TECHNICAL PROTOCOL FOR SMART NUTRITION SURVEY
Rubkona County, Northern Liech State
SUBMITTED TO: Nutrition Information Working Group (NIWG) STUDY AREA: Rubkona County, Northern Liech State STUDY PERIOD: 14-24th May 2018 IMPLEMENTING AGENCY: CARE
Table of Contents
1.0 Background information .......................................................................................................................................... 3
1.1 Introduction ........................................................................................................................................................ 3
1.2 Purpose of the survey ......................................................................................................................................... 3
1.3 Survey objectives ................................................................................................................................................. 3
1.4 Specific objectives ............................................................................................................................................... 4
2.0 Survey timing ........................................................................................................................................................... 4
2.1 Survey area .......................................................................................................................................................... 4
3.0 METHODOLOGY ....................................................................................................................................................... 4
3.1 Study Design ........................................................................................................................................................ 4
3.2 Survey Target Population .................................................................................................................................... 4
3.3Sample Size Determination .................................................................................................................................. 4
3.3.1SAMPLING PROSEDURE ................................................................................................................................ 5
3.3.2 First stage sampling – cluster selection ....................................................................................................... 5
3.3.3. Second stage sampling– Household selection ............................................................................................ 6
3.3.4 Selection of children .................................................................................................................................... 6
3.4 Survey team and training ......................................................................................................................................... 6
3.5 CASE DEFINITIONS OF THE VARIABLES .................................................................................................................... 6
3.5.1 Anthropometry survey ................................................................................................................................. 6
4.0Data quality control .............................................................................................................................................. 8
4.1 Data entry and analysis............................................................................................................................................ 8
Table 2: Anthropometry and Mortality Sample Size ..................................................................................................... 5
Table 3: Proposed Survey Timeline ............................................................................................................................... 8
Appendix 1: Survey questionnaires ............................................................................................................................... 9
1.0 Background information
CARE South Sudan is a subsidiary of CARE International, a leading humanitarian and development agency fighting global poverty around the world. CARE’s operations in South Sudan dates back to the early 1980s, focusing on emergency and disaster relief to the conflict affected populations. Currently, CARE South Sudan works in three States, Unity, Jonglei and Upper Nile States, addressing both humanitarian and recovery/development needs. In development/recovery programming, CARE South Sudan focuses on four broad areas namely governance and sustainable integrated livelihoods (Food security, health and Nutrition, WASH, protection of civilians and peace building) focusing on women and youth. Rubkona County which was targeted for the Nutrition SMART Survey is made up of ten administrative Payams (Rubkona, Budang, Norlamwel, Ngop, Kaljak, Dhor Bor, Wathjak, Nhialdiu, Panhiany and Bentiu). It is situated in northern part of South Sudan in the newly created state of Northern Liech. The county's population is estimated at 100,236 according to 2008 Sudan census. However majority of the inhabitants had been displaced across the county with some moving to Bentiu PoCs due to the protracted strife in the area that had started in December 2013.
1.1 Introduction CARE Emergency Nutrition Project Unity State aims to provide 60% of malnourished children and
women nutritional therapies and contribute to 10% reduction in Global Acute Malnutrition rate in four
counties in Unity State through health facility based Outpatient Therapeutic Program (OTPs) and
supplementary feeding programme. One of the Project key activities is to conduct annual nutrition
surveys/ assessment in project service delivery locations in order to monitor /determine the general
nutritional status among the under-five children, boys and girls, pregnant and lactating mothers.
The Standardized Monitoring and Assessment of Relief and Transition (SMART) survey conducted in May
2017 by CARE in Rubkona County determined a GAM prevalence rate of 17.4% (12.9-23.0 95% CI), and a
SAM rate of 3.9% (2.1-7.3 95% C.I). This level of malnutrition was classified as critical according to WHO
2006 classification.
1.2 Purpose of the survey
The main purpose of conducting the SMART surveys is to determine the prevalence of acute
malnutrition among the population in the survey area in order to allow comparison to prior year
surveys. The survey is expected to provide robust data, in line with the recommendations and
methodology developed by the national nutrition cluster in South Sudan. The result of the surveys will
inform the program progress towards the project outcome as well as form a basis for adjusting the
modalities of implementation of nutrition program in the county as will be necessary.
