| A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | |
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1 | type | name | label | hint | required | relevant | appearance | |||||||||||||||||||
2 | start | start | ||||||||||||||||||||||||
3 | end | end | ||||||||||||||||||||||||
4 | note | _Background_informat_mong_other_countries | **Background information** Team interventions must be monitored systematically. The CORTs are monitored through a PIM mechanism. PIM should be conducted within two weeks of the implemented intervention, selecting an appropriate sample size. The PIM should measure the proper use of the supplies distributed, the understanding and application of key water, sanitation and health practices, and the level of satisfaction of the response by households. The systematic analysis of the PIM results aims to have a better understanding of local hygiene practices – while limited due to the time frame – to further protect households against the risks associated with disease transmission. In the case that the findings demonstrate little to no improvement of understanding and practices in the target population, the PIM should be used to adjust or change the response strategy. PIM data-collection tools and templates have been successfully used in Zimbabwe, Mozambique, Haiti, Yemen, among other countries. | false | ||||||||||||||||||||||
5 | note | _Methodology_This_sment_team_of_course | **Methodology:** This assessment is to be conducted within 2 weeks of the Case-Area Targeted Intervention (CATI) and ideally it should NOT be implemented by the same Cholera Outbreak Response Team (CORT, or RRT) who assisted the cholera case, surrounding households and community. This is subject to availability of another assessment team of course. | false | ||||||||||||||||||||||
6 | note | Plan_your_visit_a_fe_unication_modalities | Plan your visit a few days in advance informing local leader(s) and known community health volunteers (phone or other communication modalities) | false | ||||||||||||||||||||||
7 | begin_group | group_ia2wb16 | Post-Intervention Monitoring form | false | ||||||||||||||||||||||
8 | begin_group | group_vn8ct91 | General | false | ||||||||||||||||||||||
9 | text | PIM_Team | PIM Team | false | ||||||||||||||||||||||
10 | text | Locality | Locality | false | ||||||||||||||||||||||
11 | date | Enter_a_date | Enter a date | false | ||||||||||||||||||||||
12 | end_group | |||||||||||||||||||||||||
13 | note | _A_Introduce_yourse_ty_health_volunteers | **A. Introduce yourself/your assessor team, and the purpose of the visit**. Be accompanied by local leader(s) and known community health volunteers. | false | ||||||||||||||||||||||
14 | note | _B_Start_with_the_h_to_the_questionnaire | **B. Start with the household with cholera case. Introduce the team and the purpose of the visit. Start with courtesy discussion before moving to the questionnaire.** | false | ||||||||||||||||||||||
15 | select_one et3ff41 | _1_Have_you_recently_received_ | 1. Have you recently received the assistance of a health team [CORT] in relation to the outbreak of cholera and diarrhoeas? | This includes interventions, messages, NFIs... | false | |||||||||||||||||||||
16 | text | _1_a_If_Other_specify | 1.a If Other, specify | false | ${_1_Have_you_recently_received_} = 'other' | |||||||||||||||||||||
17 | begin_group | group_rt1yj94 | Received intervention | false | ${_1_Have_you_recently_received_} = 'yes' | |||||||||||||||||||||
18 | date | _2_When_was_the_visit | 2. When was the visit? | false | ||||||||||||||||||||||
19 | text | _3_Who_were_they | 3. Who were they? | false | ||||||||||||||||||||||
20 | select_one ty6bs63 | _4_Has_the_team_met_with_commu | 4. Has the team met with community leaders to explain why they were here and the process, incorporated their ideas, views and concerns? | false | ||||||||||||||||||||||
21 | text | _4_a_If_Other_specify | 4.a If Other, specify | false | ${_4_Has_the_team_met_with_commu} = 'other' | |||||||||||||||||||||
22 | text | _5_What_were_the_mes_n_you_show_me_please | 5. What were the messages communicated to you by the Health team? Was it clear? Were you able to understand them well? Were you given a document or a poster? Can you show me please | false | ||||||||||||||||||||||
23 | text | _6_What_has_the_Heal_m_done_in_your_house | 6. What has the Health team done in your house? | household interventions -desinfection, observation… | false | |||||||||||||||||||||
