| a_1 | Screening Number | ||||
| a_2 | Initial of the child | ||||
| a_3 | Date (according to English calendar- DDMMYY) | ||||
| a_4 | Researcher code | ||||
| a_5 | Date of birth (if known), (English calendar-DDMMYY) | ||||
| a_6 | Age of child (in months) | ||||
| a_7 | Sex of child (1=Male, 2=Female) | ||||
| a_8 | Are there any plans to migrate within one year? | ||||
| a_9 | Does the child have any acute illness? | ||||
| a_10 | Does the child have any chronic illness? | ||||
| a_11 | Does the child taking multivitamins that include vitamin B12? | ||||
| a_12 | Does the child have any food allergy (peanut)? | ||||
| a_13 | Does parent consenting for participate in the study? | ||||
| a_14 | Weight (in kg) | ||||
| a_15 | Length (in cm) | ||||
| A _16 | Head Circumference (cm) | ||||
| a_17 | Length for age <-1 z score | ||||
| a_18 | Weight for length / HC for age ≤-3 z score | ||||
| a_19 | Hemoglobin (g/dL) | ||||
| a_20 | Child enroll number (as on the packet with medicine) | ||||
| b_1 | Initials of the child | ||||
| b_2 | Field Worker code | ||||
| b_3 | Date of Interview (DDMMYY) | ||||
| b_4 | Date of Birth (English calendar-DDMMYY) | ||||
| b_5 | Age in months (completed) | ||||
| b_6 | Sex (1=Male, 2=Female) | ||||
| b_7 | Birth order of the child | ||||
| b_8 | Mother's occupation (2=No work, 3=Agriculture, 4=Carpet worker, 5=Daily wage earner, 6=Self employs, 7=Services, 8=Working abroad, 9=Not applicable) | ||||
| b_9 | Father's occupation (2=No work, 3=Agriculture, 4=Carpet worker, 5=Daily wage earner, 6=Self employs, 7=Services, 8=Working abroad, 9=Not applicable) | ||||
| b_10 | Literacy of father (2=Illiterate 3=Primary, 4=Secondary, 5=SLC/Intermediate, 6=Bachelors, 7=Above) | ||||
| b_11 | Literacy of mother (2=Illiterate 3=Primary, 4=Secondary, 5=SLC/Intermediate, 6=Bachelor, 7=Above) | ||||
| b_12 | Where was the child born? (1=Home, 2=Health Facility) | ||||
| b_13 | Type of delivery (1=Normal, 2=Caesarean section,3=Vacuum/forceps) | ||||
| b_14 | Gestation week (1=Full-term (40 weeks), | ||||
| 2=Preterm (before 37 weeks), 3=Post-term (after 42 weeks) | |||||
| b_14.1 | Total gestation weeks | ||||
| b_15 | Birth weight in grams according to card/Mother’s recall (Not applicable 9999) | ||||
| b_16 | Was the child hospitalized during the first month after birth?(2=No, 3=Meningitis, 4=Pneumonia, 5=Preterm, LBW, 6=Sepsis, 7=Others) | ||||
| b_17 | Is there history of hospitalization since one months of age (1=Yes, 2=No) | ||||
| b_17i | Specify, reason for hospitalization | ||||
| b_18 | Days with loose watery stool three or more times in a day? | ||||
| b_19 | Did the child have cough and difficulty breathing (1=Common cold, 2=No, 3=Pneumonia, 4=Reactive airway diseases, 5=Others) | ||||
| b_20 | Days of fever (if no, 00) | ||||
| b_21 | Visit to health center/traditional healer because child was ill ? (1=Yes, in health facility, 2=No, 3=Yes, traditional healer, 4=Pharmacy) | ||||
| b_22 | BCG (at 0-45 days) | ||||
| b_23 | OPV 1st (at 1 & 1/2 month) | ||||
| b_24 | OPV 2nd (at 2 & 1/2 month) | ||||
| b_25 | OPV 3rd (at 3 & 1/2 month) | ||||
| b_26 | IPV (3 & ½ months) | ||||
| b_27 | DPT/Hep B/HIB 1st (at 1 & 1/2 month) | ||||
| b_28 | DPT/Hep B/HIB 2nd (at 2 & 1/2 month) | ||||
| b_29 | DPT/Hep B/HIB 3rd (at 3 & 1/2 month) | ||||
