PHC  MANAGEMENT  ADVANCEMENT PROGRAMME



ASSESSING  COMMUNITY  HEALTH  NEEDS
AND  COVERAGE




MODULE  2:
USER'S GUIDE




USER'S  GUIDE




Dr. Jack Reynolds

ISBN:  1-882839-01-3
Library of Congress Catalog Number: 92-75462

Monitoring the health of children, such as this child 
in Portugal, helps to identify health needs and, later, assess
coverage 
of children with priority services
Photo by Jean-Luc Ray for AKF



Dedicated toDr. Duane L. Smith (1939-1992),Dr. William B. Steeler
(1948-1992)and all other health leaders, managers and workers who
follow their example in the effort to bring quality health care
to all in need.
Assessing the awareness of women about good nutrition 
and the treatment of common problems, such as
diarrhoea,  is important
Photo by Jean-Luc Ray for AKFAn overview of PHC MAP
 The main purpose of the Primary Health Care Management
Advancement Programme (PHC MAP)  is to help PHC management teams
collect, process and analyse useful management information<P9BI>. 

Initiated by the Aga Khan Foundation, PHC MAP is a collaborative
programme of the Aga Khan Health Network1 and PRICOR.2  An
experienced design team and equally experienced PHC practitioner
teams in several countries, including Bangladesh, Chile,
Colombia, the Dominican Republic, Guatemala, Haiti, India,
Indonesia, Kenya, Pakistan, Senegal, Thailand and Zaire, have
worked together to develop, test and refine the  PHC MAP
materials to make sure that they are understandable, easy to use
and helpful.
PHC MAP includes nine units called modules. These modules focus
on essential information that is needed in the traditional
management cycle of planning-doing-evaluating.  The relationship
between the modules and this cycle is illustrated below.

PHC MAP modules and the planning-evaluation cycle

PHC MAP MODULES
1. Information needs
2. Community needs
3. Work planning
4. Surveillance
5. Monitoring indicators
6. Service quality
7. Management  quality
8. Cost analysis
9. Sustainability



1 The Aga Khan Health Network  includes the Aga Khan Foundation, 
the Aga Khan Health    Services, and the Aga Khan University, all
of which are involved in the strengthening of primary health care

2 Primary Health Care Operations Research is a worldwide project 
of the Center for Human Services, funded by  the United States
Agency for International Development
Managers can easily adapt these tools to fit local conditions. 
Both new and experienced programmers can use them. Government and
NGO managers, management teams, and communities can all use the
modules to gather information that fits their needs.  Each module
explains how to collect, process and interpret information that
managers can use to improve planning and monitoring.  The modules
include User's guides, sample data collecting and data processing
instruments, optional computer programs, and Facilitator's
guides, for those who want to hold training workshops.
The health and management services included in PHC MAP are listed
below. 

OTHER HEALTH CARE
Water supply, hygiene and 
  sanitation
School health
Childhood disabilities 
Accidents and injuries 
Sexually transmitted diseases
HIV/AIDS
Malaria
Tuberculosis
Treatment of minor ailments
Chronic, non-communicable diseases

HEALTH SERVICES

Planning
Personnel management
Training
Supervision
Financial management
Logistics management
Information management
Community  organisation

MANAGEMENT      SERVICES
Health and management services

GENERAL        
PHC household visits          
Health education      
          
MATERNAL CARE       
Antenatal care      
Safe delivery       
Postnatal care      
Family planning     
               

CHILD CARE
Breastfeeding      
Growth monitoring   
Nutrition education 
Immunization        
Acute respiratory infection   
Diarrhoeal disease control     
Oral rehydration therapy

Several Manager's guides supplement these modules.  These are:
Better Management: 100 Tips, a helpful hints book that describes
effective ways to help managers improve what they do;
Problem-solving, a guide to help managers deal with common
problems; Computers, a guidebook providing useful  hints  on
buying  and operating computers, printers, other hardware and
software; and The computerised  PRICOR thesaurus, a compendium of
PHC indicators.  
Women carry the burden of most family chores and of 
promoting health and preventing disease within their
 families and communities
Photo by Jean Luc Ray for AKFThe Primary Health Care Management Advancement Programme has been
funded by the Aga Khan Foundation Canada, the Aga Khan Foundation
USA, the Aga Khan Foundation's head office in Geneva, the
Rockefeller Foundation, the Canadian International Development
Agency, Alberta Aid, and the United States Agency for
International Development under two matching grants to AKF USA. 
The first of these grants was "Strengthening the Management,
Monitoring and Evaluation of PHC Programmes in Selected Countries
of Asia and Africa" (co-operative agreement no.
OTR-0158-A-00-8161-00, 1988-1991); and the second was
"Strengthening the Effectiveness, Management and Sustainability
of PHC/Mother and Child Survival Programmes in Asia and Africa"
(co-operative agreement no. PCD-0158-A-00-1102-00, 1991-1994). 
The development of Modules 6 and 7 was partially funded through
in-kind contributions from the Primary Health Care Operations
Research project (PRICOR) of the Centre for Human Services under
its co-operative agreement with USAID (DSPE-6920-A-00-1048-00).

This support is gratefully acknowledged.  The views and opinions
expressed in the PHC MAP materials are those of the authors and
do not necessarily reflect those of the donors.

All PHC MAP material (written and computer files) is in the
public domain and may be freely copied and distributed to others.
Contents
QUICK START1
INTRODUCTION3
 What are "rapid community surveys"3
 Some limitations of rapid surveys 6
 How you can use this module10
 How the module is organized11
RAPID SURVEY PROCEDURES15
 Step 1: Specify the objectives of the rapid survey15
 Step 2:Decide what indicators to use19
 Step 3:Develop an outline for the survey report 21
 Step 4:Design the data collection instruments23
 Step 5:Develop the sampling procedures30
 Step 6:Schedule the survey41
 Step 7: Collect the data41
 Step 8:Enter, verify, and tabulate the data43
 Step 9:Analyse, interpret, and report the findings 47
 Step 10:Develop an action plan 50
APPENDICES: TEMPLATES, TOOLS, GUIDELINES, AND COMPUTER PROGRAMS53
 A.How to use Epi Info for rapid surveys  55
 B.Questionnaire design guidelines 81
 C.Rapid survey instruments 87
 D.Cluster survey registers147
 E.Guidelines for training and supervising interviewers183
 F.Cluster sampling programmes cluster identification
worksheet187
 G.Other sampling tools191
 G.1 Estimates of target group sizes191
 G.2 Sample size estimation for WHO two-stage cluster      
survey193
 G.3 Random number table195
 G.4 Random sampling procedures197
 G.5 Estimating fertility and child mortality rates and ratios199
 H.  Survey management forms203
 I.   Tabulation and analysis templates207
 I.1. Analysis plan207
 I.2. Data entry and analysis templates211
 I.3. Confidence interval estimation templates221
REFERENCES AND BIBLIOGRAPHY223
ACRONYMS AND ABBREVIATIONS 225
GLOSSARY226

Acknowledgements
This module draws heavily on concepts and procedures used by the
World Health Organization in its rapid assessments of
immunization coverage, the recent work of Ralph R. Frerichs of
the UCLA School of Public Health on rapid surveys, and Anthony
Bennett's work on mini-surveys.  Bennett and Peerasit
Kamnuansilpa (both in Thailand) have been instrumental in early
field tests of prototypes of rapid surveys in PHC, and their
experience has been incorporated into this module.  Early
versions of the rapid survey instruments were reviewed by members
of the Aga Khan Health Network at a workshop in Dhaka,
Bangladesh, in May 1990.  Subsequent feedback from Khatidja
Husein of the Aga Khan University (Pakistan) and Esther Sempebwa
of the Kisumu Primary Health Care Project (Kenya) were especially
helpful.
Thanks are due also to Pierre Clauquin of AKF for his suggestions
on computer programs, and to Paul Richardson of URC/CHS for his
advice on sampling.
The computerised version of this module is based on, Epi Info,
Version 5: A Word Processing, Database and Statistics System for
Epidemiology on Microcomputers, by A.G. Dean, J.A. Dean, A.H.
Burton, and R.C. Dickers. Epi Info is a joint project of the
Centers for Disease Control (CDC) and the World Health
Organization (WHO).  The Epi Info manual and computer program are
in the public domain and may be freely copied.  The program is
"bundled" with this module to enable managers to use the computer
version of the module.

Reviewers:
Donald  Belcher Veterans' Administration, Seattle, Washington USA
William Reinke Johns Hopkins School of Hygiene and Public Health, 
Johns Hopkins University, Baltimore, Maryland USA
Gilbert M. Burnham Johns Hopkins School of Hygiene and Public
Health, Johns Hopkins University, Baltimore, Maryland, USA
David H. Peters Johns Hopkins School of Hygiene and Public
Health, Johns Hopkins University, Baltimore, Maryland, USA
Paul Zeitz. 
Johns Hopkins School of Hygiene and Public Health, Johns Hopkins
University, Baltimore, Maryland USA
Al Henn
AMREF, Nairobi, Kenya
Asif Aslam, Melvyn Lobo, Inaam-ul-Haq, Syed Meboob Ali Shah,
Khatidja Husein Aga Khan University, Karachi
Barkat-e-Khuda URC, Bangladesh


Field tests: , Countries,, participating organisations,, field
test facilitators
Pakistan:, Aga Khan University,, Karachi; Facilitator:  Khatidja
Husein,, Aga Khan University
Thailand:, Ministry of Public Health,, Srisaket; Somboon
Vachrotai Foundation (SVF); ASEAN Institute for Health
Development (AIHD); Health and Population Research Company
(HPRC); Facilitators: Pearasit Kamnuansilpa,, HPRC,, Thongchai
Sapanuchart,, SVF,, Butsabar Subongkot,, HPRC
India:, Junagadh PHC Project,, Jonpur; Sidhpur PHC Project,,
Ahmedabad; Aga Khan Health Service,, India; URMUL Trust PHC
Project
Kenya:, Mombasa PHC Programme; Kisumu PHC Programme;
Facilitators: Paul Richardson,, URC,, Esther Sempebwa,, Mombasa
PHC Programme
Columbia:, Fundacion Santa Fe de Bogota; Facilitator: Jorge E.
Medina

Quick start
How to use the prototype questionnaires - rapid surveys
 Select a questionnaire
If you already know something about community surveys, you can
use the questionnaires in this manual to carry out a PHC survey. 
Go to Appendix C and select a questionnaire.  Modify it to fit
your particular needs and situation.  If you do not need to make
any changes to the questionnaire, simply print out as many copies
as you need, one per interview.
 Draw your sample
You also need to draw your sample.  The User's guide includes
instructions for drawing a cluster sample (30 clusters by seven
respondents each).  This is normally a large enough sample for a
rapid survey.  These instructions show you how to do this
manually. You do not need a computer.  However, if you have a
computer, see Appendix F for instructions.  It describes how to
use the enclosed computer program to draw your sample quickly.
 Collect the data
We are assuming that you will interview seven eligible mothers in
each of 30 clusters.  It is best to send a two-person team to
each cluster - one to conduct the interviews, the other to find
the respondents and check the completed interviews.  You only
need to complete seven interviews in each cluster.  See Step 7 in
the User's guide if you need more information about selecting
households.
 Summarise the data
Assemble all of your questionnaires. Then calculate the totals
for each question and enter them into a blank questionnaire. this
will give you a summary of the entire survey on one sheet.
 Analyse the data
Compute percentages for each "yes" answer, and summarise the
results.  Write out the major findings for each question.  See
the analysis section in the User's guide for analysis
instructions.
Computerised surveys
If you would like to use a computer to conduct your survey, turn
to Appendix A, which describes how to use Epi Info to design,
collect, and analyse your survey data.  A copy of the Epi Info
manual and the Epi Info computer program is included in this
module for your use.


In Bangladesh, the empowerment of women for social 
and economic development has yielded substantial improvements in
the health status of their families
Photo by Jean-Luc Ray for AKFPHC MAP MANAGEMENT COMMITTEE
Dr. Ronald Wilson Aga Khan Foundation, Switzerland (Co-Chair)
Dr. Jack Bryant Aga Khan University, Pakistan (Co-Chair)
Dr. William Steeler Secretariat of His Highness the Aga Khan,
France (Co-Chair)
Dr. Jack Reynolds Center for Human Services, USA (PHC MAP
Director)
Dr. David Nicholas Center for Human Services, USA
Dr. Duane Smith Aga Khan Foundation, Switzerland
Dr. Pierre Claquin Aga Khan Foundation, Switzerland
Mr. Aziz Currimbhoy Aga Khan Health Service, Pakistan
Mr. Kabir Mitha Aga Khan Health Service, India
Dr. Nizar Verjee Aga Khan Health Service, Kenya
Ms. Khatidja Husein Aga Khan University, Pakistan
Dr. Sadia Chowdhury Aga Khan Community Health Programme,
Bangladesh
Dr. Mizan Siddiqi Aga Khan Community Health Programme, Bangladesh
Dr. Krasae Chanawongse ASEAN Institute for Health Development,
Thailand
Dr. Yawarat Porapakkham ASEAN Institute for Health Development,
Thailand
Dr. Jumroon Mikhanorn Somboon Vacharotai Foundation, Thailand
Dr. Nirmala Murthy Foundation for Research in Health Systems,
India
PHC MAP TECHNICAL ADVISORY COMMITTEE
Dr. Nirmala Murthy 
Foundation for Research in Health Systems, India (Chair)
Dr. Krasae Chanawongse ASEAN Institute for Health Development,
Thailand
Dr. Al Henn African Medical and Research Foundation (AMREF),
formerly of the Harvard Institute for International Development
Dr. Siraj-ul Haque Mahmud Ministry of Planning, Pakistan
Dr. Peter Tugwell Faculty of Medicine, University of Ottawa,
Canada
Dr. Dan Kaseje  Christian Medical Commission, Switzerland,
formerly of the  University of Nairobi, Kenya
KEY PHC MAP STAFF AT THE CENTER FOR HUMAN SERVICES
Dr. Jack Reynolds (PHC MAP Director)Dr. Neeraj Kak
Dr. Paul RichardsonMs. Lori DiPrete Brown
Dr. David NicholasMs. Pam Homan
Dr. Wayne StinsonDr. Lynne Miller Franco
Ms. Maria FranciscoMs. Mary Millar

Introduction
This module introduces and shows you how to use rapid community
surveys to assess community PHC needs and to evaluate programme
effects on PHC coverage.
 What are "rapid community surveys"?
PHC managers need timely and useful information about the health
status of their target populations so that they can do a better
job of planning and monitoring PHC services.  The traditional way
to collect health information is through large surveys, done
infrequently and generally on a national scale.  This information
is of little use to local managers.
"Local programme managers often totally lack data upon which to
assess or evaluate the health problems in their area. It is
usually not possible to interpolate the results of large general
population surveys (for) local estimates."

<$FSmith, G. S. "Development of rapid epidemiological assessment
methods to evaluate health status and delivery of health
services." International journal of epidemiology 18 (4
[Supplement] ) S4, 1989.>

The "rapid survey" is a new tool for getting this kind of
information quickly and inexpensively.  It is especially useful
for local PHC managers who need information about their local
populations.
The "rapid survey" is an alternative to traditional large-scale
sample surveys. It was originally developed to assess
immunization coverage

These surveys are designed to help PHC managers collect
population-based information on health status, behaviour, and
knowledge. The typical rapid survey can be carried out in two to
three weeks, from design to final report. It involves 200-300
household interviews, drawn from 30 clusters of seven to ten
respondents each. The interview schedule is short (20-30 items),
and the questions are phrased in "yes"/"no" terms to permit
statistical tests of significance. The surveys are often
pre-coded so that the data can be entered into a local computer
and immediately analysed. The analysis is simple.

Example
When they are done well, rapid surveys are very impressive. The
author participated in his first rapid survey in  Thailand in
late 1987. Twenty two participants from three developing
countries attended a one-week workshop where they learned the
principles of rapid surveys in the first three days and designed
questionnaires and developed the samples in the next two days for
two simultaneous surveys - one on antenatal care, and one on
family planning. In the second week they collected the data
(three days), processed it (one day), and presented a report (one
day) on the findings to the provincial management team. Excerpts
from the presentation are shown below.

<$FHenderson, R. H. and T. Sunaresan, "Cluster sampling to assess
immunization coverage: A review of experience with a simplified
method."  Bulletin of the World Health Organization 60 (2):
253-260, 1982.> and has been adapted to other epidemiological
areas by Frerichs.

<$FFrerichs, R. R. and Tar Tar, K. "Computer-assisted rapid
surveys in developing countries." Public health reports 104:
14-23, 1989.> Recently, some exploratory work has been undertaken
to adapt the methodology to family planning and primary health
care, with special emphasis on using rapid surveys to help
managers improve planning and monitoring of services.

<$FFrerichs, R.R., et al. "Family planning survey and antenatal
survey, Srisaket, Thailand," December, 1987 (unpublished paper,
URC/CHS); "Institutionalizing the use of rapid surveys for family
planning decision-making," an Operations Research Proposal, Gadja
Mada University and University Research Corporation, November
1989; and "Primary Health Care Management Advancement Programme
1989-1992," a proposal of the Aga Khan Health Network and PRICOR,
November, 1989.>

Table 1: Type of attendant at last delivery,, N = 206, +, +
Type attendant             Number       Percent
Government health worker    114          55.3
Traditional birth attendant, 89          43.2
Unattended,                   3           1.5
Total                       206         100.0



Table 2: Received tetanus toxoid last pregnancy,, N = 209, +, 
+
Received TT, Number, Percent
Yes, 145, 69.4
No, 52, 24.9
DK/NR, 12, 5.7
Total, 209, 100.0

Figure 1: Received tetanus toxoid last  pregnancy, N= 
209

The entire survey, including training, was conducted in only two
weeks. This was not a survey of a small population. Six districts
with an estimated combined population of 410,891 were sampled. 
The antenatal care (ANC) survey targeted married women currently
living in these six districts who had had a pregnancy outcome,
live birth, stillbirth, miscarriage, or abortion, within the past
24 months.  This population was estimated to be 24,653 women.  
 The total number of people interviewed in a rapid survey is
typically 210, i.e., 30 clusters x 7 respondents each.   Although
this number appears small, it has been used extensively in the
Expanded Programme for Immunization (EPI) and has been shown to
produce unbiased estimates within the desired level of precision,
that is, plus or minus 10 percent.
A number of improvements can be made in this methodology to
reduce sampling error, increase the level of confidence, and
gather more detailed information.  These are described in this
guide.
 
Some limitations of rapid surveys
Although rapid surveys are attractive alternatives to traditional
large-scale sample surveys, there are trade-offs.  The most
obvious is that the number of questions must be limited.  The
manager cannot expect detailed findings or analysis.  Another is
that these surveys are designed to assess levels of health or
service coverage, not to identify the determinants or causes.  A
rapid survey can tell you the proportion of women who breast feed
their children, but it usually cannot tell you the differences
between women who do and do not breast feed. This is because the
sample is very small and provides a single estimate.  You cannot
break the sample into sub-samples to see, for example, if younger
women breast feed longer than older women, or if rural women are
different from urban woman, or if Moslem women are different from
Christian women.  If you want to have that kind of information,
you need to do a separate rapid survey for each group.
Questions that are going to be tested for statistical
significance must be tabulated in a "yes"/"no" format, as certain
statistical rules apply to this type of sample.  For this reason,
questions that are going to be analysed statistically should not
be multiple choice or open-ended.  However, it is possible to do
statistical tests of multiple choice questions by recoding the
questions into a "yes"/"no" format.  (This is explained in the
text.)  There is some value in using multiple choice and
open-ended questions, even if their results cannot be analysed
statistically. This is because they may produce useful
descriptive information that can give you suggestions of possible
explanations.
Rapid surveys often rely on CHW's, health staff, or community
members to conduct the interviews rather than on professional
interviewers. Even with careful training, non-professionals are
often tempted to take shortcuts, thus producing biased results.
Typical problems include not contacting certain households or
women because: they are too far away; the interviewer "knows"
that some women are not eligible and therefore do not need to be
contacted; and the interviewer knows the respondents so well that
he or she answers the questions for them.
These problems are not unique to rapid surveys however, and can
usually be controlled through training, close supervision, and
spot checks, or re-interviews with a small sample of respondents. 
Appendix E provides some guidelines for dealing with this
problem.
Sampling can be a problem if the WHO/EPI cluster sampling
procedure isn't appropriate for a given survey.  This technique
seems to work better for EPI than some other PHC interventions.
Immunizations are often carried out as campaigns where all of the
children in a target village or urban block are immunized at one
time. Thus, the villages tend to be "homogeneous," i.e., either
most of the children are immunized, or most are not. This means
that it is not overly important who is interviewed in a given
cluster, since most children have the same characteristic (they
are immunized or not). This is not so for some of the other PHC
interventions, such as antenatal care. In such cases, this
technique may produce biased results if households are skipped
because eligible respondents are not at home when the survey is
conducted.
Given the distances that might have to be travelled to get to a
cluster, the standard WHO/EPI procedure is to interview only
those women who are at home.  This can produce significant bias,
particularly during planting and harvest periods when many
able-bodied women are away in the fields.  This problem can be
largely avoided, by scheduling the survey during seasons when
respondents are likely to be home, by visiting villages early in
the morning or in the evening, by arranging the visit to coincide
with a special event, or by making call-back visits.  The
trade-off is that this can increase the costs of and the time
needed to conduct the survey.
Rapid survey results do not produce exact estimates of values. 
Rather, they produce confidence intervals, usually plus or minus
10 percent.  For example, the ANC survey described previously
showed that 69.4 percent of the respondents received tetanus
toxoid immunization during their last pregnancy.  It is more
accurate to say that we are 95 percent confident that the true
percentage lies somewhere between 59.4 and 79.4 percent.  Another
way to state this is that the estimate is 69.4 percent, plus or
minus 10 percentage points.
This is a large interval and may not be of much use to some
managers, especially if they want to plot trends over time.  All
surveys have a potential sampling error, but it is usually much
lower, around three to five percentage points.  This problem can
be dealt with, at least partially, in several ways:  by
increasing the sample size; by accepting a lower confidence
interval (e.g., 90 percent, 80 percent); and by conducting a
post-enumeration survey to validate and adjust the results, if
necessary.
You can survey several target groups at the same time, such as
children under two years of age (for immunization), pregnant
women (for antenatal care), and children under age five (for
ORT).  However, the overall sample for this type of study will
usually be larger than 210 because you need 210 respondents from
each target group.  But many respondents fall into two or more
categories.  A typical example is a pregnant woman with a child
under age five.  She can respond to questions on antenatal care,
ORT, immunization, growth monitoring, nutrition, ARI, water and
sanitation, and other topics.

Figure 2: Proportion of married women who received TT
, 90%, 95%, 99%

High, 0.774, 0.79, 0.821
Mean , 0.694, 0.694, 0.694
Low, 0.613, 0.597, 0.567


Proportion
Confidence intervals
0.774
0.79
0.821
0.694
0.613
0.597
0.567

Surveys of mortality and morbidity require much larger samples
because the events are so rare.  For example, if you want to
assess infant mortality, you may need a sample of 2,000 mothers
to identify enough infant deaths.  For child and maternal
mortality rates you may need 7,000 interviews.  If the maternal
mortality rate (MMR) is 250/100,000 live births, you would
normally need to identify 1,000 women who had been pregnant just
to find two to three maternal deaths.
Some indirect estimation techniques have been developed to get
estimates with smaller samples.  These are described in Appendix
G.5.  However, the samples are still relatively large and the
analytical techniques are complex.  You should probably get
expert advice before trying to measure mortality rates.
Identifying broad disease patterns and health problems is
probably more useful to PHC managers. This can be done through
the Vital Events questionnaire provided in this module.   It may
also be important to determine the causes of some of the more
serious events, such as a maternal death or a case of polio. 
Module 4 (Surveillance) describes how to do that.
Finally, these surveys are completed most rapidly if computers
(laptops or PCs) are used. The survey programs, including those
provided in this module, can help you to calculate your sample in
a matter of minutes. Data entry and analysis can also be done
very quickly. Surveys for which computers are not used will take
longer. But they can be done, and this User's guide describes
how.
 How you can use this module<$&common gaps>
This module is designed to provide PHC managers, consultants, and
researchers with simple and inexpensive tools that they can
readily adapt to assess quickly community health needs and/or PHC
programme effects on health knowledge, behaviour, and status.
The most common information gaps that managers have fall into
these two areas. First, many managers have no way of determining
what the real PHC needs of their target population are.  What do
people know about immunizable diseases?  What do they do about
diarrhoea?  What is the health condition of their infants?  And,
second, they have no way of assessing the effects that their PHC
programme activities are having on those needs: What have mothers
learned about nutrition? What are they doing about sanitation?
What improvements have been made in immunization coverage?
Module 2 is designed to help managers collect and analyse this
kind of information and to do it quickly, simply, and
inexpensively.  It can be used by established and new PHC
programmes.  Public and private programmes can use it, as well as
single (categorical) and comprehensive (integrated) programmes.
Although this module is part of a series, it can be used
independently. You do not need to use any other module before or
after this one. We hope that you will, however.  That's the
purpose of having a series, after all.
Module 2 is linked to Modules 3 (Work Planning), 4
(Surveillance), and 6 (Service Quality) in particular.  Module 2
can provide broad findings which the other modules can be used to
examine in more detail. In addition, the instruments in Module 2
can be used in Module 4 for surveillance of morbidity and
mortality.
 How the module is organised
This User's guide includes:
 Basic instructions: how to design and conduct a rapid survey by
hand (without a computer); ten easy steps described in pages
14-49.
 Epi Info to design and carry out a rapid survey (with a
computer):  See  Appendix A,  26 pages of instructions, and use
the complete computer files.
 Sample questionnaires and "cluster registers" that you can adapt
to fit your own needs.  There is one for each PHC topic,
pre-coded and ready to use or adapt to fit local needs in
Appendices C and D.
 A simple computer program for drawing cluster samples quickly
and accurately (Appendix F), and other tools for estimating
sample sizes and drawing random samples (Appendix G).
 Other guidelines and tools that you may find useful: suggestions
for constructing questionnaires (Appendix B); guidelines for
training and supervising interviewers (Appendix E); survey
management forms (Appendix H); and tabulation and analysis
templates (Appendix I).
 
Sample rapid survey questionnaires have been included for each of
the principal PHC services:
 
 Health education
 Antenatal care, safe delivery and postnatal care
 Family planning
 Breast feeding, growth monitoring, nutrition education
 Acute respiratory infections
 Breast feeding
 Diarrhoeal disease control/oral rehydration therapy
 Childhood disabilities
 Child immunization
 Growth monitoring/nutrition education
 Water supply, environmental hygiene and sanitation
 Accidents and injuries
 Chronic, non-communicable diseases
 Malaria
 Tuberculosis
 Sexually-transmitted diseases, HIV/AIDS
 
In addition, one questionnaire has been prepared for assessing
multiple health needs/services and three others for morbidity and
mortality.
 
 Community assessment of PHC services
 Vital events and health status
 Child morbidity and mortality
 Adult morbidity and mortality
 
There is also a Facilitator's guide that you can use if you wish
to conduct a workshop or seminar on rapid surveys.  Computer
programs are also included on the disks that are included.  One
disk contains the complete Epi Info manual and program files.
 Where to begin
If you already know something about surveys and computers, you
may want to skip to Appendix A: How to use Epi Info to conduct
rapid surveys.  If not, you should start with the basic
guidelines in the next section: Rapid survey procedures. These
include worksheets that you can fill out as you follow the steps.
You may also want to have a facilitator help you, especially if a
group is going to learn how to do rapid surveys.
The facilitator should have experience in surveys and computers. 
He or she need not be an expert trainer.  The Facilitator's guide
includes session plans and provides charts that can be
photocopied for handouts or transparencies.

 Adaptations
All of the tools, checklists, guidelines, computer programmes,
and other material included in this module are illustrative.  It
is expected that they will need to be revised to fit local
conditions, and you are encouraged to do so.
You may want to change the wording of questions in the prototype
questionnaires; you may want to eliminate certain questions and
add others; you may want to redesign the format, design your own
instrument, use another computer programme (SPSS or dBase), draw
your sample from your computerised household registration
database, create other kinds of graphs, and so on. We want to
make it very clear that this is encouraged. These tools are not
presented as "standards" that should be used in all PHC
programmes.  Rather, they are designed to encourage and help
managers to carry out community surveys by providing them with a
starting point, general tools, and guidelines that they can adapt
to fit their own situations.
Don't forget to include the target communities and your CHWs in
the design, execution and analysis of the survey.  There are
several advantages to this:

 It increases awareness and knowledge about PHC in general;
 It increases awareness in the communities of their own health
problems and needs; and 
 It increases "ownership" of the survey, its results and
recommendations.

Community representatives can also help you to phrase questions
in local terms so that they are better understood.  They can help
you to identify common health problems to be  included in your
survey, help you to find eligible respondents, and help you to
understand responses and hidden meanings.
The elderly need to be targeted with health messages 
so that their authority in the family helps support good health 
practices
Photo by Jean-Luc Ray for AKFRapid survey procedures
The steps in the design and conduct of rapid surveys are no
different from those of larger, more traditional sample surveys. 
If a team is going to design the survey, field experience has
shown that it may be faster to divide the tasks and have one
group develop the data collection instrument (Steps 1-4) and
another the sampling (Steps 5-6). 

Step 1:, Specify the objectives of the rapid survey
Step 2:, Decide what indicators to use 
Step 3:, Develop an outline for the survey report
Step 4:, Design the data collection instruments
Step 5:, Develop the sampling procedures
Step 6:, Schedule the survey
Step 7:, Collect the data
Step 8:, Enter,, verify and tabulate the data
Step 9:, Analyse,, interpret and report the findings
Step 10:, Develop an action plan

 Step 1: Specify the objectives of the rapid survey
If you have gone through Module 1, you may already have
determined the information you want about the health needs and
PHC coverage of your target groups.
Module 1 asked you to summarise your programme's major health
goals, target groups, the PHC services offered to each target
group, and indicators of coverage for each PHC service.  It also
suggested that you include additional target groups or health
services if you think your programme should be expanded.  The
point of going through these steps was to determine if you have
enough information about coverage, and if not, the information
that you need to collect.
A summary worksheet from Module 1 is reproduced below.
If you haven't already filled out a worksheet like this, it would
be helpful to do so now. This should give you a summary of the
coverage information you need to collect.

Target group (yrs), Health services , Coverage indicators
 5, Child immunization, % << 24 mos. fully immunized
, Growth monitoring, % << 5 yrs. weighed
, Oral rehydration, % using ORT last episode diarrhoea
, Nutrition education, % << 2 yrs low weight-for-age 
Married women 15-49, Antenatal care & TT, % pregnant women
enrolled in ANC
, Family planning,    No. new acceptors

Now you can be specific and state the objectives of your rapid
survey.  The following worksheet can help you to summarise them.
First, you need to identify the user or users of the information. 
This is critical, since each could have different interests.  If
there are multiple users (yourself, a donor, an evaluation team),
you should find out exactly what each one wants.
You also need to clarify precisely why this information is
needed.  The two most common purposes are to assess health needs
and to evaluate programme performance.  These are quite
different, and although Module 2 can address both, the design and
analysis of your rapid survey will be slightly different
depending on which purpose you have.  For one thing, if you are
interested in assessing performance, you would limit the survey
to current PHC services.  But if you want to assess needs, you
would not.

WORKSHEET FOR SPECIFYING RAPID SURVEY OBJECTIVES, +
User, Target groups
     ___Manager, ___Children
___Board, ___Women
___Donor, ___Other:______________
___Community , 
___Other:______________ , 
Purpose, PHC service(s)
___Planning,  _____________________
___Health status/needs,  _____________________
___Service status/needs, _____________________
___Evaluation, _____________________
___Service coverage/effects, _____________________
___Health status/impact,  Geographic area: _______________
Start Date:______________, End Date:  _______________
, 
Next, you should decide which target population and which PHC
component the user(s) wants to study.  The summary worksheet from
Module 1 is a place to start.  But you may have listed several
target groups and services.  Do you want to study all of them or
just one?  You can study as many as you want, but keep in mind
that you will have to draw a separate sample for each target
group that you include.  So if you decide to study ANC,
immunization, and sanitation, you will have to do three rapid
surveys: one of pregnant women, one of children 12-23 months, and
one of households.  These can all be done at one time, but each
will require 30 clusters of seven respondents.   In many cases,
the clusters and respondents can be the same for each survey.  So
if you plan to do several rapid surveys, it would be economical
to combine them.
This module describes how to do this in a relatively simple way,
so do not be intimidated.  If you need information on several
target groups and services, then note who and what they are in
the worksheet.
You also need to specify the geographic scope of the survey. 
Will it cover the entire catchment area or a part of it?  Keep in
mind that the survey results will only represent the area
covered. If you decide to limit the survey to five districts
because they are close by, then the outlying areas will not be
represented in the study.  That means you cannot apply the
results to the entire project, only to the five districts.
Lastly, it is helpful to determine immediately when the study
will start and especially when the results will be needed.  It
does no good to provide rapid survey results after the deadline
for making key decisions.

Measuring  effects and impact, +
Module 2 can be used to measure:, +
Programme effects on target groups, +
, Knowledge
, Attitudes/motivation
, Behaviour/coverage
Programme impact on target groups, +
, Morbidity
, Mortality
, Disability
, Fertility
 
You can use Module 2 to attribute changes in knowledge, attitude,
and practice (KAP) to your programme.  To do this you should:
conduct a baseline survey of the current KAP of your target
groups; carry out your programme for a specified period, e.g.,
1-2 years; and conduct a follow-up survey sometime later.
Use the computer program in Appendix G-2  (Hypothesis testing -
two samples of equal size) to determine the sample sizes needed
for a "before-after" comparison.  Estimate the current level of
your principal effect or impact measure, such as coverage. Enter
this in the line that reads "Est. proportion with the attribute
FIRST (or BEFORE) population." Decide the amount of change you
wish to detect and enter that in the next line "Est. the
proportion with the attribute in the SECOND (or AFTER)
population."  For example, if you want to measure changes in
infant mortality, you would enter the current figure (say .08) as
the BEFORE proportion and .06 as the AFTER proportion.  Thus you
will be able to detect a drop in the IMR from 80/1,000 to
60/1,000. Enter the other information requested, and the
programme will compute the sample sizes you will need for the
baseline survey and the follow-up survey.
Your evaluation will be even better if you include a control area
which is similar to your project area but which does not get PHC
services. Conduct baseline and follow-up surveys there at the
same time. The design of this kind of study is summarised below,
in which O indicates an observation (baseline and follow-up
surveys) and X indicates the PHC programme intervention.


, Study design, +, +
, Baseline, Intervention, Follow-up
Programme area, O1, X, O2
Control area, O1, , O2

Note: Impact evaluations are easy to conceptualise, but difficult
to carry out.  Seek professional advice before you start.

Step 2: Decide what indicators to use<$FSee Module 1 for a
discussion of types of indicators and Module 5 for lists of
indicators.>
This module focuses on outcome indicators, especially coverage.
These are the best indicators for assessing health needs and the
effects of the PHC programme on health.
Other modules deal with input and process indicators: the
performance of health workers (Module 3), short-term assessment
of PHC activities (Module 5), the quality of PHC services (Module
6), and the effectiveness and efficiency of PHC management
(Module 7). You can include any of these indicators in a rapid
survey, of course, as long as they are community-based.  Rapid
surveys gather information about populations, not about health
centres or staff.
Thus, the manager (or team) needs to decide which outcome
indicators to examine.  In most cases these will deal with
coverage.  In general, coverage indicators tell you the
proportion of the target population that is protected by your
programme.  Examples of coverage indicators (taken from Module 1)
are shown below.

Examples of PHC coverage indicators , +
Service, Coverage indicator
Antenatal care, % made 3 or more ANC visits
Tetanus toxoid immunization, % received TT immunization
Safe delivery, % delivered by trained attendant
Family planning, % current users of FP services
Breast feeding, % breast feeding to 18 months
Growth monitoring, %  2 yrs weighed last quarter
Child immunization, % 12-23 mos. fully immunized 
Acute respiratory infection, % ARI cases treated
Diarrhoea disease control, No. children << 5 yrs with
diarrhoea/1,000
Oral rehydration therapy, % used ORT last episode diarrhoea
Water,, sanitation,, hygiene, % households with safe
water/latrine
Vitamin A, % 6-12 mo. received Vit. A
Tuberculosis, % cases followed to cure
Malaria, % cases treated
Sexually transmitted diseases/HIV, % target group
infected/treated
Disability, % 5 yrs disabled
Health education at home, % schools receiving or participating in
health education activities
Drug supply, % communities with adequate supplies
Accidents and injuries,  No. accidents + injuries/1,000
population
Chronic,, non-communicable diseases, % target group with
hypertension,, 
chronic heart disease,, anaemia,, diabetes
Treatment of minor ailments, % episodes treated
Nutrition education, % low weight-for-age

You may also be interested in finding out what people know about
a service or health problem, the skills they have in diagnosing
and treating health problems, or people's opinions about your
health workers and programme.  You may also want to assess health
status and the impact of the programme on health.  These are all
legitimate interests and can be included in a rapid survey.
Module 5 includes lists of recommended indicators for each PHC
and management service.  It also includes separate lists of
morbidity and mortality indicators.  These lists can be helpful
guides in designing a questionnaire.
Make a list of the key indicators you want to measure.  It
shouldn't be a long list. Start with the desired outcome.  Select
one or two indicators for that. Then work backwards (as described
in the "If-then" sequence and Worksheet A in Module 1) to
determine what needs to happen for this outcome to be achieved. 
Select one or more key indicators for that outcome, and so on.
This is a good time to involve the staff, community
representatives, and others who are part of the programme. They
can articulate the perspectives of the community, and they often
have valuable insights as to what is important, and feasible, to
measure.
In addition to performance indicators, three other types of data
are usually needed in a rapid survey:
 Descriptors: respondent name, village name, address of
household, etc;
 Characteristics of respondent: age, sex, parity, education,
literacy, income, caste, race, ethnic group, etc; and
 Survey management data: interviewer name, supervisor, date of
interview, etc.
The descriptors and management data are needed to identify the
respondent and, in particular, to make a call-back visit and to
correct possible errors.
The characteristic used to describe the surveyed group.  If
several surveys are done, then the characteristics can be useful
for making comparisons between one kind of respondent and
another.  The manager may want, for example, to know if there is
any difference between the health behaviour of people in one
district and another, or between one ethnic group and another. 
Separate surveys would be required to do this, of course. 
Remember that each rapid survey is designed only to provide
information about a single population.
 Step 3: Develop an outline for the survey report
Most researchers don't do this, but it will be very helpful at
this point to outline a report so that you and your colleagues
know what information will be produced. That will make
construction of the questionnaire, data analysis, and especially
interpretation much easier.  If this is not done, you may get a
lot of information that you don't want, such as 10 pages of
tables describing the characteristics of the survey population.
Step 10 includes a generic outline for getting started.
This is also a good time to check with outside users to make sure
that the report will meet their expectations.
Most managers aren't interested in background, methodology,
qualifications, descriptions of the survey process, descriptions
of the survey population, etc.  They want results. So write your
report outline to suit the user's needs. The other information
should be presented, but not necessarily first. Many managers
want the "bottom line" first and will ask about the sample, data
collection procedures, and other methodological issues later.
Construct a list of "dummy tables" (blank tables -- without data)
and identify the kinds of frequency distributions and
cross-tabulations the user(s) wants. Don't forget to include
graphs (pie charts, histograms).  Appendix I includes an
illustrative list of frequency distributions and
cross-tabulations.  This type of list will be needed so that the
analyst knows which tables and graphs to produce.  Obviously, it
can be modified later, but it can help your planning to start it
now.
List questions and issues that you think should be addressed in
the report.  Typical questions are:
 What percentage of the target group is covered?
 What are the major reasons some people aren't covered?
 Where do people go for services?
 What are the major reasons they don't utilise available
services?
Finally, make an outline, and set a page limit.  Put more
emphasis on visual presentation through handouts, transparencies,
slides, etc. These attract managers' attention more than written
text.  Remember KISS - "Keep It Straightforward and Simple".

Step 4: Design the data collection instruments
The following checklist summarises your main options and the
substeps that you will need to follow.

Checklist for designing questionnaires, +
Type survey instrument:, Types of questions/fields:
__Register, ___Multiple choice
___Other, ___Open-ended
, ___Dates
, ___Ranges (e.g.,, 1-4 years)
, 
Target group(s):, Coding:
, 
___Children, ___Uncoded
___Women, ___Pre-coded
___Other, ___Numerical
, ___Alphabetical
, ___NA: Not applicable
, ___DK: Don't know
, ___NR: No response

 Questionnaire or register
First you need to decide if you want to use a questionnaire or a
"cluster register."
Questionnaires usually provide more information, including
instructions for the interviewer, the exact phrasing of each
question, and pre-coded responses.  But you have to have one
questionnaire for each of the 210 respondents.  That is, a
minimum of 210 pages, 420 if its a two-page questionnaire.
Cluster registers allow the interviewer to record the responses
of all seven or eight respondents from one cluster on the same
page. This means you will need only 30 pages, one for each
cluster.
But the number of items ("questions") is limited by the size of
the paper.  Instructions and question phrasing have to be
provided elsewhere, or learned beforehand.  Excerpts of both are
shown on the next pages.


Exhibit 1: Excerpt from rapid survey questionnaire on antenatal
care, safe delivery, and postnatal care
Complete for all women currently living in the household 
who have had a pregnancy outcome during the past 24 months. The
outcome may be a live birth, stillbirth, or abortion. If the
woman has had more than one pregnancy, ask about the most recent
pregnancy outcome.                                                
                                     
IDENTIFICATION, +, +, +, +, +, +, +, +
1., Study no, , 2., Province no., , 3., Cluster no, 
4., Interviewer no, , 5., Respondent no., , 6., Date of
interview,   /  /
7., Respondent age, , 8., Respondent sex, , , , 

NAME OF RESPONDENT________________________________, +, +, +, +,
+, +, +, +

9.   How many live births have you had so far? Number 
of live births:____ <R>
     ___(99) DK/NR

10.  Did you receive antenatal care during your last 
pregnancy?
___(1) Yes    ___(0) No, go to Q14    ___(9) DK/NR, 
go to Q14

11.  How many times did you get antenatal care? _____times

 DK/NR, enter 99)

12.  How many months had you been pregnant before 
you got antenatal care?
____(1) 3 mo. (first trimester)
____(2) 4-6 mo. (second trimester)
____(3) 7-9 mo. (third trimester)
____(9) DK/NR

13.  Which is the principal place you received antenatal 
care?
____(1) Hospital
____(2) Health centre/clinic
____(3) Private hospital/clinic
____(4) Local TBA/healer
____(5) Other site of care specify: _______________
____(9) DK/NR

14.  Did anyone advise you to get antenatal care? ___ 
(0) No

Yes:
____(1) Physician, nurse           ____(5) Mother, relative
____(2) Community nurse/midwife         ____(6) Friend, 
neighbour
____(3) CHW/volunteer              ____(7) Other:_________
____(4) Traditional birth attendant          ____(9) DK/NR
15.  Did you receive a tetanus vaccination during 
your last pregnancy?
___(1) Yes    ___(0) No, go to Q17    ___(9) DK/NR, 
go to Q17
16.  How many vaccinations did you receive?
___(1) One   ___(2) Two   ___(3) Three or more   ___(9)DK/NR, go 
to Q17

Questionnaire continues for four months


Exhibit 2: Excerpt from cluster form on antenatal 
care, safe delivery and postnatal care
(1), Study No.  , N, , +, +, +, +, +, +, +, +, +
(2), Province No., A, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(3), Cluster No. , M, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(4), Interviewer, E, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(5), Respondent No. , , 1, 2, 3, 4, 5, 6, 7, 8, 9, 10
(6), Date     /     /     , , , , , , , , , , , 
(7), Age, , , , , , , , , , , 
(8), Sex, , , , , , , , , , , 
(9), How many live births have you had so far?, , , , , , , , , ,
, 
(10), Did you receive antenatal care during your last pregnancy?,
, , , , , , , , , , 
(11), How many times did you get antenatal care?, , , , , , , , ,
, , 
(12), How many months had you been pregnant before you got
antenatal 
care?, , , , , , , , , , , 
(13), Which is the principal place you received antenatal care?,
, , , , , , , , , , 
(14), Did anyone advise you to get antenatal care?, , , , , , , ,
, , , 
(15), Did you receive a tetanus vaccination during your last
pregnancy?, , , , , , , , , , , 
(16), How many vaccinations did you receive?, , , , , , , , , , ,
(17), During your pregnancy,, did you take iron pills to keep you
strong?, , , , , , , , , , , 
(18), What was the outcome of your most recent pregnancy?, , , ,
, , , , , , , 
(19), Where did the delivery take place?, , , , , , , , , , , 
(20), Who was the main person attending the delivery?, , , , , ,
, , , , , 
(21), What is the name of the local CHW?, , , , , , , , , , , 
(22), Has the CHW visited/contacted you during the last three
months?, , , , , , , , , , , 
Key (12), +, (18), , , , , , , , , , 
1, three mo. (first trimester), 1, live birth, 
+, +, +, +, +, +, +, +, +

2, 4-6 mo. (second trimester), 2, stillbirth, 
+, +, +, +, +, +, +, +, +
3, 7-9 mo. (third trimester), 3, abortion/miscarriage, 
+, +, +, +, +, +, +, +, +
9, DK/NR, 4, DK/NR, +, +, +, +, +, +, +, +, +
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 


Procedures
For larger clusters, 15 or more respondents, you may want to
switch the rows and columns.  That is, put the questions in the
top row and the respondents in the left column.  Here's a partial
example.  See Appendix I for an example of how to set up a
register like this on a spreadsheet so that all 210 respondents
can be recorded and analysed on one (long) page or spreadsheet.