1.3 Survey objectives
The overall objective is to determine the prevalence of acute malnutrition among children aged 6 to 59
months, estimate retrospective mortality rate of the population as well as to assess the food security
situation and Infant and young children feeding practice (IYCF) in the county.
1.4 Specific objectives
• To determine prevalence of Global and Severe Acute Malnutrition (GAM and SAM) among
children aged 6 to 59 months in the County.
• To determine retrospective crude mortality rates (CMR) and under five mortality rates (U5MR)
• To estimate the coverage of measles vaccination (9-59 months), Vitamin A supplementation (6-
59 months) and deworming (12-59 months).
• To determine the morbidity and health seeking behaviors in the county.
• To determine infant and young child feeding practices
• To assess the current household food security situation of the county
• To assess the hygiene practices and access to water and sanitation.
2.0 Survey timing
The surveys will be conducted from 14– 24th May 2018, inclusive of coordination with authorities, training and data collection.
2.1 Survey area
The survey will be carried out in all payams in Rubkona County. The smallest geographical unit (village) in the County will be considered as a cluster. When on the ground if there are areas that are not accessible due to security and population movement/displacements they will be removed from the sampling frame.
3.0 METHODOLOGY
3.1 Study Design
A cross-sectional two-stage cluster sampling following SMART methodology will be adopted. The first stage will involve selection of the clusters. The villages will be considered as the smallest geographical unit (clusters) in the host community while in the comp block/zone will be considered as the smallest geographical unit. Household1 will be considered as the basic sampling unit. The second stage will involve selection of households.
3.2 Survey Target Population
The target population for this survey will be the children aged 6–59 months for the anthropometric and the health questionnaire, respondents will be the mothers or caregivers of the children. The household heads will be the respondents for individual mortality questionnaires which will include all members of the household. The sampling frame will contain only the list of villages considered secure and accessible. Only selected households will be surveyed.
3.3Sample Size Determination
Emergency Nutrition Assessment (ENA) for SMART software updated version 9th July 2015 will be used for sample size calculation. The purpose of the sample calculation is to get a sample having the optimal units so that results are reliable; with reasonable precision. The sample size calculation takes into
consideration the most important indicators: the anthropometry and the mortality. The parameters for the sample size calculation are as outlined in table 1 and 2 below.
Table 1: Anthropometry and Mortality Sample Size
The sample size of households determined for Anthropometry and Mortality is different. In Mortality 412 households were obtained whereas in Anthropometry it was 497. Therefore, 497 households will be considered in both Anthropometry and Mortality for consistency. Taking in to account travel hours, introduction and household listing, time taken to administer a questionnaire in a household and lunch break, it was estimated that 14 households could be visited by each team per day. Thus, the total number of clusters was determined after dividing the total number of households (497/14) 35.5 rounds to 36 clusters.
3.3.1SAMPLING PROSEDURE
3.3.2 First stage sampling – cluster selection
A cross sectional, two‐stage cluster survey will be employed to collect nutritional and mortality data as well as contextual data. The Emergency Nutrition Assessment (ENA) for Standardized Monitoring of Relief and Transitions (SMART), July 9th 2015 version will be used to determine the cluster assignment using the updated village‐level population data.
Parameters
Anthropometry value
Mortality value
Rationale/source
Estimated prevalence (%)
17.4%
1.1
Point prevalence (GAM) 17.4% (12.9-23.0) CARE Rubkona SMART survey result May 2017.
Point prevalence CMR1.1 (0.77-1.6), CARE Rubkona SMART survey result, May 2017.The anticipated acute malnutrition as well as mortality situation is likely to be the same.
Desired precision (%) 4.0 0.5 As per SMART guideline
Design effect 1.2 1.3 CARE Rubkona May 2017 SMART survey result
Recall period in days 95 Ninety five days recall period with possible correction at field during the training.
