order type name

0 audit audit
1 begin group Interviewer
2 text Id10010
3 integer Id10010a
4 select_one select_2 Id10010b
5 text Id10010c
6 select_one language language
7 end group
8 begin group presets
9 select_one HIGH_LOW_VERY Id10002
10 select_one HIGH_LOW_VERY Id10003
11 select_one select_58 Id10004
12 end group
13 begin group respondent_backgr
14 text Id10007
15 select_one select_2 Id10007a
16 integer Id10007b
17 select_one select_32 Id10008
18 select_one YES_NO_DK_REF Id10009
19 today Id10012
20 select_one YES_NO Id10013
21 start Id10011
22 end group
23 begin group consented
24 begin group deceased_CRVS
25 begin group info_on_deceased
26 text Id10017
27 text Id10018
28 select_one select_2 Id10019
29 select_one YES_NO_REF Id10020
30 date Id10021
31 select_one YES_NO_REF Id10022
32 date Id10023_a
33 date Id10023_b
34 calculate Id10023
35 date Id10024
36 calculate ageInDays
37 calculate ageInDays2
38 calculate ageInYears
39 calculate ageInYearsRemain
40 calculate ageInMonths
41 calculate ageInMonthsRemain
42 calculate isNeonatal1
43 calculate isChild1
44 calculate isAdult1
45 note displayAgeNeonat
46 note displayAgeChild
47 note displayAgeAdult
48 select_one age_group age_group
49 integer age_neonate_day
50 integer age_neonate_hou
51 select_one unitsc age_child_unit
52 integer age_child_days
53 integer age_child_months
54 integer age_child_years
55 integer age_adult
56 calculate ageInMonthsByYear
57 calculate ageInYears2
58 calculate isNeonatal2
59 calculate isChild2
60 calculate isAdult2
61 calculate isNeonatal
62 calculate isChild
63 calculate isAdult
64 calculate ageInDaysNeonate
65 note Id10008_check
66 select_one select_18 Id10058
67 select_one YES_NO_DK_REF Id10487
68 select_one YES_NO Id10051
69 select_one select_500 Id10052
70 text Id10053
71 text Id10054
72 text Id10055
73 text Id10057
74 select_one select_19 Id10059
75 select_one select_23 Id10063
76 select_one YES_NO_DK_REF Id10064
77 select_one select_25 Id10065
78 text Id10066
79 text Id10061
80 text Id10062
81 end group
82 end group
83 begin group narrat
84 note noteon
85 audio Id10476_audio
86 text Id10476
87 select_multiple select_510 Id10477
88 select_multiple select_511 Id10478
 89 select_multiple select_512 Id10479
90 note notenarr
91 end group
92 begin group stillbirth
93 select_one YES_NO_DK_REF Id10104
94 select_one YES_NO_DK_REF Id10105
95 integer Id10106
96 select_one YES_NO_DK_REF Id10107
97 select_one YES_NO_DK_REF Id10377
98 select_one select_532 Id10376
99 select_one YES_NO_DK_REF Id10109
100 select_one YES_NO_DK_REF Id10110
101 select_one YES_NO_DK_REF Id10111
102 select_one YES_NO_DK_REF Id10112
103 select_one YES_NO_DK_REF Id10113
104 select_one YES_NO_DK_REF Id10114
105 select_one YES_NO_DK_REF Id10115
106 select_one YES_NO_DK_REF Id10116
107 end group
108 begin group med_hist_final_ill
109 note note_s_s
110 select_one YES_NO_DK_REF Id10125
111 select_one YES_NO_DK_REF Id10126
112 select_one YES_NO_DK_REF Id10127
113 select_one YES_NO_DK_REF Id10128
114 select_one YES_NO_DK_REF Id10129
115 select_one YES_NO_DK_REF Id10482
116 select_one YES_NO_DK_REF Id10483
117 select_one select_531 Id10484
118 select_one YES_NO_DK_REF Id10130
119 select_one YES_NO_DK_REF Id10131
120 select_one YES_NO_DK_REF Id10132
121 select_one YES_NO_DK_REF Id10133
122 select_one YES_NO_DK_REF Id10134
123 select_one YES_NO_DK_REF Id10135
124 select_one YES_NO_DK_REF Id10136
125 select_one YES_NO_DK_REF Id10137
126 select_one YES_NO_DK_REF Id10138
127 select_one YES_NO_DK_REF Id10139
128 select_one YES_NO_DK_REF Id10140
129 select_one YES_NO_DK_REF Id10141
130 select_one YES_NO_DK_REF Id10142
131 select_one YES_NO_DK_REF Id10143
132 select_one YES_NO_DK_REF Id10144
133 end group
134 note nmh
135 begin group injuries_accidents
136 select_one YES_NO_DK_REF Id10077
137 begin group injuries_accident
138 select_one select_534 Id10077_a
139 trigger Id10077_b
140 select_one YES_NO_DK_REF Id10079
141 select_one YES_NO_DK_REF Id10082
142 select_one YES_NO_DK_REF Id10083
143 select_one YES_NO_DK_REF Id10084
144 select_one YES_NO_DK_REF Id10085
145 select_one YES_NO_DK_REF Id10086
146 select_one YES_NO_DK_REF Id10087
147 select_one select_299 Id10088
148 select_one YES_NO_DK_REF Id10089
149 select_one YES_NO_DK_REF Id10091
150 select_one YES_NO_DK_REF Id10092
151 select_one YES_NO_DK_REF Id10093
152 select_one YES_NO_DK_REF Id10096
153 select_one YES_NO_DK_REF Id10094
154 select_one YES_NO_DK_REF Id10095
155 select_one YES_NO_DK_REF Id10097
156 select_one YES_NO_DK_REF Id10098
157 select_one YES_NO_DK_REF Id10099
158 select_one YES_NO_DK_REF Id10100
159 end group
160 end group
161 begin group illhistory
162 integer Id10351
163 select_one YES_NO_DK_REF Id10408
164 begin group illdur
165 integer Id10120_0
166 select_one units_1 id10120_unit
167 integer Id10121
168 integer Id10122
169 integer Id10120_1
170 calculate Id10120
171 end group
172 select_one YES_NO_DK_REF Id10123
173 begin group signs_symptoms_fi
174 select_one YES_NO_DK_REF Id10147
175 integer Id10148_a
176 select_one units_2 Id10148_units
177 integer Id10148_b
178 integer Id10148_c
179 calculate Id10148
180 select_one YES_NO_DK_REF Id10149
181 select_one select_63 Id10150
182 select_one select_64 Id10151
183 select_one YES_NO_DK_REF Id10153
184 select_one units_2 Id10154_units
185 integer Id10154_a
186 integer Id10154_b
187 calculate Id10154
188 select_one YES_NO_DK_REF Id10155
189 select_one YES_NO_DK_REF Id10156
190 select_one YES_NO_DK_REF Id10157
191 select_one YES_NO_DK_REF Id10158
192 select_one YES_NO_DK_REF Id10159
193 begin group breathdur
194 integer Id10161_0
195 select_one units id10161_unit
196 integer Id10161_1
197 integer Id10162
198 integer Id10163
199 calculate Id10161
200 end group
201 select_one select_80 Id10165
202 select_one YES_NO_DK_REF Id10170
203 select_one YES_NO_DK_REF Id10171
204 select_one YES_NO_DK_REF Id10166
205 integer Id10167_a
206 select_one units_2 Id10167_units
207 integer Id10167_b
208 integer Id10167_c
209 calculate Id10167
210 select_one YES_NO_DK_REF Id10172
211 select_multiple select_501 Id10173_nc
212 select_one YES_NO_DK_REF Id10173_a
213 calculate Id10173
214 select_one YES_NO_DK_REF Id10174
215 select_one YES_NO_DK_REF Id10175
216 integer Id10176
217 begin group paindur
218 select_one H_D_DK_REF Id10178_unit
219 integer Id10179
220 integer Id10179_1
221 end group
222 select_one YES_NO_DK_REF Id10181
223 select_one units_2 Id10182_units
224 integer Id10182_a
225 integer Id10182_b
226 calculate Id10182
227 integer Id10183
228 integer Id10184_a
229 select_one units_2 Id10184_units
230 integer Id10184_b
231 integer Id10184_c
232 select_one YES_NO_DK_REF Id10185
233 select_one YES_NO_DK_REF Id10186
234 select_one YES_NO_DK_REF Id10188
235 select_one units_2 Id10190_units
236 integer Id10190_a
237 integer Id10190_b
238 select_one YES_NO_DK_REF Id10189
239 select_one YES_NO_DK_REF Id10189_1
240 select_one YES_NO_DK_REF Id10191
241 select_one YES_NO_DK_REF Id10192
242 select_one YES_NO_DK_REF Id10194
243 select_one YES_NO_DK_REF Id10195
244 begin group abdominal_pain
245 select_one H_D_M_DK id10196_unit
246 integer Id10196
247 integer Id10197_a
248 integer Id10198
249 calculate Id10197
250 end group
251 select_multiple select_100 Id10199
252 select_one YES_NO_DK_REF Id10200
253 select_one D_M_DK_REF Id10201_unit
254 integer Id10201_a
255 integer Id10202
256 calculate Id10201
257 select_one select_103 Id10203
258 select_one YES_NO_DK_REF Id10204
259 select_one D_M_DK_REF Id10205_unit
260 integer Id10205_a
261 integer Id10206
262 calculate Id10205
263 select_one YES_NO_DK_REF Id10207
264 select_one YES_NO_DK_REF Id10208
265 select_one units_2 Id10209_units
266 integer Id10209_a
267 integer Id10209_b
268 calculate Id10209
269 select_one YES_NO_DK_REF Id10212
270 select_one units_2 Id10213_units
271 integer Id10213_a
272 integer Id10213_b
273 calculate Id10213
274 select_one YES_NO_DK_REF Id10214
275 select_one units_3 Id10216_units
276 integer Id10216_a
277 integer Id10216_b
278 calculate Id10216
279 select_one YES_NO_DK_REF Id10217
280 select_one YES_NO_DK_REF Id10220
281 select_one YES_NO_DK_REF Id10222
282 select_one YES_NO_DK_REF Id10275
283 select_one YES_NO_DK_REF Id10276
284 select_one YES_NO_DK_REF Id10223
285 select_one YES_NO_DK_REF Id10226
286 select_one YES_NO_DK_REF Id10224
287 select_one YES_NO_DK_REF Id10230
288 select_one YES_NO_DK_REF Id10231
289 select_one units_2 Id10232_units
290 integer Id10232_a
291 integer Id10232_b
292 calculate Id10232
293 select_one YES_NO_DK_REF Id10227
294 select_one YES_NO_DK_REF Id10229
295 select_one YES_NO_DK_REF Id10233
296 integer Id10234
297 select_multiple select_135 Id10235
298 select_one YES_NO_DK_REF Id10236
299 select_one YES_NO_DK_REF Id10237
300 select_one YES_NO_DK_REF Id10238
301 select_one YES_NO_DK_REF Id10239
302 select_one YES_NO_DK_REF Id10240
303 select_one YES_NO_DK_REF Id10242
304 select_one YES_NO_DK_REF Id10243
305 select_one YES_NO_DK_REF Id10244
306 select_one YES_NO_DK_REF Id10245
307 select_one YES_NO_DK_REF Id10246
308 select_one YES_NO_DK_REF Id10247
309 select_one units_2 Id10248_units
310 integer Id10248_a
311 integer Id10248_b
312 calculate Id10248
313 select_one YES_NO_DK_REF Id10249
314 select_one units_2 Id10250_units
315 integer Id10250_a
316 integer Id10250_b
317 calculate Id10250
318 select_one YES_NO_DK_REF Id10251
319 select_one YES_NO_DK_REF Id10252
320 select_one YES_NO_DK_REF Id10254
321 select_one YES_NO_DK_REF Id10253
322 select_one YES_NO_DK_REF Id10255
323 select_one YES_NO_DK_REF Id10256
324 select_one YES_NO_DK_REF Id10257
325 select_one YES_NO_DK_REF Id10258
326 select_one YES_NO_DK_REF Id10259
327 select_one YES_NO_DK_REF Id10260
328 select_one YES_NO_DK_REF Id10261
329 select_one units_5 Id10262_units
330 integer Id10262_a
331 integer Id10262_b
332 calculate Id10262
333 select_one YES_NO_DK_REF Id10262_c
334 select_one YES_NO_DK_REF Id10265
335 select_one units_2 Id10266_units
336 integer Id10266_a
337 integer Id10266_b
338 calculate Id10266
339 select_one YES_NO_DK_REF Id10267
340 select_one YES_NO_DK_REF Id10268
341 select_one YES_NO_DK_REF Id10269
342 select_one YES_NO_DK_REF Id10271
343 select_one YES_NO_DK_REF Id10272
344 select_one YES_NO_DK_REF Id10273
345 integer Id10274_a
346 select_one units_2 Id10274_units
347 integer Id10274_b
348 integer Id10274_c
349 calculate Id10274
350 select_one YES_NO_DK_REF Id10277
351 select_one YES_NO_DK_REF Id10278
352 select_one YES_NO_DK_REF Id10279
353 select_one YES_NO_DK_REF Id10281
354 select_one YES_NO_DK_REF Id10282
355 select_one YES_NO_DK_REF Id10283
356 begin group neonatal_childC
357 select_one YES_NO_DK_REF Id10284
358 select_one YES_NO_DK_REF Id10286
359 select_one YES_NO_DK_REF Id10287
360 select_one YES_NO_DK_REF Id10288
361 select_one YES_NO_DK_REF Id10289
362 end group
363 select_one YES_NO_DK_REF Id10485
364 select_one YES_NO_DK_REF Id10486
365 end group
366 begin group pregnancy_wome
367 select_one YES_NO_DK_REF Id10294
368 select_one YES_NO_DK_REF Id10296
369 select_one YES_NO_DK_REF Id10299
370 select_one YES_NO_DK_REF Id10300
371 select_one YES_NO_DK_REF Id10301
372 select_one YES_NO_DK_REF Id10302
373 integer Id10303
374 select_one YES_NO_DK_REF Id10305
375 select_one YES_NO_DK_REF Id10312
376 select_one YES_NO_DK_REF Id10313
377 select_one YES_NO_DK_REF Id10314
378 select_one YES_NO_DK_REF Id10306
379 select_one YES_NO_DK_REF Id10334
380 select_one YES_NO_DK_REF Id10333
381 select_one YES_NO_DK_REF Id10308
382 select_one confirm Id10310
383 select_one YES_NO_DK_REF Id10304
384 select_one YES_NO_DK_REF Id10304_a
385 begin group group_maternal
386 integer Id10309
387 select_one select_533 Id10317
388 select_one YES_NO_DK_REF Id10321
389 select_one YES_NO_DK_REF Id10322_a
390 select_one YES_NO_DK_REF Id10325
391 select_one YES_NO_DK_REF Id10327
392 select_one YES_NO_DK_REF Id10323
393 select_one YES_NO_DK_REF Id10324
394 select_one YES_NO_DK_REF Id10328
395 select_one YES_NO_DK_REF Id10329_a
396 select_one YES_NO_DK_REF Id10329_b
397 select_one YES_NO_DK_REF Id10322_b
398 select_one YES_NO_DK_REF Id10331
399 integer Id10332
400 begin group deliverytype
401 select_one YES_NO_DK_REF Id10342
402 select_one YES_NO_DK_REF Id10343
403 select_one YES_NO_DK_REF Id10344
404 end group
405 select_one YES_NO_DK_REF Id10330
406 select_one select_208 Id10337
407 integer Id10319
408 select_one YES_NO_DK_REF Id10320
409 end group
410 select_one YES_NO_DK_REF Id10340
411 end group
412 begin group neonatal_child
413 begin group neonatal_childA
414 select_one YES_NO_DK_REF Id10354
415 select_one YES_NO Id10366_check
416 begin group g10366
417 note n10366
418 integer Id10366
419 end group
420 select_one YES_NO_DK_REF Id10363
421 select_one YES_NO_DK_REF Id10365
422 integer Id10367
423 select_one YES_NO_DK_REF Id10369
424 select_one YES_NO_DK_REF Id10370
425 select_one YES_NO_DK_REF Id10371
426 select_one YES_NO_DK_REF Id10372
427 select_one YES_NO_DK_REF Id10373
428 end group
429 begin group neonatal_childB
430 integer Id10382
431 select_one YES_NO_DK_REF Id10383
432 select_one YES_NO_DK_REF Id10384
433 select_one select_520 Id10385
434 begin group mother_deliv
435 select_one YES_NO_DK_REF Id10387
436 select_one YES_NO_DK_REF Id10388
437 select_one YES_NO_DK_REF Id10389
438 end group
439 select_one YES_NO_DK_REF Id10391
440 select_one YES_NO_DK_REF Id10393
441 select_one YES_NO_DK_REF Id10395
442 select_one YES_NO_DK_REF Id10396
443 select_one YES_NO_DK_REF Id10397
444 select_one YES_NO_DK_REF Id10398
445 select_one YES_NO_DK_REF Id10399
446 select_one YES_NO_DK_REF Id10400
447 select_one YES_NO_DK_REF Id10401
448 select_one YES_NO_DK_REF Id10402
449 select_one YES_NO_DK_REF Id10403
450 select_one YES_NO_DK_REF Id10404
451 select_one YES_NO_DK_REF Id10405
452 select_one YES_NO_DK_REF Id10406
453 end group
454 end group
455 begin group risk_factors
456 select_one YES_NO_DK_REF Id10411
457 select_one YES_NO_DK_REF Id10413
458 select_one select_535 Id10413_a
459 integer Id10413_d
460 select_one YES_NO_DK_REF Id10413_b
461 select_one YES_NO_DK_REF Id10414
462 select_one select_535 Id10414_a
463 integer Id10414_d
464 select_one YES_NO_DK_REF Id10414_b
465 end group
466 begin group health_service_uti
467 select_one YES_NO_DK_REF Id10418
468 select_one YES_NO_DK_REF Id10419
469 select_one YES_NO_DK_REF Id10420
470 select_one YES_NO_DK_REF Id10421
471 select_one YES_NO_DK_REF Id10422
472 select_one YES_NO_DK_REF Id10423
473 select_one YES_NO_DK_REF Id10424
474 select_one YES_NO_DK_REF Id10425
475 select_one YES_NO_DK_REF Id10426
476 select_one YES_NO_DK_REF Id10435
477 text Id10436
478 select_one YES_NO_DK_REF Id10446
479 end group
480 end group
481 begin group vital_reg_certif
482 note botecrn
483 select_one YES_NO Id10069_a
484 text Id10070
485 select_one YES_NO Id10071_check
486 date Id10071
487 text Id10072
488 text Id10073
489 end group
490 begin group deathcert
491 note noteccd
492 select_one YES_NO_DK_REF Id10462
493 select_one YES_NO_DK_REF Id10463
494 text Id10464
495 text Id10465
496 text Id10466
497 text Id10467
498 text Id10468
499 text Id10469
500 text Id10470
501 text Id10471
502 text Id10472
503 text Id10473
504 end group
505 end Id10481
506 note noteend
507 text comment
508 end group
 relevant agegroup

ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ndent_backgr ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
selected(${Id10013}, 'yes') ALL
ALL
n_deceased ALL
ALL
ALL
ALL
ALL
selected(${Id10020}, 'yes') ALL
ALL
selected(${Id10022}, 'yes') and selected(${Id10020}, 'yes') ALL
selected(${Id10022}, 'yes') and (selected(${Id10020}, 'no') or selected(ALL
ALL
selected(${Id10022}, 'no') or selected(${Id10022}, 'ref') ALL
ALL
ALL
ALL
YearsRemain ALL
ALL
MonthsRemain ALL
ALL
ALL
 ALL
${isNeonatal1} = '1' N
${isChild1} = '1' C
${isAdult1} = '1' A
${Id10020} != 'yes' or ${Id10022} != 'yes' ALL
${age_group} = 'neonate' N
${age_neonate_days} = 0 N
${age_group} = 'child' C
${age_child_unit} = 'days' C
${age_child_unit} = 'months' C
${age_child_unit} = 'years' C
${age_group} = 'adult' A
MonthsByYear ALL
ALL
ALL
ALL
ALL
ALL
ALL
ALL
DaysNeonate ALL
selected(${Id10008}, 'child') and (selected(${isNeonatal}, '1') or selecteN_C
ALL
ALL
ALL
selected(${Id10051}, 'yes') ALL
selected(${Id10051}, 'yes') ALL
selected(${Id10051}, 'yes') ALL
selected(${Id10051}, 'yes') ALL
selected(${Id10051}, 'yes') ALL
selected(${isAdult}, '1') A
((selected(${isChild}, '1') and ${ageInMonthsByYear} >=48 ) or selected( C_A
selected(${Id10063}, 'no_formal_education') or selected(${Id10063}, 'p C_A
((selected(${isChild}, '1') and ${ageInMonthsByYear} >=96 ) or selected( C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${ C_A
(selected(${isChild}, '1') or selected(${isNeonatal}, '1')) and selected($N_C
(selected(${isChild}, '1') or selected(${isNeonatal}, '1')) and selected($N_C
ALL
ALL
ALL
ALL
ALL
string-length(${Id10476_audio})=0 ALL
selected(${isAdult}, '1') A
selected(${isChild}, '1') C
selected(${isNeonatal}, '1') N
ALL
ALL
selected(${isNeonatal},'1') N
N
selected(${Id10104}, 'yes') N
selected(${Id10104}, 'yes') N
selected(${Id10104}, 'yes') N
N
selected(${Id10377}, 'yes') or selected(${Id10377}, 'dk') or selected(${N
N
N
selected(${Id10110}, 'yes') N
selected(${Id10110}, 'yes') N
selected(${Id10110}, 'yes') N
not(selected(${Id10104}, 'yes')) and not(selected(${Id10109}, 'yes')) N
N
selected(${Id10114}, 'yes') or selected(${Id10114}, 'ref') or selected($N
N
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
ALL
C_A
C_A
C_A
C_A
not(selected(${Id10128}, 'yes')) C_A
C_A
C_A
selected(${Id10483}, 'yes') C_A
C_A
C_A
C_A
C_A
C_A
C_A
C_A
C_A
selected(${isAdult}, '1') A
selected(${isAdult}, '1') A
selected(${isAdult}, '1') A
selected(${isAdult}, '1') A
C_A
C_A
C_A
C_A
 ALL
s_accidents ALL
${Id10114}!='yes' ALL
selected(${Id10077}, 'yes') or selected(${Id10077}, 'dk') or selected($ALL
selected(${Id10077}, 'yes') ALL
selected(${Id10077_a}, 'less') ALL
ALL
selected(${Id10079}, 'no') or selected(${Id10079}, 'dk') or selected(${IALL
selected(${Id10082}, 'no') or selected(${Id10082}, 'dk') or selected(${IALL
selected(${Id10083}, 'no') or selected(${Id10083}, 'dk') or selected(${IALL
selected(${Id10084}, 'no') or selected(${Id10084}, 'dk') or selected(${IALL
selected(${Id10085}, 'no') or selected(${Id10085}, 'dk') or selected(${IALL
selected(${Id10086}, 'no') or selected(${Id10086}, 'dk') or selected(${ALL
selected(${Id10087}, 'yes') or selected(${Id10086}, 'yes') ALL
selected(${Id10087}, 'no') or selected(${Id10087}, 'dk') or selected(${IALL
selected(${Id10089}, 'no') or selected(${Id10089}, 'dk') or selected(${IALL
selected(${Id10091}, 'no') or selected(${Id10091}, 'dk') or selected(${IALL
selected(${Id10092}, 'no') or selected(${Id10092}, 'dk') or selected(${IALL
selected(${Id10093}, 'no') or selected(${Id10093}, 'dk') or selected(${IALL
selected(${Id10096}, 'no') or selected(${Id10096}, 'dk') or selected(${IALL
selected(${Id10096}, 'no') or selected(${Id10096}, 'dk') or selected(${IALL
selected(${Id10095}, 'no') or selected(${Id10095}, 'dk') or selected(${IALL
not(selected(${Id10095}, 'yes')) ALL
${ageInYears2}>=10 and (selected(${Id10098}, 'no') or selected(${Id1009 C_A
not(selected(${Id10098}, 'yes')) and (selected(${Id10099}, 'no') or seleALL
ALL
ALL
ALL
(selected(${Id10114}, 'no') or ${Id10114} = 'NaN' or string-length(${IN
(((selected(${Id10114}, 'no') or ${Id10114} = 'NaN' or string-length(${N_C
not(selected(${Id10114}, 'yes')) and not(selected(${Id10077_a}, 'less'ALL
selected(${isNeonatal}, '1') N
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
${id10120_unit}='months' C_A
${id10120_unit}='years' C_A
${id10120_unit}='days' C_A
ALL
ALL
not(selected(${Id10114}, 'yes')) and not(selected(${Id10077_a}, 'less')ALL
not(selected(${Id10114}, 'yes')) and not(selected(${Id10077_a}, 'less'ALL
ALL
selected(${Id10147}, 'yes') and selected(${isNeonatal}, '1') N
selected(${Id10147}, 'yes') and (selected(${isChild}, '1') or selected(${is
C_A
${Id10148_units}='days' C_A
${Id10148_units}='months' C_A
selected(${Id10147}, 'yes') ALL
selected(${Id10147}, 'yes') ALL
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
ALL
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
${Id10154_units}='days' C_A
${Id10154_units}='months' C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
(selected(${isChild}, '1') and selected(${Id10153}, 'yes')) or (selected N_C
ALL
selected(${Id10159}, 'yes') ALL
selected(${isNeonatal}, '1') N
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
${id10161_unit}='days' C_A
${id10161_unit}='months' C_A
${id10161_unit}='years' C_A
ALL
ALL
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
selected(${isAdult}, '1') and selected(${Id10159}, 'yes') A
selected(${isAdult}, '1') and selected(${Id10159}, 'yes') A
ALL
selected(${Id10166}, 'yes') and selected(${isNeonatal}, '1') N
selected(${Id10166}, 'yes') and (selected(${isChild}, '1') or selected(${isC_A
${Id10167_units}='days' C_A
${Id10167_units}='months' C_A
selected(${Id10166}, 'yes') ALL
selected(${isNeonatal}, '1') or selected(${isChild}, '1') N_C
selected(${isNeonatal}, '1') or selected(${isChild}, '1') N_C
selected(${isAdult}, '1') A
A
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
selected(${isAdult}, '1') and selected(${Id10174}, 'yes') A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
selected(${Id10174}, 'yes') C_A
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
${Id10178_unit}='hours' C_A
${Id10178_unit}='days' C_A
C_A
ALL
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
${Id10182_units}='days' C_A
${Id10182_units}='months' C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
(selected(${isChild}, '1') or selected(${isNeonatal}, '1')) and selected($N_C
selected(${Id10181}, 'yes') and selected(${isNeonatal}, '1') N
selected(${Id10181}, 'yes') and selected(${isChild}, '1') C
${Id10184_units}='days' C
${Id10184_units}='months' C
selected(${isChild}, '1') and selected(${Id10181}, 'yes') C
ALL
ALL
selected(${Id10188}, 'yes') and selected(${isAdult}, '1') A
${Id10190_units}='days' A
${Id10190_units}='months' A
not(${ageInDaysNeonate}<7 and selected(${isNeonatal}, '1')) and selec ALL
selected(${Id10188}, 'yes') ALL
(selected(${Id10188}, 'yes') or selected(${Id10189}, 'yes')) and ${isNeN
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and (selected(${I C_A
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id C_A
C_A
${id10196_unit}='hours' C_A
${id10196_unit}='days' C_A
${id10196_unit}='months' C_A
C_A
C_A
(selected(${isChild}, '1') and selected(${Id10195}, 'yes')) or (selected($C_A
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
${Id10201_unit}='days' C_A
${Id10201_unit}='months' C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
${Id10205_unit}='days' C_A
${Id10205_unit}='months' C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
${Id10209_units}='days' C_A
${Id10209_units}='months' C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
selected(${isAdult}, '1') A
(selected(${isAdult}, '1')) and selected(${Id10212}, 'yes') A
${Id10213_units}='days' A
${Id10213_units}='months' A
(selected(${isAdult}, '1')) and selected(${Id10212}, 'yes') A
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
${Id10216_units}='hours' C_A
${Id10216_units}='days' C_A
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
selected(${Id10220}, 'yes') C_A
(selected(${isNeonatal}, '1') and ${Id10114}!='yes') or (selected(${Id1 N_C
selected(${Id10275}, 'no') or selected(${Id10275}, 'dk') or selected(${IN_C
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
${Id10232_units}='days' C_A
${Id10232_units}='months' C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
(selected(${isAdult}, '1') or selected(${isChild}, '1')) and selected(${Id1C_A
ALL
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
selected(${isAdult}, '1') A
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
selected(${isNeonatal}, '1') or selected(${isChild}, '1') N_C
selected(${isNeonatal}, '1') or selected(${isChild}, '1') N_C
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
${Id10248_units}='days' C_A
${Id10248_units}='months' C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
${Id10250_units}='days' C_A
${Id10250_units}='months' C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
selected(${isAdult}, '1') A
selected(${isAdult}, '1') A
selected(${isChild}, '1') or (selected(${isAdult}, '1') and selected(${Id10C_A
selected(${isChild}, '1') or (selected(${isAdult}, '1') and selected(${Id10C_A
selected(${isChild}, '1') or (selected(${isAdult}, '1') and selected(${Id10C_A
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and (selected(${Id10259},
C_A 'no') or selected(${Id10259}, 'ref') or selected(${
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
${Id10262_units}='days' C_A
${Id10262_units}='months' C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
ALL
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
${Id10266_units}='days' C_A
${Id10266_units}='months' C_A
(selected(${isChild}, '1') or selected(${isAdult}, '1')) and selected(${Id1C_A
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
selected(${isChild}, '1') or selected(${isAdult}, '1') C_A
selected(${isChild}, '1') C
(selected(${isNeonatal}, '1') and ${Id10114}!='yes') or (selected(${is N_C
(selected(${isNeonatal}, '1') and ${Id10114}!='yes') or (selected(${is N_C
(selected(${isNeonatal}, '1') and ${Id10114}!='yes') or (selected(${is N_C
selected(${Id10273}, 'yes') and selected(${isNeonatal}, '1') N
selected(${Id10273}, 'yes') and selected(${isChild}, '1') C
${Id10274_units}='days' C
${Id10274_units}='months' C
selected(${Id10273}, 'yes') N_C
(selected(${isNeonatal}, '1') and ${Id10114}!='yes') or (selected(${is N_C
(selected(${isNeonatal}, '1') and ${Id10114}!='yes') or (selected(${is N_C
${Id10278} ='no' or ${Id10278} ='dk' or ${Id10278} ='ref' N_C
selected(${isNeonatal}, '1') N
selected(${Id10281}, 'yes') N
selected(${Id10282}, 'no') or selected(${Id10282}, 'dk') or selected(${IN
(selected(${isNeonatal}, '1')) and ${Id10114}!='yes' N
 N
N
N
N
N
N
selected(${isAdult}, '1') A
selected(${isAdult}, '1') A
ALL
selected(${isAdult}, '1') and (${Id10019} = 'female' or ${Id10019} = A
not(selected(${Id10077_a}, 'less')) A
not(selected(${Id10077_a}, 'less')) A
(selected(${Id10296}, 'yes') or selected(${Id10296}, 'ref') or selected A
selected(${Id10299}, 'yes') A
not(selected(${Id10077_a}, 'less')) A
not(selected(${Id10299}, 'yes')) and (selected(${Id10296}, 'yes') or selA
selected(${Id10302}, 'yes') A
selected(${Id10299}, 'dk') or selected(${Id10299}, 'no') or selected(${A
selected(${Id10305}, 'dk')'yes'))
not(selected(${Id10312}, or selected(${Id10305}, 'no') or selected(${
and not(selected(${Id10305}, 'yes')) A
and not(selected(${Id10299}, 'yes') and ${ageInYears2}>49) A
selected(${Id10313}, 'yes') A
selected(${Id10314}, 'no') or selected(${Id10314}, 'dk') or selected(${IA
not(selected(${Id10312}, 'yes')) and not(selected(${Id10305}, 'yes')) A
selected(${Id10334},'yes') A
not(selected(${Id10312}, 'yes')) and not(selected(${Id10305}, 'yes')) aA
not(selected(${Id10305}, 'yes')) and not(selected(${Id10312}, 'yes')) aA
(((selected(${Id10314}, 'no') or selected(${Id10314}, 'ref') or selected A
selected(${Id10304},'yes') A
not(selected(${Id10310}, 'yes')) and not(selected(${Id10077_a}, 'less'A
A
A
A
A
A
${Id10309}>5 and selected(${Id10325}, 'yes') A
${Id10309}>5 A
${Id10309}>5 A
not(selected(${Id10305}, 'yes')) and not(selected(${Id10334}, 'yes')) A
not(selected(${Id10305}, 'yes')) and not(selected(${Id10334}, 'yes')) A
not(selected(${Id10305}, 'yes')) and not(selected(${Id10312}, 'yes')) A
not(selected(${Id10305}, 'yes')) and not(selected(${Id10312}, 'yes')) aA
not(selected(${Id10305}, 'yes')) and not(selected(${Id10334}, 'yes')) A
not(selected(${Id10305}, 'yes')) and not(selected(${Id10334}, 'yes')) A
not(selected(${Id10305}, 'yes')) and not(selected(${Id10334}, 'yes')) A
A
selected(${Id10342}, 'no') or selected(${Id10342}, 'ref') or selected(${A
not(selected(${Id10342}, 'yes')) and (selected(${Id10343}, 'no') or seleA
A
(not(selected(${Id10305}, 'yes')) and ((selected(${Id10334}, 'yes')
not(selected(${Id10305}, 'yes')) and not(selected(${Id10334}, 'yes')) A
or (selected(${Id10308}, 'yes') and (selected(${Id10313}, 'no') or
not(selected(${Id10305},
selected(${Id10313}, 'dk')'yes')) and not(selected(${Id10334},
or selected(${Id10313}, 'ref') ))) or 'yes')) A
selected(${Id10299}, 'yes')) and not((selected(${Id10299}, 'no') or A
selected(${Id10299},
${Id10319} > 0 'dk') or selected(${Id10299}, 'ref')) and A
selected(${Id10310}, 'yes')) or selected(${Id10313}, 'yes') or
selected(${Id10312}, 'yes') )and not(selected(${Id10077_a}, 'less')) A
A
A
not(selected(${Id10077_a}, 'less')) N_C
selected(${isNeonatal}, '1') or selected(${isChild}, '1') N_C
selected(${isNeonatal}, '1') or (selected(${isChild}, '1') and ${ageIn N_C
selected(${isNeonatal}, '1') or (selected(${isChild}, '1') and ${ageIn N_C
(selected(${isNeonatal}, '1') or (selected(${isChild}, '1') and ${ageI N_C
N_C
N_C
N_C
(selected(${isNeonatal}, '1') or (selected(${isChild}, '1') and ${ageI N_C
selected(${Id10363}, 'dk') or selected(${Id10363}, 'no') or selected(${IN_C
selected(${isNeonatal}, '1') or (selected(${isChild}, '1') and ${ageI N_C
selected(${isChild}, '1') and ${ageInMonthsByYear}<12 C
N_C
selected(${Id10370}, 'yes') or selected(${Id10370}, 'dk') or selected($N_C
selected(${Id10370}, 'yes') or selected(${Id10370}, 'dk') or selected($N_C
selected(${Id10372}, 'no') or selected(${Id10372}, 'dk') or selected(${N_C
N_C
(selected(${isNeonatal}, '1')) N
N
N
N
N
N
N
not(selected(${Id10387}, 'yes')) N
not(selected(${Id10387}, 'yes')) and not(selected(${Id10388}, 'yes')) N
N
N
selected(${Id10391}, 'yes') N
N
N
N
N
N
N
 N
N
N
N
N
N
N
N_C
selected(${isAdult}, '1') and not(selected(${Id10077_a}, 'less')) A
A
A
selected(${Id10413}, 'yes') A
selected(${Id10413_a}, 'months') or selected(${Id10413_a}, 'years') A
selected(${Id10413}, 'yes') A
A
selected(${Id10414}, 'yes') A
selected(${Id10414_a}, 'months') or selected(${Id10414_a}, 'years') A
selected(${Id10414}, 'yes') A
A
not(selected(${Id10114}, 'yes')) and not(selected(${Id10077_a}, 'less'ALL
ALL
selected(${Id10418}, 'yes') ALL
selected(${Id10418}, 'yes') ALL
selected(${Id10418}, 'yes') ALL
selected(${Id10418}, 'yes') ALL
selected(${Id10418}, 'yes') ALL
selected(${Id10418}, 'yes') ALL
selected(${Id10418}, 'yes') ALL
(selected(${Id10418}, 'yes') and ${isNeonatal} !='1') and selected(${Id C_A
ALL
selected(${Id10435}, 'yes') ALL
selected(${isNeonatal}, '1') or selected(${isChild}, '1') N_C
ALL
ALL
ALL
ALL
ALL
selected(${Id10069_a}, 'yes') ALL
selected(${Id10069_a}, 'yes') ALL
selected(${Id10071_check}, 'yes') ALL
selected(${Id10069_a}, 'yes') ALL
selected(${Id10069_a}, 'yes') ALL
ALL
ALL
ALL
 ALL
selected(${Id10462}, 'yes') ALL
selected(${Id10463}, 'yes') ALL
selected(${Id10463}, 'yes') ALL
selected(${Id10463}, 'yes') ALL
selected(${Id10463}, 'yes') ALL
selected(${Id10463}, 'yes') ALL
selected(${Id10463}, 'yes') ALL
selected(${Id10463}, 'yes') ALL
selected(${Id10463}, 'yes') ALL
selected(${Id10463}, 'yes') ALL
selected(${Id10463}, 'yes') ALL
ALL
ALL
ALL
ALL
ALL
label::English (en)

VA interviewer
(Id10010) [Name of VA interviewer]
(Id10010a) [Age of VA interviewer]
(Id10010b) [Sex of VA interviewer]
(Id10010c) [ID of VA interviewer]
Interview language

Preset HIV-Malaria mortality and season.

(Id10002) [Is this a region of high HIV/AIDS mortality?]
(Id10003) [Is this a region of high malaria mortality?]
(Id10004) [During which season did (s)he die?]

Information on the respondent and background about interview

(Id10007) What is the full name of VA respondent?
(Id10007a) [What is the sex of VA respondent?]
(Id10007b) What is the age of VA respondent?
(Id10008) What is your/the respondent's relationship to the deceased?
(Id10009) Did you/the respondent live with the deceased in the period leading to her/his death?
(Id10012) Date of the interview
(Id10013) [Did the respondent give consent?]
(Id10011) Start time of the interview

Skip to end if not consented

Information about the deceased and vital registration
Information on the Deceased
(Id10017) What was the first or given name(s) of the deceased?
(Id10018) What was the surname(s) (or family name(s)) of the deceased?
(Id10019) What was the sex of the deceased?
(Id10020) Is the date of birth known?
(Id10021) When was the deceased born?
(Id10022) Is the date of death known?
(Id10023_a) When did (s)he die?
(Id10023_b) When did (s)he die?
(Id10023) When did (s)he die?
(Id10024) Please indicate the year of death.
Age in Days
Age in Days
Age in Years

Age in Months

The deceased person is a Neonate

The deceased person is a Child
The deceased person is an Adult
NEONATE was ${ageInDays} days old.
CHILD was ${ageInYears} years ${ageInMonths} months and ${ageInMonthsRemain} days old.
ADULT was ${ageInYears} years old.
[What age group corresponds to the deceased?]
How many days old was the baby? [Enter neonate's age in days:]
How many hours was the baby alive?
How old was the child? [Enter child's age in:]
[Enter child's age in days:]
[Enter child's age in months:]
[Enter child's age in years:]
[Enter adult's age in years:]
Age in Months
Age in Years
The deceased person is a Neonate
The deceased person is a Child
The deceased person is an Adult
The deceased person is a Neonate
The deceased person is a Child
The deceased person is an Adult
Age in days
(Id10008_check) It is not possible to select that the respondent is the child of the deceased and enter that the deceased is a neonate or ch
(Id10058) Where did the deceased die?
(Id10487) In the two weeks before death, did (s)he live with, visit, or care for someone who had any C
(Id10051) [Is there a need to collect additional demographic data on the deceased?]
(Id10052) What was her/his citizenship/nationality?
(Id10053) What was her/his ethnicity?
(Id10054) What was her/his place of birth?
(Id10055) What was her/his place of usual residence? (the place where the person lived most of the year
(Id10057) Where did the death occur? (specify country, province, district, village)
(Id10059) What was her/his marital status?
(Id10063) What was her/his highest level of schooling?
(Id10064) Was (s)he able to read and/or write?
(Id10065) What was her/his economic activity status in year prior to death?
(Id10066) What was her/his occupation, that is, what kind of work did (s)he mainly do?
(Id10061) What was the full name of the father?
(Id10062) What notes
Record detailed was the full nameorofaudio
of response the mother?
record the response if the option is available. If needed, probe
the respondent for additional details on when the deceased recognized symptoms, abnormalities, care
sought, etc. Ask the respondent if any medical records from the time preceding death are available and
record any relevant information. Some of the following questions may be repetetive or irrelevant to the
Open narrative
respondent but they are very important in the COD assignment process.

(Id10476_audio) Thank you for your information. Now can you please tell me in your own words about th
(Id10476) Thank you for your information. Now can you please tell me in your own words about
(Id10477) [Select any of the following words that were mentioned as present in the narrative.]
(Id10478) [Select any of the following words that were mentioned as present in the narrative.]
(Id10479) [Select any of the following words that were mentioned as present in the narrative.]
Some of the following questions may be repetetive or irrelevant to the respondent but they are very important in the COD assignment pro

Verification of possible stillbirth

(Id10104) Did the baby ever cry?
(Id10105) Did the baby cry immediately after birth, even if only a little bit?
(Id10106) How many minutes after birth did the baby first cry?
(Id10107) Did the baby stop being able to cry?
(Id10377) Did the baby stop moving in the womb?
(Id10376) Did the baby stop moving before or after the onset of labour?
(Id10109) Did the baby ever move after being delivered?
(Id10110) Did the baby ever breathe?
(Id10111) Did the baby breathe immediately after birth, even a little?
(Id10112) Did the baby have a breathing problem?
(Id10113) Was the baby given assistance to breathe at birth?
(Id10114) If the baby didn't show any sign of life, was it born dead?
(Id10115) Were there any bruises or signs of injury on baby's body after the birth?
(Id10116) Was the baby's body soft, discoloured and the skin peeling away?

Medical history associated with final illness

Explain to the respondent that the following section contains a series of questions on whether diagnosis from a health professional was
(Id10125) Was there any diagnosis by a health professional of tuberculosis?
(Id10126) Was an HIV test ever positive?
(Id10127) Was there any diagnosis by a health professional of AIDS?
(Id10128) Did (s)he have a recent positive test by a health professional for malaria?
(Id10129) Did (s)he have a recent negative test by a health professional for malaria?
(Id10482) Was there any diagnosis by a health professional of COVID-19?
(Id10483) Did s(h)e have a recent test for COVID-19?
(Id10484) What was the result?
(Id10130) Was there any diagnosis by a health professional of dengue fever?
(Id10131) Was there any diagnosis by a health professional of measles?
(Id10132) Was there any diagnosis by a health professional of high blood pressure?
(Id10133) Was there any diagnosis by a health professional of heart disease?
(Id10134) Was there any diagnosis by a health professional of diabetes?
(Id10135) Was there any diagnosis by a health professional of asthma?
(Id10136) Was there any diagnosis by a health professional of epilepsy?
(Id10137) Was there any diagnosis by a health professional of cancer?
(Id10138) Was there any diagnosis by a health professional of Chronic Obstructive Pulmonary Disease (
(Id10139) Was there any diagnosis by a health professional of dementia?
(Id10140) Was there any diagnosis by a health professional of depression?
(Id10141) Was there any diagnosis by a health professional of stroke?
(Id10142) Was there any diagnosis by a health professional of sickle cell disease?
(Id10143) Was there any diagnosis by a health professional of kidney disease?
(Id10144) Was there any diagnosis by a health professional of liver disease?
Unless specified, the following questions on signs, symptoms, treatment and circumstances relate
specifically to the illness and the period of illness that led to death.

History of injuries/accidents
(Id10077) Did (s)he suffer from any injury or accident that led to her/his death?
Injuries and accidents detail
(Id10077_a) How long after the injury or accident did s/he die?
(Id10077_b) [Interviewer click "OK" to confirm the answer: She/died less than or equal to 7 days after the accident]
(Id10079) Was it a road transport injury?
(Id10082) Was it a non-road transport injury?
(Id10083) Was (s)he injured in a fall?
(Id10084) Was there any poisoning?
(Id10085) Did (s)he die of drowning?
(Id10086) Was (s)he injured by a venomous bite or sting from an animal or insect?
(Id10087) Was (s)he injured by an animal or insect (non-venomous)?
(Id10088) What was the animal/insect?
(Id10089) Was (s)he injured by burns/fire?
(Id10091) Was (s)he injured by a firearm?
(Id10092) Was (s)he stabbed, cut or pierced?
(Id10093) Was (s)he strangled?
(Id10096) Was s(h)e electrocuted?
(Id10094) Was (s)he injured by a blunt force?
(Id10095) Was (s)he injured by a force of nature?
(Id10097) Did (s)he suffer any other injury?
(Id10098) Was the injury accidental?
(Id10099) Was the injury self-inflicted?
(Id10100) Was the injury intentionally inflicted by someone else?

Health history
(Id10351) How many days old was the baby when the fatal illness started?
(Id10408) Before the illness that led to death, was the baby/the child growing normally?
Duration of illness
(Id10120_0) For how many days was (s)he ill before death?
(id10120_unit) For how long was (s)he ill before death?
(Id10121) Months
(Id10122) Years
(Id10120_1) Days
(Id10120) Calculated number of Days with illness

(Id10123) Did (s)he die suddenly?

General signs and symptoms associated with final illness
(Id10147) Did (s)he have a fever?
(Id10148_a) How many days did the fever last?
(Id10148_units) How long did the fever last?
(Id10148_b) [Enter how long the fever lasted in days]:
(Id10148_c) [Enter how long the fever lasted in months]:
(Id10148) How many days did the fever last?
(Id10149) Did the fever continue until death?
(Id10150) How severe was the fever?
(Id10151) What was the pattern of the fever?
(Id10153) Did (s)he have a cough?
(Id10154_units) For how long did (s)he have a cough?
(Id10154_a) [Enter how long (s)he had a cough in days]:
(Id10154_b) [Enter how long (s)he had a cough in months]:
(Id10154) For how many days did (s)he have a cough?
(Id10155) Was the cough productive, with sputum?
(Id10156) Was the cough very severe?
(Id10157) Did (s)he cough up blood?
(Id10158) Did (s)he make a whooping sound when coughing?
(Id10159) Did s/he have any difficulty breathing or breathlessness?
Duration of breathing difficulty
(Id10161_0) For how many days did the difficulty breathing or breathlessness last?
(Id10161_unit) For how long did the difficulty breathing or breathlessness last?
(Id10161_1) [Enter how long the difficult breathing or breathlessness lasted in days]:
(Id10162) [Enter how long the difficult breathing or breathlessness lasted in months]:
(Id10163) [Enter how long the difficult breathing or breathlessness lasted in years]:
(Id10161) Calculated number of Days with illness

(Id10165) Was the difficulty in breathing continuous or on and off?

(Id10170) Was (s)he unable to carry out daily routines due to breathlessness?
(Id10171) Was (s)he breathless while lying flat?
(Id10166) Did (s)he have fast breathing?
(Id10167_a) For how many days did the fast breathing last?
(Id10167_units) How long did the fast breathing last?
(Id10167_b) [Enter how long the fast breathing lasted in days]:
(Id10167_c) [Enter how long the fast breathing lasted in months]:
(Id10167) How long did the fast breathing last?
(Id10172) Did you see the lower chest wall/ribs being pulled in as the child breathed in (chest in-drawing
(Id10173_nc) Did his/her breathing sound like any of the following:
(Id10173_a) Did (s)he have wheezing?
(Id10173) During the illness that led to death did his/her breathing sound like any of the following:
(Id10174) Did (s)he have chest pain?
(Id10175) Was the chest pain severe?
(Id10176) How many days before death did (s)he have chest pain?
Duration of the chest pain
(Id10178_unit) How long did the chest pain last?
(Id10179) [Enter how long the chest pain lasted in hours]:
(Id10179_1) [Enter how long the chest pain lasted in days]:

(Id10181) Did (s)he have diarrhoea?

(Id10182_units) How long did (s)he have diarrhoea?
(Id10182_a) [Enter how long (s)he have diarrhoea in days]:
(Id10182_b) [Enter how long (s)he have diarrhoea in months]:
(Id10182) For how many days did (s)he have diarrhoea?
(Id10183) How many stools did the baby or child have on the day that diarrhoea was most frequent?
(Id10184_a) How many days before death did the diarrhoea start?
(Id10184_units) How long before death did the diarrhoea start?
(Id10184_b) [Enter how long before death the diarrhoea started in days]:
(Id10184_c) [Enter how long before death the diarrhoea started in months]:
(Id10185) Did the diarrhoea continue until death?
(Id10186) At any time during the final illness was there blood in the stools?
(Id10188) Did (s)he vomit?
(Id10190_units) For how long did (s)he vomit?
(Id10190_a) [Enter how long before death(s)he vomited in days]:
(Id10190_b) [Enter how long before death(s)he vomited in months]:
(Id10189) Did (s)he vomit in the week preceding the death?
(Id10189_1) Did s/he vomit every time s/he ate and/or drank?
(Id10191) Was there blood in the vomit?
(Id10192) Was the vomit black?
(Id10194) Did (s)he have abdominal pain?
(Id10195) Was the abdominal pain severe?
Abdominal pain
(id10196_unit) For how long did (s)he have abdominal pain?
(Id10196) [Enter how long (s)he had abdominal pain in hours]:
(Id10197_a) [Enter how long (s)he had abdominal pain in days]:
(Id10198) [Enter how long (s)he had abdominal pain in months]:
(Id10197) Calculated number of Days with abdominal pain

(Id10199) Where was the location of the abdominal pain?

(Id10200) Did (s)he have a more than usually protruding abdomen?
(Id10201_unit) For how long before death did (s)he have a more than usually protruding abdomen?
(Id10201_a) [Enter how long before death (s)he had a more than usually protruding abdomen in days]:
(Id10202) [Enter how long before death (s)he had a more than usually protruding abdomen in months]:
(Id10201) Calculated number of Days with protruding abdomen
(Id10203) How rapidly did (s)he develop the protruding abdomen?
(Id10204) Did (s)he have any mass in the abdomen?
(Id10205_unit) For how long did (s)he have a mass in the abdomen?
(Id10205_a) [Enter how long (s)he had a mass in the abdomen in days]:
(Id10206) [Enter how long (s)he had a mass in the abdomen in months]:
(Id10205) Calculated number of Days with a mass in the abdomen
(Id10207) Did (s)he have a severe headache?
(Id10208) Did s/he have a stiff or painful neck?
(Id10209_units) How long before death did s/he have a stiff or painful neck?
(Id10209_a) [Enter how long before death did (s)he have stiff or painful neck in days]:
(Id10209_b) [Enter how long before death did (s)he have stiff or painful neck in months]:
(Id10209) For how many days before death did (s)he have stiff or painful neck?
(Id10212) Did (s)he have mental confusion?
(Id10213_units) How long did (s)he have mental confusion?
(Id10213_a) [Enter how long (s)he had mental confusion in days]:
(Id10213_b) [Enter how long (s)he had mental confusion in months]:
(Id10213) For how many months did (s)he have mental confusion?
(Id10214) Was (s)he unconscious?
(Id10216_units) How long before death did unconsciousness start?
(Id10216_a) [Enter how long before death unconsciousness started in hours]?
(Id10216_b) [Enter how long before death unconsciousness started in days]?
(Id10216) How many hours before death did unconsciousness start?
(Id10217) Did the unconsciousness start suddenly, quickly (at least within a single day)?
(Id10220) Did (s)he experience any generalized convulsions?
(Id10222) Did (s)he become unconscious immediately after the convulsion?
(Id10275) Did the baby have convulsions starting within the first 24 hours of life?
(Id10276) Did the baby have convulsions starting more than 24 hours after birth?
(Id10223) Did (s)he have any urine problems?
(Id10226) During the final illness did (s)he ever pass blood in the urine?
(Id10224) Did (s)he stop urinating?
(Id10230) Did (s)he have an ulcer on the foot?
(Id10231) Did the ulcer on the foot have pus?
(Id10232_units) How long did the ulcer on the foot have pus?
(Id10232_a) [Enter how long the ulcer on the foot had pus in days]:
(Id10232_b) [Enter how long the ulcer on the foot had pus in months]:
(Id10232) For how many days did the ulcer on the foot ooze pus?
(Id10227) Did (s)he have ulcers or sores anywhere else on the body?
(Id10229) Did the ulcers or sores have pus?
(Id10233) Did (s)he have any skin rash?
(Id10234) For how many days did (s)he have the skin rash?
(Id10235) Where was the rash?
(Id10236) Did (s)he have measles rash?
(Id10237) Did (s)he ever have shingles or herpes zoster?
(Id10238) Did her/his skin flake off in patches?
(Id10239) Did he/she have areas of the skin that turned black?
(Id10240) Did he/she have areas of the skin with redness and swelling?
(Id10242) Did (s)he bleed from the nose, mouth or anus?
(Id10243) Did (s)he have noticeable weight loss?
(Id10244) Was (s)he severely thin or wasted?
(Id10245) Did s/he have a whitish rash inside the mouth or on the tongue?
(Id10246) Did (s)he have stiffness of the whole body or was unable to open the mouth?
(Id10247) Did (s)he have puffiness of the face?
(Id10248_units) How long did (s)he have puffiness of the face?
(Id10248_a) [Enter how long (s)he had puffiness of the face in days]:
(Id10248_b) [Enter how long (s)he had puffiness of the face in months]:
(Id10248) For how many days did (s)he have puffiness of the face?
(Id10249) Did (s)he have swollen legs or feet?
(Id10250_units) How long did the swelling last?
(Id10250_a) [Enter how long the swelling lasted in days]:
(Id10250_b) [Enter how long the swelling lasted in months]:
(Id10250) How many days did the swelling last?
(Id10251) Did (s)he have both feet swollen?
(Id10252) Did (s)he have general swelling of the body?
(Id10254) Did (s)he have any lumps or sores in the mouth?
(Id10253) Did (s)he have lumps anywhere else on the body?
(Id10255) Did (s)he have any lumps on the neck?
(Id10256) Did (s)he have any lumps on the armpit?
(Id10257) Did (s)he have any lumps on the groin?
(Id10258) Was (s)he in any way paralysed?
(Id10259) Did (s)he have paralysis of only one side of the body?
(Id10260) Did she have paralysis of both legs?
(Id10261) Was there difficulty or pain in swallowing?
(Id10262_units) For how long did (s)he have difficulty or pain in swallowing?
(Id10262_a) [Enter how long before death (s)he had difficulty or pain in swallowing in days]:
(Id10262_b) [Enter how long before death (s)he had difficulty or pain in swallowing in months]:
(Id10262) For how many days before death did (s)he have difficulty swallowing?
(Id10262_c) Did swallowing become impossible?
(Id10265) Did (s)he have yellow discoloration of the eyes?
(Id10266_units) For how long did (s)he have the yellow discoloration?
(Id10266_a) [Enter how long (s)he had the yellow discoloration in days]:
(Id10266_b) [Enter how long (s)he had the yellow discoloration in months]:
(Id10266) For how many days did (s)he have the yellow discoloration?
(Id10267) Did her/his hair change in color to a reddish or yellowish color?
(Id10268) Did (s)he look pale or have pale palms, eyes or nail beds?
(Id10269) Did (s)he have sunken eyes?
(Id10271) Was the baby able to suckle or bottle-feed within the first 24 hours after birth?
(Id10272) Did the baby ever suckle in a normal way?
(Id10273) Did the baby stop suckling?
(Id10274_a) How many days after birth did the baby stop suckling?
(Id10274_units) How long after birth did the baby stop suckling?
(Id10274_b) [Enter how long after birth the baby stopped suckling in days]:
(Id10274_c) [Enter how long after birth the baby stopped suckling in months]:
(Id10274) How many days after birth did the baby stop suckling?
(Id10277) Did the baby's body become stiff, with the back arched backwards?
(Id10278) Did the baby have a bulging or raised fontanelle?
(Id10279) Did the baby have a sunken fontanelle?
(Id10281) Did the baby become unresponsive or unconscious?
(Id0282) Did the baby become unresponsive or unconscious within 24 hours after birth?
(Id10283) Did the baby become unresponsive or unconscious more than 24 hours after birth?
Neonatal child questions part C
(Id10284) Did the baby become cold to touch?
(Id10286) Did the baby become lethargic after a period of normal activity?
(Id10287) Did the baby have redness or pus oozing from the umbilical cord?
(Id10288) Did the baby have skin ulcer(s) or sore(s)?
(Id10289) Did the baby have yellow skin, palms or soles?