| b_30 | PCV 1st (at 1 & 1/2 month) | ||||
| b_31 | PCV 2nd (at 2 & 1/2 month) | ||||
| b_32 | PCV3rd (at 12 months) | ||||
| b_33 | MR (at 9 months) | ||||
| b_34 | JE (at 12 months) | ||||
| b_35 | Others (specify) | ||||
| c_1 | Initials of the child | ||||
| c_2 | Field Worker code | ||||
| c_3 | Date of Interview | ||||
| c_4 | Type of family (1=Nuclear, 2= Joint) | ||||
| c_5 | No. of family members | ||||
| c_6 | No. of children up to the age of 5 years | ||||
| c_7 | Family Ownership of land (1=yes, 2=no, 3=rented) | ||||
| c_8 | If yes, how much land (ana)? (If no, 9999) | ||||
| c_9 | Is this your own house? (1=Yes, 2= No/Rented) | ||||
| c_10 | Number of rooms in use by the household (1 = 1-2 rooms, 2 = 3-5 rooms, 3 = >5 rooms) | ||||
| c_11 | Bedroom & Kitchen (1=separate, 2=not separate) | ||||
| c_12 | Type of cooking fuel use? (1=firewood/straw/cow dung, 2=kerosene, 3=Gas, 4= electricity, 5=Others) | ||||
| c_13 | Indoor tobacco/tamakhu smoking (1= yes, 2=no) | ||||
| c_14 | Drinking water supply (1= mineral water 2= tanker supply 3=tap water, 4=well, 5=hand pump, 6=stone spout, 7=other) | ||||
| c_15 | Place of defecation (1= toilet connected with drainage, 2= toilet with septic tank, 3=field, 4=others) | ||||
| c_16 | Caste (1=Bramhin, 2=Chhetri, 3=Newar, 4=Gurung, 5=Rai, 6=Tamang, 7=Lama, 8=Muslim, 9=Others) | ||||
| c_17 | Ownership of vehicle (2= No, 3= car/bus/truck, 4= motorbike, 5= Tractor) | ||||
| c_18 | Do you have tenants in your house? (1=Yes, 2=No) | ||||
| c_19 | Remittance from abroad (1=Yes, 2=No) | ||||
| d_1 | Initials of the child | ||||
| d_2 | Field Worker code | ||||
| d_3 | Date of Interview | ||||
| d_4 | Age of Mother | ||||
| d_5 | Gravida | ||||
| d_6 | Paria | ||||
| d_7 | Regular ANC visit for last pregnancy? (Yes=1, No=2) | ||||
| d_8ia | Folate (vitamin/mineral supplement during last pregnancy start trimester) | ||||
| d_8iia | Iron (vitamin/mineral supplement during last pregnancy start trimester) | ||||
| d_8iiia | Calcium ((vitamin/mineral supplement during last pregnancy start trimester) | ||||
| d_8iva | Taken any other medicines? | ||||
| d_8v.txt | D_8v. Specify: | ||||
| d_8ib | Folate (vitamin/mineral supplement during last pregnancy duration ) | ||||
| d_8iib | Iron (vitamin/mineral supplement during last pregnancy duration) | ||||
| d_8iiib | Calcium (vitamin/mineral supplement during last pregnancy duration) | ||||
| d_8ivb | Taken any other medicines? | ||||
| d_9 | Any illness during pregnancy? (1=Yes, 2=No) | ||||
| d_9_txt | If yes, Specify? | ||||
| d_10 | Has the women been hospitalized during pregnancy? (Yes=1, No=2) | ||||
| d_10_txt | If yes, specify cause. | ||||
| d_11 | Any current illness? (1=Yes, 2=No) | ||||
| d_11_txt | If yes, specify | ||||
| d_12 | Does the women/spouse use any kind of contraception (2 = No, 3 = Condom,4 =Progesterone injection, 5 = Pills, 6 = IUCD, 7=Norplant, 8 = She or husband has gone through operation, 9 = Not applicable) | ||||
| d_13 | Measure weight of mother (kgs) | ||||
| d_14 | Measure height of mother (cms) | ||||
| d_15_s | Measure Blood pressure systolic | ||||
| d_15_d | Measure Blood pressure diastolic | ||||
| e_1 | Initials of the child | ||||
| e_2 | Field Worker code | ||||
| e_3 | Date of Interview | ||||
