Final KPC Survey Report_Relief International Healthy Start Child Survival Project-Niger_Jan 2012

FINAL SURVEY REPORT: KNOWLEDGE, PRACTICE

AND COVERAGEHealthy Start Child Survival Project

Konni Department, Relief International-Niger

Mahaman Hallarou, MD Child Survival Project Manager/Head of Country Office and Survey Team Leader

January 16, 2012This Final Knowledge, Practice and Coverage Survey Report has been made possible through support provided by the United States Agency for International Development, under the terms of the USAID Cooperative Agreement GHS-A-00-07-00028 between USAID and Relief International, for the Healthy Start Child Survival Project in the Republic of Niger.

Acknowledgements

The author of this report, Dr. Mahaman Hallarou of Relief International, would like to thank various contributors who participated in this Knowledge, Practice and Coverage final survey.

In particular, thanks are due to the people who supported this survey either through their involvement in its planning and implementation. These include the staff of the Konni District Ministry of Health, especially Medical District Coordinator Dr. Alio Tayabou; Supervisor Abuzeidi Chahabou; District Administrator Suleymane Issaka; Health Supervisor Abuzeidi Chahabou; Konni Statistics Department Supervisor Alio Nahantchi, Mouviento Por La Paz Medical Officer Dr. Soumana Oumarou; and Initiative for Secure Households Supervisor Sangaré; survey personnel listed in Appendix A; Meredith Chang of the USAID-Child Survival and Health Grants Program; and Paulin Ntawangundi of RI.

Thanks are also due to the USAID-Child Survival and Health Grants Program, which funded the implementation of the survey.

Abbreviations and acronyms

CSHGP Child Survival and Health Grants ProgramDHS Demographic and Health SurveyDPP/AT/DC Department for Spatial Planning and Community Development (French:

Direction Departementale de l’aménagement du Territoire/Developpement communautaire)

DPT Diphtheria-Pertussis-Tetanus vaccineDS Health District of Konni (District Sanitaire)EOP End of ProjectISCV Initiative for Secure HouseholdsKPC Knowledge, Practice and CoverageMOH Ministry of HealthMPDL Mouviento Por La PazNCHS National Center for Health StatisticsONG Non-governmental organization (Organisation non gouvernementale)ORS Oral Rehydration SolutionORT Oral Rehydration TherapyTBA Traditional Birth AttendantTT Tetanus ToxoidUNICEF United Nations Children’s FundUSAID The U.S. Agency for International DevelopmentWHO World Health Organization

Table of Contents

Executive summary.........................................................................................................................1

1 Background..............................................................................................................................2

1.1 Project location.................................................................................................................2

1.2 Characteristics of the target beneficiary population.........................................................2

1.3 Health, social and economic conditions in the project area..............................................3

1.4 National standards and policies regarding maternal and child health...............................3

1.5 Overview of the Healthy Start Child Survival Project......................................................4

1.5.1 Goal............................................................................................................................4

1.5.2 Strategic objectives....................................................................................................4

1.5.3 Intervention activities................................................................................................4

1.6 Objectives of the Final KPC Survey.................................................................................5

2 Process and partnership building.............................................................................................6

2.1 Steering Committee collaboration....................................................................................6

3 Methods...................................................................................................................................6

3.1 Questionnaire....................................................................................................................6

3.2 Rapid CATCH indicators..................................................................................................7

3.3 Sampling design................................................................................................................8

3.4 Training.............................................................................................................................9

3.4.1 Core Team training....................................................................................................9

3.4.2 Training of trainers and supervisors..........................................................................9

3.4.3 Training of enumerators............................................................................................9

3.5 Data collection................................................................................................................10

3.6 Data analysis...................................................................................................................10

3.7 Challenges faced during survey implementation............................................................10

4 Results....................................................................................................................................11

4.1 Final KPC Survey Rapid CATCH indicators.................................................................11

4.2 Demographics.................................................................................................................13

4.3 Maternal and newborn care.............................................................................................13

4.4 Breastfeeding..................................................................................................................15

4.5 Complementary feeding..................................................................................................15

4.6 Vitamin A supplementation............................................................................................16

4.7 Child immunization.........................................................................................................16

4.8 Malaria............................................................................................................................17

4.9 Nutritional status.............................................................................................................18

5 Discussion..............................................................................................................................18

5.1 Key findings and programmatic implications.................................................................18

6 Conclusion.............................................................................................................................22

7 Bibliography..........................................................................................................................23

8 Appendices............................................................................................................................24

A. Survey personnel.............................................................................................................24

B. Maps of the Republic of Niger’s regions and the Department of Birni n’Konni............26

C. Survey Steering Committee invitation letter...................................................................27

D. Questionnaire (English)..................................................................................................28

E. Questionnaire (French)...................................................................................................46

F. Translations of key survey words (English-French-Hausa)............................................63

G. Populations of communities............................................................................................64

H. Budget.............................................................................................................................66

I. Training of trainers agenda (English and French)..........................................................67

J. Training of enumerators agenda (English and French)...................................................68

K. Comparison of Baseline and Final Rapid CATCH indicators........................................70

Executive summary

This report summarizes the findings of the Final Knowledge, Practice and Coverage (KPC) Survey of the Healthy Start Child Survival Project that was implemented from 2008 to 2011 by Relief International (RI) in the Department of Birni n’Konni in the Republic of Niger.

From September 18 to 22, 2011, RI and the Niger Ministry of Health (MOH) conducted the Final KPC Survey using Rapid CATCH 2006 indicators to measure the impact of Healthy Start Project interventions on mother and child survival.

Results of the Final KPC Survey show two major trends:

1. Significant improvements in maternal and newborn care, the prevention and treatment of infant disease, child immunization, and water and sanitation

Thirteen of 14 Rapid CATCH indicators showed significant improvements since 2008 and exceeded End of Project targets. The percentage of children who received an appropriate antimalarial increased by an estimated 385%. The percentage of children who were given oral rehydration salts increased an estimated 270%, exclusive breastfeeding increased by nearly 200%, and nearly 500% more households treated water effectively than had at project launch.

2. Continued poor nutritional status of children

The survey found that 41.7% of children in the intervention area are underweight when compared to international reference standards. Repeated famines during the project period constrained improvements in nutritional status despite observed increases in appropriate feeding behaviors.

Figure 1. Healthy Start Project care group meeting

Relief International 1Final KPC Survey Report

1 Background

1.1 Project locationNiger is a landlocked Sub-Saharan African nation that is ranked third from the last on the 2010 Human Development Index, with 69% of its population living below the poverty line (UNDP,2011). Niger has a long history of endemic hunger characterized by seasonal fluctuations and geographic variation.

In 2005, a severe drought resulted in a famine that affected nearly three million people and exacerbated the already fragile health and nutritional status of the country, with disproportional suffering among women and children.

In 2007, in the aftermath of a nutritional crisis, Relief International (RI) launched the four-year USAID-funded Healthy Start Child Survival Project in the Department of Birni n’Konni, in the Tahoua Region in southern central Niger1.

The Department of Birni n’Konni occupies a 5,317 square miles area in the southwestern section of the Tahoua region, 417 kilometers east of Niamey. It is divided into six communes: Konni City, Allela, Bazaga, Malbaza, Dogueraoua, and Tsernaoua. Villages are widely disbursed. The climate is dry and hot. Maps of the Republic of Niger and the Department of Birni n’Konni are included as Appendix B.

1.2 Characteristics of the target beneficiary populationThe project targets 91,297 women of reproductive age (WRA) and 83,324 children under five(Ministry of Health, 2005):

Table 1. Beneficiary population: children age 0-59 months

CATEGORY POPULATION2

Infants, 0-11 months 24,200

Children, 12-23 months 25,944

Children, 24-59 months 33,180

Total children 0-59 months

83,324

1 RI implemented its first project in northern Niger in 2005 to improve food security for pastoralists. During the Healthy Start Project period of 2007-2011, RI-Niger also implemented a United States Department of Agriculture-funded Food for Education project in Dosso and Tillabery regions, and a professional training project for water drillers in Dosso and Tillabery regions.

2 When the project period began in 2007, the Department of Birni n’Konni’s population was estimated at 428,623 individuals. Since 2007, the population of Birni n’Konni has grown to an estimated 478,687 individuals, including 93,057 children aged under five and 101,960 women of reproductive age.


1.3 Health, social and economic conditions in the project areaThe Republic of Niger covers a land area of almost 1,270,000 km2 and is inhabited by 14 million people. Niger’s national development is hampered by food and political insecurity. The largely agrarian and subsistence-based economy is frequently disrupted by extended, deadly droughts. Niger has experienced two droughts during the project’s implementation period, requiring Niger to import 60% of its food in 2009 and threatening the health of more than a million people in 2010. Political instability, such as violent conflict in Niger’s northern region and last year’s presidential coup, discourages foreign investment and complicates the implementation of health and nutritional services.

Poorly resourced health services are reflected in national health indicators. The 2010 maternal mortality rate per 100,000 births for Niger is 820. This is compared with 600.7 in 2008 and 890.1 in 1990. The neonatal mortality as a percentage of under 5's mortality is 22 (United NationsPopulation Fund, 2011). The under-five mortality rate (U5MR) is 131 in per 1000 live births, according to the Niger National Institute of Statistics.

Despite this challenging national context, the economy and welfare of the Department of Birni n’Konni benefits from its privileged location as a hub of commercial transportation in Niger’s fertile south.

The major ethnic group in the department is Hausa, with a minority Tuareg and Peulh population. Hausa are traditionally sedentary agriculturalists, while the Tuareg and Peulh groups are nomadic pastoralists. Konni’s population has a high illiteracy rate. The predominant religion is Islam. As common to traditional sub-Saharan social norms, men maintain control over resources. In some villages, women must ask male household leaders for permission to access health services outside the home.

The provision of health services is divided between private and public sector providers. Private health care providers in Konni City include one private hospital in Galmi, six clinics, and two drugstores. The Ministry of Health District Health Team manages the Department of Birni n’Konni’s public health infrastructure, which is based on a two-tiered system that covers 35% of Konni’s population3. There is one public hospital in Konni City. Twelve integrated health centers (Centre de Santé Intégré) and 60 health posts (Case de Santé) provide outreach services to rural areas. People seeking care must either travel long distances on bad roads to health posts or rely on traditional birth attendants in their villages. Malaria, respiratory infections and diarrhea are leading morbidities. Malnutrition is a common aggravating co-morbidity.

1.4 National standards and policies regarding maternal and child healthNiger’s National Health Plan for 2011 to 2015 seeks to “contribute to the reduction of maternal and child mortality by building on existing capacity to improve the efficiency and quality of the

3 The Department of Birni n’Konni is the political territory within Tahoua Region. The Konni District is the territory of the local office of Ministry of Health responsible for the management of public health services.


health system” (Ministry of Health, 2011). Government-mandated free health care has been in force since 2006 for children aged under-five. Antenatal care, caesarean sections, and family planning are also free. Since 2005, active screening, referral and case management of Severe Acute Malnutrition (SAM) have been scaled up.

Niger’s Expanded Programme on Immunization (EPI) provides three doses of combined diphtheria/pertussis/tetanus vaccine (DPT3 as Pentavalent vaccine). Vaccination campaigns against measles are coupled with the distribution of Vitamin A capsules. Public sector facilities and non-governmental organizations implement large-scale distribution of bednets. The 2008 National Child Survival Strategy includes increased access to health services through community-based disease management, reinforced human resources and supply chains and monitoring (Ministry of Health, 2008). Niger is currently finalizing its Human Resources Development Plan, Nutrition Plan, and National Strategy on Community Case management(Ministry of Health, 2011).

1.5 Overview of the Healthy Start Child Survival Project

1.5.1 GoalThe goal of the Healthy Start Child Survival Project was to reduce morbidity and mortality rates of mothers and children under five years of age through strengthening community based health care services and information; developing mechanisms to augment food security and food availability for improved maternal and child nutrition; and create awareness of key behaviors for health at the community and household levels through capacity building of local primary health care workers, committee members and local organizations.

The project’s levels of effort were divided between Maternal and Newborn Care (30% level of effort); Malaria (30%); Diarrheal Disease Prevention and Control (20%); and Nutrition (30%).

1.5.2 Strategic objectivesThe project’s Strategic Objectives were:

SO1: Increase practice of selected emphasis behaviors for Mother and Child survivalSO2: Institutionalize sustainable MOH and community support for community health workersSO3: Strengthen the capacity of communities, local and district health teams

1.5.3 Intervention activitiesThe project addressed leading causes of childhood morbidity and mortality. Using behavior change communication (BCC) at the community level, an adaptation of the care group model, and training for health care providers at the facility level, the project implemented activities in 61 villages in order to increase demand for services, promote healthy behaviors for child survival, and improve the quality of services offered at health posts and health centers.

The intervention activities for achieving the Strategic Objectives were designed to:


1. Increase access to, demand for, and use of quality maternal and child health services, including emergency care, in order to improve family behaviors related to maternal and child health.

2. Improve case management of malaria at the community and health post levels; increase access to treatment for malaria; improve access and use of treated mosquito nets; and to improve use of chemoprophylaxis for malaria among pregnant women.

3. Improve prevention and treatment of diarrheal disease among rural children under five.4. Improve nutrition of women and children, through education and household/community

food security and nutrition activities.5. Improve the capacity of the Ministry of Health and local partner agencies, to plan,

implement, monitor, and evaluate child survival interventions at the community and district levels, with an emphasis on capacity in maternal and child health, nutrition, and household food security.

The project plan initially targeted 90 villages in a two-phased coverage approach. The project established 266 women care groups and support for 50 health posts. After the mid-term evaluation in January 2010, RI revised the project plan to focus on an intervention area of 61 villages.

RI and partners conducted the project’s Baseline KPC Survey, Health Facility Assessment, and Detailed Implementation Plan workshop from January to February 2008. RI brought together stakeholders from the Ministry of Health, NGOs, and rural communities to design the project. To drive consensus on a project plan, the RI project management team facilitated structured problem solving from rigorous analysis of the household and facility surveys. RI and the partners agreed to adapt the “care group” model adapted to the context of Department of Birni n’Konni and to conduct training for health care providers at the facility level.

The mid-term evaluation reported that Phase 1 activities had increased stakeholder knowledge and practice of malaria prevention, improved nutrition, control of diarrheal disease, and increased access to essential obstetric and neonatal care.

In September 2011, RI and partners conducted the Final KPC Survey as part of the Final Evaluation Process.

1.6 Objectives of the Final KPC SurveyThe goal of the Final KPC Survey was to inform the RI project team, local partners, and stakeholders on the level of achievement of the Healthy Start Project. Sub-objectives were:

1. To collect data on the Rapid CATCH 2006 indicators by: Assessing the knowledge and practice of mothers in selected technical packages Measuring the nutritional status of children aged 0-23 months in the project zone

2. To build the capacity of project local staff and partners data collection and analysis.


2 Process and partnership building

2.1 Steering Committee collaborationIn August 2011, RI contacted the following institutions to invite representatives to participate in a Steering Committee for the Final KPC Survey:

USAID Mission in Niamey Tahoua Regional Ministry of Health Konni Health District Department of Birni n’Konni’s Directorate of Agriculture Department of Birni n’Konni’s Directorate of Planning Konni NGOs including Mouviento Por La Paz (MPDL) and the Initiative for Secure

Households (ISCV) National Directorate for Health Information (DSSRE)

A sample invitation letter is included as Appendix C.

The Final KPC Survey Steering Committee met on September 16-17, 2011 to advise on the preparation of the survey. The Steering Committee reviewed and provided guidance and on the terms of reference for the training of enumerators; drafts of the data collection tools; survey logistical needs (including measurement equipment such as height boards, scales, medicines, and bednets); and the identification of enumerators.

