SlideShare a Scribd company logo
1 of 5
Download to read offline
Form ID: 
1 
Department of Community Medicine 
VMCH & RI, Madurai 
Family health survey 
General info 
1. House no. / EB no. 
2. Street or area name 
3. Name of head of the family 
4. Education of the head of the family 
5. Occupation of the head of the family 
6. Total family income Rs. 
7. Total no. of family members 
8. Type of the family 1. Nuclear 2. Extended 
9. Religion of the family 1. Hindu 2. Islam 3. Christianity 
Family members 
No. Name Age 
(yr) 
Sex Relation 
with 
head 
Marital 
status 
Edu Occu Income 
Per 
month 
1. 0 
2. 
3. 
4. 
5. 
6. 
7. 
Codes: 
Sex: 
1-Male, 
2-Female 
Relation with head 
0-Head 
1-Wife 
2-Husband 
3-Son 
4-Daughter 
5-Son in law 
6-Daughter in law 
7-Grand children 
8-Other (uncle, aunt, nephew, niece etc.,) 
Marital status: 
1-Never married 
2-Currently married 
3-Divorced 
4-Widowed 
5-Separated 
Education: 
1-Not yet started school 
2-Still studying 
3-No formal schooling but can read and write 
4-Completed primary school (1-5 std) 
5-Completed middle school (6-8 std) 
6-Completed secondary school (9-10 std) 
7-Completed higher secondary school (11-12 std) 
8-Completed diploma 
9-Completed college degree 
Occupation: (only for persons aged 14 and more) 
1-Still studying or student 
2-Unemployed (not studying, not working) 
3-Retired from work (for persons aged >60 years) 
4-Unskilled 
5-Semiskilled, 6-Skilled 
Income: 
Ask about the usual income per month 
Add income from rent and other sources to the total family 
income.
Form ID: 
2 
Environmental sanitation 
10. Type of house 
1. Kutcha 
2. Pucca 
3. Semi-pucca 
11. No. of living rooms 
12. Overcrowding 
1. Present 
2. Absent 
13. Ventilation 
1. Adequate 
2. Inadequate 
14. Lighting 
1. Adequate 
2. Inadequate 
15. Kitchen location 
1. Separate room 
2. Within a room used for other 
purpose 
3. Outside the house 
16. Kitchen type 
1. Smokeless 
2. Smoky 
17. Bathroom 
1. Present within house 
2. Present outside house 
3. Absent 
18. Sanitary latrine 
1. Present and using 
2. Present but not using 
3. Absent 
19. Drainage 
1. Proper 
2. Improper 
20. Source of drinking water 
1. Hand pump within house 
2. Public hand pump 
3. Municipal pipe in house 
4. Public tap 
5. Well within house 
6. Public well 
7. Pond 
8. Mineral/RO water bought from 
shops in cans 
9. Tube well within house 
10. Others:____________________________ 
Over crowding criteria 
Rooms Persons 
1 2 
2 3 
3 5 
4 7 
5 10
Form ID: 
3 
Maternal health (fill only for married women in 15-45 years age group who have been pregnant in the last five years) 
Name Age at 
marriage 
No. of 
pregnancies 
in last 5 
years 
(including 
abortions) 
No. of 
children 
born in 
last 5 
years 
Whether TT 
taken during 
last pregnancy 
Whether IFA 
taken during 
last pregnancy 
(approx.. 100 
tablets) 
Place of delivery 
of last pregnancy 
Last 
pregnancy 
outcome 
Present status of 
last child born alive 
(fill only if alive in 
prev. column) 
1 1. Yes 
2. No 
1. Yes 
2. No 
1. Hosp 
2. Home 
1. Alive 
2. Stillbirth 
3. Aborted 
1. Alive 
2. Dead 
2 1. Yes 
2. No 
1. Yes 
2. No 
1. Hosp 
2. Home 
1. Alive 
2. Stillbirth 
3. Aborted 
1. Alive 
2. Dead 
3 
4 
5 
Currently pregnant women (fill only if there is a currently pregnant women in the house) 
Name Which trimester? 
Registered or 
not so far? 
No. 
of 
visits 
TT1 TT2 TT Booster 
IFA received 
so far or not 
Choice of 
delivery place 
1 1. First 
2. Second 
3. Third 
1. Yes 
2. No 
1. Yes 
2. No 
1. Yes 
2. No 
1. Yes 
2. No 
1. Yes 
2. No 
1. Home 
2. Govt. 
3. Pvt. 
2 
3
Form ID: 
4 
Child feeding practices (fill only for children below 2 years) 
No. Name Age 
(mo) 
Prelacteal 
feed 
Type of 
prelacteal feed 
given 
Breast feeding Type of weaning food 
Initiation time EBF time 
When stopped 
given at start 
(hours after 
(mo) 
completely (mo) 
birth) 
1 1. Given 
2. Not 
given 
1. Sugar water 
2. Honey 
3. Animal milk 
4. Holy water 
5. ___________ 
99. Not at all 
given 
1. <30 min 
2. 30 min-1hr 
3. 1-4hr 
4. >4hr 
99. Not at all 
given 
1. <6 months 
2. >6 months 
99. Not at all 
given 
1. <6 months 
2. 6 mo-1 yr 
3. > 1 year 
99. Not yet started 
1. animal milk 
2. rice 
3. dal 
4. vegetable 
5. kichdi 
6. cerelac, nestum, 
lactogen, milk powder 
7. others 
____________________ 
2 
3 
Immunization (fill only for children aged 12 to 24 months at present) 
No. Name 
Whether immunization 
card present 
BCG, OPV 
0 dose 
OPV, Pentavalent 
Measles 
Reasons: If any 
1 2 3 vaccine is not given 
1 
1. Yes 
2. No 
1. Yes 
2. No 
1. Yes 
2. No 
1. Yes 
2. No 
1. Yes 
2. No 
1. Yes 
2. No 
2
Form ID: 
5 
Health care utilization 
No. 
When some one in your family falls sick, where do you go 
for treatment? (Write the most common option) 
1. We don’t go anywhere, prefer home remedy 
2. Local healer 
3. Govt. hospital 
4. Pvt. qualified doctor 
1 Reasons for preferring this option (only for options 2,3,4) 
1. Known to us 
2. Comfortable 
3. Cheap 
4. Recommended by friends or relatives 
5. Others _______________ 
Diabetes and Hypertension 
No. Name What disease? 
Whether currently 
taking treatment? 
What type of 
treatment? 
Regularity of treatment 
1 
1. HTN 
2. Diabetes 
3. Both 
1.Yes 
2. No 
1. Allopathic 
2. Alternative medicine 
3. Both 
1. Regular 
2. Irregular 
2 
3

