| Variables in End of Supplementation Form (ESF) | ||||
| Question# | Question | Field name | Response nat | Response options |
| 1 | Participant ID | PID | ### | |
| 2 | Child ID | esf_A | 9### | |
| 3 | Initial of participant mother | esf_B | XX | |
| 4 | Researcher code | esf_C | ## | |
| 5 | Date (according to English calendar) | esf_D | ##-XXX-## | dd-mmm-yy |
| 6 | Age of the child | esf_E | ##.# | weeks: days |
| Compliance of the supplement | ||||
| 7 | Do you have any problem to take the supplement (biscuit)? | esf_1 | # | 1=Yes, 2=No |
| 8 | If yes, specify | esf_1txt | TXT | TEXT
if esf_1=1 NA if esf_1=2 |
| 9 | Usually, which time you had taken the supplement (biscuit)? | esf_2 | # | 1= Morning at tea time, 2= Day time after lunch, 3= Evening time, 4=Night time after dinner |
| 10 | How often you did not take the supplement? | esf_3 | # | 1=once a week (4 days a month), 2=two times a month, 3=once a month, 4= less than once a month (< 12 times a year), 5=frequently( > 4 days a month), 6= Every day taken |
| 11 | Reason for do not taking supplement regularly? | esf_4 | # | 1= Forget, 2= Illness, 3= Travel, 4 =Do not like taste, 5= Not available supplement in home, 6= Do not want to take, 7= Delivery time, 8= Other |
| 12 | If do not want, or other reason ,specify | esf_5 | TXT | TEXT if esf_4=6 or 8, else NA |
| 13 | What about your health condition? | esf_6 | # | 1= Very good, 2= Good, 3= Satisfactory, 4= Bad |
| Health and feeding status of child | ||||
| 14 | What is your impression of growth and development of your child compare to other child? | esf_7 | # | 1= Very good, 2= Good, 3= Satisfactory, 4= Bad |
| 15 | H/O illness hospitalization which required antibiotic / hospitalization in the last 6 month? | esf_8 | # | 2=No, 3=Illness require antibiotic, 4= Hospitalization, 6= Referred to other hospital |
| 16 | When start to give water or janmaghuti/ water based drink (juice, grape water ) ? | esf_9 | # | Completed months |
| 17 | When start to give other drink or food (milk, semisolid/ solid food) than breast milk? | esf_10 | # | Completed months |
| 18 | Is the child on exclusive breastfeeding? | esf_11 | # | 1= Yes, 2=No |
| 19 | If not, upto which month the child was on exclusive breastfeeding | esf_12_a | ## | Completed months |
| Anthropometry of the mother | ||||
| 20 | Weight of the participant mother (KG) | esf_13 | ##.# | |
| 21 | Height of the mother (CM) | esf_14 | ###.# | |
| 22 | BMI of the mother | esf_15 | ##.# | |
| Anthropometry of the child | ||||
| 23 | Weight (KG) | esf_16_i | ##.### | |
| 24 | Weight (KG) | esf_16_ii | ##.### | |
| 25 | Length (CM) | esf_17_i | ###.# | |
| 26 | Length (CM) | esf_17_ii | ###.# | |
| 27 | Head Circumference (CM) | esf_18_i | ##.# | |
| 28 | Head Circumference (CM) | esf_18_ii | ##.# | |
| 29 | Length for age in z score: | esf_19 | # | 1= <-1, 2= <-2, 3= < -3, 4= -1 to +1, 5=>+1, 6=>+2, 7= >+3 |
| 30 | Weight for length z score: | esf_20 | # | 1= <-1, 2= <-2, 3= < -3, 4= -1 to +1, 5=>+1, 6=>+2, 7= >+3 |
| 31 | Remarks | TXT | ||