Kenya 2011

Under-five child information panel: UF

This questionnaire is to be administered to all mothers or caretakers (see Household Listing Form, column HL8) who care for a child that lives with them and is under the age of 5 years (see Household Listing Form, column HL5). A separate questionnaire should be used for each eligible child. Fill in the cluster and household number, and names and line numbers of the child and the mother/caretaker in the space below. Insert your own name and number, and the date.

UF-A. Province Name and Code: _ _ _

UF-B. County Name and Code: _ _ _

UF-C. District Name and Code: _ _ _

UF1. Cluster number: _ _ _

UF2. Household number: _ _

UF3. Child's name: ____

UF4. Child's line number: _ _

UF5. Mother's / caretaker's name:
Name ____

UF6. Mother's / caretakers line number: _ _

UF7. Interviewer name and number
Name ____ _ _

UF8. Day / month / year of interview _ _ / _ _ / _ _ _ _

Repeat greeting if not already read to this respondent:

We are from Kenya National Bureau of Statistics (KNBS). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take around 20-25 minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. Also, you are not obliged to answer any question you don't want to, and you may withdraw from the interview at any time. May I start now?

If permission is given, begin the interview. If the respondent does not agree to continue, thank him/her and go to the next interview. Discuss this result with your supervisor for a future revisit.

UF9. Result of interview for children under 5
Codes refer to mother/caretaker.

Interviewer/editor/supervisor notes ________

UF91. Supervisor

UF92. Field edited by (name and number)

UF93. Data Entry (name and number)

UF9A. Record the time.

UF10. Now I would like to ask you some questions about the health of each child under the age of 5 in your care, who lives with you now. Now I want to ask you about (name). In what month and year was (name) born?

Probe: what is his / her birthday? If the mother/caretaker knows the exact birth date, also enter the day; otherwise, circle 98 for day. Month and year must be recorded.

UF11. How old was (name) at his/her last birthday?

Record age in completed years.

Birth registration and early learning: BR

BR1. Does (name) have a birth certificate?

May I see it?

BR2. Has (name)'s birth been notified or registered with the civil authorities?

BR4. Why is (name)'s birth not registered?

BR4. Do you know how to register your child's birth?

BR5. Check age of child in UF11: Child is 3 or 4 years old?

BR6. Does (name) attend any organized learning or early childhood education programme, such as a private or government facility, including kindergarten or community child care?

BR7. Since (day of the week), excluding today, about how many hours did (name) attend?

BR8. In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name):

For each item: If yes, ask: Who engaged in this activity with (name) ? the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Circle all that apply.


[A] Read books, look at picture books, or tell stories to/with (name)?

[D] Took (name) outside the home, compound, yard or enclosure?

[E] Play with (name)?

[F] Name, count, or draw things to/with (name)?

Child development: CE

CE1. How many children's books or picture books do you have for (name)?

If 'none' enter 0

CE3. I am interested in learning about the things that (name) plays with when he/she is at home.

If the respondent says "yes" to the categories above, then probe to learn specifically what the child plays with to ascertain the response

Does he/she play with:

[A] Household objects or objects found outside (such as bowls or pots, sticks, rocks, animal shells or leaves)?

[B] Homemade toys (such as dolls, cars, or other toys made at home)?

[C] Toys that came from a shop?

CE4. Sometimes adults taking care of children have to leave the house to go shopping, wash clothes, or for other reasons and have to leave young children.

On how many days in the past week was (name):

If 'none' enter '0'

[A] Left alone?

[B] Left in the care of another child (that is, someone less than 10 years old)?

CE5. Check UF11: Age of child 3 or 4

CE6. I would like to ask you some questions about the health and development of your child. Children do not all develop and learn at the same rate. For example, some walk earlier than others. These questions are related to several aspects of your child's development.
Can (name) identify or name at least ten letters of the alphabet?

CE7. Can (name) attach sounds to most or more than half of the letters?

CE8. Can (name) read at least four simple, one-syllable, popular words?

CE9. Is (name) interested in numbers, counting, sorting or adding?

CE10. Does (name) know the name and recognize the symbol of all numbers from 1 to 10 most of the time?

CE11. When you compare two numbers up to 10, does (name) know which one is bigger most of the time?

CE12. Is (name) able to use and manipulate small objects and toys?

CE13. Is (name) sometimes too tired, sleepy or sick to play?

CE14. Is (name) sometimes too hungry to play?