| e_4 | Is child on breastfeeding (1=Yes, 2=No) | ||||
| e_5 | If not, when breastfeeding stopped | ||||
| e_6 | When was breastfeeding initiated after birth? (1=within 1 hour, 2=2-4 hours, 3= 5-24 hours, 4=after 24 hours) | ||||
| e_7 | Which food was given first just after birth (1= Breast milk of mother, 2=Donner milk, 3= glucose water, 4=Formula milk, 5=Animal milk, 6=others, specify) | ||||
| e_8 | Reason for giving other food/drink just after birth.(1= Ceasarian section, 2=Preterm/LBW 3=Illness of Baby, 4=Illness of mother, 5=No milk secretion, 6= Others, specify) | ||||
| e_8i | Did you continue to give the other food/drink after starting breastfeeding ? (1= Yes, 2= No, 9= NA) | ||||
| e_8ii | If no, how long other food/drink was given? (1= less than1 day, 2=1-2 days, 3=3 to 7days, 4= more than 7 days, 9=NA ) | ||||
| e_9 | Which complementary food was given first? (1=Lito, 2=Cerelac, 3=Animal/dairy milk, 4= Formula milk, 5= Rice, 6=Others | ||||
| e_10 | When (month) start to feed water or water based drink? | ||||
| e_11 | When (month) start to feed with animal or formula milk? | ||||
| e_12 | When (month) start to feed solid. Semisolid foods | ||||
| e_13 | Reason for introducing other food before 6 months of age (1=crying/hungry, 2=mother illness, 3=no enough breast milk, 4=working mother, 5= others, 9=not applicable) | ||||
| e_14 | Did you give janma ghuti? (Yes=1, No=2) | ||||
| e_14i | If yes, when started to give? (months) | ||||
| e_14ii | Up to which age (in month) it was given ( if still giving write 99) | ||||
| e_14iii | Reason for giving janmaghuti. (1= to make vomiting, 2= to make abdomen comfort, 3= advice from other 4= do not know, 5=other, specify) | ||||
| e_15 | How long child was feed on exclusively breastfeeding (months)? Write 00 if < 2 weeks and 99 if still practicing exclusive breastfeeding. | ||||
| f_1 | Day | ||||
| f_2 | Is child available? | ||||
| f_3 | Did he/she eat all paste of a sachet? | ||||
| f_4 | Vomiting after supplementation? | ||||
| f_5 | Why paste not given? | ||||
| f_6 | Fever? | ||||
| f_7 | Diarrhea /vomiting? | ||||
| f_8 | Blood in stool? | ||||
| f_9 | Cough/ Shortness of breath? | ||||
| f_10 | Visit to health center? | ||||
| f_11 | Antibiotic use? | ||||
| f_12 | Group of Antibiotic? | ||||
| f_13 | Hospitalization? | ||||
| f_14 | Other illness | ||||
| F14_txt | If yes, specify | ||||
| f_15 | Breast milk | ||||
| f_16 | # times during night | ||||
| f_17 | # times during day | ||||
| f_18 | Infant formula | ||||
| f_19 | Animal,Tinned or powdered milk | ||||
| f_20 | Tea, coffee | ||||
| f_21 | Fruit juices | ||||
| f_22 | Other liquids | ||||
| f_23 | Lito, cerelac? | ||||
| f_24 | Rice or other cereals? | ||||
| f_25 | Dal or other lentils/pulses | ||||
| f_26 | White potatoes, white yams, manioc, other roots? | ||||
| f_27 | Meat/fish/ egg? | ||||
| f_28 | Green and other vegetable | ||||
| f_29 | Fruits like Bananas, Apples? | ||||
| f_30 | Curd? | ||||
| f_31 | Other foods | ||||
| g_1 | Initials of the child | ||||
| g_2 | Researcher Code | ||||
| g_3 | Date of blood collection | ||||
| g_4 | Time of blood collection | ||||
| g_5 | Time of last meal (khana) / snack (khaja) (If not today enter 8888) | ||||
| g_6 | Time of last breast feed (If not today enter 8888) | ||||