More Related Content

What's hot

Concepts of community health and community health nursing
Concepts of community health and community health nursingConcepts of community health and community health nursing
Concepts of community health and community health nursingHarsh Rastogi
 
Health Education with individual, Family and Community
Health Education with individual, Family and CommunityHealth Education with individual, Family and Community
Health Education with individual, Family and CommunityRaksha Yadav
 
Principles of community health nursing
Principles of community health nursingPrinciples of community health nursing
Principles of community health nursingmary jacob
 
COMMUNITY HEALTH NURSING
COMMUNITY HEALTH NURSINGCOMMUNITY HEALTH NURSING
COMMUNITY HEALTH NURSINGJAYDIP NINAMA
 
Family health nursing process
Family health nursing processFamily health nursing process
Family health nursing processJose Anilda
 
Vital statistics
Vital statisticsVital statistics
Vital statisticsanjalatchi
 
School health service ppt
School health service pptSchool health service ppt
School health service pptkarizz vaidya
 
Community health nursing
Community health nursingCommunity health nursing
Community health nursingNursing Path
 
Seminar on trends, issue, challanges in community health nursing and care de...
Seminar on trends, issue, challanges in community health nursing and  care de...Seminar on trends, issue, challanges in community health nursing and  care de...
Seminar on trends, issue, challanges in community health nursing and care de...PaRas JaIn
 
Primary health care slide share
Primary health care  slide sharePrimary health care  slide share
Primary health care slide shareanjalatchi
 
VITAL STATISTICS IN INDIA
VITAL STATISTICS IN INDIAVITAL STATISTICS IN INDIA
VITAL STATISTICS IN INDIABHANU DIXIT
 

What's hot (20)

Concepts of community health and community health nursing
Concepts of community health and community health nursingConcepts of community health and community health nursing
Concepts of community health and community health nursing
 
Health Education with individual, Family and Community
Health Education with individual, Family and CommunityHealth Education with individual, Family and Community
Health Education with individual, Family and Community
 
Home visit
Home visitHome visit
Home visit
 
Community Health Nursing- referral-system
Community Health Nursing-  referral-systemCommunity Health Nursing-  referral-system
Community Health Nursing- referral-system
 
Family health record
Family health recordFamily health record
Family health record
 
Principles of community health nursing
Principles of community health nursingPrinciples of community health nursing
Principles of community health nursing
 
COMMUNITY HEALTH NURSING
COMMUNITY HEALTH NURSINGCOMMUNITY HEALTH NURSING
COMMUNITY HEALTH NURSING
 
Family health nursing process
Family health nursing processFamily health nursing process
Family health nursing process
 
Vital statistics
Vital statisticsVital statistics
Vital statistics
 
Iphs for subcentre
Iphs for subcentreIphs for subcentre
Iphs for subcentre
 
Family Health Care Plan
Family Health Care PlanFamily Health Care Plan
Family Health Care Plan
 
School health service ppt
School health service pptSchool health service ppt
School health service ppt
 
Community health nursing
Community health nursingCommunity health nursing
Community health nursing
 
Recent Advances in RCH - India
Recent Advances in RCH - IndiaRecent Advances in RCH - India
Recent Advances in RCH - India
 
Seminar on trends, issue, challanges in community health nursing and care de...
Seminar on trends, issue, challanges in community health nursing and  care de...Seminar on trends, issue, challanges in community health nursing and  care de...
Seminar on trends, issue, challanges in community health nursing and care de...
 
Small family norms
Small family normsSmall family norms
Small family norms
 
Bag technique
Bag techniqueBag technique
Bag technique
 
Primary health care slide share
Primary health care  slide sharePrimary health care  slide share
Primary health care slide share
 
VITAL STATISTICS IN INDIA
VITAL STATISTICS IN INDIAVITAL STATISTICS IN INDIA
VITAL STATISTICS IN INDIA
 
1 concepts of health & health care
1  concepts of health & health care1  concepts of health & health care
1 concepts of health & health care
 

Viewers also liked

Family folder format
Family folder formatFamily folder format
Family folder formatNursing Path
 
Family folder format
Family folder formatFamily folder format
Family folder formatNursing Path
 
Family case study
Family case studyFamily case study
Family case studyaschnei
 
Family study community medicine presentation
Family study community medicine presentationFamily study community medicine presentation
Family study community medicine presentationMohit kadyan
 
Revise Family Case Presentation Final
Revise Family Case Presentation   FinalRevise Family Case Presentation   Final
Revise Family Case Presentation Finalliza mariposque
 
A ideal case presention in psm
A ideal case presention in psmA ideal case presention in psm
A ideal case presention in psmASHWANI123PANDEY
 
Village health survey format
 Village health survey format  Village health survey format
Village health survey format Rizwan S A
 
