| Name | Label | Question |
| CA1 |
IN THE LAST TWO WEEKS, HAS (name) HAD DIARRHOEA?
| |
|
| CA2 |
DURING THE TIME (name) HAD DIARRHOEA, WAS HE/SHE GIVEN LESS THAN USUAL TO DRINK, ABOUT THE SAME AMOUNT, OR MORE THAN USUAL?
| |
|
| 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?
| |
|
| CA3A |
DID YOU SEEK ANY ADVICE OR TREATMENT FOR THE DIARRHOEA FROM ANY SOURCE?
| |
|
| CA3BA |
Specialized professional health center (Mother and child center)
|
From where or whom did you seek advice or treatment?
|
|
| CA3BB |
General hospital (Aimag centre/ district health centre)
|
From where or whom did you seek advice or treatment?
|
|
| CA3BE |
Soum/ family group practice
|
From where or whom did you seek advice or treatment?
|
|
| CA3BF |
Bag health physician
|
From where or whom did you seek advice or treatment?
|
|
| CA3BG |
Private sector, Ulaanbaatar, Hospital
|
From where or whom did you seek advice or treatment?
|
|
| CA3BH |
Private sector, Ulaanbaatar, Clinic
|
From where or whom did you seek advice or treatment?
|
|
| CA3BI |
Private sector, Aimag/ Soum, Hospital
|
From where or whom did you seek advice or treatment?
|
|
| CA3BJ |
Private sector, Aimag/ Soum, Clinic
|
From where or whom did you seek advice or treatment?
|
|
| CA3BK |
Physician
|
From where or whom did you seek advice or treatment?
|
|
| CA3BL |
Pharmacy
|
From where or whom did you seek advice or treatment?
|
|
| CA3BP |
Other source Relative/Friend
|
From where or whom did you seek advice or treatment?
|
|
| CA3BR |
Other source Traditional practitioner
|
From where or whom did you seek advice or treatment?
|
|
| CA3BX |
Other (specify)
|
From where or whom did you seek advice or treatment?
|
|
| CA3BOTHER |
Other
|
From where or whom did you seek advice or treatment?
|
|
| CA3BDK |
If unable to determine whether referred to public or private sector, write the name of the place.
|
From where or whom did you seek advice or treatment?
|
|
| CA3D |
WHERE OR WHOM DID YOU FIRST SEEK ADVICE?
| |
|
| CA3DOTHER |
Other
| |
|
| CA3DDK |
If unable to determine whether referred to public or private sector, write the name of the place.
| |
|
| CA4A |
“Khorosol” ORS packet
|
During the time (name) had diarrhoea, was (name) given to drink any of the following?
|
|
| CA4F |
“Oralit” ORS packet
|
During the time (name) had diarrhoea, was (name) given to drink any of the following?
|
|
| CA4G |
“Unicef” ORS packet
|
During the time (name) had diarrhoea, was (name) given to drink any of the following?
|
|
| CA4H |
ANY OTHER ORS PACKET?
|
During the time (name) had diarrhoea, was (name) given to drink any of the following?
|
|
| CA4HOTHER |
Other
|
During the time (name) had diarrhoea, was (name) given to drink any of the following?
|
|
| CA4BB |
WHERE DID YOU GET THE ORS?
|
Where did you get the ORS?
|
|
| CA4BBOTHER |
Other
|
Where did you get the ORS?
|
|
| CA4BBDK |
If unable to determine whether referred to public or private, write the name of the place.
|
Where did you get the ORS?
|
|
| CA4CA |
ZINC TABLETS?
|
During the time (name) had diarrhoea, was (name) given:
|
|
| CA4CB |
ZINC SYRUP?
|
During the time (name) had diarrhoea, was (name) given:
|
|
| CA4E |
WHERE DID YOU GET THE ZINC?
| |
|
| CA4EOTHER |
Other
| |
|
| CA4EDK |
If unable to determine whether referred to public or private, write the name of the place.
| |
|
| CA4FA |
A HOMEMADE ORS FLUID FOR DIARRHOEA?
|
During the time (name) had diarrhoea, was (name) given to drink any of the following:
|
|
| CA4FB |
BOILED WATER?
|
During the time (name) had diarrhoea, was (name) given to drink any of the following:
|
|
| CA4FC |
DILUTED SOUP?
|
During the time (name) had diarrhoea, was (name) given to drink any of the following:
|
|
| CA4FD |
RICE JUICE?
|
During the time (name) had diarrhoea, was (name) given to drink any of the following:
|
|
| CA5 |
WAS ANYTHING (ELSE) GIVEN TO TREAT THE DIARRHOEA?
