13.07.2015 Views

Characteristics of Households - Childinfo.org

Characteristics of Households - Childinfo.org

Characteristics of Households - Childinfo.org

SHOW MORE
SHOW LESS

Create successful ePaper yourself

Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.

CA7. At any time in the last two weeks, has (name) had an illnesswith a cough?CA8. When the child had an illness with a cough, did he/shebreathe faster than usual, with short, quick breaths or havedifficulty breathing?CA9. Was the fast or difficult breathing due to a problem in thechest or a blocked or runny nose?CA10. Did you seek any advice or treatment for the illnessoutside the home?CA11. From where did you seek advice or help?Probe:Anywhere else?Circle all providers mentioned, but do NOT prompt with anysuggestions.Probe to identify each type <strong>of</strong> source.If unable to determine if public or private sector, write the name <strong>of</strong>the place.(Name <strong>of</strong> place)Yes 1No 2DK 8Yes 1No 2DK 8Problem in chest only 1Blocked or running nose only 2Both 3Other (specify) 6DK 8Yes 1No 2DK 8Public sectorGovt. hospitalAGovt. health centreBGovt. health postCOther public (specify)HPrivate medical sectorPrivate hospital/clinicIPrivate physicianJPrivate pharmacyKOther private medical (specify)OOther sourceRelative/friendPTraditional practitionerRRoma health mediatorSOther (specify)XCA12. Was (name) given any medicine to treat this illness? Yes 1No 2DK 8CA13. What medicine was (name) given?Probe:Any other medicine?Circle all medicines given. Write brand name(s) <strong>of</strong> all medicinesmentioned.(Names <strong>of</strong> medicines)CA14. Check AG2: Child less than 3 years?Yes Continue with CA15No Go to the Next ModuleCA15. The last time (name) passed stools, what was done todispose <strong>of</strong> the stools?AntibioticPill/SyrupInjectionParacetamol/Panadol/Acetamin<strong>of</strong>enAspirinBrufenOther (specify)DKChild used toilet/latrine 01Put/Rinsed into toilet or latrine 02Put/Rinsed into drain or ditch 03Thrown into garbage (solid waste) 04Buried 05Left in the open 06Other (specify) 96DK 98UF13. Record the time. Hour and minutes :ABPQRXZ2 CA148 CA142 CA148 CA142 CA146 CA142 CA128 CA122 CA148 CA14336MULTIPLE INDICATOR CLUSTER SURVEY 2010

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!