Child Development Survey - 2016


Under-five child information panel: UF

This questionnaire is to be administered to all mothers or caretakers (see List of Household Members, column HL15) who care for a child that lives with them and is under the age of 5 years (see List of Household Members, column HL7B).
A separate questionnaire should be used for each eligible child.

UF1. Cluster number: _ _ _

UF2. Household number: _ _

UF3. Child's name: Name ____

UF4. Child's line number _ _

UF5. Mother's/caretaker's name:
UF6. Mother's/caretaker's line number: _ _

UF7. Interviewer's name and number:
UF8. Year/month/day of interview
UF8A. Number of times visited
Repeat greeting if not already read to this respondent:
We are from the National Statistics Office of Mongolia and conducting a survey about the situation of children, women, families and households. I would like to talk to you about (name)'s health and well-being nearly 20 minutes. According to the article 5, paragraph 4 of the Mongolian State "Law of Confidentiality of an Individual" and article 22, paragraph 3 of the "Law of Statistics" all the information we obtain will remain strictly confidential.

If greeting at the beginning of the household questionnaire has already been read to this person, then read the following:
Now I would like to talk to you more about (child's name from UF3)'s health and other topics. This interview will take about 20 minutes. Again, all the information we obtain will remain strictly confidential and anonymous.

May I start now?

UF9. Result of the interview
Codes refer to mother/caretaker.

UF12. Record the time.
Age: AG

AG1. I would like to talk to you about (name).
On what year, month and day 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.
AG2. How old is (name)?
Probe: How old was (name) at his / her last birthday? Record age in completed years. Record '0' if less than 1 year. Must compare and correct AG1 and/or AG2 if inconsistent.
Birth Registration: BR

BR1. Does (name) have a birth certificate?
If yes, probe: may I see it?
BR2. Has (name)'s birth been registered with the civil authorities?

BR3. Do you know how to register (name)'s birth?

Early childhood development: EC

EC1. How many children's books or picture books do you have for (name)?

EC2. I am interested in learning about the things that (name) plays with when he/she is at home.
Does he/she play with:
If the respondent says "yes" to the categories above, then probe to learn specifically what the child plays with to ascertain the response.




EC3. 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 alone or leave in the care of another child.
On how many days in the past week was (name):
If 'none' enter '0'. If 'don't know' enter '8'.

[A] Left alone for more than an hour?

[B] Left in the care of another child whose under 10, for more than an hour?

EC4A. Check AG2 for age of child.
EC5. Does (name) attend any organized learning/kindergarten/ or alternative form of education, such as a shift group, visiting teacher or mobile kindergarten?

EC5B. If (name) attended alternative form of education, which alternative form of education and how many days does (name) attend?

EC5C. Does (name) attend child care services?

EC5A. Check AG2 for age of child
EC7. In the past 3 days, did you or any your household member aged 15 or over engage in any of the following activities with (name):
If yes, probe: Who engaged in this activity with (name)?
Circle all that apply.







EC7N. I would like to ask you some questions about the health and development of (name). 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 (name)'s development.
Can (name) identify colours?

EC7M. Can (name) recognize simple shapes such as triangles, rectangles and circles?

EC8. Can (name) identify or name at least ten letters of the alphabet?

EC9. Can (name) read at least four simple words?

EC9A. Can (name) count?

EC10. Does (name) know the name and recognize the symbol of all numbers from 1 to 10?

EC11. Can (name) pick up a small object with two fingers, like a stick or a rock from the ground?

EC12. Is (name) sometimes too sick to play?

EC13. Does (name) follow simple directions on how to do something correctly?

EC14. When given something to do, is (name) able to do it independently?

EC15. Does (name) get along well with other children?

EC16. Does (name) kick, bite, or hit other children or adults?

EC17. Does (name) get distracted easily?

Breastfeeding and dietary intake: BD

BD1. Check AG2 for age of child.
BD2. Has (name) ever been breastfed?

BD3. Is (name) still being breastfed?

BD4. Yesterday, during the day or night, did (name) drink anything from a bottle with a nipple?

BD5. Did (name) drink ORS (oral rehydration solution) yesterday, during the day or night?

BD6. Did (name) drink or eat vitamin or mineral supplements or any medicines yesterday, during the day or night?