| g_7 | Amount of whole blood (ml) | ||||
| g_8 | Time of Plasma separation | ||||
| g_9 | Hemoglobin level | ||||
| g_10 | Blood group | ||||
| g_11 | Number of Plasma Aliquots | ||||
| g_12 | Time of transfer plasma aliquots from field | ||||
| hit_1 | Date | ||||
| hit_2 | Field Worker's Code | ||||
| hit_3 | Identity of primary caregiver (person being interviewed)Mother=01, Father=02, Grandmother=03, Grandfather=04, Aunt=05, Uncle=06, Other relative=07, Other non-relative=08 | ||||
| hit_4 | Identity of those present in addition to the child and primary caregiver (Mother=01, Father=02, Brother=03, Sister=04, Grandmother=05, Grandfather=06, Aunt=07, Uncle=08, Cousin=09, Other relative=10, Other non-relative=11 | ||||
| hit_5 | Caregiver spontaneously vocalizes to the child at least twice during the visit (exclude scolding). (Observation) | ||||
| hit_6 | Caregiver responds to child’s vocalizations with a verbal response.(Observation) | ||||
| hit_7 | Caregiver reports no instances of physical punishment during the past week. (Interview) | ||||
| hit_8 | Caregiver does not scold or criticize the child during the visit. (Observation) | ||||
| hit_9 | Caregiver tends to keep the child within visual range and looks at the child quite often. (Observation) | ||||
| hit_10 | Caregiver consciously encourages developmental advances. (Either) | ||||
| hit_11 | Caregiver structures the child’s day. (Interview) | ||||
| hit_12 | Caregiver believes the child’s behavior can be changed or modified and is influenced by the parent’s behavior. (Interview) | ||||
| hit_13 | When the primary caregiver is away, care is provided by one of three regular substitutes. (Interview) | ||||
| hit_14 | Child is not cared for by another child (under 12 years of age). (Interview) | ||||
| hit_15 | There are some toys, tins, balls, dolls, slates, or material in the house that are appropriate play materials for the child. (Either) | ||||
| hit_16 | The child has a riding toy or some toy that provides gross motor stimulation. (Either) | ||||
| hit_17 | The caregiver provides toys or interesting activities for the child during the visit. (Observation) | ||||
| hit_18 | There are some magazines, newspapers, or books visible in the house.(Observation) | ||||
| hit_19 | The caregiver tells the child stories or nursery rhymes at least once a week. (Interview) | ||||
| hit_20 | The caregiver sings to the child everyday. (Interview) | ||||
| hit_21 | Where is taken the observation/interview? 1= Own home, 2=Mother's home, 3=Relative's home, 4=Tent/temporary home, 5=Rent | ||||
| J _1 | Initials of the child | ||||
| J _2 | Field worker code | ||||
| J _3 | Date | ||||
| J _4 | Age of the Child (Months) | ||||
| J _5 | Weight (kg) | ||||
| J _6 | Length (cm) | ||||
| J _7 | Head Circumference (cm) | ||||
| J _8 | Vaccination in the last month? | ||||
| J _8_txt | If yes, specify | ||||
| J _9 | Deworming on the last one month? (Yes=1, No=2) | ||||
| J _10 | Vitamin A on the last one month? (Yes=1, No=2) | ||||
| J _11 | Overall feeding status (appetite) of the child on the last month? 1=Poor, 2=Satisfaction, 3=Good. 4=Excellence1=Poor, 2=Satisfaction, 3=Good. 4=Excellence | ||||
| J _12 | Overall growth of the child according to caregiver on the last month? (1=Poor, 2=Satisfaction, 3=Good. 4=Excellence) | ||||