(Id10485) Did s(h)e suffer from extreme fatigue?

(Id10486) Did (s)he experience a new loss, change or decreased sense of smell or taste?

Signs and symptoms associated with pregnancy and women

(Id10294) Did she have any lump(s) and/or ulcer(s) in the breast?
(Id10296) Did she ever have a period or menstruate?
(Id10299) Did her menstrual period stop naturally because of menopause?
(Id10300) Did she have vaginal bleeding after cessation of menstruation?
(Id10301) Was there excessive vaginal bleeding in the week prior to death?
(Id10302) At the time of death was her period overdue?
(Id10303) For how many weeks had her period been overdue?
(Id10305) Was she pregnant and not yet in labour at the time of death?
(Id10312) Did she die during labour or delivery?
(Id10313) Did she die after delivering a baby?
(Id10314) Did she die within 24 hours after delivery?
(Id10306) Did she die within 6 weeks after delivery?
(Id10334) Did she have a pregnancy that ended in an abortion or miscarriage within 6 weeks before her death?
(Id10333) Did she attempt to terminate the pregnancy?
(Id10308) Did she die less than 1 year after delivery, abortion or miscarriage?
[ Please confirm that in the 12 months prior to her death, the woman was not pregnant, she did n
(Id10304) Did she have a sharp abdominal pain in the first 3 months of pregnancy?
(Id10304_a) Did she faint when she had the sharp abdominal pain?
Questions about possible maternal deaths
(Id10309) For how many months was she pregnant?
(Id10317) How many babies was she pregnant with?
(Id10321) During pregnancy, did she suffer from high blood pressure?
(Id10322_a) Did she have foul smelling vaginal discharge during pregnancy?
(Id10325) Did bleeding occur while she was pregnant?
(Id10327) Was there vaginal bleeding during the last 3 months of pregnancy but before labour started?
(Id10323) Did she suffer from convulsions during the last 3 months of pregnancy and/or after delivery?
(Id10324) Did she have blurred vision during the last 3 months of pregnancy and/or after
(Id10328) Did she have excessive bleeding during labour or delivery?
(Id10329_a) Did she have excessive bleeding after delivery?
(Id10329_b) Did she have excessive bleeding during or after abortion or miscarriage?
(Id10322_b) Did she have foul smelling vaginal discharge after delivery/abortion?
(Id10331) Did she deliver or try to deliver an abnormally positioned baby?
(Id10332) For how many hours was she in labour?
How did the mother deliver her baby?
(Id10342) Was the delivery normal vaginal, without forceps or vacuum?
(Id10343) Was the delivery vaginal, with forceps or vacuum?
(Id10344) Was the delivery a Caesarean section?

(Id10330) Was the placenta completely delivered?

(Id10337) Where did she give birth?
(Id10319) How many births, including stillbirths, did she/the mother have before this p
(Id10320) Had she had any previous Caesarean section?

(Id10340) Did she have an operation to remove her uterus shortly before death?

Neonatal and child history, signs and symptoms

Neonatal child questions part A
(Id10354) Was the child part of a multiple birth?
is the child health card is available?
Weight (in grammes) of the deceased at birth
Enter the birth weight from the card. Record the weight in grammes in 4 digits. For data entry, convert to grammes as needed. 1 kilogram=
(Id10366) What was the weight (in grammes) of the deceased at birth?

(Id10363) At birth, was the baby smaller than usual, (weighing under 2.5 kg)?
(Id10365) At birth, was the baby larger than usual, (weighing over 4.5 kg)?
(Id10367) How many months long was the pregnancy before the child was born?
(Id10369) Were there any complications during labour or delivery?
(Id10370) Was any part of the baby physically abnormal at time of delivery? (for example: body part too large or too small, additional grow
(Id10371) Did the baby/ child have a swelling or defect on the back at time of birth?
(Id10372) Did the baby/ child have a very large head at time of birth?
(Id10373) Did the baby/ child have a very small head at time of birth?

(neonatal_childB) Neonatal child questions part B

(Id10382) How many hours did labour and delivery take?
(Id10383) Was the baby born 24 hours or more after the water broke?
(Id10384) Was the liquor foul smelling?
(Id10385) What was the colour of the liquor when the waters broke?
(mother_deliv) How was the baby delivered?
(Id10387) Was the delivery normal vaginal, without forceps or vacuum?
(Id10388) Was the delivery vaginal, with forceps or vacuum?
(Id10389) Was the delivery a Caesarean section?

(Id10391) Did you/the baby's mother receive any vaccinations since reaching adulthood including during this pregnancy?
(Id10393) Did you/the baby's mother receive tetanus toxoid (TT) vaccine?
(Id10395) During labour, did the you/the baby's mother suffer from fever?
(Id10396) During the last 3 months of pregnancy, labour or delivery, did you/the baby's mother suffer from high blood pressure?
(Id10397) Did you/the baby's mother have diabetes mellitus?
(Id10398) Did you/the baby's mother have foul smelling vaginal discharge during pregnancy or after delivery?
(Id10399) During the last 3 months of pregnancy, labour or delivery, did you/the baby's mother suffer from convulsions?
(Id10400) During the last 3 months of pregnancy did you/the baby's mother suffer from blurred vision?
(Id10401) Did you/the baby's mother have severe anemia?
(Id10402) Did you/the baby's mother have vaginal bleeding during the last 3 months of pregnancy but before labour started?
(Id10403) Did the baby's bottom, feet, arm or hand come out of the vagina before its head?
(Id10404) Was the umbilical cord wrapped more than once around the neck of the child at birth?
(Id10405) Was the umbilical cord delivered first?
(Id10406) Was the baby blue in colour at birth?

Risk factors
(Id10411) Did (s)he drink alcohol?
(Id10413) Did s/he ever smoke tobacco?
(Id10413_a) For how long did s/he smoke tobacco?
(Id10413_d) How many (months/years)
(Id10413_b) Did s/he ever smoke daily?
(Id10414) Did s/he ever chew and/or sniff tobacco?
(Id10414_a) For how long did s/he chew and/or sniff tobacco?
(Id10414_d) How many (months/years)
(Id10414_b) Did s/he ever chew and/or sniff tobacco daily?

Health service utilisation

(Id10418) Did (s)he receive any treatment for the illness that led to death?
(Id10419) Did (s)he receive oral rehydration salts?
(Id10420) Did (s)he receive (or need) intravenous fluids (drip) treatment?
(Id10421) Did (s)he receive (or need) a blood transfusion?
(Id10422) Did (s)he receive (or need) treatment/food through a tube passed through the nose?
(Id10423) Did (s)he receive (or need) injectable antibiotics?
(Id10424) Did (s)he receive (or need) antiretroviral therapy (ART)?
(Id10425) Did (s)he have (or need) an operation for the illness?
(Id10426) Did (s)he have the operation within 1 month before death?
(Id10435) Did a health care worker tell you the cause of death?
(Id10436) What did the health care worker say?
(Id10446) Has the deceased’s (biological) mother ever been told she had HIV/AIDS by a health worker?

Civil registration numbers

Civil registration: "This refers to the legal death certificate obtained from the civil registration authorities (show image of local death certific
(Id10069_a) Do you have a Death Certificate from the Civil Registry?
(Id10070) [Death registration number/certificate]
(Id10071_check) [Is the date of registration available?]
(Id10071) [Date of registration]
(Id10072) [Place of registration]
(Id10073) [National identification number of deceased]

Medical certificate of cause of death

Death certificate with cause of death: "This refers to the medical certificate of cause of death (show image of local medical certificate of ca
(Id10462) Was a medical certificate of cause of death issued?
(Id10463) Can I see the medical certificate of cause of death?
(Id10464) [Record the immediate cause of death from the certificate (line 1a)]
(Id10465) [Duration of the immediate cause of death (Ia):]
(Id10466) [Record the first antecedent cause of death from the certificate (line 1b)]
(Id10467) [Duration of the first antecedent cause of death (Ib):]
(Id10468) [Record the second antecedent cause of death from the certificate (line 1c)]
(Id10469) [Duration of second antecedent cause of death (Ic):]
(Id10470) [Record the third antecedent cause of death from the certificate (line 1d)]
(Id10471) [Duration of third antecedent cause of death (Id):]
(Id10472) [Record the contributing cause(s) of death from the certificate (part 2)]
(Id10473) [Duration of the contributing cause(s) of death (part2):]

End time of the interview

[ Inform the respondent that the VA interview has come to an end. Thank the respondent for their time and answers, and ask if the respon
(comment) Comment
hint::English (en)

Enter 99 if do not wish to disclose age

Enter "NA" if ID of interviewer is not available.

<span style="color:red">Should be completed by the central off

<span style="color:red">Should be completed by the central off
<span style="color:red">Should be completed by the central of

First verify if the respondent is a family member, and only if it

The period leading to her/his death refers to the period when th

If the deceased was a stillborn baby, enter the date of delivery

If the deceased was a stillborn baby, enter the date of delivery
 Please verify that the age is correct, before you proceed. You will now be filling in the questionnaire for a NEONATE.
Please verify that the age is correct, before you proceed. You will now be filling in the questionnaire for a CHILD.
Please verify that the age is correct, before you proceed. You will now be filling in the questionnaire for an ADULT.
(1) Neonatal 0-27 completed days; (2) Child 28 days - through 11
Neonatal age is under 28 days, or 0 to 27 completed days. If less than 1 day or 24 hours, enter 0 days. A response is required fo

Child age is between 28 days through 11 years. A response is required for this question. If the exact age is unknown, enter the

A response is required for this question. If the exact age is unknown, enter the best estimate.

and enter that the deceased is a neonate or child. Please go back and correct the selection.

COVID-19 symptoms include fever, difficulty breathing, cough, e

If you choose 'No', this question allows to skip asking details a

Enter a “-“ if this information is not available.

Specify here village and district. A question on the facility and c
For perinatal cases, just ask for the address of the health facil
<span style="color:red">Should be completed as instructed by t
Life partner is defined here as living with someone for a long t

This question is aimed at measuring literacy (i.e. not disability)

The deceased might have had several activities. Choose the one

[Record the audio information or skip and enter the text on next question]
[If there's no information available, please enter "no information available"]
y are very important in the COD assignment process.

If the respondent is unable to answer, prompt: Did the baby fir

This question serves to finally determine if the baby was born a

Macerated means the body was pulpy. This indicates

ether diagnosis from a health professional was obtained for a number of illnesses. Clarify that the aim of this series is on medical diagnosis of specifi
Remind the respondent that we are asking for the diagnosis asses
Remind the respondent that we are asking for the diagnosis asses
Remind the respondent that we are asking for the diagnosis asses
Remind the respondent that we are asking for the diagnosis asses
Remind the respondent that we are asking for the diagnosis asses
Remind the respondent that we are asking for the diagnosis asses
Remind the respondent that we are asking for the diagnosis asses
Prompt for the result of the most recent test in case the dece
Remind the respondent that we are asking for the diagnosis asses
Remind the respondent that we are asking for the diagnosis asses
Remind the respondent that we are asking for the diagnosis asses
Remind the respondent that we are asking for the diagnosis asses
Remind the respondent that we are asking for the diagnosis asses
Remind the respondent that we are asking for the diagnosis asses
Remind the respondent that we are asking for the diagnosis asses
Remind the respondent that we are asking for the diagnosis asses
Remind the respondent that we are asking for the diagnosis asses
Remind the respondent that we are asking for the diagnosis asses
Remind the respondent that we are asking for the diagnosis asses
Remind the respondent that we are asking for the diagnosis asses
Remind the respondent that we are asking for the diagnosis asses
Remind the respondent that we are asking for the diagnosis asses
Remind the respondent that we are asking for the diagnosis asses
 Establish whether the deceased died within 7 days or more of the accident or injury that led to death. This is important as it will determine
days after the accident]

Non-road transport injuries include those involving air (e.g.

This includes accidents and cases where it is unknown if it was
This includes accidents and cases where it is unknown if it was
This includes accidents and cases where it is unknown if it was
This includes accidents and cases where it is unknown if it was

This includes accidents and cases where it is unknown if it was

A blunt force trauma is a non-penetrating injury from an object
Forces of nature can include lightning, flooding, earthquake, tsu

If the respondent is unable to answer, prompt: Was s(h)e ill

Maximum number
for less than 1 weekof- days for neonates
interviewer is 27
to enter days.1The
6 days; to 2answer cou
weeks - interviewer to enter 13 days; 2 to 3 weeks -
interviewer to enter 20 days; 3 to 4 weeks – interviewer to
enter 27 days.

If the respondent is unable to answer, prompt: Was s(h)e ill fo

Less than 24 hours = 0 days.

If the respondent is unable to answer, prompt: Did

Suddenly
the feverrefers to dying
last less within
than 24 hours
1 week of being in to
(interviewer regular
entergoo
6 days); less than two weeks (interviewer to enter
13
Feverdays); or more
is a term thanthe
used when 2 weeks( interviewer
body feels abnormally to enter
warm or
15 days)? Enter 1 unit only: 0-30 days or 1-60
If less than 1 day or 24 hours, enter 0 days. Use 1 week = 7 da
months. Less than 1 day or 24 hours = 0 days; 1
week
Enter = 7 days.
0-30 days. Less than 1 day or 24 hours = 0
days; 1 week = 7 days.
Enter 1-60 months.
If the respondent is unable to answer, prompt: Did
the cough last less than 3 weeks (interviewer to
enter 20 days); or at least 3 weeks (interviewer to
enter 22 days)? Enter 1 unit only: 0-30 days or 1-60
months. Less than 1 day or 24 hours = 0 days; 1
week
Enter = 7 days.
0-30 days. Less than 1 day or 24 hours = 0
days; 1 week = 7 days.
Enter 1-60 months.

If the respondent
Breathing difficulties is
areunable to answer,
an important featureprompt: Did
that aid identifi
the difficulty breathing or breathlessness last for
less than 3 days (interviewer to enter 2 days), or for
If
atless than
least 3 1days
day or 24 hours, enter
(interviewer 0 days.4Use
to enter 1 week = 7 da
days)?
Enter 0-30 days. Less than 1 day or 24 hours = 0
days; 1 week = 7 days.
Enter 1-60 months.
Enter number of years less than age at death.

A person with severe breathlessness will struggle to do daily routines, such as walking short distance or taking a bath, and will need assista

If the respondent is unable to answer, prompt: Did

the difficulty breathing last for less than 2 weeks
If less than 1 day or 24 hours, enter 0 days. Use 1 week = 7 da
(interviewer to enter 13 days), or for at least 2
weeks0-30
Enter (interviewer
days. Lessto enter
than 15 days)?
1 day or 24 hours = 0
days; 1 week = 7 days.
Enter 1-60 months.

Ask only for children under the age of 12 years. Show photos if

If the respondent is unable to answer, prompt: Did s(h

Round up the response given by the respondent as neede

Enter 0-23 hours.
Enter 0-30 days. 1 week = 7 days.

Ask the respondent about his/her understanding of what is diarr

If the respondent is unable to answer, prompt: Did the
Enter 0-30 days. Less than 1 day or 24 hours = 0
days; 1 week = 7 days.
Enter
If 1-60 months.
the respondent is unable to answer, prompt: Did
the diarrhoea start less than 3 days before death
(interviewer
For don't know,toenter
enter 2 days),
"99." or didenter
For refused, it start
"88."at least 3
days before death (interviewer to enter 4 days)?
If the respondent is unable to answer, prompt: Did the diarrhoea
Enter 1 unit only: 0-30 days or 1-60 months. Less
than
Enter10-30
day or 24 hours
days. = 0 days;
Less than 1 day1orweek = 7 days.
24 hours =0
days; 1 week = 7 days.
Enter
If 1-60 months.
the respondent is unable to answer, prompt: Did
s(h)e vomit for less than 3 days (interviewer to enter
2 days), or for more than 3 days (interviewer to
enter 4 days)? Enter 1 unit only: 0-30 days or 1-60
months. Less than 1 day or 24 hours = 0 days; 1
week =
Enter 7 days.
0-30 days. Less than 1 day or 24 hours = 0
days; 1 week = 7 days.
Enter 1-60 months.

In some instances, there could be minor bleeding into the stoma

If the respondent is unable to answer, prompt: Did the

Enter 1-23 hours.
Enter 0-30 days. 1 week = 7 days.
Enter 1-60 months.
If the respondent is unable to answer, prompt: Did
s(h)e have a more than usual protruding abdomen
for less than 2 weeks (interviewer to enter 13 days),
or for at least 2 weeks (interviewer to enter 15
days)? Enter 1 unit only: 0-30 days or 1-60 months.
A morethan
Less than1usual
dayprotruding
or 24 hoursabdomen presents
= 0 days; as an expansio
1 week =7
days.
Enter 0-30 days. Less than 1 day or 24 hours = 0
days; 1 week = 7 days.
If the respondent
Enter 1-60 months. is unable to answer, prompt: Did
s(h)e have a mass in the abdomen for less than 2
weeks (interviewer to enter 13 days), or for at least
2 weeks (interviewer to enter 15 days)? Enter 1 unit
Abdominal
only: 0-30mass
daysis or
a localized swelling Less
1-60 months. or enlargement in one
than 1 day or
24 hours
Enter = days.
0-30 0 days; 1 week
Less than=1 7day
days.
or 24 hours = 0
days; 1 week = 7 days.
Enter 1-60 months.
If the respondent is unable to answer, prompt: Did
s/he have a stiff or painful neck for less than 1 week
(interviewer to enter 6 days), or for at least 1 week
(interviewer to enter 8 days)? Enter 1 unit only: 0-
30 days or 1-60 months. Less than 1 day or 24
hours = 0 days;
Enter 0-30 days.1Less
weekthan=71days.
day or 24 hours = 0
days; 1 week = 7 days.
Enter 1-60 months.
If the respondent is unable to answer, prompt: Did
the mental confusion last for less than 3 months
(interviewer to enter 2 months), or for at least 3
months (interviewer to enter 4 months)? Enter 1 unit
only: 0-30 days or 1-60 months. Less than 1 day or
24
If hours
Enter
the 0-30 = days.
0 days;
respondent is1unable
Lessweek
than= 1 7day
to days.
or 24prompt:
answer, hours =Did
0
days; 1 week = 7 days.
the unconsciousness start less than 6 hours before
death (interviewer
Enter 1-60 months.to enter 5 hours), did it start
between 6 and 23 hours (interviewer to enter 23
hours); or did it start at least 24 hours before death
(interviewer to enter 1 day)? Enter 1 unit only: 0-23
hours or 1-99 days. 1 week = 7 days.
The question needs input in hours but the respondent may not kn
If more than 99, enter 99.

Convulsions are rapid twitching or jerking movements of the wh

Urine problems can include pain or difficulty in passing urine, p

If the
This respondent
means is unable
that the deceased to answer,
stopped prompt:
urinating and didDid
not uri
the ulcer on the foot have pus for less than 2 weeks
(interviewer to enter 13 days), or for at least 2
weeks (interviewer to enter 15 days)?
Enter 0-30 days. Less than 1 day or 24 hours = 0
days; 1 week = 7 days.
Enter 1-60 months.
If the respondent is unable to answer, prompt: Did the
skin
Ulcersrash
andlast forrefer
sores lesstothan 1 week
breaking (interviewer
of the to enter
skin or mucous 6
membr
days), or for at least 1 week (interviewer to enter 8
days)? . Less than 1 day or 24 hours = 0 days; 1
week=7 days; 1 month=30 days. Enter "99" for "don't
know." Enter "88" for "refuse."

If the respondent is unable to answer, prompt: Did

the puffiness of the face last for less than 1 week
(interviewer to enter 6 days), or for at least 1 week
(interviewer to enter 8 days)? Enter 1 unit only: 0-
Clarify with the respondent that puffiness of the face can includ
30 days or 1-60 months. Less than 1 day or 24
hours = 0 days;
Enter 0-30 days.1Less
weekthan
=71 days.
day or 24 hours = 0
days; 1 week = 7 days.
Enter 1-60 months.
If the respondent is unable to answer, prompt: Did
the swelling last for less than 3 days (interviewer to
enter 2 days), or for more than 3 days (interviewer
to enter 4 days)? Enter 1 unit only: 0-30 days or 1-
60 months. Less than 1 day or 24 hours = 0 days; 1
week
Enter = 7 days.
0-30 days. Less than 1 day or 24 hours = 0
days; 1 week = 7 days.
Enter 1-60 months.

Lumps can be in the neck, armpit, groin or other areas of the b

If the respondent is unable to answer, prompt: Did

the difficulty or pain in swallowing last for less than 1
week (interviewer to enter 6 days), or for at least 1
week
Enter (interviewer
0-30 days. Lessto enter
than81days)?
day or 24 hours = 0
days; 1 week = 7 days.
Enter
If 1-60 months.
the respondent is unable to answer, prompt: Did
the yellow discoloration last for less than 3 weeks
(interviewer to enter
The question aims 20ifdays),
to know or for
it became at leastfor3the decea
impossible
weeks (interviewer to enter 22 days)? Enter 1 unit
only: 0-30 days or 1-60 months. Less than 1 day or
24 hours
Enter 0-30= days.
0 days; 1 week
Less than=1 7day
days.
or 24 hours = 0
days; 1 week = 7 days.
Enter 1-60 months.

Long term deficiency of the blood results in a pale, whitish appe

If the
This respondent
question should is
beunable to answer,
asked only if the childprompt:
was less Did
than 1
the baby stop suckling within the first day of life
This question should be asked only if the child was less than 1
(interview to enter 0 days), or at least by the second
This question should be asked only if the child was less than 1
day of life (interviewer to enter 3 days)? Enter 1 unit
If the respondent
only: 0-30 daysisor
unable
1-11tomonths.
answer, prompt:
Less Did the 1
than baby stop s
day
or 240-30
Enter hours = 0Less
days. days;
than1 1week
day or=24 7 hours
days.= 0
days; 1 week = 7 days.
Enter 1-11 months.

This question should be asked only if the child was less than 1
Show photo if available.
Show photo if available.
This question should be asked only if the child was less than 1 ye
This question should be asked only if the child was less than 1 ye
This question should be asked only if the child was less than 1 ye
 Probe whether the deceased felt so tired that (s)he found it har

If the answer is "NO", please ensure that there was no chance

If the respondent is unable to answer, prompt: Was the

period overdue
Important for less than
is the excessive 4 weeks
quantity (interviewer to enter
of blood.
3 weeks) or for at least 4 weeks (interviewer to enter 5
weeks)?. Less than 1 week=0. 7 days=1 week. Enter
"99" for "don't know." Enter "88" for "refuse."
A "Yes" response to this question means a foetus or baby remain
A "Yes" response to this question excludes women dying during
Note that a maternal death is relevant up to 1 year after deliver

s before her death?

Note: If this was a maternal death, please go back to i

If the respondent is unable to answer, prompt: Was she pregnant

The last 3
The last 3 months
months of
of pregnancy
pregnancy refers
refers to
to the
the 7th-9th
7th-9th months
months of
of
Thea last
full term pregnancy.
3 months of pregnancy refers to the 7th-9th months
of a full term pregnancy.
Here the excessive quantity of blood DURING birth is what we as
Here the excessive quantity of blood AFTER birth is what we ask
Here
If thethe excessive is
respondent quantity
unableoftoblood AFTER
answer, abortion
prompt: or misscarr
Was she
in labour for less than 24 hours (interviewer to enter 23
hours), or for more than 24 hours (interviewer to enter 25
Enquire
hours). the
Lessrespondent about his/hers
than 60 minutes understanding
= 0 hours. 1 day=24 of what is a
hours.
Enter "99" for "don't know." Enter "88" for "refuse."
 For don't know, enter "99." For refused, enter "88."

Question is relevant for cases of obstructured labour and ruptu

This question should be asked only if the child was less than 1 y

try, convert to grammes as needed. 1 kilogram=1,000 grammes.

Show photos if available. This question should be asked only if t

Show photos if available. This question should be asked only if t
If the respondent is unable to answer, prompt: Did the pregnanc

body part too large or too small, additional growth on body)?

If the respondent is unable to answer, prompt: Did the labour la

luding during this pregnancy?

ther suffer from high blood pressure?

y or after delivery?
ther suffer from convulsions?
gnancy but before labour started?

To clarify, the series inquires about tobacco consumption about a

[ If deceased smoked for less than 1 month, enter 1 month as du

The question intends to know if there was ever a period in the

To clarify, the series inquires about tobacco consumption about a

The question intends to know if there was ever a period in the l

Injectable antibiotics exclude immunisations, vaccines

n authorities (show image of local death certificate if available)."

Enter a “-“ if this information is not available.

Enter a “-“ if this information is not available.

Record the National Identification Number. For newborns that hav

th (show image of local medical certificate of cause of death if available)."