Respondent no. name house, Age, Rec'd
ANC, No.visits, Source of service, +, +, Rec'd
TT, No. doses, Pregnancy outcome, +
^, ^, ^, ^, Hosp, Hlth.
Cntr., TBA, ^, ^, Live, Still

1, , , , , , , , , , 
2, , , , , , , , , , 
3, , , , , , , , , , 
4, , , , , , , , , , 
5, , , , , , , , , , 
6, , , , , , , , , , 
7, , , , , , , , , , 
8, , , , , , , , , , 



One target group or several
Many managers will want to include several topics and target
groups in the same survey.  This will not be a problem as far as
instrument design is concerned.  Generally, you have three
choices. First, you could use the sample Community assessment of
PHC questionnaire in Appendix C. This instrument includes 4-5 key
questions on each of several PHC topics: 
Availability of health care
Antenatal care and childbirth
Family planning/child spacing
Breast feeding and growth monitoring
Immunization
Diarrhoea and ORT
Water and environmental sanitation
Malaria
Child disabilities
Tuberculosis
Sexually-transmitted diseases
Second, you could combine several questionnaires from Appendix C
into a single instrument.  Third, you could pick out questions
you are interested in from other questionnaires and construct
your own instrument.
However, be aware that combined questionnaires usually require
information about different target groups.  If that is the case,
you will have to draw separate samples for each target group.
This will be explained more fully in the discussion of the
sampling step.
When doing a multi-target group survey, it is best to prepare the
questionnaire in modular form.  Combine all of the questions for
one target group and put them in one section.  Develop a separate
section for each target group.  Be sure to include descriptor
information in each module so you can identify the respondent.
 Design the data collection instrument(s)
The sample instruments in Appendices C (questionnaires) and D
(cluster registers) can be photocopied and used as is. They can
also be revised, new ones can be compiled, etc. The questions
should be designed to collect the indicators you identified in
Step 2.
The sample instruments show how most questions can be structured
in a "Yes/No," precoded format.  This is important for those
questions that you want to analyse statistically.  When multiple
choice and continuous variable questions are needed, make sure
they can be recoded later to be analysed as "yes"/"no"
(dichotomous) questions.  Some examples:

Multiple choice, Recoded as dichotomous (Yes/No)
Received care from :, Received care from:
, 
1 Provincial hospital , 1 Provincial hospital
2 District hospital, 2 Other
3 Health centre, 
5 Traditional birth att., 
6 Private clinic, 
7 Other (name:          )   , 
9 Don't know/No response<P12M>, 9 Don't know/No response
, 
 
You can repeat this procedure for each response.  That is, you
can recode the question as District vs. Other; Health centre vs.
Other, and so forth.  You can recode the question for a different
age group: under 25 years vs. 25 years and over.
Continuous variables can be recoded as shown in the following
example.

Continuous , Recoded as dichotomous (Yes/No)
Age of respondent_ _ yrs., Age of respondent
(Enter completed years, 1 ___ Under 30 years
or 99 if DK/NR), 2 ___ 30 years and over
, 9 ___ Don't know/no response
 
Most rapid survey questions allow only one response per question.
If you include questions that allow multiple responses, you can
do one of two things.  First, you can ask the respondent for the
most important (principal, major, etc.) single response, and code
only this response.  For example:
 
Q.8. Where did you first hear about ORT? (Check the first source
mentioned)
 (1)  Friend or relative 
 (2)  CHW 
 (3)  Doctor/nurse 
 (4)  Television 
 (5)  Radio 

Or, you can record each response as a separate question.
 
Where did you hear about ORT? (List all mentioned)
 Q.8  Friend or relative (Y/N)
 Q.9  CHW (Y/N)
 Q.10 Doctor/nurse (Y/N)
 Q.11 Television (Y/N)
 Q.12 Radio (Y/N)
 
Appendix B includes some other suggestions for designing
questionnaires.

 Pre-test the instrument
If the questionnaire has to be translated into a local language,
this should be done after it is drafted, but before it is
pre-tested.  Do not leave it to each interviewer to do his or her
own translation.  This can cause confusion and misinterpretation. 
It is best to translate the instrument into the local language
and then have someone else translate it back to make sure the
questions are clear.
When the instrument has been drafted, it should be pre-tested
with a small sample (five to ten women) to make sure that the
questions are understandable, the pre-coded responses are
realistic, and the sequence of questions is logical. Then the
instrument should be revised as appropriate.
Ideally, the interviewers should be involved in the pre-testing,
perhaps as part of their training.  Their feedback can be very
helpful in making revisions. It is also important that they
follow the sampling procedures for selecting households and
respondents.  They may have questions and suggestions about those
procedures, as well.
Pre-testing is very important and should be done carefully with
the intended target group as respondents.  Pre-tests with office
colleagues or PHC staff are of very limited value, since they do
not represent the target groups.  A worksheet should be devised
for summarising feedback.  Or notes could be written on the
instruments to identify problems with comprehension (interviewer
and respondent), coding, and logical sequence.
 Estimate the data collection requirements
The pre-tests should give you an idea of the amount of time it
will take to find a respondent, and complete an interview.  With
this information you can estimate the number of interviewers you
will need and the number of days it will take to complete data
collection.
Usually you will want a two-person team to complete at least one
cluster per day, seven or eight interviews.  You will also need
several supervisors, the number of which will depend on the
number of interviewer teams you have and the distance the
supervisors will need to travel between clusters.
If the questionnaire is short, the respondents are easy to find,
and distances between clusters are short, then a team  should be
able to complete two or three clusters each day.  Use the
following formula to make a quick estimate:

over {complete~~2~~clusters~/~day}> = 15 "team days"

If you have five teams (ten persons) the data collection could be
completed in three days.  Or three teams would require five days. 
Fifteen teams could finish in one day!
 Develop a code book
This can be very useful, especially when the questionnaire is
long or in modular form.  Code books can be important during
analysis, especially if tables are produced with codes instead of
labels.
Code books generally include the following: variable number,
name, label, value codes, and  value labels.  An example is
included in Appendix B.

Step 5: Develop the sampling procedures<$&step 5[v]>
 Target groups, attributes and sample sizes
These instructions are for manually drawing a cluster sample of
30 clusters with seven respondents each.<$FThis module emphasizes
cluster samples.  If you can draw a simple random sample, you are
encouraged to do so.  See Appendix G for instructions. 
Stratified samples can be even more effective, but they are also
more complex.  You should seek expert advice for this kind of
sample.  Stratified samples are not described in this module.>
 You may skip this step if:
 You have a complete household listing of your survey area so
that you can draw a random sample.  See Appendix G
 You plan to use a computer to draw your sample. See Appendix F
which describes how to use a spreadsheet program (Cluster
Identification Worksheet) to draw a cluster sample
First we will describe the basic procedures for drawing a sample
of 30 clusters.  Then we will discuss some variations of those
procedures that you may have to apply.  The selection of the
seven respondents from each cluster is described in Step 7.
 Determine the size of the clusters
Although most people think of clusters as natural groupings of
people (villages, census tracts, urban blocks), clusters have a
different meaning in sampling. In cluster sampling you will
divide your total survey population into 30 equal groups.  Each
of those groups will be a "cluster."  Then you will identify
seven respondents in each of those clusters.  This second step
will be discussed in Step 7:  Collect the data.
You need to know the total population of your survey population
to determine the size of each cluster.  Simply divide the total
population by 30.  For example, if your catchment area has 45,000
people, each cluster will include 1,500 people (45,000/30 =
1,500).
It doesn't matter if there are fewer or more than 30 villages or
districts, since you will define the clusters by dividing the
total population into 30 groups of equal size.
It also doesn't matter if the population is scattered over a
large area.  People can even be on islands or in remote areas and
still be included in the sample. If you want your sample to
represent all of your target population, then do not leave any
"natural clusters" out. However, if it is not feasible to include
some areas, then leave them out. BUT, remember, your sample will
not represent those who are left out. If you limit your sample to
people within one kilometre of a health centre, for example, then
that is all it represents.
You must have population size estimates of the sub-units of your
sample. List these sub-units, villages, census tracts, voting
precincts, towns, in Columns A and B of a Cluster identification
worksheet(see Exhibit 3).


Exhibit 3: Cluster Identification Worksheet            
Cluster.WQ1
Number of Clusters, +, +, 30, , (Enter Number Desired), 
+, +, +
Sample Population Size, +, +, 29,481, , (Enter total from Column
C), +, +, +

Cluster Size (sampling interval), +, +, 983, ^, , +, +, +
Random Start Number, +, +, 491, ^, ^, ^, ^, ^
INPUT DATA, +, +, , ^, OUTPUT DATA, +, , Sample Sites
Enter, Preset, Enter, Computer, ^, Preset, Computer, ^, 
A, B, C, D, ^, E, F, ^, G
Community, Community, Estimated, Cumulative, ^, Selected, 
Start, ^, Community
Name, Number, Population, Population, , Cluster, Number, , Name
Pagai, 1, 548, 548, ^, 1, 491, ^, Pagai
Santai, 2, 730, 1,278, ^, 2, 1,474, ^, Serina
Serina, 3, 686, 1,964, ^, 3, 2,457, ^, Fanta
Mulrose, 4, 280, 2,244, ^, 4, 3,440, ^, Fanta
Fanta, 5, 1,256, 3,500, ^, 5, 4,423, ^, Rostan
Bagia, 6, 684, 4,184, ^, 6, 5,406, ^, Mt. Sil
Rostan, 7, 919, 5,103, ^, 7, 6,389, ^, Mt. Sil
Mt. Sil, 8, 1,374, 6,477, ^, 8, 7,372, ^, Livton
Livton, 9, 1,133, 7,610, ^, 9, 8,355, ^, Pulau
Farry, 10, 544, 8,154, ^, 10, 9,338, ^, Pingra
Tunis, 11, 193, 8,347, ^, 11, 10,321, ^, Pingra
Pulau, 12, 375, 8,722, ^, 12, 11,304, ^, Pingra
Sasarota, 13, 333, 9,055, ^, 13, 12,287, ^, Pingra
Pingra, 14, 3,504, 12,559, ^, 14, 13,270, ^, Srivish
Kanata, 15, 336, 12,895, ^, 15, 14,253, ^, Srivish
Sirvish, 16, 2,115, 15,010, ^, 16, 15,236, ^, Balding
Balding, 17, 258, 15,268, ^, 17, 16,219, ^, Manalopa
Rescuut, 18, 678, 15,946, ^, 18, 17,202, ^, Manalooa
Krista, 19, 207, 16,153, ^, 19, 18,185, ^, Masraf
Manalopa, 20, 1,162, 17,315, ^, 20, 19,168, ^, Abrama
Garafa, 21, 408, 17,723, ^, 21, 20,151, ^, Singri
Spiltar, 22, 455, 18,178, ^, 22, 21,134, ^, Chitoma
Masraf, 23, 978, 19,156, ^, 23, 22,117, ^, St. Kitt

Abrama, 24, 335, 19,491, ^, 24, 23,100, ^, Nevis
Junagadh, 25, 541, 20,032, ^, 25, 24,083, ^, Mt. Carans
Singri, 26, 725, 20,757, ^, 26, 25,066, ^, Charga
Kalarata, 27, 355, 21,112, ^, 27, 26,049, ^, Fosterville
Ichitoma, 28, 498, 21,610, ^, 28, 27,032, ^, Maryoak
Chaplar, 29, 347, 21,957, ^, 29, 28,015, ^, Slipfern
St. Kitt, 30, 186, 22,143, ^, 30, 28,998, ^, Punjak
Nevis, 31, 1,341, 23,484, ^, , , ^, 
Mt. Carans, 32, 670, 24,154, ^, , , ^, 
Betul, 33, 321, 24,475, ^, , , ^, 
Charga, 34, 672, 25,147, ^, , , ^, 
Rio Negra, 35, 705, 25,852, ^, , , ^, 
Fostervill, 36, 444, 26,296, ^, , , ^, 
Maryoak, 37, 781, 27,077, ^, , , ^, 
Slipfern, 38, 959, 28,036, ^, , , ^, 
Tinggi, 39, 305, 28,341, ^, , , ^, 
Punjak, 40, 763, 28,104, ^, , , , 
Capital, 41, 377, 29,481, , , , , 
TOTAL, , , 29,481, , , 28,998, , 
To add more rows see Appendix I.2,, "Adjusting the Spreadsheet."

Press <<CTRL + W>> to widen columns., +, +, +, +, +, +, , +

Record the population of each sub-unit in Column C. This figure
does not have to be exact. The relative size of each sub-units is
what is important. Thus, you can even use data which are a few
years old. In Column D, add the cumulative population.  For
example, add the population of the second district (730) to that
of the first (548) to get the cumulative population of the first
two districts (1,278). Add the population of the third district
(686) to that total (1,278) to get the next cumulative figure
(1,964).
The total size of this population is 29,481.  If your addition is
correct, this should be the figure you end up with at the bottom
of Columns C and D.  Divide that total by the number of clusters
(30) to get the cluster size (both numbers are entered at the top
of the form). 
 
29,481/30 = 982.7,  rounded off to 983
 
This figure is also called the sampling interval, which means the
interval between one cluster and the next.
You are now going to select randomly a number in the first
cluster.  That will be a number between 1 and 983.  Theoretically
this number represents the first person in the cluster that you
will interview.
Use the random number table in Appendix G or take a three-digit
number from any currency note.  In our example, the random number
turned out to be 491.  Enter this at the top of the form. This is
the "start number" for your first cluster.  Now add 983 to that
number to get the start number of the second cluster (491+983 =
1,474). Add 983 to that total to get the third start number
(2,456), and so on.  Repeat this process until you have 30 start
numbers.  These are listed in the table in Column F.
The last step is to identify the communities where those start
numbers are located.  Compare the first number (491) with the
cumulative figures.  Find the first number in Column D that is
greater than 491.  This is 548 (Pagai).  Thus, the first start
number is in Pagai.  Put a 1 in Column A to identify Pagai as the
location of the start number for the first cluster or list the
names of the selected sites in Column G.  Do the same thing with
the second start number in Column E (1,474).  The first number in
Column D that is greater than 1,474 is 1,964 (Serina).  Put a 2
in Column E to identify Serina or write the name in Column G. 
Continue until you have identified all 30 communities where your
start numbers are located.
Communities that have large populations (such as #14 and #16,
Pingra and Srivish) are likely to have more than one start
number.  This is because their populations are two or three times
larger than the cluster size (983). Therefore, two or three of
your clusters may be in one community.  
Now that you know where you have to go, you should look at the
data collection estimate that you made at the end of Step 4. Will
travel time to the clusters increase or decrease the amount of
time it will take to collect the data?  Do you need to revise
your estimates?  Do not draw another sample to make data
collection easier!
This procedure may seem complicated at first, but try it a few
times and you will quickly get the hang of it.  You can also run
the computerized version of this worksheet, which is even easier. 
See Appendix F.
 Variations
 If your sample population is very large, say 300,000, you can
still follow this procedure by doing it twice.  First, list the
large sub-unitss, districts for example.  Follow this same
procedure to identify the districts where the 30 clusters are
located.  Then list the smaller sub-units in each of those
districts.  Make the computations again to find the village where
each start number occurs.  As you will learn, it is better to
start with a large number of sub-unitss. If you only have 30-35
sub-unitss, almost all will be selected and you will have to do a
lot of listing for the next selection.  It would be better to
start with 100-200 sub-units.

 If your population is very small, say 15,000 or less, you should
make sure that there will be enough respondents in each cluster
to interview.  For example, WHO estimates that the target group
for EPI surveys of children 12-23 months of age, averages three
percent of the population in developing countries.   Thus, you
would need clusters of at least 250 people to find seven children
in this age group.  To take account of those who are away,
ineligible, etc.,  WHO suggests doubling that number to 500.  For
30 clusters, therefore, you would need a minimum of 15,000 people
to do a survey of that target group.

 If there are fewer than 30 "natural clusters," then what? For
example, what should you do if there are only 24 villages, or 13
districts.  Remember that these administrative units are not the
sampling clusters.  Follow the same procedures described above to
fill in the Cluster identification worksheet (Exhibit 3).  You
will simply select more clusters per administrative unit.  Try
this with Exhibit 3.  Take the first 20 communities listed and
follow the same procedures.  The total population will be 17,315
and the cluster size (sampling interval) will be 577.  After you
draw a random start number you will add 577 to it to select the
first cluster; then add 577 again to select the second, and so
on.  You will still get 30 clusters and 30 start numbers, but
there will be several communities that will have more than one
cluster.  If you can, it would be best to divide your communities
into smaller administrative units first, say into
sub-communities.  In this way you can avoid having several
sampling clusters in the same community.
 If you are looking for a rare event, say an infant death or a
pregnant woman who received two TT shots, then you may have to
have much larger clusters in order to find them.  To estimate the
cluster size for rare events, you need to know:  the percentage
of the target group in the sample population (e.g., women who
were pregnant last year);  and the percentage of that target
group that has the attribute you are looking for (e.g., two TT
shots).
@SPASI-HALF = 
 An attribute is similar to an outcome indicator. For each PHC
component there are usually one to three important attributes
that a manager is likely to want to measure.  These would have
been identified in Step 2 and would be included in the data
collection instrument.  Some examples are listed below as well as
included in the next worksheet:
Example:  Let us assume that the survey is of antenatal care
(ANC) and that the target group consists of women who had a
pregnancy outcome within the past 12 months.  Local figures may
show that approximately 4 percent of the total population is
pregnant in a year. The survey wants to determine how many of
those women:  1) received at least one tetanus toxoid
immunization during their pregnancy; and,  2)  were delivered by
a trained attendant.  The rough estimates, which might be based
on service records or prior experience, show that 33 percent
probably received TT, and 15 percent were delivered by a trained
attendant.
For the first indicator the survey needs to be able to find seven
women in each cluster who were pregnant in the last 12 months. 
That is estimated as 4 percent of the population.  Thus, the
minimal cluster and sample size would be:

<$E{7~~respondents} over .04> = 175 cluster size * 30 clusters<R> 
                        = 5,250 population

However, this is a minimum size. You would probably want to
double it to make sure that there would be at least 15 people in
each cluster from which to draw. Thus, the clusters should be at
least 350 population each.
The second indicator requires finding seven women in each cluster
who were pregnant and were delivered by a trained attendant. 
Only 15 percent of the women who were pregnant were delivered by
a trained attendant.  Thus, the minimal cluster size would be

<$E{7~~respondents} over {.04~*~.15}> = 1,167 cluster size * 30
clusters <R>                          = 35,000 population

If doubled to be safe, that would require clusters of 2,334 and a
total sample population of 70,000.  
See Appendix G for a computer program (Target.WK1) that will help
you make the estimates of various target groups.
Increasing the number of clusters and the number of respondents
per cluster may help you get more accurate results.  Of course,
that will also increase the cost.  


WORKSHEET FOR IDENTIFYING ATTRIBUTES AND ESTIMATES, +, +, +, 
+, +, +
PHC component, Target population, Percent of total pop., Minimum
cluster size
No. eligible in cluster, +, Size of sample population <R>
(# respondents * # clusters), +
, , , 7, 15, 7 * 30, <%-2>15 * 30<%0>

Antenatal, Pregnant last 12 months
Delivered by trained attend., 4%
15%, 175
1,167, 375
2,334, 5,250
35,000, 11,250
70,000
Family plan., Married women 15-44, 20%, 35, 75, 1,050,   2,250
Growth mon., Child << 2, 8%, 88, 188, 2,640, 5,640
ORT, Child << 5, 14%, 50, 107, 1,050, 3,210
Immunisation, Child 12-23 mo., 3%, 233, 500, 6,990, 15,000
Water/sanit., Household, 100%, 7, 15, 21, 450


Whether it is worth  doing depends partly on how homogeneous the
clusters are.  Homogeneous means that all of the respondents in a
cluster are the same with respect to the attribute you are
studying.  As mentioned previously, this is often the case in
immunization programmes.  In any given cluster either most of the
children have been immunized or most have not been. 
Heterogeneous is the opposite.  It means that the respondents are
different.  For example, some children would be fully immunized,
some would have had one shot, others two, others three, and some
none at all.  
The rule of thumb is: if the clusters are homogeneous, reduce
sampling error by increasing the number of clusters (since all of
the respondents are similar, increasing the number of respondents
will not help); and if the clusters are heterogeneous, reduce
sampling error by increasing the number of respondents per
cluster.
The number of clusters should not be reduced below 30.  This is
the minimum number that is required to produce relatively valid
results.  Do not succumb to the temptation to double the number
of respondents in order to cut the clusters in half.  You can
increase the number of clusters, but there must be at least 30.
Generally, it is easier and less costly to increase the number of
respondents in a cluster, since the interviewers are already
there, than to add more clusters, which means travelling to
another site.  If you can reduce the sampling error from plus or
minus 10 percent to plus or minus 6 percent by increasing the
number of respondents in a cluster, it may be well worth the
extra cost.
See Appendix G for a computer program that can help you estimate
the required sizes for clusters and respondents.
 Multiple target groups
In Step 4 we noted that many managers will want to include
several PHC topics and target groups in the rapid survey. If the
target groups for all of the topics are the same, then there will
be no effect on the sample.  For example, if the survey covers
growth monitoring, immunization, and use of ORT, and the target
group for all three services is children under two years old,
then only one sample needs to be drawn.
However, if the target group for immunization is children 12-23
months of age, then you will not be able to get information on
those under 12 months of age for the immunization portion of your
survey.  Thus, you will need to contact an additional number of
people to find seven eligible respondents.
The previous worksheet can help you to determine the cluster
sizes you will need for each target group. From this you can also
estimate the number of households you will probably have to visit
to find your quotas for each part of the survey.
"For the same overall total sample size, however, a survey in
which a large number of clusters is selected and a few households
visited in each, will give more precise results than a survey in
which a larger number of households is visited in each of a
smaller number of clusters."
A rough rule of thumb is: find the target group in your survey
with the lowest percentage of the target population, and
calculate the minimal cluster size for that group.  Use that as
the minimal size for your survey. Then examine the ratios between
the size of that cluster and the size of the clusters needed for
your other target groups. That ratio will tell you roughly how
many more households you must contact to complete the survey. For
example

PHC service, Target group, Minimum cluster size
ORT, Children << 5 years, 107
Immunization, Children 12-23 months, 500
, , Ratio 500:107 = 4.7
 
You will have to contact about five times as many households to
complete your immunization questions as your ORT questions.  If
you get all your ORT data from the first 10 households contacted,
you will probably have to contact 40 more to complete the
immunization questions.This assumes that you follow the EPI "next
nearest front door" approach. If you have a complete household
listing, you will be able to identify seven eligible respondents
for each part of your survey from this listing.
Again, if you want to find only 20-30 people with the attribute,
you will only have to find one or two per cluster, not all seven.
Again, see the TARGET program in Appendix G for help in making
these estimates.
The last step (selecting the households) will be described in
Step 7.
 Sampling for mortality estimates
If you want to measure infant, child, or maternal mortality rates
or ratios, you will have to modify these procedures.  As
mentioned earlier, you will probably need samples of 2,000
eligible respondents for an infant mortality survey and 7,000 for
child and maternal mortality surveys.  You can conduct a
mortality survey at the same time as a conventional cluster
survey, but you will have to interview all eligible women in each
household, and you will have to visit an additional number of
households to find the 2,000 to 7,000 eligible women.  Use the
SIZE.WK1 worksheet in Appendix G to estimate the size of the
sample you will need.  Use the Vital Events questionnaire in
Appendix C to collect your mortality data.
A recent UNICEF publication describes how to conduct childhood
mortality surveys.<$FDavid, P. H., et al.  Measuring childhood
mortality:  A guide for simple surveys.  Unicef, Regional Office
of the Middle East and North Africa, Amman, Jordan, 1990.> This
handbook contains complete information for formulating
questionnaires, drawing samples, collecting and analysing data,
and preparing reports.  One of the questionnaires from this
handbook is included in Appendix C, Childhood Mortality.  The
instructions for drawing a sample for this questionnaire are in
Appendix G.  The calculation and analysis procedures for direct
estimations are straightforward, but the indirect estimation
techniques described in the handbook are complicated.  You should
call on a trained demographer if you wish to make indirect
estimates.
To measure maternal mortality you will need to find even more
eligible respondents.  One approach, called the sisterhood
method,<$FGraham, W. et. al. Estimating maternal mortality; The
sisterhood method. Studies in Family Planning, Vol. 20, No. 3,
May/June, 1989, pp. 125-135.> involves interviewing all adults in
the household þ  or even in the village or block þ  to identify
everyone who had an adult sister who had been pregnant.  This
method produces indirect estimates of the probability of dying. 
It is relatively simple, and since all adults are interviewed,
you may find enough eligible respondents in 1,000 to 2,000
households.  But, this is still a large number of households to
contact.  In addition, the method is controversial.<$FTrussell,
J. & Rodriguez, G.  A note on the sisterhood estimator of
maternal mortality.  Studies in Family Planning, Volume 21,
Number 6, November/December, 1990, pp 344-346.>
Again, we recommend that you get expert advice before designing a
mortality survey.

Step 6: Schedule the survey
The three most important things to do at this point are: finalise
the data collection schedule; prepare the survey management
forms; and recruit and train the interviewers.
At the end of Step 5 you made some estimates of the "data
collection requirements," meaning the number of interviewers and
supervisors you would need and the number of days required to
collect the data.  You should finalise the data collection
schedule now and prepare an overall schedule for all other
aspects of the study.  This includes the recruitment and training
of data collection staff; the production of the questionnaires;
logistical arrangements to get the interviewers to the clusters;
procedures for checking and verifying the completed
questionnaires, data entry, and analysis; and report preparation.
Survey management forms are important for keeping track of the
numbers of households contacted, the number of call-back visits
made, interviews completed, and so forth.  Appendix H includes
illustrative sample survey management forms for single and
multiple target groups.
Appendix E includes some guidelines for training and supervising
field interviewers.  You should prepare written instructions for
the interviewers that describe exactly how they should select
households, how to identify eligible respondents, which
respondents to interview, when and how often to make call-back
visits, how to check the completed form before leaving the
household, and what to do if a mistake is made.

Step 7: Collect the data
 Selecting households
The selection of the starting household must be made from within
the cluster.  The first house must be selected at random. It
would be best to select all seven households at random.
This may be possible if there is an up-to-date household listing
of the community.  The listing must be up to date, otherwise the
sample will be biased toward old-timers.  Use currency notes or
the random number table in Appendix G to select your seven
households.  To be safe, select ten, just in case there are
refusals, ineligible respondents, or people have recently moved
away.
If there is no list but the community is small, it would be best
to do a quick enumeration of all households and then select the
sample at random.
If that is not possible, the next best approach is the EPI
method.  The typical approach that WHO uses is to select the
first household at random in each cluster, interview an eligible
woman, if there is one at home, and then go to the next nearest
household to find the next respondent.  Respondents who are not
home are skipped, even if they are eligible.  This search
continues until the required number of interviews, usually seven,
has been completed.
The starting household is usually selected by choosing some
central point in the community, such as a market; spinning a
bottle to select a direction at random; walking in that
direction, counting, mapping, and numbering the households you
pass as you walk from the central point to the edge of the
community; and finally selecting one of these houses at random.
This house is the starting point.
There are several improvements on this approach that have been
suggested:

"It would be better to choose, say, the fifth nearest
household..."
 
"In large communities it would be a good idea to spread the
sample around by having more than one starting point in different
parts of the community."
 
"Any method which achieves a random or near-random selection of
households, preferably spread wide apart over the community,
would be acceptable as long as it is clear and unambiguous, and
does not give the field worker the opportunity to make personal
choices which may introduce bias."<$F Bennett, et al. op cit.>
 Multiple target groups
If you draw a random sample, remember to draw a separate one for
each target group.  If a household that you draw includes
respondents for two or more of your target groups, it is quite
alright to collect data from that household for as many of your
survey modules as possible.
If you follow the EPI approach, or the variations suggested
above, you would just keep going from house to house until you
completed all parts of your questionnaire.
 Call-backs
The EPI method replaces respondents who aren't at home with the
next available respondent. It is much better to try at least two
revisits to collect data from the household originally selected.
This maintains the integrity of the sample, whereas replacement
introduces bias.  People who stay at home may be very different
from those who are away at work.<%0>

Step 8:  Enter, verify, and tabulate the data

You may skip this step if:
 You are going to use the Epi Info computer program<R>Appendix A
contains complete instructions for entering, tabulating, and
producing tables and graphs
 You plan to use another computer program for data entry,
verification, and tabulation
This step describes manual procedures for: 1) summarising the
data that have been collected; and 2) producing some simple
tables. Suggestions for using standard spreadsheet programs are
described in Appendix I.
 Manual data entry
If you have been collecting data in cluster registers, you only
need to take the summary tabulations from each of the 30
registers and compile them on a summary form.  In the following
example, the sample cluster register shown in Step 4 is
reproduced with some illustrative data. The interviewer (or
supervisor) will tally the totals in the right column, as shown. 
For simple "yes"/"no" questions count the number of "yes"
responses. For example, five of the seven women received ANC
during their last pregnancy. One received care from a hospital,
two from a health centre, and two from TBAs.
For continuous variables, age, number of visits, add the numbers
and also show the number of respondents.  For example, the ages
of all seven respondents totals 190 years.  The total column
shows 190/7. Later, when the data from all of the clusters are
summarised, these figures can be used to compute average age.
Averages should not be calculated  for each cluster. The number
of ANC visits made by the five women who received ANC is shown as
10/5.
The summaries from each cluster can then be transferred to a
master sheet, such as that shown below. This form would have 30
columns, one (1) for the data from each cluster, and a column to
summarise the totals.
The data from the above form for cluster No. 1 are shown in the
second column from the left marked "1." For example, age is shown
as 190/7, Rec'd ANC is 5, and so forth. The data from each
cluster register would be entered this way and then the totals
produced at the end.
Data collected on questionnaires can be summarised in a similar
manner. This can be done in two steps or one. The two-step
process would be the same as that shown above.  Each interviewer
or supervisor would summarise the data from a cluster on a form
similar to the cluster register. That would then be summarised on
a cluster summary form and tabulated.
The one-step alternative is to develop a large summary form with
210 columns, or as many as there are interviews.
This is especially easy to do on a spreadsheet. Appendix I
includes two computerised forms that are designed for this
purpose.
 
Verifying and cleaning the data
The data need to be "verified" to make sure that no mistakes were
made in summarising the totals and transferring them to the
summary sheets.
This can be done by having two separate teams independently
summarise and transfer all of the data to summary tables. The
results are then compared.  Discrepancies can be checked and
corrected fairly easily this way.
Cleaning the data involves correcting mistakes in the original
interview forms and summary sheets.  Although the supervisors
probably checked each questionnaire and cluster register,
mistakes can still happen.  Typical mistakes include using the
wrong code, leaving a question blank, misinterpreting a written
code (e.g., 0 for 8), skipping to the wrong question, and
entering an answer in the wrong space.
Some of these mistakes will be caught by the supervisor, others
by the verification process, and some won't be noticed until the
preliminary analysis is done.  To find the source of the error,
you will usually have to go step-by-step back through the data
entry process: first to the summary sheets, then the cluster
forms, then the original questionnaires or registers.

Tabulation
Manual tabulation will usually be limited to summarising counts,
computing a few averages, and preparing some frequency
distributions. If you are using a computer, you can do much more.
See Appendix I for examples of simple computerised tabulation
procedures that use a spreadsheet program.
For manual tabulation, you will already have totals summarised in
the Summary Form.  Use these and the report outline that you
prepared in Step 3 to decide what to prepare. At that time you
also prepared some dummy tables. Prepare the data needed to fill
them in. Appendix I includes an illustrative list of frequency
distributions and cross-tabulations.

Interviewer name: B. Rangka, +, +, Date : 03/04/92, +, Book no.
1, +, +, +, +
Cluster: 1, +, +, Area: So. Bajju, +, Supervisor: Sonia Barang,
+, +, +, +
Respondent no., 1, 2, 3, 4, 5, 6, 7, 8, Total
Name, JB, KH, TD, MJ, NKT, TR, JN, , 
House no., 13, 25, 37, 38, 42, 54, 65, , 
Age, 23, 25, 22, 34, 42, 18, 26, , 190/7

Rec'd ANC last pregnancy, Y, Y, N, Y, Y, N, Y, , 5
No. ANC visits, 2, 2, , 1, 3, , 2, , 10/5
Source of service:, , , , , , , , , 
Hospital, Y, , , , , , , , 1
Health centre, , Y, , Y, , , , , 2
Local TBA, , , , , Y, , Y, , 2
Other:, , , , , , , , , 


Summary cluster form, +, +, +, +, +, +, +, +, +
Date of first interviewer: 03/04/92, +, +, +, +, Date of last
interview: 
03/21/92, +, +, +, +
Area: Bajju, Prepared by : Sonia Barang, +, +, +, Checked by:
Marcus 
Stefensen, +, +, +, +
Cluster No., 1, 2, 3, 4, 5, , 29, 30, Total
Age, 190/7, 185/7, 210/8, 175/7, 197/7, , 180/8, 180/7, 5715/214
Received ANC last pregnancy, 5, 4, 6, 3, 4, , 5, 5, 156
No. ANC visits, 10/5, 10/4, 13/6, 9/3, 10/4, , 12/5, 10/5,
314/156
Source of service:, , , , , , , , , 
Hospital, 1, , 1, , , , 1, , 15
Health Centre, 2, 1, 2, 1, , , 1, 2, 47
Local TBA, 2, 3, 3, 2, 4, , 3, 3, 94
Other:, , , , , , , , , 
Averages: Let's start with computing averages.  All of the data
that are continuous variables were entered in the summary table
as two numbers: the total years, visits, and events divided by
the total number of those who responded to that item. Examples
are age and number of ANC visits.  Just perform this division to
compute the average (mean): 

5715/214 = 26.7 years (the average age of your sample)
No. ANC Visits 314/156 = 2.01 visits (the average number of
visits made by women who received ANC during their last
pregnancy)

Please note that the denominators (the number of respondents) is
different in these examples.  A common mistake is to use the
wrong denominator, for example, dividing the total number of ANC
visits by 214, the total sample.  Be careful to use the correct
denominator.

Coverage percentages:  Your most important data will probably be
coverage data. This is computed by counting the number of people
covered and dividing it by the number of eligible respondents.
Examples from the Summary Form are the number who received ANC. 
The sheet shows that 156 women out of 214 received ANC.  To
compute the coverage percentage, divide 156/214 and multiply by
100.

Received ANC last pregnancy: 156/214 = .72897 * 100 = 72.9% (the
percent of eligible women covered)

Frequency distributions:  This information will also be important
for determining the numbers and percentages of people who use
different services, use different providers, have different
reasons for accepting a service, and so forth.  The Summary Form
shows that there were three sources of service for the 156 women
who received ANC.  To compute the frequency distribution, divide
the counts of each of these by 156 and multiply by 100.
You should go through your Summary Form and compute these three
types of statistics for your report. It is possible to do more
sophisticated tables by hand, such as cross-tabulations of ANC
use by age and computation of tests of significance, but these
are tedious when done manually.  If you need this information, it
would be best to use a computer programme or find someone who has
a computer and can do it for you.  They may want to use the
programmes included in Appendix I for tabulation and statistical
analysis.  Appendix I.3 also includes examples of a programme
developed by Ralph Frerichs for computing confidence intervals
for selected indicators (ANC.WK1).

Step 9: Analyse, interpret and report the findings
Consult your report outline again to make sure that you know the
user's most important indicators, questions, and issues. You have
already produced some of these in Step 8: coverage data and
frequency distributions of key variables, for example.
 Analysis and interpretation
When you have your tables completed, examine them to make sure
that you understand what they mean. Think in terms of different
kinds of interpretations:
 Descriptions: This is the most basic level of analysis.  Simply
present the facts: X number of women were served; Y percent
covered. 
 Performance: This requires comparing the descriptive data with
performance expectations or standards. Is 73 percent coverage
adequate, excellent, below expectations? Where is the programme
performing well? Where is it not?<%0>
 Explanations: Some of your frequency distributions can provide
explanations. Where did women go for service?  What reasons did
they give for not coming back? Rapid surveys usually do not get
into much detail in this category, but the results can stimulate
staff discussion and result in insightful explanations. For
example, why don't women come to the hospital? Why are so many
going to TBAs? Modules 6 and 7 can help you get some explanatory
data.
 Implications: This involves going beyond the data to think of
implications for the future.  If coverage is low, what does that
mean for the future? Can it be increased?  Is it feasible? How
could it be done? Should the programme try to get more women to
come to hospitals and health centres for ANC? Or should we train
TBAs to provide better services?
 Issues needing further study: Most studies raise questions, as
well as answer them. Rapid surveys are no different. Identify
questions that cannot be answered with the available data. Some
of those might be investigated with a second survey or through
one of the other modules that look at the quality of services
(Module 6), short-term monitoring of an activity (Module 5),
identifying high-risk women (Module 3), etc.
Remember that you can only do an analysis of the entire sample.
You cannot divide the sample into sub-sample<%0>s to compare
groups. This requires separate rapid surveys for each group.

Source of service, Number served, Percentage
Hospital, 15,   (15/156)*100 =   9.6
Health centre, 47, (47/156)*100 = 30.1%
TBA, 94, (94/156)*100 = 60.3%
Total, 156,                 100.0%


 Reporting
The easiest way to prepare a report is to present the findings
from each question in the sequence followed in the questionnaire. 
Another is to present the major findings first, since this is
what most managers want to know.  Most rapid survey reports are
presented orally at first and include a few tables and graphs of
key findings. The final written report may include additional
tables at the manager's request.
A typical formal outline of a research report is shown below:<%0>
 Title, authors, date, acknowledgements, table of contents
 Executive summary (key findings, implications, brief description
of the study design)
 Statement of the research problem (the background and problems
to be investigated)
 Study objectives (purpose of the study, expected outcomes)
 Methodology (brief description of the key indicators, sample,
instruments used, analysis procedures, timetable)
 Findings (summary of findings, divided into sections, formatted
to address questions and issues the user wants answered þ  should
include tables and graphs of key points)
 Discussion (interpretation of the findings, discussion of
implications for the future, identification of other issues
needing study or analysis)
Recommendations (suggested courses of action to take for policy,
planning, services, management, further research)<%0>
 Appendices (detailed data tables, questionnaire or register
used, reference materials)
The formal report does not have to be long.  Some of the sections
listed above can be covered in a paragraph, others in a page. 
The longest sections are likely to be the findings.  Keep the
audience in mind when preparing the report.  Managers, in
particular, are not likely to read long reports.  That's why the
executive summary is so important.  That may be all that they
read.

Step 10: Develop an action plan
The Implications and Recommendations sections of the formal
report may not necessarily lead to action. That is why it is
important to make development of an action plan a separate step
and to introduce it as part of the study objectives. The managers
and other users should be expecting to take action on the study
results. Make that a stated expectation from the beginning and
reinforce it throughout the study.
The best time to begin preparing an action plan is during the
oral presentation of the study results. The plan does not have to
be detailed, but it should include:
 WHAT: the action(s) to be taken should be specified (e.g.,
provide ANC training to TBAs, or brainstorm what can be done to
enrol high-risk women in ANC).
 WHO: the specific people who will be responsible for each action
should be identified (by name or position).
 WHEN: the dates for starting and/or completing the actions.
In some cases it may be important to include WHERE, to specify
the sites or locations where the actions will take place, HOW, to
outline the procedures that will be followed, and the RESOURCES
that will be made available to carry out the actions.
Specific details may need to be worked out later, and even some
of the above elements may have to wait until the formal report is
ready and can be studied more carefully.  If so, then they should
be incorporated into the preliminary action plan.


Worksheet for developing action plans, +, +, +
ACTION TO TAKE
(What), RESPONSIBLE
(Who), DATES
(When), OTHER (Where)
Appendices: Templates, tools, guidelines, and computer programs
A. How to use Epi Info to conduct rapid surveys
B. Questionnaire design guidelines
C. Rapid survey instruments
 Community assessment of PHC (overall)
 Health education
 Antenatal care, safe delivery and postnatal care
 Family planning
 Acute respiratory infection
 Breast feeding
 Diarrhoeal disease control/oral rehydration therapy
 Childhood disabilities
 Child immunization
 Growth monitoring/nutrition education
 Water supply, hygiene and sanitation
 Accidents and injuries
 Chronic, non-communicable diseases
 Tuberculosis
 Malaria
 Sexually-transmitted diseases, HIV/AIDS
 Vital events and health status
 Child morbidity and mortality assessment
 Adult morbidity and mortality assessment
 
D. Cluster survey registers
 Health education
 Antenatal care, safe delivery and postnatal care
 Family planning
 Acute respiratory infection
 Breast feeding
 Diarrhoeal disease control/oral rehydration therapy
 Childhood disabilities
 Child immunization
 Growth monitoring/nutrition education
 Water supply, environmental hygiene and sanitation
 Accidents and injuries
 Sexually-transmitted diseases, HIV/AIDS
 Malaria
 Tuberculosis
 Chronic, non-communicable diseases
 Vital events and health status
 Child morbidity and mortality assessment
 Adult morbidity and mortality assessment
 
E. Guidelines for training and supervising interviewers
F.Cluster sampling programmes
 Cluster identification worksheet
G.  Other sampling tools
G.1  Estimates of target group sizes (TARGET.WK1)
 G.2 Sample size estimation for WHO two-stage cluster survey 
 (SIZE.WK1)
 G.3 Random number table
 (RANDOM.WK1)
 G.4 Random sampling procedures
 H.  Survey management forms
 Form 1: Household enumeration
 Form 2: Respondent disposition
 Form 3: Multiple-target group management form
I. Tabulation and analysis templates
 I.1 Data analysis plan
 I.2 Rapid survey analysis template (RAPID_ANC.WK1)
 I.3 Cluster summary template (MINI_GM.WK1)
 I.4 Confidence interval estimation templates (TT.WK1; ANC.WK1)
Appendix A: How to use Epi info for rapid<R>surveys
What is Epi Info?
Epi Info is a simple computer program for surveys.  You can
design a questionnaire right on the computer screen or import one
from an unformatted (ASCII) file.  You can edit your questions
right on the screen þ  add, delete, move, and insert.
It allows you to insert the codes, skip patterns, range checks,
and directly apply other data entry instructions to the
questionnaire, as well as enter the data from your completed
interviews onto the questionnaire.  You can also import data from
a spreadsheet or dBase file for analysis.
The program includes simple commands for analysing the data, and
you can produce frequency distributions, tables, cross-tabs, and
more sophisticated statistical analyses right on the screen. You
can even produce bar and pie charts, and print the results.
In short, Epi Info is an all-in-one package for practically any
survey your project needs. You can set up the questionnaires,
data entry instructions, even the analysis instructions here and
give them to your colleagues in the field.  All they will have to
do is print out and duplicate the questionnaire, collect and
enter the data, and run the analysis program to get the results.
This document provides instructions for using Epi Info and
includes a prototype survey questionnaire that has been set up to
conduct a family planning contraceptive prevalence survey.
 What this appendix includes
 Instructions that describe how to:
 Install Epi Info and use the tutorials
 Develop a questionnaire in Epi Info
 Include data entry instructions in the questionnaire
 Enter data into Epi Info
 Analyse the data in Epi Info
 Produce tables and graphs for a report
@PGBRK = 
 Sample files that you can use to illustrate the<R>instructions:
 RAPIDFP.QES (a family planning questionnaire)
 RAPIDFP.REC (a data entry file)
 RAPIDFP.CHK (a file for including range checks and other
instructions for data entry)
 RAPIDFP.PGM (a file of analysis instructions to produce tables
and graphs)
 FPTEST.WK1 (a Lotus 1-2-3 spreadsheet file with sample data)
 FPTEST1.REC (a data entry file constructed from FPTEST.WK1)
@SPACI KECIL = 
Use the sample files that come with these instructions in
conjunction with the Epi Info computer program to learn how to
use Epi Info in conducting rapid surveys in family planning and
primary health care.  You can also read and print out sections or
all of the Epi Info User's guide from the enclosed diskette.

Installing EPI info and using the tutorials
Installation:  Epi Info is very easy to install. Follow the
instructions in the README file on the first PHC MAP diskette. It
will tell you how to extract Epi Info and other files.  When you
have extracted the Epi Info files and put them on separate
diskettes you can install Epi Info onto your computer.  Place
Disk 1 of the Epi Info System in one of your floppy drives, say
drive A.  At the A prompt type INSTALL.  Then just follow the
directions on the screen. See Chapter 4 of the Epi Info User's
guide for more details.

Notations:  These instructions use the same notations as the Epi
Info User's guide (see p. 7 of the guide).  Keys on the
computer's keyboard are indicated by <<   >>. Examples : << F1 >>
(means press the F1 key), << Ctrl + S >> (means hold down the
Control key and press the S key).  The material that you should
type is shown in boldface. Example: type EPI and press <<Enter>>.
Tutorials:  Epi Info includes a tutorial program in a file called
EPIAID.  First get into the EPI5 directory.  Then type EPI to
load EPI5.  The main menu should appear.  Move the cursor to EPED
and press <<Enter>> to load it. Then press <<F3>>.  Next move the
cursor to EPIAID and press <<Enter>>. Choose one of the tutorial
programs þ Word processing, Make Epi Info Questionnaire þ  and
press <<Enter>>.
There are also two analysis tutorials. Load EPI5 as before. Move
the cursor to ANALYSIS on the menu and press <<Enter>>. Then type
RUN TUTOR1 and <<Enter>> for basic analysis procedures or RUN
TUTOR2 for developing an analysis program.
The User's guide also includes Tutorial Instructions at the
beginning of Chapters 4 (Installation), 5 (Starting Epi Info), 8
(Entering Data), and 10 (the CHECK program). It also includes a
number of tutorials for advanced work with Epi Info.
 
