Tonga Multiple Indicator Cluster Survey 2019

Under-five child information panel: UF

UF1. Cluster number: _ _ _

UF2. Household number: _ _

UF3. Child's name and line number:
UF4. Mother's/caretaker's name and line number:
UF5. Interviewer's name and number:
UF6. Supervisor's name and number:
UF7. Day/month/year of interview
UF8. Record the time:

Check respondent's age in HL6 in list of household members, household questionnaire:
If age 15-17, verify that adult consent for interview is obtained (HH33 or HH39) or not necessary (HL20=90). If consent is needed and not obtained, the interview must not commence and '06' should be recorded in UF17. The respondent must be at least 15 years old.


UF9. Check completed questionnaires in this household: Have you or another member of your team interviewed this respondent for another questionnaire?

UF10A. Hello, my name is (your name). We are from Tonga Statistics Department. We are conducting a survey about the situation of children, families and households. I would like to talk to you about (child's name from UF3)'s health and well-being. This interview will take about 30 minutes. All the information we obtain will remain strictly confidential and anonymous. If you wish not to answer a question or wish to stop the interview, please let me know. May I start now?
UF10B. Now I would like to talk to you about (child's name from UF3)'s health and well-being in more detail. This interview will take about number minutes. Again, all the information we obtain will remain strictly confidential and anonymous. If you wish not to answer a question or wish to stop the interview, please let me know. May I start now?

UF17. Result of interview for children under 5
Under-five's background: UB

UB0. Before I begin the interview, could you please bring (name)'s Birth Certificate, National Immunisation Record, and any immunisation record from a private health provider? We will need to refer to those documents.

UB1. On what day, month and year was (name) born?

UB2. How old is (name)?

UB3. Check UB2: Child's age?
UB4. Check the respondent's line number (UF4) and the respondent to the household questionnaire (HH47): Is this respondent also the respondent to the Household Questionnaire?
UB5. Check ED10 in the education module in the household questionnaire: Is the child attending ECE in the current school year?
UB6. Has (name) ever attended any early childhood education programme, such as Kindergarten?

UB6A. What is the main reason for (name) not attending any early childhood education programme?

UB7. At any time since February, did (he/she) attend (programmes mentioned in UB6)?

UB8A. Does (he/she) currently attend (programmes mentioned in UB6)?
UB8B. You have mentioned that (name) has attended an early childhood education programme this school year. Does (he/she) currently attend this programme?

UB9. Is (name) covered by any health insurance?

UB10. What type of health insurance is (name) covered by?

Birth registration: BR

BR1. Does (name) have a birth certificate?

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:

[A] Homemade toys, such as dolls, cars, or other toys made at home?

[B] Toys from a shop or manufactured toys?

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

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.
On how many days in the past week was (name):
[A] Left alone for more than an hour?
[B] Left in the care of another child, that is, someone less than 10 years old, for more than an hour?
If 'None' record '0'. If 'Don't know' record '8'.

EC4. Check UB2: Child's age?
EC5. In the past 3 days, did you or any household member age 15 or over engage in any of the following activities with (name):

[A] Read books or looked at picture books with (name)?

[B] Told stories to (name)?

[C] Sang songs to or with (name), including lullabies?

[D] Took (name) outside the home?

[E] Played with (name)?

[F] Named, counted, or drew things for or with (name)?

EC5G. Check UB2: Child's age?
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.

EC6. Can (name) identify or name at least ten letters of the alphabet?

EC7. Can (name) read at least four simple, popular words?

EC8. Does (name) know the name and recognize the symbol of all numbers from 1 to 10?

EC9. Can (name) pick up a small object with two fingers, like a stick or a rock from the ground?

EC10. Is (name) sometimes too sick to play?

EC11. Does (name) follow simple directions on how to do something correctly?

EC12. When given something to do, is (name) able to do it independently?

EC13. Does (name) get along well with other children?

EC14. Does (name) kick, bite, or hit other children or adults?

EC15. Does (name) get distracted easily?

Child discipline: UCD

UCD1. Check UB2: Child's age?
UCD2. Adults use certain ways to teach children the right behavior or to address a behavior problem. I will read various methods that are used. Please tell me if you or any other adult in your household has used this method with (name) in the past month.

[A] Took away privileges, forbade something (name) liked or did not allow (him/her) to leave the house.

[B] Explained why (name)'s behavior was wrong.

[C] Shook (him/her).

[D] Shouted, yelled at or screamed at (him/her).

[E] Gave (him/her) something else to do.

[F] Spanked, hit or slapped (him/her) on the bottom with bare hand.

[G] Hit (him/her) on the bottom or elsewhere on the body with something like a belt, hairbrush, stick or other hard object.

[H] Called (him/her) dumb, lazy or another name like that.