24 | select_one uv5an67 | _7_Have_you_received_any_item_ | 7. Have you received any item by any organisation or the health team? | false | ||||||||||||||||||||||
25 | text | _7_a_Please_explain_w_s_and_what_are_those | 7.a Please explain who provided the items and what are those? | false | ${_7_Have_you_received_any_item_} = 'yes' | |||||||||||||||||||||
26 | text | _8_Observation_Cou_at_you_have_received | 8. (Observation) Could we see what you have received? | note down confirmation of items or other relevant information | false | |||||||||||||||||||||
27 | text | _9_Do_you_know_why_y_sick_due_to_cholera | 9. Do you know why you or your family member and neigbours were sick due to cholera? | false | ||||||||||||||||||||||
28 | text | _10_Observation_Co_e_water_for_drinking | 10. (Observation) Could you please show us the container where you store water for drinking? | note down confirmation of items or other relevant information | false | |||||||||||||||||||||
29 | select_one lf0rz75 | _10a_Do_you_treat_the_water_be | 10a. Do you treat the water before drinking it? | false | ||||||||||||||||||||||
30 | text | _10_b_Observation_n_if_they_say_chlorine | 10.b (Observation) note: approx. quantity, visual quality, if treatment what type of treatment, if they say chlorine | false | ${_10a_Do_you_treat_the_water_be} = 'yes' | |||||||||||||||||||||
31 | select_one jg12j37 | _10c_Chlorine_testin_t_performed_in_mg_L | 10c. Chlorine testing. What is the result of the test for residual chlorine (if test performed) in mg/L? | false | ||||||||||||||||||||||
32 | select_one tz8kk45 | _11_Do_you_and_the_children_wa | 11. Do you and the children wash their hands with soap? | false | ||||||||||||||||||||||
33 | select_multiple wq0rw62 | _11b_If_No_why | 11a. If No, why? | false | ||||||||||||||||||||||
34 | text | _11b_If_Other_specify | 11b. If Other, specify | false | selected(${_11b_If_No_why}, 'other') | |||||||||||||||||||||
35 | select_multiple qo8ny24 | _12_Do_you_know_3_times_in_the | 12. Do you know 3 times in the day for which it is very important for people to wash their hands with soap? | Mark all that apply | false | |||||||||||||||||||||
36 | text | _12a_If_Other_specify | 12a. If Other, specify | false | selected(${_12_Do_you_know_3_times_in_the}, 'other') | |||||||||||||||||||||
37 | select_one gs4de84 | _13_Observation_Ca_use_for_handwashing | 13. (Observation) Can we see the water basin and the soap you use for handwashing? | false | ||||||||||||||||||||||
38 | begin_group | _14_Were_you_satisfi_cholera_health_team | field-list | |||||||||||||||||||||||
39 | select_one up86y42 | _14_Were_you_satisfi_cholera_health_team_header | 14. Were you satisfied with the support provided by the cholera health team? | label | ||||||||||||||||||||||
40 | select_one up86y42 | Level_of_satisfaction | Level of satisfaction | false | list-nolabel | |||||||||||||||||||||
41 | end_group | |||||||||||||||||||||||||
42 | text | _15_What_kind_of_sup_against_the_cholera | 15. What kind of support would have been useful to help you to protect your family against the cholera? | false | ||||||||||||||||||||||
43 | text | _16_Any_other_inform_you_want_to_tell_us | 16. Any other information you want to tell us? | false | ||||||||||||||||||||||
44 | end_group | |||||||||||||||||||||||||
45 | note | _Always_be_grateful_n_has_spent_with_you | **Always be grateful for the time the person has spent with you** | false | ||||||||||||||||||||||
46 | note | _C_Continue_with_a_to_the_questionnaire | **C. Continue with a group of villagers (possibly in the surrounding of the case household) who have benefitted from the CORT/RRT assistance). Introduce the team and the purpose of the visit (focus group discussion on cholera). Start with courtesy discussion before moving to the questionnaire.** | Kobo should not be used for FGD as the analysis is not possible. Use the same questions as before to conduct the FGD, take notes, make observations. | false | |||||||||||||||||||||
47 | text | _D_Discussion_with_ould_not_do_and_why | **D. Discussion with community leaders and CHV on actions taken since the visit of the CORT/RRT , what they have changed to stop the cholera risk and transmissions, and what they could not do, and why?** | Kobo should not be used for FGD/Discussions as the analysis is not possible. Take notes, make observations. | false | |||||||||||||||||||||
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