Percent of U5 children (%)
16.5% CARE Rubkona May 2017 SMART survey result
Average HH size 6.3 6.3 CARE Rubkona May 2017 SMART survey result.
Percent of non-responsive HH (%)
3 3 Anticipated non-response
Sample size
451 children 497 HHs
2518 people 412 HHs
The smallest geographic unit/villages included in the sample frame will be entered into the software with their population numbers. The SMART software then randomly assigned clusters, with the chance of each village being chosen proportional to its population size (PPS) and 36 clusters will be selected. This technique allows every village has the same probability of being selected. In order for a survey to be truly representative, every member of the population must have an equal chance of being chosen.ENA for SMART will also generate reserve clusters that will only be implemented if 10% of clusters cannot be included or 80% of sample size of children is not reached.
3.3.3. Second stage sampling– Household selection
The second stage of sampling will be the household selection within the clusters/village. On arrival at the village, the survey team will introduce themselves and the objectives of the survey to the village leader. If the selected village/cluster is big which is more than 100 households then the team will segment the village into smallest sub villages/hamlets. Then the team will select one out of the smallest hamlet/sub villages using a lottery method. By asking the selected village leader, the team will list out all households residing in the village at the date of the survey. Then, using simple random sampling method (SRS) the team will select 14 household from the name listed between 1 and the last number which correspond the listed households. The team will start the survey from any convenient randomly selected household. If the household is missing, the survey team will return back to check for the household later in the day. If the household is still away then the team will consider as absent. No replacement of absent household.
3.3.4 Selection of children
The mother of every household who have children 0-59 months will be interviewed. If a child is missing, the survey team will return to the household to check for the child later in the day. If the child is still away then the team will consider as absent. No replacement of absent children.
3.4 Survey team and training
Six survey teams each comprising of 1 team leader and 2 enumerators will be involved in the survey.A four days training will be given for enumerators (measurer and assistant measurer), team leaders and supervisors. The first three days of training, the trainees will attend theoretical sessions on basic malnutrition, sampling and demonstration on body measurement, recognition of the signs and symptoms of malnutrition including nutritional bi-lateral oedema and how to fill the questionnaire, interview techniques and standardization test.The standardization test will include at least 10 healthychildren and will take place on the 4th day of the training. A field test will also be performed on a nearby purposively selected non-sampled cluster on the 4th day of the training. On both occasions feedback will be shared and notable gaps addressed sufficiently before proceeding toactual data collection.
3.5 CASE DEFINITIONS OF THE VARIABLES
3.5.1 Anthropometry survey
The following data will be collected for all children aged between 6 and 59 months (children between 65 and 110 cm will be included in the survey).
Age: Children 6-59 months from the selected households are eligible for the survey. The team will ask mothers/caregivers to bring birth certificate, baptism certificate, immunization card and other
documents to get accurate age of the child. If the child doesn’t have official documents the team will use a local event and seasonal calendar to remind the mothers or caregivers. A height stick can be used for selecting children who are shorter than 110 cm to determine their age and include them in the survey. In case the age of the child cannot be estimated, children measuring between 65 and 110 cm will be included in the survey. However, children who are above six months old but less than 65 cm will also be considered as eligible for the survey.
Weight: Electronics scale (SECA) will be used to take the weight of children 6 to 59 months of age.
Height: A height stick can be used for screening children shorter than 110cm, and for deciding whether the child should be measured standing up or lying down. This should consist of a simple stick measuring exactly 110cm, with a mark at 87 cm and 110 cm against which the child is set standing. Height/length measurements be taken as describe in the assessment guideline and read to the nearest 0.1 cm.
Children less than 24 months will be measured lying down, and children greater than or equal to 24 months will be measured in standing position. Where age cannot be estimated a height will be taken for children greater than or equal to 87.0 cm and length will be taken for those less than 87.0 cm in a lying position.