| J _13 | Overall developmental of the child according to a caregiver on the last month? (1=Poor, 2=Satisfaction, 3=Good. 4=Excellence1=Poor, 2=Satisfaction, 3=Good. 4=Excellence) | ||||
| J _14 | Complains of the caregiver on the B12 supplementation on the last month (1=Poor, 2=Satisfaction, 3=Good. 4=Excellence) | ||||
| k_1 | Day | ||||
| k_2 | Does the FW visit the child? | ||||
| k_3 | Did he/she eat B12 supplement? | ||||
| k_4 | Vomiting after supplementation? | ||||
| k_5 | Why paste not given? | ||||
| k_6 | Fever? | ||||
| k_7 | Diarrhea /vomiting? | ||||
| k_8 | Blood in stool? | ||||
| k_9 | Cough/ Shortness of breath? | ||||
| k_10 | Visit to health center? | ||||
| k_11 | Antibiotic use? | ||||
| k_12 | Group of Antibiotic? | ||||
| k_13 | Hospitalization? | ||||
| k_14 | Other problem | ||||
| k_14txt | If yes, specify | ||||
| k_15 | Breast milk | ||||
| k_16 | # times during night | ||||
| k_17 | # times during day | ||||
| k_18 | Infant formula | ||||
| k_19 | Animal,Tinned or powdered milk | ||||
| k_20 | Tea, coffee | ||||
| k_21 | Fruit juices | ||||
| k_22 | Other liquids | ||||
| k_23 | Lito, cerelac? | ||||
| k_24 | Rice or other cereals? | ||||
| k_25 | Dal or other lentils/pulses | ||||
| f_26 | White potatoes, white yams, manioc, other roots? | ||||
| k_27 | Meat/fish/ egg? | ||||
| k_28 | Green and other vegetable | ||||
| k_29 | Fruits like Bananas, Apples? | ||||
| k_30 | Curd? | ||||
| k_31 | Other foods | ||||
| l_1 | Study Researcher /Supervisor ID | ||||
| l_2 | Today’s date | ||||
| l_3 | Weight (kg) | ||||
| l_4 | Length (cm) | ||||
| l_5 | Head circumference (cm) | ||||
| m_1 | Initials of the child | ||||
| m_2 | Researcher code | ||||
| m_3 | Date of Interview | ||||
| m_4 | Why did the caregiver seek health care for the child (1=Diarrhoea/vomiting, 2=Cough /cold/sore throat, 3= Fever, 4= ENT problem, 5= Feeding problems, 6= Skin problem, 7=Eye, 8= Other, specify) | ||||
| m_4txt | If other, specify | ||||
| m_5 | Did the child seek out medical care as a result of the illness before? (1= Yes, 2=No) | ||||
| m_6 | Was any medicine given the child for the illness? (2=No, 3= Symptomatic, 4= Antibiotic, 5=vitamins/minerals, 6= Others | ||||
| m_6txt | If other, specify | ||||
| m_7 | Clinical Diagnosis 1 (1=AGE, 2= AGE with dehydration, 3=Bacterial dysentery,4=URTI, 5= ALRI, 6= RAD, 7=Otitis Media, 8= Anemia, 9= Malnutrition, 10=Skin allergic rash, 11=Pyoderma, 12= Fever 13= Eye infection, 14=Others | ||||
| m_7txt | If other, specify | ||||
| m_8 | Hospitalization?( 2 = No, 3= Severe pneumonia, 4=AGE with dehydration, 5=High grade fever under investigations, 6=Fever with convulsion, 7=Severe PEM, 8=UTI, 9= Meningitis, 10=Other)( 2 = No, 3= Severe pneumonia, 4=AGE with dehydration, 5=High grade fever under investigations, 6=Fever with convulsion, 7=Severe PEM, 8=UTI, 9= Meningitis, 10=Other) | ||||
| m_8txt | If other, specify | ||||
| m_9 | Referred to other Health Facility? | ||||
| m_9txt | If Yes, reason? | ||||
| m_10 | Medication given (2=No, 3= Symptomatic, 4= Antibiotics, 5= Anti-convulsant, 6= Local medicine,7=Other) | ||||
| m_10txt | If Antibiotic, which group? | ||||
| NCF_1 | Initials of the child | ||||
| ncf_2 | Study researcher ID | ||||