Steering Committee representatives agreed to contribute personnel and materials from their respective institutions. The Konni Health District provided a staff member to work as a survey supervisor and contributed scales, bednets and samples of Paracetamol, iron folic acid, Vitamin A, zinc, and sulfadoxine/pyrimethamine. The local NGO ISCV provided staff to work as a supervisor and enumerators, and contributed a video projector and chairs for the enumerator training. The Konni District Directorate provided staff to work as supervisors, and contributed basic demographic data for survey planning. The international NGO Concern-Tahoua contributed height boards and scales.

3 Methods

3.1 QuestionnaireThe survey questionnaire covered the Healthy Start Project’s four Technical Areas:

1. Maternal and Newborn Care2. Prevention and Treatment of Malaria3. Control of Diarrheal Disease4. Nutrition

The survey questionnaire was 88 questions in length, excluding anthropometrics. The anthropometric module consisted of three measurements: height, weight, and mid-upper arm


circumference. RI translated the questionnaire into French from English. The questionnaire in English is included as Appendix D, and the French translation is included as Appendix E. During the survey, the French questionnaire was used as a guide for the verbalization of the survey into Konni’s local language of Hausa. The Hausa translations of key words are included in Appendix F.

3.2 Rapid CATCH indicatorsThe Final KPC Survey questionnaire covered these Rapid CATCH 2006 indicators:

Maternal and Newborn Care: Maternal TT vaccination: Percentage of mothers with children age 0-23 months who

received at least two Tetanus toxoid vaccinations before the birth of their youngest child Skilled delivery assistance: Percentage of children age 0-23 months whose births were

attended by skilled personnel Post-natal visit to check on newborn within the first 3 days after birth: Percentage of

children age 0-23 who received a post-natal visit from an appropriate trained health worker within three days after the birth of the youngest child

Breastfeeding and Infant and Young Child Feeding (IYCF) Exclusive breastfeeding: Percentage of children age 0-5 months who were exclusively

breastfed during the last 24 hours Infant and young child feeding: Percentage of infants and young children age 6-23

months fed according to a minimum of appropriate feeding practices Vitamin A supplementation in the last 6 months: Percentage of children age 6-23 months

who received a dose of Vitamin A in the last 6 months (Mother’s recall)

Immunization Measles vaccination: Percentage of children age 12-23 months who received a measles

vaccination Access to immunization services: Percentage of children age 12-23 months who received

a DPT1 vaccination before they reached 12 months Health system performance regarding immunization services: Percentage of children age

12-23 months who received a DPT3 vaccination before they reached 12 months

Malaria Child with fever receives appropriate antimalarial treatment: Percentage of children age

0-23 months with a febrile episode during the last two weeks who were treated with an effective anti-malarial drug within 24 hours after the fever began

Child sleeps under an insecticide-treated bednet: Percentage of children age 0-23 months who slept under an insecticide-treated bed net (in malaria risk areas, where bed net use is effective) the previous night.

Control of Diarrhea


ORT use: Percentage of children age 0-23 months with diarrhea in the last two weeks who received oral rehydration solution (ORS) and/or recommended home fluids

Acute Respiratory Infections Appropriate care seeking for pneumonia: Percentage of children age 0-23 months with

chest-related cough and fast and/ or difficult breathing in the last two weeks who were taken to an appropriate health provider.

Water and Sanitation Point of use: Percentage of households of children age 0-23 months that treat water

effectively Appropriate hand washing practices : Percentage of mothers of children 0-23 months who

live in a household with soap or a locally appropriate cleanser at the place for hand washing that and who washed their hands with soap at least 2 of the appropriate times during the day or night before the interview

Anthropometry Underweight : Percentage of children 0-23 months who are underweight (-2 standard

deviation for the median weight for age, according to WHO/NCHS reference population)

3.3 Sampling designThe sampling design of the Final KPC Survey included 30 clusters of 12 households each. Only one mother of a child aged between 0-23 months was interviewed per household, for a total sample size of 358.

The sampling design of the Final KPC Survey was modified from the Baseline Survey. The Baseline KPC Survey’s sampling was conducted from a population of 453 villages throughout the Department. After the first phase of the project, RI followed recommendations made in the mid-term evaluation to focus interventions in 61 villages. To identify a sampling design that would fairly measure the project’s impact in the revised intervention area, RI consulted with the Final Evaluation Consultant and the Maternal and Child Health Integrated Program team, and agreed to adjust the sampling design to choose 30 clusters from a sampling frame of 61 villages.

The population of the villages was provided by the Niger Bureau of Statistics. A master list with cumulative population totals was constructed including all villages. The total estimated population of the project intervention zone of 61 villages is 83,286 divided by 30, giving a sampling interval of 2,776. A start number of 3,839 was randomly identified among the last four numbers of a serial number on a Niger 10,000 CFA currency note. After the selection of the first cluster, the remaining 29 clusters were identified using the sampling interval. The list of selected communities and their populations is included as Appendix G.


3.4 Training

3.4.1 Core Team trainingThe RI project team assembled a Core Team to oversee survey trainings and data collection. The Core Team consisted of six persons: the Konni District Communications Officer, representatives from the Konni Agriculture Office and the local NGO Community Development Office; and RI’s project manager, training coordinator, and monitoring and evaluation officer. The Core Team prepared for the trainings and data collection by reviewing the purpose and methodology of the Final KPC Survey; reviewing the survey questionnaire and adapting it for use in training exercises; and finalizing logistical arrangements and the budget.

The Core Team planned the survey to meet budgetary and time constraints stemming from a project budget realignment process that was conducted in summer 2011. The budget realignment process delayed the transfer of a project funds wire to Niger until only a few weeks before the end of the project funding period. The team worked within the revised budget by apportioning remaining funds among the Final KPC Survey, Final Evaluation and project costs. The budget for the Final KPC Survey is included as Appendix H.

The team addressed the challenge of a compressed timeline by conducting focused trainings of two days’ duration for a Training of Enumerators’ Trainers and for a Training of Enumerators. To save time and to ensure the quality of the survey results, the Core Team also decided to recall survey trainers and enumerators who had participated in the Baseline KPC Survey in 2008.

3.4.2 Training of trainers and supervisorsOn September 16 and 17, 2011, staff from Konni Health District, the Local Government Technical Services Chief Officer and RI trained five survey supervisors as enumerators’ trainers. All of the trainers had previous professional survey experience. The training included a review of the survey’s sampling methodology and questionnaire, and planning of the enumerator training. The enumerators’ trainers were instrumental in adapting the French questionnaire into Hausa, and contributing insights into relevant local traditions that could impact survey results. The training agenda is included as Appendix I.

3.4.3 Training of enumeratorsRI’s survey supervisors conducted a two-day training of 30 survey enumerators to prepare them in the use of the questionnaire, anthropometric measurement equipment, and the presentation of samples. The supervisors asked enumerators who had participated in the Baseline survey to help train new enumerators. The supervisors also asked enumerators with experience in taking anthropometric measurements to be responsible for anthropometric data collection in the field. During the second day of training, the teams of interviewers practiced completing the questionnaire in Konni City. The supervisors met with the RI project manager and the Core Team at the end of each day to provide feedback and to finalize plans for the survey’s actual implementation. The agenda for the training of enumerators is included as Appendix J.


3.5 Data collectionFrom September 18 to 22, 2011 six enumerator teams collected data from households. Each team was composed of four enumerators, one anthropometric measurer and one supervisor. Each day, a team covered one cluster and filled out 12 questionnaires. The supervisors were responsible for the selection of the starting household and survey direction. Teams obtained information and approval from village authorities before data collection commenced to facilitate access to households. At the end of the data collection, the teams had completed a total of 358 questionnaires.

The data’s quality was assured through daily field supervision and nightly checks for errors. Supervisors monitored teams as they completed questionnaires. Each evening, the supervisors checked the questionnaries to detect errors and address them the following day. Each team was also supervised at least twice by a member of the Core Team.

3.6 Data analysisThe survey data management team was comprised of one staff person from the MOH health information systems office, the RI monitoring and evaluation officer, and the RI project manager. The team entered data into Epi Info 7 software and transferred it to SPSS for analysis. The RI project manager collaborated with a GON National Institute Of Statistics statistician to analyze the indicators. Rapid CATCH indicator confidence limits were calculated with a design effect of 2, for 95% confidence that the indicators represented true proportions of knowledge, practice and coverage in the target population. Two-tailed tests for statistical significance of differences between the Baseline and Final indicator results were calculated using software available online (http://faculty.vassar.edu/lowry/propdiff_ind.html). Anthropometric data was analyzed using Emergency Nutrition Assessment (ENA) software.

3.7 Challenges faced during survey implementationThe Core Team faced these challenges during the survey:

Data collection phase: The Core Team faced the challenge of having only nine days before the end of the

project’s funding period to complete the survey. Some mothers’ prenatal consultation cards were not filled out even though their

children’s vaccinations were confirmed by the village worker’s registers and the mothers’ recall.

Anthropometric weight-for-height measurements were done by a single team of six measurers, which increased the risk of measurement errors.

Anthropometric weight measurements may have been biased. For children who were aged under one month, or were too small or sick to be weighed, anthropometric weight measurements were replaced by birth weight in the Child Cards or were by the weights of same-aged children who were known either by recall or in the Child Health Cards.


Data analysis: During data analysis, the data management team realized that two questionnaires

from a remote cluster were missing. The team did not have any practical option for returning to the missed villages to complete the missing questionnaire.

Lack of time for data verification resulted in missing data in some questionnaires.

4 ResultsThis section presents the findings of the Final knowledge, attitude and coverage survey that was conducted in the Konni District, Niger. This section also compares the results between the Final and Baseline KPC Surveys.

4.1 Final KPC Survey Rapid CATCH indicatorsTable 2 summarizes the indicators measured in the Final KPC Survey.


Table 2. Final KPC Survey Rapid CATCH Indicators

INDICATOR NUMERATOR DENOMINATORPERCEN

TCONFIDENCE

LIMITS

1. Percentage of mothers with children age 0-23 months who received at least two Tetanus toxoid vaccinations before the birth of their youngest child

261 322 81.1% 75.1–87.1%

2. Percentage of children age 0-23 months whose births were attended by skilled personnel

189 358 52.8% 45.5–60.1%

3. Percentage of children age 0-23 who received a post-natal visit from an appropriate trained health worker within three days after the birth of the youngest child

38 358 10.6% 6.1–15.1%

4. Percentage of children age 0-5 months who were exclusively breastfed during the last 24 hours

70 105 66.7% 54.0–79.4%

5.% of infants and young children age 6-23 months fed according to a minimum of appropriate feeding practices

147 251 58.6% 50.0–67.2%

6. Percentage of children age 6-23 months who received a dose of Vitamin A in the last 6 months (Mother’s recall)

184 251 73.3% 65.6–81.0%

7. Percentage of children age 12-23 months who received a DPT1 vaccination before they reached 12 months

94 120 78.3% 67.9-88.7%

8. Percentage of children age12-23 months who received a DPT3 vaccination before they reached 12 months

49 120 40.8% 28.4–53.2%

9. Percentage of children age 12-23 months who received a measles vaccination according to the vaccination card or mother’s recall by the time of the survey

94 189 49.7% 39.6–59.8%

10. Percentage of children age 0-23 months with a febrile episode during the last two weeks who were treated with an effective anti-malarial drug within 24 hours after the fever began

144 212 67.9% 59.0–76.8%

11. Percentage of children age 0-23 months who slept under an insecticide-treated bed net the previous night

266 344 77.3% 71.0–83.6%

12. Percentage of children age 0-23 months with diarrhea in the last two weeks who received oral rehydration solution (ORS) and/or recommended home fluids

96 193 49.7% 39.7–59.7%

13. Percentage of children age 0-23 months with chest-related cough and fast and/ or difficult breathing in the last two weeks who were taken to an appropriate health provider

86 189 45.5% 35.4-55.6%

14. Percentage of households of children age 0-23 months that treat water effectively 270 358 75.4% 69.1–81.7%

15. Percentage of mothers of children 0-23 months who live in a household with soap or a locally appropriate cleanser at the place for hand washing

85 358 23.7% 17.5–29.9%

16. Percentage of children 0-23 months who are underweight 145 350 41.4% 33.8–48.7%


4.2 Demographics

Table 3. Age of children age 0-23 months

AGE FREQUENCY PERCENT

0 to 5 months 107 30.0%

6 to 11 months 95 26.5%

12 to 23 months 156 43.6%

Total 358 100.0%

Table 4. Sex of children age 0-23 months

SEX FREQUENCY PERCENT

Female 137 45.7%

Male 163 54.3%

Total 358 100.0%

4.3 Maternal and newborn care

Table 5. Birth assisted by skilled personnel

BIRTH ASSISTANT FREQUENCY PERCENT

Doctor/Nurse/Midwife 150 41.9%

Health Post worker 28 7.8%

Traditional birth attendant 142 39.7%

Other 36 10.1%

Not assisted 2 1.0%

Total 358 100.0%

Half of deliveries were assisted by a qualified person. 39.6% of deliveries are attended by traditional birth attendants (TBAs, or matrons) even though the MOH does not consider them as skilled personnel. The project conducted sensitization activities to teach TBAs about their new role as “companions to delivery.” Some health post workers are nurses, but may not be known as such by respondents.

Table 6. Home delivery by Traditional Birth Attendant (TBA)

HOME DELIVERY BY TBA FREQUENCY PERCENT

Yes 67 47.2%

No 75 52.8%

Total 142 100.0%


More than half of deliveries assisted by TBAs (matrons) outside the home, in health centers (75/142). This is a well-known practice, particularly in integrated health centers and district hospitals, where matrons work night shifts under the supervision of a midwife. Officially, matrons are expected in those centers to only accompany parturient women to the maternity ward and help mothers in the post-partum wards. In reality, the matrons continue to assist deliveries when midwifes rest during night shifts.

Table 7. Delivery at home or health center

DELIVERY LOCATION FREQUENCY PERCENT

Home 144 40.3%

Health center 213 59.7%

Total 357 100.0%

60% of deliveries take place in health centers, doubling the baseline measurement (29%). The Healthy Start Project’s interventions to improve health care delivery and support community mobilization in the project area may have contributed to the change. The increase in access may also be related to a modest increase in the extension of health facility coverage in Konni District between 2007 and 2011 (52 and 60 health posts, respectively). In the surveyed villages, the number of health posts and integrated health centers has remained unchanged.

Table 8. Clean delivery kit use at delivery

CLEAN DELIVERY KIT USED FREQUENCY PERCENT

Yes 272 76.0%

No 84 23.0%

Did not know 2 1.0%

Total 358 100.0%

Clean delivery kits were used in 76% of the deliveries performed in these facilities, a significant increase from the baseline value of 20%. The Healthy Start Project provided a single use kit to each health center. Approximately 16% of kits were used either at home or elsewhere.

Table 9. Post-natal check for mother within first week

TIME OF MOTHER’SPOST-NATAL CHECK FREQUENCY PERCENT

Hour 1 159 79.1%

Day 1 19 9.5%

Week 1 3 1.5%

Did not know 20 10.0%

Total 201 100.0%


88.6% (178/201) of mothers who delivered in health centers received a post-natal check within the first week and 80% of them were checked the day after delivery. Only 29 mothers were able to identify the health personnel who performed the post-natal check. Half of them (51%) were done by a health post worker. Midwives performed four post-natal checks doctors performed two checks.

Table 10. Post-natal check within three days for newborn

POST-NATAL CHECKFOR NEWBORN FREQUENCY PERCENT

Yes 34 54.0%

No 29 46.0%

Total 63 100.0%

36% (63/216) of mothers said that their baby was ever checked by the health personnel of the facility where they delivered. Half of the newborns (38) were checked within a week after birth.

