ABCDEFGHIJKLMNOPQRSTUVWXYZ
1
typenamelabelhintrequiredrelevant
appearance
2
startstart
3
endend
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
Generalfalse
9
text
PIM_Team
PIM Team
false
10
textLocalityLocalityfalse
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
48
end_group
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100