| ncf_3 | Date of Interview | ||||
| ncf_4 | What is the reason for leaving the study? | ||||
| ncf_4i | If refused, reason for refusal | ||||
| ncf_5 | Date of last contact | ||||
| o_1 | Initial of the child | ||||
| o_2 | Field Worker code | ||||
| o_3 | Date of Interview (DD/MM/YY) | ||||
| o_4 | Age of Father | ||||
| o_5 | Any chronic illness? (1=Yes, 2=No) | ||||
| o_5_txt | If yes, Specify? | ||||
| o_6 | Cigarette smoking? (1=Yes, regularly, 2=No, 3=Yes, occasionally, 4=Previous smoker) | ||||
| o_7 | Alcohol drinking? (1=Yes, 2=No) | ||||
| o_7.1 | If yes, how often? (1= Daily, 2= Once a week, 3=2-4 times a week, 4=Once a month or less) | ||||
| o_8 | How much time per day spending with the child? hours | ||||
| o_9 | Is father taking care of the child eg, feeding, bathing? (Yes=1, No= 2) | ||||
| o_9_txt | If yes, specify (feeding, bathing, playing, napping/sleeping, toilet/diaper changes, or others) | ||||
| o_10 | Measure weight of father (kgs) | ||||
| o_11 | Measure height of father (cms) | ||||
| o_12 | Measure blood pressure systolic | ||||
| o_13 | Measure blood pressure diastolic | ||||
| p_1 | Child enroll number | ||||
| p_2 | Researcher code | ||||
| p_3 | Date (according to English calendar- DDMMYY) | ||||
| p_4_a | Age | ||||
| p_4_b | Sex (1=Male, 2=Female) | ||||
| p_5 | Is there any problem to feed the paste? 1=Yes, 2=No | ||||
| p_6 | If yes, what is the main problem? 1=Difficult to feed any food, 2= difficult to feed only paste, 3= Frequent illness, 4= No time to feed, 5= other, 9=NA | ||||
| p_6txt | If other, specify | ||||
| p_7 | Usually, how did you give the paste? 1= direct only paste, 2= with water, 3=with breast feeding, 4=with liquid or food, 5= other | ||||
| p_7txt | If other, specify | ||||
| p_8 | Usually, how frequently you give the paste? 1= once a day, 2= twice a day, 3= three or more times a day. | ||||
| p_9 | Does the child finished whole packet of the paste most of the time? 1= yes, 2 = only 3/4 paste, 3=only1/2 paste, 4= only ¼ paste | ||||
| p_10 | 1=once a week (4 days a month), 2=two to three days a month, 3=once a month, 4= less than once a months, 5=frequently( > 4 days a month), 6= never | ||||
| p_10txt | If frequently did not take, Specify reason | ||||
| p_11 | What is your impression of the paste on growth and development of your child? 1= Very good, 2= Good, 3= satisfactory, 4= bad | ||||
| p_12 | Weight (in kg) | ||||
| p_13 | Length (in cm) | ||||
| p_14 | Head Circumference (cm) | ||||
| p_15 | Length for age in z score:1= <-1, 2=<-2, 3=< -3, 4= >-1 | ||||
| p_16 | Weight for length z score:1= <-1, 2=<-2, 3=< -3, 4= >-1 | ||||
| p_17 | Hemoglobin (g/dL) | ||||
| bsd_1 | Initials of the child | ||||
| bsd_2 | Researcher's code | ||||
| bsd_3 | Date | ||||
| bsd_4 | Identity of primary caregiver (person being interviewed) (Mother=01, Father=02, Grandmother=03, Grandfather=04, Aunt=05, Uncle=06, Other relative=07, Other non-relative=08) | ||||
| bsd_5 | Cognitive | ||||
| bsd_6 | Receptive Communication | ||||
| bsd_7 | Expressive Communication | ||||
| bsd_8 | Total Score (sum of Receptive and Expressive Communication Scores) | ||||
| bsd_9 | Fine Motor | ||||
| bsd_10 | Gross Motor | ||||
| bsd_11 | Total Score (sum of Fine and Gross Motor Scores) | ||||
| bsd_12 | Social-Emotional | ||||