4.4 Breastfeeding

Table 11. Time of first breastfeeding after birth

TIME OF BREASTFEEDING FREQUENCY PERCENT

Within 1 hour 339 94.7%

After 1 hour 13 62.0%

Did not know 6 2.7%

Total 358 100.0%

94.7% of newborns were breastfed immediately after delivery (within one hour). The same proportion was given colostrum during the first three days after birth, and 84% of the newborns were not given any other food during the first three days after birth. The increase in immediate breastfeeding is significant, and doubles the baseline value (42% at baseline).

4.5 Complementary feeding

Table 12. Complementary feeding, among children age 6-23 months

BREASTFEEDING STATUS FREQUENCY PERCENT

Breastfed 138 55.0%

Not breastfed 8 3.1%

Did not know 6 0.1%


Not fed minimum frequency 99 39.4%

Total 152 100%

The Final KPC Survey noted that 59% of children at 6-23 months of age were fed appropriate minimum frequency of meals. Breastfed children were more likely to be fed a minimum frequency of meals than non-breastfed children (44% or 138/324 vs. 24% or 8/34). In rural areas, children who are not breastfed after six months are commonly orphans, have sick mothers, or may have been weaned early.

4.6 Vitamin A supplementation

Table 13. Vitamin A received

VITAMIN A RECEIVED FRQUENCY PERCENT

Yes 184 74%

No 62 24.7%

Did not know 4 1.0%

Blank 1 0.1%

Total 251 100.0%

Among children at 6-23 months of age, 74% received a dose of vitamin A in the six months before data collection, which was not a significant increase from the baseline survey (72%).

4.7 Child immunization

Table 14. Vaccination card in household

HAVING VACCINATION CARD FREQUENCY PERCENT

Yes, and seen by enumerator 273 76.3%

Did not know 1 0.3%

Not available 68 19.0%

Never had a card 16 4.5%

Total 358 100.0%

73% of mothers possess health or vaccination cards, a significant increase from the baseline value of 61%. The major issue with Health/vaccination card is that they are often not filled out by health facility personnel. 72% (258/358) of mothers reported vaccinations that are not shown on their cards.

Table 15. DPT1 (Penta 1) or DPT3 (Penta 3) vaccinations received

PENTA 1/PENTA 3 RECEIVED FREQUENCY PERCENT


Penta 1 94 78.3%

Penta 3 49 40.8%

In Niger, Penta 1 and 3, which include five antigens, now are provided in place of DPT1 and DPT3.

Table 16. Vitamin A provision shown on vaccination card

VITAMIN A SHOWN ON CARD FREQUENCY PERCENT

Yes 140 55.8%

No 46 18.3%

Did not know 65 * 25.9%

Total 251 100.0%

This result is obtained from a cross tabulation of survey questions 44 (“Did the child receive a single dose of Vitamin A with the last 6 months?”) and 45 (“Does the mother possess a vaccination card?”). The 65 responses categorized as “NA” includes children at 8-23 months of age who had a card that was not available (n=50), had never possessed a vaccination card (n= 11), or and one mother respondent who was unsure if she possessed a card and was classified as “No.” If ownership of a vaccination card is not considered in the calculation, the percentage of children reported to have received Vitamin A increases to 74%.

Table 17. BCG vaccination received

BCG RECEIVED FREQUENCY PERCENT

Yes 236 65.9%

No 32 8.9%

Did not know 90 24.1%

Total 358 100.0%

Overall, 66% of children were reported to have received BCG (tuberculosis) vaccinations. At baseline, BCG was provided to 70% of infants under 12 months of age (137/202) and 63% (99/156) of children at 12-23 months of age. Konni District appears to have a lower proportion of children receiving BCG than Tahoua Region (72%) (INS, 2010). Historically, Konni District has experienced low vaccination coverage and recurrent outbreaks of measles and meningitis.

4.8 Malaria

Table 18. Appropriate malaria treatment received

APPROPRIATE MALARIA TREATMENT RECEIVED FREQUENCY PERCENT

Yes 144 67.9%


No 72 34.0%

Did not know - -

Total 216 100.0%

59% (212/358) of children had fevers in the two weeks prior the survey. An appropriate antimalarial (Artemisinin-based combination therapy, Fansidar®, chloroquine, or amodiaquine) was provided to 68% of children within 24 hours of the onset of the fever4.

4.9 Nutritional statusThe nutritional status of children in the intervention area remains poor, as represented in Figure 2 by the red curve for weight-for-age skewed to the left of the WHO/National Center for Health Statistics reference. The survey found that 41.7% (145/350) are underweight.

Figure 2. Nutritional status of children in intervention area

5 DiscussionFindings of the Final KPC Survey in Konni District have shown two major trends: (1) significant improvements in indicators for maternal and newborn care, the prevention and treatment of infant disease, child immunization, and water and sanitation; and, (2) a deterioration in the nutritional status of children in the project area.

5.1 Key findings and programmatic implications

Indicator 1. Percentage of mothers with children age 0-23 months who received at least two Tetanus toxoid vaccinations before the birth of their youngest child

4 Choloroquine was an appropriate treatment in 2008 according to the Niger MOH, and was therefore included in the Baseline survey. The Final survey included chloroquine as an appropriate treatment for comparability, although national policy requires ACTs be provided as first-line therapy.


A significantly increased proportion (81% vs. 28.8% at baseline) of mothers with children at 0-23 of age had received at least two doses of Tetanus Toxoid (TT) vaccine before the birth of their youngest child. (A table comparing indicators from the Final and Baseline KPC surveys in included as Appendix K.) The Final result exceeded the End of Project (EOP) target of 40%. The indicator is higher than in Tahoua Region (62.1%) (INS, 2010).

The increase may be linked to an increased utilization of antenatal consultation and maternal health services. Despite several vaccine stock-outs during the four year project period, the Government of Niger’s 2008 policy of free mother and child care and the Healthy Start’s community sensitization activities may also have contributed to the increased utilization of services. The survey found that 73% of mothers possessed health/vaccination cards, and that 60% of mothers gave birth in health centers. The project area showed a higher correlation of completed ANC/TT visits and subsequent births in health facility than the 2010 National Child Survey, which who showed that despite a significant increase of Antenatal visits (55% in Tahoua Region), deliveries in health facilities were uncommon (31%).

Indicator 2. Percentage of children age 0-23 months whose births were attended by skilled personnel

Among the 60% of pregnant women who gave birth in health centers, 52% of the deliveries were attended by skilled personnel, a significant increase from the baseline value (26.4%). The Final result exceeded the EOP target of 40%.

Although Ministry of Health policy does not consider health post workers to be skilled personnel, they account for 60% of all health workers in the 60 health posts of Konni District. Therefore, the Healthy Start Project trained health post workers in clean delivery, and included them in the tabulation of this Rapid CATCH indicator.

Indicator 3. Percentage of children age 0-23 who received a post-natal visit from an appropriate trained health worker within three days after the birth of the youngest child

The indicator for post-partum check did not change significantly for mothers (88% vs. 92% at baseline) and children (11% vs. 13%). While these results may indicate a stagnation of the post-natal check-ups, it should be noted that the responses rate in the Final KPC is low. Even though 60% (201/358) of mothers answered positively that they were checked after delivery, only 29 mothers were able to identify who assisted her during the delivery.

Indicator 4. Percentage of children age 0-5 months who were exclusively breastfed during the last 24 hours

The survey has noted a significant increase (72% vs. 36%) in the proportion of children at 0-5 months of age who were exclusively breastfed during the 24 hours prior to the survey. This is more than twice the proportion of 26.9% found by the national-level Nutrition and Child


Survival Survey of June 2010. The KPC Final Survey results support the observations made in the Healthy Start Project Mid-term Evaluation that breastfeeding behavior has increased in the project area.

Indicator 5. Percent of infants and young children age 6-23 months fed according to a minimum of appropriate feeding practices

50 % of children at 6-23 months of age who were fed according to a minimum of appropriate feeding practices (147/251). This a significant increase over the baseline estimate of 36%.

Indicator 6. Percentage of children age 6-23 months who received a dose of Vitamin A in the last 6 months (Mother’s recall)

According to mothers’ recall, 74% of children at 6-23 months of age received a dose of Vitamin A in the six months prior to the survey, a significant increase over the baseline (10%). When excluding responses from mothers whose cards did not show a precise date for when Vitamin A was received, the proportion drops to 8% (20/251).

This indicator was expected to be higher. Two months before the survey, in June 2010, Niger distributed Vitamin A as part of its semi-annual national vaccination day. This indicator result indicates that Niger’s distribution strategy is not achieving full coverage.

Indicator 8. Percentage of children age12-23 months who received a DPT3 vaccination before they reached 12 months

41% of children at 12-23 months of age received a Penta 3 vaccination (which now replaces DPT3 in Niger), a significant increased over the baseline value of 28%. This indicator exceeds the EOP target of 40%, despite repeated vaccine stock-outs reported in Konni District’s annual health plan evaluations.

Indicator 9. Percentage of children age 12-23 months who received a measles vaccination according to the vaccination card or mother’s recall by the time of the survey

51% of children received measles vaccination, a significant increase over the baseline value of 38% and exceeding the EOP target of 40%.

Indicator 10. Percentage of children age 0-23 months with a febrile episode during the last two weeks who were treated with an effective anti-malarial drug within 24 hours after the fever began

Indicator 11. Percentage of children age 0-23 months who slept under an insecticide-treated bed net the previous night

The Survey found a significant improvement in the prevention and treatment of malaria. Use of 67.9% of children who had experienced a febrile episode two weeks before the survey had been


treated with an appropriate antimalarial, a significant increase over the baseline (17.6%) and exceeding the EOP target of 40%. Furthermore, 77.3% of children had slept under a bednet, compared to 40.0% at baseline, exceeding the EOP target of 60%.

Despite public sector stock outs of nets during the project period the Healthy Start Project’s timing of behavior change activities around peak malaria transmission periods (rainy seasons) and an increased availability of bednets in the communities may have contributed to these positive results.

Indicator 12. Percentage of children age 0-23 months with diarrhea in the last two weeks who received oral rehydration solution (ORS) and/or recommended home fluids

49.7% of children received ORS when they had diarrhea, a significant increase from the baseline value of 17.5%, but below the EOP target of 70%. ORS coverage might be improved through direct distribution at the household level through care group volunteers. Instead, access to ORS is limited to mothers who are able to access and utilize health post services.

Indicator 13. Percentage of children age 0-23 months with chest-related cough and fast and/ or difficult breathing in the last two weeks who were taken to an appropriate health provider

The endline survey identified a significant improvement in health seeking behavior among mothers with children aged 0-23 months, as evidenced by increased use of appropriate health provider to manage cough and fast and/or difficult breathing of children at 0-23 months of age from baseline findings (45.5% vs. 18.2%). Even though ARI management is not among the four priority technical intervention of the project.

The project supported the improvement in the case management of childhood illnesses through capacity building of health post workers in Community-based Integrated Management of Childhood Illness and care group mobilization to strengthen community-based referral systems.

Indicator 14. Percentage of households of children age 0-23 months that treat water effectively

75.4% of households treat water effectively, a significant increase from 15.2%. The project’s behavior change messages included locally- and culturally-appropriate methods for protecting water quality.

Indicator 15. Percentage of mothers of children 0-23 months who live in a household with soap or a locally appropriate cleanser at the place for hand washing

23.7% of mothers of children at 0-23 months of age live in houses with soap or cleanser at the place for hand washing, a significant increase from the baseline value of 11.5%.

The promotion of hand washing was a challenging activity for several reasons. The project adopted a gradual introduction of BCC packages, so hand washing messages were introduced in Year 2 and did not benefit from as much time for sensitization as did maternal and newborn care


or breastfeeding. Second, the placement of soap at an appropriate point of use is highly culturally dependent. Soap is usually used in the bathing area and for prayer ablution. People instead wash their hands using a kettle, without soap. Soap and detergent cannot be left in the open air by latrines because birds, hens or domestic animals tend to displace or spoil them, nor kept in a container because they can easily melt or dilute in the midday heat. Not least, soap and detergent are costly, so the project launched training for women volunteers in soap production during the last quarter of implementation period (April-June 2010). Village residents expressed interest in continuing the activity.

Indicator 16. Percentage of children 0-23 months who are underweight

41.7% (145/350) of children at 0-23 months of age were measured to be underweight (having a weight for age measurement that is -2 standard deviations from the median weight for age, according to WHO/NCHS reference population). This indicator is significantly higher than the baseline survey result of 30.3%.

Despite increases in exclusive breastfeeding and complementary feeding practices noted in the final KPC, the nutritional status of people in Konni District may have been compromised by Niger’s repeated food insecurity during the project period. In 2009 and 2010, Niger recorded food shortages with almost half of the population estimated to be food insecure. At the Konni District level in 2009, 169 villages were identified by the Local Government Food Security Watching Committee system to have a crop deficit of up to 80%.

The 2006 Niger DHS found that 46% of children aged under five were underweight. Based on this prevalence, the projected underweight prevalence target for 2011 is 25% to meet the Millennium Development Goal for reduced infant mortality. A Situational Analysis of IYCF policies and programmatic activities in Niger conducted in 2008-2009 showed that, “Mortality rates are on track to reaching the Millennium Development Goal to reduce mortality among young children by two-thirds by 2015, but there has been no change in under nutrition, and total mortality rates are still high among young children” (Whueler & Biga, 2011).

6 ConclusionThe Results of the Final KPC Survey in the Konni District showed that knowledge, practices and coverage have improved in mother and child health while and improvements in the nutritional status (underweight) of children remain challenged.

RI has shared the results of the survey data with the Niger Ministry of Health. The Konni Health District management team plans to utilize the lessons learned from this survey when it refines the maternal and child health indicator targets of its new four-year District Health Development Plan (2011-2016).


7 Bibliography

Institut National de la Statistique (

INS). (2010). Nutrition and Child Survival Survey among children aged 6 to 59 months. Niger, May - June 2010. Niamey: Institute National de la Statistique-Niger/UNICE/WFP/HKI.

Ministry of Health. (2005). Konni Health District Development Plan 2005-2010. Konni City: Government of Niger.

Ministry of Health. (2008). National Child Survival Strategy (Avant-projet de Stratégie National de Survie de l’Enfant). Niamey: Republic of Niger-Ministry of Health.

Ministry of Health. (2011). National Nutritional Plan 2011-2015 (Plan National pour la Nutrition PNN 2011-2015). Niamey: Republic of Niger- Ministry of Health.

Ministry of Health. (2011). Plan de Developpement Sanitaire du Niger. Niamey: Republic of Niger-Ministry of Health.

United Nations Development Programme (UNDP). (2011). Niger Country Profile: Human Development Indicators. Retrieved September 30, 2011, from International Human Development Indicators: http://hdrstats.undp.org/en/countries/profiles/NER.html

United Nations Population Fund (UNFPA). (2011). State of the World's Midwifery. Geneva: UNFPA.

Whueler, S., & Biga, A. (2011). Situational analysis of infant and young child nutrition. Maternal and Child Nutrition 7 (Suppl. 1), 133–156.