Proforma for village household survey
Proforma for village household surveyProforma for village household survey
Proforma for village household surveyRizwan S A
 
Clinico social case Presentation
Clinico social case PresentationClinico social case Presentation
Clinico social case PresentationKyaw San Lin
 
NATIONAL IMMUNISATION PROGRAMME ...
NATIONAL IMMUNISATION PROGRAMME ...NATIONAL IMMUNISATION PROGRAMME ...
NATIONAL IMMUNISATION PROGRAMME ...amol askar
 
public attitudes water and sanitation marwan haddad 2005
public attitudes water and sanitation marwan haddad 2005public attitudes water and sanitation marwan haddad 2005
public attitudes water and sanitation marwan haddad 2005Marwan Haddad
 
Slideshare rural health survey analysis
Slideshare    rural health survey analysisSlideshare    rural health survey analysis
Slideshare rural health survey analysisyellowpomelo_pratik
 
Family Assessment Interview
Family Assessment InterviewFamily Assessment Interview
Family Assessment InterviewCodi Leggett
 
Guidelines for filling Village Health Survey proforma
Guidelines for filling Village Health Survey proformaGuidelines for filling Village Health Survey proforma
Guidelines for filling Village Health Survey proformaRizwan S A
 
Health Survey Results 2013
Health Survey Results 2013Health Survey Results 2013
Health Survey Results 2013PhRMA
 
Gender inequality in advertising
Gender inequality in advertisingGender inequality in advertising
Gender inequality in advertisingdolface88
 

Viewers also liked (20)

Family folder format
Family folder formatFamily folder format
Family folder format
 
Family folder format
Family folder formatFamily folder format
Family folder format
 
Family case study
Family case studyFamily case study
Family case study
 
Family study community medicine presentation
Family study community medicine presentationFamily study community medicine presentation
Family study community medicine presentation
 
Revise Family Case Presentation Final
Revise Family Case Presentation   FinalRevise Family Case Presentation   Final
Revise Family Case Presentation Final
 
A ideal case presention in psm
A ideal case presention in psmA ideal case presention in psm
A ideal case presention in psm
 
Village health survey format
 Village health survey format  Village health survey format
Village health survey format
 
IFPRI -AOS Survey in Bhutan
IFPRI -AOS Survey in BhutanIFPRI -AOS Survey in Bhutan
IFPRI -AOS Survey in Bhutan
 
Proforma for village household survey
Proforma for village household surveyProforma for village household survey
Proforma for village household survey
 
Clinico social case Presentation
Clinico social case PresentationClinico social case Presentation
Clinico social case Presentation
 
NATIONAL IMMUNISATION PROGRAMME ...
NATIONAL IMMUNISATION PROGRAMME ...NATIONAL IMMUNISATION PROGRAMME ...
NATIONAL IMMUNISATION PROGRAMME ...
 
CLINICO SOCIAL CASE STUDY
CLINICO SOCIAL CASE STUDYCLINICO SOCIAL CASE STUDY
CLINICO SOCIAL CASE STUDY
 
public attitudes water and sanitation marwan haddad 2005
public attitudes water and sanitation marwan haddad 2005public attitudes water and sanitation marwan haddad 2005
public attitudes water and sanitation marwan haddad 2005
 
The family as a unit
The family as a unitThe family as a unit
The family as a unit
 
Oral health surveys
Oral health surveysOral health surveys
Oral health surveys
 
Slideshare rural health survey analysis
Slideshare    rural health survey analysisSlideshare    rural health survey analysis
Slideshare rural health survey analysis
 
Family Assessment Interview
Family Assessment InterviewFamily Assessment Interview
Family Assessment Interview
 
Guidelines for filling Village Health Survey proforma
Guidelines for filling Village Health Survey proformaGuidelines for filling Village Health Survey proforma
Guidelines for filling Village Health Survey proforma
 
Health Survey Results 2013
Health Survey Results 2013Health Survey Results 2013
Health Survey Results 2013
 
Gender inequality in advertising
Gender inequality in advertisingGender inequality in advertising
Gender inequality in advertising
 

Similar to Family health survey format

Family index case.pptx
Family index case.pptxFamily index case.pptx
Family index case.pptxSuhani Chhabra
 
Family case study OBG. Use for Assignment
Family case study OBG. Use for AssignmentFamily case study OBG. Use for Assignment
Family case study OBG. Use for Assignmentsonal patel
 
Clinic psychosocial Case on functional constipation in a child
Clinic psychosocial Case on  functional constipation in a childClinic psychosocial Case on  functional constipation in a child
Clinic psychosocial Case on functional constipation in a childYogesh Arora
 
Descriptive Assessment of Depression and Anxiety Symptoms in an Outpatient Ob...
Descriptive Assessment of Depression and Anxiety Symptoms in an Outpatient Ob...Descriptive Assessment of Depression and Anxiety Symptoms in an Outpatient Ob...
Descriptive Assessment of Depression and Anxiety Symptoms in an Outpatient Ob...ErikaAGoyer
 
Clinical Social Cultural Demographic Proforma.pptx
Clinical Social Cultural Demographic Proforma.pptxClinical Social Cultural Demographic Proforma.pptx
Clinical Social Cultural Demographic Proforma.pptxshubha davalgi
 
Clinical lecture- 2History Taking-1.pptx
Clinical lecture- 2History Taking-1.pptxClinical lecture- 2History Taking-1.pptx
Clinical lecture- 2History Taking-1.pptxsantosh Sk.Singh48
 
A case study on cirrhosis of liver
A case study on cirrhosis of liverA case study on cirrhosis of liver
A case study on cirrhosis of livereducation4227
 