MUAC: Mid-upper arm circumference measurements will be made using a flexible and non-stretch tape. The MUAC is interpreted as both for graduated and color labeled. Red color (MUAC <115 mm) will be classified as severe and yellow color (MUAC >=115 cm and <125 mm) will be considered as moderately malnourished. While the green color (MUAC >= 125 mm) will be categorized as normal as per WHO classification. MUAC measurement will be taken on the midpoint of the left upper arm. All children in the selected households aged 6-59 months will be measured to the nearest 0.1 cm or 1.0 mm.
Oedema (Nutritional bi-lateral Oedema):to diagnose oedema, normal thumb pressure is applied to the tops of the feet for about three seconds (if you count “one thousand and one, one thousand and two, one thousand and three” in English, pronouncing the words carefully, this takes about three seconds). If there is oedema, an impression remains on both feet for some time (at least a few seconds) where the oedema fluid has been pressed out of the tissue.
Measles immunization: information will be collected from the records on the immunization card and if there is no card mother/caregiver recall will be considered. Mothers/care givers will be interviewed for their children between 9-59 months age. Finally both verbal (mother recall) and cards will be computed separately.
Vitamin A supplementation:When asking a mother about vitamin A supplementation, the team will bring a capsule and show the mother to check whether or not the child has taken vitamin ‘A’ in the past six months prior to the survey date. Mothers/care givers will be interviewed for their children between 6 and 59 months.
De-worming: Information will be collected from the records on the immunization card and if there is no card mothers/caregiver recall will be considered. Mothers/caregiver will be interviewed for their children between 12 and 59 months age.
Retrospective mortality: The number of deaths by age group (below five and above five years) during the recall period will be recorded retrospectively for all visited households. The information that will be collected in each individual household in the recall period may include total household size, total under
five children in the household, joined and left in the household and join and left under five children, births and finally deaths for both under five and above five year old. The Mortality information will be collected on an individual level.
Retrospective morbidity:Two-weeks retrospective morbidity data will be collected from mothers/caregivers of all children (6-59 months) included in the anthropometric measurement. The mother/caregiver will be asked whether or not the child had had diarrhea, cough, fever, skin infection and eye infection in the two weeks preceding the survey. The operational definition of diarrhea, fever and cough will be clearly placed at the bottom of the data collection format. The survey teams will be trained about these operational definitions.
Other indicators: Food security and Livelihoods, WASH and IYCF will be collected
4.0Data quality control
The high quality of the training coupled with standardization test, practical field exercise (pre-test survey questionnaires) and close supportive supervision, Calibration and use of faultless survey equipment and daily plausibility checks and sharing feedback with the teams every morning before proceeding to the field will ensure the quality of the data collected from the field.
4.1 Data entry and analysis
ENA for SMART software will be used to manage and analyze anthropometric and mortality data. Data entry for immunization, Vitamin A supplementation & Morbidity will be entered on EPI Info 3.5.4 version7 and analysis will be done using EPI Info/SPSS.
Table 2: Proposed Survey Timeline Date Activity
14th May 2018 Travel to Rubkona and Planning and discussion with field program staff and relevant government officials
15th -18th May 2018 Four days training for enumerators, team leaders and supervisors
19th -24th Ma2018 Six days data collection
25th -27TH May 2018 Four days data cleaning, analysis and write up preliminary report
Appendix 1: Survey questionnaires
Anthropometry
To be conducted in every selected HH with children 6-59 months
Date: _ _ /_ _/_ _ _ _ (dd/mm/yyyy) County: _______________ Payam: ________Boma: ________ Cluster number: ____Team Number_______
8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
HHID
(ensure
this
matche
s HH
questio
nnaire)
Child ID
Child
Full
Name
Sex
M= male
F=
female
Date of
Birth
(DD/M
M/YY)
Age in
Months
Weig
ht in
kg
(eg
12.4)
To
neares
t
0.1kg
Heigh
t in
cm
(eg
87.3)
To
neares
t
0.1cm
MUAC
in mm
(eg
126)
Childre
n 6-59
months
Oedem
a
N= No
Y= Yes
BCG
scar
N= No
Y= yes
Please
check
both
lower
arm
hands
Measles
Vaccinatio
n
(9-59
months)
0=Not vac
1= Yes
card
2= Yes,
Mother
Recall
Vitami
n A in
the last
6
months
0= No
1= Yes
card
2= Yes,
mother
recall
3= DK
Childre
n 6-59
months
De-
wor
ming
N=
No Y=
Yes
Has
child
been ill
in the
last two
weeks
(14
days)
N= No
Y= Yes
If no go
Ques. 24
If yes, type
of illness
1 = Fever
2 =
Diarrhoea
3 = Cough
4= Skin
infection
5= Eye
infection
6= Blood in
stool
7= Measles
8 = Other
(specify)
Treatment Sought:
1 = Not sought
2 = Hospital
3 =HF/clinic
4= Mobile /outreach
clinic
5= Village health care
worker
6= Private
physician/doctor
7= Relative/friends
8= Traditional
practitioner
9= Bought drug from
shop/market
10= Bought drug from
pharmacy
11= Other (Specify)
Last nit,
did the
child sleep
under the
mosquito
net
(LLITN)
N= No
Y= Yes
Two weeks prior to the survey period, has the child been sick? Diarrhea, Cough, Fever, Malaria, Measles and others........