The following summarises the basic tutorial programs included in
Epi Info:
 
 Tutorials  Source
 1. Installation    Chapter 4 (page 1)
 2. Starting        Epi Info Chapter 5
 3. Word processing EPIAID: Word processing
 4. Designing questionnaires EPIAID: Make EPI info questionnaire
 5. Data entry    Chapter 8
 6. Data entry instructions Chapter 10
 7. Analysis  ANALYSIS: RUN TUTOR1
 8. Analysis programs ANALYSIS: RUN TUTOR2

These instructions are based on Epi Info, Version 5: A
wordprocessing, database, and statistics system for epidemiology
on microcomputers, by A.G. Dean, J.A. Dean, A.H. Burton, and R.C.
Dickers.  Epi Info is a joint project of the Centers for Disease
Control (CDC) and the World Health Organization (WHO).
The User's guide and the computer programs are in the public
domain and may be freely copied, as can these instructions.  The
program and User's guide can be purchased for $35 from USD
Incorporated, 2075A West Park Place, Stone Mountain, GA 30087. 
The User's guide is also available from several countries, often
through Departments of Epidemiology in local schools of public
health.
 How to develop a questionnaire in Epi Info
You may construct a questionnaire directly in Epi Info or import
one that you developed on a word processor.  We recommend that
you develop (or revise/edit) your questionnaire on your word
processor first.  It will be easier for you to work on a word
processor with which you are already familiar. Epi Info uses a
simple word processor based on WordStar.  It may take some time
to get used to Epi Info's wordprocessing commands. We strongly
recommend that you read Chapters 6 and 7 of the Epi Info User's
guide for instructions.  Also, run the EPIAID tutorials on Word
processing and make the Epi Info Questionnaire.
The following instructions first tell you how to prepare a
questionnaire on your word processor (A). This is followed by
instructions for preparing one within Epi Info (B).

How to prepare a questionnaire that will be imported to Epi Info
1. Prepare your questionnaire on your word processor.
Use one of the draft questionnaires in Appendix C as a guide.
Also see the sample Family Planning questionnaire that follows. 
You may load these questionnaires into your word processor and
revise them by adding, deleting, or editing the questions.  List
the most likely responses and give each a code number. Make sure
to include 9 or 99 for "Don't Know/No" response (DK/NR). Example:

8. Are you using a method now? Yes (1),  No (0), DK/NR (9)

When you are finished, save the questionnaire twice.  Save it
first as a regular document, for example RAPIDFP.DOC.  You will
use this version for your interviewers.
Save it a second time as an unformatted file (ASCII).  You will
use this version to set up a data entry programme in Epi Info. 
When you save it, add QES as the extension.  Example: RAPIDFP.QES

2. Enter the Fields.
Now you will enter "fields" in the *.QES version of the
questionnaire.  You should still be working in your word
processor.

Types of fields.  A "field" is an area in the questionnaire where
you will enter data.  After each question you will insert symbols
for an appropriate field. These are examples of questionnaire
items followed by different kinds of fields:
 Today's date: <</mm/yy>>  Interviewer name ______
 2. How old are you? ##   3. Are you married? <<Y>>

The first is a "date" field. You would enter two numerals each
for the day, month, and year. The second, to the right, is called
a "string" field.  You can enter up to 80 characters in a string
field.  The third, following, "How old are you/," is a "numeric"
field.  The # symbol represents a numeral, in this case, a
two-digit number.  The last is a field for entering "yes"/"no"
responses.

Symbols. The following list summarises the major symbols you can
used for your fields.  Usually, each question will have one field
for the response, and you will decide which type of field is
appropriate and where to place it.  The numeric and string fields
require a symbol for each digit or character in the response. 
For example, if you record the respondent's age, you need to
allow space for two digits, so enter ##.  If you want to record
the person's name, you might allow space for 20 or 30 characters. 
Type one underline character for each space : ________________ . 
(This is a 20-space string.)

#, For numbers:  ## (26)     ###.# (26.4)     .###(.264)
<<Y>>, For Yes/No responses: Y = Yes,, N = No,<R>(Accepts Y,, N,,
and space (missing value. Does not allow DK/NR codes.)
<<dd/mm/yy>> , For dates:  23/04/92
_______, For written responses (especially for open-ended
questions) maximum length is 80 characters.
<<IDNUM>>,  For the case number:  0231

Instructions. Type in the appropriate symbols in the second
(*.QES) version of your questionnaire.  Put them where you want
the data to be entered. Later you will use this questionnaire to
construct a file for entering data into the computer.  The
computer program will display this questionnaire, and the cursor
will skip from one field to the next to allow you to enter data.  
Thus, it is important where you place the symbols. In the sample
questionnaire, we have placed all of the symbols in the right
margin.  You may also place them at the end of the questions,
below them, inside them, wherever you wish.  For example:
 
Are you using a method now? # Yes  (1), No  (0) DK/NR  (9)
Are you using a method now?  Yes  (1), No  (0) DK/NR  <T>(9) #
# Are you using a method now?<T>Yes  (1), No  (0) DK/NR  <T>(9)


Remove any symbols that you don't want to be read as fields by
the computer.  Underlines ___, chevrons <<2>>, pound signs #3,
will all be read as fields.  In the following examples you would
remove all of these symbols except the one # sign at the end,
which is the field you want.

Are you using a method now? <T>Yes___(1), No___(0),
<T>DK/NR___(9) #
Are you using a method now? <T>Yes <<1>>,    No <<0>>,  <T>DK/NR
<<9>>#
Are you using a method now? <T>Yes (#1),    No (#0), <T>DK/NR
(#9) #

Rapid survey questionnaire: Family planning
Complete for all married women aged 15-44 years who are currently
living in the household.
CASE NO:  IDENTIFICATION  , +, +, +, , , Office Use<<ID number>>
     
1. , {Study} No        , +, , , ,  1.##
2. , {Province} No       , +, , , , 2.##
3. , {Interviewer}      , +, , , , 3.##
4. , {Date} of Interview        , +, +, , , 4. 

, , +, +, , , <<dd/mm/yy>>

5. , ID Number (4 digits) : {Cluster No}. {Woman No}. in Cluster,
+, +, , , 5.##

, {NAME} OF RESPONDENT:, +, +, , , 
6. , How {old} are you? (Probe) years (if DK/NR,, enter 99), +,
+, , , 6.##
7. , How many living {children} do you have? (if DK/NR,, enter
99) , +, +, , , 7.##
8. , Are you or your husband currently using any family planning
{method}? , +, +, , , 8.#  
    Yes (1)     No (0)   Go to Q 13    DK/NR (9)  Go to Q13, +,
+, +, , , 
9. , Which method are you/your husband using now (select
principal {method only})?, +, +, , , 9.##
, Tubectomy, (1), NORPLANT, (6), , 
, Vasectomy, (2), Condom, (7), ,      <%-5><<dd/mm/yy>><%0>
, IUD, (3), Foam,, emco,, jelly,, cream,, diaphragm, (8), , 
, Oral pill, (4),  <%-2>Safe period,, withdrawal,, abstain<%0>,
(9),  , 
, Injection, (5), Other:       , (10), , 
,  DK/NR, (99), , , , 
10., {How long} have you been continually using this method?, +,
+, , , 10.#  
, 0-3 months, (1), 1-2 years, (4), , 
, 4-6 months, (2),  3-4 years, (5), , 
,  7-12 months, (3),  5 years or more, (6), , 
, DK/NR, (9), , , , 
11., For how long have you been practising family planning,,
i.e.,, continuously using one method or another without
{interruption}?, +, +, , , 11.#  
, 0-3 months, (1), 1-2 years, (4), , 
, 4-6 months, (2), 3-4 years, (5), , 
, 7-12 months, (3), 5 years or more, (6), , 
, DK/NR, (9), , , , 
, , +, +, , , 
, , +, +, , , 
12., What is the main source of your family planning service or
{supplies}?, +, +, +, +, 12.##
,  Govt. hospital/clinic, (1) , Private hospital/clinic, (6),  , 
, Govt. field worker, (2), NGO clinic, (7), , 
, <%-2>Social marketing prog.<%0>, (3), NGO field worker, (8), , 
, Private physician, (4), Other: _______, (9),  , 
,  Pharmacy, (5),  DK/NR, (<%-6>99)<%0>, , 
, Go to Q17, , , , , 
13., If you are not using family planning now,, have you or your
{husband ever} used any method in the past?, +, +, , , 13.#
, Yes (1), (1), No, (0), Go to Q15, 
, DK/NR , (9) , , , , 
14, Which method did you/your husband use most recently (select
{latest  method} only)?, +, +, , , <R>14.##
, Tubectomy, (1), NORPLANT, (6), , 
, Vasectomy, (2), Condom<T>, (7), , 
, IUD   , (3), Foam,, emco,, jelly,, cream,, diaphragm, (8), , 
, Oral pill, (4), Safe period,, withdrawal,, abstain, (9), , 
, Injection, (5), Other, (10), , 
, DK/NR, (99), , , , 
15., Do you/your husband intend to practice family planning in
the {future}?, +, +, +, +, 15.#
, Yes, (1) , No, (0), , 
, DK/NR , (9), , , , 
16., What is the most important reason you are not using family
{planning now}?, +, +, , , 16.##
, Want more children, (1), <%-6>Method/service unavailable<%0>,
(6), , 
, Husband objects, (2), Sterilily, (7), , 
, Health reasons, (3), Breast feeding, (8), , 
, Religious reasons, (4), Pregnant, (9), , 
, Fear side effects, (5), Other, <%-2>(10)<%0>, , 
, DK/NR, <%-2>(99)<%0>, , , , 
17., What is the name of the local {Community} Health Worker?<T>,
+, +, , , 17.#
,  Knows (said name) , (1), Does not know, (0) ,   , 
, No response, (9), , , , 
18., Has the Community Health Worker visited or contacted you
during the {last three months}?, +, +, , , 18.#
, Yes , (1), No, (0),   , 
, DK/NR, (9), , , , 
This concludes the interview.  Thank you for taking the time to
participate in this survey., +, +, +, +, +, +


In this version the data are entered in a column on the right;
many researchers prefer this format.  However, it is important
for only the data entry version of the questionnaire. The
interviewers can enter responses anywhere on the paper. That is
why you should save one version of the questionnaire for your
interviewers and this second one for the data entry program.

3.Enter names for each field by placing { } around key words in
each question.
You should still be working in your word processor on the *.QES
version of your questionnaire.
Next you must give each field a name so that you can analyse the
data later. Examples:
How {old} are you?  Field name = OLD
Which {method} are you using {now}? Field name = METHOD NOW
{A.1}  Which method are you using now? Field name = A.1
If your question is longer than one line, the field name must be
in the last line.  For example:
8. Are you or your husband currently using any family planning
{methods}?
 
Actually, you do not need to enter field names. This is an
optional step, because Epi Info will create field names
automatically if you do not specify a name.  It selects the first
10 non-punctuation characters before each field.  See page 53 of
the Epi Info User's guide for more detail.  The major advantage
to entering your own field names is that they will be immediately
recognisable to you.
When finished, save the file in ASCII format with a QES
extension.
Example: save the file as RAPIDFP.QES

How to prepare a questionnaire within EPI info.
1. Load EPI5.  At the C prompt type <<EPI>> and press <<Enter>>.
2. Open EPED.  In the main menu move the cursor to EPED and press
<<Enter>>.
3. Type the questionnaire onto the screen.
Type the questions, instructions, codes, etc., directly onto the
screen, using the program's wordprocessing commands to tab,
backspace, delete, 
If you have a questionnaire on your disk that you want to use or
edit, load the file by pressing <<F2>>.  Enter the file location
and name, e.g., b:\RAPIDFP.QES. Press <<Enter>>. Then make your
corrections, additions, etc.
4. Enter the fields and field names, and remove unwanted symbols.
You can enter the field symbols directly, as described above. 
You can also call up a menu of field symbols by pressing <<CTRL +
Q>>, then <<Q>> again.  To insert one of these in your
questionnaire, first make sure the cursor is where you want to
make the insertion.  Then press <<CTRL + Q>>, Q, then highlight
the symbol you want and press <<Enter>>.  If you know what the
symbols are, it is easier to type them in directly.

You may skip this step if you don't want to insert any data entry
instructions

5. When finished, save the file. Press <<F9>>, then <<F10>> to
exit.
 Inserting data entry instructions in Epi Info
(See Chapter 10 of the Epi Info User's guide)
You can insert codes into your basic questionnaire to check for
errors, to do automatic coding of some entries, and to skip over
inappropriate questions. The instructions describe in this
section how to insert the following into your questionnaire:
Range Checks:  Specify the range of values that can be entered;
e.g., 1-5. The programme will reject all numbers outside the
range, e.g., Q, 6, 8 etc.
Legal Values:  Specify individual values that can be entered;
e.g., 2, 8, 9. The program will reject all other numbers (e.g.,
1,3,4, N, etc.).
Must Enter:  Specify that an entry must be made in the field, it
cannot be left blank or skipped.  The program will not move to
the next field until an entry is made. However, you can override
this by pressing the <<Down Arrow>> or <<page Down. >>
Repeat:  Specify that the same value entered into a field will be
repeated in all subsequent records until it is changed.  For
example, enter Q 3 for province, which will be entered
automatically on all subsequent questionnaires until you change
it.
Skips: Specify which questions will be skipped, depending on the
previous answer.  For example, "If No, go to Q16."

1. Create a data file.
Before you can enter these instructions, you must have a data
file in which to insert them. This is a file with a *.REC
extension. You can create one as part of this step or as part of
the data entry step.
Load EPI5 by typing EPI and pressing <<Enter>>. At the main menu,
move the cursor to ENTER and press <<Enter>>.
At the prompt type in the name of the questionnaire file you just
prepared, e.g., RAPIDFP, but leave off the extension.  Don't
forget to include the path name.  Example: b:\RAPID and press
<<Enter>>.
Follow the commands. Press <<ESC>>. Enter the name of your
questionnaire file, e.g., b:\RAPIDFP.QES and <<Enter>>.
Inspect the file, especially to make sure that all of the fields
are included and are in the correct places. Then press <<F10>> to
exit. If you need to make corrections, go back to the EPED
programme to edit your file.
 
2. Load the CHECK programme from the main Epi Info menu.
Load EPI5 by typing EPI and pressing <<Enter>>. At the main menu,
move the cursor to CHECK and press <<Enter>>.
@SPACI KECIL = 

3. Load your questionnaire.
You should load the data entry version of your questionnaire.
That is the one with the *.QES extension.  At the prompt, enter
the path and name of your questionnaire (e.g., b:\RAPIDFP.QES)
and answer <<Y>> to the question "Are you ready?" Press
<<Enter>>.
 
4. Enter the appropriate check codes in the appropriate fields.
Place the cursor in the first field to be changed and make the
appropriate entry; see the menu at the bottom of the screen. 
Move to each field to be changed until finished.
Range check:  Enter the minimum number that will be accepted,
press <<F1>>, then enter the maximum number that will be
accepted, press <<F2>>.
Example: Age 15-44.  Put the cursor on the field symbol in the
age question, type: <<15>> <<F1>> <<45>> <<F2>> and <<Enter>>. To
remove a range, see "6. Editing the commands," below.
Legal Values:  Enter the letter(s) and/or number(s) that will be
accepted, press <<F6>>.
Example:  Male=M, Female=F.  Put the cursor on the field symbol, 
type: <<M>> <<F6>> <<F>> <<F6>>, and <<Enter>>.
Example:  Male=1, Female=2, Unknown=9; Type:<R> <<1>> <<F6>>
<<2>> <<F6>> <<9>> <<F6>> and <<Enter>>.
Press <<SHIFT + F6>> to display all legal values for the field.
To remove a legal value, enter it into the field and press <<CTRL
+ F6>>.
Must enter data in this field:  Place the cursor in the field and
press <<F4>>. Press <<F4>> again to remove the command.
Repeat entry made in this field in subsequent records:  Move the
cursor to the field symbol, enter the number or characters you
want repeated, and press <<F3>>. Example:  Study No <<6>> <<F3>>. 
Press <<F3>> again to remove the command.
Skip:  Place the cursor in the field.  Enter the value that
triggers the skip, press <<F7>>, move to the question to be
skipped to, press <<F7>>.
Example:  Q 8 says "If 'No', go to Q13."  Place the cursor on the
field symbol in Q8. Type:  <<N>>, press <<F7>>, (move the cursor
to the field symbol in Q13, press <<F7>>.
You can have several different skips for the same question.  For
example, in addition to the skip above, you might have: "If Yes,
go to Q15."  Place the cursor on the field symbol in Q8 again,
type <<Y>>, press <<F7>>, move the cursor to the field symbol in
Q15, type <<F7>>. The program will now skip to Q13 if the
response is "no" and to Q15 if it is "yes."
If you want to skip to another question regardless of the
response, place the cursor on the field symbol and press <<F7>>
when the field is blank.  Move to the field symbol in Q15 and
press <<F7>> again. To display all current skips for a field,
place the cursor on the field symbol and press <<SHIFT + F7>>.
To remove a skip use <<CTRL + F7>>.
 
5. Save your changes.
Press <<F10>> when finished to save. "Write Data to Disk [Y/N]?"
appears.  Press <<Y.>>

6. Editing the commands.
Place the cursor in a field you wish to change and press <<F9>>. 
The commands for that field will be displayed in an indented
hierarchy.  You can edit, add, delete commands directly. 
Example: To change the Male and Female codes from M and F to 1
and 2, simply press <<F9>>, move the cursor to M and replace with
1, move to F and replace with 2.

How to enter data into EPI info 
(Chapters 8 and 17 of the Epi Info User's guide)
There are two ways to enter data into Epi Info. The first is to
enter the data from one questionnaire at a time directly into the
Epi Info data file.  The second, is to import all of the survey
data from a spreadsheet, dBase or ASCII file.
 
How to enter data from questionnaires (see Chapter 8)
1.  Load ENTER from the main menu.
Load EPI5 by typing EPI at the C prompt and pressing <<Enter>>. 
At the main menu move the cursor to highlight ENTER and press
<<Enter>>.  If you are creating a new data file, type in the path
and name of the questionnaire file that you want to use, but
leave off the extension, e.g., a:\RAPIDFP and press <<Enter>>. 
The program will create a data file and give it a *.REC
extension, such as RAPIDFP. REC.   If you are loading a data file
that has already been created, follow the same steps.  When you
type the name of the data file (RAPIDFP), the program will find
RAPID.REC and load it.  Or you can type in the path, e.g., b:\
and press <<F1>> to display a list of REC files.  Move the cursor
to the one you want to load and press <<Enter>>.

2. Enter the data from each completed questionnaire.
The case identification number <<idnum>> is entered
automatically, and the number increases by 1 for each record. 
The cursor will move to the first field that you specified to
receive data.  In the sample Family Planning questionnaire, this
field is "Study No"  Type in the number (e.g., 6) and then press
<<F3>>.  Since the study number is the same for all
questionnaires, you need to enter that only once.  The <<F3>> key
turns the "Repeat" function on and off.  When you turn it on, you
will not have to enter the same number for each questionnaire.
The Province number is also the same.  The interviewer number
will be the same for 7 or more cases, as will the date of the
interview and cluster number.  When the number changes, e.g.,
from 6 to 7, just type in 7 and it will repeat until you type in
a new number.
In most cases, after you enter data in a field, the cursor will
automatically move to the next field. If it does not, press
<<Enter>> to move to the next field.  This happens when the
spaces in the field are larger than the number entered.  For
example:  "How many living children do you have?"  Allow 2 spaces
for a two-digit number (12, 15, 10).  When you enter two digits,
the cursor goes to the next variable.  If you entered one digit
(2, 3, 1), you would also need to press <<Enter>> to move to the
next question.
If you have installed range checks and legal numbers, the program
will only accept the numbers you indicated.  "How old are you?"
will accept any number between 15 and 45. If you enter 13 or 54,
the program will not accept the entry.  For a "yes"/"no"
question, the program will accept Y, N, or blank.  If you enter Q
by mistake, it will not be accepted.  Dates must be entered in
the correct order: dd/mm/yy. The first entry (day) cannot exceed
31, the second (month) cannot exceed 12.
The program will skip questions that do not apply (identified on
the questionnaire as "Go to QXX").  You cannot enter data in
fields that are to be skipped.
Some fields are designated as "Must enter."  The program will
beep if you try to skip by pressing <<Enter>>. If the data item
is missing on the questionnaire, you can leave the field blank by
pressing the down arrow or <<Page Down>>.
 
3. Make corrections, as needed.
If you make a mistake, use the up or down arrows, the <<Home>>,
<<End>>, <<PgDn>>, and <<Pg Up>> keys to move the cursor to the
error and re-enter the correct data.
When you have finished a form, the message, "Write data to disk
(Y/N)" will appear at the bottom of the screen. Type <<Y>> to
save the data.  The program will go to the top of the screen so
that you can enter the next record.  Notice that the Case ID has
increased by one.
You can go back or forward to look at each completed
questionnaire by pressing <<F7>> or <<F8>>.  You can also make
changes at that time, if necessary.
When you are finished, press <<F10>> to exit.

How to import data from other files (see Chapter 17)
Epi Info can import four kinds of files:  ASCII fixed-length
records, comma-delimited records, Lotus 1-2-3 *.WKS and *.WK1
files, and dBase II files. The following instructions cover the
Lotus and dBase files only. Consult the Epi Info User's guide for
instructions on importing the other kinds of records.

1. Prepare the file to be imported.
dBase files do not need any special preparation.  They can be
imported directly. Lotus 1-2-3 files should contain variable
field names on the first line (and only the first line).  Data
items should not be on the first line, since Epi Info will read
whatever is on this line as variable names.
The variable names can be of any length and can be different from
those used in the original data set. That is, you can use new,
short names for the variables.  An example is shown below:


Age, Sex, V1, V2, V3, V4, variable names
23, M, 1, 0, 2, 3, 
25, F, 2, 0, 3, 2, 
32, M, 1, 1, 9, 2, 
Save the file with a:*.WK1 or *.WKS extension., +, +, +, +, +, +

2. Load IMPORT.
Before you import your data, you need to create a *.REC file into
which you can put the data.
First load EP15 by typing EPI at the C prompt and pressing
<<Enter>>. Then at the main menu move the cursor to highlight
IMPORT. Press <<Enter>>. Type in the destination and name for the
.REC file you will create, (e.g., a:\FAMPLAN).
On the next line type the path and name of the dBase or Lotus
file to be imported (e.g., a:\BALIFP.WKS).  Type the appropriate
number, 3 or 4, for the format of the imported file, 3 for Lotus,
4 for dBase.  Press <<F4>> when you are ready to continue.
The program will return to the main menu when finished.  It will
have created and saved a file with a *.REC extension. For
example, FAMPLAN.REC.  You can now load the ANALYSIS program to
analyse the data.

How to analyse data with EPI info
(See Chapter 9 of the Epi Info User's guide)
1. Load the data file.
First load EP15 by typing EPI at the c: prompt and pressing
<<Enter>>. Before you can analyse the data, you need to load the
*.REC data file into ANALYSIS and then read it.  At the main
menu, highlight ANALYSIS and press <<Enter>>. The ANALYSIS screen
will appear.  The cursor will appear at the bottom left of the
screen after EPI >>.  Type READ and the location and name of the
desired data file. Example:  EPI >> READ b:\FAMIPLAN.REC  Press
<<Enter>>.
If you are loading a dBase file, just type its name and the DBF
extension. For example: EPI >> READ b:\FAPLAN.DBF <<Enter>>.
If the file has been read correctly, you will see at the top left
of the screen the file name and the number of records that have
been read.

2. Select and run the analysis commands.
After you have read a data file, you can enter analysis commands
one at a time or create a small program to run several commands
at once.  These programs can be prepared on your own word
processor and saved as an ASCII file with a *.PGM extension. 
Example:  RAPIDFP.PGM.
 
A short program is shown below.  This file summarises the major
ANALYSIS commands:
READ b:\FP\FPTEST1
FREQ METHOD METHODONLY HOWLONG1 SUPPLIES FUTURE
SET PERCENTS=ON
ROUTE PRINTER
TABLES CHILDREN METHOD
TABLES SUPPLIES METHOD
ROUTE SCREEN
PIE METHOD
HISTOGRAM METHOD
 
This program instructs Epi Info to read a data file called
FPTEST1.  Then it produces frequency distributions for five
variables. The SET PERCENTS=ON command instructs Epi Info to
display percentage distributions as well as counts for the tables
that follow.  The ROUTE PRINTER command tells the program to send
the tables that follow to the printer.  Two cross-tabulations are
then produced: contraceptive method concurrently used by number
of living children, and  method used by source of  method. The
program instructs Epi Info to send the next commands to the
computer screen instead of the printer.  The first graph is a pie
chart showing the distribution for family planning users and
non-users.  The second is a histogram of the distribution of
contraceptive methods used.
Examples of the lists, frequency distributions,
cross-tabulations, and statistics produced are shown on the
following pages.

ANALYSIS TABLE. The following are examples of 
tables that Epi Info produces:
1 LIST Produces a list of all variables in the data set
2 FREQ Produces a frequency distribution of a single variable
3 TABLES Produces a cross-tabulation of two discrete variables
4 MEANS  Produces a table of continuous variables
TABLES and MEANS can be produced with and without percentages 
by typing SET PERCENTS ON or SET PERCENTS OFF before typing the
calculation command.  See the *.PGM files for example.

Mann-Whitney or Wilcoxon Two-sample test ( Kruskai-Wallis for two
groups), +, +, +
Kruskai-Wallis H (equivalent to chi square), +, =, 17.397
Degrees of freedom, +, =, 1
p value, , =, 0.000030

1    LIST This is a partial listing of the data file,, showing
all of the values in the top row and the data for each case in
the succeeding rows, +, +, +, +, +, +, +, +, +
This listing was produced by typing LIST* and pressing
<<Enter>>., +, +, +, +, +, +, +, +, +
Rec, Case, Study, Prov, Interv, Date, ID, Old, Childrn, Mthd
1, 1, 12, 3, 4, 33333, 101, 23, 1, 1
2, 2, 12, 3, 4, 33333, 102, 24, 3, 1
3, 3, 12, 3, 4, 33333, 103, 31, 1, 1
4, 4, 12, 3, 4, 33333, 104, 45, 2, 1
5, 5, 12, 3, 4, 33333, 105, 32, 1, 0
6, 6, 12, 3, 4, 33333, 106, 17, 1, 0
7, 7, 12, 3, 4, 33333, 107, 27, 4, 1
8, 8, 12, 3, 4, 33333, 111, 29, 1, 1
9, 9, 12, 3, 4, 33333, 112, 32, 2, 1
10, 10, 12, 3, 4, 33333, 113, 37, 1, 0

2   FREQUENCY This is a frequency distribution of age with
percents on.This table was produced by typing FREQ AGE and
pressing <<Enter>>., +, +, +, +
AGE, Freq, Percent, Cum., This shows the distribution of
respondents by age group where 1 =  15 -  19  years,2 =  20 - 24 
years,, etc. These statistics are produced automatically by the
program.
1 , 23, 10.5%, 10.5%, ^
2 , 57, 26.0%, 36.5%, ^
3, 42, 19.2%, 55.7%, ^
4 , 36, 16.4%, 72.1%, ^
5 , 29, 13.2%, 85.4%, ^
6, 32, 14.6%, 100.0%, ^
Total , 219, 100.0%, , ^
Sum= 744.00, +, +, +, ^
Mean =     <%-2>3.40<%0>, +, +, +, ^
Standard deviation=     1.59, +, +, +, ^
3  CROSS-TABS:  TABLES This is a cross-tabulation of age and
contraceptive method with the percent  off.This table was
produced by typing TABLES AGE METHOD and pressing <<Enter>>.      
                      METHOD, +, +, +, +

AGE, 0, 1, Total, These are also 5-year age  groups. These
statistics are also produced automatically.
1 , 14, 9, 23, ^
2 , 15, 42, 57, ^
3, 12, 30, 42, ^
4 , 15, 21, 36, ^
5 , 12, 17, 29, ^
6, 6, 26, 32, ^
Total , 74, 145, 219, ^

Chi square=   14.45, +, +, +, ^
 Degrees of freedom=    5, +, +, +, 
p value =    0.012970389, , , +, 

This is the same cross-tab table with percent set to on., +, +,
+, 
AGE, 0, 1, Total, This row shows that 14 is 60.9% of 23 (15-19
yrs). 
1 , 1460.9%18.9%, 939.1%6.2%, 2310.5% , 
2 , 1526.3%20.3%, 4273.7%29.0%, 5726.0%, This row shows that 15
is 20.3% of all 0s (74 using no method in column 2).
3, 1228.6%16.2%, 3071.4%20.7%, 4219.2%, 
4 , 1541.7%20.3%, 2158.6%14.5%, 3616.4%, 
5 , 1241.4%16.2%, 1758.6%11.7%, 2913.2%, 
6, 618.8%8.1%, 2681.3%, 3214.6%17.9%, 
Total , 7433.8%, 14566.2%, 219, This is a row that shows 33.8% do
not use a FP method,, 66.2% do.
Chi square=   14.45, +, +, +, 
 Degrees of freedom=     5, +, +, +, 
p value=   0.012970389, +, +, +, 

4   MEANS TABLES This is a means table comparing number of
children (continuous variable) with method (discrete variable)
with percents OFF and statistics OFF This table was produced by
typing MEANS CHILDREN METHOD and pressing <<Enter>>, +, +, +, +
               METHOD, +, +, +, +
CHILDREN, 0, 1, Total, 
0 , 4, 5, 9, ^
1 , 44, 35, 79, ^
2, 0, 29, 29, ^
3 , 20, 45, 65, ^
4 , 6, 25, 31, ^
5, 0, 6, 6, ^
Total , 74, 145, 219, ^

This is the same cross-tab table with percents on  and statistics
on., +, +, +, +
METHOD, +, +, , 
CHILDREN, 0, 1, Total, This row shows that 4 is 44.4% of 9 (no of
children). This row shows that 44 is 59.5% of all 0s (74 13.2%
using no method).
1 , 444.4%5,4%, 555.6%3.4%,  94.1%, ^
2 , 4455.7%59.5%, 3544.3%24.1%, 7936.1%, ^
3, 00.040.04, 29100.0%20.0%, 2913.2%, ^
4 , 2030.8%27.0%, 4569.2%31.0%, 6529.7%, ^
5 , 619.4%8.1%, 2580.6%17.2%, 3114.2%, ^
6, 00.0%, 6100.0%4.1%, 62.7%, ^
Total , 7433.8%, 14566.2%, 219, ^
, , , , , 
, , , , , 
, , , , , 
, , , , , 
, , , , , 
, , , , , 
, , , , , 
, , , , , 
, , , , , 

Method, Obs, Total, Mean, Variance, Std Dev

0 1 , 74145, 128358, 1.7302.469-0.739, 1.3511.542, 1.1621.242
Difference, ^, ^, ^, ^, ^
Method Min., 25%ile, Median, 79%ile, Maximum, Mode
    0  0.0001  0.000, 1.0001.000, 1.0003.000, 3.0003.000,
4.0005.000, 1.0003.000
ANOVA(For normally distributed data only).  The p value is
equivalent to that for the Student's T Test,, since there are
only 2 samples., +, +, +, +, +
, SS, df, MS, F statistic, p-value
VariationBetweenWithinTotal, 26.775320.705347.479, 1217218,
26.7751.478, 18.117, .000135
Bartlett's test for homogeneity of variance Bartlett's chi
square=0.419 deg freedom=1 p-value=0.517657, +, +, +, +, +
The variances are homogeneous with 95% confidence.  If samples
are also normally distributed,, ANOVA results can be used., +, +,
+, +, +


3. Basic analysis commands.
When you are in ANALYSIS, you can view a list of the ANALYSIS
commands by pressing <<F2>>.  Press <<Esc.>> and then <<F3>> to
see a list of the variables in your data set.  Press <<Esc>> and
then <<F4>> to see the data set itself. HELP <<F1>> provides a
handy explanation of each of the analysis commands.<F4ES>
The following instructions cover only commands to produce
frequency distributions, tables, averages (means), and
cross-tabulations. To enter a command, find the EPI >> prompt at
the lower left of the screen and type the command. Example: EPI
>> LIST OLD SEX and press <<Enter>>.
LIST  This produces a listing of records. Type LIST * to list all
of the variables or to select the variables you want to list. 
Example: type  LIST OLD SEX METHOD.  Press <<Enter>> to start the
listing.
FREQ  This produces a list of the frequency, percentage
distribution, and cumulative percentage of each variable listed. 
For numeric fields, the program also produces a sum, mean, and
standard deviation.  Type FREQ * to produce frequencies for all
variables or to select the variables you want.  Example: type
FREQ OLD METHOD CHILDREN.  Press <<Enter>>.
TABLES  This is used for variables that can be counted, like sex
[male or female] and use [yes or no].  This produces a
cross-tabulation table of two variables to determine if there is
a relationship between the two, such as contraceptive use and
number of living children.  The results also produce several
statistical tests.  Type TABLES and then the names of the two
variables.  Example: TABLES CHILDREN METHOD.  Press <<Enter>>.
MEANS  For continuous variables, e.g., age, months of use.  This
displays continuous data grouped into selected categories, such
as age by current use of contraception.  This will give the mean
(average) age of people who do and do not use contraception.  It
also provides a number of statistical tests.  Type MEANS OLD
METHOD and press <<Enter>>. Type the continuous variable first.

4. Select and run graphs.
Epi Info makes histograms, scatter plots, pie charts, and bar
line graphs drawn directly from the data files.  To create a
graph, enter the type of graph desired followed by the
variable(s).  Examples:  HISTOGRAM METHOD; PIE CHILDREN; BAR
REASON; LINE OLD; SCATTER OLD HOWLONG1.

5. Print the results.
 Press <<F5>> to turn the printer on, and <<F5>> again to turn it
off.
There are two ways to print results.  The first is to turn the
printer on <M>and enter the desired analysis command.  Example:
<<F5>> EPI >> FREQ<M> OLD METHOD <<Enter>>, then press to turn
the printer off. If you leave the printer on, all subsequent
commands will be printed.<F5D>
The second way is to use the up arrow (when the cursor is at EPI
in the lower part of the screen).  Turn <<F5>> on, move the up
arrow to the command you want to print, edit if so desired, and
then press <<Enter>> to send it to the printer. Press again to
turn the printer off.

6. Save the results to a file.
Press <<F6>> instead of <<F5>> if you want to save your
calculations in a file rather than print them.  The first time
you press <<F6>>, you will be asked to provide a filename. Don't
forget to include the path (e.g., c:\DATA\FPRESULT.DOC). After
that, when you press <<F6>> your last calculations will be added
to that file. You can also reload a file and add new calculations
to it.  To stop adding to a file, press <<F6>> again.

7., Some other useful ANALYSIS commands., +
, ROUTE, This command sends the subsequent out put to the
computer screen (ROUTE SCREEN) or printer (ROUTE PRINTER).
, SET PERCENTON/OFF  , This command produces percentages with the
tables when it is on and without them when it is off.
, SET STATISTICSON/OFF, Similarly,, this produces statistical
results when on and suppresses them when off.
, DEFINE , Use this command to create a new variable and its
field.  For example,, DEFINE AGE# creates a variable named AGE
with a one-digit numeric field.
, RECODE  , Often used together with DEFINE to create new codes
for new variables.  Often used together with DEFINE to create new
codes for new variables.  Example: RECODE OLD TO AGE 15-19=1 
20-24=225-29=3  30-34=4  35-39=5  40-44=6 ELSE=6.  This changes
the codes for the variables named "OLD" to new codes for the new
variable named "AGE."  The new codes create 5-year age groups.
 
Regrouping.  DEFINE and RECODE can be used to regroup age and
other continuous variables in another way.  First define the new
variable and give it a "string" field.  Then recode by whatever
grouping you want (5, 10, 15 years, etc.) using the word BY.  In
the example, the instruction specifies a 5-year grouping.
DEFINE AGE STRING
RECODE OLD TO AGE BY 5
 
Labels.  DEFINE AND RECODE can also be used to change numeric
codes into labels.  This can help you to avoid having to look up
the codes to interpret the tables.  In the following example, the
codes for contraceptives are grouped and given labels of "MODERN"
and "TRADITIONAL."
DEFINE CURRENTUSE STRING
RECODE METHOD TO CURRENTUSE 0=NONE 1-7= MODERN
8-9=TRADITIONAL  99=DK/NR  ELSE=OTHER
 
If your string includes spaces, you need to put quotation marks
around it.  Otherwise, the program will conclude that the first
word is the new label.  For example: 1-7="NEW METHODS."
Finally, the labels can be no longer than the variable.  If the
variable is six letters in length the tables will allow only 6
characters for the labels.  Thus, you should make your variables
as long as needed, up to the maximum of ten characters.
 
ILLUSTRATIVE DATA ANALYSIS PROGRAMS
The computer files include an automated data analysis and
printing program in a file called RAPIDFP.PGM. You can edit this
programme on your word processor or in EPED.  You can also write
your own program.
 Super short version
Although RAPIDFP.PGM includes instructions, identified by * in
the first column, and quite a few recodes designed to change
numbers to labels, you might want to try something simpler.  Just
type the following commands into the ANALYSIS program at the EPI
>> prompt.  Don't forget to READ your data file first.
 DEFINE AGE #
 RECODE OLD TO AGE 15-19=1  20-24=2  25-29=3  30-34=4  35-39=5 
ELSE=6
 FREQ METHOD METHODONLY HOWLONG1 SUPPLIES FUTURE PLANNING NOW
LASTTHREM
 SET PERCENTS=ON
 ROUTE PRINTER
 TABLES AGE METHOD
 TABLES CHILD METHOD
 TABLES SUPPLIES METHOD
 TABLES LASTTHREM METHOD
 ROUTE SCREEN
 PIE METHOD
 HISTOGRAM METHODONLY
 Data analysis program
The computerised analysis program is reproduced on the next two
pages.  It can be run by typing the following at the EPI prompt
in the ANALYSIS window:
EPI>>  READ (filename) <<Enter>> #
EPI >> RUN RAPIDFP.PGM <<Enter>>


RAPIDFP.PGM Version 1.2, 21 November, 1991, 
Revised 18 March, 1992  
Load EP15, open the ANALYSIS programme  
At the EPI>> prompt type READ (filename) and press <<Enter>> 
At the EPI>> prompt type RUN RAPIDFP2.PGM and press <<Enter>>  
To print, press <<F5>> to turn the printer on before running  
this file 
Type SET PERCENTS=ON if you want the crosstabs to show 
percentages 
The program will pause if a table is not completely
displayed and show <<more>>.  Press <<Enter>> to continue
Press CTRL+BREAK to stop the programme 


 *QUESTION #6
 DEFINE AGE STRING
 RECODE OLD TO AGE BY 5

 *QUESTION #7
 DEFINE CHILD #
 RECODE CHILDREN TO CHILD 0=0 1=1 2=2 ELSE=3
 
 *QUESTION #8
 DEFINE USINGFP STRING
 RECODE METHOD TO USINGFP 1=YES 0=NO 9=DK/NR
 
 *QUESTION #9
 DEFINE METHOD_NOW STRING
 RECODE METHOD_ONLY TO METHOD_NOW 1=1.TUBE 2=2.VAS 3=3.IUD
4=4.PILL 5=5.INJECT 6=6.NORPLANT 99=99.DK/NR ELSE=OTHER

 *QUESTION #10
 DEFINE TIME_USED STRING
 RECODE HOWLONG1 TO TIME_USED 1="1. 0-3 MO" 2="2. 4-6 MO" 3="3. 
-12 MO" 4="4. 1-2 YR" 5="5. 3-4 YR" 6="6. 5+ YR" 9="9. DK/NR"

 *QUESTION #11
 DEFINE CONTINUAL STRING
 RECODE INTERRUPTI TO CONTINUAL 1="1. 0-3 MO" 2="2. 4-6 MO" 3="3.
7-12 MO" 4="4. 1-2 YR" 5="5. 3-4 YR" 6="6. 5+ YR" 9="9. DK/NR"

 *QUESTION #12
 DEFINE SPLYSOURCE STRING
 RECODE SUPPLIES TO SPLYSOURCE 1="1.GOV HOSP" 2="2.GOV FW"
3="3.SOC  MKT" 4="4.PRIV MD" 5="5.PHARMACY" 6="6.PRIV HOS"
7="7.NGO CLIN" 8="8.NGO FW" 9=OTHER 99=DK/NR
 *QUESTION #13
 DEFINE EVERUSE_FP STRING
 RECODE HUSBANDEVE TO EVERUSE_FP 1=YES 0=NO 9=DK/NR

 *QUESTION #14
 DEFINE LASTMETHOD STRING
 RECODE LATESTMETH TO LASTMETHOD 1=1.TUBE 2=2.VAS 3=3.IUD
4=4.PILL  5=5.INJECT 6=6.NORPLANT 99=99.DK/NR ELSE=OTHER

 *QUESTION #15
 DEFINE FUTURE_USE STRING
 RECODE FUTURE TO FUTURE_USE 1=YES 0=NO 9=DK/NR
 *QUESTION #16
 DEFINE WHYNOT_USE STRING
 RECODE PLANNINGNO TO WHYNOT_USE 1="1.WANT KID" 2="2. HUSBN NO"
3="3.HEALTH" 4="4.RELIG RZ" 5="5.SIDE EFF" 6="6.NOTAVAIL"
7="7.STERIL" 8="8.BRESTFEED" 9="9.PREGNANT" 10="10.OTHER"
99="99.DK/NR"

 *QUESTION #17
 DEFINE CHWNAME STRING
 RECODE COMMUNITY TO CHWNAME 1=YES 0=NO 9=DK/NR

 *QUESTION #18
DEFINE CHWVISIT STRING

The following frequency distributions will be computed 

RECODE LASTTHREEM TO CHWVISIT 1=YES 0=NO 9=DK/NR
 FREQ AGE CHILD USINGFP METHOD_NOW TIME_USED CON

The following graphs will be prepared 
  TINUAL SPLYSOURCE EVERUSE_FP
 FREQ LASTMETHOD FUTURE_USE WHYNOT_USE CHWNAME CHWVISIT
SET PERCENTS=ON
TABLES AGE USINGFP

The following cross tabulations will be computed
TABLES CHILD USINGFP
TABLES SPLYSOURCE USINGFP
TABLES CHWNAME USINGFP
TABLES CHWVISIT USINGFP
PIE USINGFP
PIE METHOD_NOW
HISTOGRAM TIME__USED
HISTOGRAM SPLYSOURCEAppendix B: Questionnaire design guidelines
General guidelines for designing questionnaires can be found in
any standard textbook on survey research methods. The following
are a few suggestions specifically related to rapid survey
instrument design for PHC.

Physical layout
The way that the questionnaire is laid out on the page is
important for both the interviewer and the coder. The questions
should be clearly separated from one another. The response
categories should be next to or directly beneath the questions so
that they are easy to locate.  The response categories should be
clearly printed, separated from one another, and easy to
distinguish. Instructions to the interviewer should be easily
distinguishable from the questions so that the interviewer knows
which items to read to the respondent. If some questions may be
skipped, depending on the response, the next question should be
clearly identified.

The type size used in the questionnaire should be easy to read.
Questions and pages should be numbered so that the interviewer
does not get lost.

Although all of the model questionnaires are presented the same
way, there are other ways to lay them out.  One of the easiest to
use is the "matrix" format for the cluster registers, which
allows 7-30 interviews to be entered on a single page. A
variation of this is to have one questionnaire for the
interviewer to read and one matrix-like tally sheet on which to
record all the responses.

Question construction
Most rapid survey questions are constructed to permit "yes"/"no"
responses. With a little thought, almost any question can be
phrased this way. For example, instead of asking "What do you
think about ORT," ask "Do you believe ORT is effective?" 
 Multiple choice questions can be analysed as "yes"/"no"
questions if they can be recoded, as explained in Step 4.
 Some of the model questions are phrased to test whether the
respondent knows something, can do something, or has some PHC
item on hand.  This type of question may require some probing by
the interviewer as well as an assessment of the appropriate
response.  For example, in the case of "Do you know what is meant
by diarrhoea?" the interviewer would need to know the correct
response and would then record it as "yes," meaning the
respondent does know what it means), or "no," does not know what
it means.

Responses should be mutually exclusive. That is, there should be
no overlap between responses, to avoid confusion. Be especially
careful with age and multiple choice questions.  A common mistake
is to list overlapping categories for age, e.g., 1-5 yrs, 5-10,
10-15; rather than 1-4, 5-9, 10-14. Multiple choice questions
often include several appropriate responses.  For example, "What
is the reason you don't attend the clinic?"  could have several
responses,  e.g., too far away, too expensive, poor service.  To
avoid this, ask for the major reason and instruct the interviewer
to code only one response.

Screening questions.  Sometimes it is necessary to include
questions that are not going to be analysed but which are
necessary in order to determine if a respondent should be asked
the next series of questions.  An example:  "What are the names
of your children and how old are they?" This question is designed
to provide the interviewer with the information needed to decide
which child to gather information about, but the response would
not be coded or analysed.  Therefore, this type of question will
usually not be precoded.

Marking responses. The model instruments provide spaces that the
interviewer checks to indicate the response.  Options include
circling the code of the response, using an X to cross it out,
and writing in the code.