[I] Hit or slapped (him/her) on the face, head or ears.

[J] Hit or slapped (him/her) on the hand, arm, or leg.

[K] Beat (him/her) up, that is hit (him/her) over and over as hard as one could.

UCD3. Check UF4: Is this respondent the mother or caretaker of any other children under age 5 or a child age 5-14 selected for the questionnaire for children age 5-17?
UCD4. Check UF4: Has this respondent already responded to the following question (UCD5 or FCD5) for another child?
UCD5. Do you believe that in order to bring up, raise, or educate a child properly, the child needs to be physically punished?

Child functioning: UCF

UCF1. Check UB2: Child's age?
UCF2. I would like to ask you some questions about difficulties (name) may have.
Does (name) wear glasses?

UCF3. Does (name) use a hearing aid?

UCF4. Does (name) use any equipment or receive assistance for walking?

UCF5. 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.

UCF6. Check UCF2: Child wears glasses?
UCF7A. When wearing (his/her) glasses, does (name) have difficulty seeing?
UCF7B. Does (name) have difficulty seeing?

UCF8. Check UCF3: Child uses a hearing aid?
UCF9A. When using (his/her) hearing aid(s), does (name) have difficulty hearing sounds like peoples' voices or music?
UCF9B. Does (name) have difficulty hearing sounds like peoples' voices or music?

UCF10. Check UCF4: Child uses equipment or receives assistance for walking?
UCF11. Without (his/her) equipment or assistance, does (name) have difficulty walking?

UCF12. With (his/her) equipment or assistance, does (name) have difficulty walking?

UCF13. Compared with children of the same age, does (name) have difficulty walking?

UCF14. Compared with children of the same age, does (name) have difficulty picking up small objects with (his/her) hand?

UCF15. Does (name) have difficulty understanding you?

UCF16. When (name) speaks, do you have difficulty understanding (him/her)?

UCF17. Compared with children of the same age, does (name) have difficulty learning things?

UCF18. Compared with children of the same age, does (name) have difficulty playing?

UCF19. 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?

Breastfeeding and dietary intake: BD

BD1. Check UB2: Child's age?
BD2. Has (name) ever been breastfed?

BD3. Is (name) still being breastfed?

BD3A. Check UB2: Child's age?
BD4. Yesterday, during the day or night, did (name) drink anything from a bottle with a nipple?

BD5. Did (name) drink Oral Rehydration Salt solution (ORS) 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 all other liquids that (name) may have had yesterday during the day or the night.
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] Hu'a supo?

[D] Infant formula, such as SMA, Karicare, S-26?

[D1] How many times did (name) drink infant formula?

[E] Milk from animals, such as fresh, tinned, or powdered milk?

[E1] How many times did (name) drink milk?

[X] Any other liquids?

[X1] Record all other liquids mentioned.

BD8. Now I would like to ask you about everything that (name) ate yesterday during the day or the night. Please include foods consumed outside of your home.
Think about when (name) woke up yesterday. Did (he/she) eat anything at that time?
If 'Yes' ask: Please tell me everything (name) ate at that time. Probe: Anything else?
Record answers using the food groups below.
What did (name) do after that? Did (he/she) eat anything at that time?
Repeat this string of questions, recording in the food groups, until the respondent tells you that the child went to sleep until the next morning. For each food group not mentioned after completing the above ask: Just to make sure, did (name) eat (food group items) yesterday during the day or the night.

[A] Yogurt made from animal milk?

[A1] How many times did (name) eat yogurt?

[B] Any baby food, such as Cerelac, Gerber, Hero, or Nestum?

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

[D] Pumpkin, carrots, squash, or sweet potatoes that are yellow or orange inside?

[E] White potatoes, white yams, cassava, or any other foods made from roots?

[F] Any dark green, leafy vegetables, such as taro leaves?

[G] Ripe mangoes or ripe papayas or ripe bananas?

[H] Any other fruits or vegetables, such as watermelon, apple, pear, most commonly eaten fruits and vegetables?

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

[J] Any other meat, such as beef, pork, lamb, goat, chicken, duck or sausages made from these meats?

[K] Eggs?

[L] Fish or shellfish, either fresh or dried?

[M] Beans, peas, lentils or nuts, including any foods made from these?

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

[X] Other solid, semi-solid, or soft food?

[X1] Record all other solid, semi-solid, or soft food that do not fit food groups above.

BD9. How many times did (name) eat any solid, semi-solid or soft foods yesterday during the day or night?

Immunisation: IM

IM1. Check UB2: Child's age?
IM2. Do you have a National Immunisation card, immunisation records from a private health provider or any other document where (name)'s vaccinations are written down?