HEALTH 8: Dating, Courtship and Marriage
HEALTH 8: Dating, Courtship and MarriageHEALTH 8: Dating, Courtship and Marriage
HEALTH 8: Dating, Courtship and MarriageKristineRanyah
 
English for midwife unit 2
English for midwife unit 2English for midwife unit 2
English for midwife unit 2Chanmara Cheng
 
case study on Cardiomyopathy
case study on Cardiomyopathycase study on Cardiomyopathy
case study on Cardiomyopathyeducation4227
 
Courtship, Dating, and Marriage MAPEH 8.pptx
Courtship, Dating, and Marriage MAPEH 8.pptxCourtship, Dating, and Marriage MAPEH 8.pptx
Courtship, Dating, and Marriage MAPEH 8.pptxquimcokeichie
 
FAMILY HEALTH CARE
FAMILY HEALTH CAREFAMILY HEALTH CARE
FAMILY HEALTH CARESuraj Dhara
 
100321536 case-study
100321536 case-study100321536 case-study
100321536 case-studyhomeworkping7
 
Case Study on Mucopolysaccharidosis
Case Study on MucopolysaccharidosisCase Study on Mucopolysaccharidosis
Case Study on MucopolysaccharidosisRashmi Regmi
 
210489573 62553270-case-study-on-chronic-kidney-disease
210489573 62553270-case-study-on-chronic-kidney-disease210489573 62553270-case-study-on-chronic-kidney-disease
210489573 62553270-case-study-on-chronic-kidney-diseasehomeworkping8
 

Similar to Family health survey format (20)

Family index case.pptx
Family index case.pptxFamily index case.pptx
Family index case.pptx
 
Family case study OBG. Use for Assignment
Family case study OBG. Use for AssignmentFamily case study OBG. Use for Assignment
Family case study OBG. Use for Assignment
 
Clinic psychosocial Case on functional constipation in a child
Clinic psychosocial Case on  functional constipation in a childClinic psychosocial Case on  functional constipation in a child
Clinic psychosocial Case on functional constipation in a child
 
Descriptive Assessment of Depression and Anxiety Symptoms in an Outpatient Ob...
Descriptive Assessment of Depression and Anxiety Symptoms in an Outpatient Ob...Descriptive Assessment of Depression and Anxiety Symptoms in an Outpatient Ob...
Descriptive Assessment of Depression and Anxiety Symptoms in an Outpatient Ob...
 
Clinical Social Cultural Demographic Proforma.pptx
Clinical Social Cultural Demographic Proforma.pptxClinical Social Cultural Demographic Proforma.pptx
Clinical Social Cultural Demographic Proforma.pptx
 
Clinico-social case format
Clinico-social case formatClinico-social case format
Clinico-social case format
 
Clinical lecture- 2History Taking-1.pptx
Clinical lecture- 2History Taking-1.pptxClinical lecture- 2History Taking-1.pptx
Clinical lecture- 2History Taking-1.pptx
 
A case study on cirrhosis of liver
A case study on cirrhosis of liverA case study on cirrhosis of liver
A case study on cirrhosis of liver
 
HEALTH 8: Dating, Courtship and Marriage
HEALTH 8: Dating, Courtship and MarriageHEALTH 8: Dating, Courtship and Marriage
HEALTH 8: Dating, Courtship and Marriage
 
English for midwife unit 2
English for midwife unit 2English for midwife unit 2
English for midwife unit 2
 
case study on Cardiomyopathy
case study on Cardiomyopathycase study on Cardiomyopathy
case study on Cardiomyopathy
 
Courtship, Dating, and Marriage MAPEH 8.pptx
Courtship, Dating, and Marriage MAPEH 8.pptxCourtship, Dating, and Marriage MAPEH 8.pptx
Courtship, Dating, and Marriage MAPEH 8.pptx
 
FAMILY HEALTH CARE
FAMILY HEALTH CAREFAMILY HEALTH CARE
FAMILY HEALTH CARE
 
100321536 case-study
100321536 case-study100321536 case-study
100321536 case-study
 
Case Study on Mucopolysaccharidosis
Case Study on MucopolysaccharidosisCase Study on Mucopolysaccharidosis
Case Study on Mucopolysaccharidosis
 
Questionnaire
QuestionnaireQuestionnaire
Questionnaire
 
Tle
TleTle
Tle
 
All clinico social formats
All clinico social formatsAll clinico social formats
All clinico social formats
 
Family health assessment
Family health assessmentFamily health assessment
Family health assessment
 
210489573 62553270-case-study-on-chronic-kidney-disease
210489573 62553270-case-study-on-chronic-kidney-disease210489573 62553270-case-study-on-chronic-kidney-disease
210489573 62553270-case-study-on-chronic-kidney-disease
 

More from Rizwan S A

Introduction to scoping reviews
Introduction to scoping reviewsIntroduction to scoping reviews
Introduction to scoping reviewsRizwan S A
 
Sources of demographic data 2019
Sources of demographic data 2019Sources of demographic data 2019
Sources of demographic data 2019Rizwan S A
 
Effect sizes in meta-analysis
Effect sizes in meta-analysisEffect sizes in meta-analysis
Effect sizes in meta-analysisRizwan S A
 
Presenting the results of meta-analysis
Presenting the results of meta-analysisPresenting the results of meta-analysis
Presenting the results of meta-analysisRizwan S A
 
Heterogeneity in meta-analysis
Heterogeneity in meta-analysisHeterogeneity in meta-analysis
Heterogeneity in meta-analysisRizwan S A
 
Overview of the systematic review process
Overview of the systematic review processOverview of the systematic review process
Overview of the systematic review processRizwan S A
 
Biases in meta-analysis
Biases in meta-analysisBiases in meta-analysis
Biases in meta-analysisRizwan S A
 
