Children’s Questionnaire
CARE OF ILLNESS MODULE
Children’s Questionnaire
CARE OF ILLNESS MODULE
UNDER FIVE DEATHS BY CAUSE, 2000-2003
Diarrhoeal diseases
(post-neonatal)
17% Other
Acute diseases and
respiratory injuries
infections 13%
19% Malaria
More than half of
under five deaths
8%
associated with
malnutrition
Measles
4%
Neonatal
HIV/AIDS
causes
3%
36%
Children’s Questionnaire
CARE OF ILLNESS MODULE
Purpose
• To provide basic data to calculate
indicators on
– Treatment for diarrhoeal disease
– Treatment and care seeking for pneumonia
– Sanitary means of excreta disposal for young
children
Children’s Questionnaire
CARE OF ILLNESS MODULE
Background
Acute Respiratory Infection
• WHO defines cases of suspected pneumonia as children
reported to have an illness with a cough accompanied by fast
and/or difficult breathing.
• Simple cases of cold with a blocked nose are filtered out with a
second question: “Were these symptoms due to a problem in
the chest or a blocked nose?”
• If a local term for “rapid breathing” exists, using that term may
be the simplest way to obtain cases of ARI that need to be
seen by a health care provider.
Children’s Questionnaire
CARE OF ILLNESS MODULE
Background
Diarrhoeal Disease
• WHO and UNICEF recommend that children with
diarrhoeal disease be treated with either Oral Rehydration
Solution (ORS) or increased fluids AND continued feeding.
• Treatment recommendations and indicators have changed
over the last ten years.
• New indicator has been added.
Children’s Questionnaire
CARE OF ILLNESS MODULE
Indicators
Treatment for dehydrating diarrhea:
• ORT use
• Home management of diarrhoea
• Received ORT or increased fluids, and continued feeding
Treatment for suspected pneumonia:
• Antibiotic treatment of pneumonia
• Care seeking for pneumonia
Hygiene:
• Sanitary disposal of child’s feces
Children’s Questionnaire
CARE OF ILLNESS MODULE
Preparation
• Definition of appropriate health provider should be defined at
country level.
• Adapt for country-specific term used for the ORS packet and
for the pre-packaged ORS fluid. If no pre-packaged ORS is
available in the country, delete this category.
• Include country-specific recommended home fluid. Ingredients
promoted by the government for making the recommended
home fluid should be reflected in this category.
CARE OF ILLNESS MODULE CA
CA1. Has (name) had diarrhoea in the last two Yes 1
weeks, that is, since (day of the week) of the week No 2 2CA5
before last?
Diarrhoea is determined as perceived by mother or DK 8 8CA5
caretaker, or as three or more loose or watery stools
per day, or blood in stool.
CA2. During this last episode of diarrhoea, did
(name) drink any of the following:
Read each item aloud and record response before
proceeding to the next item.
CA2a. A fluid made from a special packet called Yes No DK
(local name or ORS packet solution)? A. Fluid from ORS packet 1 2 8
CA2b. Government-recommended homemade B. Recommended homemade
fluid? fluid 1 2 8
CA2c. A pre-packaged ORS fluid for diarrhoea? C. Pre-packaged ORS fluid 1 2 8
CA3. During (name’s) illness, did he/she drink Much less or none 1
much less, about the same, or more than usual? About the same (or somewhat less) 2
More 3
DK 8
CA4. During (name’s) illness, did he/she eat less, None 1
about the same, or more food than usual? Much less 2
If “less”, probe: Somewhat less 3
much less or a little less? About the same 4
More 5
DK 8
Adapt locally to include the country-specif ic term used f or the ORS packet
Adapt locally to include the country-specif ic recommended home f luid. Ingredients promoted by the government f or making the reco mmended home f luid
should be ref lected in this category.
Adapt locally to include the country-specif ic terms used f or the pre-packaged ORS f luid. Adapt locally to include the common names/brands f or pre-
packaged ORS f luids available in the country. If no pre-packaged ORS is available in the country, delete this category.
CA5. Has (name) had an illness with a cough at Yes 1
any time in the last two weeks, that is, since (day of No 2 2CA12
the week) of the week before last? DK 8 8CA12
CA6. When (name) had an illness with a cough, did Yes 1
he/she breathe faster than usual with short, quick No 2 2CA12
breaths or have difficulty breathing? DK 8 8CA12
CA7. Were the symptoms due to a problem in the Problem in chest 1
chest or a blocked nose? Blocked nose 2 2CA12
Both 3
Other (specify) 6 6CA12
DK 8
CA8. Did you seek advice or treatment for the Yes 1
illness outside the home? No 2 2CA10
DK 8 8CA10
CA9. From where did you seek care? Public sources
Govt. hospital A
Anywhere else? Govt. health centre B
Govt. health post C
Circle all providers mentioned, Village health worker D
but do NOT prompt with any suggestions. Mobile/outreach clinic E
Other public (specify) H
If source is hospital, health center, or clinic, write the Private sources
name of the place below. Probe to identify the type of Private hospital/clinic I
source and circle the appropriate code. Private physician J
Pharmacy K
Mobile clinic L
Other private medical (specify) O
(Name of place) Other source
Relative or friend P
Shop Q
Traditional practitioner R
Other (specify) X
CA10. Was (name) given medicine to treat this Yes 1
illness? No 2 2CA12
DK 8 8CA12
CA11. What medicine was (name) given? Antibiotic A
Circle all medicines given. Paracetamol/Panadol/Acetaminophen P
Aspirin Q
Ibupropfen R
Other (specify) X
DK Z
CA12. Check UF11: Child aged under 3?
Yes. Continue with CA13
No. Go to CA14
CA13. The last time (name) passed stools, what Child used toilet/latrine 01
was done to dispose of the stools? Put/rinsed into toilet or latrine 02
Put/rinsed into drain or ditch 03
Thrown into garbage (solid waste) 04
Buried 05
Left in the open 06
Other (specify) 96
DK 98
Ask the following question (CA14) only once for Child not able to drink or breastfeed A
each caretaker. Child becomes sicker B
CA14. Sometimes children have severe Child develops a fever C
illnesses and should be taken immediately to a Child has fast breathing D
health facility. What types of symptoms would Child has difficult breathing E
cause you to take your child to a health facility Child has blood in stool F
right away? Child is drinking poorly G
Other (specify) X
Keep asking for more signs or symptoms until the
caretaker cannot recall any additional symptoms. Other (specify) Y
Circle all symptoms mentioned,
But do NOT prompt with any suggestions. Other (specify) Z
Develop categories to include locally-used antibiotics, then pre-test