8 Appendices

A. Survey personnelThe following people were instrumental in bringing the Final KPC Survey to a completion:

CORE TEAM

NAME ORGANIZATION PHONE CONTACTSalissou Iliassou DDP/AT/DC Konni 96 87 94 64

Abouzeidi Chouhabou DS Konni 96 87 89 38

Dr Soumana Oumarou MPDL Konni 96 08 11 33

Dr Mahaman Hallarou RI 96 29 27 84

Moustapha Tcharimi RI 96 88 33 75

Rakia Azouma RI 96 87 66 43

Remi Sugurono Consultant 90 61 22 27

SURVEY SUPERVISORS

NAME ORGANIZATION PHONE CONTACTAbouzeidi Chouhabou DS Konni 96 87 89 38

Ali Hantchi DDP/AT/DC Konni 96 59 07 60

Ary Issaka Ousmane Jeunesse Sport Konni 98 09 19 04

Garba Nana Haouaou ISCV Konni 90 79 09 60

Kamayé Goga Alphabétisation 96 88 76 92

Maman Sani Moussa Oumarou ISCV Konni 91 79 38 57

Moussa Maman Tela ISCV Konni 96 87 89 38

Moustapha Tcharimi Tchari PSE/RI Konni 90 46 65 51

Sangaré Rachide ISCV Konni 96 99 45 52

Dr Soumana Oumarou MPDL Konni 96 08 11 33

ENUMERATORS

NAME PROFESSION PHONE CONTACTAbdou Andin Teacher 91 59 95 35

Abdoul Razakou Habou Nagodi Logistics assistant 96 50 40 96

Abdoulkarim Ado Marketer 96 89 75 48

Aichatou Abdou Garba Teacher 96 89 89 97

Ali Abdoul Karim DDP/AT/DC 96 29 03 63

Alzouma Mahaman Moustapha Student 96 57 44 20

Alzouma Mayaki Oumarou Student 96 21 88 44

Arzika Halimatou Biologist 94 25 45 87

Béga Alou Sociologist 96 27 78 38

Binta Ibrahim Teacher 96 58 72 63


Dakaou Alio Sociologist 96 46 73 34

Fatimatou Issaka Bilali Nurse 96 26 75 84

ENUMERATORS (continued)

NAME PROFESSION PHONE CONTACTGarba Kano Retired teacher 96 97 29 14

Hadiza Ibrahim Rural development specialist 97 28 74 80

Hassane Almou Amadou Animateur 90 04 12 63

Ibrahim Gado Professor 98 74 37 40

Ibrahim Maman Sani Professor 96 46 66 01

Ibrahim Oumarou Student 96 52 95 02

Ibro Mahamadou Animateur 96 07 69 59

Maman Fati Idi Planning agent 98 58 42 66

Mato Touraki Journalist 96 75 89 77

Mohamed Abolbol Sociologist 96 98 08 66

Moussa Abdou Extension agent 90 57 95 34

Moussa Jean Traoré Sociologist 91 71 50 83

Oumarou Djibo Teacher 96 01 43 04

Oumarou Ibrahim Student 96 02 76 40

Salamatou Habou Journalist, Radio Anfani 96 06 42 47

Salifou Moumouni Kadidja Sociologist 96 58 04 76

Salissou Dan Nana Sociologist/ Municipal agent 91 36 34 32

Souley Hamidine Sociologist 96 40 20 88


B. Maps of the Republic of Niger’s regions and the Department of Birni n’Konni

Map 1. The Republic of Niger and its regions

Map 2. Department of Birni n’Konni5

5 Source: Relief International and the Konni District Ministry of Health, 2007


C. Survey Steering Committee invitation letter

Représentation au Niger Tél. : (227) 20 35 08 79 / 21 76 74 69 Fax 20 64 00 29

BP : 12 245 NIAMEY

Mr. Noble WilliamsUSAID Program Manager USAID Office Niamey, Niger

Reference: USAID CA # GHS-A-00-0-00028-00,Niger Child Survival Project

Dear Mr. Williams,

Thank you for the opportunity to inform you that under the referenced project, Relief International (RI) is planning to carry out a Final Evaluation that will enable the Ministry of Health, the local community, and RI to verify achievements towards the project objectives. Planned evaluation activities are participatory and we are expected to invite donors and partner organizations including USAID to participate in the evaluation activities in Konni district.

The attached documents provides information on planned field level evaluation activities in Konni District and we would appreciate it very much if you could confirm your availability to participate in this evaluation activity so that we can also take into account the Mission’s ideas and concerns in current and future health program development activities in the region.

Sincerely yours,

Edwards FarrelRI Country DirectorProject Manager

Encl.


D. Questionnaire (English)

Ask the mother if she has a child under 24 months who lives with her. If yes, proceed with interview, if no thank the mother and end the interview.

IdentificationCluster NumberHousehold NumberRecord NumberCommunityName of MotherName of SupervisorData Entered by Date: ___/___/____

day/month/year

1 2 3 Final VisitInterview date ___/___/____

day/month/year___/___/____

day/month/year___/___/____

day/month/yearFor SupervisorDay

Name of Interviewer MonthYear

Result Code* Result Code*Result Codes:

1. Completed2. Respondent not at home3. Postponed4. Refused5. Other______________________________________

Specify

Consent

INFORMED CONSENT

Hello. My name is ______________________________, and I am working with Relief International and MSP. We are conducting a survey and would appreciate your participation. I would like to ask you about your health and the health of your youngest child under the age of two. This information will help Relief International and MSP to plan health services and assess whether it is meeting its goals to improve children’s health. The survey usually takes _______ minutes to complete. Whatever information you provide will be kept strictly confidential and will not be shown to other persons.

Participation in this survey is voluntary and you can choose not to answer any individual question or all of the questions. However, we hope that you will participate in this survey since your views are important.

Will you participate in this survey?

At this time, do you want to ask me anything about the survey?

Signature of interviewer: __________________________________________________ Date: ____________________ESPONDENT AGREES TO BE INTERVIEWED__________RESPONDENT DOES NOT AGREE TO BE INTERVIEWED


Questionnaire

ALL QUESTIONS ARE TO BE ADDRESSED TO MOTHERS WITH A CHILD LESS THAN 24 MONTHS OF AGE

IntroductionNo. Questions and Filters Coding Categories Skip

1 How many children do you have?Total number of children

2 What is the name, sex, date of birth of your youngest child that you gave birth to and that is still alive?

Youngest Child

Name _______________________________

SexMale……………………………………………....1

Female………………………………...………....2

Date of Birth

Day

Month

Year

Tetanus Toxoid Immunization

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

3 During pregnancy with (NAME) did you receive an injection in the arm to prevent the baby from getting tetanus, that is, convulsions after birth?

Yes...................................................................1No.....................................................................2Don’t know........................................................9

4 5 5

4 While pregnant with (NAME), how many times did you receive such an injection? Times

Don’t know........................................................9

5 At any time before the pregnancy with (NAME) did you receive any tetanus injections?

Yes...................................................................1No.....................................................................2Don’t know........................................................9

6 7 7

6 How many other times did you receive a tetanus injection?

IF 7 OR MORE TIMES, RECORD 7

Times

Don’t know........................................................9


Skilled attendance and clean cord care


7 Who assisted you with the delivery of (NAME)?

Anyone else?

PROBE FOR THE TYPE(S) OF PERSON(S) AND RECORD ALL MENTIONED.

IF RESPONDENT SAYS NO ONE ASSISTED, PROBE TO DETERMINE WHETHER ANY ADULTS WERE PRESENT AT THE DELIVERY.

HEALTH PERSONNEL DOCTOR......................................................A NURSE or MIDWIFE.....................................B AUXILIARY MIDWIFE...................................C OTHER HEALTH STAFF WITH MIDWIFERY SKILLS...................................D

OTHER PERSON TRADITIONAL BIRTH ATTENDANT............E COMMUNITY HEALTH WORKER................F RELATIVE/FRIEND......................................G OTHER___________________....................H (SPECIFY)

NO ONE...........................................................Y

8 Was a Clean Delivery Kit used during delivery?(SHOW DELIVERY KITS LOCALLY PROMOTED)

Yes...................................................................1No....................................................................2Don’t know........................................................9

10 9 9

9 What instrument was used to cut the cord? New razor blade...............................................1

New and boiled razor blade..............................2

Used razor blade..............................................3

Used and boiled razor blade.............................4

New scissors....................................................5

New and boiled scissors...................................6

Used scissors...................................................7

Used and boiled scissors..................................8

Knife.................................................................9

Reed...............................................................10

Other ____________________.....................96

(Specify)Don’t know......................................................97

Active management at delivery10 Immediately after (NAME) was born, before the

placenta was delivered, did you receive an injection to prevent you from bleeding too much?

Yes...................................................................1

No.....................................................................2

Don’t know........................................................9

11

13

1311 Immediately after you got an injection to prevent you

from bleeding, did the birth attendant hold your stomach and pulled on the cord to help the placenta come out?

Yes...................................................................1

No.....................................................................2

Don’t know........................................................9

12

13

1312 Immediately after the Placenta was delivered, did

someone massage your uterus to make it contract strongly and to prevent you from bleeding too much?

Yes...................................................................1

No.....................................................................2

Don’t know........................................................9


Drying and wrapping after birth


13 Was (NAME) dried (wiped) immediately after birth before the placenta was delivered?

Yes...................................................................1No....................................................................2Don’t know.......................................................9

14 Was (NAME) wrapped in a warm cloth or blanket immediately after birth before the placenta was delivered?

Yes...................................................................1No....................................................................2Don’t know.......................................................9

Breastfeeding/ Infant and Young Child Feeding15 Did you ever breastfeed (NAME)? Yes...................................................................1

No....................................................................2 16 19

16 How long after birth did you first put (NAME) to the breast?

IF LESS THAN 1 HOUR, RECORD 00 HOURS,IF LESS THAN 24 HOURS RECORD THE HOURS,OTHERWISE RECORD DAYS

IMMEDIATE...................................................00

HOURS

DAYS

Don’t remember................................................917 During the first three or four days after delivery,

before your regular milk began flowing, did you give (NAME) the liquid (colostrum) that came from your breasts?

YES .................................................................1

NO .................................................................2

DON’T KNOW ................................................918 In the first three days after delivery, was (NAME)

given anything to drink other than breast milk? YES ................................................................1

NO .................................................................2

DON’T KNOW ................................................919 Now I would like to ask you about liquids or foods

(NAME) had yesterday during the day or at night.

Did (NAME) drink/eat:

READ THE LIST OF LIQUIDS (A THROUGH E, STARTING WITH “BREAST MILK”).

Milk of animalsPowdered milksimple watersugar waterSalt water sweetenedDécoctions. / infusionsFruit juicehoneyOther specify

20 Currently do you breastfeed (NAME)?YES 1NO 2

21 How long did you breastfeed?IF LESS THAN A MONTH RECORD '00 'MONTH . MONTHS..........................░░░░░░



22

22A

22B

22C

22D

22E

22F

PLEASE FILL OUT THE FOLLOWING TABLE WITH THE ANSWERS TO THE QUESTIONS BELOW:Now I would like to ask you about (other) liquids or foods that (NAME) may have had yesterday during the day or at night. I am interested in whether your child had the item even if it was combined with other foods.

Did (NAME) drink/eat:

CHECK THE BOX IF THE CHILD drank the liquid in question.

Breast milk?

Water Plate?

Milk powder sold in commerce?

Milk as in any other box, powder, fresh milk or animal?

Fruit juice?

Other liquids such as sugar water, tea, coffee, soft drinks or broth?

A............................................░░░

B............................................░░░

C............................................░░░

D............................................░░░

E............................................░░░

F............................................░░░



22G

22H

22I

22J

22K

22L

22M

22N

22O

22P

Now I would like to ask you about the types of aliments4 that [NAME] ate yesterday during the day or night.

Does [NAME] ate the following foods during the day or last night?

Check the box if the child to eat the food in question.

Foods made of seeds [eg, millet, sorghum, maize, rice, wheat, boiled, or other local seeds]?

Pumpkin, red or yellow yams or squash, carrots or sweet potatoes red?

Any other food from roots or tubers [eg, potatoes, white yams, cassava and other roots / tubers local]? 5

Of green leafy vegetables?

Mango, papaya [or other local fruits rich in Vitamin A]?

Other fruits and vegetables [eg, bananas, apples / applesauce, avocados, tomatoes]?

Meat, poultry, fish, seafood or eggs?

Food prepared from vegetables [eg, lentils, beans, soybeans, pulses, peanuts or]?

Cheese or yogurt?

Food-based oil, grease or butter?

G...........................................░░░

H............................................░░░

I.............................................░░░

J............................................░░░

K............................................░░░

L............................................░░░

M...........................................░░░

N............................................░░░

O...........................................░░░

P………………………………..░░░



23 How many times did (NAME) eat solid, semi-solid, or soft foods other than liquids yesterday during the day or at night?

IF CAREGIVER ANSWERS SEVEN OR MORE TIMES, RECORD “7”

WE WANT TO FIND OUT HOW MANY TIMES THE CHILD ATE ENOUGH TO BE FULL. SMALL SNACKS AND SMALL FEEDS SUCH AS ONE OR TWO BITES OF MOTHER’S OR SISTER’S FOOD SHOULD NOT BE COUNTED.

LIQUIDS DO NOT COUNT FOR THIS QUESTION. DO NOT INCLUDE THIN SOUPS OR BROTH, WATERY GRUELS, OR ANY OTHER LIQUID.

USE PROBING QUESTIONS TO HELP THE RESPONDENT REMEMBER ALL THE TIMES THE CHILD ATE YESTERDAY

Number of Times

Don’t Know…………… …….9

24 Can I see the salt used for cooking? 6TAKE A teaspoon of SALT and test it for iodine.

IODINE PRÉSENT 1IODINE NOT PRÉSENT...................................2

25 Has (NAME) received a dose of Vitamin A like this in the past six months? 7BULB SHOW / CAPSULE / SYRUP.

YES 1NO 2DON’T KNOW..................................................8

Postpartum visit (for mother)26 Where did you give birth to (NAME)? HOME (own or other).......................................1

HEALTH FACILITY (public sector or private) . .2

33

27

27 After (NAME) was born, before you were discharged, did any health care provider check on your health?

Yes...................................................................1

No.....................................................................2

28

3028 How long after delivery did the first check take place?

IF LESS THAN ONE DAY, RECORD HOURS.IF LESS THAN ONE WEEK, RECORD DAYS.

HOURS

DAYS

WEEKS

DON'T KNOW................................................9929 Who checked on your health at that time?

PROBE FOR MOST QUALIFIED PERSON.

HEALTH PERSONNELDOCTOR.........................................................ANURSE or CLINICAL OFFICER.......................BMIDWIFE.........................................................CAUXILIARY......................................................D

OTHER PERSONTRADITIONAL BIRTHATTENDANT...................................................EHEALTH WORKER..........................................F

OTHER............................................................Z (SPECIFY)

30 After you were discharged, did any health care provider or a traditional birth attendant check on your health?

Yes...................................................................1

No.....................................................................2

31



HOURS

DAYS

WEEKS

DON'T KNOW................................................99



32 Who checked on your health at that time?



OTHER PERSONTRADITIONAL BIRTHATTENDANT...................................................EHEALTH WORKER..........................................FTRAINED TBA ................................................GTRAINED HW..................................................H

OTHER............................................................Z (SPECIFY)

33 After (NAME) was born, did any health care worker or a traditional birth attendant check on your health?

Yes...................................................................1

No.....................................................................2

34

42



HOURS

DAYS

WEEKS

DON'T KNOW................................................99

35 Who checked on your health at that time?




OTHER............................................................Z (SPECIFY)

42

42 42 42

42 42 42 42

42

Postnatal visit (for baby)

36 After (NAME) was born, before you were discharged from the health facility, did any health care provider check on (NAME)’s health?

Yes...................................................................1

No.....................................................................2

37

39

37 How many hours, days or weeks after the birth of (NAME) did the first check of (NAME) take place?

HOURS

DAYS

WEEKS

DON'T KNOW................................................99



38 Who checked on (NAME)’s health at that time?



OTHER PERSONTRADITIONAL BIRTHATTENDANT...................................................EHEALTH WORKER..........................................F

OTHER............................................................Z (SPECIFY)

39 After you were discharged, did any health care provider or a traditional birth attendant check on (NAME)’s health?

Yes...................................................................1

No.....................................................................2

40

4540 How many hours, days or weeks after the birth of

(NAME) did the first check of (NAME) take place?


HOURS

DAYS

WEEKS

DON'T KNOW................................................9941 Who checked on (NAME)’s health at that time?