BD7. Now I would like to ask you about (other) liquids that (name) may have had yesterday during the day or the night. I am interested to know whether (name) had the item even if combined with other foods.
Please include liquids consumed outside of your home.
Did (name) drink (name of item) yesterday during the day or the night:

[A] Plain water?

[B] Juice or juice drinks?

[C] Clear soup?

[D] Milk such as tinned, powdered, fresh animal milk or milk diluted with water?

[E] Infant formula, e.g., milasan, nana?

[G] Tea?

[F] Any other liquids?

BD8. Now I would like to ask you about foods that (name) may have had yesterday during the day or the night. Again, I am interested to know whether (name) had the item even if combined with other foods.
Please include foods eaten outside of your home.
Did (name) eat (name of food) yesterday during the day or the night:

[A] Yogurt?
If yes: How many times did (name) drink or eat yogurt? If 7 or more times, record '7'. If unknown, record '8'.

[B] A commercially fortified baby food, e.g., humana?

[C] Bread, rice, noodles, porridge, or other foods made from grains?

[D] Carrots, pumpkin, squash or sweet potatoes that are yellow or orange inside?

[E] Potatoes, turnip, wild radish or any other foods made from roots?

[F] Any dark green, leafy vegetables such as broccoli, spinach?

[G] Vitamin A-rich fruits such as peach, kiwi, or banana?

[H] Any other fruits or vegetables?

[I] Liver, kidney, heart or other organ meats?

[J] Any meat, such as beef, pork, lamb, goat, chicken, or duck?

[K] Eggs?

[L] Fresh or dried fish?

[M] Any foods made from beans, peas, lentils, or nuts?

[N] Cheese, milk or other food made from milk?

[O] Any other solid, semi-solid, or soft food that I have not mentioned?

BD9. Check BD8 (Categories "A" through "O").
BD10. Ask to determine whether the child ate any solid, semi-solid or soft foods yesterday during the day or night.
BD11. How many times did (name) eat any solid, semi-solid or soft foods yesterday during the day or night?
If 7 or more times, record '7'.
Immunization: IM

If an immunization (child health) card or mother and child's health book is available to a mother/caretaker, copy the dates in IM3 for each type of immunization and Vitamin A recorded on the card. IM6-IM17 are for registering vaccinations that are not recorded on the card. IM6-IM17 will only be asked when a card is not available.

IM1. Does (name) have a vaccination card?
If yes: May I see it?
IM2. Did (name) ever have a vaccination card?

IM2A. Has (name) been registered with corresponding community health post?

IM2B. Does (name) have mother and child's health book?
If yes, probe: May I see it?

IM3.

BCG

Polio at birth

Polio 1

Polio 2

Polio 3

Pentavalent 1

Pentavalent 2

Pentavalent 3

HepB

Measles (or MMR or MR) 1

Measles (or MMR or MR) 2

Vitamin A (first dose)

Vitamin A (second dose)

Vitamin A (third dose)

IM4. Check IM3. Are all vaccines (BCG to Measles1) recorded on the card or book?
IM5. In addition to what is recorded on this card or child's health book, did (name) receive any other vaccinations ? including vaccinations received in campaigns or immunization days?

IM6. Has (name) ever received any vaccinations to prevent him/her from getting diseases, including vaccinations received in a campaign or immunization day?

IM7. Has (name) ever received a BCG vaccination against tuberculosis ? that is, an injection in the arm or shoulder that usually causes a scar?

IM7A. When did (name) receive the BCG vaccination against tuberculosis after birth?
[A] Within 24 hours after birth?

[B] Within 2 weeks after birth?

[C] 15 and more days after birth?

IM8. Has (name) ever received any vaccination drops in the mouth to protect him/her from polio?

IM9. When did (name) receive the first polio vaccine after birth?
[A] Within 24 hours after birth?

[B] Within 2 weeks after birth?

[C] 15 and more days after birth?

IM10. How many times was the polio vaccine received?

IM11. Has (name) ever received a pentavalent vaccination ? that is, an injection in the thigh?
Pentavalent is a vaccination against tetanus, whooping cough, diphtheria, hepatitis B and haemophilus influenzae B.
Probe by indicating that pentavalent vaccinations are sometimes given at the same time as Polio vaccination.
IM12. How many times was a pentavalent vaccine received?