Sequence of questions
 Questionnaires are usually designed with an opening statement to
be read by the interviewer to the respondent. This statement
usually explains what the survey is about, who is sponsoring it,
why it is being conducted, how the respondent was chosen to be
interviewed, how long the interview will take, assurance that the
responses will be confidential, and a request for permission to
begin asking the questions. This statement can be written on each
questionnaire or on a separate card that the interviewer carries.
 The opening questions are usually factual and non-threatening to
set a comfortable tone (age, number of children, etc.).  The
questions should follow a logical sequence. When the subject is
changed it helps to have an explanatory statement for the
interviewer to read.  For example, "Now I am going to ask a few
questions about your experience with the local CHW."
 Many questionnaires are designed to get to the most important
questions early in order to maintain the interest of the
respondent.  Demographic and other descriptive data are left for
last.  However, the rapid surveys are so short that this may not
be an important strategy to incorporate.
 Sometimes you need to skip some questions if they are not
applicable to a respondent. Include instructions on the
questionnaire that tell the interviewer when to skip and where to
go next. For example:

Q 12. Has anyone in this household been sick during the last
month?
___Yes (1)___ No (2), go to Q22___DK/NR (9), go to Q22

Precoding
 The variables that are to be examined, e.g., age, sex, use of
ORT, should be given a code number.  In the model instruments,
this number is the same as the question number. Sometimes a
question includes more than one variable. In that case the
response may include a code for each response, as in the Breast
feeding, Growth monitoring and Immunization rapid survey
instruments. For example:

Optional weighing to determine current nutritional status, +, +,
+, +, +

Name, Sex, Age (mo), Wt. (kg), Height, Remark
, , , , , 
, (24), (25), (26), (27), 
 
 In this example four variables are coded in one item.
 
 The responses should also be precoded. The convention used in
the model questionnaires is to use 1 to mean "yes", 0 to mean
"no" and 9 to mean "don't know" or "no response."  Obviously, any
other codes could be used. The important thing is to be
consistent so that the interviewers will not become confused.
 Some questions ask whether the respondent knows something in
particular. In these cases a "no" means that he or she does not
know, and would be coded 0.  A code of 9 should not include
"don't know," as that would be confusing.  In the models, 9 means
"no response."

Identification items
 Questionnaires will need to include certain identifying
information so that they can be sorted, classified, followed up,
etc.  The model questionnaires that follow include five standard
identification items: 1) the number of the study, which is
optional, unless a large number of studies will be carried out;
2) province number, which is also optional, unless the study is
to be done in several provinces; but you can then substitute
district, sub-district, village as appropriate; 3) interviewer
name or code; 4) date of interview; and 5) respondent
identification number. In this case a 3-4 digit code is used,
made up of the cluster number and the respondent's number, e.g.,
01-01, 1009.
 Other identification items that might be needed for special
studies are: time of interview, address of household, telephone
number, and national identification number (or social security
number).

Code books
 You can usually conduct a rapid survey without needing a code
book, because these types of surveys are so short. But code books
are very useful if your questionnaire isn't precoded, if it is
long and complex, if many questions are multiple-choice, if the
responses are to be coded by someone other than the interviewer,
or if the survey is large. Most code books are useful in checking
for errors, preparing analysis plans, and recoding.
 Code books summarise the responses and their codes for each
question. They also include the name of the variable and
sometimes other useful information, such as the variable's length
and format.
Variable name, Question number, Length, Variable value, Variable
label

ADVICE, 117, 12, Where sought advice/treatment, +
, , , Value, Label
, , , 1, Government hospital
, , , 2, Private hospital
, , , 3, Health centre
, , , 4, Private clinic
, , , 5, Health post
, , , 6, Private doctor
, , , 7, Nurse/midwife
, , , 8, Community health worker
, , , 9, Traditional healer
, , , 10, Pharmacy/drugstore
, , , 11, Shop
, , , 12, Other
, , , 99, DK/NR
, , , BLANK, Not applicable
, , , , +
TREAT, 129, 1, Anything to treat diarrhoea, +
, , , Value, Label
, , , 1, Yes
, , , 2, No
, , , 8, DK/NR
, , , 9, Missing value
, , , BLANK, Not applicable
, , , , +
TREATMENT, 130, 6, Given to treat diarrhoea, +
, , , Value, Label
, , , 1, Capsule
, , , 2, Pill
, , , 3, Syrup
, , , 4, ORS sachet
, , , 5, ORS home made
, , , 6, Cereal
, , , 7, Other
, , , 9, DK/NR
, , , BLANK, Not applicable

Appendix C: Rapid survey questionnaires
GENERAL  PHC Community assessment of primary health care /health
education
MATERNAL CARE Antenatal care, safe delivery, and postnatal care
Family planning
CHILD CAREAcute respiratory infectionsBreast feedingDiarrhoeal
disease control/oral rehydration therapyChildhood
disabilitiesChild immunizationGrowth monitoring/nutrition
education

COMMUNITY HEALTHWater supply, hygiene, and sanitation

OTHER HEALTH CAREAccidents and injuriesChronic, non-communicable
diseasesMalariaTuberculosisSexually-transmitted diseases,
HIV/AIDS

MORBIDITY, MORTALITY AND FERTILITYVital events and health
statusChild morbidity and mortality assessmentAdult morbidity and
mortality assessment

 The following instruments have been designed to collect the most
important indicators of health knowledge, behaviour and status
for each PHC service. The first instrument, Community assessment
of PHC, covers the most common PHC services, plus some data on
household composition, parity, drug supply, and service
availability.
 The instruments can be used as presented or modified as
appropriate to any given situation. You are encouraged to "mix
and match" questions and sections from the various
questionnaires, add, delete, revise, and combine to adapt the
instruments to your situation and needs. 
 The vital events, morbidity and mortality questionnaires can be
added to other rapid surveys such as child immunization, family
planning, etc. However, they will usually require much larger
sample sizes.  See the User's guide for guidelines.
 The rapid surveys are designed for cluster samples, typically,
30 clusters of 7-10 respondents each. The responses should be
"yes"/"no", or otherwise classifiable into dichotomous variables. 
Please note that these are only the instruments.  Examples of how
they can be modified and used with different sampling techniques
are described in the User's guide.
 
Rapid survey questionnaireCommunity assessment of primary health
care
Complete ALL SECTIONS for each currently married woman aged
15-49. For women with a child under age two years (24 months),
collect information for SECTIONS 2, 4, 5, 6, 8, and 9. If the
woman has a second child under age two years, collect the
information for the oldest child. If she has no children under
age five years, SKIP SECTIONS 2, 4, 5, 6, 8, 9.<%0>

IDENTIFICATION, +, +, +, +, +, +, +, +

101., Study no, , 102., Province no, , 103., Cluster no, 
104., Interviewer no, , 105., Respondent no, , 106., Date of
interview,   /  /
 107., Respondent age, , 108., Respondent sex, , , , 
NAME OF RESPONDENT________________________________, +, +, +, +,
+, +, +, +
109.How many people live in this household:_____(total)
Married women of reproductive age (15-49):_____(in household)
Currently pregnant women:_____(in household)
Children less than 24 months of age:_____(in household)
Children 2-5 years old: _____(in household)
@SPASIHALF = 
110.How many children do you have under two years of age?
___(no children.)  If none, go to Q11
What are their names and how old are they?
Name:______________ Age (in months): _______Sex (m/f):_____
Name:______________ Age (in months): _______Sex (m/f):_____
Name:______________ Age (in months): _______Sex (m/f):_____
111.How many live births have you had? ____(number) (If DK/NR
enter 99.)
112.How many of these are still living? ____(number) (If DK/NR
enter 99.)
113.How far away is the nearest health unit or health worker?
___(1) << 5 km/60 min. walk ___(2) >> 5 km/60 min. walk ___ (9)
DK/NR
114-7. Which of the following health services are available
there?
14. Maternal and child health___ (1) Yes___(0) No___(9) DK/NR
15. Family planning___ (1) Yes___(0) No___(9) DK/NR
16. Immunization___ (1) Yes___(0) No___(9) DK/NR
17. Medical care services___ (1) Yes___(0) No___(9) DK/NR
118.Does anyone in this household need to use prescription or
non-prescription drugs?___(1) Yes___(0) No, go to Q21___(9) DK/NR
go to Q21
119.Are you able to get them easily?
___(1) Yes, go to Q21___(0) No___(9) DK/NR
120.Why aren't you able to get them?
_____(1) Too far
_____(2) Too expensive
_____(3) Don't know where to get them
_____(4) Other: ___________________
_____(9) DK/NR
121.What is the name of the local Community Health Worker (CHW)?
____(1) Knows (said name)____(0) Does not know___(9) NR
122.Has the local Community Health Worker visited or contacted
you during thelast three months?____(1) Yes____(0) No____(9)
DK/NR
 
INTERVIEWER: PLEASE CHECK OFF THE SECTIONS TO BE USED FOR THIS
INTERVIEW.
_____Antenatal care, safe delivery, and postnatal care
_____Family planning
_____Acute respiratory infections
_____Breast feeding
_____Diarrhoeal disease control/oral rehydration therapy
_____Childhood disabilities
_____Child immunization
_____Growth monitoring/nutrition education
_____Water supply, hygiene, and sanitation
_____Accidents/trauma
_____Chronic, non-communicable diseases
_____Malaria
_____Tuberculosis
_____Sexually-transmitted diseases
GO TO Q200
Section 1: Antenatal care, safe delivery, and postnatal care
200.Have you been pregnant within the past 24 months?
____(1) Yes___(0) No,  go to Q301
201.Did you receive antenatal care during your last pregnancy?
____(1) Yes___(0) No, go to Q204   ____(9) DK/NR, go to Q204
202.How many times did you get antenatal care? ____times (If
DK/NR,enter 99.)
203.Which is the principal place where you received antenatal
care?
____(1) Hospital, health centre/clinic
____(2) Local TBA/healer, other non-prof.
____(9) DK/NR
204.Did you receive a tetanus vaccination during your last
pregnancy?
____(1) Yes____(0) No, go to Q206____(9) DK/NR, go to Q206
205.How many vaccinations did you receive?
____(1) One____(2) Two____(3) Three or more____(9) DK/NR
206.What was the outcome of your most recent pregnancy?
____(1) Live birth
____(2) Still birth
____(3) Abortion/miscarriage, go to Q301
____(9) DK/NR, go to Q301
207.Where did the delivery take place?
____(1) Home____(2) Hospital/clinic____(9)DK/NR

208.Who was the main person attending the delivery?
____(1) Doctor, nurse, nurse-midwife
____(2) Trained TBA, CHW
____(3) Untrained TBA, CHW, relative, neighbour
____(9) DK/NR
GO TO Q 301

Section 2: Family planning
301.Are you or your husband currently using any family planning
method?
___(1) Yes___(0) No, go to Q304___(9) DK/NR, go to  Q304
302.Which method are you/your husband using now?(select principal
method only)
___(1) Tubectomy___ (6) NORPLANT
___(2) Vasectomy___ (7) Condom
___(3) IUD___ (8) Foam, emco, jelly, cream, diaphragm
___(4) Oral pill___ (9) Safe period, withdrawal, abstinence
___(5) Injection ___(10) Other: _________________
___(99) DK/NR

303.What is the main source of your family planning service or
supplies?(Record response and go to Q400.)
___(1) Govt hospital/clinic___ (6) Private hospital/clinic
___(2) Govt. field worker___ (7) NGO clinic
___(3) Social marketing prog.___ (8) NGO field worker
___(4) Private physician___ (9) Other: ___________
___(5) Pharmacy___(99) DK/NR

304.Do you/your husband intend to practice family planning in the
future?
___(1) Yes___(0) No  ___  (9) DK/NR
305.What is the most important reason you are not using family
planning now?
___(1) Want more children  ___ (6) Method/service unavailable
___(2) Husband objects  ___ (7) Sterility
___(3) Health reasons  ___ (8) Breast feeding
___(4) Religious reasons___ (9) Pregnant
___(5) Fear side effects   ___(10) Other: _____________
___(99) DK/NR
GO TO Q400
Section 3: Acute respiratory infections
400.Check Q110 or ask: Do you have children under the age of two
years?
____(1) Yes____(0) No, go to Q502

401.Have any of your children been sick from a respiratory
illness within the last two weeks?
____(1) Yes____(0) No, go to Q501___(9) DK/NR, go to Q501

402.Did you seek treatment for the illness?
____(1) Yes____(0) No, go to Q501___(9) DK/NR, go to Q501

403.Did you give the medicine for the prescribed length of time?
(Probe forcorrect response)
____(1) Yes____(0) No____(9) DK/NR
GO TO Q501
Section 4: Breast feeding

501.Are you now breast feeding your baby or a child under age two
years?
____(1) Yes, go to Q503___(0) No, go to Q502____(9) DK/NR, go to
Q502
502.At what age of the baby did you stop breast feeding?
____months.____(9) DK/NR
503.At what age of the baby will you/did you begin giving it
supplementary
foods?____months.____(9) DK/NR
GO TO Q601
Section 5: Diarrhoeal disease control/oral reyhdration therapy
601.Has (name of oldest child under age two years) had diarrhoea
in the last month?
___(1) Yes ___(0) No, go to Q603___(9) DK/NR, go to Q603
602.Did you give your child ORS? ____(1) Yes____(0) No____(9)
DK/NR

603.Do you know how to mix ORS solution? If no, please explain
(explanation includes the following: pour the contents of the ORS
packet into the correct amount of clean water, e.g., cooled
boiled water or rainwater).
____(1) Yes, knows how to mix ORS solution ____(0) No____(9)
DK/NR
GO TO  Q701
Section 6: Childhood disabilities
701.Is any child afflicted by disability?
___(1) Yes, go to Q702___(0) No, go to Q801___(9) DK/NR, go to
Q801
702.What type of disability? Please fill the following:
Disability type
___(1) Movement___(5) Speech
___(2) Deformity___(6) Behaviour___(3) Hearing___(7)
Other__________
___(4) Blindness___(9) DK/NR

703.Do you know how your child became disabled? (Probe for
explanation.)
____(1) Yes____(0) No____(9) NR

704.Do you know how to prevent a similar disability from
occurring again? (Probe for correct response: e.g., immunization,
safe maternal and childcare, iodine, Vitamin A.)
____(1) Yes____(0) No____(9) NR

705.Have you sought treatment or therapy for your child? 
____(1) Yes____(0) No, go to Q707___(9) DK/NR, go to Q707

706.Where has your child received treatment?
Record response and, go to Q801
____(1) Therapy or treatment centres
____(2) Community groups
____(3) Special schools
____(4) Other______________

707.Do you know of available centres which provide services to
help your child?
Therapy or treatment centres:____(1) Yes____(0) No ___(9) DK/NR
Community groups:   ____(1) Yes____(0) No ___(9) DK/NR
Special schools:   ____(1) Yes____(0) No ___(9) DK/NR
Other ______________    ____(1) Yes____(0) No ___(9) DK/NR
GO TO Q801
Section 7: Child immunization

801.Do you know at what age children should be vaccinated against
measles? 
___(1) Yes (9-12 months)___(0) No___(9) DK/NR

802.Has (name of oldest child under age 2) been immunized?
___(1) Yes___(0) No, go to Q901___(9) DK/NR, go to Q901

803.Do you have the immunization card for this child?
___(1) Yes, has card correctly filled out
___(2) Yes, has card but incorrectly filled out
___(0) No, does not have card
___(9) DK/NR

Check card or probe for immunization history. Check each
vaccination received:
BCGDPT1DPT2DPT3Pol1Pol2Pol3Measles
________________________
804805806807808809810811

812.For children aged 12-24 months: Child is fully
vaccinated(BCG, DPT3, Polio3, Measles)
___(1) Yes___(0) No ___(9) DK/NR
GO TO Q 901
Section 9: Growth monitoring/nutrition education
901.Is (name of oldest child under age 2) registered for growth
monitoring?
___(1) Yes ___(0) No ___(9) DK/NR
902.Has this child ever been weighed by a health worker, nurse,
or doctor?
___(1) Yes___(0) No, go to Q1001___(9) DK/NR, go to Q1001
903.Please show me your child's growth card. (Show sample card.)
___(1) Yes, has growth card___(0) No, cannot find it, go to Q1001
904.(Interviewer: record weighing history from growth card):
Total no timesweighed____

905.Times weighed last 3 months____
906.Can you explain the information on the growth card to me?
___(1) Yes, mother can correctly interpret the information
___(0) No, mother cannot interpret the information or incorrectly
interprets
GO TO Q1001
Section 9: Water supply, hygiene, and sanitation
1001. Where do you usually get your drinking water?
____(1) Clean source: faucet/tap, pipe, covered well, other
____(2) Unclean source: open well, pond, dirty stream, other
____(9) DK/NR 

1002. Do you usually boil water for drinking?
____(1) Yes___(0) No___(9) DK/NR

1003. How long does it take you to get to your source of water?
____(1) Less than 15 minutes walk___(2) More than 15 minutes
walk____(9) DK/NR

1004. Do you have enough water all year?
____(1) Yes___(0) No___(9) DK/NR

1005. What type of sanitary facility do you use?
____(1) Clean facility: water-seal, pit privy, WC
____(2) Unclean facility: open field, bucket
____(9) DK/NR
GO TO  Q1101
Section 10: Accidents and injuries

1101. Has anyone in this household had an injury in the past
year?
___(1) Yes___(0) No, go to Q1106 ___(9) DK/NR, go to Q1106

1102. What was the injury?
____(1) Fall___(4) Poisoning
____(2) Occupational injury ___(5) Other (specify)____
____(3) Traffic injury ___(9) DK/NR

1103. What was the outcome of the injury?
____(1) Permanent disability ____(4) Other
____(2) Lost time away from normal activity____(9) DK/NR
____(3) Death

1104. Where did they receive treatment?
____(1) Hospital____(4) Traditional healer
____(2) Health care centre____(5) Other (specify)______
____(3) CHW____(9) DK/NR

1105. What was the treatment?
____(1) Treatment for wounds or bleeding____(5) Treatment for
shock
____(2) Resuscitation ____(6) Treatment for head,       neck, or
back injury
____(3) Treatment for poisoning____(7) Treatment for burns
____(4) Setting or splinting bones ____(9) DK/NR

1106. Where are the nearest emergency care facilities? (Probe for
correct answer.)
____(1)Yes (respondent knows correct answer)
____(2)No (respondent does not know correct answer) 
____(9)DK/NR
GO TO Q1201

Section 11: Chronic, non-communicable diseases 
Diabetes

1201. Have you or any household member ever been diagnosed with
diabetes?
____(1) Yes____(0) No, go to Q1204___(9) DK/NR, go to Q1204
1202. Is the prescribed treatment being followed? (Probe for
explanation.)
____(1) Yes____(0) No ___(9) DK/NR
1203. Do you and your family members know how to handle a
diabeticemergency? (Probe for explanation.)
____(1) Yes____(0) No ___(9) DK/NR

Hypertension
1204. Have you or any household member ever been told by a health
care  provider that you have hypertension?
____(1) Yes____(0) No, go to Q1208___(9) DK/NR, go to Q1208

1205. Have you been prescribed medication or a special diet to
control your hypertension?
____(1) Yes____(0) No, go to Q1207___(9) DK/NR, go to Q1207

1206. Do you follow the prescribed diet or medication plan?
____(1) Yes ____(0) No ____(9) DK/NR

1207. Have you ever been told by a health care provider you have
complications due to hypertension?
____(1) Yes ____(0) No  ____(9) DK/NR 

Anaemia
1208. Have you or any household member ever been diagnosed as
having anaemia?
____(1) Yes____(0) No____(9) DK/NR 

1209. Does anyone in this household have anaemia now?
____(1) Yes____(0) No, go to Q1301___(9) DK/NR, go to 1301 

1210. Has this person been prescribed a special diet or
supplements to control the anaemia?
____(1) Yes ____(0) No, go to Q1301___(9) DK/NR, go to Q1301 

1211. Is the prescribed treatment being followed? (Probe for
explanation.)
____(1) Yes____(0) No____(9) DK/NR
GO TO Q1301

Section 12: Malaria
Interviewer: ask the questions in this section only in areas
wheremalaria is endemic
1301. Do you know how malaria is spread? (Probe for explanation:
Malaria is spread by mosquitoes.)
____(1) Yes ____(0) No____(9) NR

1302.What are you currently doing to protect yourself and your
householdmembers against malaria?
Using mosquito nets?___(1) Yes ___(0) No ___(9) NR 
Using household sprays?___(1) Yes ___(0) No ___(9) NR 
Eliminating standing water?___(1) Yes ___(0) No ___(9) NR 
Using anti-malarial drugs?___(1) Yes ___(0) No___(9) NR 
Others? ___(1) Yes ___(0) No___(9) NR

1303. Have you or any household member experienced unexplained
and/or  repeated fevers within the last month? ____(1) Yes
____(0) No ___(9) NR

1304. Have you or any household member experienced vomiting,
fits, or convulsions?
____(1) Yes____(0) No____(9) NR

1305. Have you or any household member been given a blood test
for malaria? 
____(1) Yes____(0) No____(9) DK/NR

1306. Have you or any household member been treated for malaria
in the last six months?
____(1) Yes____(0) No, go to Q1401____(9) DK/NR, go to Q1401
1307. What treatment was received?
 Anti-malarials (probe for type)  ____(1) Yes____(0) No____(9) NR
 Antipyretic drugs:_________  ____(1) Yes____(0) No____(9) NR
 Other:_________________  ____(1) Yes____(0) No____(9) NR

1308. If anti-malarials have been prescribed, do you know the
correct treatment  schedule? (Probe for explanation.) ____(1)
Yes____(0) No____(9) NR 
GO TO Q1401

Section 13: Tuberculosis
1401. Have you or any family members ever been diagnosed/tested
for TB?(Sputum or skin test)
____(1) Yes____(0) No____(9) DK/NR

1402. Have you ever sought treatment of TB for yourself or your
family?
____(1) Yes____(0) No, go to Q1501___(9) DK/NR, go to Q1501

1403. If so, is or was treatment taken for the prescribed length
of time? (Probe     for explanation.)
 ____(1) Yes____(0) No____(9) DK/NR
GO TO Q1501

Section 14: Sexually-transmitted diseases, HIV/AIDS
1501. Do you know what is meant by a sexually-transmitted
disease? (Probe for explanation and example.)
____(1) Yes____(0) No____(9) DK/NR

1502. Do you know what HIV or AIDS is? (Probe for explanation:
HIV is the virus that infects a person and eventually causes a
person to get AIDS.)
____(1) Yes____(0) No____(9) DK/NR

1503. Do you know how people get STDs, HIV/AIDS?  (Probe for
correct answers.)
____(1) Yes____(0) No____(9) DK/NR

1504. What is your primary source of STD/HIV/AIDS knowledge?
____(1) Friends/relatives ____(4) Newspaper/magazine
____(2) CHW or other health staff____(5) Other source: ______
____(3) Radio____(9) DK/NR

1505. What are you doing to protect yourself against STDs or
HIV/AIDS? (Probe for explanation.)
 Using a condom:___(1) Yes ___(0) No ___(9) DK/NR
 Using safe sex practices ___(1) Yes ___(0) No ___(9) DK/NR

1506. Have you ever been diagnosed with STD, HIV/AIDS?
___(1) Yes___(0) No___(9) DK/NR

1507. Have you ever used a condom?___(1) Yes___(0) No___(9) DK/NR

1508. Do you know how to use a condom correctly? (Probe for
correct response.)
___(1) Yes___(0) No___(9) DK/NR 

1509. Where have you obtained condoms during the last 6 months?
____(1) Govt. hospital/clinic/health centre
____(2) Private hospital/clinic/health centre
____(3) Local dispensary/pharmacy
____(4) Health worker delivered at home
____(5) Other ____________
____(9) DK/NR

1510. Can a person who looks healthy be infected with STDs/HIV?
___(1) Yes___(0) No___(9) DK/NR

1511. Can a person get HIV through ordinary social contact like
shaking handswith someone infected with the virus?
___(1) Yes___(0) No___(9) DK/NR 

1512. Can a pregnant woman who is infected with HIV give the
virus to her  unborn child?
___(1) Yes___(0) No___(9) DK/NR

1513. Should an HIV infected mother continue to breast
feed?___(1) Yes___(0) No___(9) DK/NR

1514. Can STDs/HIV be transmitted by having sex with someone who
is infected with STDs/HIV?
___(1) Yes___(0) No___(9) DK/NR

1515. Is there a cure for AIDS?___(1) Yes___(0) No___(9) DK/NR
This concludes the interview. Thank you for taking part in this
survey.

Rapid survey questionnaire Health education
Complete for each household. Interview the female head of
household, if possible.    

IDENTIFICATION, +, +, +, +, +, +, +, +
1., Study no, , 2., Province no, , 3., Cluster no, 
4., Interviewer no, , 5., Respondent no, , 6., Date of interview, 
 /  /
7., Respondent age, , 8., Respondent sex, , , , 
NAME OF RESPONDENT________________________________, +, +, +, +,
+, +, +, +
9.How many people live in this household:_____(total)

10.Is anyone in this household a married woman of reproductive
age?
___(1) Yes___(0) No, go to  Q12___(9) DK/NR, go to Q12

Has a health worker visited this household in the last three
months to discuss:
Family planning?____(1) Yes___(0) No___(9) DK/NR 
Malaria?____(1) Yes___(0) No___(9) DK/NR 
Tuberculosis?____(1) Yes___(0) No___(9) DK/NR 
STDs?____(1) Yes___(0) No___(9) DK/NR 
Water and sanitation____(1) Yes___(0) No___(9) DK/NR 
Chronic/noncomm. diseases?____(1) Yes___(0) No___(9) DK/NR 
Others (specify)? ____(1) Yes___(0) No___(9) DK/NR 

Do you know the importance of the topic(s) discussed? (Probe.)
___(1) Yes___(0) No___(9) DK/NR 

11. Is anyone in this household pregnant?
___(1) Yes ___(0) No___(9) DK/NR

12.Are there children under 24 months old in this household?
___(1) Yes___(0) No___(9) DK/NR

13.Are there children 24-60 months old in this household?
___(1) Yes___(0) No___(9) DK/NR

14.Has a health worker visited or contacted you in the last 3
months? 
___(1) Yes___(0) No___(9) DK/NR 

15.What type of health worker visited (check all that apply)?
____(1) CHW____(4) Doctor
____(2) Public health nurse____(5) Other (specify)______
____(3) Midwife____(9) DK/NR


16.What did the health worker discuss (check all that apply)?

A. Maternal care
Antenatal care/delivery___(1) Yes___(0) No___(9) DK/NR
Safe delivery___(1) Yes___(0) No___(9) DK/NR
Postnatal care___(1) Yes___(0) No___(9) DK/NR

B. Child care
Acute respiratory infections___(1) Yes___(0) No___(9) DK/NR
Breast feeding___(1) Yes___(0) No___(9) DK/NR
Diarrhoeal disease control___(1) Yes___(0) No___(9) DK/NR
Oral rehydration therapy___(1) Yes___(0) No___(9) DK/NR
Childhood disabilities___(1) Yes___(0) No___(9) DK/NR
Child immunizations___(1) Yes___(0) No___(9) DK/NR
Growth monitoring/
nutrition education___(1) Yes___(0) No___(9) DK/NR

C. Community health
Water supply___(1) Yes___(0) No___(9) DK/NR
Hygiene___(1) Yes___(0) No___(9) DK/NR
Sanitation___(1) Yes___(0) No___(9) DK/NR

D. Other health care
Accidents and injuries___(1) Yes___(0) No___(9) DK/NR
Chronic/noncomm. diseases ___(1)Yes___(0) No___(9) DK/NR
Malaria___(1) Yes___(0) No___(9) DK/NR
Tuberculosis___(1) Yes___(0) No___(9) DK/NR
Sexually-transmitted diseases, HIV/AIDS___(1) Yes___(0) No___(9)
DK/NR

17.Do you believe you have enough information about these topics
or do you need to know more?

A. Maternal careKnow more    Enough   DK/NR
Antenatal care/delivery___(1) Yes___(0) No___(9) DK/NR
Safe delivery___(1) Yes___(0) No___(9) DK/NR
Postnatal care___(1) Yes___(0) No___(9) DK/NR

B. Child care
Acute respiratory infections___(1) Yes___(0) No___(9) DK/NR
Breast feeding___(1) Yes___(0) No___(9) DK/NR
Diarrhoeal disease control___(1) Yes___(0) No___(9) DK/NR
Oral rehydration therapy___(1) Yes___(0) No___(9) DK/NR
Childhood disabilities___(1) Yes___(0) No___(9) DK/NR
Child immunizations___(1) Yes___(0) No___(9) DK/NR
Growth monitoring/
nutrition education___(1) Yes___(0) No___(9) DK/NR
 
C. Community health
Water supply___(1) Yes___(0) No___(9) DK/NR
Hygiene___(1) Yes___(0) No___(9) DK/NR
Sanitation___(1) Yes___(0) No___(9) DK/NR

D. Other health care
Accidents and injuries___(1) Yes___(0) No___(9) DK/NR
Chronic/noncomm. diseases___(1) Yes___(0) No___(9) DK/NR
Malaria___(1) Yes___(0) No___(9) DK/NR
Tuberculosis___(1) Yes___(0) No___(9) DK/NR
Sexually-transmitted diseases, HIV/AIDS___(1) Yes___(0) No___(9)
DK/NR

18.What is the name of the local Community Health Worker (CHW)?
____(1) Knows (said name)____(0) Does not know____(9) NR
This concludes the interview. Thank you for taking the time to
participate in this survey.

Rapid survey questionnaire Antenatal care, safe delivery, and
postnatal care
Complete for all women currently living in the household who have
had a pregnancy outcome during the past 24 months. The outcome
may be a live birth, stillbirth, or abortion. If the woman has
had more than one pregnancy, ask about the most recent pregnancy
outcome. 

1., Study no, , 2., Province no, , 3., Cluster no, 
4., Interviewer no, , 5., Respondent no, , 6., Date of interview, 
 /  /
7., Respondent age, , 8., Respondent sex, , , , 

NAME OF RESPONDENT________________________________, +, +, +, +,
+, +, +, +
9.How many live births have you had so far? Number of live
births:____ ____(99) DK/NR

10.Did you receive antenatal care during your last pregnancy?
___(1) Yes___(0) No, go to Q14___(9) DK/NR, go to Q14

11.How many times did you get antenatal care? _____times
(If DK/NR, enter 99)

12.How many months had you been pregnant before you got antenatal
care?
____(1) 3 mo. (first trimester)
____(2) 4-6 mo. (second trimester)
____(3) 7-9 mo. (third trimester)
____(9) DK/NR

13.Which is the principal place you received antenatal care?
____(1) Hospital
____(2) Health centre/clinic
____(3) Private hospital/clinic
____(4) Local TBA/healer
____(5) Other site of care specify: _______________
____(9) DK/NR

14.Did anyone advise you to get antenatal care?___ (0) No
Yes:
____(1) Physician, nurse____(5) Mother, relative
____(2) Community nurse/midwife____(6) Friend, neighbour
____(3) CHW/volunteer____(7) Other:_________
____(4) Traditional birth attendant____(9) DK/NR

15.Did you receive a tetanus vaccination during your last
pregnancy?
____(1) Yes____(0) No, go to Q17____(9) DK/NR, goto Q17

16.How many vaccinations did you receive? 
____(1) One____(2) Two____(3) Three or more____(9) DK/NR

17.During your pregnancy, did you take iron pills to keep you
strong? 
____(1) Yes____(0) No____(9) DK/NR 

18.What was the outcome of your most recent pregnancy?
____(1) Live birth
____(2) Still birth
____(3) Abortion/miscarriage, go to Q20
____(9) DK/NR, go to Q20

19.Where did the delivery take place?
____(1) Home___(2) Hospital/clinic___(9) DK/NR

20.Who was the main person attending the delivery?
____(1) Doctor, nurse, nurse-midwife
____(2) Trained TBA, CHW
____(3) Untrained TBA, CHW
____(4) Relative, neighbour, friend
____(5) Other: ____________________
____(9) DK/NR

21.  What is the name of the local Community Health Worker (CHW)?
____(1) Knows (said name)____(0) Does not know___(9) NR

22.  Has the local Community Health Worker visited or contacted
you duringthe last three months?
____(1) Yes____(0) No____(9) DK/NR 
This concludes the interview. Thank you for taking the time to
participate in this survey.



Rapid survey questionnaire Family planning
Complete for all married women aged 15-49 years who are currently
living in the household.

IDENTIFICATION, +, +, +, +, +, +, +, +
1., Study no, , 2., Province no, , 3., Cluster no, 
4., Interviewer no, , 5., Respondent no, , 6., Date of interview, 
 /  /
7., Respondent age, , 8., Respondent sex, , , , 
RESPONDENT, TABLE TEXT, TABLE TEXT, TABLE TEXT, NAME OF
RESPONDENT________________________________, +, +, +, +, +, +, +,
+
9. Are you currently married or living with a partner?
__(1) Yes, go to Q10___(0) No, go to Q24___ (9) DK/NR, go to Q24

10.How many living children do you have?_____ (if DK/NR, enter
99)

11.Have you given birth in the past 12 months? 
____(1) Yes, go to Q12____(0) No, go to Q13___(9) DK/NR, go to
Q13

12.When was the child born? ____MM/____YR DK/NR____(99)

13.Can you name one modern method of contraception? (Probe.)
____(1) Yes____(0) No, go to Q15___(9) DK/NR, go to Q15 

14.Do you know where you can obtain this method? (Probe.)____(1)
Yes____(0) No___(9) NR

15.Are you or your husband currently using any family planning
method?
____(1) Yes____(0) No, go to Q20___(9) DK/NR, go to Q20

16.Which method are you/your husband using now?
(Select principal method only.)
____  (1) Tubectomy____ (6) NORPLANT___ (99) DK/NR
____  (2) Vasectomy____ (7) Condom
____  (3) IUD ____ (8) Foam, emco, jelly, cream, diaphragm
____  (4) Oral pill____ (9) Safe period, withdrawal, abstinence
____  (5) Injection    ____(10) Other:_______________
____(99) DK/NR

17.For how long have you been continually using (current method)?
____(1) <<3 months____(4) 1-2 years
____(2) 4-6 months____(5) 3-4 years
____(3) 7-12 months____(6) 5 years or more____(9) DK/NR

18.For how long have you been continually practicing family
planning, i.e., contin-ually using one method or another without
interruption?
____(1) <<3 months____(3) 7-12 months____(5) 3-4 years
____(2) 4-6 months____(4) 1-2 years____(6) 5 years or more____(9)
DK/NR

19.What is the main source of your family planning service or
supplies?
____(1) Govt. hospital/clinic____  (6)  Private hospital/clinic
____(2) Govt. field worker____  (7)  NGO clinic
____(3) Social marketing prog____  (8)  NGO field worker
____(4) Private physician____  (9)  Other:_____________
____(5) Pharmacy____(99) DK/NR
go to Q24
20.If you are not using family planning now, have you or your
husband ever used any method in the past?
____(1) Yes____(0) No, go to Q22___(9) DK/NR, go to Q22

21.Which method did you/your husband use most recently?
(Select latest method only.)
____(1) Tubectomy____  (6)   NORPLANT
____(2) Vasectomy____  (7)   Condom
____(3) IUD____  (8)   Foam, emco, jelly, cream, diaphragm
____(4) Oral pill ____  (9)   Safe period, withdrawal, abstain
____(5) Injection____(99) Other:____________________

22.Do you/your husband intend to practice family planning in the
future?
____(1) Yes____(0) No____(9) DK/NR 

23.What is the most important reason you are not using family
planning now?
____  (1) Want more children____ (6) Method/service unavailable
____  (2) Husband objects____ (7) Sterility
____  (3) Health reasons____ (8) Breast feeding
____  (4) Religious reasons____ (9) Pregnant
____  (5) Fear side effects____(10) Other:________________
____(99) DK/NR

24.What is the name of the local Community Health Worker?
____(1) Knows (said name)____(0) Does not know____(9) No response

25.Has the Community Health Worker visited or contacted you
during thelast three months?
____(1) Yes____(0) No____(9) DK/NR 
This concludes the interview. Thank you for taking the time to
participate in this survey.


Rapid survey questionnaireAcute respiratory infections<$FSelected
items on this questionnaire were taken from a rapid survey
instrument developed by Drs. David Marsh, Inyat Thawar, and Qayum
Noorani of the Aga Khan University, Pakistan.>
Complete for women with children under five years of age
currently living in the household.

IDENTIFICATION, +, +, +, +, +, +, +, +
1., Study no, , 2., Province no, , 3., Cluster no, 
4., Interviewer no, , 5., Respondent no, , 6., Date of interview, 
 /  /
7., Respondent age, , 8., Respondent sex, , , , 
NAME OF RESPONDENT________________________________, +, +, +, +,
+, +, +, +

9.How many living children do you have under five years of age?
___ children (If DK/NR, enter 99.)
What are their names and ages?
Name:___________________ Age:____(in months) Sex:____(M/F)
Name:___________________ Age:____(in months) Sex:____(M/F)
Name:___________________ Age:____(in months) Sex:____(M/F)

10.How many children <<5 sleep in the same room as adults or
other children?
___ DK/NR (99)

11.How many people in your household smoke inside the house?
___ smokers (If DK/NR, enter 99.)

12.Are open fires for cooking or heating used inside your house?
____(1) Yes____(0) No____(9) DK/NR 

13.Have any of your children been sick with a respiratory illness
within the last 2 weeks? 
____(1) Yes____(0) No, go to Q18___(9) DK/NR, go to Q18

14.Did you seek treatment for the most recent episode?
____(1) Yes____(0) No, go to Q18___(9) DK/NR, go to Q18

15.Where did you seek treatment?
____(1) Treated at home
____(2) Visited the health centre
____(3) Contacted the CHW
____(4) Other:__________
____(9) DK/NR
 
16.What treatment were you given?
____(1) Anti-microbial drugs
____(2) Bronchodilator and/or cough mixture (locally determined)
____(3) Antipyretic drugs
____(4) Other:__________
____(9) DK/NR

17.Did you take the medicine for the prescribed length of time?
(Probe for cor-rect response.)
____(1) Yes____(0) No____(9) DK/NR

18.What is the name of the local Community Health Worker (CHW)?
____(1) Knows (said name)____(0) Does not know____(9) NR

19.Has the CHW visited or contacted you in the last three months?

____(1) Yes____(0) No____(9) DK/NR
This concludes the interview. Thank you for taking the time to
participate in this survey.


Rapid survey questionnaireBreast feeding
Complete for the oldest child under two years of age currently
living in the household. Interview the mother of the child, if
possible. See questionnaire on Growth monitoring/nutrition
education for related questions.
IDENTIFICATION, +, +, +, +, +, +, +, +
1., Study no, , 2., Province no, , 3., Cluster no, 
4., Interviewer no, , 5., Respondent no, , 6., Date of interview, 
 /  /
7., Respondent age, , 8., Respondent sex, , , , 
NAME OF RESPONDENT________________________________, +, +, +, +,
+, +, +, +
9.How many living children do you have under two years of age?___
(no. children) If none, terminate the interview.

10. Are you now breast feeding your youngest child?
____(1) Yes____(0) No____(9) DK/NR

11.After your baby was born, when did you begin breast feeding?
____(1) Within 3 hours____(2) 3-12 hours
____(3) 13-24 hours____(4) >>24 hours
____(5) Not breast-fed, go to Q16____(9) DK/NR, go to Q16

12.Did you give the baby the colostrum (local word)?
____(1) Yes, go to Q14  ___(0) No, go to Q13____(9) DK/NR, go to
Q13

13.Why didn't you give the baby the colostrum (local word)?
____(1) Problem with breast milk____(3) Other
____(2) Baby could not suck____(4) DK/NR

14.Do you know why it is important to give the baby the colostrum
(local word)? (Probe.)
____(1) Yes, mother knows correct reason
____(0) No, mother names incorrect reason
____(9) DK/NR

15.At what age of the baby will you/did you stop breast feeding?
___monthsDK/NR_____(9)

16.At what age will you/did you begin giving your baby formula or
milk otherthan breast milk?____months____(9) DK/NR

17.Water?____months____(9) DK/NR

18.Other liquids?____months____(9) DK/NR

19.Solid foods?____months____(9) DK/NR
Questions about breast feeding education

20.Did any health worker teach you about the benefits of breast
feeding?
____(1) Yes____(0) No____(9) DK/NR

21.Can you explain why it is important to breast feed? (Probe.)
____(1) Knows____(0) No, does not know____(9) No response

22.Were you taught about the supplemental foods and when they
should beintroduced? (Probe.)
____(1) Yes, does know____(0) No, does not know____(9) NR

23.Were you taught how to care for your breasts? (Probe.)
____(1) Yes____(0) No____(9) DK/NR

24.What is the name of the local Community Health Worker (CHW)?
____(1) Knows (said name)____(0) Does not know____(9) NR

25.Has the CHW visited or contacted you in the last 3 months? 
____(1) Yes____(0) No____(9) DK/NR 
This concludes the interview. Thank you for taking the time to
participate in this survey.



Rapid survey questionnaireDiarrhoeal disease control/ORT
Complete for first woman encountered who is currently living in
the household and who has a child under two years of age. If the
woman has more than one child under two, take the information for
the oldest child under age two. See Water, sanitation and hygiene
questionnaire for related questions on diarrhoeal disease
control.

IDENTIFICATION, +, +, +, +, +, +, +, +
1., Study no, , 2., Province no, , 3., Cluster no, 
4., Interviewer no, , 5., Respondent no, , 6., Date of interview, 
 /  /
7., Respondent age, , 8., Respondent sex, , , , 
NAME OF RESPONDENT________________________________, +, +, +, +,
+, +, +, +

 9.How many children do you have under two years of age?
____(no. children) If none, terminate interview.

What are their names and how old are they?

 Name:_______________ Age (in months):_____ Sex (m/f):_____
 Name:_______________ Age (in months):_____ Sex (m/f):_____
 Name:_______________ Age (in months):_____ Sex (m/f):_____

10.Do you know what is meant by "diarrhoea?" (Probe for
explanation: Three or more watery stools within past 24 hours?)
____(1) Knows____(0) Does not know____(9) No response

Explain what WE mean by diarrhoea and say, "I would like to ask
you some questions about diarrhoea among your young children."

11.Has (name of oldest child under 2) had diarrhoea in the last
month?
____(1) Yes ____(0) No ____(9) DK/NR, go to Q15

12.How long did it last (____hours;____days). 
Classify as "severe" if three or more days.
____(1) Severe____(2) Not severe____(9) DK/NR

13.Did you do anything to treat it or just let it run its course?
____(1) Treated it
____(2) Let it run its course, go to Q15
____(9) DK/NR, go to Q15

14. How did you treat it?
____  (1) Treated it myself with packet ORS
____  (2) Treated it myself with homemade SSS
____  (3) Treated it myself with gruel/cereal-based sol.
____  (4) Took child to relative
____  (5) Took child to neighbour
____  (6) Took child to local health worker
____  (7) Took child to CHW health provider
____  (8) Took child to health clinic, hospital
____  (9) Other (specify): ______________
____(99) DK/NR

15.Have you ever heard of ORT, ORS, SSS or (local name)?
___(1) Yes:_________ Specify, if answer to Q14 was 1, 2, or 3.
___(0) No, go to Q21
___(9) DK/NR, go to Q21

16.Is there any source of ORS in your village (around here)?
____(1) Yes____(0) No____(9) DK/NR

17. Is there a person in your village (around here) who has been
trained to use ORS?
____(1) Yes____(0) No____(9) DK/NR

18.Do you know how to mix ORS? (Probe.)
If "no," please explain, explanation includes the following:
Pour the contents of the ORS packet into the correct amount of
clean water,e.g., cooled boiled water or rainwater.
____(1) Yes, knows how to mix ORS ____(0) Does not know____(9) NR

19.How long can this solution be used?
____(1) Knows (1 day)____ (0) Does not know____(9) NR

20.How long can you administer ORS to a child with diarrhoea?
___(1) Knows (until the diarrhoea ends) ___(0) Does not
know____(9) NR

21.Do you give extra fluids during diarrhoea?
___(1) Yes (If any of those listed are mentioned) ___(0) No___(9)
DK/NR
a. gruel?___Yes___No
b. soup? ___Yes___No
c. rice water?___Yes___No
d. milk solutions with twice the water?___Yes___No
e. other fluid:____________________Yes___No

22.If the child is still breast feeding, do you continue breast
feeding duringdiarrhoea? 
____(1) Yes ____(0) No ____(9) DK/NR 
 
23.When your child has diarrhoea how often do you feed it?
____(1) At least every 3-4 hours
____(0) Less often than every 3-4 hours
____(9) DK/NR

24.What is the name of the local Community Health Worker (CHW)?
____(1) Knows (said name)  ____(0) Does not know ____(9) NR

25.Has the local CHW come to visit you in the last three months?
____(1) Yes  ____(0) No ____(9) DK/NR
This concludes the interview. Thank you for taking the time to
participate in this survey.