OTHER............................................................Z (SPECIFY)

42 During the first days after (NAME) was born, did any health care provider or a traditional birth attendant check on (NAME)’s health?

Yes...................................................................1

No.....................................................................2

43

4543 How many hours, days or weeks after the birth of

(NAME) did the first check of (NAME) take place?


HOURS

DAYS

WEEKS

DON'T KNOW................................................9944 Who checked on (NAME)’s health at that time?




OTHER............................................................Z (SPECIFY)

Childhood Immunization



45 Did (NAME) take a vitamin A dose like this during the last 6 months?

SHOW AMPULE/CAPSULE/SYRUP.

YES..............................................................1NO................................................................2DON’T KNOW..............................................8

46 Do you have a card where (NAME’S) vaccinations are written down?

IF YES: May I see it please?YES, SEEN BY INTERVIEWER...................1NOT AVAILABLE/LOST/MISPLACED..........2NEVER HAD A CARD..................................3DON’T KNOW..............................................8

47 49 49 49

47 (1) COPY VACCINATION DATE FOR EACH VACCINE FROM THE CARD.

(2) WRITE ‘44' IN ‘DAY’ COLUMN IF CARD SHOWS THAT A VACCINATION WAS GIVEN, BUT NO DATE IS RECORDED. DAY MONTH YEAR

DPT 1

DPT 3

MEASLES

VITAMIN A (MOST RECENT)

D D M M Y Y Y Y

48 Has (NAME) received any vaccinations that are not recorded on this card, including vaccinations received in a national immunization day campaign?

YES 1

NO 2

DON’T KNOW 8

49

51

51

49 Did (NAME) ever receive any vaccinations to prevent him/her from getting diseases, including vaccinations received in a national immunization day campaign?

YES 1

NO 2

DON’T KNOW 8

49

51

51



50

50A

50B

50C

50D

50E

50F

50G

Please tell me if (NAME) received any of the following vaccinations:

A BCG vaccination against tuberculosis, that is, an injection in the arm or shoulder that usually causes a scar?

Polio vaccine, that is, drops in the mouth?

When was the first polio vaccine received, just after birth or later?

How many times was the polio vaccine received?

DPT vaccination, that is, an injection given in the thigh or buttocks, sometimes at the same time as polio drops?

How many times?

=======================================

In Rapid CATCH:

An injection in the arm to prevent measles?

=======================================

YES 1

NO 2

DON’T KNOW 8

YES 1

NO 2

DON’T KNOW 8

JUST AFTER BIRTH 1

LATER 2

NUMBER OF TIMES |___|___|

YES 1

NO 2

DON’T KNOW 8

NUMBER OF TIMES |___|___|

===========================

YES 1

NO 2

DON’T KNOW 8

==========================

43C

43E 43E

43F

43G

43G

Malaria - Treatment of Fever of Child

51 Has (NAME) been ill with fever at any time in the last 2 weeks?

Yes……...……………………1

No…………………………….2

Don’t know…………………. 9

52

56

56

52 Did you seek advice or treatment for the fever?

Yes………………………………1

No……………………………….2

53

54

53 How many days after the fever began did you first seek treatment for (NAME)?

Same day………………………0

Next day………………………...1

Two or more days………………2


54 At any time during the illness did (NAME) take any drugs for the fever?

Yes…………..……………………1

No……………………………..….2

Don’t know……………………….9

55

56

56

55 What drugs did (NAME) take?Any other drugs?RECORD ALL MENTIONED.

ASK TO SEE DRUG(S) IF TYPE OF DRUG IS NOT KNOWN. IF TYPE OF DRUG IS STILL NOT DETERMINED, SHOW TYPICAL ANTIMALARIAL DRUGS TO RESPONDENT**COUNTRY SPECIFIC BASED ON NATIONAL MALARIAL PROTOCOL.

FOR EACH ANTIMALARIAL MEDICINE ASK: How long after the fever started did (NAME) start taking the medicine?

CIRCLE THE APPROPRIATE CODES:SAME DAY = 0NEXT DAY AFTER THE FEVER = 1TWO OR MORE DAYS AFTER THE FEVER = 2DON’T KNOW = 9

ANTI-MALARIALA. SP/Fansidar…...0 1 2 9

B. Chloroquine……0 1 2 9

C. Amodiaquine…..0 1 2 9

D. Quinine………....0 1 2 9

E. ACT…………..…0 1 2 9

OTHER DRUGS

F. ASPRIN………….0 1 2 9

G. PARACETAMOL…0 1 2 9

X. Other……………...0 1 2 9

56 What causes malaria?RECORD ALL MENTIONED.

Anything else?

RECORD ALL MENTIONED.

MOSQUITO BITES....................................AWITCHCRAFT...........................................BINTRAVENOUS DRUG USE ....................CBLOOD TRANSFUSIONS.........................DINJECTIONS .............................................ESHARING RAZORS/BLADES....................FKISSING....................................................G

OTHER _________________________(SPECIFY)

OTHER __________________________(SPECIFY)

DON’T KNOW Z

Malaria prophylaxis during pregnancy

57 When you were pregnant with (NAME), did you take any drugs to prevent you from getting malaria?

YES............................................................1 NO..............................................................2DON’T KNOW.............................................8

58 59 59

58 Which drug did you take?


FANSIDAR.................................................ACHLOROQUINE.........................................B

OTHER____________________ X(SPECIFY)

UNKNOWN DRUG.....................................Z


Malaria – Insecticide-treated Net use


59 Does your household have any mosquito nets that can be used while sleeping?

Yes………………………...……..……1

No…………………………………..….2

60

64

60 Who slept under a bed net last night?

If ANYONE OTHER THAN THE CHILD IS MENTIONED, RECORD OTHER.

No One………………………..……….0

Child (NAME)…………………………..1

Other ……………………………..........2

64

61

5761 Which brand of bed net did (NAME) sleep

under last night?

SHOW PICTURES OF TYPICAL NET TYPES AND BRANDS.

Permanent Net

Brand A……............................................1

Brand B……………………….………….…2

Pretreated Net

Brand C…………………….………...…….3

Brand D……………………….……...…….4

Other Net

Other N et ….……………….…..…….…..5

Don’t know brand……………….…………9

64

64

62

62

62

62

62 Was the bed net that (NAME) slept under last night ever soaked or dipped in a liquid treated to repel mosquitoes or bugs?

Yes…………………………………………1

No…………………………………………..2

Don’t know………………………….….. 9

63

64

64

63 How long ago was the net last soaked or dipped in a liquid treated to repel mosquitoes or bugs?

IF LESS THAN 1 MONTH AGO, RECORD 00 MONTHS. IF LESS THAN 2 YEARS AGO, RECORD MONTHS AGO. IF 12 MONTHS AGO OR 1 YEAR AGO, PROBE FOR EXACT NUMBER OF MONTHS.

Months

More than 2 years ago………95

Don’t know…………………….98

Diarrhea case management64 Has (NAME) had diarrhea in the last 2 weeks? YES...........................................................1

NO............................................................2DON’T KNOW...........................................8

65 74 74

65 What was given to treat the diarrhea?

Anything else?If answer pill or syrup, show local packaging for zinc and ask if the child received this medicine


NOTHING.................................................AFLUID FROM ORS PACKET....................BHOME-MADE FLUID................................CPILL OR SYRUP, ZINC...…...DPILL OR SYRUP, NOT ZINC....................EINJECTION...............................................F(IV) INTRAVENOUS.................................GHOME REMEDIES/

HERBAL MEDICINES.........................H

OTHER_________________ X



66 When (NAME) had diarrhea, did you breastfeed him/her less than usual, about the same amount, or more than usual?

LESS.........................................................1SAME........................................................2MORE.......................................................3CHILD NOT BREASTFED........................4DON’T KNOW...........................................8

67 When (NAME) had diarrhea, was he/she offered less than usual to drink, about the same amount, or more than usual to drink?

LESS.........................................................1SAME........................................................2MORE.......................................................3NOTHING TO DRINK...............................4DON’T KNOW...........................................8

68 Was (NAME) offered less than usual to eat, about the same amount, or more than usual to eat?

LESS.........................................................1SAME........................................................2MORE.......................................................3NOTHING TO EAT...................................4DON’T KNOW...........................................8

69 Did you seek advice or treatment from someone outside of the home for (NAME’S) diarrhea?

YES...........................................................1NO............................................................2

70 74

70 Where did you first go for advice or treatment?

IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE.

_______________________________________________________(NAME OF PLACE)

HEALTH FACILITYHOSPITAL...........................................01HEALTH CENTER...............................02HEALTH POST....................................03PVO CENTER.....................................04CLINIC.................................................05FIELD/COMMUNITY HEALTH

WORKER.........................................06OTHER HEALTH

FACILITY____________ 07 (SPECIFY)

OTHER SOURCE TRADITIONAL PRACTITIONER..........08 SHOP...................................................09

PHARMACY........................................10 COMMUNITY DISTRIBUTORS...........11

FRIEND/RELATIVE.............................12

OTHER ________________ 88(SPECIFY)

71 Who decided that you should go there for (NAME’S) illness?


RESPONDENT.........................................AHUSBAND/PARTNER..............................BRESPONDENT’S MOTHER.....................CMOTHER-IN-LAW....................................DFRIENDS/NEIGHBORS...........................E

OTHER _________________________ X (SPECIFY)



72 Where did you go next for advice or treatment?

IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE.

______________________________________(NAME OF PLACE)

HEALTH FACILITYHOSPITAL...........................................01HEALTH CENTER...............................02HEALTH POST....................................03PVO CENTER.....................................04CLINIC.................................................05FIELD/COMMUNITY HEALTH

WORKER.........................................06OTHER HEALTH

FACILITY _______________ 07(SPECIFY)

OTHER SOURCE TRADITIONAL PRACTITIONER..........08 SHOP...................................................09

PHARMACY........................................10 COMMUNITY DISTRIBUTORS...........11

FRIEND/RELATIVE.............................12

OTHER ___________________ 88(SPECIFY)

73 During the period when (NAME) was recovering from diarrhea, did you give him/her less than usual to drink, about the same amount, or more than usual to drink?

LESS.........................................................1SAME........................................................2MORE.......................................................3NOTHING TO DRINK...............................4DON’T KNOW...........................................8

ORS preparation

74 Have you heard of ORS?

IF YES, ASK MOTHER TO DESCRIBE ORS PREPARATION FOR YOU.IF NO, CIRCLE 3 (NEVER HEARD OF ORS).

ONCE MOTHER HAS PROVIDED A DESCRIPTION, RECORD WHETHER SHE DESCRIBED ORS PREPARATION CORRECTLY OR INCORRECTLY.

CIRCLE 1 [CORRECTLY] IF THE MOTHER MENTIONED THE FOLLOWING: USE 1 LITER OF CLEAN DRINKING WATER (1 LITER=3

SODA BOTTLES) USE THE ENTIRE PACKET DISSOLVE THE POWDER FULLY

DESCRIBED CORRECTLY......................1DESCRIBED INCORRECTLY...................2NEVER HEARD OF ORS.........................3

ARI/Pneumonia

75 Has (NAME) had an illness with a cough that comes from the chest at any time in the last two weeks?

Yes………………………………1

No………………………….…….2

Don’t know……………………. 9

76

79

79

76 When (NAME) had an illness with a cough, did he/she have trouble breathing or breathe faster than usual with short, fast breaths?

Yes………………………………1

No………………………….…….2

Don’t know……………………. 9

77

79

79



77 Did you seek advice or treatment for the cough/fast breathing?

Yes………………………………1

No…………………………….….2

78

79

78Who gave you advice or treatment?Anyone else?


Doctor……………………...….….A

Nurse…………...........................B

Auxiliary Nurse………………….C

Trained Community Health Worker……………………….…..D.Other……………………………..X

Water and Sanitation

79 Do you treat your water in any way to make it safe for drinking?

Yes………………………….….…1

No……………………………..….2

79

81

80 If yes, what do you usually do to the water to make it safer to drink?

ONLY CHECK MORE THAN ONE RESPONSE IF SEVERAL METHODS ARE USUALLY USED TOGETHER, FOR EXAMPLE, CLOTH FILTRATION AND CHLORINE.

Let it stand and settle/sedimentation…...…….A

Strain it through cloth…………………………..B

Boil……………………………………………….C

Add bleach/Chlorine……………………………D

Water filter (Ceramic, sand, composite)……..E

Solar Disinfection……………………………….F

Other ..............................................................X

Don’t Know…………………..…………………..Z

81 Can you show me where you usually wash your hands and what you use to wash hands?

ASK TO SEE AND OBSERVE

Inside/near toilet facility...................................1

Inside/near kitchen/cooking place...................2

Elsewhere in yard...........................................3

Outside yard...................................................4

No specific place.............................................5

No permission to see......................................8

82

82

82

82

85

85



82 OBSERVATION ONLY: IS THERE SOAP OR DETERGENT OR LOCALLY USED CLEANSING AGENT?

THIS ITEM SHOULD BE EITHER IN PLACE OR BROUGHT BY THE INTERVIEWEE WITHIN ONE MINUTE. IF THE ITEM IS NOT PRESENT WITHIN ONE MINUTE CHECK NONE, EVEN IF BROUGHT OUT LATER.

Soap...............................................................1

Detergent........................................................2

Ash.................................................................3

Mud/sand........................................................4

None...............................................................5

Other ............................................................. 6

83

83

85

85

85

85

83 Did you use soap of any kind for any reason yesterday during the day or night?

Yes………………………………..…...…………1

No………………………………………………….2

83

85

84 When you used soap yesterday in the day or night, what did you use it for?

RECORD ALL MENTIONED. DO NOT READ THE ANSWERS, ASK TO BE SPECIFIC, ENCOURAGE “WHAT ELSE” UNTIL NOTHING FURTHER IS MENTIONED. IF WASHING MY OR MY CHILDREN’S HANDS IS MENTIONED,PROBE WHAT WAS THE OCCASION, BUT DO NOT READ THE ANSWERS.

Before food preparation..................................A

Before feeding children...................................B

After defecation..............................................C

After attending to a child who has defecated .D

Other ............................................................ X

Growth Monitoring

85 Was (NAME) weighed at birth? YES.............................................................1NO...............................................................2DON’T KNOW.............................................8

86 Does (NAME) have a growth monitoring card?

IF YES: May I see it please?YES, SEEN.................................................1NOT AVAILABLE/LOST/MISPLACED........2NEVER HAD A CARD.................................3DON’T KNOW.............................................8

87 88 88 88

87 LOOK AT (NAME’S) GROWTH MONITORING CARD AND SEE IF (NAME) HAS BEEN WEIGHED IN THE LAST FOUR MONTHS.

YES.............................................................1NO...............................................................2DON’T KNOW.............................................8

88 FOR CHILDREN OVER ‘X’ MONTHS::Has (NAME) received a medicine for worms in the last six months?

YES.............................................................1NO...............................................................2DON’T KNOW.............................................8


Child anthropometry

ASK THE MOTHER FOR PERMISSION TO WEIGH AND MEASURE (NAME). IF SHE AGREES TO LET YOU TAKE (NAME’S) MEASUREMENTS, RECORD THE NECESSARY INFORMATION IN THE SPACES BELOW. IF THE MOTHER REFUSES PERMISSION TO MEASURE (NAME), LEAVE COLUMNS 1-4 BLANK AND RECORD

‘3' [REFUSED] IN COLUMN 5.ASK TO MEASURE EACH OF (NAME’S) SIBLINGS UNDER FIVE YEARS OF AGE. RECORD (NAME’S)

MEASUREMENT IN THE FIRST ROW.

1

NAME OF CHILD

MEASURE (NAME) FIRST, THEN MEASURE

HIS/ HER BROTHERS AND SISTERS WHO ARE

UNDER AGEFIVE YEARS.

2

WHAT IS HIS/HER DATE OF BIRTH?