Moderator analysis in meta-analysis
Moderator analysis in meta-analysisModerator analysis in meta-analysis
Moderator analysis in meta-analysisRizwan S A
 
Fixed-effect and random-effects models in meta-analysis
Fixed-effect and random-effects models in meta-analysisFixed-effect and random-effects models in meta-analysis
Fixed-effect and random-effects models in meta-analysisRizwan S A
 
Inverse variance method of meta-analysis and Cochran's Q
Inverse variance method of meta-analysis and Cochran's QInverse variance method of meta-analysis and Cochran's Q
Inverse variance method of meta-analysis and Cochran's QRizwan S A
 
Data extraction/coding and database structure in meta-analysis
Data extraction/coding and database structure in meta-analysisData extraction/coding and database structure in meta-analysis
Data extraction/coding and database structure in meta-analysisRizwan S A
 
Introduction & rationale for meta-analysis
Introduction & rationale for meta-analysisIntroduction & rationale for meta-analysis
Introduction & rationale for meta-analysisRizwan S A
 
Types of correlation coefficients
Types of correlation coefficientsTypes of correlation coefficients
Types of correlation coefficientsRizwan S A
 
Checking for normality (Normal distribution)
Checking for normality (Normal distribution)Checking for normality (Normal distribution)
Checking for normality (Normal distribution)Rizwan S A
 
Analysis of small datasets
Analysis of small datasetsAnalysis of small datasets
Analysis of small datasetsRizwan S A
 
A introduction to non-parametric tests
A introduction to non-parametric testsA introduction to non-parametric tests
A introduction to non-parametric testsRizwan S A
 
Kruskal Wallis test, Friedman test, Spearman Correlation
Kruskal Wallis test, Friedman test, Spearman CorrelationKruskal Wallis test, Friedman test, Spearman Correlation
Kruskal Wallis test, Friedman test, Spearman CorrelationRizwan S A
 
Kolmogorov Smirnov good-of-fit test
Kolmogorov Smirnov good-of-fit testKolmogorov Smirnov good-of-fit test
Kolmogorov Smirnov good-of-fit testRizwan S A
 
Mantel Haenszel methods in epidemiology (Stratification)
Mantel Haenszel methods in epidemiology (Stratification) Mantel Haenszel methods in epidemiology (Stratification)
Mantel Haenszel methods in epidemiology (Stratification) Rizwan S A
 
Use of checklists in critical appraisal of health literature
Use of checklists in critical appraisal of health literatureUse of checklists in critical appraisal of health literature
Use of checklists in critical appraisal of health literatureRizwan S A
 

More from Rizwan S A (20)

Introduction to scoping reviews
Introduction to scoping reviewsIntroduction to scoping reviews
Introduction to scoping reviews
 
Sources of demographic data 2019
Sources of demographic data 2019Sources of demographic data 2019
Sources of demographic data 2019
 
Effect sizes in meta-analysis
Effect sizes in meta-analysisEffect sizes in meta-analysis
Effect sizes in meta-analysis
 
Presenting the results of meta-analysis
Presenting the results of meta-analysisPresenting the results of meta-analysis
Presenting the results of meta-analysis
 
Heterogeneity in meta-analysis
Heterogeneity in meta-analysisHeterogeneity in meta-analysis
Heterogeneity in meta-analysis
 
Overview of the systematic review process
Overview of the systematic review processOverview of the systematic review process
Overview of the systematic review process
 
Biases in meta-analysis
Biases in meta-analysisBiases in meta-analysis
Biases in meta-analysis
 
Moderator analysis in meta-analysis
Moderator analysis in meta-analysisModerator analysis in meta-analysis
Moderator analysis in meta-analysis
 
Fixed-effect and random-effects models in meta-analysis
Fixed-effect and random-effects models in meta-analysisFixed-effect and random-effects models in meta-analysis
Fixed-effect and random-effects models in meta-analysis
 
Inverse variance method of meta-analysis and Cochran's Q
Inverse variance method of meta-analysis and Cochran's QInverse variance method of meta-analysis and Cochran's Q
Inverse variance method of meta-analysis and Cochran's Q
 
Data extraction/coding and database structure in meta-analysis
Data extraction/coding and database structure in meta-analysisData extraction/coding and database structure in meta-analysis
Data extraction/coding and database structure in meta-analysis
 
Introduction & rationale for meta-analysis
Introduction & rationale for meta-analysisIntroduction & rationale for meta-analysis
Introduction & rationale for meta-analysis
 
Types of correlation coefficients
Types of correlation coefficientsTypes of correlation coefficients
Types of correlation coefficients
 
Checking for normality (Normal distribution)
Checking for normality (Normal distribution)Checking for normality (Normal distribution)
Checking for normality (Normal distribution)
 
Analysis of small datasets
Analysis of small datasetsAnalysis of small datasets
Analysis of small datasets
 
A introduction to non-parametric tests
A introduction to non-parametric testsA introduction to non-parametric tests
A introduction to non-parametric tests
 
Kruskal Wallis test, Friedman test, Spearman Correlation
Kruskal Wallis test, Friedman test, Spearman CorrelationKruskal Wallis test, Friedman test, Spearman Correlation
Kruskal Wallis test, Friedman test, Spearman Correlation
 
Kolmogorov Smirnov good-of-fit test
Kolmogorov Smirnov good-of-fit testKolmogorov Smirnov good-of-fit test
Kolmogorov Smirnov good-of-fit test
 
Mantel Haenszel methods in epidemiology (Stratification)
Mantel Haenszel methods in epidemiology (Stratification) Mantel Haenszel methods in epidemiology (Stratification)
Mantel Haenszel methods in epidemiology (Stratification)
 