 The following information serves only to complete cause of deat
This section aims to collect information from the international
If this detail is not present, record "-” (not available).
For all following lines, add duration, if stated. If this detail is n
An antecedent cause is the one that caused the one on the line ab
If this detail is not present, record "-” (not available).
If this detail is not present, record "-” (not available).
If this detail is not present, record "-” (not available).
If this detail is not present, record "-” (not available).
If this detail is not present, record "-” (not available).
If this detail is not present, record "-” (not available).
If this detail is not present, record "-” (not available).

or their time and answers, and ask if the respondent has any question(s) or c
guidance_hint::English (en) required

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likely "YES", according
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may beinterviewers.</span> How the information is completed
"NO" if the respondent indicates a circumstance where they were not with their varies by site, but ideally it is yes
question
filled hidden
by the central the
office; with interviewers being able to edit the information if verified differently in
neonate.</span> yes
consultation with the centralIf office.</span>
<span style="color:blue">● the respondent is not the mother and it was a stillbirth, record "YES" if the
respondent indicates that (s)he lived with the mother of the deceased. </span>
<span style="color:blue">●
style="color:blue">Record If the therespondent
reportedisname not the of themother and it was
respondent. a neonate,
Report namesifstandardly
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needed However,
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respondent
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needed. </span>
<span
<span style="color:blue">First
style="color:blue">Record verify
the if the respondent is a family member, theand only if refer
it is not a familyto the yes
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style="color:blue">NOTE:
style="color:blue">Record
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Unless
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Question
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have shown symptoms in the past, but if the person recovered from these symptoms prior to the death,
yes
they are not likely related to the death.</span> yes
<span style="color:blue">Select the appropriate response. If the respondent did not give consent, close the
interview here, and record the time the interview was completed.Consent is asked following Id10007-10009
as the minimum information needed for quality control of VA processes. </span> yes

<span style="color:blue">Verify the name(s) of the deceased in the paperwork/electronic list on the
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electronic
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<span style="color:blue">Record the year of death. </span> yes

 symptoms did s(he) have, when did the respondent/family realise it was severe, who recognized the first
and most severe symptoms);</span>
<span style="color:blue"> ● Timing (how long it took from first symptoms to realising it was severe);
</span>
<span style="color:blue"> ● Actions taken in home and outside the home (how long after first symptom(s)
and
<span severe symptom(s) was any
style="color:blue">This action
item applies taken, forwhat actions, was
the electronic datathere any treatment
collection format only. given, what
If you weretreatment,
unable
who made the
to complete thedecision
full datetoofseek birth oror notdate to seek
of death care,you reasonwill be forforced
this action,
to selectif care outside the home was not
a questionnaire
sought – why?)</span>
corresponding to the three age groups: neonate, child or adult. Select the age group of the deceased, based
oceed. You will
onnow
<span be filling in the
yourstyle="color:blue">
assessment of questionnaire
the●age of thefor
Transport a NEONATE.
(time
deceased. spent fromthis
Select making option thevery
decision
carefully. for seeking
If you make care aoutside
mistake thein
home
thenow
oceed. You will agetobe getting
group, transport,
fillingimportant
in type of transportation
questions
the questionnaire will
for be skippedused
a CHILD. becauseto reach some thesections
first level of care
of the and any potential
questionnaire depend on
referrals,
the age group time to spent during transport,
determine the questions any asked.
delays Note that may that have occurredisbefore
this question used to reaching
determine care). </span>
which
oceed. You will nowstyle="color:blue">
<span
sequence be of filling in the questionnaire
questions to ● Provider
use. This is for
a an ADULT.
behaviour
required (advice given,
question. If the treatment
respondent given,
does hownot long
know did theit take
exact toage,
<span
receive style="color:blue">If
the care after reaching youhealth
have selected
care services, the neonatal
complete questionnaire,
referral history, youtiming
have to ofenter the time
referral, age in spent yes
enter
days. the best
Neonatal estimate.</span>
on travel to andage is under
between 28 days,reasons
facilities, or 0 tofor 27 notcompleted
going ordays; delaying a valid entry isreferral
referral, between 0 and 27. If the
experience).</span>
neonate is less than 1 day When
<span style="color:blue"> or 24 hours,
attempting enterto "0" suspected COVID-19 deaths, the open narrative can yes
days.</span>
identify
be very useful to uncover important details and information not included in the closed questions’ section of yes
s. A responsethe is VA
information
questionnaire. For guidance on useful questions that can be used to probe respondents on relevant
required forfor this question.
COVID-19, see theIfPCVA the exactguidance agemanual
is unknown, (to be made enteravailable
the beston estimate.
the WHO VA standards yes
webpage). The checklist below provides a list of additional items that may be included in the open narrative yes
if identified in the interview. You should feel free to denote additional items even if they are not included on
the checklist. </span> yes
<span style="color:blue"> CHECKLIST OF ADDITIONAL ITEMS TO RECORD IN THE NARRATIVE OPEN yes
SPACE</span>
ct age is unknown,
<spanenter the best estimate.
style="color:blue"> ● If there is an official police or medico-legal opinion as to the cause of death – yes
provided by local authorities (usually for accidents or injuries). Additional information about injuries If the
family reported an injury, record the specifics of the injury (type, mode, location of event, and affected body
parts that were injured);</span>
<span style="color:blue"> ● If it was self-inflicted even when you did not ask;</span> yes
<span style="color:blue"> ● if it was an accident in transport other than on the road, e.g. fatal injury from
train / boat / aircraft; </span> yes
<span style="color:blue">Having a recent history
<span style="color:blue"> ● If a fall, record the body parts injured; </span> of living with, visiting or caring for someone who had yes
suffered from COVID-19 would
<span style="color:blue"> ● If a suggest
poisoning that fromthepesticides,
deceased,kerosene, too, mightorhave any suffered from COVID
other chemicals, record 19.thePlease
type
take note that in the case of neonates or young children, you should omit from the question “care for”. The yes
of poison;</span>
respondent may not know●whether
<span style="color:blue"> If a drowning,the deceased had anywhere
record location contact thewith a person
drowning with COVID-19.
occurred – river / lake However,
/ sea / yes
you can probe gently.
swimming pool, etc.;</span> First ask whether anyone who lived with or visited the deceased tested positive for
COVID-19. Sometimes people
<span style="color:blue"> who had
● If injured bysymptoms
burns / fire, suggestive
record the ofallCOVID-19
of the body mayparts
not haveaffecteddonebyaburns test toand yes
confirm COVID-19.
how the burn occurred;</span> In case the respondent says that no one whom the deceased lived with or visited the yes
deceased had a COVID test,
<span style="color:blue"> ● Ifthen gently
injured by probe
a forcewhether of nature, anyone
recordhad thethetype following
of force symptoms: high fever,
of nature (lightning, flood, yes
ck and correctdifficulty in breathing,
the selection.
earthquake, etc.). </span> cough, extreme fatigue and changes in smell and/or taste. If someone had tested
positive
<span or had at least 4 ofAdditional
style="color:blue">Record
<span style="color:blue">
style="color:blue">The these
projectsymptoms,
thesiteplace
findings willin thenof
determineselect
thedeath ifthe
bythis
deceased</span> answer
selecting “YES”.</span>
information the appropriate
should be collected. box.</span> If you yes
<span
<span
choose style="color:blue">NOTE:
style="color:blue">
"NO", you will skip●details The
If the deceased
aboutquestions
the had
place from
any of Id10051
birth defects,
residence, to Id10073
describeare
education, body
andrelated
part(s)
family. to Ifcitizenship,
and
you what
select it socio
looked
"YES",
<span
economics style="color:blue">Select
like, and/or are
if thenotdeceased
required the appropriate
for assessing
had ambiguous causes response
of may
death.</span>
genitalia/intersex. according
</span> to the local definitions for citizenship. A yes
proceed
naturalized with next question. Site programmers make this question hidden to the of the country. A
<span style="color:blue"> ● If you recorded the birth weight given to you become
interviewers.</span>
citizen is an individual that was born elsewhere but now has and it was a citizen
self-reported (not yes
foreign
verified national
on the records),is an individual
<span style="color:blue">Record then record who isreported
thethat notthea birth
citizen of theDo
weight
ethnicity. washost
not country
reported
probe too in which
by the
much (s)he
if theisrespondent
respondent residing oris
here. </span>
temporarily
<span staying.</span>
style="color:blue">
Enter “-“, ● If theinformation
deceased appeared healthyorand
uncomfortable.
<span
<span style="color:blue">Select
style="color:blue">Record if this thethe is not
appropriate
reported place available
ofresponse.
birth. SpecifyAdied
if the life suddenly
respondent
partner
here
(unexpectedly
villageisis notdistrict.
similar
and to aAtowithin
happy report
common
question
24the
on
hours of
ethnicity.
law being
partner. </span> in regular
These termshealth) and
indicate there
a are any
partnership other
where details people aboutare theliving
death, record
together them (e.g.
continuously happened in a
the
duringfacility and circumstances
the sleep). In some instances,
<span style="color:blue">For will be
perinatal asked
thiscases,
may belater.
justtheEnter
askmain a “-“
for the if this
information information
address ofprovided the health is not
by the available
respondent.
facility or unknown.
or if released </span> and
relationship
</span>
<span
at home, equivalent
style="color:blue">
the home address. to marriage.
● IfFortheneonatal
deceased The response
had
deaths, a recent
the placeoptions
health provided
visit,
of residence notewill are
any used
details
usually by the
of the
be the algorithms.
diagnosis,
same location as
Note that
laboratory
where setting
tests,
the death andspecific
treatment
occurred.</span> terms etc.may in the beopen relevantnarrative andsection
whereofpossible use local terminology to
the questionnaire.</span>
<span
ascertain
<span style="color:blue">You
marital status ●asIflong
style="color:blue"> can fill
there asisin anytheadditional
original city/town
meaning instead
has not
information of village
been
on ifaltered.
health more applicable.
services Response
or medical The question
options
opinions should
should
be be
customized customized specifically
specifically for for
the the
local local context
context by by
the the project
project
provided on the cause of death for the deceased who may have attended medical care prior to his/her death, team.</span>
team.</span>
record that here. </span> yes
<span style="color:blue">
style="color:blue">Select ● If theappropriate
deceased received response. or Answer
needed treatment "YES" also or foodone
if only passed through
of either the nose,
reading or
<span
enquire
writing style="color:blue">Select
howknown
was long feedings
to the deceased. the appropriate
were provided Note through
that havethisresponse.
the tube and
question </span> whether
is aimed the tube was
at measuring in place
literacy (i.e.prior
not to death,
<span style="color:blue">The
and record ifrelevant information deceased
here. might
</span> had several activities. Choose the one that was probably
disability),
true the deceased learned to read and/or write in her/his lifetime.</span>
<spanforstyle="color:blue">
most of the year preceding ● If the deceasedillness and haddeath. Select appropriate
any presence of lumps onresponse. the neck, If if the
there response
was an opinionis
“Mainly
as to the
<span employed”,
style="color:blue">This proceed
medical cause for thequestion with the
lump andwill next question.
(s)heonly received
be Otherwise,
asked treatment,
if the names skip to
record to
response Id10476</span>
relevant
Id10065 information
is “Mainly here. </span>
employed”.
<span
<span style="color:blue">Record
style="color:blue"> ● If the the father’s
deceased hadfullan name. Report
operation, enquire from standardly as first
the respondent name
if (s)he(given
knows the
Record
name), the
surname.appropriate response.</span>
medical conditionThis (e.g.information
<span style="color:blue">Record cancer, stomach may
the be
mother’s used
ulcer, forname.
heart
full civil registration
disease, etc.)names
Report thatpurposes
was theand/or
standardlyreason asto forassist
firstthe
name in matching
operation;
(given note or
location
relevant purposes.</span>
details here.</span>
name), surname. This information may be used for civil registration purposes and/or to assist in matching or
<span
location style="color:blue">
purposes.</span>Maternal and delivery information</span>
<span style="color:blue"> ● For stillbirths and neonatal deaths, record any details of the pregnancy, labour
and delivery. </span>
<span style="color:blue"> ● If the water broke for delivery, and the water was abnormal, record any
description here. </span>
<span style="color:blue"> ● If the mother died and you obtained any additional information, record what you
learned about the mother’s death (e.g. timing of death in relation to delivery, symptoms, etc.).</span>
er the text on nextstyle="color:blue">This
<span
<span question]
style="color:blue">This question lists some of the key risks associated with mortality in the age group
question liststheir
some of the key risks associatedsurrounding with
of the deceased.
er "no information available"] After the respondent has provided description of the circumstances the yes
mortality in the age group of the deceased. After
death, read back through and record all of the key words which they may have mentioned that the the respondent has provided their
deceased had.</span>
description of the circumstances surrounding the death, read back through and record all of yes
the key words which they may have mentioned that the deceased had. </span> yes
 <span style="color:blue">This question lists some of the key risks associated with
mortality in the age group of the deceased. After the respondent has provided their
description
<span of the circumstances
style="color:blue">Crying surrounding
is a sign of breathing.the
If a death, read
baby cried at back
birth, itthrough
indicatesand
thatrecord allwas
the baby of
the key
<span
alive words
birth. which
In some they question
atstyle="color:blue">This may
instances, have
the baby mentioned
is relevant
may not for that
cry both
but were
therepresent
potential
still be ainvisible
responses
may thethedeceased.</span>
to previous effort,
breathing butIf yes
question.
the
this answer
may be to Id10105
difficult was "YES",
to observe. thenthe
Hence thisreliance
questiononaims the to cryconfirm
at birth,the to timing. If the babyand
signify breathing, cried therefore
immediately,
life. There is arecord
separate as “0” (zero)on
question minutes.
breathing However,
later onif in thethis crysection.
was delayed, then theonly
This question timepertains
it took between
to crying.
birth
This and
is an the first cryfilter
important is a helpful
question, indicator
as a to assess
negative whether
response willthe babytowards
point died from a events that
stillbirth. occurred
Stillbirth
<span
during style="color:blue">The
labour or delivery. Probe timing of the
carefully first
to28find cry
outistheindicative
time and of record
whether in the baby’sAhealth
minutes. valid was refers
response affected
is
to
babies
by born
events0–60 with
during no signs
the pregnancy,of life at or after
labour or can’t weeks
delivery. of
Probe gestation.
carefully Fetal death before 28 weeks is regarded
between
as abortion minutes.
or miscarriage. If the
Ifthe respondent
"NO/DK/Ref", skip recall the exact
to Id10377. timewhether
If "YES", interval
proceed
the baby cried
between
withhavethe the
immediately
nextbirth and the first
after birth, and if so, record response as "YES". In some instances,
cry, prompt and record according to what is medically relevant to capture: if baby cried approximately there may been some delay yes
question.</span>
(from
withinone to several
5 minutes minutes) to
(interviewer between
enter 4birth, and the
minutes); or iffirst
baby cry. In such
cried a case, record
approximately afterthemoreresponse
than 5asminutes
“NO”,
yes
and proceed to
(interviewer with
enter the6next question.
minutes). For </span>
“don’t know”, enter “99”. For “refused to answer”, enter “88”. If the
<span
<span
style="color:blue">Reduced
respondent states
style="color:blue">Athat the baby
baby
movements
never cried,
that cried
leading
revert
at birth back
may
totocomplete
become Id10104 absence
and
weak and enter ofthe
movement,
stoptocryingcorrect particularly in
response.</span>
laterAton. This is an it
yes
the
<spandays to hours before
style="color:blue">This the delivery, may
questiondeaths. be a
is to confirm sign that
the death
well-being occurred
of the prior
foetus delivery.
during</span> a minimum,
the period leading yes
indicator
is for sign
some causes
thereofmay neonatal Probe carefully to
of get
the the true response.
upatowarning
the delivery. that
Absence be a problem
of movements wouldwithsuggest
the health
the potential foetus.
for theMothers
baby beingare usually
stillborn. aware
Noteof yes
such changes, and can recall and report this sign. If the response
that this question is not required for the automated analysis software, but it serves as an internal is "NO/DK/Ref" skip to Id10109.</span>
consistency check.</span>
<span style="color:blue">This question helps to confirm a positive response to the previous question. Probe
yes
<span
<span style="color:blue">Ask this question only if the response to Id10114 was "YES", i.e. yes
carefully style="color:blue">Similar
to get the true response in to
orderthe question
to make thisabout
important the first cry
distinction, afterand birth,
record this question
“YES” if the too
baby
<span
breathed style="color:blue">The
immediately after birth. provision
On the ofother
special
tohand,attention
if there towasassist
somewith breathing
delay in the atonset
birth ofisorindicative
breathing, of
it is yes
it was
<span
there
an a stillbirth.
being
important a serious
indicator Inproblem
style="color:blue">This
style="color:blue">If thisthe question
regarding
question
response
with the the weto are
serves
health
potential thisof looking
finally
question
the
cause newborn.
of isto"YES",
determine
death. assess
Assistance
In which the
itifconfirms
the integrity
baby
could
case,
was
thatbe
record ofthe
born
this
in
the the
alive
was a skin
form
answer liveof of“NO”,
dead.
birth.
as aThis
As
question
<span is to be asked only if the
style="color:blue">This responses
question to Id10104;
clarifies whether Id10109;
thereor was and Id10110 are
a noticeable issueanyincombination
regard be theof
to readily yes
stillborn
proceed
"NO/DK/Ref".
breathing baby.
stimulation/rubbing
and of with
he Sometimes
A baby.theofThe
"YES" next
response the
the question.</span>
back/buttocks,
to this
acknowledgement term “macerated”
chest
question compression,
of awould
breathing is problem
indicate used that tothe
oral
atdescribe
resuscitation.
babyiswas
birth antheborn skin
This dead.
important ofindicator
would stillborn
In which of case,
recalled by the respondent, and should be confirmed in there is a positive response. Assistance to breathe
babies.
the "YES"
conditions
<span
could haveWhen
response
such
been macerated
as would
birth
style="color:blue">Birth
provided
need
asphyxia.
for theisinjury
both used
to </span> to describe
be means
followed
stillbirths an up with
injury
asthere
well may skin,
as that
live it means
questions
occurred Id10115 that
during theId10116;
and
birth, skin,
such sometimes
asand subsequent
a large bruise,
yes
instructions after Id10116.On other hand,may bebirths with
a possibility delayed/difficult
thatAfter
despite thebreathing,
nature of so the
answers
discoloured,
swelling
response
to previous
on the
needs has
head,
to
questions, bepeeled
or broken
taken or
in is
bone peeling.
conjunction
the respondent
which
may Macerated
with lead
the
say "NO", (i.e.
to death
responses means
theare to the
ofprevious
the
baby was on body
child. was pulpy.
asking
questions.</span>
notthe
born dead), in
and This
recordingindicates
the yes
response tothis case, If the
that
proceedthetoto
response to
Id10115, apply
baby
the hasquestion
next
Id10114 been
was
the following
dead
"YES" i.e.(i.e. inside instructions,
Id10115.</span>
stillborn the mother
child); then or
which
somebased
proceed totime.
Id10116. If the response
term
If the
Id10114.
macerated
response to Id10114 is not yes
used then listen(i.e.
was "NO/DK/Ref" forlivea similar
born); then description
proceed toofId10077</span>
skin integrity – peeling, pulpy, discoloured, yes
etc.After Id10116, if this was a stillbirth, skip to Id10354.</span> yes