IM13. Has (name) ever been given a Hepatitis B vaccination ? that is, an injection in the thigh to prevent him/her from getting Hepatitis B?
Probe by indicating that the Hepatitis B vaccine is sometimes given at the same time as Polio and DPT vaccines.
IM14. When did (name) receive the first hepatitis B vaccine after birth?
[A] Within 24 hours after birth?

[B] Within 2 weeks after birth?

[C] 15 and more days after birth?

IM16. Has (name) ever received a measles injection (or an MMR or MR) ? that is, a shot in the arm at the age of 9 months or older - to prevent him/her from getting measles?

IM16A. How many times was measles injection received?

IM18. Did (name) take vitamin A that is given at the age of more 6-11 months?
Show Vitamin A blue coloured capsules with 100000 IU
IM18A. Did (name) take vitamin A that is given at the age of 12-59 months?
Show Vitamin A red coloured capsules with 200000 IU
IM18B. Did (name) take vitamin D in the last 12 months?

IM18C. Which month was it when (name) took vitamin D the last time?

IM18D. Has (name) received vitamin D by tablet or syrup?
[A] Received vitamin D by tablet?

[B] Received vitamin D by syrup?

IM19. Has (name) ever participated in the following national immunization days:
[A] May immunization

[B] October immunization

[C] October immunization

IM20. Check IM3:
Care of illness: CA

CA1. In the last two weeks, has (name) had diarrhoea?

CA2. I would like to know how much (name) was given to drink during the diarrhoea (including breastmilk and other liquid).
During the time (name) had diarrhoea, was he/she given less than usual to drink, about the same amount, or more than usual?
If 'less', probe: Was he/she given much less than usual to drink, or somewhat less?
CA3. During the time (name) had diarrhoea, was he/she given less than usual to eat, about the same amount, more than usual, or nothing to eat?
If 'less', probe: Was he/she given much less than usual to eat or somewhat less?
CA3A. Did you seek any advice or treatment for the diarrhoea from any source?

CA3B. From where or whom did you seek advice or treatment?
Probe: Anywhere else or someone else? Circle all providers mentioned, but do not prompt with any suggestions. Probe to identify each type of source. If unable to determine whether referred to public or private sector, write the name of the place.
(Name of place) ____

CA3C. Check CA3B: Whether 2 or more codes circled.
CA3D. Where or whom did you first seek advice?
Probe: Probe to identify the type of source. Do not prompt with any suggestions. If unable to determine whether referred to public or private sector, write the name of the place.
(Name of place) ____

CA4. During the time (name) had diarrhoea, was (name) given to drink any of the following:
Read each and record response before proceeding to the next item.

[A] "Khorosol" ORS packet?

[F] "Oralit" ORS packet?

[G] "Unicef" ORS packet?

[H] Any other ORS packet? (specify) ____

CA4A. Check CA4: ORS.
CA4B. Where did you get the ORS?
Probe to identify the type of source. If unable to determine whether referred to public or private, write the name of the place.
(Name of place) ____

CA4C. During the time (name) had diarrhoea, was (name) given:

[A] Zinc tablets?

[B] Zinc syrup?

CA4D. Check CA4C: Any zinc?
CA4E. Where did you get the zinc?
Probe to identify the type of source. If unable to determine whether referred to public or private, write the name of the place.
(Name of place) ____

CA4F. During the time (name) had diarrhoea, was (name) given to drink any of the following:
Read each and record response before proceeding to the next item.
[A] A homemade ORS fluid for diarrhoea?

[B] Boiled water?

[C] Diluted soup?

[D] Rice juice?

CA5. Was anything (else) given to treat the diarrhoea?

CA6. What (else) was given to treat the diarrhoea?
Probe: Anything else? Record all treatments given. Write brand name(s) of all medicines mentioned.
(Name) ____

CA6C. Who recommended such treatment?

CA6A. In the last two weeks, has (name) been ill with a fever at any time?

CA7. At any time in the last two weeks, has (name) had an illness with a cough?

CA8. When (name) had an illness with a cough, did he/she breathe faster than usual with short, rapid breaths or have difficulty breathing?

CA9. Was the fast or difficult breathing due to a problem in the chest or a blocked nose?