Use of checklists in critical appraisal of health literature
Use of checklists in critical appraisal of health literatureUse of checklists in critical appraisal of health literature
Use of checklists in critical appraisal of health literature
 

Recently uploaded

Next Gen Ophthalmic Imaging for Neurodegenerative Diseases and Oculomics
Next Gen Ophthalmic Imaging for Neurodegenerative Diseases and OculomicsNext Gen Ophthalmic Imaging for Neurodegenerative Diseases and Oculomics
Next Gen Ophthalmic Imaging for Neurodegenerative Diseases and OculomicsPetteriTeikariPhD
 
Nutrition of OCD for my Nutritional Neuroscience Class
Nutrition of OCD for my Nutritional Neuroscience ClassNutrition of OCD for my Nutritional Neuroscience Class
Nutrition of OCD for my Nutritional Neuroscience Classmanuelazg2001
 
Phytochemical Investigation of Drugs PDF.pdf
Phytochemical Investigation of Drugs PDF.pdfPhytochemical Investigation of Drugs PDF.pdf
Phytochemical Investigation of Drugs PDF.pdfDivya Kanojiya
 
23470206-Esophageal-Cancer.ppt for medical surgical nursing
23470206-Esophageal-Cancer.ppt for medical surgical nursing23470206-Esophageal-Cancer.ppt for medical surgical nursing
23470206-Esophageal-Cancer.ppt for medical surgical nursingakoeljames8543
 
World-Health-Day-2024-My-Health-My-Right.pptx
World-Health-Day-2024-My-Health-My-Right.pptxWorld-Health-Day-2024-My-Health-My-Right.pptx
World-Health-Day-2024-My-Health-My-Right.pptxEx WHO/USAID
 
Rapid Release Granulation Technology ppt
Rapid Release Granulation Technology pptRapid Release Granulation Technology ppt
Rapid Release Granulation Technology pptHasnat Tariq
 
Plasma proteins and their functions for Nursing .pptx
Plasma proteins and their functions for Nursing .pptxPlasma proteins and their functions for Nursing .pptx
Plasma proteins and their functions for Nursing .pptxRajendra Dev Bhatt
 
CEHPALOSPORINS.pptx By Harshvardhan Dev Bhoomi Uttarakhand University
CEHPALOSPORINS.pptx By Harshvardhan Dev Bhoomi Uttarakhand UniversityCEHPALOSPORINS.pptx By Harshvardhan Dev Bhoomi Uttarakhand University
CEHPALOSPORINS.pptx By Harshvardhan Dev Bhoomi Uttarakhand UniversityHarshChauhan475104
 
Plant Fibres used as Surgical Dressings PDF.pdf
Plant Fibres used as Surgical Dressings PDF.pdfPlant Fibres used as Surgical Dressings PDF.pdf
Plant Fibres used as Surgical Dressings PDF.pdfDivya Kanojiya
 
Presentació "Real-Life VR Integration for Mild Cognitive Impairment Rehabilit...
Presentació "Real-Life VR Integration for Mild Cognitive Impairment Rehabilit...Presentació "Real-Life VR Integration for Mild Cognitive Impairment Rehabilit...
Presentació "Real-Life VR Integration for Mild Cognitive Impairment Rehabilit...Badalona Serveis Assistencials
 
L1.INTRODUCTION to ENDOCRINOLOGY MEDICINE.pptx
L1.INTRODUCTION to ENDOCRINOLOGY MEDICINE.pptxL1.INTRODUCTION to ENDOCRINOLOGY MEDICINE.pptx
L1.INTRODUCTION to ENDOCRINOLOGY MEDICINE.pptxDr Bilal Natiq
 
CPCSEA guidelines and IAEC committee.pptx
CPCSEA guidelines and IAEC committee.pptxCPCSEA guidelines and IAEC committee.pptx
CPCSEA guidelines and IAEC committee.pptxMs. Kiran Divekar
 
Aditi Jagtap (Daughter of Ranjit Jagtap).pdf
Aditi Jagtap (Daughter of Ranjit Jagtap).pdfAditi Jagtap (Daughter of Ranjit Jagtap).pdf
Aditi Jagtap (Daughter of Ranjit Jagtap).pdfAditi Jagtap Pune
 
Presentation for Bella Mahl 2024-03-28-24-MW-Overview-Bella.pptx
Presentation for Bella Mahl 2024-03-28-24-MW-Overview-Bella.pptxPresentation for Bella Mahl 2024-03-28-24-MW-Overview-Bella.pptx
Presentation for Bella Mahl 2024-03-28-24-MW-Overview-Bella.pptxpdamico1
 
Chronic-Fatigue-Syndrome-CFS-Understanding-a-Complex-Disorder.pptx
Chronic-Fatigue-Syndrome-CFS-Understanding-a-Complex-Disorder.pptxChronic-Fatigue-Syndrome-CFS-Understanding-a-Complex-Disorder.pptx
Chronic-Fatigue-Syndrome-CFS-Understanding-a-Complex-Disorder.pptxSasikiranMarri
 
Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...
Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...
Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...MehranMouzam
 
PHYSIOTHERAPY IN HEART TRANSPLANTATION..
PHYSIOTHERAPY IN HEART TRANSPLANTATION..PHYSIOTHERAPY IN HEART TRANSPLANTATION..
PHYSIOTHERAPY IN HEART TRANSPLANTATION..AneriPatwari
 
Tans femoral Amputee : Prosthetics Knee Joints.pptx
Tans femoral Amputee : Prosthetics Knee Joints.pptxTans femoral Amputee : Prosthetics Knee Joints.pptx
Tans femoral Amputee : Prosthetics Knee Joints.pptxKezaiah S
 
