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Swaziland 2007 - (NERCHA), the Info Centre - National Emergency ...

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LAST BIRTH NEXT-TO-LAST BIRTH SECOND-FROM-LASTBIRTHNO. QUESTIONS AND FILTERS NAME ________________ NAME ________________ NAME ________________526 Was anything (else) given to YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1treat the diarrhea? NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2(SKIP TO 530) (SKIP TO 530) (SKIP TO 530)DON'T KNOW . . . . . 8 DON'T KNOW . . . . . 8 DON'T KNOW . . . . . 8527 What (else) was given to treat PILL OR SYRUP PILL OR SYRUP PILL OR SYRUPthe diarrhea? ANTIBIOTIC . . . . . . . . A ANTIBIOTIC . . . . . . . . A ANTIBIOTIC . . . . . . . . AANTIMOTILITY . . . . . B ANTIMOTILITY . . . . . B ANTIMOTILITY . . . . . BAnything else? VITAMIN A . . . . . . . . C VITAMIN A . . . . . . . . C VITAMIN A . . . . . . . . COTHER (NOT ANTI- OTHER (NOT ANTI- OTHER (NOT ANTI-RECORD ALL TREATMENTS BIOTIC, ANTI- BIOTIC, ANTI- BIOTIC, ANTI-GIVEN. MOTILITY/VIT. A . . D MOTILITY/VIT. A . . D MOTILITY/VIT. A . . DUNKNOWN PILL UNKNOWN PILL UNKNOWN PILLOR SYRUP . . . . . E OR SYRUP . . . . . E OR SYRUP . . . . . EINJECTION INJECTION INJECTIONANTIBIOTIC . . . . . F ANTIBIOTIC . . . . . F ANTIBIOTIC . . . . . FNON-ANTIBIOTIC. G NON-ANTIBIOTIC. G NON-ANTIBIOTIC. GUNKNOWN UNKNOWN UNKNOWNINJECTION . . . H INJECTION . . . H INJECTION . . . H(IV) INTRAVENOUS . . . I (IV) INTRAVENOUS . . . I (IV) INTRAVENOUS . . . IHOME REMEDY/ HOME REMEDY/ HOME REMEDY/HERBAL MED- HERBAL MED- HERBAL MED-ICINE . . . . . . . . . . J ICINE . . . . . . . . . . J ICINE . . . . . . . . . . JOTHER X OTHER X OTHER X(SPECIFY) (SPECIFY) (SPECIFY)528 CHECK 527: CODE "C" CODE "C" CODE "C" CODE "C" CODE "C" CODE "C"CIRCLED NOT CIRCLED NOT CIRCLED NOTCIRCLED CIRCLED CIRCLEDGIVEN VITAMIN A?(SKIP TO 530) (SKIP TO 530) (SKIP TO 530)529 How many times was(NAME) given vitamin A? TIMES . . . . . TIMES . . . . . TIMES . . . . .DON'T KNOW . . . . . . 98 DON'T KNOW . . . . . . 98 DON'T KNOW . . . . . . 98530 Has (NAME) been ill with a fever YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1at any time in the last two weeks? NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2DON'T KNOW . . . . . 8 DON'T KNOW . . . . . 8 DON'T KNOW . . . . . 8531 Has (NAME) had an illness with YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1a cough at any time in the NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2last two weeks? (SKIP TO 534) (SKIP TO 534) (SKIP TO 534)DON'T KNOW . . . . . 8 DON'T KNOW . . . . . 8 DON'T KNOW . . . . . 8532 When (NAME) had an illness with YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1 YES . . . . . . . . . . . . . . 1a cough, did he/she breathe faster NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2 NO . . . . . . . . . . . . . . 2than usual with short, rapid breaths (SKIP TO 535) (SKIP TO 535) (SKIP TO 535)or have difficulty breathing? DON'T KNOW . . . . . 8 DON'T KNOW . . . . . 8 DON'T KNOW . . . . . 8533 When (NAME) had this illness, did CHEST ONLY . . . 1 CHEST ONLY . . . 1 CHEST ONLY . . . 1he/she have a problem in the chest NOSE ONLY . . . . . 2 NOSE ONLY . . . . . 2 NOSE ONLY . . . . . 2or a blocked or runny nose? BOTH . . . . . . . . . . . . 3 BOTH . . . . . . . . . . . . 3 BOTH . . . . . . . . . . . . 3OTHER 6 OTHER 6 OTHER 6(SPECIFY) (SPECIFY) (SPECIFY)DON'T KNOW . . . . . 8 DON'T KNOW . . . . . 8 DON'T KNOW . . . . . 8(SKIP TO 535) (SKIP TO 535) (SKIP TO 535)534 CHECK 530: YES NO OR DK YES NO OR DK YES NO OR DKHAD FEVER?(GO BACK (GO BACK (GO BACKTO 503 IN NEXT TO 503 IN NEXT TO 503 IN NEXTCOLUMN; OR, IF COLUMN; OR, IF COLUMN; OR, IFNO MORE BIRTHS, NO MORE BIRTHS, NO MORE BIRTHS,GO TO 546) GO TO 546) GO TO 546)398 | Appendix F

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