COPY DATE OF BIRTH FROM GM CARD, IF

AVAILABLE. IF GM CARD IS NOT AVAILABLE, RECORD DATE OF BIRTH PROVIDED

BY MOTHER.

3

WEIGHT (KILOGRAMS)

4

HEIGHT (CENTIMETER)

5

RESULT1

MEASURED2 NOT

PRESENT3 REFUSED

6 OTHER

_______________

PB__________cm (child from 6 months) and PB_________ (mother)

Bilateral edema (child) NO ______YES________

THANK THE MOTHER FOR THE INTERVIEW.


E. Questionnaire (French)Demander a la mere si elle a un enfant age de moins de 24 mois qui vit avec elle. Si oui proceder a l’interview. Si Non, remercier la maman et mettre fin à l’interview.

Identification

Num de la grappe

Num de la concession

Numero d’ enregistrement

Village

NOM de la mere

NOM du Superviseur

Saisie des donnees par : Date: ___/___/____ Jour/mois/annee

1 2 3 Derniere visite

date d’Interview ___/___/____Jour/mois/annee

___/___/____Jour/mois/annee

___/___/____Jour/mois/annee

Du superviseur

jour

NOM de l’ interviewer Mois

annee

Resultat * Resutat

* Resultat:6. questionnaire complete7. enquetee absent de la concession8. reporte9. Refus10. autre______________________________________

Specifier

NB: pour toute reponse cochée dans ce questionnaire, l’enqueteur doit verifier la presence ou non d’un numero de avec fleche ; si ce numero est present suivez l’indication de la fleche

CONSENTEMENT ECLAIRE

Bonjour. Je m’appelle ______________________________, et je travaille avec Relief International et MSP. Nous effectuons une enquête à laquelle nous souhaiterions que vous participiez. Je voudrais vous poser des questions sur votre santé et sur la santé de votre plus jeune enfant de moins de deux ans. Ces informations seront utiles à Relief International et MSP.) pour planifier des services de santé et pour évaluer s’ils sont conformes avec les objectifs d’amélioration de la santé de l’enfant. L’enquête prend habituellement 60 minutes. Quelles que soient les informations que vous nous fournirez, elles resteront strictement confidentielles et ne seront divulguées à personne..

La participation à cette enquête est volontaire et vous pouvez décider de ne pas répondre à des questions personnelles ou à toutes les questions. Cependant, Nous espérons que vous allez participer à cette enquête car ce que vous pensez est d’un grand intérêt.

Avez-vous maintenant des questions à me poser concernant l’enquête ?

Signature de l’enquêteur: ________________________________ Date: ____________________

L’ENQUÊTÉE ACCEPTE D’ÊTRE ENQUÊTÉE............1 L’ENQUÊTÉE REFUSE D’ÊTRE ENQUÊTÉE.............................2 ──FIN


Questionnaire

TOUTES LES QUESTIONS DOIVENT ÊTRE POSÉES AUX MÈRES AYANT UN ENFANT DE MOINS DE 24 MOIS

PrésentationNo.

Questions and Filters Coding Categories SAUT

1 Combien d’enfants avez vous? Nombre total d’enfant

2 Quelle est le Nom, date de votre dernier vivant?

Dernier enfant vivant

NOM _______________________________

sexeMasculin……………………………………………....1

Feminine....………………………………...………....2

Date de naissance

jour

Mois annee

Vaccination antitétanique

NO. QUESTIONS AND FILTERS CODING CATEGORIES SAUT

3 Pendant la grossesse de (NOM), avez-vous reçu une injection dans le bras pour protéger le bébé contre le tétanos, c’est à dire, des convulsions après la naissance ?

Oui....................................................................1Non...................................................................2Ne sait pas.......................................................9

4 5 5

4 Pendant cette grossesse, combien de fois avez-vous reçu cette injection ?

Nombre de fois

Ne sait pas.......................................................9

5 Avant la grossesse de (NOM) avez vous recu une injection pour prevenir le TETANOS ?

Oui....................................................................1Non...................................................................2Ne sait pas.......................................................9

6 7 7

6 Combine de fois l’avez vous recu?

Si le score est 7 ou plus, inscrivez 7.

Nombre de fois

Ne sait pas.......................................................9


Skilled attendance and clean cord care


7 Qui vous a assisté pour l’accouchement de (NOM) ?

Autre personne?

INSISTER POUR AVOIR LE TYPE D’AGENT . ENREGISTRER TOUTES LES REPONSES

SI L’ENQUETEE DIT QUE PERSONNE NE L’A ASSISTER, INSISTER POUR SAVOIR SI AUCUNE AUTRE PERSONNE N’ASSISTER A L’ACCOUCHEMENT

AGENT DE SANTE MEDECIN…………………………….…A INFIRMIERE/SF………………………..B AUXILIAIRE………………………….…C AUTRE AGENT DE SANTE QUALIFIE*……………………………..D

AUTRE PERSONNES MATRON…………………………….…..E AGENT DE SANTE COMMUNAUTAIRE……………………...FMEMBRE DE LA FAMILLLE …………...G AUTRE__________.............................H (SPECIFIER)

PERSONNE………………………………Y

8 Est-ce qu’on a utilisé une trousse propre ou kit d’accouchement ?

(MONTRER LE KIT D’ACCOUCHEMENT)

Oui…………………………………………1Non………………………………………...2Ne sait pas………………………………..9

10 9 9

9 Quel instrument a-t-on utilisé pour couper le cordon ?

Lame de Rasoir Neuve…………………….1

Lame neuve et lame bouillie………………2

Lame utilisee………………………………..3

Lame utilize et lame bouillie……………….4

Sciseaux neufs……………………………...5

Scisseau neuf ou bouillie…………………..6

Sciseaux utilise……………………………..7

Sciseaux utilize et bouillie…………………8

Couteau……………………………………...9

autre ___________________________96

(SPECIFIER)Ne sait pas…………………………………97

Active management at delivery

10 Juste après la sortie de(NOM) et avant la sortie du placenta avez vous recu une injection pour vous eviter de trop saigner apres l’accouchement?

Oui ………………………………………………..1

Non………………………………………………..2

Ne sais pas………………………………………9

11

13

13

11 Immediatement après cette injection, est ce l’accoucheur vous a fait une pression sur le ventre et une traction du cordon pour aider a la sortie du placenta

Oui ...................................................................1

Non...................................................................2

Ne sais pas.......................................................9

12

13

1312

Immediatement après la sortie du placenta est ce l’agent vous a fait un massage uterin pour favoriser la contraction de l’uterus et empecher de trop saigner après .

Oui ...................................................................1Non...................................................................2Ne sais pas.......................................................9


Séchage et emballage après la naissance


13 Est ce que (NOM) a ete essuyé ou secher immediatement après sa sortie et avant la sortie du placenta


14 Est ce que (NOM) a ete envoloppe dans une couverture immediatement après sa sortie et avant la sortie du placenta


Allaitement / alimentation du nourrisson et du jeune enfant

15 Avez vous allaité (NOM)? Oui ...................................................................1Non...................................................................2

16 19

16 Combien de temps après lanaissance avez-vous mis (NOM)au sein pour la première fois ?

SI MOINS D'UNE HEURE,NONTER '00' HEURE.SI MOINS DE 24 HEURES, NOTER EN HEURES.AUTREMENT, NONTER EN JOURS.

IMMEDIATE...................................................00

HEURES

JOURS

NE SE SAIT PAS.............................................9

17 Au cours des 3 ou 4 premiers jours apres l’accouchement avant le premier lait,avez vous donner a (NOM) le colustrum ; un liquide epais produit par le sein

OUI ..................................................................1

NON ...............................................................2

NE SAIS PAS ..................................................9

18 Dans les 3 jours qui ont suivi la naissance, (NOM) est ce que (NOM) a bu quelque chose autre que le lait maternel

OUI ..................................................................1

NON ...............................................................2

NE SAIS PAS ..................................................9

19 Pouvez vous me les citer ?

Cochez toutes les réponses.

Lait des animauxLait en poudreEau simpleEau sucréeEau salée sucréeDécoctions./infusionsJus de fruitMielAutre à préciser

20 Actuellement est-ce que vous allaitez (NOM)?OUI...........................................................1NON.........................................................2

21 Pendant combien de temps l’avez-vous allaité ?SI C’EST MOINS D’UN MOIS, ENREGISTREZ ‘00’ MOIS.

MOIS...............................░░░░░░



22

22A

22B

22C

22D

22E

22F

22G

22H

22I

22J

22K

22L

22M

22N

22O

22P

Maintenant j’aimerais vous poser des questions sur les types de liquides que (NOM) a bus au cours de la journée et de la nuit. Est-ce que (NOM) a bu les liquides suivants hier au cours de la journée ou de la nuit?COCHEZ DANS LA CASE SI L’ENFANT A BU LE LIQUIDE EN QUESTION.

Lait maternel ?

Eau Plate ?

Lait en poudre vendu en commerce ?

Tout autre lait tel qu’en boîte, en poudre, ou du lait frais d’animal ?

Jus de fruit ?

Autres liquides tels que de l’eau sucrée, du thé, du café, des boissons gazeuses ou du bouillon ?

Maintenant je voudrais vous poser des questions sur les types d’aliments4 que [NOM] a mangés hier au cours de la journée ou de la nuit. Est-ce que [NOM] a mangé les aliments suivants au cours de la journée ou de la nuit d’hier ? COCHEZ LA CASE SI L’ENFANT A MANGÉ L’ALIMENT EN QUESTION.

Des aliments à base de graines [par exemple, mil, sorgho, maïs, riz, blé, bouillie, ou d’autres graines locales] ?

Citrouille, ignames rouges ou jaunes ou de la courge, des carottes ou des patates douces rouges ?

Tout autre aliment à base de racines ou de tubercules [par exemple, les pommes de terre, les ignames blanches, le manioc ou d’autres racines/tubercules locaux] ?5

Des légumes à feuilles vertes ?

Mangue, papaye [ou d’autres fruits locaux riches en Vitamine A] ?

Autres fruits et légumes [exemple, les bananes, pommes/compote, avocats, tomates] ?

Viande, volaille, poisson, fruits de mer ou des œufs ?

Aliments préparés à partir de légumes [exemple, les lentilles, haricots, soja, légumes à gousses, ou arachides] ?

Fromage ou yaourt ?

Aliments à base d’huile, graisse ou de beurre ?

A............................................░░░

B............................................░░░

C............................................░░░

D............................................░░░

E............................................░░░

F............................................░░░

G...........................................░░░

H............................................░░░

I.............................................░░░

J............................................░░░

K............................................░░░

L............................................░░░

M...........................................░░░

N............................................░░░

O...........................................░░░

P............................................░░░



23Combien de fois (NOM) a t-il mangé un aliment semi-solide (broyés ou en purée) au cours de la journée ou de la nuit d’hier ?

SI 7 FOIS OU PLUS, ENREGISTREZ 7.

NOMBRE DE FOIS ………………░░░

NE SAIT PAS ….......................................8

24Puis-je voir le sel utilisé pour la cuisine ? PRENEZ UNE CUILLERÉE A CAFÉ DE SEL ET TESTEZ-LE POUR L’IODE.

IODE PRESENT.......................................1

IODE PAS PRESENT ……………………2

25Est-ce que (NOM) a reçu une dose de Vitamine A comme celle-ci au cours des six derniers mois ?MONTREZ L’AMPOULE/CAPSULE /SIROP.

OUI...........................................................1

NON.........................................................2

NE SAIT PAS ……………………………..8

Visite post-partum (pour la mère)

26 Ou avez vous accouché (NOM)? MAISON (sienne ou autre)...............................1

CENTRE DE SANTE (public ou prive) ............2

33

27

27 Après la naissance de (NOM) et avant votre depart de l’hopital, est que un agent de sante vous a examiné ?

Oui....................................................................1

Non...................................................................2

28

30

28 Combien de temps après l’accouchement l’agent de sante est venu vous examiner?

SI MOINS D’UN JOUR NONTER EN HEURES, SI MOINS D’UNE SEMAINE, NONTER EN JOUR

Heures

JOURS

SEMAINES

NE SAIT PAS.................................................99

29 Qui vous a examine en ce moment?

Nonter la personne la plus qualifiee.

AGENT DE SANTEMEDECIN........................................................AINFIRMIER/CLINICIEN....................................BSF....................................................................CAUXILIAIRE.....................................................D

AUTRES PERSONNESACCOUCHEUSES TREDITIONNELLE...........EASC..................................................................FMATRONE QUALIFIE.....................................GASB QUALIFIE................................................H

AUTRE.............................................................Z __________________ (SPECIFIER)

30 Après etre libere du centre de sante, est ce que un agent de sante ou une accoucheuse traditionnelle vous a visité?

Oui....................................................................1

Non...................................................................2

24

29

31 Après l’accouchement, quand est cette visite est intervenu?


Heures

JOURS

SEMAINES

NE SAIT PAS.................................................99



32 Qui vous a examine en ce temps la?

NONTER LA PERSONNE LA PLUS QUALIFIEE.



AUTRE.............................................................Z (SPECIFIER)

33 Après la naissance de (NOM) est que sante communautaire a controle votre sante?

Oui....................................................................1

Non...................................................................2

34

42

34 Combien de temps après l’accouchement ce controle est intervenu?


Heures

JOURS

SEMAINES

NE SAIT PAS.................................................99

35 Qui vous a examine en ce temps la?

NONTER LA PERSONNE LA PLUS QUALIFIEE.

AGENT DE SANTEMEDECIN........................................................A

INFIRMIER/CLINICIEN....................................BSF....................................................................CAUXILIAIRE.....................................................D


AUTRE.............................................................Z

42

42 42 42

42 42 42 42

42

Visite postnatale (pour bébé)

36 Après la naissance de (NOM) et avant votre depart de l’hopital, est que un agent de sante a controle la sante de (NOM)?

Oui....................................................................1

Non...................................................................2

37

39

37 Combien de temps après l’accouchement l’agent de sante est venu controlé la santé de (NOM)?

Heures

JOURS

SEMAINES

NE SAIT PAS.................................................99


38 Qui a examine (NOM) en ce moment?

Nonter la personne la plus qualifiee..


AUTRES PERSONNESACCOUCHEUSES TREDITIONNELLE EASC..................................................................FMATRONE QUALIFIE.....................................GASB QUALIFIE................................................H


39 Après etre libere du centre de sante, est ce que un agent de sante ou une accoucheuse traditionnelle a controle la sante de (NOM)?

Oui....................................................................1

Non...................................................................2

40

4540 Apres Combien d’heures, de jour ou de semaines

ce controle est intervenu?

SI MOINS D’UN JOUR NONTER EN HEURES, SI MOINS D’UNE SEMAINE, NONTER EN JOUR.

Heures

JOURS

SEMAINES

NE SAIT PAS.................................................9941 Qui a examine (NOM) l’autre fois

Noter la personne la plus qualifiee.


AUTRES PERSONNESACCOUCHEUSES TREDITIONNELLE E ASC.........................................................................FMATRONE QUALIFIE.....................................GASB QUALIFIE................................................H


42 Le premier jour de la naissance de (NOM), est ce que un agent de sante ou une accoucheuse traditionnelle l’a examiné (NOM)

Oui....................................................................1

Non...................................................................2

43

4543 Après combien d’heure,de jours ou de semaines

après la naissance de (NOM) ce premier examen est intervene?SI MOINS D’UN JOUR NONTER EN HEURES, SI MOINS D’UNE SEMAINE, NONTER EN JOUR.

Heures

JOURS

SEMAINES

NE SAIT PAS.................................................9944 Qui a examine (NOM)

Nonter la personne la plus qualifiee.


