Christian Mission Aid CMA - Action Against Hunger
Christian Mission Aid CMA - Action Against Hunger
Christian Mission Aid CMA - Action Against Hunger
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
25.IX.3. Retrospective Mortality Survey QuestionnaireDATE:VILLAGE:CLUSTER No:TEAM No:FamilyN°.123456789101112131415161718192021222324252627282930TRIBE(1)Numberof < 5YearsalivetodayNumberof < 5yearsdead inlast 3monthsCAUSE(2)NUMBERof >= 5yearsalivetodayNumber ofdead >=5years inthe last 3monthsCAUSE(3)Number ofpeople alive inthe last 3months**(1) Status: 1=Resident, 2=Displaced (because of fighting, length < 6 months), 3=Family temporarilyresident in village (cattle camp, water point, visiting family…).(2) Tribe: Nuer, Dinka, Shilluk. Murle.Cause: Diarrhoea (watery diarrhoea), 2=Bloody diarrhoea (Dysentery), 3=Measles, 4=Malaria, 5=TB, 6=Pneumonia, 7=Malnutrition, 8= Kala-Azar, 9=Accident (gunshot, snakebite…), 10=other(write presumed cause of death).
Change language