number of illnesses. Clarify that the aim of thisthe

<span style="color:blue">Remind series is on medical
respondent diagnosis
that we of specific
are asking illnesses, assessed
for the diagnosis and not on
by signs and symptoms or the perceived ca
a doctor,
health worker, or other health professional during the final illness.</span> yes
<span style="color:blue">Ask if the deceased had ever been tested for HIV, and if so, whether the tyes
<span style="color:blue">Ask whether the deceased was ever diagnosed to have AIDS, the final illnes yes
<span style="color:blue">Ask whether a malaria test (dipstick or blood slide) was done during the illyes
<span style="color:blue">Ask whether a malaria test (dipstick or blood slide) was done during the ilyes
<span style="color:blue">Ask whether the deceased was ever diagnosed to have COVID-19. Remindyes the
<span style="color:blue">Ask whether a COVID-19 test (nasal/throat swab or dipstick; viral rapid testyes
<span style="color:blue">If the deceased had been tested for COVID-19, probe gently about what was the result. In case some
<span style="color:blue">Ask whether a diagnosis of dengue was done during the illness that led toyes
<span style="color:blue">Ask whether a diagnosis of measles was done during the illness that led toyes
<span style="color:blue">Ask whether the deceased was ever diagnosed to have high blood pressure yesby
<span style="color:blue">Ask whether the deceased was ever diagnosed to have heart disease by ayes ph
<span style="color:blue">Ask whether the deceased was diagnosed to have diabetes by a physicianyes or
<span style="color:blue">Ask whether the deceased was diagnosed to have asthma by a physician or yesa
<span style="color:blue">Ask whether the deceased was diagnosed to have epilepsy by a physician yes or
<span style="color:blue">Ask whether the deceased was ever diagnosed to have cancer by a physician yes
<span style="color:blue">Ask whether the deceased was diagnosed to have COPD by a physician oryes any
<span style="color:blue">Ask whether the deceased was ever diagnosed to have dementia by a physicia yes
<span style="color:blue">Ask whether the deceased was ever diagnosed to have depression by a physi yes
<span style="color:blue">Ask whether the deceased was diagnosed to have a stroke by a physician yes or
<span style="color:blue">Ask whether the deceased was ever diagnosed to have sickle cell disease by yes
<span style="color:blue">Ask whether the deceased was diagnosed to have kidney disease by a physicia yes
<span style="color:blue">Ask whether the deceased was diagnosed to have liver disease by a physician yes
 <span style="color:blue">This is an opening question to check whether the death was associated with any
injury or accident. If the response is “YES”, proceed with the following questions. These questions are
generally straightforward and readily understood, with little potential for error in the response, except in
the case of stigma or apprehension of involvement with police or other administration.If the answer is
<span style="color:blue">This
"NO", then skip to Id10351. However, is an opening questionis to
if the answer check whether
"DK/Ref", the deathshould
the interviewer was associated
probe further withandany injuyes
<span
<spanstyle="color:blue">Establish
continue with the subsequent questions.
style="color:blue">Enquire if the
anddeceased
record ifdied
</span> the within
death 7was daysdue or more
to anofinjurythe accident
in transport or injury that
other
led to death. This is important as it will determine the length of the VA interview. If within 7 days, then the yes
than
<span
or more of the on
accident
deceased the orroad.
likely diedThese
style="color:blue">Road
injury that led
from include
the to death.
accident fatal
transport injuries
injuries
This
or involving
are
is important
injury and
theas
only itair
most
some will (e.g.
common plane),
determine
maternal
causes rail
the
questions
of (e.g.
deaths
length will train),
of from
the sea
VA
betransport
asked or
injuries river
interview.
in
in
addition If
developing
(e.g. boat, countries.
canoe) You do
transportation. not need If to have
"YES", been
record in a
the vehicle
nature to ofhave
the suffered
accident a road
and the injuries injury, yes
to
forthe injury for
example section.
deaths If more than 7 days,the
of pedestrians. theresponse
full VA interview will be conducted.</span>
sustained in the free text section ofIfthe questionnaire. to Id10079
If theisresponse
"YES", questions
to Id10082 Id10082–Id10097
is "YES",
<span
should style="color:blue">If
questionsbe skipped. If
Id10083–Id10097
<span style="color:blue">If the the
answer response
is
the should is
"NO/DK/Ref",
death was be due "YES",
skipped. then
then record
go to the body
Id10082.</span>
If the answer
to poisoning parts
is "NO/DK/Ref",
from pesticides, that were
kerosene,then injured
or any in
goother
to the yes
narrative section
Id10083.</span>
chemicals, of the
record "YES" here, questionnaire. This includes accidents and cases where it is unknown if it was an yes
<span style="color:blue">If
accident orandwhether there was theand note the
response
intentional
naturerecord
isviolence.If
"YES", of the thepoison
the response
in thewhere
location narrative
to Id10083 the section.
drowning
iswas
"YES",
This includes
occurred
questions Id10084–
accidents cases
–river/lake/sea/swimming where it
poolis unknown
– in if it
the narrative was an accident
section of or
thego whether
questionnaire. there intentional violence.
This includes accidents and yes
Id10097
Poisoning should
from be skipped. Ifanimal
the answer is "NO/DK/Ref", then to Id10084.</span>
cases where it issnakebite
unknownor if it was an sting etc.
accident isor
not to be included
whether there was here. If the response
intentional violence.If to Id10084
the responseis "YES",to yes
questions
Id10085 is Id10085–Id10097
"YES", questions should be
Id10086–Id10097 skipped. If the
should answer
be skipped. is "NO/DK/Ref",
If the answer then
is go to
"NO/DK/Ref", Id10085.</span>
then go to
<span style="color:blue">Record "YES", if the injury was due to snake bite or any other poisonous insect. yes
Id10086.</span>
This includes accidents and cases where it is unknown if it was an accident or whether there was intentional
violence. If "YES", skip to Id10088.</span>
<span style="color:blue">Record "YES" in the case of dog bite, or injuries from an attack by another animal,
yes
<span style="color:blue">Burn
and record the detail in the response injuriestoresulting
the nextinquestion.
death usually cover extensive
If "NO/DK/Ref", skip to parts of the body. If the
Id10089.</span> yes
response is "YES", then record the parts of the body affected by burns in the narrative section of the yes
<span style="color:blue">Select
questionnaire.If the response to dog, snake, insect,questions
scorpion, or other. If not known, select "DK". </span>
<span style="color:blue">Use theId10089
local term is "YES",
for firearms, andId10091–Id10097
record the response. should be skipped.
If the responseIftothe yes
answer
Id10091 is "NO/DK/Ref", then
is "YES", questions Id10092–Id10097 go to Id10091.</span> should besuch skipped. If the
<span style="color:blue">The use of sharp instruments as knife oranswer
sword shouldis "NO/DK/Ref",
be recorded then go to
here. If yes
Id10092.</span>
the response to Id10092 is "YES", questions Id10093–Id10097
<span
<span style="color:blue">Use
style="color:blue">If thethe localwas
death term due fortochoking theshould
electricofshock, neck
record bybeforce,
skipped.
whether
"YES" here.
If theby answer
hand,isrope
This includes or
accidents yes
"NO/DK/Ref",
other object. then
If the go to
response Id10093.</span>
toifId10093 is accident
"YES", questions Id10094–Id10097 should be skipped. If the
and cases where it is unknown it was an or whether there was intentional violence. If the yes
answer
response is to
"NO/DK/Ref",
Id10096 is "YES", then go to Id10096.</span>
questions Id10094–Id10097
<span style="color:blue">Injury caused by blunt force suchshould as a stick be skipped.
or a heavy If the
object,answer which is "NO/DK/Ref",
may not cause yes
then
directgo to Id10094.</span>
<span external injury but can be sufficiently
style="color:blue">Forces of nature include seriouslightning,
to cause flood,
fractures, internal bleeding
earthquake, tsunami, and bushdeath. Explain
fire, volcanic yes
the meaning
eruption, etc. ofIf blunt
the force, and
response is recordthen
"YES", the response
record the accordingly.</span>
force of nature in the narrative section of the
<span style="color:blue">In case the injury occurred under circumstances that do not fit into the above
<span style="color:blue">This
questionnaire.
categories (e.g.Ifhanging,
the responselandmine isblast
is "YES",a sensitive
skip question,
etc.)torecord
Id10100. given the
the </span>
response traumatic
accordingly personal
in the narrative event. Ensure yes
that this question
section.</span> is put across in an empathetic manner, and allow sufficient time for the yes
respondent to answer. This is a subjective opinion of the respondent. If possible, try to
corroborate the evidence with other local information, and record notes in the narrative portion yes
<span style="color:blue">This question identifies whether the injury was unintentional. If "YES", go to Id103
of the questionnaire. If "YES", go to Id10120_unit.</span>
<span style="color:blue">Enquire if the injury was caused by an act of violence either directly by another
yes
person or by a circumstance intentionally created by another person (e.g. act of terrorism).</span> yes
<span
<span style="color:blue">This
style="color:blue">Ask the question
number is asked
of days to(s)he
determine
was ill the agethe
during in days at that
illness the start
lead of
to the illness.
death. In
If less
most
than instances of early neonatal death, this would be right from the day of birth, day zero. You should only
<span24style="color:blue">Select
answer
hours, enter “0”. A validthe
in days. The maximum
entry
number
is less
bestof unit
days
than
for
the neonate’s
according to the
neonates is 27
age at death.
response
days. – days,
Less
Ifmonths,
than
the respondent
24 hours or=years.
0
can’t
days. Use
recall
If less 1
exactly
than 24 how many
hours, days
select wasand
days theenter
deceased
“0”.of Ifilldays.
before
the death,was
response prompt
greater andthan
record according
30 For
days, ask theto respondent
what is medically
to
week =
relevant 7 days to determine the number For don’t know, enter “99”. refused, enter “88”.
report
Responseinto capture. If the
either
shouldmonths
not be or
deceased
years.
more
wasresponse
If the
than the week
age
ill for:</span>
thewas greater than 11 months, ask the respondent to report yes
<span style="color:blue">●
in years. A valid response is less
style="color:blue">The than
than 1the
question
less is to of neonate
- interviewer
ascertain
child’s to
age atadeath.
atenter
period death.</span>
Ifofthe 6respondent
days;</span>
normal health can’t
whererecall
thereexactly
is the
<span style="color:blue">●
growth/weight gain before 1
theto 2 weeks
onset of -
the interviewer
terminal to enter
illness. 13
</span> days;</span>
duration of illness, prompt and record according to what is medically relevant to capture:</span>
yes
<span
<span style="color:blue">●
style="color:blue">● 2 if to
the3deceased
weeks - interviewer to enter
was ill for less than 20 days;</span>
3 weeks - interviewer to enter 14
<span style="color:blue">● 3 to 4 weeks – interviewer to enter 27 days.</span>
days;</span>
<span
<span style="color:blue">For
style="color:blue">● if don’t know, enter
the deceased “99”.
was ill For refused
for more than 3to answer,
weeks enter “88”.</span>
- interviewer to enter 1
yes
month.</span> yes
yes
yes
yes
yes
<span style="color:blue">Fever is a term used when the body feels abnormally warm or hot to touch,
and/or when a thermometer records an abnormally high temperature. Fever is a common symptom of
<span style="color:blue">Ask
infections, and is often presentwhether
in acute the deceased
combination died unexpectedly
withfever
other within 24 hourssign
of being yes
in regular goo
<span style="color:blue">In most infections, issymptoms.
present forFever is a1–2
at least subtle in newborn
days during the period
infants, and
leading to may not
death. be noticed
In some chronicbyinfections,
the mother or relatives.
fever Most communities
can be present / languages
for a longer duration. have a local
Obtaining the term
for fever, which
approximate shouldisbe
duration included
helpful in the local
in making languageoftranslated
the diagnosis version
the specific of theIf questionnaire.If
infection. the24
less than 1 day or
response is "NO/DK/Ref", skip to Id10153.</span>
hours, enter “0”. Use 1 week = 7 days to determine the number of days. For don’t know, enter “99”. For
yes
refused, enter “88”.</span> yes
yes
yes
yes
 symptoms pertaining to other body systems. In some cases, there may be frequent,
recurrent episodes of cough over several years, so if required, the interviewer should
clarify this point with the respondent. Probe carefully and if necessary double check to
ensure
<span an accurate response
style="color:blue">Cough is ato the duration
common symptom ofand
cough
very during
important thesign
period leadingand
of infections toother
conditions
death.Select of thethe respiratory
best unit system.
according Respiratory
to theconditions
response such as pneumonia
– days or months. are sometimes present is
A valid response
during
<span
between terminal stages
0–30 days or 1–60of
style="color:blue">Severity other illnesses
refers
months. especially
to the
For in
degree the
of
less than elderly,
fever, hence
which
1 day maya positive
be response
rather
oror24breathlessness
hours, high in
enterwhether to this
some
“0” days. question
Use
<span
<span
can bestyle="color:blue">In
conditions,style="color:blue">Duration
found.
when Askthethisbody the with
question
feels case of
verycare
hot.fevers
of
In the
and of difficult
longer
double
many duration,
check
instances, breathing it is
aitnegative
may beimportant
response,
difficult forto know
asthe can
thisrespondent
will lead tothe
help fever
toa skip of
define
was
1
all
the also
week
other a
= part
7
questions
severity of of
days. the
fever, A terminal
likely
onhence
cough.recordillness
response
If therethe period
isdegreeis prior
less
a positiveof to
thandeath.
response
severity 60 </span>
months.
for cough,
perceived If
care
and the response
should
reported be
by taken
the given was
in following
respondent. up
Select
yes
understand
<span the severity
style="color:blue">Some of the illness
infections and
produce its relationship
characteristic to
patternsthe cause
of the of death.
feverrespondent
–iscontinuous, In young
or on and
greater
closely
the than
with
appropriate
children the60
with months,
subsequent
response.</span>
asthma, the confirm
questions
difficulty thewithresponse,
characterising
breathingtheand enter
cough.for
occurs "60".If
Nenonates:this
as specific episodesasked because can’t
lasting recall
cough
for a yes
off;
can or fever
be a sign only
of at night. In
a lung infection case the question
or other prompt is not
health problem directly understood,
relatedaccording
to the throat mention these different patterns
exactly
and
few enquire
days, theatifduration
the
the fever
most. of thethe
followed
In cough,
any
caseof these
of and record
patterns,
breathing and record
difficulty the
with toorwhat
response
pneumonia,
chest. isitAlthough
medically
accordingly.</span>
may be
cough may
present
not be a prominent
relevant signIfofthe
disease in newborn infants, it can be recalled by the mother, and is a useful
for a fewto
diagnostic
capture.
days
sign. Ifup to 1–2 weeks,
"NO/DK/Ref",
cough lasted:</span>
skip toduring the illness. In very young children (neonates and
Id10159.</span> yes
<span
infants). style="color:blue">●
the difficulty may be less than 3only
present weeks - interviewer
for several hoursto orenter
up to20 2–3 days;</span>
days. Hence,
<span style="color:blue">● at least 3 weeks – interviewer to enter 22 days. </span> in yes
depending on the age and the likely condition, the response on duration of difficulty
breathing
<span could vary. Usually
style="color:blue">Often the history
a person may justofhave breathlessness
a dry cough. When associatedsomeonewith congenital
is suffering from
yes
heart diseases
diseases like pneumonia will beorseveralTB, a bout weeks.
of cough However,
could endepisodes with the spitting of breathlessness
of some secretions in asthma
produced yes
from
usually
<span the breathing
last only tubes
style="color:blue">Thefor a in few the chest, in
days,
severity which
of the isfinal
the cough termed episode
refersas phlegm
to itsbefore (sputum).The
prominence death.among Insecretions
thethe case could
symptomsof bepresent clear or
<span
whitish style="color:blue">A
fluid,
breathlessness or coloured child
(pus), orwith even pneumonia
blood (see may produce
Id10157). Therestreaksis of
often blood
a local in the
term sputum.
for phlegm, This may
which
in theoccur
<span
also deceased. It in children
is often
style="color:blue">Breathing
in tuberculosis difficult
and
with
lung cancer,
pneumonia,
todifficulties
define severity.
but
itHowever,
may also becould
importantone
are anconditions
these feature
are
for aassess
that aid
relatively
few days the only. of
severity
rareidentification
in children.
Select
ofcough
the cause
Presence
the
by
of yes
should
asking be
if used
there to
were probe.</span>
prolonged bouts of cough, or whether the cough was aggravated by lying down
best
of death,
blood unit
in the according
andsputum
can be is to
observed the response
a readilyinrecognized
the form of – days,
abnormally
sign, months,
and something or
noisy breathing,years.
that respondents If less
as if created than 24
by some
are likely hours, sort of
to remember, select as
position
daystoand
obstruction
told or physical
them enter
inbythe exertion,
“0”.
theairways If the
deceased and/or
response it affected
(windpipe).Breathlessness
or witnessed was
by them. sleep.
greater is</span>
This than
defined
sign often 30 days,
as taking ask breaths,
deep
also triggers thean respondent
or having
attempt to seek report yes
atofeeling
health
of
in or
care, observed
hencemonths
either to beor
is usually making
remembered
years. anIfexcessive
theby response or extra was
relatives.</span> effortgreater
to breathe. than A short
11 months, period ofask breathlessness
the respondent can yes
occur
to report
<span in association
in years.
style="color:blue">In with
A pneumonia
valid response
some as part is
instances, of
less the the terminal
than the
child may illness
age make in
at neonates.If
death.If
a loud can thethe
whooping deceased
respondent was
sound while can’t breath yes
<span
reported style="color:blue">Duration
to have difficulty breathing ofand/or
the difficult breathing or
breathlessness, breathlessness
record “Yes”. If the help understand
response is "NO/DK/Ref", the
recall
severity exactly
of the illness
skip to Id10166.</span> the duration of the difficulty
and its relationship to the cause breathingof death. orRecord
breathlessness,
the number of prompt
days forand which record
the yes
according
child was observed to what to isbemedically
having difficulty relevant breathing to capture.
or being Ifbreathless.the difficulty If it was breathing
observedor only less than 1
day = 0 days. A response
breathlessness lasted: to </span>
the duration of difficulty breathing can go from 0–30 days. Use 1 week = 7 days
to determine the
<span style="color:blue">● number of days.less For don’t
than know, 3 days enter “99”. For refused,
- interviewer to enter enter “88”.</span>
2 days; </span> yes
<span style="color:blue">● at least 3 days – interviewer to enter 4 days. </span>
yes
<span style="color:blue">Usually the duration of fast breathing in the case of pneumonia yes
will be similar to the duration of the final illness. If the respondent reports a longer duration yes
of fast breathing 2022 WHO VA questionnaire for the death of a child aged under 4 weeks yes
to 11 years than final illness clarify that you are asking about the fast breathing during the
final
<span illness. Select the best
style="color:blue">In unit according
advanced stages oftoheart
the response
failure, –COPD,
orcausing daysbreathlessness
or months. A even valid occurs
<span
response style="color:blue">As described above, the breathing difficulty wheezing inhours,
asthma is on and yes
in of
when lying flat, and often interferes with sleep. In many instances, the person sleeps in a enter
<span is between
style="color:blue">Fast 0–30 days
breathing or 1–60
usually months.
accompanies For less
fever, andthan is 1
one day
of or
the 24
signs of pneumonia propped “0”
neonates
o do daily routines,
days.
up position such
Use and as children.
walking
1with
week several This
=short isdistance
7 days. a subtle
pillows or
Atolikelysign,
taking
support andathe
response may
bath, not
back isbe
and and noticed
will
less thanto
need
neck. bewhether
assistance
60
Ask independent
months. from of breathlessness
Ifsomeone.
the the response
deceased was or yes
noisy
given breathing.
breathless
<span was greater
while This is usually
than
lying flat
style="color:blue">The 60 a
during subjective
months,
duration theof finalobservation
confirm
fast illness,
breathing the and of the
response,
record
indicates respondent, and of illness but is a difficultassign
so
enter
the response.</span>
severity record"60". the If response
the respondent told,for yes
without
recognition further
and probing.
recall. the Neonates
If less than 1 day and children
or 24fast if
hours, the response
enter “0”. prompt is "NO/DK/Ref",
A valid duration skip to Id10172.
cannotaccording
be longer than For the yes
can’t
ADULTS recall
ONLY exactly
- if "NO/DK/Ref" durationskips to ofId10173_a</span>
the breathing, and record to what
agemedically
is in days of the deceased.
relevant Use 1 week
to capture. If =the7 days
fasttobreathingdeterminelasted:</span>
the number of days. For don’t know, enter
“99”.
<span For refused, enter “88”.</span>
style="color:blue">Chest
<span style="color:blue">● less than 2 weeks - interviewer pain associated with cardiac disease to enter is usually of acute onset and yes
13 days;</span>
short duration. It often occurs within 24 hours before death. However, there may have been
<span
previousstyle="color:blue">●
episodes of acute sudden at least chest weeks
pain, –orinterviewerchronic chest to painenterunder medication, which may yes
15 days.</span>
appear
<span on exercise. If there were
style="color:blue">Usually themultiple
chestshould
walls episodes,
rise record during
and expand the duration since the caselast severe yes
<span
chest style="color:blue">VA
pain episode before interviewers
death. On the other behand,
aware of and bepain
however ableinspiration.
to describeInand/or
associated with
ofdemonstrate
chest
airway
disease
obstruction
<spanexamples
these or severe lung disease,
style="color:blue">Sometimes,
of difficulty in breathing therewhich is a reversal,
the boutwith
produce of the lower
chest
abnormal pain
sounds,chest leads wallrecord
(particularly
to unconsciousness the spaces and yes
such
between as pneumonia
ribs) being couldinwards
pulled have been
while present
breathing forin.several
This can days,
be and is and
noticed associated
by a person
the
with
who
response
isbreathing,
closely origincaring
death,
accordingly.
and
for is
the
within
not
sick
These
very asevere.
short
include
neonate/child.
period
a whistling
Record
Some
after
the
communities
the onset
sound
response (commonly
have in of
number
a
chest
local
called of
term
pain.
days;
for
Acute
wheezing). if
this less
sign.
chest
Other
than
If so, 1 pain
abnormal
day
include
ofthis
or cardiac
sounds
24 hours,
term in thein)
produced
could during difficult breathing in neonates with respiratory illness are stridor (noisy while breathing
enter
<span
local
and 0last
days. forUse 2–31 hours
style="color:blue">Chest
translated
grunting version
(noisy week
while =or7questionnaire.</span>
ofbreathing
the so.
daysout).
pain Hence,
has manythe
to determine
Use
duration
possible
audio thecauses
files ifnumber
ofthat
available.
chestoffall
days.pain
into If
Demonstrate
isthe
two important
respondent
major
the
for can’t
categories:
three different recall
cardiac
types
yes
establishing
and
<span non-cardiac
exactly the diagnosis.
causes.
style="color:blue">Wheezing
the duration This
of the chest Select
question is aaims
pain, the tobest
whistling
prompt identify unit
sound
and according
whether
that
record comeschest topain
from
according the the response
occurred
chest during
while
to what is medically - hours
the
breathing or
illness days.
out.
relevant The yes
of breathing
preceding and
death, ask
and whether (s)he had any of them. Select the relevant box.</span>
VA
A
to interviewer
valid
capture.
<span response should
If the istobe
chest
style="color:blue">Severity identify
trained
between
pain cardiac
lasted:to
1–23
of chest
demonstrate painpain
hours,
</span>
chest can or related
wheezing
days
be judged totoheart
less the
fromthan attack.
respondent.
response
descriptions Cardiac Play chest
offor audio pain
Id10176:
extreme starts
fileheaviness
if available.
Howor
suddenly,
</span>
<span
many
tightness days is central
in often
before very
style="color:blue">● chest severe,
death didlasts
less
completely for
than
(s)he about
3 days
have
overwhelming 30chestminutes
before all pain.
the toindividual’s
death anUsehour,
- 1 and
interviewer
week usually
functions = to
7 subsides
enter
days.
and 2 onlythat
days;
Note
activities, with
</span>
with medical yes
this
<span
attention. style="color:blue">This
On the other hand, non-cardiac question chest ispainasked is less if severe,
the deceased is usually reported
aggravated having
by breathing or
<span
sweating
question
coughing;
diarrhoea. style="color:blue">●
and
and
possibly
isThis
not
lasts used collapse.
several
could by the
days.
occur atLess
Ifleast
automated
over more
severe
necessary,varying than
chest analysis
clarify 3 what
pain
periodsdays isbefore
is associated
software,
ofmeant
time; death
with breath
bybut
e.g.chestit–inis
interviewer
movements
important
pain according
conditions to
for enter
to
such
local4 days.
orphysician
the astypes
tenderness
</span>
review. on
If the chest wall,
respondent and is often
can’t recall non-cardiac
exactly chest pain.
the duration This is ofusually
the chest tolerated, and
pain,could brought
prompt andthe yes
to
above,
HIV/AIDS,
attention and ofrecord
chronic
caregiversthe malnutrition;
response
over time;accordingly. or
in contrast Ifto"NO/DK/Ref",
coeliac disease,
cardiac chest skip
the
pain to Id10181.</span>
affected
which individual
is severe andAdramatic have
in its is
<span
record style="color:blue">For
according to what is don't
medically know, enter
relevant "99". For
to capture. refused, enter
If months.
the chestOn "88". valid
pain lasted response
diarrhoea
effects.</span>
between 0 over
and 99. prolonged
If the answer periods happens extending to be 88 over days, weeksenterorinstead “87” sothe thatother hand, it is
the response
for:</span>
may be an episode of diarrhoea immediately preceding death. Select the best unit
not automatically coded as refused to answer.</span> yes
<span
according style="color:blue">●
to the response –0-1 days hour or – enter 0Ahours;</span>
months. valid response is between 0–30 days or 1–
<span
60 months. style="color:blue">●
For less than 1 day 1-4 hours or 24 hours,– enterenter 4 hours;</span>
“0” days. Use 1 week = 7 days. A likely
<span style="color:blue">●
response is less than 60 months. If the response 5-23 hours – enter 23 givenhours.</span>
was greater than 60 months, yes
confirm the response, and
<span style="color:blue">Ask theenter respondent“60”. Ifabout the respondent
her/his understanding can’t recall of what exactly the duration
is diarrhoea (having of
yes
the diarrhoea,
more frequent loose prompt
or liquid andstools record thanaccording
usual); if unclear to what is medically
or wrong, explain to relevant
the respondentto capture. that If the yes
diarrhoea
diarrhoeais lasted: the frequent </span> passage of loose or watery stools, with or without blood. There may be local
terms
<spantostyle="color:blue">●
describe it, if so include less themthan in the2local weeks translated
- interviewerversion oftothe enterquestionnaire.
13 days;</span> If "NO/DK/Ref",
skip to Id10186.</span> yes
<span style="color:blue">● 2 to 4 weeks – interviewer to enter 15 days;</span>
<span style="color:blue">● more than 4 weeks – interviewer to enter 29 days. </span> yes
from onset to death. If chronic diarrhoea (recurrent episodes over several weeks), record
the duration of the final episode. Select the best unit according to the response – days or
months. A valid response is between 0–30 days or 1–60 months. For less than 1 day or 24
hours, enter “0” days. Use 1 week = 7 days. A likely response is less than 60 months. If
<span style="color:blue">This
the response given was greater questionthan is asked 60 to specifically
months, confirmrelate the the episode
response, of diarrhoea
and enter to the“60”.death.If
If acute diarrhoea,
the respondent
<span
record
can’t recall
style="color:blue">This
the number of
exactlyrecords
question
days
the numberfrom
the
onset
frequency
to
of days, death.
of
If chronic
prompt and
diarrhoea. Ask
diarrhoea,
record
the
record
respondentaccording the
the
duration
to yes
of the final episode. If less than 1 day or 24 hours, enter “0” days. A valid duration cannot be longer than yes
maximum
what number
the ageisinmedically
days of theofrelevant
times
deceased. the to deceased
Usecapture.
1 week had=Ifdiarrhoea
7thedaysdiarrhoea on any day
to determine in the
started:</span>
the numberperiodofimmediately
days. For don’t preceding
know,
death,
<span
enter and
“99”. record
For refused,this number
style="color:blue">● enter “88”. inless
theIfspace
than
the provided.
3 days before
respondent A validrecall
can’t response
death exactly is between
- interviewer
the number 0 and 20. If prompt
toofenter
days, the response
2 days; and
was
recordmore than 20tostools,
according what confirm
is medically the relevant
responseto and enter “20”.
capture. If the For don’t know, enter “99”. For refused,
diarrhoea:</span>
</span>
enter “88”.</span> yes
<span
<span style="color:blue">It
style="color:blue">● started is helpful
less
<span style="color:blue">● started at least 3 days before death than to 3 know
days the
before period
death - of time over
interviewer which2 days;
to enter
– interviewer thetoepisodes
</span>
enter 4 of
<span
vomitingstyle="color:blue">●
were present, started in order at to
least 3 days before
understand the death – interviewer
relationship of this to enter symptom4 days.</span>
to a yes
days.</span>
potential
<span cause. Select positive
style="color:blue">A the best unit according
response to this question to thegives responsesubstantial – days basisor formonths.
considering A valid yes
diarrhoea
responseamong is betweenthe potential0–30causes days of ordeath.
1–60 However, months.inFor some less instances,
than 1 the daydeceased
or 24 hours, may have enter “0”
slipped
days. Use into unconsciousness
1 week = 7 days. and A notlikely
consumed response food for is some
less than time before
60 months. death, therefore
If the response the diarrhoea yes
may have stopped before death. Then, the response to this question would need to be taken into yes
given was greater
consideration along with than themay60 months,
responses to confirm
other the response,
questions in ifregard and
to enter “60”.
formulating If the respondent
a diagnosis ofmay
diarrhoea
<span
can’t
<span style="color:blue">It
recall exactly
style="color:blue">Vomiting the number be related
of days, to the diarrhoea,
prompt and present.
record
is a well-recognised symptom common to abdominal disease, but can In some
according infections,
to what there
is medically be yes
as the in
blood cause of death.</span>
the stools, but mostly in children andurinaryadults,tract but rare in neonates.
occur in other
relevant conditions
to carers
capture. If such
the as meningitis,
vomiting lasted:</span> infection or otherItsystemic is common for this Its
infections. to be
yes
observed
association by of sick
with other symptomsfor neonates, if
canless present.</span>
assistthan with 3identification of the cause
<span style="color:blue">● days - interviewer to of enterdeath. Neonates: if
2 days;</span>
"NO/DK/Ref", skip to Id10275. For ADULTS and CHILDREN ONLY - if "NO/DK/Ref", skip to Id10194 </span> yes
<span style="color:blue">● for more than 3 days – interviewer to enter 4 days.</span>
yes
<span style="color:blue">This question is asked to confirm whether the patient had an episode of yes
vomiting specifically during the week preceding death. Although vomiting may not have been a
prominent
<span symptom of the illness
style="color:blue">Vomiting of that
bloodcaused isthere death, presence
an important sign ofbleeding of an episode
stomach or liver of vomiting
disease, and ifin the
ofperiod
yes
<span style="color:blue">In
preceding week could some
complicate instances,
or exacerbate couldthe be minor
illness. </span> into the stomach over a yes
considerable
of hours, beforevolume, could
accumulating haveintoprecipitated
sufficient death. to
volume Freshtriggerblood in the vomit
vomiting. In such is easily
cases, recognized
the contents and of
<span
<span
creates style="color:blue">The
style="color:blue">The
immediate awareness presence
and timeofrelationship
concern abdominal
about the pain between
illness. canItgiveis theindication
an
important symptom to as to
carefully and the the
natureevent
distinguish ofthe
ofbetween
the
vomitus
<span
death
abdominal
vomiting isdoimportant
not appearand
style="color:blue">This
condition, toasdetermine
bright
could red, have
question
also as
the theled
helps blood
cause assess
toand angets the mixed
ofattempt
death. towith
severity Select
seekofother the
medical stomach
vomiting.</span>
bestthe unit
care contents
or according
relief and changes
for
thisthe to the
pain. In
yes
colour to of blood (contents
a blackish, semi-solid from the stomach)
substance. There may coughing
be more ofthanblood one (from
episode chest);
of such as
vomiting is sometimes
of
some instances,
confused
response
<span
blackish among the
– hours,
style="color:blue">The
substance
pain
respondents.
days,
- that
of
may or
a heart
Clarify attack
months.
severity
look like with
of the
coffee
may
the
Apain be
validcan
grounds.
felt
respondent or
response
help described
</span>and note
formulating as an
the
is between acute
response
the diagnosis. pain in the upper
accordingly.</span>
0–23 hours, Severe 1–30 pain that days, yes
abdomen.
In general,
or 1–60inmonths.
resulted this question
collapse and focuses
Userequired
1 weekmedicalon the presence
= 7 days. assistance of
A likely a sudden
would response onset
be recorded of
is lessabdominal
as a thanpositive pain. There
60response.
months.Probe mayIf thea
be yes
local term
carefully, to
and describe
ensure it. Ensure
thatgreater
a negative that the local
response term is
is recorded included in
only ifthe the
there ttranslated
was someand version
non enter of the
specific,“60”.transient
response
questionnaire, givenand was
use thefrom local term than 60
to probe. asmonths, If the confirm
response is response,
"NO/DK/Ref", skip toshould If the yes
<span
pain. Anystyle="color:blue">Distension
respondent direct response
can’t recall thethe respondent
duration ofofthe the abdomen
aabdominal
"YES" even due pain,toprompt
without obstruction
qualification and record ofId10200.</span>
intestine
be startsas
recorded
according to
such,
rapidlyand proceed lastswith the following questions.</span>
what is and medically for a few
relevant days because
to capture. If the theabdominal
person needs pain to seek urgent treatment to
lasted:</span>
survive the condition. It is possible that
<span style="color:blue">● for less than 2 weeks - interviewer to enter the deceased would have sought 13some medical
days;</span>
attention for relief, as this condition could
<span style="color:blue">● for at least 2 weeks – interviewer to enter 15 days.</span>be associated with significant discomfort, yes
breathlessness, and reduction in mobility. Select the best unit according to the response – yes
days or months. A valid response is between 0–30 days or 1–60 months. For less than 1
day or 24 hours, enter “0” days. Use 1 week = 7 days. A likely response is less than 60 yes
months.
<span If the response given
style="color:blue">The ofwas
acutegreater
sitediseases abdominal than pain 60is months,
alsofailure)
an importantconfirmclue, thebut response,
this is more and of ain
yes
<span style="color:blue">Certain
enter “60”. If the respondent can’tand (most
recall commonly
the duration liverof the more thancause an accumulation
usual of
protruding fluid
subjective
the abdomen, perception
and thisby the deceased,
results in an increase mayin the notsize be of clearly communicated
the abdomen makingtoitthe respondent.
unusually prominent Hence, and it yes
could be
abdomen, difficult
prompt for the
and respondent
record to provide
according an
to accurate
what
protruding. Also, in case of intestinal obstruction, there could be an accumulation of gas and other is recall
medically and response
relevant to this
to question.
capture. Show
If the the
four quadrants
protruding
intestinal of the
abdomen
contents, butabdomen
lasted:</span>
this is very(upper
rare,right;
as comparedupper left; to thelower right; lowerof
accumulation left)
fluid.andThisaskincrease
whetherinthe size of
deceased
the abdomen pointed
is oftento that area
observed when
and (s)he
recalled had by the pain.</span>
relatives of deceased. If "NO/DK/Ref", skip to
yes
<span style="color:blue">● for less than 2
<span style="color:blue">The duration for which the mass was present could help guide weeks - interviewer to enter 13 days;</span>
Id10204.</span>
<span style="color:blue">● forunit
at least 2 weeks – interviewer yes
the diagnosis. Select the best according to the response to – daysenteror15months. days.</span> A valid
response
<span is between 0–30 daysmass
style="color:blue">Abdominal or 1–60 months.
is a localized For less
swelling than 1 dayin or
or enlargement one24 hours,
area of theenter “0”
yes
abdomen.
days. UseThis may not
1 week = be seen visibly
7 days. A likely by respondents,
response isand less may thanonly60 be reported
months.by If the
thedeceased
response to his yes
relatives,
given was as agreater
sense ofthan heaviness 60 or discomfort.
months, confirm Often, the there
response,could have and been
enter an attempt
“60”. If to
the seek medical yes
respondent
<span style="color:blue">The
care, which could be recalled by onset and progression
relatives. In which case, of this theresignisfollows
potential different patternsofinadifferent
for availability diagnosis
conditions;
can’t
which recall
may be in the
intestinal
duration
recalled byobstruction the itmass
theofrespondent. would bethe
Ifinthere relatively
abdomen,
is a positiveshortresponse,
(a matterand
prompt of hours
probe record – 2/3according
carefully, days); but istomore
and remember what to yes
gradual
is in
medically the other
relevant more to common
capture. conditions
If the such
mass as
in liver
the failure,
abdomen
come back to this issue during enquiry about health records in Section 9, and record all relevant details on yes cancers and
lasted:</span> heart failure. Clarify and
record the response.</span>
health care access and diagnosticfor information
<span style="color:blue">● less thanin 2that weekssection. If the answerto
- interviewer is enter
"NO/DK/Ref", skip to
13 days;</span>
Id10207.</span>
<span style="color:blue">● for at least 2 weeks – interviewer to enter 15 days.</span> yes
<span style="color:blue">Headache is a common and relatively minor symptom. It is important for the yes
interviewer to stress on the word “severe”, in order to relate the headache to the potential cause of death. yes
Clarify the importance of severity
<span style="color:blue">A stiff neck to the respondent,
is generally and record
identified by thethe response
inability to bend accordingly.
the neckSevere forward headache
to
can
<span
touchbethe
reported
chin tointhe many
style="color:blue">A chest,conditions
or in stiff including
neckin is
difficulty meningitis
generally
raising headand malaria.
identified
from the pillow. Sudden,
by the It is an severe
inability headache
important to bend
featurefollowed
theof neck by yes
unconsciousness
forward to(atouch
meningitis is sometimes
brain infection), observed
the chin particularly
to the chest, in cerebrovascular
or in difficulty
in children. This sign indisease/stroke.
may raising
not behead There
easily from may
observed be
theora local
pillow. term
recalled to
It is
by anthe yes
describe
respondent. it. Ensure
For some, that athe stifflocal
neckterm can(a isalso
included
be reported in the as translated
painfulversion
aparticularly neck. in Ifofrequired,
the questionnaire,
clarify tosignand use the
the
important
local term tothe feature
probe.</span> of meningitis brain infection), children. This may not yes
respondent
be easily observed description as provided
or recalled by above,
the respondent.and record the Forresponse.
some, aIf stiff "NO/DK/Ref",
neck canskip alsoto be
Id10212.</span> yes
reported as a painful neck. If required, clarify to the respondent the description as provided
above, and record the response. If "NO/DK/Ref", skip to Id10212.</span> yes
yes
yes
illness,
months. theAperson valid may response have episodes is between when they 0–30dodays not recognise
or 1–60people, months. or are Forunawareless than of their1 day location
or 24
(in hospital or at home); or may not be aware of the time, part of day, month etc. “Confusion” is sometimes
hours,
associated
<span enter “0” days. Use
with periodic agitated or restless
style="color:blue">Select 1 week =
the best 7 days.
behaviour, A
unit accordinglikely response
with no obvious to thereason. is less
response than
It is not 60
the same
– hours months.orasdays. If A
losing
the response
consciousness. Ingiven
fact, was
there greater
is no than
associated
valid response is between 0–23 hours or 1–99 days. Use 1 week = 7 days. A likely 60 months,
impairment ofconfirm
consciousness. the response,
“Confusion” and is enter
an “60”.If
important sign
of chronic
the respondent conditions can’t causing
recall dementia
the (e.g. Alzheimer’s
duration of mental disease;
confusion, long term prompteffectand followingrecord paralysis;
according etc.).
response
This question is only
lesspertainsthan 99 to days.
longto If the response
standing mental confusiongivenlasting was greater than 99
severallasted:</span>
months or days,
years. Clarifyconfirm these the
to what
response, is medically
and enter relevant
“99”. If the capture.
respondent If the can’tmental recall confusion
when the unconsciousness started,
points with the respondent, and record the response accordingly. If "NO/DK/Ref", skip to Id10214.</span> yes
<span
prompt style="color:blue">●
<span style="color:blue">Unconsciousness
and record according fortoless what than
means 3 the
is medicallymonths complete - interviewer
relevant inability to enter
to arouse
to capture. If 2
the months;</span>
individual
the with no
<span
movement style="color:blue">●
except
unconsciousness started: </span> for breathing. for
The at least
individual 3 months
does not –
respondinterviewereven to to enter
physical 4
stimuli months.</span>
including pain. yes
Death due to any illness is usually preceded by a period of loss of consciousness. This series of questions is yes
<span
oriented style="color:blue">●
toward identifying loss the less
of than 6 hours
consciousness as anbefore important death - interviewer
specific factoror to enter
associated with5response
the illnessis
<span style="color:blue">Select best unit according to the response – hours days. A valid
hours;</span>
leading to death, usually indicating involvement of the
between 0–23 hours or 1–99 days. Use 1 week = 7 days. A likely response is less than 99 days. If the brain. Sometimes there is some hesitation or yes
uncertainty
<span about
responsestyle="color:blue">●
given wasthis question.
greater than Therebetween
99 days, may 6beand
confirm a localthe23term hours
response, to describe
before
and enter unconsciousness.
death “99”. – Ifinterviewer
the respondentEnsure tothat
enter
can’tthe 23
local
recallterm
whenisthe
hours;</span> included in the translated
unconsciousness started, version
prompt of theandquestionnaire,
record according andtouse whattheislocal term to
medically probe. to
relevant If
"NO/DK/Ref",
capture. If the skip to Id10220.</span>
unconsciousness started:</span> yes
<span style="color:blue">● at least 24 hours before death – interviewer to enter 1
<span
<span style="color:blue">● lessofthan 6 hours before coulddeath occur- suddenly
interviewer to enter
case 5ofhours;</span>
stroke (cerebrovascular yes
day.</span>
<span
style="color:blue">Loss
style="color:blue">●
consciousness
between 6off and 23on hours
in the
disease), or more gradually occurring and overbefore a period death – interviewer
of hours/days in lossto enter 23 hours;</span>
of consciousness yes
<span style="color:blue">● at least 24 hours before death
associated with brain infections or other conditions. This is usually the case for infectious diseases. This – interviewer to enter 1 day.</span>
question is aimed at ascertaining sudden loss of consciousness within at most a day, which occurs in yes
cerebrovascular disease, which is rare in case of a children. Clarify this aspect with the respondent as
required, and record the response.</span>
<span style="color:blue">Questions Id10275 and Id10276 are to confirm the timing and to identify the
yes
onset
<span
<span
<span
of convulsions immediately
style="color:blue">This
style="color:blue">The
style="color:blue">Loss question
ofof
after birth, to
refers
duration
consciousness
within
for which
usually
the first
convulsions occursthethat day
after
of life,the
affect
infected which
ulcer
aofgeneralised whole arebody,
was likely
present
convulsion,
to both
i.e. beon associated
aarms
the foot and boyes
with some congenital disorders the brain or other abnormalities chemicals in the blood.soAsk positive
only for yes
indicates
response
<span
deceased the
will severity
confirm
style="color:blue">This
style="color:blue">Explain
who were < 1 year old. the of the
occurrence,
means condition,
to and thus
therespondent
the
Neonates: deceasedandhelp
If "YES", itsaid potential
stopped
that the
skipurine diagnosis.
tourinating. contribution
problems
Id10233. </span>
We ask this
refer
Children: among
Ifquestion
to urinating
"YES", skip the factors
abecause
lotto or not at all,
causing
stoppage
and bloodof
Id10223.</span> death.
inurination
the urine.Longer for
This duration
over day oralso
is aageneral two indicates
prior to death
question thecan
identify difficulty
be due
if the deceasedin disorder
to treating
had any ororfailure
controlling
problems of the the
withkidney. yes
<span
underlying
Less style="color:blue">Convulsions
commonly,
urination. The factors
key it may
problemssuch as
be a symptom
with diabetes, occurringhence
of obstruction
urination that after
are also the
to theguiding
related first
canal
to day that
specific of
the life
carries
causescould
diagnosis urine
of be
death associated
of
from the
arethe with
underlying
bladderinout of yes
difficulty
<span
neonatal style="color:blue">Passage
tetanus. isAsk onlyorfor of
by blood inabdominal
the urine ispain.
a major feature of urinary bladder or kidney
the
cause body,
passing
cancer. of
This
but
urine,death.
can
this
passing
also
accompanied
Select less
happen the nodeceased
in urine
best
some for who
severe
unit some
parasitic
were
accordingperiod,
infections.
<1 yearincreased
to There
old</span>
theInresponse
kidney
is frequency
passage
disease,
– of
of days usually
urination,
frank
there
or months.
(red) andispassage
blood
a A valid
and wouldof
considerable
blood
response
<span
be in the period
urine.
is between
style="color:blue">In
readily recognised Ask of illness
whether
0–30 prior
certain (s)he
days to the
had development
any
or reported
conditions, of these
1–60particularly
months. of stoppage
problems. For
among If
less of urination.
"NO/DK/Ref",
the than
elderly 1 dayand Clarify
skip
in to what
ordiabetics, is meant
Id10230.</span>
24tohours, enter
chronic, by
non“0” yes
stoppage
healing of
ulcers urine,
appear andby on
the
record
the
patient,
the response
foot. These
and
ulcersas told.
are
to the relatives,
NOTE:
prone toIt becoming
is possible and possibly
that
septic an leading
individual
(see next
seeking
both
question), urinated
and
of health
often yes
care.
days.
more Hence,
Usethan
often if this
1 week symptom
usual =AND 7 days. was
stopped present,
A likely
urinating;there
response is a good
both conditions likelihood
is less could than 60 of a
exist positive
months. response.</span>
at isdifferent If the
times response
during the of
keep enlarging
given that wasled in
greater size, with poor chances of healing. Presence
than 60 months, confirm the response, and enter “60”. If the respondent yes of such ulcers a vital clue in the diagnosis
illness
these to death.</span>
<span conditions.
can’t style="color:blue">The
recall the
This has considerable
duration, presenceand
prompt
significance
of pus in thein
record
the case of ulcer
non-healing
according
individuals
to what on the with
footdiabetes.
is medically is an important If "NO/DK/Ref",
relevant to yes
skip to
diagnostic Id10227. </span>
capture. Ifsign. thePus ulcer is a thick
on the fluid foot whichhadcould be green or yellow in colour, which continually accumulates
pus:</span>
on the floor of the ulcer.</span> yes
<span style="color:blue">● forofless
<span style="color:blue">Disorders the ofthan
skin are2 weeks
sometimes - interviewer to enter 13 days;</span>
<span style="color:blue">The duration the rash will helpobserved us understand during thetheillness
severity preceding
and also death.
<span
These
whether style="color:blue">●
could thishave problembeen in was thepartform for atsores
ofofthe least or 2ulcers,
illness weeks
that – interviewer
or blisters,
led to death. lesstothan
orIfinfected enter
or “septic”
1 day 15 or days</span>
wounds,
24 hours, andentercould yes
be associated with chronic ill health. In adolescents and adults, they may initially appear as blisters or raised yes
“0” days.ofUse
patches skin 1with week fluid= in 7 them.
days or In 1adults/elderly,
month = 30 days there to may determine
be pressure thesores
number on the of back
days.asIfathe result of a
respondent can’t recall the duration, prompt and
long-standing bed ridden state. Clarify these points with the respondent, and record the response record according to what is medically relevant to yes
capture.
accordingly. If theThere skinmay rash belasted:
local sometimes
terms </span>to describe it. Ensureasthat the local terms
<span
<span style="color:blue">Sores
<span style="color:blue">●
style="color:blue">"Rash" less is than
a skinand appear
1abnormality
week initially
- interviewer
thatterms tiny
is not totoabubbles
enter
cut on theare
or6bruise.
days;</span>Itskin,
included
usually calledappears
in the
blisters.
translated
“Blisters” version
are raised of the
skin questionnaire, use the local probe. If "NO/DK/Ref", skip to as a
collection
Id10233.</span>
<span of red
style="color:blue">●spots onthat
the contains
skin,
at least
fluid. Such as
or sometimes
1 week –into
blisters
a red may
interviewer blotch be observed
to or enter a patch in
oninfants
8 days.</span> the skin. or Ityoung children,
is sometimes yes
along
<span with
associated fever.
style="color:blue">It Often,
with irritation, itching the clear
is importantfluid
or pain. changes
toThere
know maywhere pus. In
be aexactly other instances,
the rash
localrefused,
term the
may be
to describe chronic
located
skin rash. pressure
onEnsure
the sore
body. may
that Thisthe is yes
<span
get style="color:blue">For
infected and be filled with don’t
pus. know,
</span> enter “99”. For enter “88”. A valid response is
because
local
between term the0isandlocation
included 99. Ifof the
inthe
the rash is characteristic
translated
response version
was more offor thecertain
than questionnaire,
98 days, conditions,
confirmandand use
the could
the assist
local
response terminanddiagnosing
toenter
probe.“98”. them.
For If
Also,
Adult this
if will
"NO/DK/Ref",help us know
skip whether
to Id10237. this problem
For Children
the answer to duration happens to be 88 days, enter instead “87” so that the response is not was if part
"NO/DK/Ref",of the illness
skip that
to led to
Id10238.</span> death. Check the yes
<span style="color:blue">This
appropriate boxes, multiple responses is a specific areform of skin condition which is associated with problems with the yes
allowed.</span>
automatically
immune
<span coded
system. In some instances,
style="color:blue">● as refused to
“Trunk”isarefers answer.</span>
localised
to the patch of rash with small blisters
chest/back/abdominal areathat containing clear fluid occurs
</span>
<span
in a linestyle="color:blue">Measles
along the ribs, or on“Extremities” the face, a condition
which associated
is accompanied with
by an skin rashes
electric current occurs mostly in
like burning early
pain. The yes
<span
childhood.style="color:blue">● refers tooccur
the arms and legs.</span>
occurrence of such an infectious rash can be associated with other serious symptoms involving the lungsmay
Occasionally such infections may also in older children or adults, but the presentation or yes
not
brain.be accompanied by rash, andrespondent
is usually inwhether the form ofdeceased
fever andcomplained respiratory of illness. </span>
<span This is quite rare.
style="color:blue">In Ask the a person with long standing the malnutrition, the skin becomes a localised extremelypatchdry of rash
and yes
with burning pain.</span>
tends to break away or peel off in patches. This is a readily recognised sign when present, and is a useful
diagnostic
<span
<span sign. </span>
style="color:blue">The duration of puffiness of thethechild facehad before death into is important, which to
yes
<span style="color:blue">We
style="color:blue">Skinask this
infections because it might
can sometimes indicate
be observed as patches bleeding
of redness the
andskin, swelling, yes
understand
could
<span
without be duepresence
the the
to an presence
style="color:blue">Certain infection
of any that pus, of caused
chronic
diseases
or the
anyrefers kidney
are
liquid. death.</span> disease.
characteristically
Such infections The patient
associated
can be may
with
associated rapid have
with weight
fever been lossunder
and preceding
can lead to
<span
treatment,
death, style="color:blue">This
in which
which could be described case question
the puffiness
as “becoming to
could bleeding have thatbeen is not off associated
and on with
over any
severalspecific injury.
months.
death.</span>
<span
Bleeding
Ask
<span style="color:blue">This
and from
record the nose,
style="color:blue">Whitishthe gums,
duration question
oralloss
of mucosa,aims
puffiness
patches at very
and
inside anus
of
the
thin and
identifying
face is commonly
mouth during
weak”, “developing
malnutrition
or on the observedin thein
terminal
tongue are
sunken The
deceased.
case
illness.
cheeks”,
of bleeding
indicative ofindividual
Select due
“clothes
the
infections to may
best
/
in yes
belt
have becoming
been loose”
consistently etc. Weight
underweight of
forlikeover 10%
a prolonged within
period, 3 months
and not or so is an
have experienced important sign. Clarify these
blood
aspects
unit
clotting
thoseaccording
withwith very disorders
the weak
respondent
to the
and infections
immune
response tosystems.
confirm Immune
– days
dengue
or wasted or systems
exclude and
weight
months.
Ebola.</span>
provide
loss,
Awould and
valid a defence
record
response forresponse
the the bodyaaccordingly.
is between
rapid
to fight weight
0–30 against
days
loss
in the terminal
<span
infections. This stage.
style="color:blue">Puffiness
sign may A chronically
be difficult thin
orfor or
swelling
the in
respondent, individual
the face is
unless observed
they havewhen
are had
told malnutrition
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of this is accumulation
by the which
patient of
or fluid
by a yes
Irrespective
or 1–60 months.
predisposes of whether
to several For the response
less than
infections leading is "YES/NO/DK/Ref",
1 day death. or 24 This hours, the
enter next question
“0” days. should
Use 1stages be asked.</span>
weekof=cancer, 7 days. andA
(or water) particularly
healthcare provider. in
Record the the spaces response/ bagstoas around
reported. the eyes, is also
There and observed
may other
be a parts.in terminal
local Clarify
term towith
describe the respondent
rash. Ensure yes
some
likely other
the localchronic
response
that puffiness of the
term isisdiseases
less
face
included than
can which
in 60
include
the could
months. affectIf
puffiness
translated nutritional
of the
the eye.
version response
of the intake
This over time.
given
accumulation
questionnaire, was</span>
ofgreater
and fluid
useisthe anthan 60
important
local term months,
tothe
<span
confirm style="color:blue">Certain
diagnosticthe sign,response,
particularlyand nervous
enterdisease,
of kidney system
“60”. Ifbut infections
thealso respondent result
in some hormonal in complete
can’t recall disorders.stiffness
the Itduration, and rigidity
can be observed of
promptand yes
probe.</span>
back andby allrespondents,
limbs, along with a tight jaw withfacial
inability to open the
recalled
and record according ifto
prominent.
what is Such
medically puffiness
relevant may
to bemouth.
capture.presentIfThis with
the
isor usually
without
puffiness
a dramatic
any
of fluidsign,
the face yes
and can
accumulation be recalled by respondents who have cared for the
on other parts of the body such as the ankles or feet, as asked in a later question. If deceased during the terminal illness.</span>
lasted: </span>
"NO/DK/Ref", skip to Id10249.</span> yes
<span style="color:blue">● for less than 1 week - interviewer to enter 6 days;</span>
<span style="color:blue">● for at least 1 week – interviewer to enter 8 days.</span> yes
yes
yes
Use 1 week = 7 days. A likely response is less than 60 months. If the response given was
greater than 60 months, confirm
<span style="color:blue">Swollen feet, the response,
ankles andmay
and even legs enter “60”.
occur dueIftothe
therespondent
accumulationcan’t
of fluid in
recall the
diseases exact
of the duration,
heart promptorand
and circulation, record
kidney according
disease. to what
Several diseases is medically
produce relevant
an imbalance to
in water
regulation,
capture. Ifresulting in its accumulation
the swelling in the dependent parts of the body. Such accumulation most often
lasted:</span>
appears as collection of fluid around
<span style="color:blue">● the ankles,
for less than 3thedays
presence of which could
- interviewer be recalled
to enter by respondents. If
2 days;</span>
"NO/DK/Ref", skip to Id10252.</span> yes
<span style="color:blue">● for more than 3 days – interviewer to enter 4 days.</span>
yes
yes
<span style="color:blue">Long standing disorders lead to fluid accumulation in the soft tissues in different
yes
<span style="color:blue">Small, purple or brown lumps may be observed in are
thefoot,mouth in some patients
<span
parts
with ofstyle="color:blue">In
style="color:blue">Lumps
weak theimmune
body including
systems.
some
legs,
These
instances,
are
abdomen, small,
lumps may
there
solid
arms and
and
bleed
may be
painless
hands,
or get
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face,
infected asofduring
swellings only
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in the
chewing
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lung.
etc. Such
The
case
observed thenear
generalised
presence of
underlying
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groin.occur be
They in different,
arekidney
seen in more likely
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disease, heartto be
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certain condition
typesfailure,
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of infections affected
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in certain
rarer
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heart
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or kidney
In someor patches
disease. may
Hence,
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it is
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may of more
to severe
confirm systemic
that the disease.
swelling wasIn other
on bothrarer situations,
feet.</span> there yes
causes. Also, the generalised
<spanbestyle="color:blue">This
may a chronic swelling fluid
question is tobe
accumulation present
confirm develops
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ofover
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the bothofsides,
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the indicative
weeks.
neck. of Clarify
In of
some
athese
moreaspects
instances, generalised
the with
lump form
the
may ofordisease.
respondent,
break
growth
through
situated
Unless
and record
the theonlumps
skin
the tongue
the
and are rather
response
some
or gums,
large, which
or the
accordingly.</span>
whitish material
would
or patient
pus may issome
in a bed
ooze
form
from ridden
the
cancer
lump.
yes
of the
<span
state, mouth. There may
style="color:blue">The be a likelihood
by duration of an attempt
indicates to seek
the medical
severity care
and for its diagnosis
progression and
of thistreatment.
In suchthey
Probe
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situations, be observed
if there
Difficulty isisapain
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in
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response
swallowingan attempt
and
There
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record
progressing the
may be a local
medical
overcare,
response
term
and iftoof describe
so,
aaccordingly.</span>
period there may
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lumps. be Ensure
weeks an is yes
that
opinion as to the medical cause for the lump, and the treatment received. Clarify these aspects,term
the local term is included in the translated version of the questionnaire, and use the local andto if there
usually
probe.
is a positive observed
If "NO/DK/Ref",
response, withskipmajor
note the conditions
to Id10258.</span>
additional details suchin assection
the cancers on of thetothroat,
access health food
care, pipe
or in and/or
the “Open
yes
<span
stomach. style="color:blue">This
Carefully elicit the question
duration is to of confirm the presence
the symptom with of lumps
probing in theabout armpit. theThese
onsetmay and have yes
narrative”
been difficultsection.</span>
to have been observed by the respondent, unless pointed out by the deceased, or notified by
progression,
<span
a<span
health
and confirm the of
<span style="color:blue">Paralysis
style="color:blue">Paralysis
professional.</span>
presence
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implies the
of the
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orbrain,
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till and
death,
strength
leg; or and
orofpower
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arm andthe
inincertain
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feature of obstruction
style="color:blue">This
accordingly. Select the best of
question when
the
unit blood
is swallowing
to supply
confirm
accordingtotal, to is
the
to thethe
the sensation
presence
responsewhich
of that
is
lumps
– food
one in
days is
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the common
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which throat
causes
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Aisvalid of
body.
chest. The
This weakness
may bethe may
felt high bein partial
the neckor
in sometimes
or 1–60
lower down, with
behind complete loss of power. Paralysis usually an yes
death
junction
response
easily
among
recognized isadults
between between
and
and
body theand
0–30
recalled
elderly
the
days
sign, and
most
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populations.
limb.</span>
an months.
important Forthe
Paralysis
feature less
of
breastbone
of one
thanside
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or
(sternum),
of the
injuries orbody 24
to
or
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the
very
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the
enter entry
clearly “0”
into the belly.sign,
recognizable Thisandis a is
subjective
readily recalledsensation by and is usually
relatives of thereported
deceased. by Several
patientscommunities
(and recalledeven by relatives)
have a yes
system.
days.
especially
local term If
Use "NO/DK/Ref",
when 1 week =
interfering
to describe skip
7 days.to Id10261.</span>
A
with dailyClarify
this condition. likely response
food intake, is less
which isofwhen
the presence thisthan 60
it is readily
sign, months.
and record recognized If the
the response response
and recalled by
<span
given style="color:blue">It
relatives. was Also,greater
there couldthanbe is60 important
months,
pain associatedtoconfirm
confirm
with thewhether
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response, paralysis
and was
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as“60”.
a burning only
If the a particular
or respondent
squeezing yes
accordingly.</span>
limb, or parts of the body or the whole body. Mark the specific body parts that were observed to have been
pain inrecall
can’t the centre the of the chest,
exact duration, behind the breastbone,
prompt and record or inaccording
the upper stomach.
to what This
is is an important
medically relevant yes
paralysed.
symptom, Select
so probe all carefully
that apply.</span>
and try to ensure there is no false negative response. If "NO/DK/Ref", skip to
to capture. If the difficulty or pain in swallowing lasted: </span>
Id10265.</span> yes
<span style="color:blue">● for
<span style="color:blue">The less than
duration 1 week
for which - interviewer
yellowish to enter
discoloration was6present
days;</span>
helps
<span style="color:blue">● for at least 1 week – interviewer to enter
indicate the severity of the illness. Ascertain if jaundice was present throughout the terminal 8 days.</span> yes
illnessstyle="color:blue">Yellow
<span leading to death, and record the duration.
discolouration of the Select the best
eyes, known unit according
as jaundice, is often to the response
present in – yes
neonates, and is usually
days or months. A validmild. However,
response in the newborn,
is between 0–30 daysit canoroccur
1–60inmonths.
relation to Forproblems
less thanwith the or
1 day blood
24 yes
group
hours,ofenter
the mother andUse
“0” days. baby, particularly
1 week observed
= 7 days. within
A likely 1–2 days
response is after birth.60
less than It can also beIf seen
months. the with
severe
responseinfections.
given Sometimes
was greater inthan
advanced
60 stages there
months, confirm is also
the yellow discolouration
response, and enter of“60”.
palmsIfor
theskin, and if
<span style="color:blue">The
observed, thecan’t
urinerecall
is alsothe question
of an intense aims
yellowto know if it became
colour.Children impossible
and Adults: If for the deceased
"NO/DK/Ref", skiptoto
swallow
respondent
any solid or liquid food.</span> exact duration, prompt and record according to what is medically yes
Id10267.</span>
relevant to capture. If the yellow discoloration lasted: </span> yes
<span style="color:blue">● for less than 3 weeks - interviewer to enter 20 days; </span>
<span style="color:blue">● for at least 3 weeks – interviewer to enter 22 days.</span> yes
yes
<span style="color:blue">Ask only for deceased who were < 1 year old. The number of yes
<span style="color:blue">In
days
<span
brown after
orand birthis the
style="color:blue">Long
yellow babyolder
indicative of
termchildren
stopped withof
sucking
deficiency
moderate
black
is an
the
to advanced
coloured
important
blood hair,ina achange
results
malnutrition. indicator
This
in the hair
to diagnose
pale, whitish
may occur
colour toofred,
appearance
intoconjunction
thedull
neonatal lips,
withloss,
tongue,
tetanus. eye
Probe sac. Sometimes
carefully to it
getis referred
an to
accurate as thinning
response. of blood.
Select This can
the be
best due
unit chronic
according bloodto the yes
other symptoms
destruction such as thinness, wasting, anddueinfections. </span>
response
<span –ordays
decreased
style="color:blue">This
style="color:blue">Deep
recognized and recalled by
production
or months. question
sunken ofeyes
A valid blood
response
is asked
respondents.</span>
may to betoenquire
infection
is between
observed ofsick
if there
in cancer.
0–30
was aPale
infants daysappearance
normal
and or 1–11
healthy
very young could
effort be
months.at and
children, Foris yes
suckling,
aless
signthan or1if day
of markedly theredecreased
orwas 24any weakness
water
hours, of“0”
in the
enter lethargy
body. ThisinUse
days. isthe
an suckling
week effort.
1important = sign Clarify
that
7 days. Athe
helps distinction
diagnose
likely responsethebetween
cause of
is less
<span
death,
than 12
<span
style="color:blue">The
‘normal/healthy’
butmonths.
is subtle,and the
style="color:blue">Normal may number
weak/lethargic’
Ifand not
response be of days
effort.
easily
given
suckling
after greater
Also,
observed
or was
feeding
birth
sucklingthe could
orisrecalled
a sign
baby
than stopped
be
11affected
bygood
of the sucking is an important
byconfirm
certain
respondent.</span>
months,
health in the
congenital
newborn.
indicator
the response,
Absence
defects
of
yes
to diagnose
of the neonatal
lips, mouth tetanus.Where
or throat. Probenecessary,
carefully toexplain
get an these
accurate response.
aspects Less than
of normal 1 day = “0”.
and problems For don’t
with
suckling
and
know, enter at
enter
suckling, birth
“11”.
and“99”. is
record indicative
If the
Forthe refuse, of
respondentcertain conditions.
can’t
enteraccordingly.
response “88”. Responserecall Ask only
exactly
Ask should
only for
whendeceased
forbedeceased
no morewho the who
baby
thanwere were
stopped
the neonatal < 1 year
year age
< 1ability old.</span>
suckling,
in days at
old.</span>
<span
death. style="color:blue">In
prompt andrespondent
If the can’tcertain
record according recalltoinfections
whatwhen
exactly is such asbaby
medically
the tetanus, the baby
relevant
stopped losesprompt
to capture.
suckling, the If and to
the recordsuckle.
baby The
stopped
according
mother
to can recognise this and is able to report such a stoppage if asked carefully.
what is medically relevant to capture: if the baby stopped suckling within the first day of life - interviewer Ask only for deceased
suckling:.</span>
who were <1 year. yes
to enter
<span 0 days; or ifIfthe
style="color:blue">●
"NO/DK/Ref",
baby stopped skip to Id10277.</span>
withinsuckling
the first at least
day of by life
the second day of life
- interviewer to –enter
interviewer to enter 3
0 days;.</span>
days</span> yes
<span style="color:blue">● at least by the second day of life – interviewer to enter 3
days.</span> yes
yes
<span style="color:blue">The neonate’s
<span style="color:blue">Fontanelle is thebody
soft can
spotbecome
toward stiff and arched
the front backwards inhead
of an baby/infant's neonatal
whichtetanus.
can get
yes
Mothers
<span canraised
and recognise
whenthis andisreport
swollenstyle="color:blue">Unconsciousness
there when
an infection asked.
means Ifcomplete
the respondent
thebrain.
of the Bulging inability
means has difficulty
tothat
arouse thein
it was understanding
neonate
swollen no this
withpushed
and
question,
movement
out demonstrate
except for ainfant
stiff body
breathing. The arching
child backwards.
does not Askeven
respond onlycanforphysical
to deceased who
stimuli were <this
including 1 pain.
year Sick
<span style="color:blue">Unconsciousness means the complete inability to arouse the neonate with no if it
and tense
old.</span>
when the was in a sitting position. Mothers recognise and report correctly yes
neonates
was present.could be for
Probe sleeping
carefully for
inlong
order periods,
to get butaccurate
an need to check
response. if they could
Ask not
onlyoffor be aroused
deceased even forSick
feeding.
movement
<span
<span
The
except breathing.
style="color:blue">A sunken
style="color:blue">Unconsciousness
identification of unconsciousness
Thefontanelle,
child
is
does
means
largely
not
or
in
respond
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the soft
regardcomplete
to
even
spot
its in to
thephysical
front
inability
suggestion to stimuli
the
arouse
of brain the
or is who
including
head, neonate
central
were
pain.
a sign < 1 year
of serious
with
nervous no
system yes
old. For
neonates Children:
dehydration. could
This If
bemay "YES",
sleeping skip
be a for to Id10354.
long
difficult periods,
sign for For
theNeonate:
butnot
need
mother If
to or "YES",
check skip
if they
caregiver to
could
to id10281.</span>
not
notice orberecall.
aroused even
However, for feeding.
ifSick
probed
movement
disease or except
disorder.for
A breathing.
short period The
of child does
unconsciousness respond
usually even to physical
precedes death.stimuli
In the including
case of pain.
neonates, yes
The identification
carefully
neonates they
could beof
can unconsciousness
respond
sleeping correctly.
for is largely
Ask only inneed
for regard
deceased to its
whosuggestion
werecould 1 of
<system brain
year be or centraleven
old.</span> nervous system
delineating
disease or unconsciousness
disorder. A short aslong
period of
periods,
a specific but
symptom
unconsciousness of to check
brain
usuallyor if they
nervous
precedes
not
death. In
aroused
involvement
the case of
for feeding.
isneonates,
difficult. If
The identification
"NO/DK/Ref"
delineating to of unconsciousness
Id10281,
unconsciousness skip to is largely in regard to its suggestion of brain or central nervous system
Id10284</span>
as a specific symptom of brain or precedes
nervous system
yes
disease or disorder. A short period of unconsciousness usually death. involvement
In the case ofisneonates,
difficult. If
yes
"YES" to Id10282, skip to Id10284.</span>
delineating unconsciousness as a specific symptom of brain or nervous system involvement is difficult. If
"NO/DK/Ref" to Id10281, skip to Id10284. If "YES" to Id10282, skip to Id10284.</span> yes
<span
<span style="color:blue">Coldness
style="color:blue">Lethargy means of the body lack of indicates
strengthbody temperature
or activity, with dullness is belowinnormal, eyes. This andsign thismay is
associated with serious illness. However, this
not be easily recalled by the respondent. Need to explain carefully what is meant by lethargy or to is a subjective sign, and may not be easily recalled by the
respondent.
demonstrate Need
how atolethargic explain carefully baby will what is meant
look bleeding
like. If thein by baby coldnever to touch.</span>
had a death periodcould of normal activity
yes
<span style="color:blue">Excessive vaginal the week before be related to–this
the yes
should
terminal beillness.
"NO". This
<span style="color:blue">A </span> excessive previousbleeding questioncould be asked related about toyellow
pregnancy, labour, delivery
discolouration of the or eyes. notThis related question to any
<span
of these.
is to
<span
style="color:blue">Redness
Whatever
crosscheck the the
style="color:blue">Presence
responsecase, record to thatthe
of
of
question, umbilical
response
skin during
andtocord
ulcer(s)and or
vaginal
asks
sores,
might
about bleeding indicate
generalised
particularly
in the a serious
ifdelivery,
they
week preceding
yellow infection.
discolouration deathThis ofhere.is
skin an andim yes
Some
palms,degree of bleedingthe
feet. Sometimes, occurs yellow naturally
discolouration of the immediately
eyes mayafter not be easilyare filled iswith
which
observed, usually
but a yellowish
that controlled
of the yes
fluid
by
<span
whole (pus),
bodyindicates
standard procedures
style="color:blue">Many
may the by
be observed sign birthofand serious
attendants.
patients
recalled. skin
who infection,
TheBleeding
had urineCOVID-19, which
iswhich
also dark could
does
experience be related
not
yellow; getextreme
easily
and to controlled
there the iscause
fatigue. often ofa death.</span>
and
Many isillnesses
local continuous
term for are
and
known prolonged
to causeover
jaundice.</span> tirednessseveral and hours fatigue,couldsobe you considered
need to probe excessive, further andtoreferred
distinguish as such by the birth
just tiredness or slight yes
attendant
<span from team
fatiguestyle="color:blue">A to household
“extreme fatigue”. members,
swelling Typically,or lump andpatientsthis
in the could
breast
who potentially
had that remains
COVID-19 be recalled,
unresolved
find it hard with particular
toover get aout ofreference
period bed of andweeks to
its occurrence
during
would thestruggling
be period in the leading
toimmediate
do to death
regular week is aafter
activities, significant delivery.
such as sign On
taking ofthe a other
potentialshower hand,
cancer there
and changing of thecould breast. be excessive
clothes. This You usually
need bleeding
occurs
tothat
<span
not
in middle style="color:blue">Some
associated aged with
or pregnancy
elderly women. orpatients
delivery,
Although suffering
atthisany from
isage.
anextreme InCOVID-19
internal relation sign,to would
andmenstrual have may
hence reported
bleeding,not be toitdirectly
their
may be carers
observed yes
gently
they probe
have noticed to find someout whether
change the
in their deceased
ability tohad smell fatigue.</span>
considered
by respondents, excessive this when
condition a woman may have bleeds been morebrought thanor to taste
7 daysthe notice (1food.
week), You
of orneed
female to
usescaregivers
more clarify than that
insixtheyou are asking
well-soaked
family, and yes
about
sanitary
may any
triggerpadschange
anper attempt in the
day. toability
Clarify seek the to
healthsmellcare.
term or taste
“excessive” In someduring
asinstances,
well theasfinal the illness.</span>
the occurrence
growth inhad in
the the few days
breast may immediately
break through
<span
preceding style="color:blue">This
death, and record question
the response is to confirm
accordingly.</span> whether the deceased attained
the skin and
puberty/menarche, cause a non healing
with monthly ulcer. This
cyclesisofrelevant is an
bleedingfor openly from observable
the womb. sign,
If “yes”,and is usually
the cause ifofknown. brought her natural to thecould
death
<span
<span
attention style="color:blue">This
style="color:blue">NOTE:</span>
style="color:blue">This
of caregivers, to clean question
question
and dress clarifies
the wound. the womenlikely
Hence, duration
who
there may
is a of pregnancy,
have
high experienced
likelihood of the
recall when In early
<span
potentially style="color:blue">This
beoverdue
linked toperiod
pregnancy-relatedquestion aims to determine
conditions. Some if probing
the deceased or was pregnant
theclarification may at
bethe time
necessary ofresult
if the
<span
menopause,
present.
stages,
death. style="color:blue">●
Also,
the
That or
is, verystoppage
there
a “YES” may of
have
response For
regular
may women
been monthly
an
not
to thisyears); reported
attempt
confirm
question cycles to to never
of
seek
pregnancy,
means bleeding
health having
a foetus that
care,
unless a period
or havehappens
with the(i.e.,
household
baby experienced
remained Id10296=NO),
during
potential late
in the
isfor adulthood.
aware a skip
medical
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previous or removed.
Caesarean sections The uterus may
increases the also becertain
risk of removed if the woman
maternal causes isof yes
the answer
bleeding
death. Some is
heavily "ONE
and the
respondents or anymaynumber
bleeding notcannot greater
be aware of than
be stabilized ONE",
the term any thenway.
other
Caesarean proceed to
so the
However,
section next
despite
you question.</span>
can alsothisask
action,
aboutthea
mother
surgical is
orsometimes critical condition, and death can occur even after the operation. Though yes
already in adelivery.</span>
operative abdominal
rare, relatives are known to recall such events, so clarify if required and record the response accordingly.
Post-menopausal women may have the uterus removed due to a cancer of the reproductive tract.</span>
yes