▪ Diarrhea (D), any episode of more than 3 stools in 24 hours (it can be bloody or not).
▪ Cough(C), cough or difficulty breathing;
▪ Fever (F), elevated body temperature; ▪ Measles (ML), fever and rash/measles can have red eyes also.
▪ Malaria (MR) High fever with other malaria symptoms
▪ Other (O), other illness two weeks prior to the survey. ** Measles: Has the child been vaccinated against Measles? 0= Not vaccinated. 1= Yes, with card, 2= Yes, with recall
** Vitamin A: Has the child received Vitamin A in the last 6 months? Y= Yes received a capsule, N= No, has not received a capsule.
** BCG: Check the BCG scar on the child upper arm (left/right). If the scar is present, answer “Y”, otherwise answer “N”.
Oedema: can be diagnosed by placing a medium pressure (with a thumb) on the forepart of the leg/on the upper side of the foot for three seconds.
Other symptoms e.g.skin change, hair loss, irritable weak mood etc.
Mortality and household demography
DEMOGRAPHY AND MORTALITY QUESTIONNAIRE(To be administered every household)
Team Number [ ] Date …… Cluster No. [ ]
Sector:………………….. Block:……….. HOUSEHOLD2 NO: [ ]
01 02 03 04 05 06 07 08 09 10
No.
Name
Sex
(M/F)
Age
(years)
Joined on
or after:
Left on or
after:
Born on or
after:
Died on or
after:
Cause of
death
(optional)
Location
of death
(optional)
15th February 2018 – 20th May 2018
(95) days recall period
WRITE ‘Y’ for YES. Leave BLANK if NO.
a) List all the household members that are currently living in this household.
1
2
3
4
5
6
7
8
9
10
b) List all the household members that have left this household (out migrants) since the start of the recall period.
1 Y
2 Y
3 Y
4 Y
5 Y
c) List all the household members who died since the start of the recall period.
1 Y
2 Y
3 Y
Was anyone in the household pregnant at the start of the recall period? No [ ] Yes [ ] If yes, how many? ______
Location and causes of death
CAUSE OF DEATH
LOCATION OF DEATH
CODE Disease CODE
1 Unknown 1 In current location
2 Injury/ Traumatic 2 During migration
3 Illness 3 In place of last residence
4 Insecurity/violence 4 Other
2Insert the household definition used in the survey in footnote here.
WASH
Date (D/M/Y): …./….…/…..... Cluster No:……… Team No…..… County……..……. Payam:…………….Boma………..……….. Village:……………..
29 30 31 32 33 34 35 36
HH Ref No.
What is the household's main
drinking source of
water ? ----------
1=Borehole/hand
pump 2= Protected
Shallow well
3= Open shallow well
4= Protected spring
5= River /Stream 6= HH connection /
Stand pipe /Tanker
7= Dam / Pond 8= Other (specify)
How long does it take
to collect HH
water (including
travel to and
from and waiting)?