Introduction to Sports Injuries by- Dr. Anjali Rai
Introduction to Sports Injuries by- Dr. Anjali RaiIntroduction to Sports Injuries by- Dr. Anjali Rai
Introduction to Sports Injuries by- Dr. Anjali RaiGoogle
 

Recently uploaded (20)

Next Gen Ophthalmic Imaging for Neurodegenerative Diseases and Oculomics
Next Gen Ophthalmic Imaging for Neurodegenerative Diseases and OculomicsNext Gen Ophthalmic Imaging for Neurodegenerative Diseases and Oculomics
Next Gen Ophthalmic Imaging for Neurodegenerative Diseases and Oculomics
 
Nutrition of OCD for my Nutritional Neuroscience Class
Nutrition of OCD for my Nutritional Neuroscience ClassNutrition of OCD for my Nutritional Neuroscience Class
Nutrition of OCD for my Nutritional Neuroscience Class
 
Phytochemical Investigation of Drugs PDF.pdf
Phytochemical Investigation of Drugs PDF.pdfPhytochemical Investigation of Drugs PDF.pdf
Phytochemical Investigation of Drugs PDF.pdf
 
23470206-Esophageal-Cancer.ppt for medical surgical nursing
23470206-Esophageal-Cancer.ppt for medical surgical nursing23470206-Esophageal-Cancer.ppt for medical surgical nursing
23470206-Esophageal-Cancer.ppt for medical surgical nursing
 
World-Health-Day-2024-My-Health-My-Right.pptx
World-Health-Day-2024-My-Health-My-Right.pptxWorld-Health-Day-2024-My-Health-My-Right.pptx
World-Health-Day-2024-My-Health-My-Right.pptx
 
Rapid Release Granulation Technology ppt
Rapid Release Granulation Technology pptRapid Release Granulation Technology ppt
Rapid Release Granulation Technology ppt
 
Plasma proteins and their functions for Nursing .pptx
Plasma proteins and their functions for Nursing .pptxPlasma proteins and their functions for Nursing .pptx
Plasma proteins and their functions for Nursing .pptx
 
CEHPALOSPORINS.pptx By Harshvardhan Dev Bhoomi Uttarakhand University
CEHPALOSPORINS.pptx By Harshvardhan Dev Bhoomi Uttarakhand UniversityCEHPALOSPORINS.pptx By Harshvardhan Dev Bhoomi Uttarakhand University
CEHPALOSPORINS.pptx By Harshvardhan Dev Bhoomi Uttarakhand University
 
Plant Fibres used as Surgical Dressings PDF.pdf
Plant Fibres used as Surgical Dressings PDF.pdfPlant Fibres used as Surgical Dressings PDF.pdf
Plant Fibres used as Surgical Dressings PDF.pdf
 
Presentació "Real-Life VR Integration for Mild Cognitive Impairment Rehabilit...
Presentació "Real-Life VR Integration for Mild Cognitive Impairment Rehabilit...Presentació "Real-Life VR Integration for Mild Cognitive Impairment Rehabilit...
Presentació "Real-Life VR Integration for Mild Cognitive Impairment Rehabilit...
 
L1.INTRODUCTION to ENDOCRINOLOGY MEDICINE.pptx
L1.INTRODUCTION to ENDOCRINOLOGY MEDICINE.pptxL1.INTRODUCTION to ENDOCRINOLOGY MEDICINE.pptx
L1.INTRODUCTION to ENDOCRINOLOGY MEDICINE.pptx
 
CPCSEA guidelines and IAEC committee.pptx
CPCSEA guidelines and IAEC committee.pptxCPCSEA guidelines and IAEC committee.pptx
CPCSEA guidelines and IAEC committee.pptx
 
Aditi Jagtap (Daughter of Ranjit Jagtap).pdf
Aditi Jagtap (Daughter of Ranjit Jagtap).pdfAditi Jagtap (Daughter of Ranjit Jagtap).pdf
Aditi Jagtap (Daughter of Ranjit Jagtap).pdf
 
Presentation for Bella Mahl 2024-03-28-24-MW-Overview-Bella.pptx
Presentation for Bella Mahl 2024-03-28-24-MW-Overview-Bella.pptxPresentation for Bella Mahl 2024-03-28-24-MW-Overview-Bella.pptx
Presentation for Bella Mahl 2024-03-28-24-MW-Overview-Bella.pptx
 
Chronic-Fatigue-Syndrome-CFS-Understanding-a-Complex-Disorder.pptx
Chronic-Fatigue-Syndrome-CFS-Understanding-a-Complex-Disorder.pptxChronic-Fatigue-Syndrome-CFS-Understanding-a-Complex-Disorder.pptx
Chronic-Fatigue-Syndrome-CFS-Understanding-a-Complex-Disorder.pptx
 
JANGAMA VISHA .pptx-
JANGAMA VISHA .pptx-JANGAMA VISHA .pptx-
JANGAMA VISHA .pptx-
 
Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...
Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...
Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...
 
PHYSIOTHERAPY IN HEART TRANSPLANTATION..
PHYSIOTHERAPY IN HEART TRANSPLANTATION..PHYSIOTHERAPY IN HEART TRANSPLANTATION..
PHYSIOTHERAPY IN HEART TRANSPLANTATION..
 