Rapid survey questionnaireChildhood disabilities
Complete for head of household or primary caretaker in the home
regardless of the presence/absence of disabled persons. Disabled
persons will refer to those children who are crippled, who have
trouble moving, speaking, seeing, hearing, or learning, and who
have physical, mental, or emotional handicaps.<$FThis definition
for disabled persons and questions 10-13 were adopted from a
survey instrument developed by Drs. David Marsh, Salma Alam,
Ghazala Parveen, Shafiq-ur-Rab, and Mohammad Zahid, Aga Khan
University, Pakistan.>
IDENTIFICATION, +, +, +, +, +, +, +, +
1., Study no, , 2., Province no, , 3., Cluster no, 
4., Interviewer no, , 5., Respondent no, , 6., Date of interview, 
 /  /
7., Respondent age, , 8., Respondent sex, , , , 
NAME OF RESPONDENT________________________________, +, +, +, +,
+, +, +, +
9. How many children do you have?___no. of children

10.What are their names, ages, type of disability?
Name_______________ Name_______________
Age___ Sex___(M/F)Age___ Sex___(M/F)
Disability type Disability type
__(1) Movement     __(1)Movement
__(2) Deformity     __(2) Deformity
__(3) Hearing      __(3) Hearing
__(4) Blindness     __(4) Blindness
__(5) Speech     __(5) Speech
__(6) Behaviour     __(6) Behaviour
__(7) Other________     __(7) Other__________
__(9) DK/NR     __(9) DK/NR

11.How did your child become disabled?
____(1) Illness____(3) Injury
____(2) Birth____(4) Other: ________(9) DK/NR

12.Do you know how to prevent a similar disability from occurring
again?(Probe for correct responses, e.g., immunization, safe
maternal and child care,Vit A.)
____(1) Yes____(0) No____(9) DK/NR

13.Have you sought treatment or therapy for your child?
____(1) Yes____(0) No, go to Q15___(9) DK/NR, go to Q15

14.Where did your child receive treatment or therapy?
____(1) Therapy or treatment centre ____(4) Other
____(2) Community group ____(9) DK/NR
____(3) Special school

15.What are the available centres which could provide services to
help your child?
____(1) Therapy or treatment centre
____(2) Community group
____(3) Special school
____(4) Other
____(9) DK/NR

16. What is the name of the local Community Health Worker (CHW)?
____(1) Knows (said name)____(0) Does not know____(9) NR

17.Has a community health worker visited or contacted you during
the past three months?
____(1) Yes____(0) No ____(9) DK/NR
This concludes the interview. Thank you for taking the time to
participate in this survey.

Rapid survey questionnaire
Child immunization
Complete for the oldest child under two years of age currently
living in the household.  Interview the mother of the child, if
possible.  See questionnaire on antenatal care for related
questions on tetanus toxoid immunization.

IDENTIFICATION, +, +, +, +, +, +, +, +
1., Study no, , 2., Province no, , 3., Cluster no, 
4., Interviewer no, , 5., Respondent no, , 6., Date of interview, 
 /  /
7., Respondent age, , 8., Respondent sex, , , , 
NAME OF RESPONDENT________________________________, +, +, +, +,
+, +, +, +
9.How many living children do you have under two years of age?
____ (no. children) If none, terminate the interview.

What are their names and how old are they?
Name: ______________Age (in months): _____  Sex (m/f):_____
Name: ______________Age (in months): _____  Sex (m/f):_____
Name: ______________Age (in months): _____  Sex (m/f):_____

10.Has anyone from the health centre ever talked to you about
vaccinatingyour child(ren)?____(1) Yes____(0) No____(9) DK/NR

11.Do you know which childhood diseases can be prevented by
immunization?
(Check all named.  Must have one correct answer for "yes"
response.)

____Diphtheria____Whooping cough____Tetanus
____Measles____Tuberculosis____Polio

____(1) Yes ____(0) No ____(9) DK/NR 

12.Do you know at what age children should be vaccinated against
measles? 
____(1) Yes (9-12 months)____(0) No____(9) DK/NR 

13.Has (name of oldest child under age 2) been immunized?
____(1) Yes____(0) No, go to Q26____(9) DK/NR, go to Q26

14.Do you have the immunization card for this child?
____(1) Yes, has card correctly filled out, go to Q16 
____(2) Yes, has card but incorrectly filled out, go to Q16
____(0) No, does not have card____(9) DK/NR
15.(If no EPI card) Can you remember when your child was
vaccinated?
____(1) Yes____(0) No, go to Q26___(9) DK/NR, go to Q26
Transfer information from the EPI card.
If no EPI card but remembers vaccination dates, enter as such.

Birthdate:, +, Date received, Age(mo.), Received on/off schedule,
+, Not received
16., BCG, _________, ____mo, On___(1), Off___(2), No___(0)
17., DPT1, _________, ____mo, On___(1), Off___(2), No___(0)
18., DPT2, _________, ____mo, On___(1), Off___(2), No___(0)
19., DPT3, _________, ____mo, On___(1), Off___(2), No___(0)
20., Polio 1, _________, ____mo, On___(1), Off___(2), No___(0)
21., Polio 2, _________, ____mo, On___(1), Off___(2), No___(0)
22., Polio 3, _________, ____mo, On___(1), Off___(2), No___(0)
23., Measles, _________, ____mo, On___(1), Off___(2), No___(0)
, , , , , , 
 

24.Child is on schedule for age: ____(1) Yes   ____(0) No 
____(9) DK/NR

25.For children 12-24 months: 
Child is fully vaccinated (BCG, DPT3, Polio3, Measles):
____(1) Yes____(0) No____(9) DK/NR 

26.When will you take your child for the (next) vaccination?
Date _______________________
Compare response with the EPI card data.  If no EPI card,compare
response with child's age
____(1) Mother correctly knows next vaccine appointment
____(0) Mother doesn't know
____(2) Fully vaccinated (not applicable)
____(9) DK/NR

27.What is the name of the local Community Health Worker (CHW)?
____(1) Knows (said name)____(0) Does not know____(9) NR

28.Has the Community Health Worker visited or contacted you
during the last three months?
____(1) Yes____(0) No____(9) DK/NR
This concludes the interview. Thank you for taking the time to
participate in this survey.

Rapid survey questionnaire
Growth monitoring/nutrition education
Complete for the oldest child under two years of age currently
living in the household. Interview the mother of the child, if
possible. See questionnaire on breast feeding for related
questions.

IDENTIFICATION, +, +, +, +, +, +, +, +
1., Study no, , 2., Province no, , 3., Cluster no, 
4., Interviewer no, , 5., Respondent no, , 6., Date of interview, 
 /  /
7., Respondent age, , 8., Respondent sex, , , , 
NAME OF RESPONDENT________________________________, +, +, +, +,
+, +, +, +
 
9.How many living children do you have under two years of age?
___ (no. children) If none, terminate the interview.

What are their names and how old are they?
Name: ______________Age (in months): _____  Sex (m/f):_____
Name: ______________Age (in months): _____  Sex (m/f):_____
Name: ______________Age (in months): _____  Sex (m/f):_____

10.Is (name of oldest child under age two) registered for growth
monitoring?
____(1) Yes____(0) No____(9) DK/NR 

11.Has any health worker ever explained growth monitoring cards
to you?
____(1) Yes____(0) No____(9) DK/NR 

12.Has this child ever been weighed by a health worker, nurse, or
doctor?
____(1) Yes____(0) No, go to Q19___(9) DK/NR, go to Q19

13.Do you have your child's growth card at home? (Show sample
card.)
____(1) Yes____(0) No, go to Q19___(9) DK/NR, go to Q19

14.Please show me the card.
____(1) Yes, has growth card____(0) No, cannot find it, go to Q19


15.(Interviewer: inspect card.  Does the growth card have age and
weight data plotted?)
____(1) Yes, plotted correctly
____(2) Yes, but plotted incorrectly
____(0) No, not plotted, go to Q19 
____(9) DK/NR, go to Q19 
16.(Interviewer: record weighing history from growth card): Total
no. times weighed) ____

17.Times weighed last quarter____

18.Can you explain the information on the growth card to me?
___(1) Yes, mother can interpret the information correctly
___(0) No, mother cannot interpret the information or interprets
incorrectly

19.During the last prenatal and/or postnatal care visit, were you
educated about how to improve the nutritional status of your
child?
____(1) Yes____(0) No____(9) DK/NR 

20.What is the name of the local Community Health Worker (CHW)?
____(1) Knows (said name)____(0) Does not know  ____(9) NR

21.Has the local CHW visited or contacted you during the past
three months?
____(1) Yes____(0) No____(9) DK/NR
This concludes the interview.  Thank you for taking the time to
participate in this survey.

OPTIONAL WEIGHING TO DETERMINE CURRENT NUTRITIONAL STATUS.

Name SexAge (mo)Wt. (Kg.)Ht. (Cm)Remarks:
 (22)(23)(24)(25)

Rapid survey questionnaire
Water supply, hygiene, and sanitation
Complete for each household.  Interview the female head of
household, if possible.
IDENTIFICATION, +, +, +, +, +, +, +, +
1., Study no, , 2., Province no, , 3., Cluster no, 
4., Interviewer no, , 5., Respondent no, , 6., Date of interview, 
 /  /
7., Respondent age, , 8., Respondent sex, , , , 
NAME OF RESPONDENT________________________________, +, +, +, +,
+, +, +, +
9.Where do you usually get your drinking water?
___(1) Clean source: faucet/tap, pipe, bore hole, covered well
___(2) Unclean source: open well, pond/river/stream, rain water
catchment
___(3) Other(specify)_________
___(9) DK/NR

10.Is your water supply chlorinated?
____(1) Yes____(0) No____(9) DK/NR

11.Do you usually boil water for drinking?
____(1) Yes____(0) No____(9) DK/NR

12.How long does it take you to walk to your source of water?
____(1) << 15 minutes____(2) >> 15 minutes____(9) DK/NR

13.Can you get enough water all year?
____(1) Yes____(0) No____(9) DK/NR

14.Do you always wash your hands before handling food?
____(1) Yes____(0) No____(9) DK/NR

15.Please explain why it is important to wash your hands? 
(Probe.)
____(1) Knows____(0) Doesn't know____(9) NR

16.What is the primary way this household disposes of human
waste?
____(1) water-seal latrine____(4) open field
____(2) pit privy____(5) bucket
____(3) WC____(9) DK/NR

17.Please explain why it is important to use a
structured/sanitary facility?(Probe.)
____(1) Knows____(0) Doesn't know____(9) NR

18.What is the name of the local Community Health Worker (CHW)?
____(1) Knows (said name)____(0) Does not know____(9) NR

19.Has the local CHW visited or contacted you during the past
three months?
____(1) Yes____(0) No____(9) DK/NR

Interviewer observations of household

20.Does water container have a clean cover/lid?
____(1) Yes____(0) No____(9) DK/NR 

21.Do pots, pans, plates, and glasses appear clean?
____(1) Yes____(0) No____(9) DK/NR 

22.Are fruits, vegetables, meats covered and stored away from
small domesticanimals? ____(1) Yes____(0) No____(9) DK/NR

23.Does the latrine appear to be used?
____(1) Yes____(0) No____(9) DK/NR

24.Are the animals penned away from water and food?
____(1) Yes____(0) No____(9) DK/NR

25.Does garbage appear to be disposed of in a sanitary way?  
____(1) Yes____(0) No____(9) DK/NR
This concludes the interview.  Thank you for taking the time to
participate in this survey.

Rapid survey questionnaire
Accidents and injuries
Complete for each household.                                      
                               
IDENTIFICATION, +, +, +, +, +, +, +, +
1., Study no, , 2., Province no, , 3., Cluster no, 
4., Interviewer no, , 5., Respondent no, , 6., Date of interview, 
 /  /
7., Respondent age, , 8., Respondent sex, , , , 
NAME OF RESPONDENT________________________________, +, +, +, +,
+, +, +, +
9.Has anyone in this household had a serious accident or injury
in the past year?
____(1) Yes, ask for information in matrix. For each person,
enter codes listed.
____(0) No, go to Q10
____(9) DK/NR, go to Q10

Name, Age, Sex, Type injury, Treated?, Where treated, Outcome
, , , , , , 
, , , , , , 
, , , , , , 
, , , , , , 
, , , , , , 


Types of injury codes:Where treated codes:Outcome codes:
(01) Fall(01) Hospital(01) Cured/recovered
(02) Occupational injury(02) Health care centre(02) Still
recovering
(03) Traffic injury(03) CHW(03) Permanent disability
(04) Poisoning(04) Traditional healer(04) Death
(05) Other (specify)(05) Other (specify)___(05) Other
(09) DK/NR(09) DK/NR

10.If someone in your household was injured, what would you do to
help him/her?
(Probe for correct answer.)
____(1) Yes, knows how to help ___(0) No, doesn't know ___(9) No
response
 
11.Where are the nearest emergency care facilities?  (Probe for
correct answer.)
____(1) Yes (respondent knows correct answer)
____(2) No (respondent does not know correct answer)
____(9) No response

12.What is the name of the local Community Health Worker (CHW)?
____(1) Knows (said name)____(0) Does not know____(9) NR

13.Has the local CHW visited or contacted you during the past
three months?
____(1) Yes____(0) No____(9) DK/NR 
This concludes the interview.  Thank you for taking the time to
participate in this survey.
 
Rapid survey questionnaireChronic, non-communicable diseases
Complete for each household. Interview the female head of
household, if possible.
IDENTIFICATION, +, +, +, +, +, +, +, +
1., Study no, , 2., Province no, , 3., Cluster no, 
4., Interviewer no, , 5., Respondent no, , 6., Date of interview, 
 /  /
7., Respondent age, , 8., Respondent sex, , , , 
NAME OF RESPONDENT________________________________, +, +, +, +,
+, +, +, +
 
Diabetes

 9.Do you know what diabetes is?  (Probe for explanation.)
____(1) Yes____(0) No____(9) DK/NR 

10.Have you or any household member ever been diagnosed as having
diabetes?
____(1) Yes____(0) No____(9) DK/NR

11.Does anyone in this household have diabetes now?
____(1) Yes____(0) No, go to Q16____(9) DK/NR, go to Q16

12.Is this person being treated now?
____(1) Yes____(0) No, go to Q15____(9) DK/NR, go to Q15

13.Is the prescribed treatment being followed? (Probe for
explanation.)
____(1) Yes____(0) No____(9) DK/NR

14.Do you monitor glucose level at home?
____(1) Yes____(0) No____(9) DK/NR

15.Do you and your household members know how to handle a
diabeticemergency?
(Probe for explanation.)
____(1) Yes____(0) No____(9) DK/NR

Hypertension

16.Do you know what hypertension is? (Probe for explanation.)
____(1) Yes____(0) No____(9) DK/NR

17.Have you or any household member ever been diagnosed as
havinghypertension?
____(1) Yes____(0) No____(9) DK/NR

18.Does anyone in this household have hypertension now?
____(1) Yes____(0) No, go to Q22____(9) DK/NR, go to Q22

19.Is this person being treated now?
____(1) Yes____(0) No, go to Q21___(9) DK/NR, go to Q21

20.Is the prescribed treatment being followed? (Probe for
explanation.)
____(1) Yes____(0) No____(9) DK/NR

21.Do you and your household members know what to do in case of a
heart at-tack or stroke? (Probe for explanation.)
____(1) Yes____(0) No____(9) DK/NR

Anaemia

22.Do you know what anaemia is? (Probe for explanation.)
____(1) Yes____(0) No____(9) DK/NR

23.Have you or any household member ever been diagnosed as having
anaemia?
____(1) Yes____(0) No____(9) DK/NR

24.Does anyone in this household have anaemia now?
____(1) Yes____(0) No, go to Q27____(9) DK/NR, go to Q27

25.Is this person being treated now?
____(1) Yes____(0) No, go to Q27____(9) DK/NR, go to Q27

26.Is the prescribed treatment being followed? (Probe for
explanation.)
____(1) Yes____(0) No____(9) DK/NR

27.What is the name of the local Community Health Worker (CHW)?
____(1) Knows (said name)____(0) Does not know____(9) NR

28.Has the local CHW visited or contacted you during the last 3
months?
____(1) Yes____(0) No____(9) DK/NR
This concludes the interview.  Thank you for taking the time to
participate in this survey.

Rapid survey questionnaireMalaria
Complete for target groups in known endemic region, especially
pregnant women and/or children under five needing malaria
treatment services.

IDENTIFICATION, +, +, +, +, +, +, +, +
1., Study no, , 2., Province no, , 3., Cluster no, 
4., Interviewer no, , 5., Respondent no, , 6., Date of interview, 
 /  /
7., Respondent age, , 8., Respondent sex, , , , 
NAME OF RESPONDENT________________________________, +, +, +, +,
+, +, +, +
 
 9. Can you explain to me what malaria is? (Probe.)
____(1) Knows____(0) Doesn't know_____(9) NR

10.Has anyone in your household had malaria (local term) since
the beginning of the year? (Or determine appropriate starting
point for recall period.)
___(1) Yes (Ask names.)___(0) No, go to Q13___(9) DK/NR, go toQ13

Name: ____________ Relation: __________ Age:___ Sex:___
Name: ____________ Relation: __________ Age:___ Sex:___
Name: ____________ Relation: __________ Age:___ Sex:___

11.How did you know that it was malaria (local term)?
In endemic areas where malaria is a well known disease, the
interviewer could forego asking about symptoms of malaria and
instead directly ask about disease.
___(1) High fever
___(2) Shivers
___(3) Headache
___(4) Other (specify)____________
___(9) DK/NR

12.How many days did the malaria episode prevent that person from
conducting his/her normal daily activities? ___No. of days

13.Do you know how malaria (local term) is spread? (Probe for
explanation.)
____(1) Yes____(0) No____(9) DK/NR 

14.What are your household members currently doing to protect
themselves from malaria? 
____(1) Using mosquito nets 
____(2) Using household sprays 
____(3) Eliminating standing water
____(4) Using anti-malarial drugs
____(5) Other: _______________
____(9) DK/NR

15.Has anyone in your household died in the last 12 months?  
____(1) Yes___(0) No, go to Q18___(9) DK/NR, go to Q18 

16.Which symptoms were present one week before death?
____(1) High fever
____(2) Shivers
____(3) Headache
____(4) Other (specify)_______
____(9) DK/NR

17.What do you think was the cause of death?  (Probe for
an-swer.)_______________

18.What is the name of the local Community Health Worker (CHW)?
____(1) Knows (said name)____(0) Does not know____(9) NR

19.Has the local CHW visited or contacted you in the last 3
months?
____(1) Yes____(0) No ____(9) DK/NR
This concludes the interview.  Thank you for taking the time to
participate in this survey.

Rapid survey questionnaireTuberculosis
Complete for households with known case of TB and/or for
high-risk segments of the population including known HIV
positives, occupational groups (miners, etc.), low SES,
densely-packed populations.  

IDENTIFICATION, +, +, +, +, +, +, +, +
1., Study no, , 2., Province no, , 3., Cluster no, 
4., Interviewer no, , 5., Respondent no, , 6., Date of interview, 
 /  /
7., Respondent age, , 8., Respondent sex, , , , 
NAME OF RESPONDENT________________________________, +, +, +, +,
+, +, +, +
 
 9. Can you explain to me what tuberculosis (local word) is?
(Probe.)
____(1) Knows____(0) Doesn't know____(9) NR

10.Do you know how TB is spread? (Probe for explanation.)
____(1) Knows____(0) Doesn't know____(9) NR

11.Do you know how to prevent infection? (Probe for explanation.)
____(1) Knows____(0) Doesn't know____(9) NR

12.Were all your children vaccinated at birth with BCG?
____(1) Yes____(0) No____(9) DK/NR

13.Have you or any family members experienced a persistent cough
lasting more than 2 weeks?
____(1) Yes____(0) No, go to Q18____(9) DK/NR, go to Q18

14.Did this person seek treatment for TB?
____(1) Yes____(0) No, go to Q18____(9) DK/NR, go to Q18

15.Where did this person go to seek treatment?
____(1) Health centre
____(2) CHW/volunteer
____(3) Other_________
____(9) DK/NR

16.Was this person given medicine to treat TB?
____(1) Yes____(0) No, go to Q18 ____(9) DK/NR, to go Q18

17.Did they take the medicine for the prescribed length of time
(Probe for explanation.)
____(1) Yes____(0) No ____(9) DK/NR
18.What is the name of the local Community Health Worker?
____(1) Knows (said name)____(0) Does not know____(9) NR
19.Has the CHW visited or contacted you in the last three months?
____(1) Yes____(0) No____(9) DK/NR
This concludes the interview.  Thank you for taking the time to
participate in this survey.

Rapid survey questionnaireSexually-transmitted diseases, HIV/AIDS

<$FPortions of this instrument are adapted from a baseline
instrument in Lamptey P. and P. Piot. The handbook for AIDS
prevention in Africa. Family Health International, 1990.>

Complete for individuals at risk of acquiring infection,
especially sexual partners of individuals practising high-risk
behaviour, or clients with STDs.
IDENTIFICATION, +, +, +, +, +, +, +, +
1., Study no, , 2., Province no, , 3., Cluster no, 
4., Interviewer no, , 5., Respondent no, , 6., Date of interview, 
 /  /
7., Respondent age, , 8., Respondent sex, , , , 
NAME OF RESPONDENT________________________________, +, +, +, +,
+, +, +, +
 
 9.Do you know what is meant by a sexually-transmitted disease?
(Probe for correct response.)
____(1) Yes____(0) No____(9) DK/NR

10.Do you know the difference between HIV infection and AIDS
(local term)?
(Probe for correct response.)
____(1) Yes____(0) No____(9) DK/NR

11.Can a person who looks healthy be infected with an STD?
____(1) Yes____(0) No____(9) DK/NR

12.Can a person get the AIDS virus by shaking hands with someone
who isinfected with the virus?
____(1) Yes____(0) No____(9) DK/NR

13.Can a pregnant woman who is infected with HIV pass on the
virus to herunborn child?
____(1) Yes____(0) No____(9) DK/NR

14.Can STDs be transmitted by having sex with someone who is
infected withan STD?
____(1) Yes____(0) No____(9) DK/NR

15.Is there a cure for AIDS?
____(1) Yes____(0) No____(9) DK/NR

16.What are you currently doing to prevent yourself or others
from becominginfected with an STD?
____(1) Using a condom
____(2) Practicing safer sex (Probe for explanation.)
____(9) Other (specify)___________
____(0) Nothing

17.Do you know how to use a condom correctly? (Probe for correct
response.)
____(1) Yes____(0) No____(9) DK/NR

18.Where have you obtained condoms during the last six months?
____(1) At a government hospital 
____(2) At a government clinic or health centre
____(3) At a private hospital
____(4) At a private clinic or health centre
____(5) At a local dispensary
____(6) A health worker came to you
____(7) Other ____________
____(9) DK/NR

19.Have you been diagnosed with an STD in the past 12 months?  
____(1) Yes____(0) No, go to Q22___(9) DK/NR, go to Q22

20.What was your diagnosed illness? (Probe for response.)
____(1) HIV/AIDS
____(2) Other STD: _____________
____(9) DK/NR

21.Where did you go for treatment?
____(1) To a government hospital
____(2) To a government clinic or health centre
____(3) To a private hospital
____(4) To a private clinic or health centre
____(5) Contacted a health worker
____(6) Other: ____________
____(9) DK/NR

22.How did you first learn about STDs?
____(1) By word of mouth
____(2) From a CHW or other health staff
____(3) Heard about it on the radio
____(4) Other:__________
____(9) DK/NR

23.What is the name of the local Community Health Worker (CHW)?
____(1) Knows (said name)____(0) Does not know____(9) NR

24.Has the local CHW visited or contacted you in the last three
months?
____(1) Yes____(0) No____(9) DK/NR
This concludes the interview.  Thank you for taking the time to
participate in this survey.


Rapid survey questionnaireVital events and health status
Complete for each household. List all people currently living in
the household, by age and sex.
IDENTIFICATION, +, +, +, +, +, +, +, +
1., Study no, , 2., Province no, , 3., Cluster no, 
4., Interviewer no, , 5., Respondent no, , 6., Date of interview, 
 /  /
7., Respondent age, , 8., Respondent sex, , , , 
NAME OF RESPONDENT________________________________, +, +, +, +,
+, +, +, +
 
 9.How many people live in this household:_____(total)

I would like to ask you for the name, age, and sex of each person
living in this household.  (List age of children under age two in
months.)

10.Married women of reproductive age (15-49):______(in household)
10.1 Name:___________Age (in years): ____ Pregnant? (Y/N/DK)____
10.2 Name:___________Age (in years): ____ Pregnant? (Y/N/DK)____
10.3 Name:___________Age (in years): ____ Pregnant? (Y/N/DK)____

11.Children less than 24 months old:______(in household)
11.1 Name:____________Age (in months): ____ Sex (m/f):_____
11.2 Name:____________Age (in months): ____ Sex (m/f):_____
11.3 Name:____________Age (in months): ____ Sex (m/f):_____

12.Children 24-60 months old:______(in household)
12.1 Name:____________Age (in years): ____  Sex (m/f):_____
12.2 Name:____________Age (in years): ____  Sex (m/f):_____
12.3 Name:____________Age (in years): ____  Sex (m/f):_____

13.Other men, women, and children:______(in household)
13.1 Name:____________Age (in years): ____  Sex (m/f):_____
13.2 Name:____________Age (in years): ____  Sex (m/f):_____
13.3 Name:____________Age (in years): ____  Sex (m/f):_____
(Total of questions 10-13 should equal total shown in Item
9.)______
 
Morbidity

14.Is there anyone in your household who has been sick this week?
_____(1) Yes_____(0) No, go to Q60___(9) DK/NR, go to Q60

Who is/are sick? (Probe and fill out following table, using SI.
No. from Q10-Q13, e.g., 10.3, 12.2):

15, , 16, 17, 18, 19, 20, 21
SI   No, Name, Age m/y, Sex M/F, Disease (code,, 01,02,etc.),
Treated(Y/N), Where treated(1,2,3,etc.), Outcome(1,2,3,etc.)
, , , , , , , 
, , , , , , , 
, , , , , , , 
, , , , , , , 
 

If more than one person is ill, continue coding with 25, 35, 45,
etc.

18.Disease code:20.    Where treated:
01 Diarrhoea/dysentery08 Polio        1 Government
clinic/hospital
02 Anaemia09 Tuberculosis        2 Mobile clinic
03 Scabies10 Acute respiratory inf. 3 Private clinic/hospital
04 Diphtheria 11 Fever        4 Private doctor
05 Whooping cough12 Malaria        5 Private midwife/nurse
06 Tetanus13 Other: _______       6 Traditional practitioner
07 Measles99 DK/NR 7 Pharmacy/drug store
  8 Other:_______________  
 9 DK/NR

21.Outcome
1 Cured/recovered 4 Died
2 Still recovering 5 Other: ______________
3 Permanent disability 6 DK/NR
 
Mortality

60.Were there any deaths in this household during the last 12
months?
_____(1) Yes_____(0) No, go to Q100___(9) DK/NR, go to Q100

Who died? (Probe and fill out following table):

61, , 62, 63, 64, 65, 66, 67
SI No, Name, Age m/y, Sex M/F, Cause of death Code 01,, 02,,
etc., Date died dd/mm/yy dd/mm/yy, Died where?code: 01,02,, etc.,
DeathY/N
, , , , , , , 
, , , , , , , 
, , , , , , , 
, , , , , , , 
, , , , , , , 

If more than one death, continue coding with 71, 81, 91 etc.

64.Cause of death code: 66.  Where died
01 Diarrhoea/Dysentery11 Preg.-related  1 Government
clinic/hospital
02 Anaemia12 Heart disease  2 Mobile clinic
03 Scabies13 Cancer  3 Private clinic/hospital
04 Diphtheria14 Diabetes  4 Private doctor's office/clinic
05 Whooping Cough15 Typhoid  5 Private midwife/nurse's clinic
06 Tetanus16 Accident  6 Traditional practitioner's centre
07 Measles17 Pneumonia  7 Home
08 Polio18 Hepatitis  8 Relative's house
09 Tuberculosis19 Malaria  9 Other:__________
10 ARI20 Other99  DK/NR
99 DK/NR
 
Fertility

100.Were there any births in this household in the last 12
months?
_____(1) Yes____(0) No, end interview___(9) DK/NR, end interview

Who was born? (Probe and fill out following table, using SI No.
from Q11,e.g., 11.1, 11.2, etc.):
101, , 102, 103, 104, 105, 106, 107
SI No, Name, Age m/y, Sex M/F, Outcome Code 01,, 02,, etc., ,
Born where?01,, 02,, etc., Birth certificate Y/N
, , , , , , , 
, , , , , , , 
, , , , , , , 
, , , , , , , 
, , , , , , , 

If more than one birth, continue coding with 111, 121, etc.
104. Outcome:106. Where born
01 Live birth (single)01 Government clinic/hospital
02 Live birth (twins)02 Mobile clinic
03 Live birth (2)03 Private clinic/hospital
04 Stillbirth04 Private doctor's office/clinic
05 Died within 1 week05 Private midwife/nurse's clinic
06 Died within 1 month06 Traditional practitioner's centre
09 DK/NR07 Home
08 Relative's house
09 Other:__________
99 DK/NR

This concludes the interview.  Thank you for taking the time to
participate in this survey.


Rapid survey questionnaire
Child morbidity and mortality assessment
Complete for each woman aged 15-49 who was ever married (i.e.,
married, separated, widowed, divorced).  If there is more than
one eligible woman in each household, use separate forms.  Give
each woman residing in the household a number starting from the
oldest to the youngest.  Use Q9-22 

(Module A<$FModule A is adapted from: David, P.H., et al.
Measuring childhood mortality: A guide for simple surveys,
UNICEF, 1990, pp. 152-154.>) if it is possible to have a more
complete birth history.  If not, use Q23-38 (Module B<$FModule B
is adapted from: David, P.H., et al, ibid. pp. 155-156.>). You
can use data from Module A to determine infant and child
mortality rates. If this survey is translated, it is important to
maintain the wording and order of questions in Modules A and B.

IDENTIFICATION, +, +, +, +, +, +, +, +
1., Study no, , 2., Province no, , 3., Cluster no, 
4., Interviewer no, , 5., Respondent no, , 6., Date of interview, 
 /  /
7., Respondent age, , 8., Respondent sex, , , , 
NAME OF RESPONDENT________________________________, +, +, +, +,
+, +, +, +

Module A: Child mortality 

 9.In what month and year were you born?   ____MM/____YR____(99)
DK/NR

10.How many of your sons are now living with you?____ ___  (99)
DK/NR

11.How many of your sons are now living elsewhere?___ ____ (99)
DK/NR

12.How many of your daughters are now living with you?_____(99)
DK/NR

13.How many of your daughters are now living elsewhere?____ (99)
DK/NR

14.Have you ever given birth to a child who later died, even if
she/he lived only
a short time?
____(1) Yes____(0) No, go to Q17____ (9) DK/NR, go to Q17

15.How many of your sons have died?____(99) DK/NR

16.How many of your daughters have died?____(99) DK/NR
17.INTERVIEWER: Sum the answers to Questions 10, 11, 12, 13, 15,
and 16:________total

18.Apart from these (Total # from Q 17) births, have you had any
other live births?
____(1) Yes____(0) No, go to Q20___(9) DK/NR, go to Q20

19.INTERVIEWER: If yes, ask if now living or dead, and correct
where necessary.

20.Could you give me the following information on all your
children born alive, even if they are now dead, beginning with
your last delivery?

INTERVIEWER: Begin to list with the woman's most recent live
birth and ask the questions that follow for each child born in
the last five years (this will allow for calculation of death
rate in children under five years):
Name of child, Month/year of birth, SexM/F, Now alive?Y/N/DK, If
dead,, date of deathMM/YR

Last child, /, , , /
Next to last, /, , , /
Second to last, /, , , /
Third to last, /, , , /
Fourth to last, /, , , /
Fifth to last, /, , , /
Twin, /, , , /

21.Respondent is:____(1) woman herself____(2) her mother
____(3) her sister living in same house____(4) other
(Marriage duration option; to be included if only ever-married
women areinterviewed):

22.How many years has it been since you were first married? (That
is, since your first marriage, even if you have married more than
once.)
Date of marriage: mm/yy
Month __ Year __or Completed years __

Module B:  Child mortality (Optional: Use if difficult to
construct     histories)

23.In what month and year were you born?
____MM/___YR  ____(99) DK/NR
 
24.How many of your sons are now living with you?____ ____(99)
DK/NR

25.How many of your sons are now living elsewhere?____ ____(99)
DK/NR

26.How many of your daughters are now living with you?____
____(99) DK/NR

27.How many of your daughters are now living elsewhere?____
____(99) DK/NR

28.Have you ever given birth to a child who later died, even if
she/he lived onlya short time?
___(1) Yes__(0) No, go to Q31   ____ (9) DK/NR, go to Q31

29.How many of your sons have died?_____ ____(99) DK/NR

30.How many of your daughters have died?____ ____(99) DK/NR

31.INTERVIEWER: Sum the answers to Questions 24, 25, 26, 27, 29,
and 30:
________Total

32.Apart from these (total # from Q31) births, have you had any
other live births?
__(1) Yes__(0) No, go to Q34___(9) DK/NR, go to Q34

33.INTERVIEWER: If yes, ask if now living or dead, and correct
where necessary.

34.Could you give me the following information on all your
children born alive,even if they are now dead, beginning with
your last delivery?

35.In what month and year was your last live birth?
__MM/__YR  ___(9) DK/NR

36.Was this child a boy or a girl?
____(1) Boy____(2) Girl___(9) DK/NR

37. Is she/he still alive? ___(1) Yes ___(0) No ___(9) DK/NR 

38.Did you have another live birth before this last one?
____(1) Yes____(0) No, go to Q41___(9) DK/NR, go to Q41

39.Was this baby a boy or a girl? ____(1) Boy ____(2) Girl 
____(9) DK/NR

40.Is she/he still alive today?  ____(1) Yes  ____(0) No  ____(9)
DK/NR 

41.Respondent is: ____(1) woman herself____(2) her mother
____(3) her sister living in same house____(4) other

(Marriage duration option (Q42); to be included if only
ever-married women areinterviewed):

42.How many years has it been since you were first married? 
(That is, sinceyour first marriage, even if you have married more
than once.)
Date of marriage:   mm/yy
Month __Year __or Completed years __

INTERVIEWER: Please check Q22 (Module A) or Q31-40 (Module B) to
see if any infant or child from this household is dead.  For the
most recent death, ask the following questions:

43.Did (name of deceased child) die because of an accident or an
illness?
 __(1) Accident, go to Q44___(2) Illness, go to Q45 ___(9) DK/NR,
go to Q45

44.What was the accident?_______________, go to Q49 

45.From what illness did (name of deceased child) die?
____________(9) DK/NR

46.What were the signs or symptoms present two weeks before
death?
____(1) Diarrhoea____(6) Fever
____(2) Diarrhoea with blood____(7) Seizures
____(3) Cold____(8) Other symptoms (specify)________
____(4) Difficulty breathing____(9) DK/NR
____(5) Rash or pimples

47.(IF INTERVIEWER IS TRAINED IN IDENTIFYING CAUSE OF DEATH)In
the opinion of the interviewer, of what did the child die?
____(1) Infection (specify)_________(5) Other (specify)_________
____(2) Diarrhoea____(6) Vaccine preventable disease____(3) ARI
(pneumonia)(specify)_____________
____(4) Malnutrition____(9) DK/NR


48.How long did (name of deceased child) have the illness?
_________days;_________months;________(9) DK/NR

49.Was she/he taken somewhere to receive treatment for the
illness/accidentbefore dying?
____(1) Yes____(0) No____(9) DK/NR 

50.Where was she/he taken?
____(1) Public hospital____(5) Pharmacy
____(2) Health centre____(6) Traditional healer
____(3) Doctor's office____(7) Other (specify)_______
____(4) Clinic/private hospital____(9) DK/NR  

51.Where did she/he die?
____(1) Public hospital____(4) At the house
____(2) Health centre____(5) Other(specify)_________
____(3) Clinic/Private hospital____(9) DK/NR

52.Do you have a death certificate?
____(1) Yes___(0) No, go to Q55___(9) DK/NR, go to Q55

53.May I see that certificate?
___(1) Yes, shows certificate ___(2) No, does not show
certificate, go to Q55

54.What was the cause of death, according to the certificate?
_________________________

55.Has anyone else in this household died in the last six months?
____(1) Yes___(0) No, go to Q57___(9) DK/NR, go to Q57
 
56.Name?________________________ Age?____
Symptoms prior to death?_______________________
Treatment received?___________________________

Child morbidity

57.Has any child under the age of two been sick in the last two
weeks?
____(1) Yes____(0) No, go to Q73___(9) DK/NR, go to Q73

58.What were the symptoms of sickness?
____(1) FeverAsk Q 59-74
____(2) DiarrhoeaAsk Q 59-74
____(3) Difficulty breathingAsk Q 63-74
____(4) Poor weight gain/weight lossAsk Q 65-74
____(5) Other (specify)____________  
____(9) DK/NR

59.If diarrhoea, how long was/is the episode?    ____days___(99)
DK/NR

60.Does the child have diarrhoea today?
____(1) Yes____(0) No____(9) DK/NR 

61.Did you give the sick child ORS? 
____(1) Yes____(0) No____(9) DK/NR 

62.Do you/did you continue breast feeding your baby during
illness?
____(1) Yes____(0) No____(9) DK/NR 

63.If coughing etc., for how many days (has the cough lasted/did
the cough last)?
(If less than one day, 00.) ____Day ____(99) DK/NR, go to Q65

64.When the child had the illness with a cough, did she/he
breathe faster thanusual with short, rapid breaths? ____(1)
Yes___(0) No___(9) DK/NR 

65.If poor weight gain, has the child had any of the following
symptoms:
swollen feetdry eyes
thin hair blindness
sores inside mouthno desire to laugh or play
failure to develop intelligence
____(1) Yes____(0) No____(9) DK/NR 

66.Did you seek advice or treatment for the illness?
____(1) Yes____(0) No, go to Q68____(9) DK/NR, go to Q68
67.Where did you seek advice or treatment?
____(1) Government clinic/hospital       ____(5) Traditional
practitioner
____(2) Mobile clinic____(6) Pharmacy/drug shop
____(3) CHW____(9) Other (specify)______
____(4) Private doctor

68.Was anything given to treat the illness?
____(1) Yes____(0) No, go to Q71____(9) DK/NR, go to Q71

69.What was given to treat the illness?
____(1) Injection____(5) Other pill or syrup
____(2) Antibiotic____(6) Unknown pill or syrup
____(3) Anti-malarial____(7) Home remedy/herbal medicine
____(4) Cough syrup____(8) Other (specify)________
____(9) DK/NR

70.Were you told by the health care provider what illness your
child had?
___(1) Yes specify:_____ ____(0) No____(9) DK/NR

71.Does the child have the symptoms (mentioned above) today?
____(1) Yes ____(0) No____(9) DK/NR  

72. (IF INTERVIEWER IS TRAINED IN IDENTIFYING CAUSE OF ILLNESS)
In the opinion of the interviewer, what illness does/did the
child have?
____(1) Infection (specify)______
____(2) Diarrhoea
____(3) ARI (pneumonia)
____(4) Malnutrition
____(5) Other (specify)___________
____(6) Vaccine preventable disease (specify)________________
____(9) DK/NR

73.Has anyone else in this household been sick in the last two
weeks?
____(1) Yes ____(0) No____(9) DK/NR

74.Name?__________________
Age?_____________________
Symptoms?_________________
Treatment received?_____________

75.What is the name of the local Community Health Worker (CHW)?
____(1) Knows (said name)  ____(0) Does not know____(9) NR

76 Has the local CHW visited or contacted you in the last three
months?
____(1) Yes  ____(0) No____(9) DK/NR 
This concludes the interview. Thank you for taking the time to
participate in this survey.

Rapid survey questionnaireAdult morbidity and mortality
assessment
Complete for each household.  List all adults currently living in
the household, by age and sex.  
IDENTIFICATION, +, +, +, +, +, +, +, +
1., Study no, , 2., Province no, , 3., Cluster no, 
4., Interviewer no, , 5., Respondent no, , 6., Date of interview, 
 /  /
7., Respondent age, , 8., Respondent sex, , , , 
NAME OF RESPONDENT________________________________, +, +, +, +,
+, +, +, +

 9.How many adults live in this household:_____(total)
I would like to ask you for the name, age, and sex of each adult
living in this household. 

10.Married women of reproductive age (15-49): ______(in
household)
Name:______________Age: __Pregnant? (Y/N/DK)____
Name:______________Age: __Pregnant? (Y/N/DK)____
Name:______________Age: __Pregnant? (Y/N/DK)____

11.Other men and  women:  ______(in household)
Name:______________Age: ____Sex (m/f):_____
Name:______________Age: ____Sex (m/f):_____
Name:______________Age: ____Sex (m/f):_____
(Total of questions 10-11 should equal total shown in Q9.) ______

Adult morbidity

12.Has any adult in this household been sick in the past 2 weeks?
___(1) Yes___(0) No___(9) DK/NR 

13.Please tell me their names and when they were sick:
Name:_______________ When?:_________________days ago
Name:_______________ When?:_________________days ago
Name:_______________ When?:_________________days ago

14.Is there any adult in your household who is sick today?
___(1) Yes___(0) No, go to Q23___(9) DK/NR, go to Q23

INTERVIEWER: For the person who is sick today, or sick most
recently in the last two weeks, please ask the following
questions.
 
15.What were/are the symptoms of the illness?
____(1) High fever____ (6) Earache or ear discharge
____(2) Diarrhoea____ (7) Seizures
____(3) Weight loss____ (8) Weakness or lethargy
____(4) Persistent cough____ (9) Other (specify) _______
____(5) Cough with sputum____(99) DK/NR

16.How long did the illness last?
____Days
____Weeks
____DK/NR

17.Was advice or treatment sought?
____(1) Yes___(0) No, go to Q19____(9) DK/NR, go to Q19 

18.Where was advice or treatment sought?
____(1) Government clinic/hospital____(5) Traditional
practitioner
____(2) Mobile clinic____(6) Pharmacy/drug shop
____(3) CHW____(7) Other (specify)_______________
____(4) Private doctor____(9) DK/NR

19.Was anything given to treat the illness?
____(1) Yes___(0) No, go to Q21___(9) DK/NR, go to Q21

20.What was given to treat the illness?
____(1) Injection____(5) Other pill or syrup
____(2) Antibiotic____(6) Unknown pill or syrup
____(3) Anti-malarial____(7) Home remedy/herbal medicine
____(4) Cough syrup____(8) Other (specify)___________
____(9) DK/NR  

21.In the opinion of the interviewee, what is/was the
illness?(use disease code from Q22)________(9) DK/NR

22.(IF INTERVIEWER IS TRAINED IN IDENTIFYING CAUSE OF ILLNESS)In
the opinion of the interviewer, what illness does/did the person
have? __
Disease code:
____(01) Dysentery____(11)Polio
____(02) Anaemia____(12)Tuberculosis
____(03) Scabies____(13)Acute respiratory infection
____(04) Diphtheria____(14)Fever
____(05) Whooping cough____(15)Malaria
____(06) Tetanus____(16)Other: _______
____(07) Measles____(99)DK/NR, go to Q23 
____(08) Diabetes
____(09) Hypertension
____(10) STD/HIV
 
Adult mortality

23.Was there any death in this household during the last 12
months?
__(1) Yes __(0) No, end interview  __(9) DK/NR, end interview

24.  Who died? (Probe and fill out following table):
Name:_______Age:__Sex:__When?____weeks/months ago
Name:_______Age:__Sex:__When?____weeks/months ago
(Interviewer: Ask Q. 25-36 for each person who has died in the
last year.)

25.What symptoms were present 2 weeks before death?
____(1) High fever____  (6) Earache or ear discharge
____(2) Diarrhoea____  (7) Seizures
____(3) Weight loss____  (8) Weakness or lethargy
____(4) Persistent cough____  (9) Other (specify)_______
____(5) Cough with sputum____(99) DK/NR

26.How long did (name of deceased) have the illness?
____Days
____Weeks
____DK/NR

27.Was advice or treatment sought?
____(1) Yes___(0) No, go to Q29____(9) DK/NR, go to Q29 

28.Where was advice or treatment sought?
____(1) Government clinic/hospital____(5) Traditional
practitioner
____(2) Mobile clinic____(6) Pharmacy/drug shop
____(3) CHW____(7) Other (specify)_________
____(4) Private doctor____(9) DK/NR

29. Was anything given to treat the illness?
____(1) Yes___(0) No, go to Q31____(9) DK/NR, go to Q31

30.What was given to treat the illness?
____(1) Injection____(5) Other pill or syrup
____(2) Antibiotic____(6) Unknown pill or syrup
____(3) Anti-malarial____(7) Home remedy/herbal medicine
____(4) Cough syrup____(8) Other (specify)___________
____(9) DK/NR

31.Where did the person die?
____(1) Government clinic/hospital____(5) At the house
____(2) Health centre____(6) Other (specify)_________
____(3) Private clinic/hospital____(9) DK/NR
____(4) Doctor's office

32.Do you have a death certificate?
____(1) Yes____(0) No____(9) DK/NR 

33.May I see that certificate?
____(1) Yes, shows certificate____(2) No, does not show
certificate

34.What was the cause of death, according to the certificate?
_____________

35. In the opinion of the interviewee, what was the illness?
(Use Disease Code from Q36) ________________(9) DK/NR

36.(IF INTERVIEWER IS TRAINED IN IDENTIFYING CAUSE OF DEATH) In
the opinion of the interviewer, what did the person die of? 
Cause of Death Code:
____(01) Diarrhoea/Dysentery____(11) Pregnancy-related
____(02) Anaemia____(12) Heart disease
____(03) Scabies____(13) Cancer  specify________
____(04) Diphtheria____(14) Diabetes
____(05) Whooping cough____(15) Typhoid
____(06) Tetanus____(16) Accident
____(07) Measles____(17) Pneumonia
____(08) Polio____(18) Hepatitis
____(09) Tuberculosis____(19) Malaria
____(10) Hypertension____(20) Other  Specify:_______
____(99) DK/NR

37.What is the name of the local Community Health Worker (CHW)?
____(1) Knows (said name)____(0) Does not know____(9) NR

38.Has the local CHW visited or contacted you in the last three
months?
____(1) Yes____(0) No____(9) DK/NR
This concludes the interview.  Thank you for taking the time to
participate in this survey.