--------------
1 = <30 min 2 = >30min
to <1hr
3 = >1hr to < 2hr
4 = more
then 2 hr
How many liters of water
did the HH use
yesterday in total (excluding
water for
washing clothes and for
animal)?
When do you usually wash your hands (more than one if appropriate - do not
prompt) ---
------ 1 = Never
2= After defecating
3 = Before cooking 4 = Before eating 5
= Before feeding the baby
6=After cleaning the baby 7=other (specify)
What is done to the water before
household’s
members drink it? ---------
1 =Nothing
2 =Boiling 3 =Filtering with a
cloth
4=Letting it settle 5 =Water treatment
chemicals
6 =Others(Specify)
What do you use to wash
hands?
--------- 1 = Nothing
2 = Water
only 3 = Water +
Soap
4 = Water + Ash
5 = other
(specify)
Where does the household usually
use the toilet (include
more than one if necessary)?
---------
1 = Undesignated open area
2 = Designated open
area 3 = Hole
4 = Latrine
5 = Communal latrine 6= Neighbor's
latrine 7=
Others (Specify)
Can you show me where you wash
your hands? 1: Inside/near
toilet facility 2= Inside/near kitchen/cooking
place
3= Elsewhere in yard
4= Outside of
yard 5= No specific
place
6= No permission to see
FOOD SECURITY AND LIVELIHOOD QUESTIONNAIRE (continue questioning HH's where you have collected Anthropometry' & Health information)
Date (D/M/Y): ……./….…/…..... Cluster No:……… Team No…..… County:……..……..payam:………………Boma………..…….. Village:………....……
HH No*
Resident status of HH: ---------- 1: Permanent residents, 2: Returnees (returned within the last 12mths) 3: Nomads 4: IDPs (in last 12 months) 5: IDPs (1-5yrs) 6: IDPs (5yrs +) 7: Refugees (in last 12mths) 8: Refugees (1-5yrs) 9: Refugees (5yrs +) 10: DK
Is there any IDP or returnee currently living in your household? --------- 0 = No 1 = Yes
Is the HH head male or female? --------- 1 = Male 2 = Female
What was your HHs main source of income in the last 30 days? ----------- 0= None 1 = Sale of crops 2 = Sale of livestock 3 = Sale of animal product 4= Sale of alcoholic beverages 5 = Sale of fish 6 = Sale of natural resources ( firewood; charcoal; grass) 7 = Sale of food aid 8 = Casual Labor 9 = Skilled labor 10 = Salaried work 11 = Petty trading 12 = Family support 13= Remittance 14=others (Specify)
What did your family eat in the last 7 days? (include more than one if necessary) (Tom to Revise based on the standard) ---------- 1 = Cereals Roots and Tubers 2 = Legumes/nuts 3 = Meat /Poultry/Offals 5 = Fish & sea foods 6 = Milk & Milk Products 7 = Vegetables 8 = Fruits 9 = Eggs 10 = Oil/ Fats 11 = Sugar & honey 12 = None
What was the main source of food in the past 7 days --------- 1 =Own production 2 =Work for food 3 =Gifts from neighbors 4 =Market/shop purchase 5 =Borrowing/debts 6 =Food aid 7= Hunting 8 = Fishing 9 = Wild food 10= Others
Did you cultivate in the recent last season? --------- 0 = No 1 = Yes
Does the HH own any livestock, herds or farm animals? --------- 0 = No 1 = Yes
Has your HH received any Humanitarian Assistance in the past 3 months? --------- 0 = None 1 = GFD 2= School meals /feeding 3=TFP/SFP 4 = Seeds & tools 5=Fishing kits
What is the main shock currently faced by the HH ---------- 1 = Insecurity /violence 2 = Food too expensive /increased price 3 = Livestock diseases 4 = Floods 5 =Human sickness 7 =Returnee/IDP living with HH 8 =Late food distribution 9 = Social event 10 = Delay of rains 11 = Weeds/ Pest 12= Other( specify)
Infant and Young Children Feeding practice (IYCF)
17.1 17.2 17.3 17.4 17.5
11.8 Yesterday, during the day or at night, did [NAME] receive any of the
following liquids?