CA9A. Check CA6A: Had fever?
CA9B. I would like to know how much (name) was given to drink (including breastmilk) during the illness with a (fever/cough).
During the time (name) had (fever/cough), was he/she given less than usual to drink, about the same amount, or more than usual?
If 'less', probe: Was he/she given much less than usual to drink, or somewhat less?
CA9C. During the time (name) had (fever/cough), was he/she given less than usual to eat, about the same amount, more than usual, or nothing to eat?
If 'less', probe: Was he/she given much less than usual to eat, or somewhat less?
CA10. Did you seek any advice or treatment from any source?

CA11. From where or whom did you seek advice or treatment?
Probe: Anywhere else or someone else? Circle all providers mentioned, but do not prompt with any suggestions. Probe to identify each type of source. If unable to determine if referred to public or private sector, write the name of the place.
(Name of place) ____

CA11A. Check CA11:
CA11B. Where or whom did you first seek advice or treatment?
Probe: Anywhere else or someone else? Circle all providers mentioned, but do not prompt with any suggestions. Probe to identify each type of source. If unable to determine if referred to public or private sector, write the name of the place.
(Name of place) ____

CA12. At any time during the illness, was (name) given any medicine/injection for the illness?

CA13. What medicine/injection was (name) given?
Probe: Any other medicine/injection? Circle all medicines given. Write brand name(s) of all medicines mentioned.
(Names of medicines) ____
____
____
____

CA13A. Check CA13 for antibiotic mentioned (codes I or J)?
CA13B. Where did you get the antibiotics?
Probe to identify the type of source. If unable to determine whether referred to public or private, write the name of the place.
(Name of place) ____

CA14. Check AG: Age of child.
CA15. The last time (name) passed stools, what was done to dispose of the stools?

Child Functioning (Age 2-4): CF

CF0. Check child's age from AG2:
CF1. I would like to ask you some questions about difficulties your child may have. Does (name) wear glasses?

CF2. Does (name) use a hearing aid?

CF3. Does (name) use any equipment or receive assistance for walking?

CF4. In the following questions, I will ask you to answer by selecting one of four possible answers. For each question, would you say that (name) has: 1) No difficulty, 2) Some difficulty, 3) A lot of difficulty, or 4) that (he/she) cannot at all.
Repeat the categories during the individual questions whenever the respondent does not use an answer category:
Remember the four possible answers: Would you say that (name) has: 1) No difficulty, 2) Some difficulty, 3) A lot of difficulty, or 4) that (he/she) cannot at all?

CF5. Check CF1: Child wears glasses (CF1 = 1)?
CF6A. When wearing (his/her) glasses, does (name) have difficulty seeing?
CF6B. Does (name) have difficulty seeing?

CF7. Check CF2: Child uses hearing aid (CF2 = 1)?
CF8A. When using (his/her) hearing aid(s), does (name) have difficulty hearing sounds like peoples' voices or music?
CF8B. Does (name) have difficulty hearing sounds like peoples' voices or music?

CF9. Check CF3: Child uses equipment or uses assistance for walking (CF3 = 1)?
CF10. Without using (his/her) equipment or assistance, does (name) have difficulty walking?

CF11. When using (his/her) equipment or assistance, does (name) have difficulty walking?

CF12. Compared with children of the same age, does (name) have difficulty walking?

CF13. Compared with children of the same age, does (name) have difficulty picking up small objects with (his/her) hand?

CF14. Does (name) have difficulty understanding you?

CF15. When (name) speaks, does (he/she) have difficulty being understood by you?

CF16. Compared with children of the same age, does (name) have difficulty learning things?

CF17. Compared with children of the same age, does (name) have difficulty playing?

CF18. The next question has five different options for answers. I am going to read these to you after the question.
Compared with children of the same age, how much does (name) kick, bite or hit other children or adults?
Would you say: not at all, less, the same, more or a lot more?

UF13. Record the time
UF14. Check List of Household Members, columns HL7B and HL15 to see if the respondent is a mother or caretaker of another child under 5 living in this household?
Anthropometry: AN

After questionnaires for all children are complete, the measurer weighs and measures each child under 5.
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 in the HL of the Household Questionnaire before recording measurements.

AN1. Measurer's name and number:
AN2. Result of height / length and weight measurement:
AN3. Child's weight:
AN3A. Was the child undressed to the minimum?
AN3B. Check AG2 age of child:
AN4. Child's length or height:
AN4A. How was the child actually measured? Lying down or standing up?
AN6. Is there another child in the household who is eligible for measurement?
Interviewer's observations

Supervisor's observations

Measurer's observations