Appendix D: Cluster-survey registers
GENERAL PHC
Health education

MATERNAL CARE
Antenatal care, safe delivery, and postnatal care
Family planning

CHILD CARE
Acute respiratory infections
Breast feeding 
Diarrhoeal disease control/oral rehydration therapy
Childhood disabilities
Child immunization
Growth monitoring/nutrition education

COMMUNITY HEALTH
WATER SUPPLY, HYGIENE, AND SANITATION

OTHER HEALTH CARE
Accidents and injuries
Chronic, non-communicable diseases
Malaria
Tuberculosis
Sexually-transmitted diseases, HIV/AIDS

MORBIDITY, MORTALITY AND FERTILITY
Vital events and health status
Child morbidity and mortality assessment
Adult morbidity and mortality assessment
The following instruments are similar to the Rapid survey
questionnaires, only in a different format.  The answers of up to
ten respondents can be recorded on a single register.
These instruments can also be used as presented or modified as
appropriate to any given situation.  You are encouraged to "mix
and match" questions and sections from the various
questionnaires, add, delete, revise, and combine to adapt the
instruments to your situation and needs. 
Please note that these are only the instruments.  Examples of how
they can be modified and used with different sampling techniques
are described in this User's guide.

Cluster form: Health education
(1), Study No. ______________ , N, , +, +, +, +, +, +, +, +, +
(2), Province No. ___________ , A, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(3), Cluster No. ____________ , M, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(4), Interviewer ____________ , E, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(5), Respondent No., , 1, 2, 3, 4, 5, 6, 7, 8, 9, 10
(6), Date ___/___/___, , , , , , , , , , , 
(7), Age, , , , , , , , , , , 
(8), Sex, , , , , , , , , , , 
(9), How many people live in this household?, , , , , , , , , , ,
(10), Is anyone in this household a married woman of reproductive
age?, , , , , , , , , , , 
(11), Is anyone in this household pregnant?, , , , , , , , , , , 
(12), Are there any children under 24 mos. in this household?, ,
, , , , , , , , , 
(13), Are there children 24 - 60 mos. in this household?, , , , ,
, , , , , , 
(14), Has a health worker visited/contacted you in the last three
months?, , , , , , , , , , , 
(15), What type of health worker visited?, , , , , , , , , , , 
(16),  What did the health worker discuss?, , , , , , , , , , , 
, Maternal care, , , , , , , , , , , 
, Antenatal care, , , , , , , , , , , 
, Safe delivery, , , , , , , , , , , 
, Postnatal care, , , , , , , , , , , 
, Child care, , , , , , , , , , , 
, Acute respiratory infections, , , , , , , , , , , 
, Breast feeding, , , , , , , , , , , 
, Diarrhoea diseases control, , , , , , , , , , , 
, Oral rehydration therapy, , , , , , , , , , , 
, Childhood disabilities, , , , , , , , , , , 
, Child immunization, , , , , , , , , , , 
, Growth monitoring/nutrition education, , , , , , , , , , , 
, Community health, , , , , , , , , , , 
, Water supply, , , , , , , , , , , 
, Hygiene, , , , , , , , , , , 
, Sanitation, , , , , , , , , , , 
, Other health care, , , , , , , , , , , 
, Accidents and injuries, , , , , , , , , , , 
, Chronic,, non-communicable diseases, , , , , , , , , , , 
, Malaria, , , , , , , , , , , 
, Tuberculosis, , , , , , , , , , , 
, Sexually-transmitted diseases,, HIV/AIDS, , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
(17), Do you believe you have enough information on these topics
or do you want to know more?, , , , , , , , , , , 
, Maternal care, , , , , , , , , , , 
, Antenatal care, , , , , , , , , , , 
, Safe delivery, , , , , , , , , , , 
, Postnatal care, , , , , , , , , , , 
, Child care, , , , , , , , , , , 
, Acute respiratory infections, , , , , , , , , , , 
, Breast feeding, , , , , , , , , , , 
, Diarrhoea diseases control, , , , , , , , , , , 
, Oral rehydration therapy, , , , , , , , , , , 
, Childhood disabilities, , , , , , , , , , , 
, Child immunization, , , , , , , , , , , 
, Growth monitoring/nutrition education, , , , , , , , , , , 
, Community health, , , , , , , , , , , 
, Water supply, , , , , , , , , , , 
, Hygiene, , , , , , , , , , , 
, Sanitation, , , , , , , , , , , 
, Other health care, , , , , , , , , , , 
, Accidents and injuries, , , , , , , , , , , 
, Chronic,, non-communicable diseases, , , , , , , , , , , 
, Malaria, , , , , , , , , , , 
, Tuberculosis, , , , , , , , , , , 
, Sexually-transmitted diseases HIV/AIDS, , , , , , , , , , , 
(18), What is the name of the local CHW?, , , , , , , , , , , 
, Key (15)1 CHW; 2 Public health nurse; 3 Midwife; 4 Doctor; 5
Other (specify); 9 DK/NR, +, +, +, +, +, +, +, +, +, +, +


Cluster form: Antental care, safe delivery, and postnatal care
(1), Study No.  , N, , +, +, +, +, +, +, +, +, +
(2), Province No., A, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(3), Cluster No. , M, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(4), Interviewer, E, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(5), Respondent No. , , 1, 2, 3, 4, 5, 6, 7, 8, 9, 10
(6), Date      /      /      , , , , , , , , , , , 
(7), Age, , , , , , , , , , , 
(8), Sex, , , , , , , , , , , 
(9), How many live births have you had so far?, , , , , , , , , ,
, 
(10), Did you receive antenatal care during your last pregnancy?,
, , , , , , , , , , 
(11), How many times did you get antenatal care?, , , , , , , , ,
, , 
(12), How many months had you been pregnant before you got
antenatal care?, , , , , , , , , , , 
(13), Which is the principal place you received antenatal care?,
, , , , , , , , , , 
(14), Did anyone advise you to get antenatal care?, , , , , , , ,
, , , 
(15), Did you receive a tetanus vaccination during your last
pregnancy?, , , , , , , , , , , 
(16), How many vaccinations did you receive?, , , , , , , , , , ,
(17), During your pregnancy,, did you take iron pills to keep you
strong?, , , , , , , , , , , 
(18), What was the outcome of your most recent pregnancy?, , , ,
, , , , , , , 
(19), Where did the delivery take place?, , , , , , , , , , , 
(20), Who was the main person attending the delivery?, , , , , ,
, , , , , 
(21), What is the name of the local CHW?, , , , , , , , , , , 
(22), Has the CHW visited/contacted you during the last three
months?, , , , , , , , , , , 
Key (12), +, , (18), +, +, +, +, , +, +, +, +
1, three mo. (first trimester), 1, Live birth, +, +, +, +, +, +,
+, +, +
2, 4-6 mo. (second trimester), 2, Stillbirth, +, +, +, +, +, +,
+, +, +
3, 7-9 mo. (third trimester), 3Abortion /miscarriage, +, +, +, +,
+, +, +, +, +
9), DK/NR, 4), DK/NR, +, +, +, +, , , +, +, +
, , , , +, +, +, +, , , +, +, +
, , , , +, +, +, +, , , +, +, +
, , , , +, +, +, +, , , +, +, +
, , , , +, +, +, +, , , +, +, +
, , , , +, +, +, +, , , +, +, +
, , , , +, +, +, +, , , +, +, +
, , , , +, +, +, +, , , +, +, +
, , , , +, +, +, +, , , +, +, +
, , , , +, +, +, +, , , +, +, +
(13), , (20), , +, +, +, +, , , +, +, +
1), Hospital, 1), Doctor,, nurse,, nurse-midwife, +, +, +, +, +,
+, +, +, +
2), Health centre/clinic, 2), Trained TBACHW , +, +, +, +, , , +,
+, +
3), Private hospital/clinic, 3), Untrained TBA,, CHW, +, +, +, +,
+, +, +, +, +
4),  Local TBA/healer, 4),  Relative,, neighbor,, friend, +, +,
+, +, +, +, +, +, +
5), Other site of care, 5), Other: ______, +, +, +, +, +, +, +,
+, +
9), DK/NR, 9), DK/NR, +, +, +, +, , , +, +, +
(14), , , , , , , , , , , , 
1), Physician,, nurse, 5), Mother,, relative, +, +, +, +, +, +,
+, +, +
2), Community nurse,, midwife , 6), Friend,, neighbour, +, +, +,
+, +, +, +, +, +
3), CHW/volunteer, 7), Other:  _________ , +, +, +, +, +, +, +,
+, +
4), Traditional birth attendant , 9),   DK/NR, +, +, +, +, +, +,
+, +, +

Cluster form: Family planning
(1), Study No. ______________ , N, , +, +, +, +, +, +, +, +, +
(2), Province No. ___________ , A, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(3), Cluster No. ____________ , M, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(4), Interviewer ____________ , E, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(5), Respondent No. , , 1, 2, 3, 4, 5, 6, 7, 8, 9, 10
(6), Date ___/___/___ , , , , , , , , , , , 
(7), Age, , , , , , , , , , , 
(8), Sex, , , , , , , , , , , 
(9), Are you currently married or living with a partner?, , , , ,
, , , , , , 
(10), How many living children do you have?, , , , , , , , , , , 
(11), Have you given birth in the past 12 months?, , , , , , , ,
, , , 
(12), When was child born?, , , , , , , , , , , 
(13), Can you name one modern method of contraception?, , , , , ,
, , , , , 
(14), Do you know where you can obtain this method?, , , , , , ,
, , , , 
(15), Are you or your husband currently using any family planning
method?, , , , , , , , , , , 
(16), Which method are you/your husband using now?, , , , , , , ,
, , , 
(17), For how long have you been continually using (current
method)?, , , , , , , , , , , 
(18), For how long have you been continually practicing family
planning without interruption?, , , , , , , , , , , 
(19), What is the main source of your family planning service or
supplies?, , , , , , , , , , , 
(20), If you are not using family planning now,, have you or your
husband ever used any method in the past?, , , , , , , , , , , 
(21), Which method did you/your husband use most recently?, , , ,
, , , , , , , 
(22), Do you/your husband intend to practice family planning in
the future?, , , , , , , , , , , 
(23), What is the most important reason you are not using family
planning now?, , , , , , , , , , , 
(24), What is the name of the local CHW?, , , , , , , , , , , 
(25), Has the CHW visited/contacted you during the last three
months?, , , , , , , , , , , 
, , , , +, +, +, +, +, +, +, +, +
, , , , +, +, +, +, +, +, +, +, +
, , , , +, +, +, +, +, +, +, +, +
, , , , +, +, +, +, +, +, +, +, +
, , , , +, +, +, +, +, +, +, +, +
, , , , +, +, +, +, +, +, +, +, +
Key (16) and (21), +, ,  (17) and (18), +, +, +, +, +, +, +, , +
1), Tubectomy, , 1), << three months, +, +, +, +, +, +, ^, ^
2), Vasectomy, , 2), pit privy, +, +, +, +, +, +, ^, ^
3), IUD, , 3), 7-12 months, +, +, +, +, +, +, ^, ^
4), Oral pill, , 4),  1-2 years, +, +, +, +, +, +, ^, ^
5), Injection, , 5), 3-4 years, +, +, +, +, +, +, +, +
6), NORPLANT, , 6),  5 years or more, +, +, +, +, +, +, +, +
7), Condom, , 9),  DK/NR , +, +, +, +, +, +, +, +
8), IUD,, 8 Foam,, emco ,jelly,, cream,, diaphram, +, , +, +, +,
+, +, +, +, +, +
9), Safe period,, withdrawal, , , +, +, +, +, +, +, +, +, +
10), Other, , , +, +, +, +, +, +, +, +, +
99), DK/NR, , , +, +, +, +, +, +, +, +, +
(19), +, , , , +, +, +, +, +, +, +, +
1), Govt hospital/clinic, , 6), Private hospital/clinic, +, +, +,
+, +, +, +, +
2), Govt field worker, , 7), NGO clinic, +, +, +, +, +, +, +, +
3), Social marketing prog., , 8), NGO field worker, +, +, +, +,
+, +, +, +
4), Private physician, , 9), Other, +, +, +, +, +, +, +, +
5), Pharmacy, , 99), DK/NR, +, +, +, +, +, +, +, +
, , , , , , , , , , , , 
(23), +, , , , , , , , , , , 
1), Want more children,, 6), Method/service unavailable, +, +, +,
+, +, +, +, +
2, Husband objects, , 7), Sterility, +, +, +, +, +, +, +, +
3), Health reason, , 8), Breast feeding, +, +, +, +, +, +, +, +
4), Religious reasons, , 9), Pregnant, +, +, +, +, +, +, +, +
5), Fear side effects, , 10), Other, +, +, +, +, +, +, +, +
, , , 99), DK/NR, +, +, +, +, +, +, +, +

Cluster form: Acute respiratory infections
(1), Study No. , N, , +, +, +, +, +, +, +, +, +
(2), Province No.  , A, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(3), Cluster No. , M, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(4), Interviewer, E, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(5), Respondent No., , 1, 2, 3, 4, 5, 6, 7, 8, 9, 10
(6), Date      /      / , , , , , , , , , , , 
(7), Age, , , , , , , , , , , 
(8), Sex, , , , , , , , , , , 
(9), How many living children do you have under five?, , , , , ,
, , , , , 
(10), How many children << five years sleep in the same room as
adults or other children?, , , , , , , , , , , 
(11), How many people in your household smoke inside your house?,
, , , , , , , , , , 
(12), Are open fires for cooking or heating used inside your
house?, , , , , , , , , , , 
(13), Have any of your children been sick with a respiratory
illness within the last two weeks?, , , , , , , , , , , 
(14), Did you seek treatment for the most recent episode?, , , ,
, , , , , , , 
(15), Where did you seek treatment?, , , , , , , , , , , 
(16), What treatment were you given?, , , , , , , , , , , 
(17), Did you take the medicine for the prescribed length of
time?, , , , , , , , , , , 
(18), What is the name of the local CHW?, , , , , , , , , , , 
(19), Has the CHW visited/contacted you during the last three
months?, , , , , , , , , , , 
Key (15), +, (16), +, +, +, +, +, +, +, +, +, +
1), Treated at home, 1), Anti-microbial drugs, +, +, +, +, +, +,
+, , 
2), Visited the health centre, 2), Bronchodilator and/or cough
mixture , +, +, +, +, +, +, +, +, +
3), Contacted the CHW, 3), Antipyretic drugs, +, +, +, +, +, +,
+, , 
4), Other: _________ , 4), Other, +, +, +, +, +, +, +, , 
9), DK/NR , 9), DK/NR, +, +, +, +, +, +, +, , 

Cluster form: Breast feeding
(1), Study No., N, , +, +, +, +, +, +, +, +, +
(2), Province No. , A, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(3), Cluster No., M, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(4), Interviewer, E, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(5), Respondent No. , , 1, 2, 3, 4, 5, 6, 7, 8, 9, 10
(6), Date      /      / , , , , , , , , , , , 
(7), Age, , , , , , , , , , , 
(8), Sex, , , , , , , , , , , 
(9), How many living children do you have under two?, , , , , , ,
, , , , 
(10), Are you breast feeding your youngest child?, , , , , , , ,
, , , 
(11), After your baby was born,, when did you begin breast
feeding?, , , , , , , , , , , 
(12), Did you give the baby the colostrum?, , , , , , , , , , , 
(13), Why didn't you give the baby colosturum?, , , , , , , , , ,
, 
(14), Do you know why it is important to give the baby the
colostrum?, , , , , , , , , , , 
(15), At what age of the baby will you/did you stop breast
feeding?, , , , , , , , , , , 
(16), At what age will you/did you begin giving your baby formula
or milk other than breast milk?, , , , , , , , , , , 
(17), Water?, , , , , , , , , , , 
(18), Other liquids?, , , , , , , , , , , 
(19), Solid foods?, , , , , , , , , , , 
(20), Did any health worker teach you about the benefits of
breast feeding?, , , , , , , , , , , 
(21), Can you explain why it is important to breast feed?, , , ,
, , , , , , , 
(22), Were you taught about the supplemental foods and when they
should be introduced?, , , , , , , , , , , 
(23), Were you taught how to care for your breasts?, , , , , , ,
, , , , 
(24), What is the name of the local CHW?, , , , , , , , , , , 
(25), Has the CHW visited/contacted you during the last three
months?, , , , , , , , , , , 
, +, +, +, +, +, +, +, +, +, +, +, +
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, +, , +, +, +, +, +, +, +, +, , 
, +, , +, +, +, +, +, +, +, +, , 
Key (11), +, (13) , +, +, +, +, +, +, +, +, , 
1), Within three hours, 1), Problem with breast milk, +, +, +, +,
+, +, , , 
2), 3-12 hours, 2), Baby could not suck, +, +, +, +, +, +, , +, +
3), 13-24 hours, 3), Other, +, +, +, +, +, +, ^, ^, ^
4), << 24 hours, 9), DK/NR, +, +, +, +, +, +, ^, ^, ^
5), Not breast fed,  , +, +, +, +, +, +, +, ^, ^, ^
9), DK/NR^, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^, 

Cluster form: Diarrhoeal disease control/ORT
(1), Study No. , N, , +, +, +, +, +, +, +, +, +
(2), Province No. , A, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(3), Cluster No., M, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(4), Interviewer, E, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(5), Respondent No. , , 1, 2, 3, 4, 5, 6, 7, 8, 9, 10
(6), Date      /      /, , , , , , , , , , , 
(7), Age, , , , , , , , , , , 
(8), Sex, , , , , , , , , , , 
(9), How many living children do you have under five?, , , , , ,
, , , , , 
(10), Do you know what is meant by "diarrhoea?", , , , , , , , ,
, , 
(11), Has (oldest child under two) had diarrhoea in the last
month?, , , , , , , , , , , 
(12), How long did is last?, , , , , , , , , , , 
(13), Did you do anything to treat it or just let it run its
course?, , , , , , , , , , , 
(14), How did you treat it?, , , , , , , , , , , 
(15), Have you ever heard of ORT,, ORS,, SSS or (local name)?, ,
, , , , , , , , , 
(16), Is there any source of ORS in your village?, , , , , , , ,
, , , 
(17), Is there a person living in your village who has been
trained to use ORS?, , , , , , , , , , , 
(18), Do you know how to mix ORS?, , , , , , , , , , , 
(19), How long can this solution be used?, , , , , , , , , , , 
(20), How long can you administer ORS to a child with diarrhoea?,
, , , , , , , , , , 
(21), Do you give extra fluids during diarrhoea?, , , , , , , , ,
, , 
, gruel?, , , , , , , , , , , 
, soup?, , , , , , , , , , , 
, rice water?, , , , , , , , , , , 
, milk solutions with twice the water?, , , , , , , , , , , 
, other fluids?, , , , , , , , , , , 
(22), If the child is still breast feeding,, do you continue
breast feeding during diarrhoea?, , , , , , , , , , , 
(23), When your child has diarrhoea how often to you feed it?, ,
, , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , +, +, +, +, +, +, , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
(24), What is the name of the local CHW?, , , , , , , , , , , 
(25), Has the CHW visited/contacted you in the last three
months?, , , , , , , , , , , 
Key (13), +, , , , , , , , , , , 
1), Treated it2)   Let it run its course, , 9), DK/NR, +, +, , ,
, , , 
(14), +, , +, +, +, +, +, +, +, +, +, +
1), Treated it myself with packet of ORS, , 6), Took child to
local health worker, +, +, +, +, +, +, +, +
2), Treated it myself with homemade SSS, , 7), Took child to CHW
health provider, +, +, +, +, +, +, +, +
3), Treated it myself with gruel/cereal-based solid, , 8), Took
child to health clinic,, hospital, +, +, +, +, +, +, +, +
4), Took child to relative, , 9), Other (specify):
______________, +, +, +, +, +, +, +, +
5), Took child to neighbour, , 99), DK/NR, +, +, +, +, +, +, +, +
, , , , , +, +, +, +, +, +, +, +

Cluster form: Childhood disabilities
(1), Study No. , N, , +, +, +, +, +, +, +, +, +
(2), Province No.  , A, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(3), Cluster No.  , M, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(4), Interviewer , E, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(5), Respondent No., , 1, 2, 3, 4, 5, 6, 7, 8, 9, 10
(6), Date       /      / , , , , , , , , , , , 
(7), Age, , , , , , , , , , , 
(8), Sex, , , , , , , , , , , 
(9), How many children do you have?, , , , , , , , , , , 
(10), What are their names,, ages,, type of disability?, , , , ,
, , , , , , 
(11), How did your child become disabled?, , , , , , , , , , , 
(12), Do you know how to prevent a similar disability from
occurring again?, , , , , , , , , , , 
(13), Have you sought treatment or therapy for your child?, , , ,
, , , , , , , 
(14), Where did your child receive treatment or therapy?, , , , ,
, , , , , , 
(15), What are the available centres which could provide services
to help your child?, , , , , , , , , , , 
(16), What is the name of the local CHW?, , , , , , , , , , , 
(17), Has the CHW visited/contacted you in the last three
months?, , , , , , , , , , , 
Key (10)      (11), +, (14), +, +, +, +, , +, +, +, +, +
1), Movement1) Illness, 1), Therapy or treatment centre, +, +, +,
+, +, +, +, +, +
2), Deformity2) Birth, 2), Community group, +, +, +, +, +, +, +,
+, +
3), Hearing3) Injury, 3), Special school, +, +, +, , +, +, +, +,
+
4), Blindness4) Other, 4),  Other_______ , +, +, +, +, +, +, +,
+, +
5), Speech9) DK/NR , 9), DK/NR, +, +, +, , +, +, +, +, +
6), Behaviour, , , +, +, +, +, +, +, +, +, +
7), Other, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
9), DK/NR, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^

Cluster form: Child immunization
(1), Study No. , N, , +, +, +, +, +, +, +, +, +
(2), Province No.  , A, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(3), Cluster No. , M, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(4), Interviewer , E, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(5), Respondent No. , , 1, 2, 3, 4, 5, 6, 7, 8, 9, 10
(6), Date       /      /, , , , , , , , , , , 
(7), Age, , , , , , , , , , , 
(8), Sex, , , , , , , , , , , 
(9), How many living children do you have under two years?, , , ,
, , , , , , , 
(10), Has anyone from the health centre ever talked to you about
vaccinating your children?, , , , , , , , , , , 
(11), Do you know which childhood diseases can be prevented by
immunization?, , , , , , , , , , , 
, Diptheria, , , , , , , , , , , 
, Measles, , , , , , , , , , , 
, Whooping cough, , , , , , , , , , , 
, Tuberculosis, , , , , , , , , , , 
, Tetanus, , , , , , , , , , , 
, Polio, , , , , , , , , , , 
(12), Do you know age children should be vaccinated against
measles?, , , , , , , , , , , 
(13), Has oldest child under two been immunized?, , , , , , , , ,
, , 
(14), Do you have the immunization card for this child?, , , , ,
, , , , , , 
(15), If no card,, can you remember when your child was
vaccinated?, , , , , , , , , , , 
Transfer info. from EPI card, +, , , , , , , , , , , 
(16, BCG, , , , , , , , , , , 
(17), DPT 1, , , , , , , , , , , 
(18, DPT 2, , , , , , , , , , , 
(19), DPT 3, , , , , , , , , , , 
(20), Polio 1, , , , , , , , , , , 
(21), Polio 2, , , , , , , , , , , 
(22), Polio 3, , , , , , , , , , , 
(23), Measles, , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
(24), Child is on schedule for age?, , , , , , , , , , , 
(25), For children 12-24 months:Child is fully vaccinated, , , ,
, , , , , , , 
(26), When will you take your child for the (next) vaccination?,
, , , , , , , , , , 
, Mother knows, , , , , , , , , , , 
, Mother doesn't know, , , , , , , , , , , 
, Fully vaccinated (NA), , , , , , , , , , , 
, DK/NR, , , , , , , , , , , 
(27), What is the name of the local CHW?, , , , , , , , , , , 
(28), Has the CHW visited/contacted you in the last three
months?, , , , , , , , , , , 
Key (16) through (23): 1) Received on schedule; 2) Received off
schedule; 3) Not received, +, +, +, +, +, +, +, +, +, +, +, +

Cluster form: Growth monitoring/nutrition education
(1), Study No., N, , +, +, +, +, +, +, +, +, +
(2), Province No., A, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(3), Cluster No., M, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(4), Interviewer, E, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(5), Respondent No., , 1, 2, 3, 4, 5, 6, 7, 8, 9, 10
(6), Date       /      /, , , , , , , , , , , 
(7), Age, , , , , , , , , , , 
(8), Sex, , , , , , , , , , , 
(9), How many children do you have under two years?, , , , , , ,
, , , , 
(10), Is (name of oldest child under two) registered for growth
monitoring?, , , , , , , , , , , 
(11), Has any health worker ever explained growth monitoring
cards to you?, , , , , , , , , , , 
(12), Has this child ever been weighed by a health worker,, nurse
or doctor?, , , , , , , , , , , 
(13), Do you have your child's growth card at home?, , , , , , ,
, , , , 
(14), Please show me the card., , , , , , , , , , , 
(15), Interviewer: inspect card. Does growth card have age and
weight data plotted?, , , , , , , , , , , 
(16), Interviewer: record weighing history from growth card.
Total number of times weighed., , , , , , , , , , , 
(17), Times weighed in last quarter., , , , , , , , , , , 
(18), Can you explain the information on the growth card to me?,
, , , , , , , , , , 
(19), During the last prenatal and/or postnatal care visit,, were
you educated about how to improve the nutritional status of your
child?, , , , , , , , , , , 
(24), What is the name of the local CHW?, , , , , , , , , , , 
(25), Has the CHW visited/contacted you in the last three
months?, , , , , , , , , , , 
Key (15), +, , +, +, +, +, +, +, +, +, +, +
1), Yes,, plotted correctly0)  No,, not plotted, +, +, +, +, +,
+, +, +, +, +, +
2), Yes,, but plotted incorrectly                       9) 
DK/NR, +, +, +, +, +, +, +, +, +, +, +

Cluster form: Water supply, environmental sanitation and  hygiene
(1), Study No., N, , +, +, +, +, +, +, +, +, +
(2), Province No. , A, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(3), Cluster No., M, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(4), Interviewer , E, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(5), Respondent No., , 1, 2, 3, 4, 5, 6, 7, 8, 9, 10
(6), Date        /       /, , , , , , , , , , , 
(7), Age, , , , , , , , , , , 
(8), Sex, , , , , , , , , , , 
(9), Where do you usually get your drinking water?, , , , , , , ,
, , , 
(10), Is your water supply chlorinated?, , , , , , , , , , , 
(11), Do you usually boil water for drinking?, , , , , , , , , ,
, 
(12), How long does it take you to walk to your source of water?,
, , , , , , , , , , 
(13), Can you get enough water all year?, , , , , , , , , , , 
(14), Do you always wash your hands before handling food?, , , ,
, , , , , , , 
(15), Please explain why it is important to wash your hands?, , ,
, , , , , , , , 
(16), What is the primary way this household disposes of human
waste?, , , , , , , , , , , 
(17), Please explain why it is important to use a structured /
sanitary facility?, , , , , , , , , , , 
(18), What is the name of the local CHW?, , , , , , , , , , , 
(19), Has the CHW visited/contacted you in the last three
months?, , , , , , , , , , , 
INTERVIEWER OBSERVATIONS OF HOUSEHOLD, +, , , , , , , , , , , 
(20), Does water contianed have a clean cover/lid?, , , , , , , ,
, , , 
(21), Do pots,, pans,, plates and glasses appear clean?, , , , ,
, , , , , , 
(22), Are fruits,, vegetables,, meats covered and stored away
from small domestic animals?, , , , , , , , , , , 
(23), Does latrine appear to be used?, , , , , , , , , , , 
(24), Are the animals penned?, , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
(25), Does garbage appear to be disposed of in a sanitary way?, ,
, , , , , , , , , 
(26), What is the name of the local CHW?, , , , , , , , , , , 
(27), Has the CHW visited/contacted you in the last three
months?, , , , , , , , , , , 
Key (12), +, , , +, +, +, +, +, +, +, +, +
1), << 15 minutes2) >> 15 minutes, 9), DK/NR, +, +, +, , , , , , 
(9), , , , +, +, +, +, +, +, +, +, +
1), Clean source: faucet/tap,, pipe,, bore hole,, covered well,
+, +, +, +, +, +, +, +, +, +, +
2), Unclean source: open well,, pond/river/stream/rain water
catchment, +, +, +, +, +, +, +, +, +, +, +
3), Other (specify): ___________, , , +, +, +, +, +, +, +, +, +
9), DK/NR, , ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(16), , , , +, +, +, +, +, +, +, +, +
1), water-seal latrine   4)  open field, , , +, +, +, +, +, +, +,
+, +
2), pit privy   5)  bucket, , , +, +, +, +, +, +, +, +, +
3), WC     , , , +, +, +, +, +, +, +, +, +
9), DK/NR, , , +, +, +, +, +, +, +, +, +


Cluster form: Accidents and injuries
(1), Study No. , N, , +, +, +, +, +, +, +, +, +
(2), Province No., A, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(3), Cluster No. , M, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(4), Interviewer  , E, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(5), Respondent No., , 1, 2, 3, 4, 5, 6, 7, 8, 9, 10
(6), Date       /      /, , , , , , , , , , , 
(7), Age, , , , , , , , , , , 
(8), Sex, , , , , , , , , , , 
(9), Has anyone in this household had a serious accident or
injury in the past year?, , , , , , , , , , , 
, 9.1 Name, , , , , , , , , , , 
, 9.2 Age, , , , , , , , , , , 
, 9.3 Sex, , , , , , , , , , , 
, 9.4 Type of injury codes, , , , , , , , , , , 
, 9.5 Treated?, , , , , , , , , , , 
, 9.6 Where treated?, , , , , , , , , , , 
, 9.7 Outcome?, , , , , , , , , , , 
(10), If someone in your household was injured,, what would you
do to help them?, , , , , , , , , , , 
(11), Where are the nearest emergency care facilities?, , , , , ,
, , , , , 
(12), What is the name of the local CHW?, , , , , , , , , , , 
(13), Has the CHW visited/contacted you in the last three
months?, , , , , , , , , , , 
Key 9.4 Type of injury codes, +, 9.7 Outcome codes, +, +, +, +,
+, +, , +, +, +
01), Fall,  01),  Cured/recovered, +, +, +, +, +, +, +, +, +
02), Occupational injury, 02),  Still recovering, +, +, +, +, +,
+, +, +, +
03), Traffic injury, 03),  Permanent disability, +, +, +, +, +,
+, +, +, +
04), Poisoning, 04),  Death, +, +, +, +, +, +, +, +, +
05), Other (specify) ____________ , 05),  Other, +, +, +, +, +,
+, +, +, +
09), DK/NR, 09),  DK/NR, +, +, +, +, +, +, +, +, +
9.6 Where treated codes, +, , , , , , , , , , , 
01), Hospital, , , , , , , , , , , 
02), Health care centre, , , , , , , , , , , 
03), CHW, , , , , , , , , , , 
04), Traditional healer, , , , , , , , , , , 
05), Other (specify) ____________, , , , , , , , , , , 

Cluster form: Chronic, non-communicable diseases
(1), Study No., N, , +, +, +, +, +, +, +, +, +
(2), Province No. , A, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(3), Cluster No., M, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(4), Interviewer , E, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(5), Respondent No. , , 1, 2, 3, 4, 5, 6, 7, 8, 9, 10
(6), Date       /       /, , , , , , , , , , , 
(7), Age, , , , , , , , , , , 
(8), Sex, , , , , , , , , , , 
Diabetes, +, +, +, +, +, +, +, +, +, +, +, +
(9), Do you now what diabetes is?, , , , , , , , , , , 
(10), Have you or any household member ever been diagnosed as
having diabetes?, , , , , , , , , , , 
(11), Does anyone in this household have diabetes now?, , , , , ,
, , , , , 
(12), Is this person being treated?, , , , , , , , , , , 
(13), Is the prescribed treatment being followed?, , , , , , , ,
, , , 
(14), Do you monitor glucose level at home?, , , , , , , , , , , 
(15), Do you and your household members know how to handle a
diabetic emergency?, , , , , , , , , , , 
Hypertension, +, +, +, +, +, +, +, +, +, +, +, +
(16), Do you know what hypertension is?, , , , , , , , , , , 
(17), Have you or any household member ever been diagnosed as
having hypertension?, , , , , , , , , , , 
(18), Does anyone in this household have hypertension now?, , , ,
, , , , , , , 
(19), Is this person being treated now?, , , , , , , , , , , 
(20), Is the prescribed treatment being followed?, , , , , , , ,
, , , 
(21), Do you and your household members know what to do in case
of a heart attack or stroke?, , , , , , , , , , , 
Anaemia, +, +, +, +, +, +, +, +, +, +, +, +
(22), Do you know what anaemia is?, , , , , , , , , , , 
(23), Have you or any household member ever been diagnosed as
having anaemia?, , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
(24), Does anyone in this household have anaemia now?, , , , , ,
, , , , , 
(25), Is this person being treated now?, , , , , , , , , , , 
(26), Is the prescribed treatment being followed?, , , , , , , ,
, , , 
(27), What is the name of the local CHW?, , , , , , , , , , , 
(28), Has the CHW visited or contacted you during the last three
months?, , , , , , , , , , , 


Cluster form: Malaria
(1), Study No. , N, , +, +, +, +, +, +, +, +, +
(2), Province No. , A, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(3), Cluster No. , M, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(4), Interviewer , E, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(5), Respondent No. , , 1, 2, 3, 4, 5, 6, 7, 8, 9, 10
(6), Date ___/___/___, , , , , , , , , , , 
(7), Age, , , , , , , , , , , 
(8), Sex, , , , , , , , , , , 
(9), Can you explain to me what malaria is?, , , , , , , , , , , 
(10), Has anyone in your household had malaria since the
beginning of the year?, , , , , , , , , , , 
(11), How did you know that it was malaria?, , , , , , , , , , , 
(12), How many days did the malaria episode prevent that person
from conducting his/her daily activities?, , , , , , , , , , , 
(13), Do you know how malaria is spread?, , , , , , , , , , , 
(14), What are your household members currently doing to protect
themselves from malaria?, , , , , , , , , , , 
(15), Has anyone in your household died in the last 12 months?, ,
, , , , , , , , , 
(16), Which symptoms were present 1 week before death?, , , , , ,
, , , , , 
(17), What do you think was the cause of death?, , , , , , , , ,
, , 
(18), What is the name of the local CHW?, , , , , , , , , , , 
(19), Has the CHW visited/contacted you in the last three
months?, , , , , , , , , , , 
Key (11) and (16), +, (14), +, +, +, +, +, +, +, +, +, +
1), High fever, , 1) Using mosquito nets , +, +, +, +, +, +, , , 
2), Shivers, , 2) Using household sprays , +, +, +, +, +, +, , , 
3), Headache, , 3) Eliminating standing water, +, +, +, +, +, +,
+, +, +
4), Other ________, , 4) Using anti-malarial drugs, +, +, +, +,
+, +, , , 
9), DK/NR, , 5) Others, +, +, +, +, +, +, , , 
, , , 9) DK/NR, +, +, +, +, +, +, , , 


Cluster form: Tuberculosis
(1), Study No., N, , +, +, +, +, +, +, +, +, +
(2), Province No. , A, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(3), Cluster No., M, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(4), Interviewer, E, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(5), Respondent No., , 1, 2, 3, 4, 5, 6, 7, 8, 9, 10
(6), Date ___/___/___, , , , , , , , , , , 
(7), Age, , , , , , , , , , , 
(8), Sex, , , , , , , , , , , 
(9), Can you explain to me what tuberculosis is?, , , , , , , , ,
, , 
(10), Do you know how TB is spread?, , , , , , , , , , , 
(11), Do you know how to prevent infection?, , , , , , , , , , , 
(12), Were all your children vaccinated with BCG?, , , , , , , ,
, , , 
(13), Have you or any family members experienced a persistent
cough lasting more than two weeks?, , , , , , , , , , , 
(14), Did this person seek treatment for TB?, , , , , , , , , , ,

(15), Where did this person go to seek treatment?, , , , , , , ,
, , , 
(16), Was this person given medicine to treat TB?, , , , , , , ,
, , , 
(17), Did they take the medicine for the prescribed length of
time?, , , , , , , , , , , 
(18), What is the name of the local CHW?, , , , , , , , , , , 
(19), Has the CHW visited/contacted you in the last three
months?, , , , , , , , , , , 
Key (15), +, , +, +, +, +, +, +, +, +, +, +
1), Health centre3)  Other, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
2), CHW/volunteer9)  DK/NR, , , , , +, +, +, +, +, +, 


Cluster form: Sexually-transmitted diseases
(1), Study No., N, , +, +, +, +, +, +, +, +, +
(2), Province No., A, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(3), Cluster No., M, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(4), Interviewer , E, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(5), Respondent No., , 1, 2, 3, 4, 5, 6, 7, 8, 9, 10
(6), Date        /       /, , , , , , , , , , , 
(7), Age, , , , , , , , , , , 
(8), Sex, , , , , , , , , , , 
(9), Do you know what is meant by a sexually-transmitted
disease?, , , , , , , , , , , 
(10), Do you know what the difference is between HIV infection
and AIDS?  Probe for explanation., , , , , , , , , , , 
(11), Can a person who looks healthy be infected with an STD?, ,
, , , , , , , , , 
(12), Can a person get the AIDS virus by shaking hands with
someone who is infected with the virus?, , , , , , , , , , , 
(13), Can a pregnant woman who is infected with the HIV pass on
the virus to her unborn child?, , , , , , , , , , , 
(14), Can STDs be transmitted by having sex with someone who is
infected with an STD?, , , , , , , , , , , 
(15), Is there a cure for AIDS?, , , , , , , , , , , 
(16), What are you currently doing to prevent yourself or others
from becoming infected with an STD?, , , , , , , , , , , 
(17), Do you know how to use a condom correctly?, , , , , , , , ,
, , 
(18), Where have you obtained condoms during the last six
months?, , , , , , , , , , , 
(19), Have you been diagnosed with an STD in the past 12 months?,
, , , , , , , , , , 
(20), What was your diagnosed illness?, , , , , , , , , , , 
(21), Where did you go for treatment?, , , , , , , , , , , 
(22), How did you first learn about STDs?, , , , , , , , , , , 
(23), What is the name of the local CHW?, , , , , , , , , , , 
(24), Has the CHW visited/contacted you in the last three
months?, , , , , , , , , , , 
, , , , , , , , , , , , 
, +, , +, +, +, +, +, +, +, +, +, +
, +, , +, +, +, +, +, +, +, +, +, +
, +, , +, +, +, +, +, +, +, +, +, +
, +, , +, +, +, +, +, +, +, +, +, +
Key (16), +, (21), +, +, +, +, +, +, +, +, +, +
1), Using a condom, 1), Government hospital, +, +, +, +, +, +, +,
+, +
2), Practicing safer sex, 2), Government clinic or health centre,
+, +, +, +, +, +, +, +, +
9), Other, 3), Private hospital, +, +, +, +, +, +, +, +, +
0), Nothing, 4), Private clinic or health centre, +, +, +, +, +,
+, +, +, +
(18), , 5), Contacted a health worker, +, +, +, +, +, +, +, +, +
1), Government hospital, 6), Other _____________, +, +, +, +, +,
+, +, +, +
2), Government clinic or health centre, 9), DK/NR, +, +, +, +, +,
+, +, +, +
3), Private hospital, (22), +, +, +, +, +, +, +, +, +, +
4), Private clinic or health centre , 1), By word of mouth, +, +,
+, +, +, +, +, +, +
5), Local dispensary , 2), From a CHW or other health staff, +,
+, +, +, +, +, +, +, +
6), Health worker came to you, 3), Heard it on the radio, +, +,
+, +, +, +, +, +, +
7), Other _______________, 4), Other: ____________, +, +, +, +,
+, +, +, +, +
9), DK/NR, 9), DK/NR, +, +, +, +, +, +, +, +, +
(20), +, , +, +, +, +, +, +, +, +, +, +
1), HIV/AIDS, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
2), Other STD, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
9), DK/NR, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^


Cluster form: Vital events and health status
(1), Study No. , N, , +, +, +, +, +, +, +, +, +
(2), Province No. , A, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(3), Cluster No. , M, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(4), Interviewer, E, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(5), Respondent No. , , 1, 2, 3, 4, 5, 6, 7, 8, 9, 10
(6), Date      /      /, , , , , , , , , , , 
(7), Age, , , , , , , , , , , 
(8), Sex, , , , , , , , , , , 
(9), How many people live in this household?, , , , , , , , , , ,
(10), Married women of reproductive age (15 - 49):, , , , , , , ,
, , , 
, Age, , , , , , , , , , , 
, Pregnant?, , , , , , , , , , , 
(11), Children less than 24 months old:, , , , , , , , , , , 
, Name, , , , , , , , , , , 
, Age, , , , , , , , , , , 
, Sex, , , , , , , , , , , 
(12), Children 24 - 60 months old:, , , , , , , , , , , 
, Name, , , , , , , , , , , 
, Age, , , , , , , , , , , 
, Sex, , , , , , , , , , , 
(13), Other men,, women and children:, , , , , , , , , , , 
, Name, , , , , , , , , , , 
, Age, , , , , , , , , , , 
, Sex, , , , , , , , , , , 
Morbidity, +, +, +, +, +, +, +, +, +, +, +, +
(14), Is there anyone in your household who has been sick this
week?, , , , , , , , , , , 
, Who is/are sick?, , , , , , , , , , , 
(15), SI number, , , , , , , , , , , 
, Name, , , , , , , , , , , 
(16), Age, , , , , , , , , , , 
(17), Sex, , , , , , , , , , , 
(18), Disease code, , , , , , , , , , , 
(19), Treated?, , , , , , , , , , , 
(20), Where treated?, , , , , , , , , , , 
(21), Outcome, , , , , , , , , , , 
, +, , , , , , , , , , , 
, +, , , , , , , , , , , 
, +, , , , , , , , , , , 
, +, , , , , , , , , , , 
, +, , , , , , , , , , , 
, +, , , , , , , , , , , 
Mortality, +, , , , , , , , , , , 
(60), Were there any deaths in this household during the last 12
months?, , , , , , , , , , , 
(61), SI number, , , , , , , , , , , 
, Name, , , , , , , , , , , 
(62), Age, , , , , , , , , , , 
(63), Sex, , , , , , , , , , , 
(64), Cause of death, , , , , , , , , , , 
(65), Date died, , , , , , , , , , , 
(66), Died where, , , , , , , , , , , 
(67), Death "yes"/"no", , , , , , , , , , , 
(100), Were there any births in this household in the last 12
months?, , , , , , , , , , , 
(101), SI number, , , , , , , , , , , 
, Name, , , , , , , , , , , 
(102), Age, , , , , , , , , , , 
(103), Sex, , , , , , , , , , , 
(104), Outcome, , , , , , , , , , , 
(105), Date born, , , , , , , , , , , 
(106), Born where, , , , , , , , , , , 
(107), Birth certificate "yes"/"no", , , , , , , , , , , 
Key (18), +, , +, +, +, +, +, +, +, +, +, +
1), Diarrhoea/dysentery, 9), Tuberculosis, +, +, +, +, +, +, +,
+, +
2), Anaemia, 10), ARI, +, +, +, +, +, +, +, +, +
3), Scabies, 11), Fever, +, +, +, +, +, +, +, +, +
4), Diphtheria, 12), Malaria, +, +, +, +, +, +, +, +, +
5), Whooping cough, 13), Other: _________, +, +, +, +, +, +, +,
+, +
6), Tetanus, 99), DK/NR, +, +, +, +, +, +, +, +, +
7), Measles, , , +, +, +, +, +, +, +, +, +
8), Polio, , , +, +, +, +, +, +, +, +, +
(20), +, (21), +, +, +, +, +, +, +, +, +, +
1), Government clinic/hospital, 1), Cured/recovered, +, +, +, +,
+, +, +, +, +
2), Mobile clinic, 2), Still recovering, +, +, +, +, +, +, +, +,
+
3), Private clinic/hospital, 3), Permanent disability, +, +, +,
+, +, +, +, +, +
4), Private doctor, 4), Died, +, +, +, +, +, +, +, +, +
5), Private midwife/nurse, 5), Other: ___________, +, +, +, +, +,
+, +, +, +
6), Traditional practitioner, 9), DK/NR, +, +, +, +, +, +, +, +,
+
7), Pharmacy/drug store, , , , , , , , , , , 
8), Other: ______________, , , , , , , , , , , 
9), DK/NR, , , +, +, +, +, +, +, +, +, +
, +, +, +, +, +, +, +, +, +, +, +, +
, , +, +, +, +, +, +, +, +, +, +, +
, , , , +, +, +, +, +, +, +, +, +
, , , , , +, +, +, +, +, +, +, +
(64), , , +, +, +, +, +, +, +, +, +, +
1), Diarrhoea/Dysentery, 11), Pregnancy related, +, +, +, +, +,
+, +, +, +
2), Anaemia, 12), Heart disease, +, +, +, +, +, +, +, +, +
3), Scabies, 13), Cancer, +, +, +, +, +, +, +, +, +
4), Diphtheria, 14), Diabetes, +, +, +, +, +, +, +, +, +
5), Whooping cough, 15), Typhoid, +, +, +, +, +, +, +, +, +
6), Tetanus, 16), Accident, +, +, +, +, +, +, +, +, +
7), Measles, 17), Pneumonia, +, +, +, +, +, +, +, +, +
8), Polio, 18), Hepatitis, +, +, +, +, +, +, +, +, +
9), Tuberculosis, 19), Malaria, +, +, +, +, +, +, +, +, +
10), Acute respiratory inf., 20), Other, +, +, +, +, +, +, +, +,
+
, ,99), DK/NR, +, +, +, +, +, +, +, +, +
Key (66) and (106), +, (104), +, +, +, +, +, +, +, +, +, +
1), Government clinic/hospital, 1), Live birth (single), +, +, +,
+, +, +, +, +, +
2), Mobil clinic, 2), Live birth (twins), +, +, +, +, +, +, +, +,
+
3), Private clinic/hospital, 3), Live birth (2), +, +, +, +, +,
+, +, +, +
4), Private doctor's office/clinic, 4), Stillbirth, +, +, +, +,
+, +, +, +, +
5), Private midwife/nurse's clinic, 5), Died within 1 week, +, +,
+, +, +, +, +, +, +
6), Traditional practitioner's centre, 6), Died within 1 month,
+, +, +, +, +, +, +, +, +
7), Home, 9), DK/NR, +, +, +, +, +, +, +, +, +
8), Relative's house, , , , +, +, +, +, +, +, +, +
9), Other: ____________, , , ^, ^, ^, ^, ^, ^, ^, ^, ^
99), DK/NR, , , ^, ^, ^, ^, ^, ^, ^, ^, ^
, +, +, +, +, +, +, +, +, +, +, +, +