<span style="color:blue">This is important to know because babies from multiple births carry additional
risks from some causes. If two or more children are born at the same time, it is counted as multiple births
even if one or more of the babies are born dead. Ask only for deceased who were < 1 year old. For
Neonates: If "NO/DK/Ref", skip to Id10356.</span> yes
<span style="color:blue">The
style="color:blue">Ask ifduration the childofhealth the pregnancy at the time
card is available. If the of card
delivery is an important
is available and the factor that
birth weight
could help inenter
is recorded, determining
the birththe causefrom
weight of deaththe card. of the neonate.
Record Deliveryinatgrams
the weight less thanin four 8 months pregnancy is
digits. Respondents
associated
may give the with smallerinsize
response babies, which
kilograms. For data carry the convert
entry, risks from to breathing
grams. 1 kilogram problems, birth injuries,
= 1,000 grams. Ifand the card
hypothermia
is not available (cold
and/or to touch). Recordisthe
birth weight notduration
available, carefully,
go to Id10363.asking the respondent
If weight is recorded,to count skipthe to completed
months from the date of last menstrual period till the date of delivery. If the respondent gives an answer in
Id10367.</span>
half-months (e.g. 6.5 months) or
<span style="color:blue">Low birthmonths
weight andis anweeks (e.g. 6 factor
important months and 2 weeks),
associated round down
with increased risk(e.g. enter
for neonatal yes
“6”)
death toparticularly
enter the completed from months.
breathing A valid response
problems, birth injury, is between
and 0–11. If the
hypothermia. response
Smaller than isusual
moresize than may 11 be
<span
months, style="color:blue">This
confirm the response question
and enter is“11”.
to beIfasked the only if the response
respondent can’t recall toexactly
Id10363the was "NO/DK/Ref".
difficult
Babies to
born explain
larger but than the mothers
usual are may be
associated able
withtoproblems
report whether
caused the baby
topregnancy
the was small.
mother during Ifduration,
“YES”,
delivery,
prompt
skipbut to
and
<spanrecord
Id10367.</span>
sometimes
according to
style="color:blue">Complications
the newborn
what is
also carries
medically relevant
during risks
increased labour to capture:
from or delivery
birth
if therefer to
injuries, and a fever lasted for
or infection,
from congenital
less than
the 8
malformations,
yes
months
occurrence - interviewer to enter 7 months; if the pregnancy lasted
of leakage of fluid from the birth canal before onset of pain; or very slow progression or for 8 or 9 months – interviewer to enter 9 yes
and diabetes.</span>
months; or ifofthe pregnancy lasted forofmore than 9injuries
monthsto– the interviewer to enter 10 months.among For don’t
obstruction labour:
<span style="color:blue">An or occurrence
abnormal birth canal mother; or
shape of limb due to physical deformity, or any external physical heavy bleeding, others. yes
know,
Ask enter “99”.
carefully, giving For refused,
these examplesenterif“88”.</span>
abnormality can cause difficult labour,required.
and can also Ask be forassociated
all children. withIf the child
other is under 1malformations
congenital year, proceed of with
yes
the
<spannext
internal questions.
style="color:blue">The
organs which If the
couldchild isthe
1 year
beduration cause orof
of older,
labour
death. skip
has to Id10418.</span>
If important
the answer implications
"NO", skipfor
is abnormalities tothe well-being
Id10382. of the
If "YES/DK/Ref"
<span
<span style="color:blue">This
newborn as well as
style="color:blue">Similarly, mother. question
thequestions.</span> Enquire specifically
and recordenquires
the occurrence ofthe about
totallarge
a very durationheadofislabour
also due affecting
from onsetthe
to conditions backbone,
of pains to
affecting yes
proceed
and with
can appear the next
as a in swelling or defect (absence of parts
delivery
the nervous of placenta
system. hours.
Again, thisIt is expected
condition is that
verythis rare, buti.e.
response bone
would
is often or tissue)
mostly associated
associated be
with an live with and
approximation,
birth the nervous ratherfor yes
survival
system.
than
some an These
exact
weeks and conditions
measurement. are Ifvery
longer, particularly lessrare,
than
with but would
1treatment.
hour enterbeThisrecalled
"0" hours. if present.</span>
condition A valid
is also response
noticeable is between 0 and 99. If the
<span
response style="color:blue">This
was more than 98Neonate: is usually
hours, confirm associated
theskip with
response either
and enterstillbirth
“98”.orIf"YES",
survival for and
the respondent onlywould few be
acan’t recalled
hours.
recall This yes
by respondents,
condition if present. If "YES", to Id10382. Children:If skip to Id10418</span>
exactly theisduration,
very rare,prompt and noticed and record by an absence
accordingoftobones whatof is the top of relevant
medically the head.toThis is a sensitive
capture: If labourissue, and so yes
need to be
delivery very careful not to upset the respondent while asking this question.</span>
lasted:</span>
<span style="color:blue">● for less than 24 hours - interviewer to enter 23 hours;</span>
<span
<span style="color:blue">●
style="color:blue">Usually for more the than
breaking 24 hoursof waters– interviewer
occurs a short to enter while25 (up
hours.</span>
to a few hours) before
<span style="color:blue">For don’t know, enter
onset of delivery. Leaking or breaking of water for more than 24 hours before delivery“99”. For refused, enter “88”. If the durationcan begiven happens
associated
to be
<span 88 hours, enter
style="color:blue">In
with infection and some other"87" so that
many causes the response
instances,
of death there is not automatically
may notbabies.
in newborn be a clear coded
Probe recall as refused
/ response
carefully to
to get answer.
tothethisaccurate </span>
question. In
<span
normal
response
<span
style="color:blue">Most
circumstances,
to this the liquor
question.</span>
style="color:blue">Liquor
deliveries
is like “water”
(waterwithout
occur with
in Such
the womb)
(i.e. no thespecific
head ofcolour).
may have
the baby
aany
In being
badinstruments,
smellbe
some delivered
instances,first,
if remembered,
thereis istermed
it may
an infection.
from the
be stained
Mothers
yes
birth canal.
with greenish Suchblack a delivery,
or brownif substances.
it occurs the assistance
discolouration of
would likely asonormal
an unclear or yes
would
delivery.be
uncertainAny able to recall
use of would
response this and
instruments, report.
usuallypresentation Probe
suggest that other carefully
the waters to
than headget a true
were first, response.
clear.orSelectdelivery </span>
the from an abdominal
appropriate response. For
operation,
any abnormal is not a normal delivery,
description, record the and is associated
response as stated, within a different
the narrative pattern of risks for the death of the
section.</span> yes
neonate. Clarify the meaning of normal vaginal delivery (taking care to specify head first”) to the yes
respondent,
<span before recording thea response.
style="color:blue">Often, local term Ifisthe response
applied for is "YES",
the use of skip to Id10391.
instruments to If thethe
assist response
delivery. is
<span style="color:blue">The
"NO/DK/Ref", proceed with theterm next “Caesarean” refers to an abdominal operation that is used to cut open yes
Enquire
the womb usingandthis term,the
extract and mark
child fromthequestion.</span>
response
the abdomen. accordingly.
This termMark the response
“Caesarean” accordingly,
is commonly known andtoifmembers
"YES",
then skip to Id10391. If "NO/DK/Ref", proceed with the next
of the community, but where necessary, the local words or terms for delivery of child through abdominal question.</span> yes
<span
operationstyle="color:blue">Pregnant
could be used.</span> women are given vaccine injections to prevent the occurrence of a yes
serious infection to newborn infants. Vaccination during previous pregnancies can also provide some
degree of protection, hence this
<span style="color:blue">Blood
style="color:blue">This question
pressure
question asks
is isasked for
checked to any suchwhether
during
identify vaccinations
periodic after
antenatal
there reaching
care visits,
is specific adulthood.
knowledge and if high, as toIf the
the
response
health
nature of is
workerthe"NO/DK/Ref",
would
vaccine inform then
received, the skip
i.e. to
pregnant Id10395.</span>
against women
tetanus. about
A high
positive blood
response pressure
to this and advise
question them
would to
help reduce
to salt
yes
<span style="color:blue">Convulsions
style="color:blue">Maternal
style="color:blue">Fever at some
the are
diabetes
time rapid twitching
ofisdelivery
associated is anor
withjerking
birth movements
indication ofoflarger
maternalsizedof infections,
parts ofwhich
babies, thewhichlimbs
have orrule
couldtheir yes
in
outthe diet,
tetanus
sometimes and
as
entirea possibly
cause
limbs, of prescribe
death
that of
usually neonates. medications.
Try carefullyHigh toblood
get a pressure
correct during
response pregnancy
to this may be
question.</span>
own
have risks
beenfor
associated with
neonatal
passed low tobirth
thedeath.
baby
weight at andthatlasts
Maternal time.
premature
for
diabetes Suchfewis minutes
infections
delivery
and
also associated
andcould stops
other bewithwhen
related the
various
complications. to person
types
the ofbecomes
cause
In some
congenital
of instances,
the death high of the
unconscious.
abnormalities
neonate, hence The common
including
identifying term
fever for
congenital convulsions
heart
induring
the isis
malformations.
mother anfits, andThe
important there
next isseries
oftenof
indicator.</span> a local
questionsterm relate
for such the health of yes
to movements.
blood
In
thesome pressure
mother instances,
during may manifest
high blood only
pregnancy pressure
and delivery. labour
during These or
pregnancydelivery.
symptoms canMothers
leadsigns
and and/or
to such are their
fits,
helpful relative
particularly
in identifying would
in thethe because
last able
3 to of yes
<span
recall
months. style="color:blue">Foul
and report
In the about
absenceMention high smelling
blood
of proper pressure
antenatalsecretionsand so from
probe the child
carefully. birth canal
</span> indicate a serious infection, and
death
are in the
usually neonate.
accompanied by pain the in nature
the lower ofcare,
the such convulsions
following
abdomen, and questions,
fever.
may
Such andbethethereason
infections
only major
canfor be
sign ofthem,
asking
transmitted
underlying
and
to
high
then
the
blood pressure in pregnant women, with its known risks to the neonate as described above.
proceed.</span>
neonate, and also cause serious
yes
Convulsions may only occurillnessduringleadinglabourto orneonatal
delivery, death. which is It ais serious
likely for and thedramatic
mother to event,remember
and would and
yes
recall
be this
readily sign if probed carefully.</span>
recalled. Clarify the meaning
<span style="color:blue">Blurred vision of the termasconvulsions,
is defined seeing objects the without
period of interest
clear shape (last 3 months)
or margins, orand yes
record the response.</span>
seeing double objects. This is also a sign of high blood pressure in pregnancy, but may be difficult to
remember and recall by the mother but careful probing may obtain an accurate response. </span> yes
<span style="color:blue">In some instances, pregnancy is associated with severe “thinning” of the blood,
which is observed as white or light colour of the tongue, nails, palms and eye margins. This condition is
known as anaemia, and is associated with premature delivery, low birth weight, birth asphyxia and other
complications.
<span Hence, identificationfrom of maternal anaemia helpsthe with theof diagnosis isofanthe cause ofsign, neonatal
<span style="color:blue">Bleeding
death. style="color:blue">The
</span> first part ofthe thebirthbabycanalto bebeforedelivered start
is usually labour
the head. important
Presentation of and
any yes
is often
other associated
body part firstwith(e.g.a bottom,
disorder feet,
of thearm placenta
or hand) (useis local
associatedterm).with Excessive
several bleeding
causes of endangers
neonatalthe life of
death,
both the mother
including and the
birth injuries, neonate.
severe This is usually
problems readily recalled and reported by the mother.</span> yes
<span style="color:blue">Mothers wouldwith know breathing
whetherand the lungcord infections.
was aroundMothers the neckusually but may know notthe body yes
part that was delivered first, and can give the true response
remember how many times. It is important to verify whether the cord was wrapped more than once, to this question if asked carefully. </span>
because
<span the risk of death of the is baby increases ifcondition,
it was wrapped more than with once.</span> yes
<span style="color:blue">This
style="color:blue">Bluish a relatively
colour of the rarebaby at birth is but is associated
suggestive of some problem adverse neonatal
affecting the yes
outcomes.
<span
breathing The
of themother may not may
style="color:blue">Consumption
baby. Mothers havebe fullof knowledge
able alcohol
to reportcouldofthat
its
beoccurrence.
associated
the baby was </span>
with blue liver
or disease,
became as darkwell as in
if carefully
relation to mental health conditions associated with depression and suicide, and also associated with risk
probed.</span> yes
taking leading to road traffic accidents or interpersonal violence. While alcohol may be directly related to
the
<spanspecific event or circumstance
style="color:blue">The termleading
“smoke” toisdeath,
used in there
thiscould question be an to underlying
specifically risk associated
capture kinds of withtobacco
chronic
that areor regularSmoking
smoked. alcohol consumption.
tobacco is related This to question
lung cancer,is intended to capture
oral cancer, regular consumption
and chronic asthma, among at others.
least
once
This question does not aim to capture use or consumption of chewing tobacco. The series inquires about of
a week or more often. Note any specific details provided by the respondent in the narrative section
the questionnaire.
smoking tobacco about This question
any period is used
during bylifethe(i.e.
automated
not only analysisthe current software.
status Because
before death). alcoholIfuse the isresponse
a
sensitive issue, no further
is "NO/DK/Ref", skip to Id10414.</span> information about frequency or quantity of use is asked.</span> yes
<span style="color:blue">Enter the duration for which the deceased smoked tobacco in number of months
yes
<span
or years. style="color:blue">The
If the deceased smoked question
for less intends
than 1to know if
month, there
enter was ever
1 month period in the life of the deceased yes
as aduration.</span>
when (s)he was smoking tobacco daily (i.e. at least 1 time per day) – even if it was not continuous or if the yes
deceased was not smoking in the period leading to death. Smoking daily is associated with significant health
<span
risks,
<span
style="color:blue">
even at low levels of In many instances of deaths that occur at home, there is a potential for the
consumption.</span> yes
<span style="color:blue">The
deceased to have received some
style="color:blue">Enter question
theform aims
of
duration medicalto
forcapture
attention
which consumption
the during thechewed
deceased ofillness
smokelessthat led
and/or tobacco
to death.
sniffed products
The in
tobacco in the
yes
form of
treatment chewing
number of could months and/or
have sniffing.
been inIf the
or years. If the
the form response
of a duration
deceased is "NO/DK/Ref",
chewed and/or of hospitalisation skip
sniffed tobaccoto Id10418.</span>
whichfor later
lessresulted
than 1 month,in the person
enter 1
being
monthdischarged prior to death, which sometimes occurs in instances where there is no potential cure, or yes
as duration.</span>
the
<spantreatment is too expensive,
style="color:blue">The or a cultural
question intends preference
to know if forthere
terminal care aatperiod
was ever home.inInthe such lifeinstances, there yes
of the deceased
is a likelihood
when (s)he was ofchewing
household members
and/or sniffing to tobacco
be awaredaily of the
(i.e.nature
at least of1medical
time per treatment
day) – even provided,
if it wasasnot well as
some information
continuous or if theondeceased
the likelywas disease or condition
not chewing and/or thatsniffing
the patientin thewas periodsuffering.
leadingIntothe following
death.</span> yes
questions,
<span record specific responses
style="color:blue">This question aboutrefershealthto services
formal healthas asked, and record
treatment, and anytraditional
not other or allied medicines,
<span style="color:blue">Oral
information on health servicesrehydration
or medical salts areassupplied
opinion as a packet of powdersection which of is to be dissolved
home
in water remedies
and given or non-professional
to individuals treatment.
suffering from If theto
diarrhoea,
the cause
response to in the
this narrative
question isThis
“NO”,is anthen
the
you will skip to
questionnaire.
Id10435. NOTE: This
These section shouldshould
questions alwaysbebe completed
answered at particularly
according the end to
children.
of the
whether interview.</span>
the patient
effective
received the
remedy
which is known to prevent death. This question only refers to packets supplied by health professionals, and yes
treatment
not home-made OR needed the treatment,
solutions. This question as recommended
is directed to assess by a health professional.
the availability and </span>
access to health
services.</span>
<span style="color:blue">Feeding
style="color:blue">A drip is through the
usually administered nasal tube in indicates potential
a healthimmunizations,
centre by damage tohealth
a trainedvaccines the nervous
care system,
worker.
yes
<span style="color:blue">Injectable antibiotics exclude and pain
and problems inofsuch
Administration a a manner
drip is of feeding
suggestive of can result
serious in partial
conditions such vomiting
as and infection of the lungs, leading yes
dehydration.</span>
killers.
<span
to death. Injectable
style="color:blue">A
Enquire about antibiotics
theblood
durationareformedications
transfusionwhichis feeding
also an against
indication
was provided bacterial
of the infections
severity
through theoftube,the administered
illness,
and whether and can bybe
the
suggestive
needle.
<span
tube was inofplace
They causes
are
style="color:blue">ART
rightof up
death
indicative associated
of therapy
drug
to death, serious with
and record acute
isinfection
given blood
to
all these of
patients loss.</span>
anywith
details part
in the or
HIV. parts
This therapy
narrative of theconsists
section body,
of the and arefor
of pills
yes
adults and oftenalmost
questionnaire.</span>
administered liquid suspensions
always only (syrups)
in health for children
facilities. that are taken usually
However, details on aof daily
such andtreatment
a long term yes
basis.
may
<spanor This question
may not bethis may
style="color:blue">An or
shared may not be
with family
operation relevant,
may also given
members.</span> the epidemiological profile of
be an indication of illness severity. The medical reason for yes the country or region
of
thethe countryiswhere
operation likely to be questionnaire
known to theisrelatives.
being administered.
If the response Also,isthe"YES",patient’s
enquire relatives
from the may not know
relatives if
these details. Explain the question carefully, and record the response
they know the medical condition (e.g. cancer, stomach ulcer, heart disease etc.) that was the reason for the accordingly.</span> yes
operation; and note the details intiming
<span style="color:blue">The the narrative
of the section
operation of the willquestionnaire.</span>
help ascertain any links between the yes
treatment and the cause of death.</span> yes
<span
<span style="color:blue">If the response
style="color:blue">Record is any
details of "NO/DK/Ref", then skip to Id10446.</span>
verbally communicated information on the likely cause of
yes
death here.</span>
<span style="color:blue">This may be a sensitive issue, but is very important information that may help
yes
determine the cause of death.</span> yes