IM3. Did you ever have a National Immunisation card or immunisation records from a private health provider for (name)?

IM4. Check IM2:
IM5. May I see the card(s) (and/or) other document?

IM6.

(a) Copy dates for each vaccination from the documents.
(b) Write '44' in day column if documents show that vaccination was given but no date recorded

HepB (at birth)

BCG

Polio (OPV) 1

Polio (OPV) 2

Polio (OPV) 3

IPV 1

Pentavalent (DTPHibHepB) 1

Pentavalent (DTPHibHepB) 2

Pentavalent (DTPHibHepB) 3

DTP 4

MR 1

MR2

IM7. Check IM6: Are all vaccines (HepB to MR2) recorded?
IM8. Did (name) participate in any of the following campaigns:
[A] April 2017 Vaccination campaign (vaccination week of the Americas)

[B] April 2016 Vaccination campaign (vaccination week of the Americas)

IM9. In addition to what is recorded on the document(s) you have shown me, did (name) receive any other vaccinations including vaccinations received during the campaigns, immunization week just mentioned?

IM10. Go back to IM6 and probe for these vaccinations.
Record '66' in the corresponding day column for each vaccine received. For each vaccination not received record '00' in day column.
When finished, go to end of module. (Go to end of module)

IM11. Has (name) ever received any vaccinations to prevent (him/her) from getting diseases, including vaccinations received in a campaign, immunisation day or child health day?

IM8. Did (name) participate in any of the following campaigns:
[A] April 2017 Vaccination campaign (vaccination week of the Americas)

[B] April 2016 Vaccination campaign (vaccination week of the Americas)

IM13. Check IM11 and IM12:
IM14. Has (name) ever received a BCG vaccination against tuberculosis - that is, an injection in the arm or shoulder that usually causes a scar?

IM15. Did (name) receive a Hepatitis B vaccination - that is an injection on the outside of the thigh to prevent Hepatitis B disease - within the first 24 hours after birth?

IM16. Has (name) ever received any vaccination drops in the mouth to protect (him/her) from polio?
Probe by indicating that the first drop is usually given at birth and later at the same time as injections to prevent other diseases.
IM17. Were the first polio drops received in the first two weeks after birth?

IM18. How many times were the polio drops received?

IM19. The last time (name) received the polio drops, did (he/she) also get an injection to protect against polio?
Probe to ensure that both were given, drops and injection.
IM20. Has (name) ever received a Pentavalent vaccination - that is, an injection in the thigh to prevent (him/her) from getting tetanus, whooping cough, diphtheria, Hepatitis B disease, and Haemophilus influenzae type B?
Probe by indicating that Pentavalent vaccination is sometimes given at the same time as the polio drops.
IM21. How many times was the Pentavalent vaccine received?

IM26. Has (name) ever received a MR vaccine - that is, a shot in the arm at the age of 1 year or older - to prevent (him/her) from getting measles, mumps and rubella?

IM26A. How many times was the MMR/MR vaccine received?

IM28. Issue a questionnaire form for vaccination records at health facility for this child. Complete the Information Panel on that Questionnaire

Care of illness: CA

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

CA2. Check BD3: Is child still breastfeeding?
CA3A. I would like to know how much (name) was given to drink during the diarrhoea. This includes breastmilk, Oral Rehydration Salt solution (ORS) and other liquids given with medicine. During the time (name) had diarrhoea, was (he/she) given less than usual to drink, about the same amount, or more than usual?
CA3B. I would like to know how much (name) was given to drink during the diarrhoea. This includes Oral Rehydration Salt solution (ORS) and other liquids given with medicine. 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?
CA4. 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?
CA5. Did you seek any advice or treatment for the diarrhoea from any source?

CA6. Where did you seek advice or treatment?
Probe: Anywhere else? Record all providers mentioned, but do not prompt with any suggestions. Probe to identify each type of provider. If unable to determine if public or private sector, write the name of the place and then temporarily record 'W' until you learn the appropriate category for the response.
(Name of place) ____

CA7. During the time (name) had diarrhoea, was (he/she) given:

[B] A fluid made from a special packet called Vai masima or pre-packaged ORS fluid?

[C] Zinc tablets or syrup?

CA8. Check CA7[B]: Was child given any ORS?
CA9. Where did you get the (ORS mentioned in CA7[A] and/or CA7[B])?
Probe to identify the type of source. If 'Already had at home', probe to learn if the source is known. If unable to determine whether public or private, write the name of the place and then temporarily record 'W' until you learn the appropriate category for the response.
(Name of place) ____

CA12. Was anything else given to treat the diarrhoea?

CA13. What else was given to treat the diarrhoea?
Probe: Anything else? Record all treatments given. Write brand name(s) of all medicines mentioned.
(Name of brand) ____

CA14. At any time in the last two weeks, has (name) been ill with a fever?