Cluster form: Child morbidity and mortality assessment
(1), Study No. , N, , +, +, +, +, +, +, +, +, +
(2), Province No. , A, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(3), Cluster No., M, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(4), Interviewer, E, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(5), Respondent No. , , 1, 2, 3, 4, 5, 6, 7, 8, 9, 10
(6), Date        /       / ,  , , , , , , , , , , 
(7), Age, , , , , , , , , , , 
(8), Sex, , , , , , , , , , , 
Module A: Child mortality, +, +, +, +, +, +, +, +, +, +, , 
(9), In what month and year were you born?, , , , , , , , , , , 
(10), How many of your sons are now living with you?, , , , , , ,
, , , , 
(11), How many of your sons are now living elsewhere?, , , , , ,
, , , , , 
(12), How many of your daughters are now living with you?, , , ,
, , , , , , , 
(13), How many of your daughters are now living elsewhere?, , , ,
, , , , , , , 
(14), Have you ever given birth to a child who later died,, even
if she/he lived only a short time?, , , , , , , , , , , 
(15), How many of your sons have died?, , , , , , , , , , , 
(16), How many of your daughters have died?, , , , , , , , , , , 
(17), INTERVIEWER: Sum the answers to questions 10-16., , , , , ,
, , , , , 
(18), Apart from these births,, have you had any other live
births?, , , , , , , , , , , 
(19), INTERVIEWER: If yes,, ask if now living or dead,, and
correct where necessary., , , , , , , , , , , 
(20), Could you give me the following information on all your
children born alive,, even if they are now dead,, beginning with
your last delivery?, , , , , , , , , , , 
, Child 1 month/year, , , , , , , , , , , 
, Child 1 sex, , , , , , , , , , , 
, Child 1 alive? If no,, date of death., , , , , , , , , , , 
, Child 2 month/year, , , , , , , , , , , 
, Child 2 sex, , , , , , , , , , , 
, Child 2 alive? If no date of death., , , , , , , , , , , 
(21), Respondent is:, , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
(22), How many years has it been since you were first married?, ,
, , , , , , , , , 
Module B: Child mortality, +, +, +, +, +, +, +, +, +, +, , +
(OPTIONAL: Use if difficult to construct histories), +, , , , , ,
, , , , , 
(23), In what month and year were you born?, , , , , , , , , , , 
(24), How many of your sons are now living with you?, , , , , , ,
, , , , 
(25), How many of your sons are now living elsewhere?, , , , , ,
, , , , , 
(26), How many of your daughters are now living with you?, , , ,
, , , , , , , 
(27), How many of your daughters are now living elsewhere?, , , ,
, , , , , , , 
(28), Have you ever given birth to a child who later died,, even
if she/he lived only a short time?, , , , , , , , , , , 
(29), How many of your sons have died?, , , , , , , , , , , 
(30), How many of your daughters have died?, , , , , , , , , , , 
(31), INTERVIEWER: Sum the answers to Questions 24 - 30., , , , ,
, , , , , , 
(32), Apart from these births,, have you had any others?, , , , ,
, , , , , , 
(33), INTERVIEWER: If yes,, ask if now living or dead and correct
where necessary., , , , , , , , , , , 
(34), Could you give me the following information on all your
children born alive,, even if they are now dead,, beginning with
your last delivery?, , , , , , , , , , , 
(35), In what month and year was your last live birth?, , , , , ,
, , , , , 
(36), Was this child a boy or a girl?, , , , , , , , , , , 
(37), Is she/he still alive?, , , , , , , , , , , 
(38), Did you have another live birth before this last one?, , ,
, , , , , , , , 
(39), Was this baby a boy or a girl?, , , , , , , , , , , 
(40), Is she/he still alive today?, , , , , , , , , , , 
(41), Respondent is:, , , , , , , , , , , 
(42), How many years has it been since you were first married?, ,
, , , , , , , , , 
, +, , , , , , , , , , , 
, +, , , , , , , , , , , 
, +, , +, +, +, +, +, +, +, +, +, +
, +, , +, +, +, +, +, +, +, +, +, +
, +, , +, +, +, +, +, +, +, +, +, +
INTERVIEWER: Check Q20 or Q28-33 to see if any infant or child
from this household is dead. For most recent death,, ask the
following questions:, +, , +, +, +, +, +, +, +, +, +, +
(43), Did (deceased child) die due to accident/illness?, , , , ,
, , , , , , 
(44), What was the accident?, , , , , , , , , , , 
(45), From what illness did child die?, , , , , , , , , , , 
(46), What were the signs/symptoms present two weeks before
death?, , , , , , , , , , , 
(47), In opinion of the interviewer,, of what did child die?, , ,
, , , , , , , , 
(48), How long did child have the illness?, , , , , , , , , , , 
(49), Was she/he taken somewhere to receive treatment for the
illness/accident before dying?, , , , , , , , , , , 
(50), Where was she/he taken?, , , , , , , , , , , 
(51), Where did she/he die?, , , , , , , , , , , 
(52), Do you have a death certificate?, , , , , , , , , , , 
(53), May I see that certificate?, , , , , , , , , , , 
(54), What was the cause of death,, stated on certificate?, , , ,
, , , , , , , 
(55), Has anyone else in this household died in last 6 mos?, , ,
, , , , , , , , 
(56), Name, , , , , , , , , , , 
, Age, , , , , , , , , , , 
, Symptoms prior to death, , , , , , , , , , , 
, Treatment received?, , , , , , , , , , , 
Child morbidity, +, +, +, +, +, +, +, +, +, +, +, +
(57), Has any child under two years been sick in last two weeks?,
, , , , , , , , , , 
(58), What were the symptoms of sickness?, , , , , , , , , , , 
(59), If diarrhoea,, how long was/is the episode?, , , , , , , ,
, , , 
(60), Does the child have diarrhoea today?, , , , , , , , , , , 
(61), Did you give the sick child ORS?, , , , , , , , , , , 
(62), Do you/did you continue breast feeding your baby during
illness?, , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
(63), If coughing etc.,, for how many days?, , , , , , , , , , , 
(64), When the child had illness with cough,, did she/he breathe
faster than usual with short rapid breaths?, , , , , , , , , , , 
(65), If poor weight gain,, has child had any of the following
symptoms?, , , , , , , , , , , 
, swollen feet?, , , , , , , , , , , 
, thin hair?, , , , , , , , , , , 
, sores inside mouth?, , , , , , , , , , , 
, dry eyes?, , , , , , , , , , , 
, blindness?, , , , , , , , , , , 
, no desire to laugh or play?, , , , , , , , , , , 
, failure to develop intelligence?, , , , , , , , , , , 
(66), Did you seek advise or treatment for the illness?, , , , ,
, , , , , , 
(67), Where did you seek advice or treatment?, , , , , , , , , ,
, 
(68), Was anything given to treat the illness?, , , , , , , , , ,
, 
(69), What was given to treat the illness?, , , , , , , , , , , 
(70), Were you told by the health care provider what illness your
child had?, , , , , , , , , , , 
(71), Does the child have the symptoms (mentioned above) today?,
, , , , , , , , , , 
(72), In opinion of interviewer,, what illnes does/did child
have?, , , , , , , , , , , 
(73), Has anyone else in this household been sick in the last two
weeks?, , , , , , , , , , , 
(74), Name, , , , , , , , , , , 
, Age, , , , , , , , , , , 
, Symptoms, , , , , , , , , , , 
, Treatment received?, , , , , , , , , , , 
(75), What is the name of the local CHW?, , , , , , , , , , , 
(76), Has the CHW visited/contacted you in the last three
months?, , , , , , , , , , , 
Key (21) and (41), +, (46), +, +, +, +, +, +, +, +, +, +
1), Woman herself, 1), Diarrhoea, +, +, , , , 7), Seizures, +, +
2), Her mother , 2), Diarrhoea with blood, +, +, +, +, +, 8),
Other, +, +
3), Her sister living in same house, 3), Cold, +, +, , , ,   
(specify):    , +, +, +
4), Other, 4), Difficulty breathing, +, +, +, +, ,  9), DK/NR, +,
+
, , 5), Rash or pimples, +, +, +, +, +, +, +, +, +
, +,  6), Fever, +, +, +, +, +, +, +, +, 
, +,     , ^, ^, ^, ^, ^, ^, ^, ^, ^, 
, +,   , +, +, +, +, +, +, +, +, +, +
, +, , +, +, +, +, +, +, +, +, +, +
, +, , +, +, +, +, +, +, +, +, +, +
, +, , +, +, +, +, +, +, +, +, +, +
(47), +, (50) and (51) , +, +, +, +, +, +, +, +, +, +
1), Infection (specify) ___________ , 1), Public hospital , +, +,
+, +, +, +, +, +, +
2), Diarrhoea, 2), Health centre, +, +, +, +, +, +, +, +, +
3), ARI (pneumonia), 3), Doctor's office, +, +, +, +, +, +, +, +,
+
4), nutrition, 4),  Clinic/private hospital , +, +, +, +, +, +,
+, +, +
5), Other (specify) _________ , 5), Pharmacy, +, +, +, +, +, +,
+, +, +
6), Vaccine preventable disease (specify) _________, 6)<R>7),   
Traditional healer Other (specify)     _________, +, +, +, +, +,
+, +, +, +
9), DK/NR, 9), DK/NR, +, +, +, +, +, +, +, +, +
(58), +, (67), +, , , , , , , , , 
1), Fever, 1), Government clinic/hospital, +, +, +, +, +, +, +,
+, +
2), Diarrhoea, 2), Mobile clinic, +, +, +, +, +, +, +, +, +
3), Difficulty breathing, 3), CHW, +, +, +, +, +, +, +, +, +
4), Poor weight gain/weight loss, 4), Private doctor, +, +, +, +,
+, +, +, +, +
5), Other (specify) _________, 5),  Traditional practitioner, +,
+, +, +, +, +, +, +, +
9), DK/NR, 6), Pharmacy/drug shop, +, +, +, +, +, +, +, +, +
, , 9), Other (specify) _________, +, +, +, +, +, +, +, +, +
, , , , , +, +, +, +, +, +, +, +
(69), +, (72), +, +, +, +, +, +, +, +, +, +
1), Injection, 1), Infection (specify) __________, +, +, +, +, +,
+, +, +, +
2), Antibiotic, 2), Diarrhoea, +, +, +, +, +, +, +, +, +
3), Anti-malarial, 3), ARI (pneumonia), +, +, +, +, +, +, +, +, +
4), Cough syrup, 4), Malnutrition, +, +, +, +, +, +, +, +, +
5), Other pill or syrup, 5), Other (specify) __________, +, +, +,
+, +, +, +, +, +
6)7), Unknown pill or syrup<R>Home remedy/herbal medicine, 6),
Vaccine preventable disease (specify) _______, +, +, +, +, +, +,
+, +, +
8), Other (specify)______________, 9), DK/NR, +, +, +, +, +, +,
+, +, +
9), DK/NR, , , +, +, +, +, +, +, +, +, +
, , , ^, ^, ^, ^, ^, ^, ^, ^, ^, ^


Cluster form: Adult morbidity and mortality assessment
(1), Study No. , N, , +, +, +, +, +, +, +, +, +
(2), Province No., A, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(3), Cluster No. , M, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(4), Interviewer , E, ^, ^, ^, ^, ^, ^, ^, ^, ^, ^
(5), Respondent No., , 1, 2, 3, 4, 5, 6, 7, 8, 9, 10
(6), Date ___/___/___, , , , , , , , , , , 
(7), Age, , , , , , , , , , , 
(8), Sex, , , , , , , , , , , 
(9), How many adults live in this household?, , , , , , , , , , ,

(10), Married women of reproductive age (15-44):, , , , , , , , ,
, , 
, Name, , , , , , , , , , , 
, Age, , , , , , , , , , , 
, Pregnant?, , , , , , , , , , , 
(11), Other men and women?, , , , , , , , , , , 
, Name, , , , , , , , , , , 
, Age, , , , , , , , , , , 
, Sex, , , , , , , , , , , 
Adult morbidity, +, +, +, +, +, +, +, +, +, +, +, +
(12), Has any adult in this household been sick in the past two
weeks?, , , , , , , , , , , 
(13), Please tell me their names and when sick?, , , , , , , , ,
, , 
, Name, , , , , , , , , , , 
, When sick?, , , , , , , , , , , 
(14), Is there any adult in your household who is sick today?, ,
, , , , , , , , , 
(15), What were/are the symptoms of the illness?, , , , , , , , ,
, , 
(16), How long did the illness last?, , , , , , , , , , , 
(17), Was advice or treatment sought?, , , , , , , , , , , 
(18), Where was advice or treatment sought?, , , , , , , , , , , 
(19), Was anything given to treat the illness?, , , , , , , , , ,
, 
(20), What was given to treat the illness?, , , , , , , , , , , 
(21), In the opinion of the interviewee,, what is/was the
illness?, , , , , , , , , , , 
(22), In the opinion of the interviewer,, what illness does/did
the person have?, , , , , , , , , , , 
Adult mortality, +, +, +, +, +, +, +, +, +, +, +, +
(23), Was there any death in this household during the last 12
months?, , , , , , , , , , , 
(24), Who died?, , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
(25), What symptoms were present two weeks before death?, , , , ,
, , , , , , 
(26), How long did (deceased),, have illness?, , , , , , , , , ,
, 
(27), Was advice or treatment sought?, , , , , , , , , , , 
(28), Where was advice or treatment sought?, , , , , , , , , , , 
(29), Was anything given to treat the illness?, , , , , , , , , ,
, 
(30), What was given to treat the illness?, , , , , , , , , , , 
(31), Where did the person die?, , , , , , , , , , , 
(32), Do you have a death certificate?, , , , , , , , , , , 
(33), May I see that certificate?, , , , , , , , , , , 
(34), What was the cause of death,, according to certificate?, ,
, , , , , , , , , 
(35), In the opinion of the interviewee,, what was the illness?,
, , , , , , , , , , 
(36), In the opinion of the interviewer,, what did the person die
of?, , , , , , , , , , , 
(37), What is the name of the local CHW?, , , , , , , , , , , 
(38), Has the local CHW visited/contacted you during the last
three months?, , , , , , , , , , , 
Key (15) and (25), +, +, (18),, (28) and (31), +, +, +, +, +, +,
+, +, +
1), High fever, , 1), Government clinic/hospita, +, +, +, +, +,
+, +, +
2), Diarrhoea, , 2), Mobile clinic, +, +, +, +, +, +, +, +
3), Weight loss, , 3), CHW, +, +, +, +, +, +, +, +
4), Persistent cough, , 4), Private doctor, +, +, +, +, +, +, +,
+
5), Cough w/sputum, , 5), Traditional practitioner, +, +, +, +,
+, +, +, +
6), Earache/ear discharge, , 6), Pharmacy/drug store, +, +, +, +,
+, +, +, +
7), Seizures, , 7), Other (specify) _________, +, +, +, +, +, +,
+, +
8), Weakness or lethargy, , 9), DK/NR, +, +, +, +, +, +, +, +
9), Other (specify), , (22), +, , , , , , , , 
99), DK/NR, , 1), Dysentery10), +, +, +, +, STD/HIV, +, +, +
, , , 2), Anaemia11 ), +, +, +, +,    Polio, +, +, +
(20) and (30), +, , 3), Scabies12) , +, +, +, +, Tuberculosis, +,
+, +
1), Injection, , 4), Diphtheria13) , +, +, +, +, ARI, +, +, +
2), Antibiotic, , 5), Whooping cough14)   Fever, +, +, +, +, +,
+, +, +
3), Anti malarial , , 6), Tetanus15) , +, +, +, +, Malaria, +, +,
+
4), Cough syrup, , 7), Measles16) , +, +, +, +, Other:, +, +, +
5), Other pill or syrup, , 8), Diabetes__________ , +, +, +, +,
+, +, +, +
6), Unknown pill or syrup, , 9), Hypertension99 , +, +, +, +,
DK/NR, +, +, +
7), Home remedy/herbal medicine, , , , , , , , , , , 
8), Other (specify) , , , , , , , , , , , 
9), DK/NR, , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
, , , , , , , , , , , , 
(35) and (36), +, , , +, +, +, +, +, +, +, +, +
1), Diarrhoea/Dysentery, 11),   Pregnancy- related, +, +, +, +,
+, +, +, +, +
2), Amemia, 12), Heart disease, +, +, +, +, , , +, +, +
3), Scabies, 13), Cancer specify, +, +, +, +, , , +, +, +
4), Diphtheria , 14), Diabetes, +, +, +, +, , , +, +, +
5), Whooping cough , 15), Typhoid, +, +, +, +, , , +, +, +
6, Tetanus , 16), Accident, +, +, +, +, , , +, +, +
7, Measles, 17, Pneumonia, +, +, +, , , , +, +, +
8,     Polio, 18, Hepatitis, +, +, +, +, , , +, +, +
9,  Tuberculosis, 19, Malaria, +, +, +, +, , , +, +, +
10 ), Hypertension, 99), DK/NR, +, +, +, +, , , +, +, +
20, Other specify, ,  , +, +, +, +, ,  , +, +, +Appendix E: Guidelines for training and supervising interviewers
Detailed guidelines can be found in any standard textbook on
survey methods. The following is a brief list of some hints that
are especially relevant for rapid surveys in PHC.

ASSIGNMENTS
Assign caseloads that can be easily completed within a few days.
Don't assign too many cases or clusters. A rule of thumb: one
interviewer can finish approximately 8-15 interviews, or 1-2
clusters per day.
Assign each interviewer to clusters close to one another to
reduce travel time and cost.
It's better to assign interviewers to areas where they are not
known, but also close to their homes.
Prepare the assignments before sending the interviewers to the
field. Make sure they know exactly where they are to go and what
they are to do.

MATERIALS
Interviewers should have the following: folder or three-ring
binder, enumeration forms, respondent assignments,
questionnaires, map of survey area, letter of introduction,
pencil, eraser.

BRIEFING AND TRAINING
Even experienced interviewers need to be given an orientation to
the survey so they can become familiar with the instrument and
the sampling plan, and raise questions.
Brief the interviewers as a group in order to develop team spirit
and a common understanding of the survey, and to share their
experiences, suggestions, and questions.
Share pre-test results and experience with similar surveys, if it
is available.
Develop a specific agenda for the briefing/training. Distribute
it to the interviewers so they will know what to expect.
Use an overhead projector or newsprint to review the instruments
and sampling procedures.
If your questionnaire includes open-ended questions or probes,
make sure that the interviewers know the most typical responses
for the former and the correct responses for the latter.
Have two experienced interviewers conduct an interview in front
of the group. Critique the interview and invite the group to join
in the critique.
Give each interviewer a chance to practice an interview, either
with another interviewer or in a practice session with a cluster.
Emphasize the importance of interviewing the selected
individuals, of not substituting, of setting up a convenient time
to call back for the interview, if necessary, and of travelling
to the household even if it is far away and the respondent may
not be home.
Review the "Interviewer's Code."  Explain to new interviewers the
rationale behind each item.

INTERVIEWER'S CODE, +
1., Be completely honest in your work.
2., Be reliable and conscientious.
3., Be completely objective in manner.
4., Be accurate and neutral in asking and recording answers to
questions.
5., Write the responses fully and legibly.
6., Be understanding,, patient,, but do not prod or lead the
respondent.  Never suggest an answer.
7., Be presentable: neat,, groomed,, clean.
8., Be prepared þ  read and understand the questions and
responses.
9., Be neutral.  Don't show reactions,, emotions,, agreement,, or
disagreement with responses.  Don't give your opinion.
10., Repeat a question if the respondent doesn't understand it.
11., Use an informal,, casual manner when asking the questions.
Try to build rapport and trust.  Avoid appearing to be superior
more intelligent,, judgmental,, or impatient.
12., Don't share the responses with others: neighbours,,
relatives. They are confidential.
13., Keep note of any problems or unexpected reactions that occur
during the interviews.  They may help improve the survey.<R>

SUPERVISION
Begin supervision during the briefing/training. Look for those
who may not be motivated in or knowledgeable about the survey.
Work with them. If they do not respond, replace them before
beginning the survey.
If enumeration is involved, have a larger number of enumerators
than needed for interviewing. Select the best enumerators to be
interviewers.
Tell the interviewers that there will be spot checks,
re-interviews to check validity, and perhaps a post-enumeration
survey.  Spot check five to ten percent of the sample.  The
smaller the sample, the greater the percentage of spot checks
should be.
Do spot checks and some re-interviews early on the first day.
Have the interviewers check their completed questionnaires before
they leave the cluster so that they can re-interview respondents,
if necessary.
At the end of the first day, have the interviewers review one
another's completed questionnaires and respondent disposition
forms to identify problems and to suggest solutions.
Appendix F: Cluster sampling programme

This appendix contains a computer program (Cluster identification
worksheet) for selecting cluster samples.  It uses a spreadsheet
program. You can load the computer file into Lotus 1-2-3,
Quattro, or any similar program that will accept 1-2-3  files.
You fill in the required information about the survey population
in the first three columns. The program generates a listing of
clusters and their locations in the last two columns. The program
can be used for single and multi-stage cluster sampling.

Cluster identification worksheet
This worksheet is the computerised version of the manual form
shown in Step 5.  It is a Lotus 1-2-3 spreadsheet named
CLUSTER.WK1.  Load it into your computer from the PHC MAP
diskette.
Although most people think of clusters as natural groupings of
people (villages, census tracts, urban blocks), this is
incorrect.  In cluster sampling you will divide your total survey
population into 30 equal groups.  Each of these groups will be a
"cluster." Then you will identify seven respondents in each of
these clusters.
You need to know the total population of your survey population
to determine the size of each cluster.  Simply divide the total
population by 30. For example, if your catchment area has 45,000
people, each cluster will include 1,500 people (45,000/30 =
1,500).
It doesn't matter if there are fewer or more than 30 "natural
clusters," since you will define the clusters by dividing the
total population into 30 groups of equal size.
It also doesn't matter if the population is scattered over a
large area. People can even be on islands or in remote areas and
still be included in the sample. If you want your sample to
represent all of your target population, then do not leave any
"natural clusters" out.  However, if it is not feasible to
include some areas, then leave them out.  BUT, your sample will
not represent those who are left out.  If you limit your sample
to people within one kilometre of a health centre, then that is
all it represents.

Complete the cluster identification worksheet
You must have estimates of the size of sample sub-units. List
these sub-units (villages, census tracts, voting precincts,
towns) in Columns A and B of the Cluster identification
worksheet. Record the population of each subunit in Column C.
This figure does not have to be exact. The relative size of each
subunit is what is important. Thus, you can use recent census
data even if it is a few years old.
The computer will calculate the cumulative population in Column D
and the total population.  In the example, this is 29,481, which
you can see at the bottom of Column C and on the second line at
the top of the page.
Enter the number of clusters you want at the top of the form (in
most cases this will be 30). The computer divides the total
population (29,481) by the number of clusters (30) to get the
cluster size (983), which is displayed on the third line at the
top.
This figure is also called the sampling interval: the interval
between one cluster and the next. That is, the cluster start
numbers will each be 983 units from one another.
The computer will now do two things when you press <<Enter>>.  It
will select a random start number and place it on the fourth
line. The example shows 491. Then it will use that number to
identify the start numbers for each cluster.  These will appear
in Column F. Column E gives you the numerical order of your 30
clusters.
DO NOT MAKE ANY CHANGES.  That will generate a new list of start
numbers. Print this list out first so that you have a record.
The last step is to identify the communities where those start
numbers are located.  Compare the first number in Column F (491)
with the cumulative figures (Column D).  Find the first number in
Column D that is greater than 491. That is 548 (Pagai).  Thus,
the first start number is in Pagai. Write that on the first line
in Column G. Do the same thing with the second start number in
Column F (1,474). The first number in Column D that is greater
than 1,474 is 1,964 (Serina).  Write that in Column G next to
1,474.  Continue until you have identified all 30 communities
where your start numbers are located.
Communities that have large populations (such as # 14 and # 16,
Pingra and Srivish) are likely to have more than one start
number.  That is because their population is two or three times
larger than the cluster size (983). Therefore, two or three of
your clusters may be in one community. 

Multi-stage sampling for large clusters
If your population is very large, you can select your sample in
stages. Start with the largest administrative unit, say
districts.  Select your 30 cluster start numbers and identify the
districts that will be in the sample.
You are going to list the population of the sub-units (say
sub-districts) of each of these districts.  Then you are going to
find the sub-district where the random start number is located.
Let's use Serina as an example.  Use the cluster identification
form to list all of Serina's subdistricts in Column A and each
subdistrict's estimated population in Column C, just as before. 
However, in the first row enter the name of the district (Serina)
and the corresponding cumulative population figure that was
generated in the first worksheet (1,278). You need to add that
number to Serina's population to match the start number with your
subdistricts.
The following example shows what your worksheet might look like.
Column D will give you a cumulative population for Serina.  Then
find the first number in Column D that is larger than the start
number for Serina (1,474), which is in Barley.

CLUSTER IDENTIFICATION WORKSHEET, +, +, +, +, +
Number of clusters, +, +, =, 30, 
Sample population size, +, +, =, 29,482, 
Cluster size (sampling interval), +, +, =, 983, 
Random start number, +, +, =, 491, 
A Community Name, B Community Number, C Estimated Population,  D
Cumulative Population, E Selected Cluster, F Start Number
Serina, , , 1278, , 
Kota, 1, 129, 1407, , 
Barley, 2, 123, 1530, 2, 1474
Sanburn, 3, 142, 1672, , 
Geneva, 4, 78, 1750, , 
N. Barn, 5, 106, 1856, , 
S. Barn, 6, 108, 1964, , 
Repeat this process for each of the 30 districts chosen.  Note
that you do not need to produce the output data (Columns E and F)
except for the first selection of start numbers.
You can also repeat this process for each selected subdistrict to
identify the villages where the start numbers are located. If the
households in the villages are numbered, you can actually
identify the individual household where you would start your
interviews.
However, it would be better to select your households at random
once you identify the smallest administrative unit. Simply number
them and select 7-10 households at random, more if the households
do not all include eligible respondents.

Appendix G: Other sampling tools
This appendix includes five computerised tools that you can use
for sampling. They are: 
APPENDIX G.1: ESTIMATES OF TARGET GROUP SIZES
APPENDIX G.2: SAMPLE SIZE ESTIMATION FOR WHO  TWO-STAGE,          
             CLUSTER SURVEY
APPENDIX G.3: RANDOM NUMBER TABLE
APPENDIX G.4: RANDOM SAMPLING PROCEDURES
APPENDIX G.5: ESTIMATING FERTILITY AND CHILD MORTALITY            
             RATES AND RATIOS
Appendix G.1:  Estimates of target group sizes
The following file (TARGET.WK1) is used to estimate the size of
the principal target groups in a given population. You will need
to know the approximate size of the total population under study
and the percentages of women and children by age. It also helps
to have approximate rates for births and deaths. Insert the
required information in the "USER INPUT" column, and the
programme will make all the necessary calculations.
For example, the data currently in the file show that in a
population of 4,196 there will probably be 1,096 married women
aged 15-49.  This would usually be a large enough group to draw
from for most samples.  However, there would be only two maternal
deaths each year in that population.  To have a large enough
sample of maternal deaths (say 20), you would have to have a much
larger population. You can determine how large that population
would have to be by increasing the estimated total population
number in the "USER INPUT" column until the "Maternal death"
figure reaches 20.
If you do not have the population size but know the number of
households and household size, multiply the two and enter the
estimated population size in cell F23.  Then insert the household
size and number of households in the appropriate cells (F24 and
GG25).  You could also change the formula in cell F23 to
(F24*G25).
Insert population estimates in the "USER INPUT" column. Estimates
of eligible subjects are computed and shown in the "COMPUTER
CALCULATED" column.  The estimates in this table are based on
data from Dhaka, Bangladesh. Enter data in WORKSHEET.

SUMMARY OF SAMPLES:, +, +, , 
Population4,196, +, Children, , 
Households800, +, Live Births, 147, 
, , Under 5, 565, 
Women2,037, +, 0-11 mo, 89, 
15-49 yrs1,096, +, 12-23 mo, 101, 
Maried women 15-49829, +, 24-60 mo, 375, 
Pregnacies  (1 yr)357, +, Deaths, , 
"Detectable"238, +, 0-11 mo, 20, 
Maternal deaths2, +, 1-4 yr, 3, 
, WORKSHEET, , USER INPUT, COMPUTER ESTIMATES
1.,  Estimated total population*(see note), , 4,196, 
2., Estimated household size, , 5.2, 
3., Estimated number of households, , 800, 
4., Estimated male/female ratio:, Males, 100, 0.94
, , Females, 106, 
5., Estimated number females, , 2,037, 
6., Population age distribution:, <<5 yrs, 13.5%, 274
, , 5-14 yrs, 28.2%, 575
, , 15-49 yrs, 53.8%, 1,096
, , >> 49 yrs, 4.4%, 89
7., Estimated married women 15-49:, , , 
, , Married, 75.7%, 829
, , Un-married, 20.0%, 219
, , Widowed, 3.3%, 36
, , Separated, 0.6%, 6
, , Divorced, 0.4%, 5
8., Estimated pregnancies (1 year):, , 357, 
, Est. crude birth rate, , 0.0350, 
, Est. pregnancy wastage, , 0.0500, 
, Est. pregnancy detection rate, , 66.6%, 
, Est. no. detected pregnancies, , 238, 
9., Estimated number of births (1 year):, , 147, 
10., Estimated number children  5 years:, , 565, 
, , 0-11   mo., 15.7%, 89
, , 12-23 mo., 17.9%, 101
, , 24-60 mo., 66.4%, 375
11., Estimated mortality:, , , 
, Infant deaths  1yr, IMR, 0.1340, 20
, Child deaths 1-4 yrs, CMR, 0.0066, 3
, Maternal deaths, MMR, 0.0110, 2
, , +, +, +
* NOTE: If you do not have the population size but have the
number of households and household size,, then multiply the two
and enter the estimated population size in cell F23.<%0>, +, +,
+, +
 
Appendix G.2: Sample size estimation for WHO two-stage cluster
survey
The program shown on the next two pages was developed by Ralph
Frerichs.  It can be used by the manager to determine the sample
size needed for a cluster and a random sample based on the
information summarised at the beginning of Step 5: Sampling.  The
manager merely needs to have:

an estimate of the proportion of the population with a particular 
attribute (children fully immunized);
the desired confidence interval (e.g., 90 percent);
the number of clusters  (usually 30);
the average number of respondents per cluster (usually 7-10);
and the estimated "intraclass correlation coefficient" (see
below). 

By trying different estimates of these five items, the program
can compute various sample sizes for both random and cluster
samples. The program also computes the design effect and
indicates with a Yes or No whether the sample size is acceptable
or not. The estimated confidence intervals at 90, 95, and 99
percent are also computed.
This program is designed to estimate the sample size for a single
population. This could be used, for example, to assess health
needs in a single district.  The "Hypothesis testing" program is
used for two samples. It could be used, for example, to compare
health needs in two districts, or in a "before and after" survey
to assess changes over time.

Note: The intraclass correlation coefficient is an estimate of
the homogeneity of subjects within a cluster. The value ranges
from 0 to 1, with 0 meaning that there is no difference between
people in one cluster and those in the others and Figure 1
meaning that the people within a cluster have similar
characteristics, e.g., they have all been immunized.
Frerichs summarised examples of coefficient values from several
studies. Infant deaths = 0.00 means that there is no difference
in the pattern of infant deaths from1 cluster to another.
Immunization coverage = 0.23 means that there is a moderate
tendency for children within a given cluster to have a similar
immunization history.  The tendency for children in a given
cluster either to have or not to have received the third dose of
DPT is even higher.

1. Infant deaths, 0.00
2. Tetanus, 0.002
3. Pertussis, 0.049
4. Measles, 0.099
5. Immunization coverage, 0.23
6. First dose DPT, 0.26
7. Trained birth attendant, 0.27
8. Second dose DPT, 0.31
9. Third dose DPT, 0.47
The computer file is reproduced on the next two pages.
Sample Size Estimation For WHO Two-stage, Cluster Survey

INSTRUCTIONS: Fill in estimates where indicated in the first
block.  The program computes sample sizes needed for: 1) random;
and 2) cluster samples.  It computes the design effect for a
cluster sample, and determines whether the sample size is
acceptable.  There are two programs: the first (below) is for
INTERVAL estimation (of one population).  The second (page down)
is for HYPOTHESIS TESTING (of two populations).

Interval estimation, , , , 
To be completed by the investigator, +, , , Fill In
Estimated proportion with the attribute, +, 0.300, , <<---
One-half length of confidence interval, +, 0.070, , <<---
Desired level of confidence, +, , , 
(90% = 1.64; 95% = 1.96; 99% = 2.58), +, 1.96, , <<---
Number of clusters (should be >>25), +, 30, , <<---
Average number per cluster, +, 7, , <<---
Intraclass correlation coefficient (ROH), +, 0.03, , <<---
Derived by the program, , , , 
Necessary variance of sample proportion, +, 0.001276, , 
Sample size if SIMPLE RANDOM SAMPLE, +, 165, , 
Variance of proposed cluster sample, +, 0.001180, , 
Sample size for proposed CLUSTER SAMPLE, +, 210, , 
Est. DESIGN EFFECT for cluster sample, +, 1.18, , 
Sample size specifications are OK, , Yes, , 
Interval estimation, , , , 
Estimated Confidence Interval, , , , 
for Prop. with Attribute of Interest, , , , 
Confidence Level, , , , 
Proportion, , , , 
ll, 90%, 95%, 99%, 
Upper, 0.3563, 0.3673, 0.3886, 
Lower, 0.2437, 0.2327, 0.2114, 
Scaling, 0, 0.2, , 
, , , , 
, , , , 
, , , , 
 
Hypothesis testing þ Two samples of equal size, +, +, +, +, +, +
, +, , , , Fill in, +
Est. proportion with the attribute in FIRST population, +, , ,
0.30000, , <<---
Est. proportion with the attribute in SECOND population, +, , ,
0.45000, , <<---
Desired level of statistical significance (<<.10=1.64;
<<.05=1.96; <<.01=2.58), +, , , 1.96, , <<---
Desired power of the test to statistically detect the est.
difference in proportions (90%=1.28; 95%-1.64; 99%=2.34), +, , ,
1.28, , <<---
Average number per cluster, +, , , 7.0, , <<---
Intraclass correlation coefficient (ROH), +, , , 0.30, , <<---
Derived by the program, , , , , , 
Necessary sample size if SIMPLE RANDOM SAMPLE, +, , , 277, , 
Necessary sample size per study group using indicated TWO-STAGE
CLUSTER SAMPLE, +, , , 268, , 
Necessary number of cluster (should be >>25), , , , 38, , 
Hypothesis testing, , , , , , 
Estimated confidence interval comparing two proportions, +, +, +,
, , 
Confidence level, , , , , , 
Proportion, 90%, +, 95%, +, 99%, +
Group, 1, 2, 1, 2, 1, 2
Upper, 0.344, 0.504, 0.360, 0.477, 0.379, 0.535
Lower, 0.250, 0.396, 0.240, 0.385, 0.221, 0.365
Scaling, 0.1, 1., , , , 

Appendix G.3:  Random number table
The following is an excerpt from a computer file that you can use
to generate a random number table to fit the exact size of your
population. Simply insert the population total in cell A5 (next
to the "name of the site") and press F9 to compute a new table.
The table shown below can also be used if desired.

Instructions: Insert population of area in cell A5, and name of
site in B5.  Press F9 to generate a new table.

POPULATION LOCATION, +, +, +, +, +, +, +, +, +, +, +, 
54333 Name of site, +, +, +, +, +, +, , , , , , 
24915, 28728, 4083, 48145, 52967, 20539, 53034, 25748, 15222,
26093, 17262, 34054, 18710
12052, 38180, 11757, 5655, 38328, 13608, 5880, 22224, 2305,
38875, 19594, 52698, 1676
24436, 1350, 8549, 34395, 22343, 49105, 50569, 22489, 52809, 
6607, 44172, 17752, 49278
35294, 41389, 12835, 6903, 10018, 42747, 44501, 36997, 17150,
54096, 4739, 50795, 26923
31465, 4052, 32750, 18660, 14822, 46328, 44573, 31431, 45381,
23786, 33666, 21510, 41315
21776, 23736, 10521, 5382, 4727, 32856, 4337, 22374, 9904, 13927,
3849, 9810, 8926
29411, 34179, 729, 40717, 22841, 33466, 27195, 50807, 6742,
48931, 27909, 34790, 50084
32584, 53626, 11545, 4857, 28178, 44561, 20125, 39882, 21661,
14308, 32240, 6268, 21327
52275, 16134, 10623, 18930, 21490, 46373, 20010, 14221, 8854,
53612, 6570, 34326, 18696
21015, 25697, 48932, 48878, 36688, 34894, 15185, 52622, 19397,
5018, 37853, 52805, 33842
13997, 28443, 30296, 7396, 1187, 33790, 18916, 17057, 34, 4524,
31494, 16299, 21785
40710, 33350, 24051, 6453, 4103, 46711, 8030, 45891, 12900,
32394, 37076, 3935, 38135
19613, 22626, 2583, 48516, 11411, 48799, 14255, 1657, 39772,
35774, 22326, 20213, 21128
  847, 45947, 51890, 20533, 50608, 41180, 6660, 24685, 36335,
21685, 3187, 17188, 16658
51940, 13339, 16290, 50604, 34248, 18475, 41654, 22904, 41918,
17744, 40221, 53259, 7454
34666, 6400, 38115, 43457, 29066, 37938, 48663, 13207, 54106,
26353, 38992, 646, 25245
53795, 42416, 37839, 4944, 49488, 3268, 29828, 31719, 25218,
8000, 54091, 1387, 10599
47298, 11475, 40299, 5581, 44313, 44970, 43092, 22395, 4123,
53023, 20522, 39512, 35042
38566, 38110, 53018, 21217, 52834, 9691, 28755, 52022, 5913,
53454, 9748, 39988, 27152
 5900, 41546, 29899, 26564, 43852, 21391, 21571, 777, 42471,
18507, 42773, 30803, 49582
17849, 33623, 22557, 50095, 4911, 14953, 50149, 15620, 43759,
3743, 5070, 46817, 39767
16971, 16508, 49742, 21519, 52255, 26407, 17498, 45044, 20970,
19092, 22916, 191, 13238
14520, 33512, 28660, 33586, 45367, 21949, 16742, 5034, 4606,
34919, 15502, 8596, 2494
48441, 24557, 17006, 52744, 47826, 41735, 24707, 29182, 30101,
22846, 25948, 22941, 46061
41316, 51594, 11655, 13294, 13885, 18902, 44388, 32140, 5591,
38674, 17344, 43322, 18216
  343, 39203, 41768, 43724, 21602, 25396, 38128, 10141, 4849,
44768, 23598, 37091, 16631
 3113, 24174, 25385, 37387, 5213, 7725, 18291, 16164, 45430, 
9772, 1635, 8887, 52886
13177, 49086, 15432, 33470, 48481, 33613, 21779, 22956, 36736,
30252, 21223, 31288, 3831
14346, 30653, 30707, 6967, 28512, 45098, 37737, 37292, 14776,
48411, 2876, 38916, 46928
20001, 35314, 530, 12032, 26052, 47288, 45279, 41895, 51900,
26258, 17915, 47449, 23819
19199, 42379, 19565, 17527, 21543, 43601, 16230, 42163, 32857, 
3619, 48956, 15042, 52169
 9642, 24455, 45602, 48868, 12106, 6764, 3057, 27829, 8733,
46640, 27891, 1943, 4840
43158, 13938, 10807, 43355, 26639, 10509, 8557, 51371, 53639,
40324, 29272, 43727, 53479
32643, 20883, 40714, 7581, 52465, 24645, 19246, 52994, 30613,
27726, 48323, 21174, 37907
51804, 31090, 22218, 30054, 3500, 25983, 36971, 9694, 721, 49434,
30191, 28057, 10290
 5645, 47968, 20234, 21049, 35440, 10047, 16982, 29559, 49152,
43912, 43427, 54206, 32397
33145, 39256, 32509, 40301, 26077, 52602, 39403, 51674, 47975,
39018, 738, 34710, 27716
13263, 41228, 39624, 42164, 21643, 17618, 34878, 31496, 10376,
16433, 51256, 19555, 53949
53580, 37567, 20427, 1890, 8027, 6334, 3690, 27925, 37262, 25135,
33802, 13097, 32877
48587, 6003, 12384, 30155, 48123, 36516, 41157, 45985, 24960,
23239, 31036, 43539, 24279

Appendix G.4:  Random sampling procedures
The random number spreadsheet shown in Appendix G.3 can also be
used to generate a random sample for you.  It can be used to
generate a complete sample or the last stage of a cluster sample. 
It can be used for any size population as well, from 100 cases to
more than 100,000 cases.
The basic principle behind random sampling is that every unit has
the same chance of being selected. To make this possible, you
need a complete and up-to-date listing of all members of the
target population that you wish to sample. If you go to a village
of 100 households, you can enumerate the households (give each
one a number) and draw your sample from that listing. Usually you
don't want to include all households, only those with eligible
respondents. Thus, your enumeration could be designed to list
only those households with children under age two years.  Then
you draw your sample from that listing.
Many PHC programmes do a complete listing of all households in
their catchment area every year.  Some have computerised records
of each family and each family member.  If you have either of
these, you can probably draw a random sample.  Stratified random
samples are preferred if the population is made up of
significantly different sub-populations. This is because they
provide more accurate data on each subgroup in your population. 
So if your population is made up of rural and urban subgroups,
poor and middle-class, or Hindu, Moslem, Christian, and Buddhist
sub-populations, AND your household registration system includes
information on these characteristics, then you can draw a random
sample fairly easily.  If the size of each group is known, it is
best to draw the sample in proportion to the total.  For example,
if Moslems constitute 60 percent of the population, then the
Moslem stratum should be 60 percent of the sample.

Once you have your listing of your population, follow these
steps:
1. Use TARGET.WK1 to estimate the size of each target group in
your population. You may skip this step if you have precise data
on the characteristics of each target group. For example, if you
know how many pregnant women there are in your area, go to the
next step. If you don't know, use TARGET to make an estimate.
2. Use SIZE.WK1 to determine the required sample size for each
target group. Suppose that you want to get information about
pregnant women who are enrolled in your programme. If you
estimate that 30 percent of them are enrolled, then you can use
SIZE.WK1 to estimate the size of the sample of pregnant women. 
At a 95 percent confidence level, that would be 165 women (see
Appendix G.2).
3. Use RANDOM.WK1 to generate a random sample of each target
group.  Finally, make sure that each pregnant woman in your
register has a sequential number (from 1 to N).  Assume that
there are 250 of these women. Enter this number (250) into cell
B4 of the Random number table (RANDOM.WK1).  Press F9 to generate
a random listing of these 250 women. Take the first 165 listed as
your sample.

The following excerpt from the Random number table displays this
listing.  If some of the women listed are not eligible or
available, substitute the next numbers on the list.

