Children’s QuestionnaireCARE OF ILLNESS MODULE

UNDER FIVE DEATHS BY CAUSE, 2000-2003

Children’s QuestionnaireCARE OF ILLNESS MODULE

Acute respiratory infections

19%

Neonatal causes

36%

HIV/AIDS3%

Measles4%

Malaria8%

Other diseases and

injuries13%

Diarrhoeal diseases (post-neonatal)

17%

More than half of under five deaths associated with

malnutrition

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 QuestionnaireCARE OF ILLNESS MODULE

• 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.

Background Acute Respiratory Infection

Children’s QuestionnaireCARE OF ILLNESS MODULE

• 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 QuestionnaireCARE OF ILLNESS MODULE

Background Diarrhoeal Disease

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 QuestionnaireCARE 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.

Children’s QuestionnaireCARE OF ILLNESS MODULE

CARE OF ILLNESS MODULE CA

CA1. Has (name) had diarrhoea in the last two weeks, that is, since (day of the week) of the week before last?Diarrhoea is determined as perceived by mother or caretaker, or as three or more loose or watery stools per day, or blood in stool.

Yes 1No 2

DK 8

2CA5

8CA5

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 (local name or ORS packet solution)?CA2b. Government-recommended homemade fluid?CA2c. A pre-packaged ORS fluid for diarrhoea?

Yes No DKA. Fluid from ORS packet 1 2 8B. Recommended homemade

fluid 1 2 8 C. Pre-packaged ORS fluid 1 2 8

CA3. During (name’s) illness, did he/she drink much less, about the same, or more than usual?

Much less or none 1About the same (or somewhat less) 2More 3DK 8

CA4. During (name’s) illness, did he/she eat less, about the same, or more food than usual?If “less”, probe:

much less or a little less?

None 1Much less 2Somewhat less 3About the same 4More 5DK 8

Adapt locally to include the country-specific term used for the ORS packetAdapt locally to include the country-specific recommended home fluid. Ingredients promoted by the government for making the recommended home fluid should be reflected in this category.Adapt locally to include the country-specific terms used for the pre-packaged ORS fluid. Adapt locally to include the common names/brands for pre-packaged ORS fluids 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 any time in the last two weeks, that is, since (day of the week) of the week before last?

Yes 1No 2DK 8

2CA128CA12

CA6. When (name) had an illness with a cough, did he/she breathe faster than usual with short, quick breaths or have difficulty breathing?

Yes 1No 2DK 8

2CA128CA12

CA7. Were the symptoms due to a problem in the chest or a blocked nose?

Problem in chest 1Blocked nose 2Both 3Other (specify) 6DK 8

2CA12

6CA12

CA8. Did you seek advice or treatment for the illness outside the home?

Yes 1No 2DK 8

2CA108CA10

CA9. From where did you seek care?

Anywhere else?

Circle all providers mentioned,but do NOT prompt with any suggestions.

If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code.

(Name of place)

Public sourcesGovt. hospital AGovt. health centre BGovt. health post CVillage health worker DMobile/outreach clinic EOther public (specify) H

Private sourcesPrivate hospital/clinic IPrivate physician JPharmacy KMobile clinic LOther private medical (specify) O

Other sourceRelative or friend PShop QTraditional practitioner R

Other (specify) X

CA10. Was (name) given medicine to treat this illness?

Yes

1No

2DK

8

2CA128CA12

CA11. What medicine was (name) given?Circle all medicines given.

Antibiotic

AParacetamol/Panadol/Acetaminophen

PAspirin

QIbupropfen

ROther (specify)

XDK

Z

CA12. Check UF11: Child aged under 3? Yes. Continue with CA13 No. Go to CA14

CA13. The last time (name) passed stools, what was done to dispose of the stools?

Child used toilet/latrine

01Put/rinsed into toilet or latrine

02Put/rinsed into drain or ditch

03Thrown into garbage (solid waste)

04Buried

05Left in the open

06Other (specify)

96DK

98

Ask the following question (CA14) only once for each caretaker.CA14. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away?

Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms.Circle all symptoms mentioned,But do NOT prompt with any suggestions.

Child not able to drink or breastfeed

AChild becomes sicker

BChild develops a fever

CChild has fast breathing

DChild has difficult breathing

EChild has blood in stool

FChild is drinking poorly

GOther (specify)

X

Other (specify)

Y

Other (specify)

Z

Develop categories to include locally-used antibiotics, then pre-test