Making Every Baby Count

8.7 What were the reasons the baby was not taken
to care outside the home?
CIRCLE ALL MENTIONED
PROBE: Any other reason?
8.8 How many hours or days after onset of the
illness that led to death was treatment initiated
outside the home?
ENTER IN HOURS OR DAYS
8.9 At what place was treatment sought?
CIRCLE ALL THAT APPLY
PROBE: Anywhere else?
INCLUDE ALL PLACES THAT WERE VISITED
WHILE SEEKING CARE FOR THE ILLNESS
THAT LED TO DEATH
MENTIONED NOT
MENTIONED
BABY DIED SUDDENLY......................1 2
DID NOT RECOGNIZE HOW
SERIOUS ILLNESS WAS.....................1 2
DID NOT KNOW WHERE TO GO.......1 2
HAD NO ONE TO TAKE CARE
OF OTHER CHILDREN.......................1 2
TRANSPORT WAS NOT AVAILABLE.....1 2
TRANSPORT WAS TOO EXPENSIVE....1 2
FAMILY LACKED MONEY FOR
HEALTH CARE....................................1 2
HEALTH FACILITY IS TOO
FAR AWAY...........................................1 2
DID NOT TRUST QUALITY OF
HEALTH CARE....................................1 2
STAFF MAY BLAME MOTHER
FOR HOME DELIVERY.......................1 2
PROVIDER REFUSE TO WAKE
DURING THE NIGHT.........................1 2
FEAR TO BE SCOLDED OR
SHOUTED AT BY THE STAFF.............1 2
OTHER (SPECIFY)________________1 2
HOURS.......................................................1
OR
DAYS...........................................................2
DON’T KNOW ........................................................... 998
YES NO DON’T
KNOW
HOSPITAL..........................................1 2 8
HEALTH CENTRE...............................1 2 8
PRIVATE CLINIC................................1 2 8
DRUG SHOP/PHARMACY.................1 2 8
TRADITIONAL HEALER.....................1 2 8
OTHER (SPECIFY) _______________ 1 2 8
DON’T KNOW...................................1 2 8
8.10 LIST CARE SOUGHT IN CHRONOLOGICAL ORDER, STARTING WITH THE FIRST PLACE WHERE CARE WAS
SOUGHT; USE CODES BELOW FOR THE LEVEL THAT BEST DESCRIBES THE PLACE
RECORD THE MAIN PROVIDER AT EACH PLACE (USE CODES LISTED BELOW)
RECORD THE NUMBER OF DAYS AFTER ILLNESS STARTED AT THE TIME OF VISITING EACH PLACE
PLACE NAME
1:___________________________
LEVEL:
__________
PROVIDER:
______________________________
WHEN?
DAY :_________________
9.1
2:___________________________
__________
______________________________
DAY :_________________
3:___________________________
__________
______________________________
DAY :_________________
4:___________________________
__________
______________________________
DAY : ________________
130 MAKING EVERY BABY COUNT: AUDIT AND REVIEW OF STILLBIRTHS AND NEONATAL DEATHS