<span style="color:blue">Ask to see the certificate or death registration paperwork. Interviewers should be
familiarized with the local civil registry
<span style="color:blue">Record authority and
the registration the appropriate
or certificate number. death
Noteregistration form(s)may
that respondents thathave
contain
a
the relevant death registration information as requested in this section. If "YES" and the paperwork is
“death notification” with a “notification” number or a “death certificate” with a “certificate”, “registration”,
available, continue with Id10070–Id10073. If the paperworkis not available, skip to Id10462.</span>
“serial,” or other number type. The project office should ensure all interviewers are clear on what number is yes
to be recorded. The project office may adapt this item to the local numbering customs. Enter “-“, if this
information is not available. </span>
yes
<span
<span style="color:blue">Record the full
style="color:blue">Record the details
National of place of registration.
Identification Number. ForThis may include
new-borns that the
havename
no IDof the yes
village/town/municipality date ofwas
registration if known. </span>
number, use the mother’s ID. If the mother’s ID is not available, use the father’s ID. If this information isThe
where the death registered. Enter “-“, if this information is not available.
project
unknown site
ormay add a drop-down
not available, listNote
enter “-“. of location
whose options.</span>
ID was entered in the blank after the ID has been
recorded.</span>
<span style="color:blue">Ask the respondent if there is a medical certificate of the cause of death for the
person that died. The medicalifcertificate
<span style="color:blue">Ask you can see of cause of death
the medical is commonly
certificate of causeobtained
of deathfrom in aorder
physician at a
to record
hospital and should be distinguished from the Death Certificate which is issued
information about the cause of death. During country adaptation, countries should specify the specific by the civil registration
organisation.
name During
civilcountry adaptation, countries should
thespecify the specific name of the local civil
<span of the local
style="color:blue">This
registration authority
registration
that section
issues the
authority
aims to
Death
that issues
collect
Certificates;
Death from
information
country
Certificates; country
the international
adaptation should also
adaptation should
standardif medical
indicate there are
also indicate
certificate if there
of cause of are other
death. “certificates”
This levelpermit
of detailsuch as
may the
or burial permit
may notmay that
be present this question
in thewith.</span> may
death certificatebe confused
issued to yes
other
with. “certificates”
<spanFill in Ifthe such
style="color:blue">This
following as the burial
section
questions aims
only tothat
ifinyou are this
collect
shownquestion
information
the copyfromofbe
theconfused
the international
certificate. Do standard
not fill from medical
in just based
the family.
certificate this detail
of cause of is not present,
death.“NO”
This iflevel fill “-”
of detail for Id10464–Id10473.
may or may notthe
becauseCopy
present the
in cause
the death of death the
certificate</span> first
issued to yes
on
lineoral
of statements.
the death Record
certificate. There medical
should information
always be a about
cause recorded here.of death
If a is not
duration available.
for which that
the family. If this detail is not present, fill in “-” for Id10464–Id10473. Copy the cause of death from the first yes
cause was experienced is also recorded in the column beside the cause, enter
line of the death certificate. There should always be a cause recorded here. If a duration for which that that in Id10465.</span>
cause
<span was experienced is also recorded
style="color:blue">Copy the causeinfrom the column beside
the second linethe
of cause,
the death enter that in Id10465.</span>
certificate if there is one listed
as well as its duration.</span>
<span style="color:blue">Copy the cause from the second line of the death certificate if there is one listed
as well as its duration.</span>
<span style="color:blue">Copy the cause from the third line of the death certificate if there is one listed as well as its duration
<span style="color:blue">Copy the cause from the third line of the death certificate if there is one listed as well as its duration
<span style="color:blue">Copy the cause from the fourth line of the death certificate if there is one listed as well as its duratio
<span style="color:blue">Copy the cause from the fourth line of the death certificate if there is one listed as well as its duratio
<span style="color:blue">List any contributing causes recorded in Part II of the death certificate.</span>
<span style="color:blue">List any contributing causes recorded in Part II of the death certificate.</span>

Record any additional details about the interviewer here.

