOMEWHAT LESS . 2than usual or nothing to eat? ABOUT THE SAME . 3 ABOUT THE SAME . 3 ABOUT THE SAME . 3MORE . . . . . . . . . . . . 4 MORE . . . . . . . . . . . . 4 MORE . . . . . . . . . . . . 4IF LESS, PROBE: Was he/she STOPPED FOOD . 5 STOPPED FOOD . 5 STOPPED FOOD . 5given much less than usual to NEVER GAVE FOOD 6 NEVER GAVE FOOD 6 NEVER GAVE FOOD 6eat or somewhat less? DON'T KNOW . . . . . 8 DON'T KNOW . . . . . 8 DON'T KNOW . . . . . 8321 Did you seek advice or treatment YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1for the illness from any source? NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2(SKIP TO 326) (SKIP TO 326) (SKIP TO 326)322 Where did you seek advice or GOV. PARASTATAL GOV. PARASTATAL GOV. PARASTATALtreatment? REFERAL/SPEC. REFERAL/SPEC. REFERAL/SPEC.HOSPITAL . . . B HOSPITAL . . . B HOSPITAL . . . BAnywhere else? REGIONAL HOSP. C REGIONAL HOSP. C REGIONAL HOSP. CDISTRICT HOSP. D DISTRICT HOSP. D DISTRICT HOSP. DRECORD ALL MENTIONED. HEALTH CENTRE E HEALTH CENTRE E HEALTH CENTRE EDISPENSARY . . . F DISPENSARY . . . F DISPENSARY . . . FVILLAGE HEALTH VILLAGE HEALTH VILLAGE HEALTHPOST . . . . . . . . G POST . . . . . . . . G POST . . . . . . . . GCBD WORKER . H CBD WORKER . H CBD WORKER . HIF UNABLE TO DETERMINE IF A RELIGIOUS/VOLUNTARY RELIGIOUS/VOLUNTARY RELIGIOUS/VOLUNTARYHEALTH FACILITY IS PUBLIC OR REFERAL/SPEC. REFERAL/SPEC. REFERAL/SPEC.PRIVATE MEDICAL, WRITE THE HOSPITAL . . . I HOSPITAL . . . I HOSPITAL . . . ITHE NAME OF THE PLACE. DISTRICT HOSP. J DISTRICT HOSP. J DISTRICT HOSP. JHEALTH CENTRE K HEALTH CENTRE K HEALTH CENTRE KDISPENSARY . . . L DISPENSARY . . . L DISPENSARY . . . LPRIVATE PRIVATE PRIVATE(NAME OF PLACE(S)) SPECIALISED SPECIALISED SPECIALISEDHOSPITAL . . . M HOSPITAL . . . M HOSPITAL . . . MHEALTH CENTRE N HEALTH CENTRE N HEALTH CENTRE NDISPENSARY . O DISPENSARY O DISPENSARY OOTHER OTHER OTHERPHARMACY . . . P PHARMACY . . . P PHARMACY . . . POTHER __________ X OTHER __________ X OTHER __________ X(SPECIFY) (SPECIFY) (SPECIFY)323 CHECK 322: TWO OR ONLY TWO OR ONLY TWO OR ONLYMORE ONE MORE ONE MORE ONECODES CODE CODES CODE CODES CODECIRCLED CIRCLED CIRCLED CIRCLED CIRCLED CIRCLED(SKIP TO 325) (SKIP TO 325) (SKIP TO 325)324 Where did you first seek adviceor treatment? FIRST PLACE . . . FIRST PLACE . . . FIRST PLACE . . .USE LETTER CODE FROM 322.325 How many days after the feverbegan did you first seek adviceor treatment for (NAME)? DAYS . . . . . DAYS . . . . . DAYS . . . . .IF THE SAME DAY, RECORD '00'.254 | Appendix D

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