Instructions: Insert population of area in cell A5, and name of
area in cell B5.
Press F9 to generate a new table.
POPULATION  LOCATION, +, +, +, +, +, +, +, +
250 Pregnant women, +, +, +, +, +, +, +, +
173, 194, 109, 50, 7, 219, 82, 210, 174
216, 124, 107, 235, 50, 90, 98, 26, 67
151, 23, 34, 129, 71, 162, 183, 172, 70
169, 17, 7, 14, 41, 235, 106, 207, 185
113, 45, 91, 129, 95, 198, 213, 54, 220
154, 91, 98, 27, 207, 12, 38, 170, 18
206, 166, 130, 191, 106, 193, 162, 223, 192
104, 45, 128, 134, 205, 49, 70, 8, 114
24, 1, 169, 16, 18, 162, 15, 122, 142
152, 41, 10, 1, 81, 125, 124, 136, 112
112, 135, 141, 115, 130, 24, 5, 17, 66
130, 207, 76, 106, 15, 173, 115, 47, 240
214, 115, 151, 55, 130, 99, 109, 249, 49
69, 137, 74, 233, 75, 27, 208, 56, 68
24, 204, 219, 213, 90, 111, 51, 233, 18
200, 137, 174, 226, 216, 174, 61, 52, 2
184, 130, 35, 24, 222, 186, 51, 208, 238
201, 231, 209, 236, 28, 2, 81, 248, 42
 

Appendix G.5:  Estimating fertility and child mortality rates and
ratios
The vital events and mortality questionnaires (Appendix C)
produces the data you will need to construct both fertility and
mortality estimates. A rough rule of thumb is that you will need
about 200 respondents in each 5-year age group to have a large
enough sample to compute the estimates.
Since there are normally 7 age groups, that means that you will
need a sample of about 1,400 married women aged 15-49. That would
give you about 300 live births (an average of 30-50 per age
group). That is enough to compute fertility rates directly.
That same sample of 1,400 women would not provide enough cases to
compute child mortality rates directly, however. You would
identify only about 30-40 infant deaths and 4-6 child deaths in
the past year. Obviously, you would have to expand your sample
significantly to get enough cases to compute mortality rates
directly. If you use the TARGET.WK1 program to make some
estimates, you will find that you need to interview over 7,000
married women to find 20 child deaths over the past year.
There are a number of indirect techniques that demographers use
to estimate mortality and fertility rates. These techniques
produce "life tables" that show the probability of deaths or
births among different age groups. An example is shown below of a
table that provides estimates of child mortality by ages 1, 2, 3,
5, 10, 15, and 20. Child mortality (age 2-5) is computed by
subtracting infant mortality from under 5 mortality (0.50 - .028
= 0.022).
, +, +, +, +, +
Indirect measures of childhood mortality, +, +, +, +, 
Age group of women, Number of women, Number of children born,
Number of children dead , Percent Dead, Mortality measures
, , , , , 
15-19, 2,826, 285, 8, 0.028,  0-1 yr 
20-24, 2,648, 3,052, 105, 0.034, 0-2 yrs
25-29, 1,818, 5,851, 318, 0.054, 0-3 yrs
30-34, 1,334, 6,978, 350, 0.050, 0-5 yrs
35-39, 1,010, 7,054, 437, 0.061, 0-10 yrs
40-44, 1,029, 8,544, 705, 0.083, 0-15 yrs
45-49, 629, 5,641, 559, 0.099, 0-20 yrs
Total, 11,294, 37,405, 2,482, , 

If you use indirect methods, you should be able to get enough
cases with a sample of 1,700-2,000 married women. That is because
these methods rely on birth and death histories of women, not
just the events of the past year. Thus, each woman interviewed
can contribute information about several years of experience,
which may include two or three births or deaths.
Indirect methods are rather complex to compute, and you should
get help from a trained demographer before deciding to undertake
this kind of analysis.
The UNICEF handbook on Measuring childhood mortality shows how to
collect and process child mortality data using a short
questionnaire that we have included in Appendix C (Child
mortality).  You can use this questionnaire just like any other
in this module.  However, the authors caution not to change the
order of wording or questions.  They have been extensively tested
and any revisions could bias the results.  On the other hand, you
may combine this questionnaire with others to carry out a
multiple survey of several topics.
You can also use the cluster sampling methodology described in
this module.  Of course, your sample will have to be 10 times
larger than the typical 30 cluster x 7 respondent sample. You can
use the SIZE.WK1 program in this appendix to examine various
combinations of clusters and respondents.  The following list
will give you a rough idea of these combinations and the
associated design effects for samples of about 2,000. These
combinations are all based on the following assumptions:

Estimated proportion with the attribute (mortality), <P10M>5% 
One-half the length of the confidence interval, <P10M>.02  
That is,, the true value will be between 4 and 6%, 
Desired level of confidence, 95% = 1.96  
Estimated intraclass correlation coefficient, .005

Let us assume that you decide to draw 60 clusters of 34
respondents each.  Use the CLUSTER.WK1 file to select your
cluster start numbers. Follow the instructions to draw 34
respondents from each cluster (preferably at random). Although
the UNICEF methodology allows you to interview all eligible women
in a selected household, it would be better to interview only one
per household.  That will ensure that your results are more
representative of the area's population.

The UNICEF Handbook describes how to construct life tables and
other estimates of mortality. But as mentioned above, the
calculations are complex, and you should seek expert assistance
before trying to estimate mortality indirectly.

Clusters, Respondents, Sample size, Design 
Effect
30, 67, 2010, 1.33
40, 50, 2000, 1.25
50, 40, 2000, 1.20
60, 34, 2040, 1.17
70, 29, 2030, 1.14
80, 25, 2000, 1.12
90, 23, 2070, 1.11
100, 20, 2000, 1.10

Note: Obviously, you should change the assumptions 
to reflect your particular situation. However, all of these
combinations would produce results at the 95 percent confidence
level that are within two percentage points of the true mortality
rates.Appendix H: Survey management forms
The two forms on the next pages can be used to: 1) enumerate
eligible respondents within a cluster; and 2) record interview
experience with selected respondents.
Form 1 (Household enumeration) should be used at the final stage
of cluster sampling to identify all households in the cluster
that include an eligible respondent.  If there were 30 clusters,
then 30 of these forms would be filled out.  The top portion of
the form includes routine data (study name, date, etc.), a
statement of the eligibility criteria for respondents (e.g., all
married women age 15-49; children under two years old), and the
cluster number and community name (to make it easier to
identify).  It also includes the estimates taken from the sample
design (see Appendix F) of the total population in the cluster,
the expected number of households there, and the expected number
of respondents. These last figures will give the enumerator an
idea of the task at hand and can serve to verify the population
estimates.
The enumerator would go to each household in the cluster, and
give it an identifying number (HH No.).  If it doesn't have one,
the enumerator should determine whether the household is occupied
(HH Occ: Yes, No). The enumerator should then interview a
household resident to determine how many eligible respondents
live there (Elig Resp) and note anything unusual in the Remarks
column (e.g., away on holiday for two mo.).
After all of the households have been enumerated in all of the
clusters, the study team would use a random number table to
select the desired number of respondents (e.g., seven) from each
of these lists.  Those selected would be marked on the form
(Selected). Those households would then be transferred to Form 2.
Form 2 (Respondent disposition) would contain a list of the
households to be contacted.  A master list can be made out in the
office and copies of the assigned households given to each
interviewer.  If there were to be seven interviews per cluster,
and an interviewer were assigned three clusters, then each of ten
interviewers would be given a list of 21 households to contact (3
clusters x 7 respondents).
The interviewer would note the date that the first attempt was
made to interview the respondent (Attempted interview).  If the
respondent is not at home or for some reason cannot be
interviewed, then up to two "call-back" attempts would be made. 
The interviewer would write in the dates of these attempts.  He
or she would indicate in the next column (Interviewed Yes, No)
whether the respondent was successfully interviewed, and include
any relevant comments (e.g., refused, sick).
After the interviews are completed, the totals for each cluster
should be calculated.
This example assumes that there is no substitution for
respondents who are not at home or cannot be interviewed.  If
substitution is permitted, then the list of eligible respondents
can be increased.  For example, instead of selecting seven
respondents at random from Form 1, an addition number (say three)
could be added to be interviewed if one of the original seven
cannot be.

FORM 1: Household enumeration, +, +, +, +, +, , +, STUDY NAME:
_______________, +, +, 
ELIGIBILITY CRITERIA:___________________________, +, +, +, +, +,
+, +, +, , DATE:__________, +
CLUSTER NO:______, +, +, COMMUNITY NAME: ___________, +, +, +,
ENUMERATOR: ____________  __, +, +, +, 
EST. POPULATION: ______________  , +, +, +, +, HH:__________ , +,
ELIGIBLE RESPONDENTS:____________, +, +, +, +
SEQ No., HH No.., HH Occ., Elig Resp., Selected, Remarks, SEQNo.,
HHNo., HHOcc., Elig Resp.,  Selected, Remarks
1, , , , , , #26, , , , , 
2, , , , , , #27, , , , , 
3, , , , , , #28, , , , , 
4, , , , , , #29, , , , , 
5, , , , , , #30, , , , , 
6, , , , , , #31, , , , , 
7, , , , , , #32, , , , , 
8, , , , , , #33, , , , , 
9, , , , , , #34, , , , , 
10, , , , , , #35, , , , , 
11, , , , , , #36, , , , , 
12, , , , , , #37, , , , , 
13, , , , , , #38, , , , , 
14, , , , , , #39, , , , , 
15, , , , , , #40, , , , , 
16, , , , , , #41, , , , , 
17, , , , , , #42, , , , , 
18, , , , , , #43, , , , , 
19, , , , , , #44, , , , , 
20, , , , , , #45, , , , , 
21, , , , , , #46, , , , , 
22, , , , , , #47, , , , , 
23, , , , , , #48, , , , , 
24, , , , , , #49, , , , , 
25, , , , , , #50, , , , , 
Total, , , , , , Total, , , , , 


Form 2: , +, Respondent disposition, +, +, +, +, +, , , Study
name:, +, +, , , , +, 
Interviewer:, +, , +, +, +, , +, , , Date:, +, +, +, +, , +, 
ClusNo., SEQNo., HHNo., AttemptedInterview, +, +, Interview, +,
Remarks, ClusNo., SEQNo., HHNo., AttemptedInterview, +, +,
Interview, +, Remarks
, , , 1, 2, 3, Y, N, ^, , ^, ^, 1, 2, 3, Y, N, ^
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , , 
, TOTAL, , , , , , , , TOTAL, +, , , , , , , 



Appendix I: Tabulation and analysis templates
This appendix includes three tools that can help you organize and
carry out your analysis more easily. They are: 
Appendix I.1:  Analysis plan
Appendix I.2:  Data entry and analysis templates
Appendix I.3:  Confidence interval estimation template
Appendix I.1:  Analysis plan
The following is an illustrative analysis plan for a rapid
survey. The plan is a list of suggested frequency distributions,
averages (means), and cross-tabulations. The first frequency
distribution shows how a table would be set up, with
subclassifications of the variable (age) and the number and
percent distributions laid out. The numbers in parentheses refer
to the variables coding numbers on the questionnaire.

RAPID SURVEY QUESTIONNAIRE: Breastfeeding and growth monitoring
Frequency distributions
1. Number of women by age (6)N and percent
Categories      N   %
aged 15 to 19 years  ________
aged 20 to 24 years  ________
aged 25 to 29 years  ________
aged 30 to 34 years  ________
aged 35 to 39 years  ________
aged 40 to 44 years ________
aged over 44 years  ________
Total  ________ 100 %
Mean age of respondents:______Yrs.

2. Number of women by number of children under age two (7)
No. children    (0)
One child (1)
Two children   (2)
Three or more children  (3)

3. Number of women currently BREAST FEEDING (8)
Yes  (1)
No   (0)
Don't Know(9)
4. Time after birth that BREAST FEEDING began (9)
Within 3 hours  (1)
3 - 12 hours   (2)
13 - 24 hours  (3)
More than 24 hours (4)
DK/NR(9)
 
5. Number for women who fed baby colostrum (10)
Yes  (1)
No   (0)
DK/NR(9)
 
6. Mean age at which BREAST FEEDING will/did stop:___months (11)
 
7Mean age at which mothers will/did begin supplementary foods: 
____months (12)
 
8.Proportion of children under 2 registered for growth monitoring
(13)
Yes  (1)
No   (0)
DK/NR(9)
 
9.Proportion of mothers who have had growth monitoring explained
to them by health workers (14)
Yes  (1)
No   (0)
DK/NR(9)
 
10.Proportion of women who have had their children weighed by a
health worker, nurse, or doctor (15)
Yes  (1)
No   (0)
DK/NR(9)
 
11.Proportion of mothers who have growth card at home (16)
Yes  (1)
No   (0)
DK/NR(9)
 
12.Proportion of mothers with card who were able to find it (17)
Yes  (1)
No   (0)
DK/NR(9)
 
13.Proportion of cards with weight and age correctly plotted (18)
Yes, correctly plotted    (1)
Plotted, but incorrectly(2)
Not plotted  (0)
DK/NR(9)
 
14.Total number of times children with cards have been weighed
(19)
Mean number of times weighed:____
 
15.Total number of times children with cards weighed in the past
quarter (20)
Mean number of times weighed:____
 
16.Proportion of mothers with cards who can explain it correctly
(21)
Yes  (1)
No   (0)
NR   (9)
 
17.Proportion who know name of their local CHW (22)
Yes  (1)
No   (0)
NR   (9)

18.Proportion who have been visited by a CHW during the past
three months (23)
Yes  (1)
No   (0)
NR   (9)

Cross-tabulations
Cross-tabs are generally not used in cluster samples because the
sample cannot be broken into subsamples for comparison of one
subgroup to another. That is, the statistics that are produced by
cross-tabs cannot be used. However, cross-tabs may still be
useful in a qualitative sense. They may give the manager an idea
of possible relationships that could be examined more closely in
future investigations.  If you are using random or stratified
samples, then cross-tabs are appropriate as one of the most
important types of analysis.
The proposed cross-tabs examine the distribution of an
independent variable (e.g., number of children) by a dependent
variable (age) to see if there is a correlation between the two
variables. That is, does the number of children vary according to
the age of the mother?  The rapid surveys tend to include very
few dependent variables.  Age is the predominant one in this
example.  Others that might be important and could be added
include sex, education, literacy, race, ethnic group, income
level, and location.

1. Age of mother (6) by
Number of children (7)
Number of women who breast fed with colostrum (10)
Number of women who have their child's growth chart at home (12)
Number of children registered for growth monitoring (13)
Number of children weighed at least once (15)
Number of mothers whose chart is correctly plotted (18)
Number of mothers who can explain the growth chart (21)
 
2. Community health worker's visit (17) by
Number of children (7)
Number of women who breast fed with colostrum (10)
Number of children registered for growth monitoring (13)
Number of children weighed at least once (15)
Number of mothers whose chart is correctly plotted (18)
Number of mothers who can explain the growth chart (21)

Appendix I.2: Data entry and analysistemplates

The sample printouts that follow illustrate how survey data can
be entered into a preformatted spreadsheet that will
automatically compute most of the basic counts, averages, and
frequency distributions that you will need.  The first
spreadsheet (MINIGM.WK1) can be used to summarise data for 30
clusters with up to 11 variables in addition to the descriptors.
The second (RAPIDANC.WK1) covers 14 variables, plus descriptors,
and includes multiple choice questions.  It can be used to enter
all 210 responses from the 30 clusters.
This same format can be used for entering data manually. Simply
use several sheets of ruled paper, draw vertical lines to
separate the columns, label the variables along the top, and
enter the data in each row.
The format and construction of these templates are identical; the
only difference is the number of variables and respondents. The
MINIGM file has been set up to summarize data for 30 clusters.
The RAPIDANC file has been set up for 210 respondents.  Both can
be enlarged or reduced simply by inserting or deleting the
appropriate number of rows. Variables can be added or deleted as
well, although this is a bit more complicated since each variable
will have its own coding structure.
The top border of both templates shows a summary of the variables
and their corresponding codes or abbreviations for easy
reference.  Those codes or abbreviations are repeated in the row
below.  For example, in the MINIGM spreadsheet Ch refers to
variable 6: No. Children under age 2.  In the RAPIDANC
spreadsheet the variable's code number (9, 12, etc.) is used
instead of abbreviations.
To enter data the interviewer simply needs to key in the precoded
data from a cluster or questionnaire into a row.  For example,
starting to the right of "Quest." 1 in the MINIGM spreadsheet,
enter the date under variable 4, then the cluster's ID number in
the next column (5), the total number of children the respondents
have under age 2 in the next column (6), and so forth through
item (17). Repeat this process until all data from all
questionnaires have been entered.
Many entries will simply be coded 1 for "Yes," 0 for "No," and 9
for "Don't Know/No" Response. Some multiple choice items may have
additional codes (see, for example, variables 9, 10, 11, 13, 15,
and 17 in the RAPIDANC spreadsheet).  If an item is blank on the
questionnaire, it should be left blank in the spreadsheet.  Do
not enter a 0, as that is usually a negative response and will be
counted as such.  Do not press the space bar, as that inserts an
invisible apostrophe (').  In fact, do not enter anything, since
the program counts all non-blank cells when it does tabulations.
This program has no error-checking features, so it will be
important to verify the entries to make sure that they are
correct.  There are two simple ways to do this: 1) enter the data
twice in two separate files, print them out, and compare the
entries; and 2) use a two-person team to enter the data, with the
first reading out the data and checking what the second person
enters.


MINI-SURVEY QUESTIONNAIRE, GROWTH MONITORING
16/January/1991
, Study No. ___________, +, +, Prov. ___________, +, +, +,
Interviewer _____________, +, +, +, +, +
, , (1), , , , (2), , (3), +, +, +, , 
, ID    ID No. , , +, BSup Begin Supp Food, +, +, +, SH Shows
card, +, +, +, , 
, Ch<<2 Children under two, +, +, <%-2>RGM Registered for GM<%0>,
+, +, +, #Wt Times weighed, +, +, +, , 
, BF Breastfeeding baby, +, +, W Ever Weighed, +, +, +, WLQ #
weights last qtr, +, +, +, +, 
, SBF Age Stop Breastfeeding, +, +, <%-2>CH <%-6>Growth chart at
home, +, +, +, EXC Can explain chart, +, +, +, +, 
, (4), (5),  (6), (7), (8), (9), (10), (11), (12), (14), (15),
(16), (17)
Ques, Date , ID, Ch 2, BF, SBF, BSup, RGM, W, CH, SH, #Wt, WLQ,
EXC
1, 24/April/1990, 101, 1, 1, 24, 6, 1, 1, 1, 0, , , 
2, 24/April/1990, 102, 2, 0, 14, 4, 1, 0, 0, , , , 
3, 24/April/1990, 103, 1, 1, 16, 7, 0, 1, 9, , , , 
4, 24/April/1990, 104, 1, 1, 4, 8, 0, 1, 9, , , , 
5, 24/April/1990, 105, 1, 1, 12, 9, 1, 1, 0, , , , 
6, 24/April/1990, 106, 1, 1, 15, 5, 1, 1, 0, , , , 
7, 24/April/1990, 107, 1, 1, 18, 7, 1, 1, 1, 0, , , 
8, 24/April/1990, 108, 1, 1, 21, 12, 1, 1, 1, 1, 3, 1, 1
9, 24/April/1990, 109, 2, 0, 22, 2, 1, 0, 1, 1, 2, 1, 1
10, 24/April/1990, 110, 1, 1, 25, 14, 0, 1, 0, , , , 
11, 24/April/1990, 111, 1, 1, 32, 13, 1, 1, 1, 1, 3, 1, 0
12, 24/April/1990, 112, 1, 1, 12, 10, 1, 1, 0, , , , 
13, 26/April/1990, 113, 2, 1, 14, 8, 1, 1, 1, 1, 4, 1, 1
14, 26/April/1990, 114, 1, 1, 16, 5, 0, 1, 9, , , , 
15, 26/April/1990, 115, 1, 1, 18, 9, 1, 1, 0, , , , 
16, 26/April/1990, 116, 1, 0, 15, 12, 1, 0, 1, 1, 2, 1, 1
17, 26/April/1990, 117, 1, 1, 13, 16, 1, 1, 0, , , , 
18, 26/April/1990, 118, 1, 1, 17, 8, 0, 1, 9, , , , 
19, 27/April/1990, 119, 1, 1, 22, 9, 1, 1, 0, , , , 
20, 27/April/1990, 120, 1, 1, 21, 6, 1, 1, 1, 1, 1, 1, 1
21, 27/April/1990, 121, 1, 1, 13, 11, 1, 1, 0, , , , 
22, 27/April/1990, 122, 2, 1, 14, 14, 1, 1, 9, , , , 
23, 27/April/1990, 123, 1, 1, 16, 6, 1, 1, 0, , , , 
24, 27/April/1990, 124, 2, 1, 18, 9, 1, 1, 1, 1, 4, 2, 1
25, 27/April/1990, 125, 1, 0, 22, 9, 1, 0, 1, 1, 3, 1, 0
26, 27/April/1990, 126, 2, 1, 21, 6, 1, 1, 1, 0, , , 
27, 27/April/1990, 127, 1, 1, 24, 5, 1, 1, 0, , , , 
28, 27/April/1990, 128, 2, 1, 26, 4, 1, 1, 1, 1, 4, 1, 1
29, 27/April/1990, 129, 1, 1, 22, 12, 1, 1, 0, , , , 
30, 27/April/1990, 130, 1, 1, 14, 10, 1, 1, 9, , , , 
Total, 30, 30, 30, 30, 30, 30, 30, 30, 30, 12, 9, 9, 9
, , , , , , , , , , , , , 
, , , , +, , , , , , , , , 
, , , , +, , , , , , , , , 
, , , , +, , , , , , , , , 
, , , , +, , , , , , , , , 
, , , , +, , , , , , , , , 
, , , , +, , , , , , , , , 
, , , , +, , , , , , , , , 
, , , , +, , , , , , , , , 
, , , , +, , , , , , , , , 
, , , , +, , , , , , , , , 
, +, , , +, , +, , +, , , +, , 
Number, +, , 37, +, 541, +, 256, +, , 26, +, 10, 
Average, +, , 1.23, +, 2.89, +, 1.11, +, , 2.89, +, 1.11, 
, +, +, +, , , , , , , , , , 
, +, +, +, , , , , , , , , , 
Frequency Distributions:, +, +, +, , BF, , RGM, W, CH, SH, , ,
EXC
, 1 Yes, , , , 26, , 25, 26, 12, 9, , 7, 
, 0 No, , , , 4, , 5, 4, 12, 3, , , 2
, 9 UNK/NR, , , , 0, , 0, 0, 6, 0, , , 0
, , +, +, +, +, +, +, +, +, +, +, +, +
, PROBLEM HIGHLIGHTER: IF NO >> 10 PROBLEM NOTED BELOW AS 1., +,
+, +, +, +, +, +, +, +, +, +, +
, PROBLEM = 1 :, +, , , 0, , 0, 0, 1, 0, , , 0
, +, +, , , , , , , , , , , 
Percentage distributions:, +, +, , , EP, , RGM, W, CH, SH, , ,
EXC
, 1 Yes, , , 86.7%, +, , 83.3%, 86.7%, 40.0%, 75.0%, +, , 77.8%
, 0 No, , , 13.3%, +, , 16.7%, 13.3%, 40.0%, 25.0%, +, , 22.2%
, 9 UNK/NR, , , ,  0%, , 0, 0, 20.0%, 0.0%, , , 0.0%
Data Base Range Instructions:, +, +, +, +, +, , , , , , , , 
, , , , , BF, , RGM, W, CH, SH, , , EXC
, , , , , 1, , 1, 1, 1, 1, , , 1
, , , , , BF, , RGM, W, CH, SH, , , <%-2>EXC<%0>
, , , , , 0, , 0, 0, 0, 0, , , 0
, , , , , BF, , RGM, W, CH, SH, , , EXC
, , , , , 9, , 9, 9, 9, 9, , , 9
GRAPH INFORMATION, +, +, +, +, +, , , , , , , , 
Three graphs have been prepared for this spreadsheet. One is
always active. Press F10 to view it,, and F10 again to return to
the spreadsheet., +, +, +, +, +, +, +, +, +, +, +, +, +
To view the other graphs press /,Graph,Name,, (highlight name
desired)., +, +, +, +, +, +, +, +, +, +, +, +, 
Graph Names:, +, +, +, +, +, +, +, +, +, +, +, , 
% Brstfed        Percent children breast fed, +, +, +, +, +, +,
+, +, +, +, +, , 
%WEIGHED   Percent of children ever weighed, +, +, +, +, +, +, +,
+, +, +, +, , 
REG_GM       Percent of children registered for growth
monitoring, +, +, +, +, +, +, +, +, +, +, +, , 
, , , , , , , , , , , , , 



When all of the data have been entered, press F9 to calculate (or
recalculate) the totals, averages, and frequency distributions.
These are shown at the bottom of each spreadsheet, after the last
respondent's questionnaire.  The large spreadsheet (RAPIDANC)
includes a macro to move quickly to this area (press << Alt + F
>>). 
There are several types of calculations shown, most of which are
shown in the same column as the data for a given variable. For
example, the computation of the average number of children under
age two is directly under the data entries for that variable in
Column D.

Counts (totals of columns)
30 respondents to questions 5-12
12 respondents to question 14
37 children >> 2 yrs

Averages (means)
1.23 children << 2 per respondent 
Stop breast feeding at 18.03 months
Children weighted 2.89 times

Frequency and percentage distributions
26 women (86.7%) breast feeding
4 women (13.3%) not breast feeding
Problem highlighter
More than 10 respondents did not have a growth chart at home
 
The "problem highlighter" allows the manager to set a level above
which a particular response is considered a problem.  In the
MINIGM spreadsheet, that level is set at 10 (cell F54).  The
level can be set to any number merely by typing it in the cell. 
The program compares the number of "No" responses in each column
to 10 and places a 0 or 1 in the next row.  The 0 indicates no
problem (10 or fewer); the 1 indicates a problem (11 or more).
Three graphs are included in the MINIGM spreadsheet.  Press F10
to display the first.  Instructions for switching to the other
graphs are found at cell A70.
The RAPIDANC spreadsheet is structured the same way, except that
multiple choice frequency distributions are placed at the bottom
of the spreadsheet because they require more room. In this
example, variables 9, 10, 11, 13, 15, and 17 are displayed.  The
excerpt illustrated here only shows the first three of these
distributions due to space limitations.
At the very bottom of each spreadsheet is a block of "data base
instructions" that the Lotus 1-2-3 program needs to compute the
frequency and percentage distributions. These do not need to be
printed for the report, but they do need to be included in any
copy that is made of these computer files.

RAPID SURVEY DATA ENTRY AND TABULATION TEMPLATE , +, +, +, +, +,
+, +, +, FILE: RAPIDANC.WK1 , +, +, +, +, +, +, +
Date., 16/January/1991, +, Press Alt + F = Go to FREQUENCY
DISTRIBUTIONS, +, +, +, +, +, +, +, +, +, ANTENATAL CARE, +, +, +
, Study No. _____________(1), +, +, +, +, +, Prov.
___________(2), +, +, +, +, +, , +, +, +
, Interviewer____________ (3) , +, +, +, +, +, , +, +, +, +, +, ,
+, +, +
, 5  ID No. (Clstr + Rspndnt), +, +, +, +, +, 12 Received TT last
preg., +, +, +, +, +, 19 <%-6>CHW visit last 3 mo.<%0>, +, +, +
, 6 Age of women, +, +, +, +, +, 13 No. of vacc. received, +, +,
+, +, +, , +, +, +
, 7 Received ANC last preg, +, +, +, +, +, 14 Took iron pills, +,
+, +, +, +, , +, +, +
, 8  No. times rec'd ANC, +, +, +, +, +, 15 Outcome of pregnancy,
+, +, +, +, +, , +, +, +
, 9  Month preg. before ANC, +, +, +, +, +, 16 Where delivered,
+, +, +, +, +, , +, +, +
, 10 Place ANC received, +, +, +, +, +, 17 Delivered by:, +, +,
+, +, +, , +, +, +
, 11 Advised to get ANC, +, +, +, +, +, 18 Name of CHW, +, +, +,
+, +, , +, +, +
Quest., Date (4), 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17,
18, 19
1, 24/Apr/90, 101, 23, 1, 1, 1, 1, 1, 1, 1, 0, 1, 1, 1, 9, 1
2, 24/Apr/90, 102, 24, 0, , , 3, 5, 0, , , 3, , , 9, 0
3, 24/Apr/90, 103, 25, 9, , , 4, 6, 0, , , 2, 1, 2, 0, 0
4, 24/Apr/90, 104, 26, 9, , , 5, 3, 0, , , 2, 1, 3, 1, 0
5, 24/Apr/90, 105, 27, 0, , , 2, 2, 9, , , 1, 1, 2, 0, 0
6, 24/Apr/90, 106, 28, 0, , , 2, 4, 0, , , 1, 1, 4, 9, 0
7, 24/Apr/90, 107, 30, 1, 2, 2, 3, 3, 0, , , 2, 2, , 0, 0
8, 24/Apr/90, 201, 35, 1, 1, 1, 4, 2, 1, 1, 0, 3, , , 0, 0
, , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , 
, , , , , , , , , , , , , , , , 
207, 27/Apr/90, 3004, 30, 1, 2, 1, 1, 3, 1, 1, 9, 3, 1, 3, 0, 9
208, 27/Apr/90, 3005, 30, 1, 2, 1, 1, 3, 1, 1, 9, 3, 1, 3, 0, 9
209, 27/Apr/90, 3006, 30, 1, 2, 1, 1, 3, 1, 1, 9, 3, 1, 3, 0, 9
210, 27/Apr/90, 3007, 28, 9, , , 1, 6, 9, 2, 1, 2, 2, , 0, 0
Total:, 210, , 30, 210, 97, 98, 210, 210, 210, 96, 96, 210, 152,
122, 210, 210
, +, +, , , , , , , , , , , , , , 
VARIABLE NO.:, +, +, (6), , (8), , , , , (13), , , , , , 
Number, +, , , , 197, , , , , 295, , , , , , 
Average, +, , *****, , *****, , , , , 3.07, , , , , , 
Frequency Distributions ........ VARIABLE:, +, +, +, +, (7), ,
(12), , (14), , (16), , (!8), , (19), 
, 1 Yes, , , , 97, , 97, , 12, , 121, , 48, , 24, 
, 0 No, , , , 85, , 84, , 35, , 32, , 134, , 158, 
, 9 UNK/NR, , , , 28, , 29, , 49, , 0, , 28, , 26, 
, , +, +, +, , , +, +, +, +, +, +, +, +, +, +
, , +, +, +, , , +, +, +, +, +, +, +, +, +, +
, , +, +, +, , , +, +, +, +, +, +, +, +, +, +
, , +, +, +, , , +, +, +, +, +, +, +, +, +, +
, , +, +, +, , , +, +, +, +, +, +, +, +, +, +
, , +, +, +, , , +, +, +, +, +, +, +, +, +, +
, PROBLEM HIGHLIGHTER:, +, +, +, 100, PROBLEM IS NOTED BELOW AS
1., +, +, +, +, +, +, +, +, +, +
, PROBLEM  =  1, +, +, , 0, 1, , 1     , , 1, , , 1, , 1, 

Percentage Distributions:, +, +, +, , (7) (12)  (14)(16)(18)  
(19), +, +, +, +, +, +
, 1 Yes, , , , 46.2%****12.5%79.6%22.9%   11.4%, +, +, +, +, +, +
, 0 No, , , , 40.5%****36.5%20.4%63.8%   75.2%, +, +, +, +, +, +
, 9 UNK/NR, , , , 13.3%****51.0%0.0%13.3%   13.3%, +, +, +, +, +,
+
, , +, +, , , +, +, , , +, +
(9), Months preg. prior ANC, +, +, (10), Place where ANC
received, +, +, (11), Advised to get ANC by:, +, +
1, 3 months, 49, 50.0%, 1, Hospital, 50, 23.8%, 1, Physician,,
nurse, 20, 9.5%
2, 4-6 months, 26, 26.5%, 2, Health centre/ clinic, 38, 18.1%, 2,
Community nurse/ midwife, 48, 22.9%
3, 7-9 months, 12, 12.2%, 3, Private hospital/clinic, 47, 22.4%,
3, CHW/Volunteer, 47, 22.4%
9, UNK/NR, 11, 11.2%, 4, Local TBA/healer, 29, 13.8%, 4, TBA, 21,
10.0%
, , , , 5, Other site of care, 16, 7.6%, 5, Mother/relative, 37,
17.6%
, , , , 9, UNK/NR, 30, 14.3%, 6, Friend/neighbor, 25, 11.9%
, , , , , , , , 7, Other, 0, 0.0%
, , , , , , , , 9, UNK/NR, 12, 5.7%
(13), No. Vaccinations Rec'd, +, +, (15),  Pregnancy outcome, , ,
(17), Delivery attendant, +, +
1, One, 61, 63.5%, 1, Live birth, 104, 49.5%, 1, GHW, 11, 9.0%
2, Two, 3, 3.1%, 2, Stillbirth, 43, 20.5%, 2, TBA, 35, 28.7%
3, Three, 10, 10.4%, 3, Abortion/miscarr., 44, 21.0%, 3,
Unattended, 35, 28.7%
9, UNK/NR, 22, 22.9%, 9, UNK/NR, 19, 9.0%, 4, Private provider,
15, 12.3%
, , , , , , , , 5, CHW, 14, 11.5%
, , , , , , , , 6, CN/NMW, 0, 0.0%
, , , , , , , , 9, UNK/NR, 12, 9.8%




Adjusting the spreadsheets
Deleting and inserting rows
As noted above, it is very easy to expand or contract the
spreadsheets to fit the number of respondents in any given
survey.
1) To DELETE rows: place the cursor on any data row except the
first and last. Press << / >>, Worksheet, Delete, Row, (highlight
the number of rows to delete), <<Enter>>. All of the formulas
will be adjusted automatically.  However, if you delete the first
or last rows, there will be an error, and the formulas will have
to be re-entered.
2) To INSERT additional rows: place the cursor on any data row
except the first and last.  Press << / >>, Worksheet, Insert,
Row, (highlight the number of rows to enter), <<Enter>>.  Next
you must copy an already formatted row into the blank spaces:
<</>>, Copy, (highlight all of the cells in the row to be
copied), <<Enter>>, (place the cursor at the first blank row,
press the period/decimal point [.] and move the highlight down to
the last blank row), <<Enter>>.  This will fill in the blank rows
and the formulas for totals, averages, and frequency
distributions will be adjusted automatically.

Deleting and inserting columns
It is slightly more complicated to delete, and especially to
insert, new columns of variables. That is because the codes and
formulas will usually have to be adjusted.  It would be prudent
to have the assistance of someone who is familiar with Lotus
1-2-3 @ functions and formulas. Two easy ways to make
adjustments:
3) Instead of DELETING unwanted columns, just leave them blank or
erase (rather than delete) the portion of the column that
contains data and tabulations (<</>>, Range, Erase, [highlight
area to be erased], <<Enter>>).
4) Instead of INSERTING new columns, find one that has the same
coding structure as the one you want to insert (e.g., Yes = 1, No
= 0, DK/NR = 9), copy the portion of the column that contains
data, tabulations, and the database instructions to the first
blank column on the right of the spreadsheet: <</>>, Copy,
(highlight range to be copied), <<Enter>>, (move cursor to cell
location), <<Enter>>). You will need to change the variable name
at the head of the column, e.g., EXC in Column N of the MINIGM
spreadsheet, and in the database instructions at the bottom of
the spreadsheet. For example, if the new variable name is ORT,
change EXC to ORT wherever it appears in the column. This is
necessary so that the program can match the instructions with the
proper column.

Adapting the spreadsheets to other PHC topics
To customise the spreadsheet completely, it would be best to get
someone who is familiar with Lotus 1-2-3 or similar spreadsheets
to work with you. Basically, you will need to: 

change the summary of variables at the top of the spreadsheet; 
insert new variable names along the row above the database; 
copy, move, or insert the appropriate number and types of columns
for each variable; 
insert or delete rows to fit the number of expected respondents; 
adjust the formulas for counts, averages, and frequency
distributions at the bottom of the spreadsheet; 
set up frequency distributions for multiple choice questions; and
adjust the data base instructions.


Appendix I.3: Confidence interval estimation template
Ralph Frerichs has developed a simple template that can be used
to compute confidence intervals for selected variables.  An
example is shown on the next page.
This template would be used after the data have been entered and
tabulated to determine the standard error, the design effect, the
intraclass correlation, and three confidence intervals (90, 95,
and 99 percent).
To use the template, select a variable to examine. In this
example, the variable is "the proportion of women who received TT
vaccination during their last pregnancy."  You must first count
the number of women in each cluster who were interviewed and the
number who responded "yes" or "no" to the variable. Then simply
enter those numbers in Column B (No. of sampled women) and Column
C (Observed). In the example, there were 7 women interviewed and
6 who answered "yes" in the first cluster. The numbers were 7 and
6 in the second cluster, 7 and 5 in the third, and so forth.
The only other data you need to enter is the total number of the
population's target group. In this case, 24,653 (entered in cell
D45).
Press F9 and the program will make all of the calculations. The
average proportion who received TT is shown in the "Total" Column
at the far right column (cell G42) as 0.694. That is, 69.4
percent of the sampled women received TT.
The confidence intervals are shown in the lower left corner of
the page. For example, we are 90 percent confident that the true
proportion of women who received TT lies somewhere between 61.3
and 77.4 percent. Or, put another way, the proportion is 69.4
percent, plus or minus 8 percentage points.
This template can be easily adjusted to increase or decrease the
number of clusters.  Simply delete or insert the appropriate
number of rows in the table.  See the instructions in the
previous section (Appendix H2) for more details.

Antenatal survey, Sisaket, Thailand
Proportion who received TT during last pregnancy, +, +, +, +, +, 
FILE:TT.WK1, +, +, , , , 
, , No. of women who received TT, +, Observed minus expected
squared, Proportion with TT in each cluster, 
A, B, C, D, E, F, 
Sequence No. of cluster, No. of sampled women, Observed,
Expected, , , 
1, 7, 6, 4.86, 1.308, 0.857, 
2, 7, 6, 4.86, 1.308, 0.857, 
3, 7, 5, 4.86, 0.021, 0.714, 
4, 7, 6, 4.86, 1.308, 0.857, 
5, 7, 7, 4.86, 4.595, 1.000, 
6, 7, 6, 4.86, 1.308, 0.857, 
7, 7, 7, 4.86, 4.595, 1.000, 
8, 7, 7, 4.86, 4.595, 1.000, 
9, 7, 1, 4.86, 14.872, 0.143, 
10, 7, 2, 4.86, 8.159, 0.286, 
11, 7, 5, 4.86, 4.591, 0.714, 
12, 7, 6, 4.86, 1.308, 0.857, 
13, 7, 7, 4.86, 4.595, 1.000, 
14, 7, 7, 4.86, 4.595, 1.000, 
15, 7, 3, 4.86, 3.446, 0.429, 
16, 7, 7, 4.86, 4.595, 1.000, 
17, 7, 4, 4.86, 0.734, 0.571, 
18, 7, 5, 4.86, 0.021, 0.714, 
19, 7, 3, 4.86, 3.446, 0.429, 
20, 7, 4, 4.86, 0.734, 0.571, 
21, 7, 4, 4.86, 0.734, 0.571, 
22, 7, 2, 4.86, 8.159, 0.286, 
23, 7, 1, 4.86, 14.872, 0.143, 
24, 7, 4, 4.86, 0.734, 0.571, 
25, 7, 7, 4.86, 4.595, 1.000, 
26, 7, 4, 4.86, 0.734, 0.571, 
27, 7, 4, 4.86, 0.734, 0.571, 
28, 7, 5, 4.86, 0.021, 0.714, 
29, 6, 3, 4.16, 1.352, 0.500, 
30, 7, 7, 4.86, 4.595, 1.000, 
Total,  209, 145, 145.00, 102.088, 0.694, 
, , , , STANDARD ERROR of estimated, +, +
Est. total women in cluster, +, 24,653., , sample proportion, +, 
Ave. no. women/cluster, +, 6.97, , for cluster sample, +, = 0.049
Ave. no. clusters, +, 30, , If simple random sample, +, = 0.032
, Confidence Intervals, +, , DESIGN EFFECT, +, 2.36
, 90%,  95%, 99%, , , 
Upper, 0.774, 0.790, 0.821, ESTIMATED INTRA-CLASS, +, +
Lower, 0.613, 0.597, 0.567, CORRELATION COEFFICIENT, +, 0.23


REFERENCES AND BIBLIOGRAPHY

Bennett, Steve, Tony Woods, Winitha M. Liyanage, and Duane L.
Smith. "A simplified general method for cluster sample surveys of
health in developing countries." World health statistics
quarterly. 44 (3) : 100, 1991.
David, Patricia H., Leila Bisharat, and Allan G. Hill. Measuring
childhood mortality: A guide for simple surveys.  Amman, Jordan:
UNICEF, Regional Office of the Middle East and North Africa,
1990.
Dean, A.G., J.A. Dean, A. H. Burton, and R.C. Dickers. EPI Info,
Version 5 : A word processing, database and statistics system for
epidemiology on microcomputers. Atlanta: Centers for Disease
Control, and Geneva: World Health Organization, 1990.
Frerichs, Ralph R., Jack Reynolds, and Melinda Wilson. "Family
planning survey and antenatal survey, Srisaket, Thailand."
December, 1987 (unpublished paper, URC/CHS); "Institutionalizing
the use of rapid surveys for family planning decision-making, an
Operations Research Proposal," Gadja Mada University and
University Research Corporation, November 1989; and "Primary
Health Care Management Advancement Programme 1989-1992, a
proposal of the Aga Khan Health Network and PRICOR," November,
1989.
Frerichs, Ralph R. and Tar Tar, K. "Computer-assisted rapid
surveys in developing countries."  Public health reports. 104: 14
- 23, 1989.
Graham, Wendy, William Brass, and Robert W. Snow "Estimating
maternal mortality: The sisterhood method." Studies in family
planning. 20 (3): 125 - 135, 1989.
Henderson, R.H. and T. Sunaresan. "Cluster sampling to assess
immunization coverage: A review of experience with a simplified
method."  Bulletin of the World Health Organization, 60 (2): 253 
260, 1982.
Lamptey P. and P. Piot. The handbook for AIDS prevention in
Africa. Family Health International, 1990.
Lemeshow, S. and D. Robinson. "Surveys to measure programme
coverage and impact: A review of the methodology used by the
expanded programme on immunization."  World health statistics
quarterly. 38: 65 - 75, 1985.
Smith, Gordon S. "Development of rapid epidemiological assessment
methods to evaluate health status and delivery of health
services." International journal of epidemiology. 18 (4
Supplement ): S4, 1989.
Trussell, James and German Rodriguez. "A note on the sisterhood
estimator of maternal mortality," Studies in family planning, 21
(6): 344 - 346,  November/December, 1990.
United Nations, Manual X: Indirect techniques for demographic
estimation.New York, 1983.
United Nations, Step-by-step guide to the estimation of child
mortality. Department of Economic and Social Affairs, 1990.
World Health Organization. Diarrhoea morbidity, mortality and
treatment practices, household survey manual. CDD/SER/86.2 
World Health Organization. Expanded programme on immunization,
Training for mid-level managers: Coverage survey.
WHO/EPI/MLM/COV/88, Revised 1988.
Acronyms and abbreviations

AIDSAcquired immune deficiency syndrome
AKFAga Khan Foundation
AKHNAga Khan Health Network
AKHSAga Khan Health Service
AKUAga Khan University
ARIAcute respiratory infections
BCGBacillus of Calmette and Guerin (tuberculosis vaccine)
CHWCommunity health worker
CMRChild mortality rate
DPTDiphtheria, pertussis and tetanus vaccines
EPIExpanded Programme for Immunization
GMGrowth monitoring
IECInformation, education, communication
IMRInfant mortality rate
KAPKnowledge, attitudes, practice (behaviour)
MISManagement information system
MMRMaternal mortality rate
MOHMinistry of health
NGONon-governmental organisations
OPVOral poliovirus vaccine
ORSOral rehydration salts
ORTOral rehydration therapy
PHCPrimary health care
PHC MAPPrimary Health Care Management Advancement Programme
PNCPeri-natal care
PRICORPrimary Health Care Operations Research
STDSexually-transmitted diseases
TBTuberculosis
TBATraditional birth attendant
TTTetanus toxoid
UNICEFUnited Nations International Children's and Education Fund
URCUniversity Research Corporation
USAIDUnited States Agency for International Development
WHOWorld Health Organization

Glossary
Attribute:  A quality or characteristic of interest, such as age
Binomial:  Refers to a variable or distribution that has only two
possible values, such as Yes/No, right/wrong, up/down.
Cluster:  A group, usually within a specific geographic area. 
Cluster sample:  A sample of a population that is divided into a
specified number of groups. In this module the standard cluster
sample consists of 30 clusters from which 7 or more respondents
are selected for interview. 
Community health worker (CHW):  A person indigenous to the
community who provides basic preventive and curative health
services to members of the community. Includes village health
workers, health guides, and other terms
Community:  A group of people having common organization or
interest or living in the same place under the same laws.
Coverage:  The percent of a target group that has received a
service or is protected from a disease or health problem
Effectiveness:  The degree to which desired outcomes are achieved
Effects:  Changes in knowledge, skills, attitudes and behariours
as a result of a PHC programme
Efficiency:  The degree to which desired outcomes are achieved
without wasting resources
Goals:  The impact the PHC programme expects to have on health.
Goal statements specify the improvement desired, target group,
amount of change expected
Impacts: Changes in health status (mortality, morbidity,
fertility, disability)
Indicator:  An indirect measure of an event or condition. For
example, a baby's weight-for-age is an indicator of the baby's
nutritional status.
Indicators:  Indirect measures of a programme's progress related
to: inputs, processes (outputs, effects, impacts); objectives;
and goals.
Inputs:  Resources (personnel, materials and equipment,
information and money)
Management:  The art and science of getting things done through
people. 
Objectives:  The output and/or effect that a programme hopes to
achieve
Outcomes:  Results of  programme, including outputs, effects and
impacts
Outputs:  Products and services provided by a PHC programme
Effects: Changes in knowledge, skills, attitude and behaviour,    
              (including coverage) as a result of a PHC programme
Impacts:  Changes in health status, (mortality, morbidity,
disability,  fertility) as a result of a PHC programme
Primary health care:  Essential health care, accessible at
affordable cost to the community and the country, based on
practical, scientifically sound and socially acceptable methods. 
It includes at least eight components:  health education, proper
nutrition, clean water and basic sanitation, maternal and child
health care, immunization, control of common diseases and
injuries, prevention of local endemic diseases, essential drugs.
Processes:  Activities or tasks carried out through programmes
Random sample:  Selection of respondents in such a way that every
member of the population being studied has an equal chance of
being selected.
Respondent: The individual/s being asked or administered
questions.
Sampling interval: In cluster sampling, this is the interval
between one cluster and the next. The sampling interval is
determined by dividing the population of the area under study by
the number of clusters required for the survey. 
Sampling interval:  In cluster sampling, this is the interval
between on e cluster and the next. The sampling interval is
determined by dividing the population of the area under study by
the number of cluster required for the survey. For example, if
the population of the study area is 45,000 and the total number
of clusters needed is 30, then the sampling interval is 1500
(45,000/30=1,500).
System:  A set of discrete, but interdependent, components
designed to achieve one or more objectives.
Tabulate:  To put data into a table or columns. To arrange
systematically.
Target group:  Specific groups of people designated to receive a
PHC service, such as children under age two years designated to
receive immunizations