| |
|
| CA6A |
WHAT (ELSE) WAS GIVEN TO TREAT THE DIARRHOEA? Antibiotic
| |
|
| CA6B |
WHAT (ELSE) WAS GIVEN TO TREAT THE DIARRHOEA? Antimotility
| |
|
| CA6G |
WHAT (ELSE) WAS GIVEN TO TREAT THE DIARRHOEA? Other pill or syrup (Not antibiotic)
| |
|
| CA6H |
WHAT (ELSE) WAS GIVEN TO TREAT THE DIARRHOEA? Unknown pill or syrup
| |
|
| CA6L |
WHAT (ELSE) WAS GIVEN TO TREAT THE DIARRHOEA? Antibiotic
| |
|
| CA6M |
WHAT (ELSE) WAS GIVEN TO TREAT THE DIARRHOEA? Non-antibiotic
| |
|
| CA6N |
WHAT (ELSE) WAS GIVEN TO TREAT THE DIARRHOEA? Unknown injection
| |
|
| CA6O |
WHAT (ELSE) WAS GIVEN TO TREAT THE DIARRHOEA? Intravenous
| |
|
| CA6Q |
WHAT (ELSE) WAS GIVEN TO TREAT THE DIARRHOEA? Home remedy / Herbal medicine
| |
|
| CA6X |
WHAT (ELSE) WAS GIVEN TO TREAT THE DIARRHOEA? Other (specify)
| |
|
| CA6OTHER |
Other
| |
|
| CA6DK |
Record all treatments given. Write brand name(s) of all medicines mentioned.
| |
|
| CA6CC |
WHO RECOMMENDED SUCH TREATMENT?
| |
|
| CA6CCOTHER |
Other
| |
|
| CA6AA |
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?
| |
|
| CA9OTHER |
Other
| |
|
| CA9B |
DURING THE TIME (name) HAD (FEVER/COUGH), WAS HE/SHE GIVEN LESS THAN USUAL TO DRINK, ABOUT THE SAME AMOUNT, OR MORE THAN USUAL?
| |
|
| 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?
| |
|
| CA10 |
DID YOU SEEK ANY ADVICE OR TREATMENT FROM ANY SOURCE?
| |
|
| CA11A |
Specialized professional health center (Mother and child center)
|
From where or whom did you seek advice or treatment?
|
|
| CA11B |
General hospital (Aimag centre/ district health centre)
|
From where or whom did you seek advice or treatment?
|
|
| CA11E |
Soum/ family group practice
|
From where or whom did you seek advice or treatment?
|
|
| CA11F |
Bag health physician
|
From where or whom did you seek advice or treatment?
|
|
| CA11G |
Private sector Ulaanbaatar Hospital
|
From where or whom did you seek advice or treatment?
|
|
| CA11H |
Private sector Ulaanbaatar Clinic
|
From where or whom did you seek advice or treatment?
|
|
| CA11I |
Private sector Aimag/ Soum Hospital
|
From where or whom did you seek advice or treatment?
|
|
| CA11J |
Private sector Aimag/ Soum Clinic
|
From where or whom did you seek advice or treatment?
|
|
| CA11K |
Physician
|
From where or whom did you seek advice or treatment?
|
|
| CA11L |
Pharmacy
|
From where or whom did you seek advice or treatment?
|
|
| CA11P |
Other source Relative/Friend
|
From where or whom did you seek advice or treatment?
|
|
| CA11R |
Other source Traditional practitioner
|
From where or whom did you seek advice or treatment?
|
|
| CA11X |
Other (specify)
|
From where or whom did you seek advice or treatment?
|
|
| CA11OTHER |
Other
|
From where or whom did you seek advice or treatment?
|
|
| CA11DK |
If unable to determine if referred to public or private sector, write the name of the place.
|
From where or whom did you seek advice or treatment?
|
|
| CA11BB |
WHERE OR WHOM DID YOU FIRST SEEK ADVICE OR TREATMENT?
| |
|
| CA11BBOTHER |
Other
| |
|
| CA11BBDK |
If unable to determine if referred to public or private sector, write the name of the place.
| |
|
| CA12 |
AT ANY TIME DURING THE ILLNESS, WAS (name) GIVEN ANY MEDICINE /INJECTION FOR THE ILLNESS?
| |
|
| CA13I |
Pill / Syrup
|
What medicine/injection was (name) given?
|
|
| CA13J |
Injection
|
What medicine/injection was (name) given?
|
|
| CA13P |
Paracetamol (Panadol, Acetaminophen)
|
What medicine/injection was (name) given?
|
|
| CA13Q |
Aspirin
|
What medicine/injection was (name) given?
|
|
| CA13R |
Ibuprofen
|
What medicine/injection was (name) given?
|
|
| CA13X |
Other (specify)
|
What medicine/injection was (name) given?
|
|
| CA13Z |
DK
|
What medicine/injection was (name) given?
|
|
| CA13OTHER |
Other
|
What medicine/injection was (name) given?
|
|
| CA13DK |
Write brand name(s) of all medicines mentioned.
|
What medicine/injection was (name) given?
|
|
| CA13BB |
WHERE DID YOU GET THE ANTIBIOTICS?
| |
|
| CA13BBOTHER |
Other
| |
|
| CA13BBDK |
If unable to determine whether referred to public or private, write the name of the place.
| |
|
| CA15 |
THE LAST TIME (name) PASSED STOOLS, WHAT WAS DONE TO DISPOSE OF THE STOOLS?
| |
|
| CA15BBOTHER |
Other
| |
|