CE15. Does (name) do everyday routine activities without being reminded? Activities such as brushing teeth, tidying up after play or a meal, or helping with chores?

If yes: Would you say often or sometimes?

CE16. Does (name) follow simple directions on how to do something correctly?

If yes: Would you say often or sometimes?

CE17. Is (name) able to work on a task, including play tasks, by himself/herself?

If yes: Would you say often or sometimes?

CE18. Does (name) play with siblings or other children for a considerable time without getting in trouble?

If yes: Would you say often or sometimes?

CE19. Does (name) show respect for other children?

Probe: Does (name) listen to what another child has to say and recognize that he or she may be different or want different things?

If yes: Would you say often or sometimes?

CE20. What is (name)'s ability to get along with other children? Would you say it is very good, average, or poor/bad?

CE21. How often does (name) bully other children or is mean to other children?

Probe: Does (name) often make other children afraid of him/her, or say mean/bad words to other children?

If yes: Would you say often or sometimes?

CE22. How often does (name) kick, bite, or hit other children or adults?

If yes: Would you say often or sometimes?

CE23. Does (name) often get very easily/quickly distracted?

If yes: Would you say often or sometimes?

Vitamin A: VA

VA1. Has (name) ever received a vitamin A capsule (supplement) like this one?

Show capsule or dispenser for different doses - 100,000 IU for those 6-11 months old (blue), 200,000 IU for those 15-59 months old (red)

VA2. How many months ago did (name) take the last dose?

VA3. Where did (name) get this last dose?

Breastfeeding: BF

BF1. Has (name) ever been breastfed?

BF2. Is he/she still being breastfed?

BF3. I would like to ask you about liquids that (name) may have had yesterday during the day or the night. I am interested in whether (name) had the item even if it was combined with other foods.

Did (name) drink or eat any (item from list): yesterday, during the day or night?

Read each item aloud and record response before proceeding to the next item. Ask the number of times the child had infant formula, milk, yogurt and solid, semi-solid foods.

BF3A. Vitamin or mineral supplements

BF3B. ORS (Oral rehydration solution)?

BF3C. Plain water?

BF3D. Infant formula?

BF3D1. How many times did (name) have infant formula?

BF3E. Milk, such as tinned, powdered or fresh animal milk?

BF3E1. How many times did (name) drink tinned, powdered or fresh animal milk?

BF3F. Juice or juice drinks?

BF3G. Soup?

BF3H. Any other liquids?

BF3I. Yogurt?

BF3I1. How many times did (name) have yogurt?

BF3J. Thin porridge?

BF3K. Semi or semi-solid (mushy) food?

BF3K1. How many times did (name) eat solid, semi-solid (mushy) foods?

BF3L. Did (name) drink anything from a bottle with a nipple yesterday during the day or night?

Care of illness: 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.

CA1A. Was there blood in the stools?

CA2. During the episode of diarrhoea, was (name) given to drink any of the following:

Read each item aloud and record response before proceeding to the next item.

[A] A fluid made from a special packet called ORS?

[B] Homemade sugar and salt solution?

[C] A pre-packaged ORS fluid for diarrhoea?

CA2D. Was anything (else) given to treat the diarrhoea?

CA2E. What (else) was given to treat the diarrhoea?

Probe: Anything else? Record all treatments given.

CA2F. Check CA2E: Zinc given?

CA2G. How many times was (name) given zinc?

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

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?

CA4B. Where did you get the ORS packet from?

(Name of place) ____

CA4C. How much did you pay for the (local name for ORS packet from C2A)?

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?

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

CA7. Was the fast or difficult breathing due to a problem in the chest or a blocked nose?

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

CA9. From where did you seek care?

Probe: Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions.

If source is a 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) ____

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

CA11. What medicine was (name) given?

Probe: Anything else? Circle all medicines given.

CA11A. Check CA11: Antibiotic given?

CA11B. Where did you get the antibiotic?

(Name of place) ____

CA11C. How much did you pay for the antibiotic?

CA12. Check UF11: Child aged under 3?

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

Malaria: ML

ML1. In the last two weeks, that is, since (day of the week) of the week before last, has (name) been ill with a fever?

ML2. Was (name) seen at a health facility during this illness?

ML3. Did (name) take medicine for fever or malaria that was provided or prescribed at the health facility?

ML4. What medicine did (name) take that was provided or prescribed at the health facility?

Probe: Anything else? Circle all medicines mentioned.