Tans femoral Amputee : Prosthetics Knee Joints.pptx
Tans femoral Amputee : Prosthetics Knee Joints.pptxTans femoral Amputee : Prosthetics Knee Joints.pptx
Tans femoral Amputee : Prosthetics Knee Joints.pptx
 
Introduction to Sports Injuries by- Dr. Anjali Rai
Introduction to Sports Injuries by- Dr. Anjali RaiIntroduction to Sports Injuries by- Dr. Anjali Rai
Introduction to Sports Injuries by- Dr. Anjali Rai
 

Family health survey format

  • 1. Form ID: 1 Department of Community Medicine VMCH & RI, Madurai Family health survey General info 1. House no. / EB no. 2. Street or area name 3. Name of head of the family 4. Education of the head of the family 5. Occupation of the head of the family 6. Total family income Rs. 7. Total no. of family members 8. Type of the family 1. Nuclear 2. Extended 9. Religion of the family 1. Hindu 2. Islam 3. Christianity Family members No. Name Age (yr) Sex Relation with head Marital status Edu Occu Income Per month 1. 0 2. 3. 4. 5. 6. 7. Codes: Sex: 1-Male, 2-Female Relation with head 0-Head 1-Wife 2-Husband 3-Son 4-Daughter 5-Son in law 6-Daughter in law 7-Grand children 8-Other (uncle, aunt, nephew, niece etc.,) Marital status: 1-Never married 2-Currently married 3-Divorced 4-Widowed 5-Separated Education: 1-Not yet started school 2-Still studying 3-No formal schooling but can read and write 4-Completed primary school (1-5 std) 5-Completed middle school (6-8 std) 6-Completed secondary school (9-10 std) 7-Completed higher secondary school (11-12 std) 8-Completed diploma 9-Completed college degree Occupation: (only for persons aged 14 and more) 1-Still studying or student 2-Unemployed (not studying, not working) 3-Retired from work (for persons aged >60 years) 4-Unskilled 5-Semiskilled, 6-Skilled Income: Ask about the usual income per month Add income from rent and other sources to the total family income.
  • 2. Form ID: 2 Environmental sanitation 10. Type of house 1. Kutcha 2. Pucca 3. Semi-pucca 11. No. of living rooms 12. Overcrowding 1. Present 2. Absent 13. Ventilation 1. Adequate 2. Inadequate 14. Lighting 1. Adequate 2. Inadequate 15. Kitchen location 1. Separate room 2. Within a room used for other purpose 3. Outside the house 16. Kitchen type 1. Smokeless 2. Smoky 17. Bathroom 1. Present within house 2. Present outside house 3. Absent 18. Sanitary latrine 1. Present and using 2. Present but not using 3. Absent 19. Drainage 1. Proper 2. Improper 20. Source of drinking water 1. Hand pump within house 2. Public hand pump 3. Municipal pipe in house 4. Public tap 5. Well within house 6. Public well 7. Pond 8. Mineral/RO water bought from shops in cans 9. Tube well within house 10. Others:____________________________ Over crowding criteria Rooms Persons 1 2 2 3 3 5 4 7 5 10
  • 3. Form ID: 3 Maternal health (fill only for married women in 15-45 years age group who have been pregnant in the last five years) Name Age at marriage No. of pregnancies in last 5 years (including abortions) No. of children born in last 5 years Whether TT taken during last pregnancy Whether IFA taken during last pregnancy (approx.. 100 tablets) Place of delivery of last pregnancy Last pregnancy outcome Present status of last child born alive (fill only if alive in prev. column) 1 1. Yes 2. No 1. Yes 2. No 1. Hosp 2. Home 1. Alive 2. Stillbirth 3. Aborted 1. Alive 2. Dead 2 1. Yes 2. No 1. Yes 2. No 1. Hosp 2. Home 1. Alive 2. Stillbirth 3. Aborted 1. Alive 2. Dead 3 4 5 Currently pregnant women (fill only if there is a currently pregnant women in the house) Name Which trimester? Registered or not so far? No. of visits TT1 TT2 TT Booster IFA received so far or not Choice of delivery place 1 1. First 2. Second 3. Third 1. Yes 2. No 1. Yes 2. No 1. Yes 2. No 1. Yes 2. No 1. Yes 2. No 1. Home 2. Govt. 3. Pvt. 2 3
  • 4. Form ID: 4 Child feeding practices (fill only for children below 2 years) No. Name Age (mo) Prelacteal feed Type of prelacteal feed given Breast feeding Type of weaning food Initiation time EBF time When stopped given at start (hours after (mo) completely (mo) birth) 1 1. Given 2. Not given 1. Sugar water 2. Honey 3. Animal milk 4. Holy water 5. ___________ 99. Not at all given 1. <30 min 2. 30 min-1hr 3. 1-4hr 4. >4hr 99. Not at all given 1. <6 months 2. >6 months 99. Not at all given 1. <6 months 2. 6 mo-1 yr 3. > 1 year 99. Not yet started 1. animal milk 2. rice 3. dal 4. vegetable 5. kichdi 6. cerelac, nestum, lactogen, milk powder 7. others ____________________ 2 3 Immunization (fill only for children aged 12 to 24 months at present) No. Name Whether immunization card present BCG, OPV 0 dose OPV, Pentavalent Measles Reasons: If any 1 2 3 vaccine is not given 1 1. Yes 2. No 1. Yes 2. No 1. Yes 2. No 1. Yes 2. No 1. Yes 2. No 1. Yes 2. No 2
  • 5. Form ID: 5 Health care utilization No. When some one in your family falls sick, where do you go for treatment? (Write the most common option) 1. We don’t go anywhere, prefer home remedy 2. Local healer 3. Govt. hospital 4. Pvt. qualified doctor 1 Reasons for preferring this option (only for options 2,3,4) 1. Known to us 2. Comfortable 3. Cheap 4. Recommended by friends or relatives 5. Others _______________ Diabetes and Hypertension No. Name What disease? Whether currently taking treatment? What type of treatment? Regularity of treatment 1 1. HTN 2. Diabetes 3. Both 1.Yes 2. No 1. Allopathic 2. Alternative medicine 3. Both 1. Regular 2. Irregular 2 3