<span style="color:blue">Record any additional details about the interviewer here.</span>

notes appearanc

field-list

no-calendar

no-calendar
no-calendar

year
horizontal-compact

field-list

new
multiline
symptoms or the perceived cause of death by the respondent.

was the result. In case someone had been tested more than once during the period of final illness, find out whether the LAST test was “po
field-list
no-calendar
listed as well as its duration.</span>
listed as well as its duration.</span>
e listed as well as its duration.</span>
e listed as well as its duration.</span>
 calculation

no-calendar

no-calendar
no-calendar
if(selected(${Id10022}, 'yes') and selected(${Id10020}, 'yes'),${Id10023_a},${Id10023_b})

(${Id10023} - ${Id10021})
(${Id10024} - ${Id10021})
int(${ageInDays} div 365.25)
${ageInDays} mod 365.25
int(${ageInYearsRemain} div 30.4375)
int(${ageInYearsRemain} mod 30.4375)
if(${ageInDays} <=27, '1', '0')
if(${ageInDays} >27 and ${ageInDays} <12*365.25, '1', '0')
 if(${ageInDays} >=12*365.25, '1', '0')

horizontal-compact

if (${ageInYears} != 'NaN' and string-length(${ageInYears}) > 0, int(${ageInYears} * 12 + ${ageInMonths}), if(${age_group} = 'ad

if(${age_group} = 'adult', ${age_adult}, int(${ageInMonthsByYear} div 12))
if(${age_group} = 'neonate', '1', '0')
if(${age_group} = 'child', '1', '0')
if(${age_group} = 'adult', '1', '0')
if(${ageInDays} = 'NaN' or ${ageInDays} = 'Invalid Date' or string-length(${ageInDays}) = 0, ${isNeonatal2}, ${isNeonatal1})
if(${ageInDays} = 'NaN' or ${ageInDays} = 'Invalid Date' or string-length(${ageInDays}) = 0, ${isChild2}, ${isChild1})
if(${ageInDays} = 'NaN' or ${ageInDays} = 'Invalid Date' or string-length(${ageInDays}) = 0, ${isAdult2}, ${isAdult1})
if(${ageInDays} = 'NaN' or ${ageInDays} = 'Invalid Date' or string-length(${ageInDays}) = 0, ${age_neonate_days}, ${ageInDays}
ved cause of death by the respondent.

someone had been tested more than once during the period of final illness, find out whether the LAST test was “positive”, “negative” or “
if(selected(${isNeonatal}, '1'),${Id10120_0}, if(${id10120_unit}='days', ${Id10120_1},if(${id10120_unit}='months', ${Id10121} *
if(selected(${isNeonatal}, '1'), ${Id10148_a},if(${Id10148_units}='days', ${Id10148_b},int(${Id10148_c} * 30)))

if(${Id10154_units}='days', ${Id10154_a},int(${Id10154_b} * 30))

if(selected(${isNeonatal}, '1'),${Id10161_0}, if(${id10161_unit}='days', ${Id10161_1},if(${id10161_unit}='months', ${Id10162} *

if(selected(${isNeonatal}, '1'), ${Id10167_a},if(${Id10167_units}='days', ${Id10167_b},${Id10167_c} * 30))

if(selected(${isAdult}, '1'),${Id10173_a} ,${Id10173_nc})

if(${Id10182_units}='days', ${Id10182_a},${Id10182_b} * 30)

if(selected(${id10196_unit}, 'days'),${Id10197_a}, if(${id10196_unit}='months', ${Id10198} * 30, int(${Id10196} div 24)))

if(selected(${Id10201_unit}, 'days'),${Id10201_a}, if(${Id10201_unit}='months', ${Id10202} * 30, null))

if(selected(${Id10205_unit}, 'days'),${Id10205_a}, if(${Id10205_unit}='months', ${Id10206} * 30, null))

if(${Id10209_units}='days', ${Id10209_a},${Id10209_b} * 30)

if(${Id10213_units}='days', ${Id10213_a} div 30,${Id10213_b})

if(${Id10216_units}='days', ${Id10216_b} * 24,${Id10216_a})

if(${Id10232_units}='days', ${Id10232_a},${Id10232_b}*30)

if(${Id10248_units}='days', ${Id10248_a},${Id10248_b}*30)
if(${Id10250_units}='days', ${Id10250_a},${Id10250_b}*30)

if(${Id10262_units}='days', ${Id10262_a},${Id10262_b}*30)

if(${Id10266_units}='days', ${Id10266_a},${Id10266_b}*30)

if(selected(${isNeonatal}, '1'), ${Id10274_a},if(${Id10274_units}='days', ${Id10274_b},${Id10274_c} * 30))

no-calendar
 ation.</span>
ation.</span>
uration.</span>
uration.</span>
default

${last-saved#Id10010}
${last-saved#Id10010a}
${last-saved#Id10010b}
${last-saved#Id10010c}
geInMonths}), if(${age_group} = 'adult', int(${age_adult} * 12),if (${age_child_unit} = 'months',${age_child_months}, int(${age_child_year

${isNeonatal2}, ${isNeonatal1})
${isChild2}, ${isChild1})
${isAdult2}, ${isAdult1})
${age_neonate_days}, ${ageInDays})
T test was “positive”, “negative” or “unclear”.</span>
10120_unit}='months', ${Id10121} * 30, ${Id10122} * 365)))
{Id10148_c} * 30)))

10161_unit}='months', ${Id10162} * 30, ${Id10163} * 365)))

10167_c} * 30))
* 30, int(${Id10196} div 24)))

* 30, null))

* 30, null))
10274_c} * 30))
constraint

(.>=18 and .<90) or .=99

.>=18 and .<=90

. <= today()

.>=${Id10021} and . <= today()

. <= today()

. <= today() and .>= date(date('1915-01-01'))

 not((${ageInDays2}>11*365.25 and selected(.,'child'))) and not(${ageInDays2}>27 and select
.>=0 and .<=27
.>=0 and .<=23

.>27 and .<=60

.>0 and .<=59
.>0 and .<=11
.>11 and .<120
child_months}, int(${age_child_years} * 12))))

not((selected(., 'dk') or selected(., 'None')) and count-selected(.)>1)

not((selected(., 'dk') or selected(., 'None')) and count-selected(.)>1)
not((selected(., 'dk') or selected(., 'None')) and count-selected(.)>1)

(.>=0 and .<=60) or .=99 or .=88

(.>=0 and .<=${ageInDaysNeonate}) or .=99 or .=88

(.>=0 and .<=${ageInDaysNeonate}) or .=99 or .=88

.>=1 and (.<= ${ageInMonthsByYear} and .<=11)

.>=1 and .<=${ageInYears2}
.>=0 and .<=30

(.>=0 and .<=${ageInDaysNeonate}) or .=99 or .=88

.>=0 and .<=30

.>=1 and .<=60
.>=0 and .<=30
.>=1 and .<=60

(.>=0 and .<=${ageInDaysNeonate}) or .=99 or .=88

.>=0 and .<=30

.>=1 and .<=11
.>=1 and .<=${ageInYears2}

(.>=0 and .<=${ageInDaysNeonate}) or .=99 or .=88

.>=0 and .<=30

.>=1 and .<=60

not((selected(., 'dk')) and count-selected(.) > 1) and not((selected(., 'ref')) and count-
selected(.) > 1) and not((selected(., 'no')) and count-selected(.) > 1)

.>=0 and .<=99

.>=0 and .<=23

.>=1 and .<=${Id10176}
.>=0 and .<=30
.>=1 and .<=60

(.>=0 and .<=20) or .=99 or .=88

(.>=0 and .<=${ageInDaysNeonate}) or .=99 or .=88

.>=0 and .<=30

.>=0 and .<=60

.>=0 and .<=30

.>=1 and .<=60

(.>=0 and .<=23) or .=99 or .=88

.>=1 and .<=30
.>=1 and .<=60

not((selected(., 'all_over')) and count-selected(.)>1)

.>=0 and .<=30

.>=1 and .<=60

.>=0 and .<=30

.>=1 and .<=60

.>=0 and .<=30

.>=1 and .<=60
.>=0 and .<=30
.>=1 and .<=60

.>=0 and .<=23

.>=1 and .<=99

.>=0 and .<=30

.>=1 and .<=60

.>=0 and .<=99

not((selected(., 'DK') or selected(., 'Ref')) and count-selected(.)>1)

.>=0 and .<=30

.>=1 and .<=60
.>=0 and .<=30
.>=1 and .<=60

not(selected(${Id10259}, 'yes') and (selected(., 'whole_body') or (selected(., 'left_side') and

.>=0 and .<=30

.>=1 and .<=60

.>=0 and .<=30

.>=1 and .<=60

(.>=0 and .<=${ageInDaysNeonate}) or .=99 or .=88

.>=0 and .<=30

.>=1 and .<=11
.>=0 and .<=99

(.>=0 and .<=11) or .=99 or .=88

.>=0 and .<=99

(.>=0 and .<=20) or .=99 or .=88

(.>=0 and .<=9999)

not(selected(${Id10363}, 'no') and selected(${Id10365}, 'no'))

(.>=0 and .<=11) or .=99 or .=88

.>=0 and .<=99

not(selected(${Id10387}, 'no') and selected(${Id10388}, 'no') and selected(., 'no'))

not(selected(${Id10413}, 'no') and (selected(., 'cigarettes') or selected(., 'pipe')))
not(selected(${Id10413}, 'no') and (selected(., 'cigarettes') or selected(., 'pipe')))

not(selected(${Id10413}, 'no') and (selected(., 'cigarettes') or selected(., 'pipe')))

constraint_message::English (en) read_only parameters

Interviewer should be an adult and not older than 89

Respondent should be an adult and not older than 90

Date can not be in the future

Year of Death can not be in the future

Age group is not compatible with date of birth and year of death indicated. Please review the selection or correct the data pre
Neonatal age is 0 to 27 days only!
maximum 23 hours

Child's age is above 28 days; If response was greater than 60 days, ask respondent to report time in another unit.
Number entered is not likely. If response was greater than 59 months, ask respondent to report time in years.
Child's age is between 28 days and 11 years only!
Adult age is above 11 years; an age above 120 years is unlikely.

quality=voice-only

It is not possible to select "Don't know" or "None of the above" together with other options.
It is not possible to select "Don't know" or "None of the above" together with other options.
It is not possible to select "Don't know" or "None of the above" together with other options.

Enter a number between 1 and 60. If the respondent says the baby never cried, go back and enter "No," the baby did not ever
Please enter a value less than the age in days at death.

Please enter a value less then neonatal age in days at death.

If response was greater than 11 months, ask respondent to report time in years. Please check as well that the value entered is
Duration entered exceeds age at death.
If response was greater than 30 days, ask respondent to report time in another unit.
TRUE

Please enter a value less then neonatal age in days at death.

If response
Likely was is
response greater
underthan 30 days,If ask
60 months. respondent
response was
to report time in months.
greater than 60 months, confirm the response and
enter 60.
If response
Likely was is
response greater
underthan 30 days,If ask
60 months. respondent
response was
to report time in months.
greater than 60 months, confirm the response and
enter 60.

Please enter a value less then neonatal age in days at death.

If response was greater than 30 days, ask respondent to report time in another unit.
If response was greater than 11 months, ask respondent to report time in years.
Duration entered exceeds age at death.
TRUE

Please enter a value less then neonatal age in days at death.

If response
Likely was is
response greater
underthan 30 days,If ask
60 months. respondent
response was
to reportthan
greater time60
in months,
months. confirm the response and
enter 60.

It is not possible to select "Don't know" or "refuse" or "no" together with other options. Please go back and correct the selecti

Please enter a value between 0 and 99. If response was greater than 98 days, confirm the response and enter 98.

If response was greater than 23 hours, ask respondent

to report time
Response in days.
should be less than the response for
ID10176.
If response
Likely was is
response greater
underthan 30 days,If ask
60 months. respondent
response was
to report time in months.
greater than 60 months, confirm the response and
enter 60.

Please enter a value between 1-20, 88, 99. If the response is more than 20, confirm the response and enter 20.
Please enter a value less then neonatal age in days at death.

If response
Likely was isgreater
response under than 30 days,
60 months. If ask respondent
response was
to report time in months.
greater than 60 months, confirm the response and
enter 60.

Likely response is under 60 months. If response was

If response
greater thanwas greater than
60 months, 30 days,
confirm ask respondent
the response and to report time in months.
enter 60.

If response was greater than 23 Hours, ask respondent to report time in another unit.
If response was greater than 30 days, ask respondent to report time in months
Likely response is under 60 months. If response is greater then 60, confirm the response and enter 60.
TRUE

Not possible to choose "All over" together with other choices

If response was greater than 30 days, ask respondent to report time in months
Likely response is under 60 months. If response is greater then 60, confirm the response and enter 60.
TRUE

If response
Likely was greater
response is underthan 30 days,If ask
60 months. respondent
response is to report time in months
greater then 60, confirm the response and enter 60.
TRUE

If response
Likely was greater
response is underthan 30 days,If ask
60 months. respondent
response is to report time in months
greater then 60, confirm the response and enter 60.
If response
Likely was greater
response is underthan 30 days,If ask
60 months. respondent
response is to report time in months
greater then 60, confirm the response and enter 60.

If response
Likely was is
response greater
underthan 23 hours,
99 days. ask respondent
If response was
to report time in days.
greater than 99 days, confirm the response and enter
99.

If response
Likely was greater
response is underthan 30 days, response
60 months.If ask respondent
is to report time in months
greater then 60, confirm the response and enter 60.

Please enter a value between 0 and 99. If response was greater than 98 days, confirm the response and enter 98.
It is not possible to select "Doesn't Know" or "Refused to answer" together with other options. Please go back and correct the

If response
Likely was greater
response is underthan 30 days, response
60 months.If ask respondent
is to report time in months
greater then 60, confirm the response and enter 60.
If response
Likely was greater
response is underthan 30 days, response
60 months.If ask respondent
is to report time in months
greater then 60, confirm the response and enter 60.

It is not possible to select "Doesn't Know" or "Refused to answer" together with other options or to select "only one side para

If response
Likely was greater
response is underthan 30 days, response
60 months.If ask respondent
is to report time in months
greater then 60, confirm the response and enter 60.

If response
Likely was greater
response is underthan 30 days, response
60 months.If ask respondent
is to report time in months
greater then 60, confirm the response and enter 60.

Please enter a value less then neonatal age in days at death.

If response was greater than 30 days, ask respondent to report time in months
Enter a response between 1-11 months.
Please enter a value between 0 and 99.

Please enter a value between 0 and 11 months. If the response is more than 11, confirm the response and enter 11.

Please enter a value between 0 and 99. If response was greater than 98 hours, confirm the response and enter 98.
Please enter a value between 0 and 20. If the response is more than 20, confirm the response and enter 20.

Please enter a value between 0 and 9999

It is not possible to select "No weighing under 2.5 kg" and "No weighing over 4.5 kg" together. Please go back and correct the
Please enter a value between 0 and 11 months.

Please enter a value between 0 and 99. If response was greater than 98 hours, confirm the response and enter 98.

It is not possible to select "No" to all three previous questions. Please go back and review the answers.
It is not possible to select cigarettes or pipe and "no" to "Did (s)he smoke tobacco?". Please go back and correct the selections
It is not possible to select cigarettes or pipe and "no" to "Did (s)he smoke tobacco?". Please go back and correct the selections

It is not possible to select cigarettes or pipe and "no" to "Did (s)he smoke tobacco?". Please go back and correct the selections
e selection or correct the data previously entered.

time in another unit.

ort time in years.
enter "No," the baby did not ever cry.
k as well that the value entered is less than the age of the deceased.
se go back and correct the selection.

sponse and enter 98.

onse and enter 20.
sponse and enter 98.
ns. Please go back and correct the selection.
s or to select "only one side paralysed" and "left and right side" or "whole body" together. . Please go back and correct the selection.
response and enter 11.

esponse and enter 98.

e and enter 20.

er. Please go back and correct the selection.

esponse and enter 98.

o back and correct the selections.
o back and correct the selections.

o back and correct the selections.

d correct the selection.
list_name name

language 1
language 2
language 3

age_group neonate
age_group child
age_group adult

YES_NO_REF yes
YES_NO_REF no
YES_NO_REF ref

YES_NO yes
YES_NO no

HIGH_LOW_VERY high
HIGH_LOW_VERY low
HIGH_LOW_VERY veryl

YES_NO_DK_REF yes
YES_NO_DK_REF no
YES_NO_DK_REF dk
YES_NO_DK_REF ref

YES_NO_DK_REF2 yes
YES_NO_DK_REF2 no
YES_NO_DK_REF2 dk
YES_NO_DK_REF2 ref

D_M_DK_REF days
D_M_DK_REF months
D_M_DK_REF DK
D_M_DK_REF ref

M_H_D_DK_REF minutes
M_H_D_DK_REF hours
M_H_D_DK_REF days
M_H_D_DK_REF DK
M_H_D_DK_REF ref

H_D_DK_REF hours
H_D_DK_REF days
H_D_DK_REF DK
H_D_DK_REF ref

H_D_M_DK hours
H_D_M_DK days
H_D_M_DK months
H_D_M_DK DK
H_D_M_DK ref

M_H_M_DK minutes
M_H_M_DK hours
M_H_M_DK months
M_H_M_DK DK

M_H_D_DK minutes
M_H_D_DK hours
M_H_D_DK days
M_H_D_DK DK
units days
units months
units years
units DK
units ref

unitsc days
unitsc months
unitsc years

units_1 days
units_1 months
units_1 years
units_1 DK
units_1 ref

units_2 days
units_2 months
units_2 DK
units_2 ref

units_3 hours
units_3 days
units_3 DK
units_3 ref

units_4 months
units_4 years
units_4 DK
units_4 ref

units_5 days
units_5 weeks
units_5 months
units_5 DK
units_5 ref

select_2 female
select_2 male
select_2 undetermined

select_18 hospital
select_18 other_health_facility
select_18 home
select_18 on_route_to_hospital_or_facility
select_18 other
select_18 DK
select_18 Ref

select_19 single
select_19 married
select_19 partner
select_19 divorced
select_19 widowed
select_19 too_young_to_be_married
select_19 DK
select_19 Ref

select_23 no_formal_education
select_23 primary_school
select_23 secondary_school
select_23 higher_than_secondary_school
select_23 DK
select_23 Ref

select_25 mainly_unemployed
select_25 mainly_employed
select_25 home-maker
select_25 pensioner
select_25 student
select_25 other
select_25 DK
select_25 Ref

select_32 parent
select_32 child
select_32 family_member
select_32 friend
select_32 spouse
select_32 health_worker
select_32 public_official
select_32 another_relationship
select_32 Ref

select_58 wet
select_58 dry
select_58 DK

select_63 mild
select_63 severe
select_63 DK
select_63 Ref

select_64 continuous
select_64 on_and_off
select_64 nightly
select_64 DK
select_64 Ref

select_80 continuous
select_80 on_and_off
select_80 DK
select_80 Ref

select_100 upper_right
select_100 upper_left
select_100 lower_right
select_100 lower_left
select_100 all_over
select_100 dk
select_100 ref

select_103 rapidly
select_103 slowly
select_103 DK
select_103 Ref

select_135 face
select_135 trunk
select_135 extremities
select_135 everywhere
select_135 DK
select_135 Ref
select_208 hospital
select_208 other_health_facility
select_208 home
select_208 on_route_to_hospital_or_facility
select_208 other
select_208 DK
select_208 Ref

select_221 before_delivery
select_221 during_delivery
select_221 after_delivery
select_221 DK
select_221 Ref

select_299 dog
select_299 snake
select_299 insect_or_scorpion
select_299 other
select_299 DK
select_299 Ref

select_306 cigarettes
select_306 pipe
select_306 chewing_tobacco
select_306 local_form_of_tobacco
select_306 other
select_306 DK
select_306 Ref

select_322 traditional_healer
select_322 homeopath
select_322 religious_leader
select_322 government_hospital
select_322 govment_health_center_or_clinic
select_322 private_hospital
select_322 community_based_pract_system
select_322 trained_birth_attendant
select_322 private_physician
select_322 relative_friend
select_322 pharmacy
select_322 dk
select_322 ref

select_500 citizen_at_birth
select_500 naturalized_citizen
select_500 foreign_national
select_500 dk
select_500 ref

select_501 stridor
select_501 grunting
select_501 wheezing
select_501 no
select_501 dk
select_501 ref

select_502 wheezing
select_502 no
select_502 dk
select_502 ref

select_510 Chronic_kidney_disease
select_510 Dialysis
select_510 Fever
select_510 Heart_attack
select_510 Heart_problem
select_510 Jaundice
select_510 Liver_failure
select_510 Malaria
select_510 Pneumonia
select_510 Renal_kidney_failure
select_510 Suicide
select_510 None

select_512 asphyxia
select_512 incubator
select_512 lung_problem
select_512 pneumonia
select_512 preterm_delivery
select_512 respiratory_distress
select_512 None

select_511 abdomen
select_511 cancer
select_511 dehydration
select_511 dengue
select_511 diarrhea
select_511 fever
select_511 heart_problem
select_511 jaundice
select_511 pneumonia
select_511 rash
select_511 None
select_520 green_or_brown
select_520 clear
select_520 other
select_520 dk
select_520 ref

select_530 Doctor
select_530 Midwife
select_530 Nurse
select_530 Relative
select_530 Self_mother
select_530 Traditional_birth_attendant
select_530 Other
select_530 DK
select_530 ref

select_531 positive
select_531 negative
select_531 unclear
select_531 dk
select_531 ref

select_532 before
select_532 after
select_532 dk
select_532 ref

select_533 singleton
select_533 twins
select_533 triplets
select_533 dk
select_533 ref

select_534 less
select_534 more
select_534 dk
select_534 ref

select_535 months
select_535 years
select_535 dk
select_535 ref
confirm yes
label::English (en)

English
Language 2
Language 3

Neonate
Child
Adult

Yes
No
Refused to answer

Yes
No

High
Low
Very low

Yes
No
Doesn't know
Refused to answer

Yes (SHE WAS NOT PREGNANT; AND SHE DID NOT RECENTLY DELIVER, HAVE ABORTION, OR MISCARRY)
No (SHE WAS PREGNANT OR SHE RECENTLY DELIVERED, HAD A
Doesn't know
Refused to answer

Days
Months
Doesn't know
Refused to answer

Minutes
Hours
Days
Doesn't know
Refused to answer

Hours
Days
Doesn't know
Refused to answer

Hours
Days
Months
Doesn't know
Refused to answer

Minutes
Hours
Months
Doesn't know

Minutes
Hours
Days
Doesn't know
Days
Months
Years
Doesn't know
Refused to answer

Days
Months
Years

Days
Months
Years
Doesn't know
Refused to answer

Days
Months
Doesn't know
Refused to answer

Hours
Days
Doesn't know
Refused to answer

Months
Years
Doesn't know
Refused to answer

Days
Weeks
Months
Doesn't know
Refused to answer

Female
Male
Ambiguous/Intersex

Hospital
Other health facility
Home
On route to hospital or facility
Other
Doesn't know
Refused to answer

Single
Married
Life partner
Divorced
Widowed
Too young to be married
Doesn't know
Refused to answer

No formal education
Primary school
Secondary school
Higher than secondary school
Doesn't know
Refused to answer

Mainly unemployed
Mainly employed
Home-maker
Pensioner
Student
Other
Doesn't know
Refused to answer

Parent
Child
Other family member
Friend
Spouse
Health worker
Public official
Another relationship
Refused to answer

Wet
Dry
Doesn't know

Mild
Severe
Doesn't know
Refused to answer

Continuous
On and off
Only at night
Doesn't know
Refused to answer

Continuous
On and off
Doesn't know
Refused to answer

Upper right abdomen

Upper left abdomen
Lower right abdomen
Lower left abdomen
All over the abdomen
Doesn't know
Refused to answer

Rapidly
Slowly
Doesn't know
Refused to answer

Face
Trunk or abdomen
Extremities
Everywhere
Doesn't know
Refused to answer
Hospital
Other health facility
Home
On route to hospital or facility
Other
Doesn't know
Refused to answer

Before delivery
During delivery
After delivery
Doesn't know
Refused to answer

Dog
Snake
Insect or scorpion
Other
Doesn't know
Refused to answer

Cigarettes
Pipe
Chewing tobacco
Local form of tobacco
Other
Doesn't know
Refused to answer

Traditional healer
Homeopath
Religious leader
Government hospital
Government health center or clinic
Private hospital
Community-based practitioner associated with health system
Trained birth attendant
Private physician
Relative, friend (outside household)
Pharmacy
Doesn't know
Refused to answer

Citizen at birth
Naturalized citizen
Foreign national
Doesn't know
Refused to answer

Stridor
Grunting
Wheezing
None of the above
Doesn't know
Refused to answer

Wheezing
No
Doesn't know
Refused to answer

Chronic kidney disease

Dialysis
Fever
Heart attack
Heart problem
Jaundice
Liver failure
Malaria
Pneumonia
Renal (kidney) failure
Suicide
None of the above words were mentioned

Asphyxia
Incubator
Lung problem
Pneumonia
Preterm delivery
Respiratory distress
None of the above words were mentioned

Abdomen
Cancer
Dehydration
Dengue fever
Diarrhoea
Fever
Heart problems
Jaundice (yellow skin or eyes)
Pneumonia
Rash
None of the above words were mentioned
Green or brown
Clear (normal)
Other
Doesn't know
Refused to answer

Doctor
Midwife
Nurse
Relative
Self (the mother)
Traditional birth attendant
Other
Doesn’t know
Refused to answer

Positive
Negative
Unclear
Don’t know
Refused to answer

Before
After
Don’t know
Refused to answer

singleton
twins
triplets or more
Don’t know
Refused to answer

less or equal to 7 days

more than 7 days
Don’t know
Refused to answer

Months
Years
Don’t know
Refused to answer
I confirm this was not a maternal death
label::French (fr)

nouveau-né
enfant
adulte

Oui
Non
Refus de repondre

Oui
Non

Haut
Bas
Très bas

Oui
Non
Ne sait pas
Refus de repondre

Yes (SHE WAS NOT PREGNANT; AND SHE DID NOT RECENTLY DELIVER, HAVE ABORTION, OR MISCARRY)
No (SHE WAS PREGNANT OR SHE RECENTLY DELIVERED, HAD AN ABORTION OR MISCARRIED)
Ne sait pas
Refus de repondre

Jour
Mois
Ne sait pas
Refus de repondre

Minutes
Heures
Jour
Ne sait pas
Refus de repondre

Heures
Jour
Ne sait pas
Refus de repondre

Heures
Jour
Mois
Ne sait pas
Refus de repondre

Minutes
Heures
Mois
Ne sait pas

Minutes
Heures
Jour
Ne sait pas
Jour
mois
année
Ne sait pas
Refus de repondre

Jour
mois
année

Jour
mois
année
Ne sait pas
Refus de repondre

Jour
mois
Ne sait pas
Refus de repondre

Heures
Jour
Ne sait pas
Refus de repondre

mois
année
Ne sait pas
Refus de repondre

Jour

mois
Ne sait pas
Refus de repondre

Féminin
Masculin
Ambiguous/intersex

hôpital
autre établissement de santé
à domicile
sur la route de hôpital ou de établissement
autres
Ne sait pas
Refus de repondre

Célibataire
Marié(e)
Vie avec un Partenaire
Divorcé(e)
Veuf (ve)
Trop jeune pour être marié(e)
Ne sait pas
Refus de repondre

Aucune éducation formelle

école primaire
Secondary school
Higher than secondary school
Ne sait pas
Refus de repondre

Principalement au chômage
Employé
Auxiliaire familial
Pensionné
Etudiant
Autres
Ne sait pas
Refus de repondre

Parent
Enfant
Autre membre de la famille
Ami
Spouse
Soignant
Agent Public
une autre relation
Refus de repondre

HUMIDE
SÈCHE
Ne sait pas

Légère
grave
Ne sait pas
Refus de repondre

Continue
Des hauts et des bas
Seul la nuit
Ne sait pas
Refus de repondre

Continue
Des hauts et des bas
Ne sait pas
Refus de repondre

Ne sait pas
Refus de repondre

Rapidement
lentement
Ne sait pas
Refus de repondre

Visage

Extrémités
partout
Ne sait pas
Refus de repondre
Hôpital
autre établissement de santé
à domicile
en route vers l'hôpital
Autres
Ne sait pas
Refus de repondre

avant accouchement
pendant accouchement
après livraison
Ne sait pas
Refus de repondre

Chien
serpent
insecte ou scorpion
autres
Ne sait pas
Refus de repondre

Cigarette
Pipe
Mâcher du tabac
autres formes locales de tabacs
Autre
Ne sait pas
Refus de repondre

Guérisseur traditionnel homéopathe

homéopathe
Homme de religion
hôpital public
centre de santé clinique
hôpital privé
Praticien communautaire
Sage femme
Médecin privé

Pharmacie
Ne sait pas
Refus de repondre

Citoyen à la naissance
Citoyen naturalisé
Ressortissant étranger
Ne sait pas
Refus de repondre

Stridor
Grognement
une respiration sifflante

Ne sait pas
Refus de repondre

une respiration sifflante

Non
Ne sait pas
Refus de repondre
Y DELIVER, HAVE ABORTION, OR MISCARRY)
D, HAD AN ABORTION OR MISCARRIED)
form_title version
2022 WHO Verbal Autopsy instrument V1.1 2023072701
form_id style default_language
va_who_2022 pages English (en)