CA16. At any time in the last two weeks, has (name) had an illness with a cough?

CA17. At any time in the last two weeks, has (name) had fast, short, rapid breaths or difficulty breathing?

CA18. Was the fast or difficult breathing due to a problem in the chest or a blocked or runny nose?

CA19. Check CA14: Did child have fever?
CA20. Did you seek any advice or treatment for the illness from any source?

CA21. From where did you seek advice or treatment?
Probe "Anywhere else?". Record all providers mentioned, but do not prompt with any suggestions. Probe to identify the type of each provider. If unable to determine if public or private sector, write the name of the place and then temporarily record 'W' until you learn the appropriate category for the response.
(Name of place) ____

CA22. At any time during the illness, was (name) given any medicine for the illness?

CA23. What medicine was (name) given?
Probe: Any other medicine? Record all medicines given. If unable to determine type of medicine, write the brand name and then temporarily record 'W' until you learn the appropriate category for the response
(Name of brand) ____
(Name of brand) ____

CA24. Check CA23: Antibiotics mentioned
CA25. Where did you get the (name of medicine from CA23, codes L to O)?
Probe to identify the type of source. If 'Already had at home', probe to learn if the source is known. If unable to determine whether public or private, write the name of the place and then temporarily record 'W' until you learn the appropriate category for the response.
(Name of place) ____

CA30. Check UB2: Child's age?
CA31. The last time (name) passed stools, what was done to dispose of the stools?

UF11. Record the time.
UF12. Language of the Questionnaire.
UF13. Language of the Interview.
UF14. Native language of the Respondent.
UF15. Was a translator used for any parts of this questionnaire?
UF16. Tell the respondent that you will need to measure the weight and height of the child before you leave the household and a colleague will come to lead the measurement. Issue the anthropometry module form for this child and complete the Information Panel on that Form.
Check columns HL10 and HL20 in list of household members, household questionnaire: Is the respondent the mother or caretaker of another child age 0-4 living in this household?
Interviewer's observations ________

Supervisor's observations ________

Anthropometry module information panel: AN

AN1. Cluster number: _ _ _

AN2. Household number _ _

AN3. Child's name and line number:
AN4. Child's age from UB2:
AN5. Mother's/caretaker's name and line number:
AN6. Interviewer's name and number
Anthropometry

AN7. Measurer's name and number:
AN8. Record the result of weight measurement as read out by the Measurer:
Read the record back to the Measurer and also ensure that he/she verifies your record.
AN9. Was the child undressed to the minimum?
AN10. Check AN4: Child's age?
AN11A. The child is less than 2 years old and should be measured lying down. Record the result of length measurement as read out by the Measurer:
Read the record back to the Measurer and also ensure that he/she verifies your record.
AN11B. The child is at least 2 years old and should be measured standing up. Record the result of height measurement as read out by the Measurer:
Read the record back to the Measurer and also ensure that he/she verifies your record.
AN12. How was the child actually measured? Lying down or standing up?
AN13. Today's date: Day/month/year:
AN14. Is there another child under age 5 in the household who has not yet been measured?

AN15. Thank the respondent for his/her cooperation and inform your supervisor that the measurer and you have completed all the measurements in this household.

Interviewer's observations for anthropometry module ________

Measurer's observations for anthropometry module ________

Supervisor's observations for anthropometry module ________



Tonga Multiple Indicator Cluster Survey 2019


Under-five child information panel: HF

This form must be appended to the Questionnaire for children under five for each child

HF1. Cluster number: _ _ _

HF2. Household number: _ _

HF3. Child's name and line number:
HF4. Mother's/caretaker's name and line number:
HF5. Name and number of field staff recording at facility:
HF6. Interviewer's name and number:
HF7. Day/month/year of facility visit:
HF8. Record the time:
HF9. Child's day/month/year of birth: Copy from UB2 in the Under-Five's Background Module of the Questionnaire For Children Under Five:
HF10. Write the name of health facility:____ (Go to HF11)

HF15. Result of health facility visit.
HF11. Record day, month, and year of birth as written on vaccination report/card:
HF12.

(a) Copy dates for each vaccination from the documents.
(b) Write '44' in day column if documents show that vaccination was given but no date recorded

HepB (at birth)

BCG

Polio (OPV) 1

Polio (OPV)) 2

Polio (OPV) 3

(IPV) 1

Pentavalent (DPTHibHepB) 1

Pentavalent (DPTHibHepB) 2

Pentavalent (DPTHibHepB) 3

DTP 4

MR1

MR 2

HF13. For each vaccination not recorded enter '00? in day column.

HF14. Record the time:
Data Collector's Observations ________

Supervisor's Observations ________