AUTRES PERSONNESACCOUCHEUSES TRADITIONNEL E ASC.................................................................FMATRONE QUALIFIE.....................................GASB QUALIFIE................................................H

AUTRE.............................................................Z __________________


Immunisation des enfants


45Est ce que (NOM) a recu une dose de la vitamine A (comme cela) pendant les 6 derniers mois 1

Montrer la capsule

Oui ...............................................................1Non...............................................................2Ne sait pas...................................................8

46Avez une carte de vaccination ou un carnet ou on peut lire les vaccinations de (NOM)?

Si oui: puis je le consulter SVP?

Oui, vu par l’enqueteur.................................1Non disponible..............................................2N’a jamais de carte.......................................3Ne sait pas...................................................8

47 49 49 49

47(1) Enregistrer les vaccinations de la carte dans le

tableau ci dessus.

(2) ECRIRE ‘44' EN ‘JOUR’ SI LE VACCIN EST ADMINISTRE MAIS LA DATE NON MENTIONNE JOUR MOIS ANNEE

DTC1

DTC 3

ROUGEOLE

VITAMIN A (LA DOSE LA PLUS RECENTE)

J J M M A A A A

48 Est ce que (NOM) a eu une vaccination qui n’a pas ete mentionne dans son carnet y compris celles recues au cours des campagnes de masse ?

Oui ………………………………………… 1

Non………………………………………… 2

Ne sait pas ……………………………….. 8

49

51

51

49 Est ce que (NOM) a une fois recu une pour le prevenir des maladies, y compris les doses recues lors des campagnes de masse.

Oui ………………………………………… 1

Non………………………………………… 2

Ne sait pas ……………………………….. 8

49

51

51



50

50A

50B

50C

50D

50E

50F

50G

SVP dites moi si (NOM) a recu les antigens suivants :

BCG vaccin contre la tuberculose, une injection au bras ou a l’epaule qui donne generalement une cicatrice?

Vaccin Polio orale?

Quand est il a recu la premiere dose de Polio oral, juste a la naissance ou plus tard?

COMBIEN DE FOIS IL A RECU LA DOSE?

DTC es t un vaccine administer dans la cuisse ou au dos le plus souvent en meme temps que le polio orale. L’a t il eu ?

Combien de fois?

====================================

Dans le Questionnaire Rapid CATCH:

Une injection dans le bras pour prevenir la rougeole?====================================

Oui ………………………………………… 1

Non………………………………………… 2

Ne sait pas……………………………….. 8

Oui………………………………………… 1

Non……………………………………….. 2

Ne sait pas……………………………….. 8

JUSTE A LA NAISSANCE ……………..1

PLUS TARD …………………………… 2

Nombre de fois |___|___|

Oui ………………………………………… 1

Non………………………………………… 2

Ne sait pas……………………………….. 8

Nombre de fois |___|___|

====================================

Oui ……………………………………….. 1

Non……………………………………….. 2

Ne sait pas……………………………….. 8 ====================================

50C

50E

50E

50F

50G

50G

Paludisme - traitement de la fièvre de l'enfant

51 Est ce (Name) a eu de la fievre dans les 2 dernieres semaines Oui ………………………...……………………1

Non …………………………………………….2

Ne sait pas……………………………………. 9

52

56

56

52 Avez cherche des conseils ou des traitementsOui………………………...……………………1

Non…………………………………………….2

53

54

53Après combien de jours avez vous cherche a traiter la fievre de (Name)?

Meme jour…………………………………….…0

Lendemain……………….……………………...1

2 jours ou plus………………………………..…2


54Est que pendant la maladie de (Name)a pris des medicaments contre la fievre

Oui………………………...………………..……1

Non……………………………………………….2

Ne sait pas……..………………………………. 9

55

56

56

55 Quels médicaments a-t-on donné à (NONM) pour sa fièvre ?1

ENCERCLEZ TOUS LES MÉDICAMENTS DONNÉS.

SI LA MÈRE NE PEUT PAS SE RAPPELER LE NONM DES MÉDICAMENTS DE (NONM), DEMANDEZ-LUI DE VOUS LES MONTRER. SI ELLE NE PEUT PAS VOUS LES MONTRER, MONTREZ-LUI DES ANTIPALUDÉENS COURANTS ET LAISSEZ-LA IDENTIFIER CEUX QUI ONT ÉTÉ DONNÉS.

POUR CHAQUE ANTIPALUDÉEN, DEMANDEZ:Combien de temps après le début de la fièvre (NONM) a-t-il commencé à prendre les médicaments ?

ENCERCLEZ LE CODE APPROPRIÉ.

CODES:MÊME JOUR = 0JOUR SUIVANT APRÈS LA FIÈVRE = 1DEUX JOURS PLUS APRÈS LA FIÈVRE = 2NE SAIT PAS= 9

Antipaludique

H. SP/Fansidar……………0 1 2 9

I. Chloroquine…………….0 1 2 9

J. Amodiaquine…………...0 1 2 9

K. Quinine………..………..0 1 2 9

L. Artemisinin-based Combination Therapy…………………..…0 1 2 9

OTHER DRUGS

M. ASPRIN……………..….0 1 2 9

N. PARACETAMOL…...….0 1 2 9

X. Other…………………….0 1 2 9

56 Par quoi est causé le paludisme ?ENREGISTREZ TOUT CE QUI EST MENTIONNÉ.

Rien d’autre ?

ENREGISTREZ TOUT CE QUI EST MENTIONNÉ

PIQÛRES DE MOUSTIQUES ASORCELLERIE BINJECTIONS DE DROGUES CTRANSFUSIONS SANGUINES DINJECTIONS EPARTAGE DE LAMES/RASOIRS FEMBRASSER G

AUTRE _________________________ W

(PRÉCISEZ)

AUTRE __________________________ X

(PRÉCISEZ)NE SAIT PAS Z

Malaria prophylaxis during pregnancy

57Quand vous étiez enceinte de (NONM), avez-vous pris des médicaments pour éviter le paludisme ?

OUI.............................................................1NON............................................................2NE SAIT PAS..............................................8

58 59 59

58 Quels médicaments avez-vous pris ?1

ENREGISTREZ TOUT CE QUI EST MENTIONNÉ.

FANSIDAR.................................................ACHLOROQUINE.........................................B

AUTRE__________________________ X(PRÉCISEZ)

MÉDICAMENT INCONNU..........................Z


Paludisme et utilization des moustiquaires


59 Avez vous des moustiquaires imprégnés qui sont utilisables dans cette concession

Oui………………………………………..………1

Non……………………………………………….2

60

64

60 Qui a dormi sous cette moustiquaire sous la moustiquaire hier nuit?

Toute autre personne mentionnée autre que l’enfant. Inscrivez dans la categorie autre

Personne……………………………………….0

Enfant Name)…………………………..………1

Autre ……………………………........................2

64

61

64

61 Quelle est la marque de moustiquaire sous laquelle (Name) a dormi hier nuit ?

Montrer les differentes marques de moustiquaires

Moustiquaire permanent

Type A…….....................................................1

type B……………………….…………….….…2

moustiquaire pre impregné

type C…………………….…………………….3

type D……………………….………………….4

autre

autre type ….……………….…………………..5Ne sais pas la marque …….…………………9

64

64

62

62

62

62

62 Est ce que le moustiquaire sous lequel (Name) a dormi hier nuit a ete lave qu savon ou trempe dans un liquide qui empeche les moustiques de s’y approcher

Oui………………………………………………1

Non……………………………………………….2

Ne sait pas……………………………………. 9

63

64

64

63 Depuis quqnd est ce le moustiquaire a été traité

SI MOINS DE 1 MOIS IF INSCRIVER 00. SI MOINS DE 2 ANS INSCRIVER LE NOMBRE DE MOIS.

Mois

Plus de 2 ans…………………………………..95

Ne sait pas ………………………………….....98

Traitement de la diarrhea

64 Est-ce que (NOM) a eu la diarrhée au cours des deux dernières semaines ? 1

OUI...........................................................1NON..........................................................2Ne sait pas................................................8

65 74 74

65 Qu’a t-on donné pour traiter la diarrhée ? 2

Rien d’autre ?


RIEN.........................................................ASOLUTION SACHET SRO.......................BPRÉPARATION MAISON.........................CPILULE OU SIROP..................................DINJECTION...............................................E(IV) INTRAVEINEUSE..............................FREMÈDES MAISON/

MÉDICAMENTS TRADITIONNELS.. . .G

AUTRE__________________________ X(PRÉCISEZ)



66 Quand (NOM) a eu la diarrhée, l’avez-vous allaité moins que d’habitude, environ la même quantité ou plus que d’habitude ?

MOINS......................................................1MÊME.......................................................2PLUS........................................................3ENFANT PAS ALLAITÉ............................4NE SAIT PAS............................................8

67 Quand (NOM) a eu la diarrhée, lui avez-vous donné moins à boire que d’habitude, environ la même quantité ou plus que d’habitude ?

MOINS......................................................1MÊME.......................................................2PLUS........................................................3RIEN À BOIRE..........................................4NE SAIT PAS............................................8

68Lui avez-vous donné moins à manger que d’habitude, environ la même quantité ou plus que d’habitude ?

MOINS......................................................1MÊME.......................................................2PLUS........................................................3RIEN À MANGER.....................................4NE SAIT PAS............................................8

69 Avez-vous recherché des conseils ou un traitement auprès de quelqu’un à l’extérieur de la maison pour la diarrhée de (NOM) ?

OUI...........................................................1NON..........................................................2

70 74

70 Où êtes-vous allé en premier pour rechercher un conseil un traitement ? 3

SI LA SOURCE EST L’HÔPITAL, LE CENTRE DE SANTÉ OU LA CLINIQUE, INSCRIVEZ LE NOM DE L’ENDROIT

_______________________________________________________

(NOM DE L’ENDROIT)

ÉTABLISSEMENT DE SANTÉHÔPITAL.............................................01CENTRE DE SANTÉ...........................02POSTE DE SANTÉ..............................03CENTRE ONG.....................................04CLINIQUE............................................05AGENT DE SANTÉ DE TERRAIN/COMMUNAUTAIRE 06AUTRE ÉTABLISSEMENT

DE SANTÉ ____________________07(PRÉCISEZ)

AUTRE SOURCE GUÉRISSEUR TRADITIONNEL..........08 BOUTIQUE..........................................09

PHARMACIE.......................................10 DISTRIBUTEURS COMMUNAUTAIRES.....................11

AMIS/PARENTS..................................12

AUTRE_________________________ 88(PRÉCISEZ)

71 Qui a décidé que vous deviez aller à cet endroit pour a maladie de (NOM) ?


ENQUÊTÉE..............................................AMARI/PARTENAIRE.................................BMÈRE DE L’ENQUÊTÉE..........................CBELLE-MÈRE...........................................DAMIS/VOISINS.........................................E

AUTRE _________________________ X (PRÉCISEZ



72Où êtes-vous allé ensuite pour obtenir un conseil ou un traitement ?3

SI LA SOURCE EST L’HÔPITAL, LE CENTRE DE SANTÉ OU LA CLINIQUE, INSCRIVEZ LE NOM DE L’ENDROIT.

________________________________________(NOM DE L’ENDROIT)

ÉTABLISSEMENT DE SANTÉHÔPITAL.............................................01CENTRE DE SANTÉ...........................02POSTE DE SANTÉ..............................03CENTRE ONG.....................................04CLINIQUE............................................05AGENT DE SANTÉ DE TERRAIN/COMMUNAUTAIRE 06AUTRE ÉTABLISSEMENT

DE SANTÉ ____________________07(PRÉCISEZ)

AUTRE SOURCE GUÉRISSEUR TRADITIONNEL..........08 BOUTIQUE..........................................09

PHARMACIE.......................................10 DISTRIBUTEURS COMMUNAUTAIRES.....................11

AMIS/PARENTS..................................12

AUTRE_________________________ 88(PRÉCISEZ)

73 Pendant la période où (NOM) se rétablissait de la diarrhée, lui avez-vous donné MOINS à boire que d’habitude, environ la MÊME quantité ou PLUS que d’habitude ?

MOINS......................................................1MÊME.......................................................2PLUS........................................................3RIEN À BOIRE..........................................4NE SAIT PAS............................................8

La préparation des SRO

74 Avez-vous entendu parler de SRO ?

SI OUI, DEMANDEZ À LA MÈRE DE VOUS DÉCRIRE LA PRÉPARATION DE SROSI NON, ENCERCLEZ 3 (N’A JAMAIS ENTENDU PARLER).

APRÈS QUE LA MÈRE A DÉCRIT LA PRÉPARATION, ENREGISTREZ SI ELLE L’A DÉCRITE CORRECTEMENT OU INCORRECTEMENT.

ENCERCLEZ 1 [CORRECTEMENT] SI LA MÈRE A MENTIONNÉ LES CHOSES SUIVANTES: UTILISE 1 LITRE D’EAU SALUBRE (1

LITRE= 3 BOUTEILLES DE SODA) UTILISE LE SACHET ENTIER DISSOUT ENTIÈREMENT LA POUDRE

A DÉCRIT CORRECTEMENT.................1A DÉCRIT INCORRECTEMENT...............2JAMAIS ENTENDU PARLER DE SRO.....3

ARI/ Pneumonia

75 Est-ce que (NOM) a souffert de la toux, à un moment quelconque, au cours des deux dernières semaines ?

OUI...........................................................1NON.........................................................2NE SAIT PAS...........................................9

76

79

79

76 Quand (NOM) souffrait de la toux, avait-il des problèmes pour respirer ou respirait-il plus vite que d’habitude avec un souffle court et rapide ?


77

79

77



77 Avez-vous recherché des conseils ou un traitement pour la toux /respiration rapide ?

OUI...........................................................1NON.........................................................2

78

79

78 De qui avez vous recu des conseils ou des traitements

Autre personne ?

ENREGISTRER TOUTES LES REPONSES.

Medecin…………………………………...…….A

Infirmier................ ............ ............ ............ ...B

auxiliaire............ ............ ............ ............ .….Cagent.de sante communautaire qualifié............ ............ ............ ............ ............ ..................D

autre............ ............ ......……………………..X

Eau et assainissement

79 Est ce vous traiter l’ eau pour la rendre propre consommation

Oui………………………...……………………1

Non……………………………………………….2

79

81

80 Si oui qu’est ce vous utilisé pour la rendre propre pour la consommation

ENVISAGER D’EXPLORER TOUTES LES REPONSES

Laisser se dimenter……………………………A

Filter avec eau…………………………………..B

Boullire………………………………………….C

choration………………………………………Dfilratrage au sable……………………..………E

disinfection solaire…………………………….F

autre……........................................................X

Ne sait pas ……………………………………..Z

81 Est-ce que dans votre ménage, il y a un endroit particulier pour se laver les mains ?

DEMANDER A EXAMINER ET VISITE

Q cote ou pres des toillettes ............................1

A cote de la cuisine ............... ............... .........2

Quelque part............... ............... ............... ...... 2

En dehors de la concession............... ............... 3

Place non specifique

Pas eu de permission d’acces............... ..............

82

82

82

82

85

85



82 OBSERVER : SI IL YA DU SAVON OU UN DETERGENT OU TOUT AUTRE LOCAL LOCAL?

SI LE SAVON ou le produit N’est pas rétrouvé dans la minute considerer comme absent

savons............................................................1

Detergent........................................................2

cendre.............................................................3

sable/boue......................................................4

aucun..............................................................5

autre .............................................................. 6

83

83

85

85

85

85

83 Avez vous utilisé du savon hier dans la journée ou dans l’apres midi

Oui………………………...…………………..1

Non…………………………………………….2

83

85

84 Lorsque vous avez utilize le savon hier; c’etait pour quelle but

REPORTER LES REPONSES DE LA MERE. NE LISER PAS LES OPTIONS PROPOSEES ; ENCOURAGER LA MERE A DONNER DES REPONSES PLUS PRECISES AVEC DES EXPRESSIONS ‘’ QUOI D AUTRE’’

Avant la preparation de repas.........................A

Avant de donner a manger a l’enfant..............B

Après la defecation.........................................C

Après avoir la defecation de l’enfant.............D

Autre ............................................................ X

Suivi de la croissance

85Est-ce que (NOM) a été pesé à la naissance ?