ML5. Was (name) given any medicine for the fever or malaria before being taken to the health facility?

ML6. Was (name) given any medicine for fever or malaria during this illness?

ML7. What medicine was (name) given?

Circle all medicines given. Ask to see the medication if type is not known. If type of medication is still not determined, show typical anti-malarials to respondent.

ML8. Check ML4 and ML7: Anti-malarial mentioned (codes A-H)

ML9. How long after the fever started did (name) first take (name of anti-malarial from ML4 or ML7)?

If multiple anti-malarials mentioned in ML4 or ML7, name all anti-malarial medicines mentioned. Record the code for the day on which the first anti-malarial was given.

MA9A. Where did you get the (name of anti-malarial from ML4 or ML7)?

If more than one anti-malarial is mentioned in ML4 or ML7, refer to the first anti-malarial given for the fever (the anti-malarial given on the day recorded in ML9).

(Name of place) ____

ML9B. How much did you pay for the (name of anti-malarial from ML4 or ML7)?

Refer to the same anti-malarial as in ML9A above

Immunization: IM

If an immunization card is available, copy the dates in IM2-IM8B for each type of immunization or vitamin A dose recorded on the card. IM10-IM18 will only be asked when a card is not available or not shown.

IM1. Is there a vaccination card for (name)?

IM3. Date of Immunization

BCG

Polio at birth

Polio 1

Polio 2

Polio 3

DPT1 (Pentavalent-1)

DPT2 (Pentavalent-2)

DPT3 (Pentavalent-3)

Measles

Yellow Fever

Vitamin A (1) (Last but one)

Vitamin A (2) (Most recent)

IM9. In addition to what vaccinations and vitamin A capsules shown on this card, did (name) receive any other vaccinations - including vaccinations received in campaigns or immunization days?

Record 'Yes' only if respondent mentions BCG, OPV 0-3, DPT 1-3, Hepatitis B 1-3, Measles, Yellow Fever vaccine(s), or Vitamin A supplements.

IM10. Has (name) ever received any vaccinations to prevent him/her from getting diseases, including vaccinations received in a campaign or immunization day?

IM11. Has (name) ever received a BCG vaccination against tuberculosis - that is, an injection in the arm or shoulder that caused a scar?

IM12. Has (name) ever been given any polio vaccination, that is, vaccination drops in the mouth to protect him/her from getting diseases?

IM13. How old was he/she when the first dose was given - within the two weeks after birth or later?

IM14. How many times has he/she been given these drops?

IM15. Has (name) ever been given a DPT vaccination - that is, an injection in the thigh or buttocks - to prevent him/her from getting tetanus, whooping cough, or diphtheria? (sometimes given at the same time as polio)

IM16. How many times?

IM17. Has (name) ever been given Measles vaccination injections - that is, a shot in the arm at the age of 9 months or older - to prevent him/her from getting measles?

IM18. Has (name) ever been given yellow fever vaccination injections - that is, a shot in the arm at the age of 9 months or older - to prevent him/her from getting yellow fever? (sometimes given at the same time as measles)

IM19. Please tell me if (name) has participated in any of the following campaigns, national immunization days and/or vitamin a or child health days:

[A] National Immunization Day in 2010?

[B] Malezibora, in May 2010?

[C] Malezibora, in November 2010?

UT2. Record the time.

IM20. Does another eligible child reside in the household for whom this respondent is mother/caretaker? Check household listing, column HL8.

[] Yes [End the current questionnaire and then go to under-5 questionnaire to administer the questionnaire for the next eligible child.]
[] No [End the interview with this respondent by thanking him/her for his/her cooperation.]

If this is the last eligible child in the household, go on to Anthropometry module.

Anthropometry: AN

After questionnaires for all children are complete, the measurer weighs and measures each child.
Record weight and length/height below, taking care to record the measurements on the correct questionnaire for each child. Check the child's name and line number on the household listing before recording measurements.

AN0A. Measurer's identification code

AN0B. Result of measurement

AN1. Child's weight

AN2. Child's length or height

Check age of child in UF11:

[] Child under 2 years old. [Measure length (lying down).]
[] Child age 2 or more years. [Measure height (standing up).]

AN3. Whether the child is having oedema?

Observe and record

AN5. Is there another child in the household who is eligible for measurement?

Gather together all questionnaires for this household and check that all identification numbers are inserted on each page. Tally on the Household information panel the number of interviews completed.