17.5 Describe what did (NAME) eat yesterday during the day or night,
whether at home or outside the home since (NAME) woke up yesterday
until NAME went to sleep?
a) Think about when (NAME) first woke up yesterday. Did (NAME) eat
anything at that time? If yes: Please tell me everything (NAME) ate at that
time.
Has
[NAME]
ever
been
breastfed
?
(EverBF
)
1= Yes
0 = No
2 =DK
How
long
after
birth did
you first
put
[NAME
] to the
breast?
1 =
Never
BF
2=
Immedia
tely
3 =From
1-24 hr
4= From
25-48 hr
5= After
48 hr
Did
you
feed
this
child
with
colostr
um
1 =
Yes
0= No
2= DK
In the first
3 days after
delivery -
was this
child given
anything to
drink other
than
breastmilk?
1 = no
(breastmilk
only)
2 = plain
water
3 =
Sugar+Wat
r
4 = Butter
5 =
Caw/Goat
milk
6= Other
7= Do not
rememeber
Is
(Nam
e)
still
breas
tfeedi
ng
now?
1=
Yes
0 =
No
2=
DK
17.6 17.6.1 17.6.2 17.6.
3 17.6.4
17.6.
5
17.6.
6
17.6.
7 17.7 17.7.1 17.7.2 17.7.3 17.7.4 17.7.5 17.7.6 17.8 17.9 18 18.1
Plain
water
1= Yes
0 = No
2= DK
Infant
formul
a
1= Yes
0 = No
2 =
DK
Milk
such as
tinned,
powdere
d, or
fresh
animal
milk
1= Yes
0 = No
2= DK
Sour
milk
or
Yogh
urt
1=
Yes
0 =
No
2=
DK
Juice
or
juice
drinks
1= Yes
0 = No
2= DK
clear
Broth
1=
Yes
0 =
No
2=
DK
Thin
Porri
dge
1=
Yes
0 =
No
2=
DK
Other
water
base
liqui
ds
1=
Yes
0 =
No
2=
DK
Cereal
s,
flours,
grains,
roots
and
tubers
1= Yes
0 = No
2 =
DK
legum
es and
nuts
(Beans
, Peas,
Lentils
, Nuts
and
Seeds)
1= Yes
0 = No
2= DK
dairy
produc
ts
(milk,
yogurt,
cheese
)
1= Yes
0 = No
2 =
Don’t
know
flesh
foods
(meat,
fish,
poultry
and
liver/o
rgan
meats)
1= Yes
0 = No
2= DK
eggs
1= Yes
0 = No
2 =
DK
vitami
n-A
rich
fruits
and
vegeta
bles
(carrot,
red
pepper
,
pumpk
in,
Ripe
Mango
es,
papaya
1= Yes
0 = No
2 =
DK
other
fruits
and
vegeta
bles
(Avoca
do,
Banan
a,
Appile
,
Grapes
,
Guava,
Lemon
,
Pinapp
eale,
Cabba
ge,
onions,
tomato
es, etc
1= Yes
0 = No
2 =
DK
How
much
liquid do
you give
this child
to drink
when
having
diarrhoea
compare
d to
when
s/he is
healthy?
---------
1 =
Nothing
to drink
2 = Much
less than
normal
3=
Somewh
at less
4 =
About
the same
5= More
than
usual
6.= Not
been sick
7 =DK
How much
food do you
give this
child to eat
when
having
diarrhoea
compared
to when
s/he is
healthy?
---------
1= Never
gave food
2 = Much
less than
normal
3 =
Somewhat
less
4= About
the same
5= More
than usual
6= Stopped
food
7 = Not
been sick
8 = Do not
know /
remember
How
many
times
did
[chil
d's
name
] eat
solid
or
semi-
solid
food
other
than
liqui
ds
yeste
rday
durin
g the
day
or at
night
?
(num
ber
of
times
)
Did
[NA
ME]
drink
anyth
ing
from
a
bottle
with
anipp
le
yeste
rday
or
last
night
?
1=
Yes
2=
No
3=
Don't
know