OUI..............................................................1NON............................................................2Ne sait, pas.................................................8

86 Est-ce que (NOM) a un carnet de suivi de croissance ?

SI OUI : Est-ce que je peux le voir ?OUI, VU....................................................1PAS DISPONIBLE/PERDU/ÉGARÉ.........2N’A JAMAIS EU DE CARNET..................3NE SAIT PAS..............................................8

87 88 88 88

87 VÉRIFIEZ LE CARNET DE (NOM) POUR VOIR S’IL A ÉTÉ PESÉ AU COURS DES QUATRE DERNIERS MOIS


88 POUR LES ENFANTS DE PLUS DE >6 = MOIS 1:Est-ce que (NOM) a pris des médicaments contre les vers dans les six derniers mois ?



L'anthropométrie des enfants

DEMANDEZ À LA MÈRE LA PERMISSION DE PESER ET DE MESURER (NOM). SI ELLE ACCEPTE DE VOUS LAISSER PRENDRE LES MENSURATIONS DE (NOM), ENREGISTREZ LES INFORMATIONS NÉCESSAIRES DANS L’ESPACE CI-

DESSOUS. SI LA MERE REFUSE QUE L’ON PRENNE LES MENSURATIONS DE (NOM), LAISSEZ LES COLONNES 1-4 EN BLANC ET ENREGISTREZ >3' [REFUSÈ] A LA COLONNE 5.

1

NOM DE L’ENFANT

PRENEZ LES MENSURATIONS DE (NOM)

EN PREMIER,

2

Quelle est sa date de naissance ?

RECOPIEZ LA DATE DE NAISSANCE À PARTIR DU CARNET S’IL EST DISPONIBLE. SI LE CARNET N’EST PAS DISPONIBLE, ENREGISTREZ LA DATE FOURNIE PAR LA MÈRE.

3

POIDS(KILOGRAMMES)

4

TAILLE(CENTIMÈTRES)

5

RÉSULTAT1 MESURÉ2 PAS PRÉSENT3 REFUSÉ6 AUTRE

_______________

PB__________cm (enfant a partir de 6 mois) et PB_________(mere)

Oedeme bilateraux (enfant) ______Oui ;________Non

Remercier la mere et passer a la concession suivante.


F. Translations of key survey words (English-French-Hausa)

ENGLISH FRENCH HAUSSAAdvice Conseils Gargadi, ko shawaraAsh Cendre Habdi-tokaBCG BCG Lamba- shaidaClean delivery kit Trousse/Kit d’accouchement Kayan aifuwaClean drinking water Eau propre a la

consummationRuwan tsabtattaci

Colostrum Colostrum Dakachi-Nonon farkoCord Cordon CibiyaCough Toux Tuarin majina-tarin majinaDiarrhea Diarrhée Zawo,diddira, goudanawa,

tutun majina-gudun dawaDPT DTC Allura baya, ko ta katattaraExamine Examiner Duban lahia-binciken lahiyaIntestinal worms Vers intestinaux Tsutsar cikiMeasles Rougeole Iska, dussaORS/ORT SRO guishiri andrisPlacenta Placenta Ma’aifa-uwar tahiya-Uwar

GariPoliomyelitis Poliomyélite Ciyon shan inna/ cutar

shan innaScissors Ciseaux Sizo-AlmakashiSuffered Souffert Fama da-Matsalar-jin jikiTetanus Tétanos Cutar dahi/Ciyon dahiTraditional birth attendant Accoucheuse traditionnelle Ingozoma-makarbiya-

arwankaUterine massage Massage utérin Mammatsa ciki-shafar marVitamin A Vitamine A Maganin DundumiWitchcraft Sorcellerie Maita, jifa


G. Populations of communitiesSurveyed villages are indicated in bold-face text in shaded cells.

COMMUNE COMMUNITYCOMMUNITY POPULATION

CUMULATIVE POPULATION

Allela Kanguiwa 448 448

Djima Djimi 733 1,181

Bazaga Gazourawa 1,807 2,988

Korop 352 3,340

Fari 1,382 4,722

Djarkassa 324 5,046

Farssawa 486 5,532

Chetao 1,916 7,448

Birni N'Konni Dossèye 5,316 12,764

Dagarka 1,930 14,694

Guidan Zaroumey 1,042 15,736

Tsaouna Kali et Bawa 2,243 17,979

Boulké 637 18,616

Dogarawa Balgaya 957 19,573

Bigal 612 20,185

Tsaidaoua Dogarawa 1,547 21,732

Bilando 685 22,417

Kama Kamo I 1,456 23,873

Kama Kamo II 1,523 25,396

Mintchizaré 550 25,946

Mounléla Kawara 526 26,472

Dessa I 956 27,428

Dessa II 578 28,006

Dessa III 373 28,379

Allokoto 1,580 29,959

Guidan Magagi 2,005 31,964

Guidan Roro I 676 32,640

Kawara I, II et III 6,305 38,945

Malbaza Mounléla Katoria. 784 39,729

Ifrikawane 1,439 41,168


COMMUNE COMMUNITYCOMMUNITY POPULATION

CUMULATIVE POPULATION

Tounga Yacouba 885 42,053

Katoria 1,315 43,368

Malbaza Zongon Karaki 909 44,277

Kaoura Alassane 1,789 46,066

Lawèye Tsangalandam 1,606 47,672

Lawèye Guidan Guirdo 2,350 50,022

Kahé Damé 2,489 52,511

Guidan Dillé 668 53,179

Lawèye Birni 1,624 54,803

Lawèye Gogé 1,092 55,895

Dakilawa 674 56,569

Kachédawa 1,115 57,684

Zourbatan 331 58,015

Dan Hayi Imo 999 59,014

Nobi Sédentaire 1,531 60,545

Foura Guirké 1,389 61,934

Tounga Maissabé 1,074 63,008

Takoro 731 63,739

Rouga Sabon Guida 709 64,448

Badabaye 886 65,334

Tadjaé 1,634 66,968

Tsernawa Nadabar 590 67,558

Maigozo 2,086 69,644

Mozagué 1,658 71,302

Tsaidaoua 320 71,622

Guidan Kadi 2,274 73,896

Tsaouna Gomma 3,178 77,074

Tounga Makéra 702 77,776

Malbaza Dadaou 1,649 79,425

Malbaza Bourgoum 1,617 81,042

Tounga Makoki 2,244 83,286

TOTAL POPULATION 83,286


H. Budget

ITEM QTY COSTDAY

STOTAL (CFA)

TOTAL (USD6)

1. TRAINING A. Supervisor training Per diem 6 15,000 1 90,000 206 Communication 1 2,000 1 2,000 5 Coffee break 13 1,500 1 19,500 45 Lunch 13 2,000 1 26,000 59 B. Enumerator training Per diem (supervisor) 6 15,000 2 180,000 412 Per diem (enumerator) 30 10,000 2 600,000 1,373 Coffee break 37 1,500 2 111,000 254 Lunch 37 2,000 2 148,000 339 Photocopies 1 23,600 1 23,600 54 Subtotal : Training 1,200,100 $ 2,746

2. DATA COLLECTION Per diem (supervisor) 6 15,000 6 540,000 1,236 Per diem (enumerator) 30 10,000 6 1,800,000 4,119 Survey materials 1 59,750 1 59,750 137 Photocopies (questionnaire) 1 300,000 1 300,000 686 Vehicle rental 4 35,000 6 840,000 1,922 Communication materials 5 5,000 1 25,000 57 Vehicle fuel 4 67,410 6 1,617,840 3,702 Contingency coverage 143,500 328 Subtotal: Data collection 2,986,090 $ 6,833

3. DATA MANAGEMENT Data entry and analysis 1 10,000 6 60,000 137 Subtotal: Data management 60,000 $ 137

TOTAL BUDGET 4,246,190 $ 9,717

6 1 USD = 437 CFA, September 2011


I. Training of trainers agenda (English and French)

Final KPC Survey(Enquête Finale Projet Survie de l’enfant à Konni)

Training of Trainers (ToT), Friday, September 16, 2011(Programme formation Formateurs Vendredi 16 septembre 2011)

Time(Horaires)

Activities(Activités)

Who (Responsables)

Day 1 : General Information – Introduction to the KPC Survey Methodology(Jour1 : Généralités-Introduction Méthodologie Enquête KPC)

8h00-8h30 Presentation of participants (Présentation des participants)

Administrative issues (Questions administratives) Training objectives and agenda

(Objectifs de la formation- Programme de travail)

Dr Mahaman-Nahiou

8h30-9h00 Overview of Healthy Start Program achievements(Aperçu Réalisations RI et du Projet Survie de l’enfant de Konni)

Dr MahamanRakia Alzouma

9h00-10h15

Survey objectives and partner roles(Objectifs de l’enquête –Rôles acteurs dans organisation)

Sampling methodology (Méthodologie : Echantillonnage KPC)

Dr Hallarou

10h15-10h30 Coffee break (Pause cafe)

10h30-12h30

Methodology : Questionnaire role play exercise and key word translations(Méthodologie : Revue Questionnaire –Jeu de rôles-Traduction Mots clés)

Rakia

12h30-13h Review of anthropometry and nutritional status assessment(Rappel Evaluation Etat Nutritionnel-Anthropométrie)

Dr Moudi

13h00-14h30 Lunch break (Pause dejeuner)14h30-16h00 Review of anthropometry and nutritional status

assessment (Rappel Evaluation Etat Nutritionnel-Anthropométrie)

Survey logistics(Aspects Logistiques Enquête Terrain (Répartition Equipes, supervision)

Dr MoudiDr Hallarou

16h00-16h30 Prayer break (Pause priere)16h 30-18h Review of program for training enumerators

(Revue Programme formation Enquêteurs J1) Practical arrangements for enumerator training

(Dispositions pratiques pour la formation enquêteurs)

Rakia Alzouma


J. Training of enumerators agenda (English and French)

Final KPC Survey(Enquête Final Projet Survie de l’enfant à Konni)

Enumerator Training, September 17-18, 2011(Programme formation des enquêteurs du 17-18 septembre 2011)

Time(Horaires)


Who(Responsables)

Day 1 : General Information – Introduction to the KPC Survey Methodology(Jour1 : Généralités-Introduction Méthodologie Enquête KPC)

15h00-15h30 Trainee registration (Inscription des participants) Introduction of participants (Présentation des participants) Administrative issues (Questions administratives) Rules of work (Normes de Travail) Agenda (Programme de travail) Training objectives (Objectifs de la formation)

Facilitateurs

15h30-16h00 Overview of Healthy Start Program achievements(Aperçu sur Relief international et le projet survie de l’enfant de Konni)

Facilitateurs

16h00-16h15 Coffee break (Pause cafe-Prière)16h15-17h KPC Survey (Enquête KPC)

o Objectives (Objectifs)o Sampling methodology (Méthodologie :

Echantillonnage)

Facilitateurs

17h-17h30 Review of anthropometry and nutritional status assessment(Récolte données: Evaluation Etat Nutritionnel (Mesures Anthropométriques))

Facilitateurs

17h30-18h30 Review of questionnaire(Récoltes données 2: Etude questionnaire)

Facilitateurs

18h 30-18h45 Summary of activities(Communications et Fin de la journée)

Facilitateurs


Day 2 : Survey practice(J2 : Stage pratique)

Time(Horaires)


Who(Responsables)

8h00 -8h30 Review of Day 1(Resume des notions clées de J1)

Facilitateurs

8h30-10h00 Enumerator role play and anthropometry demonstration(Jeu de rôle sur le questionnaire+ démonstration anthropométriques)

Facilitateurs

10h – 10h15 Coffee break (Pause cafe-Prière)10h15- 13h00 Household interview test

(Test Pratique dans les ménages environnants)Facilitateurs

13h00-14h30 Lunch break (Pause déjeuner-Prière)

14h30- 16h00 Feedback on household interview test(Feedback Test pratique- Modalités Départ sur le terrain)

Facilitateurs

16h00 – 16h30 Prayer break (Pause cafe-Prière)16h30 – 17h Field interview practice

(Modalités depart sur Terrain (suite))Facilitateurs


K. Comparison of Baseline and Final Rapid CATCH indicatorsIndicator percent values in bold-faced font are statistically significantly different from values recorded by the Baseline KPC Survey.

RAPID CATCH INDICATORTARGE

T

2008 2011

NUM/ DENOM

PERCENT (CI)

NUM/ DENOM

PERCENT (CI)

1. Percentage of mothers with children age 0-23 months who received at least two Tetanus toxoid vaccinations before the birth of their youngest child

40% 95/330 28.8(±6.1)

261/322 81.1(± 6.0)

2. Percentage of children age 0-23 months whose births were attended by skilled personnel 40% 87/330 26.4(± 6.7)

189/358 52.8(± 7.3)

3. Percentage of children age 0-23 who received a post-natal visit from an appropriate trained health worker within three days after the birth of the youngest child

40 44/330 13.3(± 5.2)

38/358 10.6(± 4.5)

4. Percentage of children age 0-5 months who were exclusively breastfed during the last 24 hours - 31/86 36.0(± 14.3)

70/105 66.7(± 12.7)

5. Percent of infants and young children age 6-23 months fed according to a minimum of appropriate feeding practices

- 93/244 38.1(± 8.6)

147/251 58.6(± 8.6)

6. Percentage of children age 6-23 months who received a dose of Vitamin A in the last 6 months (Mother’s recall)

- 26/244 10.7(± 5.5)

184/251 73.3(± 7.7)

7. Percentage of children age 12-23 months who received a DPT1 vaccination before they reached 12 months

- 61/137 44.5(± 11.7)

94/120 78.3(± 10.4)

8. Percentage of children age12-23 months who received a DPT3 vaccination before they reached 12 months

40 39/137 28.5(± 10.7)

49/120 40.8(± 12.4)

9. Percentage of children age 12-23 months who received a measles vaccination according to the vaccination card or mother’s recall by the time of the survey

40 41/137 30.0(± 10.8)

94/189 49.7(± 10.1)

10. Percentage of children age 0-23 months with a febrile episode during the last two weeks who were treated with an effective anti-malarial drug within 24 hours after the fever began

40 35/199 17.6(±7.5)

144/212 67.9(± 8.9)

11. Percentage of children age 0-23 months who slept under an insecticide-treated bed net the previous night

60 132/330 40.0(± 7.5)

266/344 73.3(± 6.3)

12. Percentage of children age 0-23 months with diarrhea in the last two weeks who received oral rehydration solution (ORS) and/or recommended home fluids

70 36/196 18.4(± 5.9)

96/193 49.7(± 10.0)

13. Percentage of children age 0-23 months with chest-related cough and fast and/ or difficult breathing in the last two weeks who were taken to an appropriate health provider

- 39/214 18.2(± 5.9)

86/189 45.5(± 10.1)

14. Percentage of households of children age 0-23 months that treat water effectively - 50/330 15.2(± 5.5)

270/358 75.4(± 6.3)

15. Percentage of mothers of children 0-23 months who live in a household with soap or a locally appropriate cleanser at the place for hand washing

- 38/330 11.5(± 4.9)

85/358 23.7(± 6.2)


RAPID CATCH INDICATORTARGE

T

2008 2011

NUM/ DENOM

PERCENT (CI)

NUM/ DENOM

PERCENT (CI)

16. Percentage of children 0-23 months who are underweight 100/330 30.3 (± 7.0)

145/350 41.4 (± 7.3)


Final KPC Survey Report_Relief International Healthy Start Child Survival Project-Niger_Jan 2012

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Transcript of Final KPC Survey Report_Relief International Healthy Start Child Survival Project-Niger_Jan 2012