{ "resourceType" : "Questionnaire", "id" : "espen-mda-supervision-cdd", "meta" : { "tag" : [{ "system" : "https://icr.healthcampaigns.org/CodeSystem/icr-project-tag-cs", "code" : "espen", "display" : "ESPEN" }] }, "text" : { "status" : "extensions", "div" : "

Generated Narrative: Questionnaire espen-mda-supervision-cdd

Tag: ESPEN (Details: ICR Project Tag code espen = 'ESPEN')

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LinkIDTextCardinalityTypeFlagsDescription & Constraints\"doco\"
\".\"\".\" EspenMDASupervisionCDDESPEN MDA demo Form 6 (CDD observation supervision): direct observation of a community drug distributor's technique and attitude during treatment, MDA-supplies availability, CDD training coverage, and free-text challenges/solutions/recommendations. No extraction templates: per ICRSupervisionReport (working doc §4.6) the QuestionnaireResponse itself is the supervision record.Questionnairehttps://icr.healthcampaigns.org/Questionnaire/espen-mda-supervision-cdd#0.1.0
\".\"\".\"\".\" s_supervisorSupervisor Team0..1choiceOptions: 5 options
\".\"\".\"\".\" s_stateSelect region1..1string
\".\"\".\"\".\" s_districtSelect district1..1string
\".\"\".\"\".\" s_health_facilityHealth facility1..1string
\".\"\".\"\".\" s_locationVillage1..1string
\".\"\".\"\".\" s_date_startCampaign start date1..1date
\".\"\".\"\".\" s_date_endCampaign end date1..1date
\".\"\".\"\".\" s_diseaseDisease covered by the MDA1..*choiceValue Set: ICR NTD Disease
\".\"\".\"\".\" s_medicineSelect the medicine package1..*choiceValue Set: ICR MDA Medicine Package
\".\"\".\"\".\" s_medicine_sufficientDo the distributors have the medications in sufficient quantities?1..1boolean
\".\"\".\"\".\" s_total_dist_trained_maleTotal Distributor Male Trained for the campagne1..1integer
\".\"\".\"\".\" s_total_dist_trained_femaleTotal Distributor Female Trained for the campagne0..1integer
\".\"\".\"\".\" s_total_distTotal Distributor Trained0..1integer\"icon\"/\"icon\"/\"icon\"/
\".\"\".\"\".\" MDA_suppliesAvaialability of MDA supplies0..1group
\".\"\".\"\".\"\".\" s_hieght_chartHeight chart1..1boolean
\".\"\".\"\".\"\".\" s_registerRegister1..1boolean
\".\"\".\"\".\"\".\" s_records_checklistRecords/checklist1..1boolean
\".\"\".\"\".\"\".\" s_med_bagThe CDD uses a medication bag1..1boolean
\".\"\".\"\".\" attitude_CDDObserve the actions, attitudes, and skills of the community health worker during the treatment of a family0..1group
\".\"\".\"\".\"\".\" attitude_CDD-hintwearing a vest, wearing a mask, using hand sanitizer, standard greetings - introduction -, administering medication, data collection0..1display
\".\"\".\"\".\"\".\" s_wear_vestIs the community health worker/healthcare worker team identifiable by a vest?1..1boolean
\".\"\".\"\".\"\".\" s_usual_greetingsThe CDD proceeds with the usual greetings1..1boolean
\".\"\".\"\".\"\".\" s_introduced_patientThe CDD introduces the patient by specifying the reason for their visit and the treatment being administered.1..1boolean
\".\"\".\"\".\"\".\" s_used_height_chart_correctlyThe CDD uses the height chart correctly.1..1boolean
\".\"\".\"\".\"\".\" s_gave_write_dosageThe CDD administers the medication correctly according to the height chart reading.1..1boolean
\".\"\".\"\".\"\".\" s_medicine_took_in_front_of_dcThe medicine is taken in the presence of the DC1..1boolean
\".\"\".\"\".\"\".\" s_filled_formDoes the CDD complete the data collection forms (checklist and register) correctly?1..1boolean
\".\"\".\"\".\"\".\" s_investigated_casesDoes the CDD investigate and report cases of FL, Buruli ulcer, leishmaniasis and rumours of VG?1..1boolean
\".\"\".\"\".\"\".\" s_identified_ineligibleAre ineligible individuals identified?1..1boolean
\".\"\".\"\".\"\".\" s_follow_side_effect_procedureIs the procedure to follow in the event of side events known?1..1boolean
\".\"\".\"\".\" s_date_trainingDate of training session1..1date
\".\"\".\"\".\" s_traning_durationDuration of training session (in days)1..1integer
\".\"\".\"\".\"\".\" s_traning_duration-hintIn days0..1display
\".\"\".\"\".\" s_training_topicWhat topics were covered during the training?1..*choiceOptions: 9 options
\".\"\".\"\".\" s_took_med_in_trainingDid you take the medication during the training?1..1boolean
\".\"\".\"\".\" s_complete_formDoes the CDD complete the data collection forms (checklist and register) correctly?1..1boolean
\".\"\".\"\".\" s_case_mngtDoes the CDD investigate and report cases of FL, Buruli ulcer, leishmaniasis and rumours of VG?1..1boolean
\".\"\".\"\".\" s_has_inegidibleAre ineligible individuals identified?1..1boolean
\".\"\".\"\".\" s_follow_side_effectIs the procedure to follow in the event of adverse events known?1..1boolean
\".\"\".\"\".\" s_difficultesChallenges encountered0..1text
\".\"\".\"\".\" s_solutionsProposed solutions0..1text
\".\"\".\"\".\" s_recommandationsSupervisor recommendations0..1text

\"doco\" Documentation for this format

Options Sets

Answer options for s_supervisor

Answer options for s_training_topic

" }, "url" : "https://icr.healthcampaigns.org/Questionnaire/espen-mda-supervision-cdd", "version" : "0.1.0", "name" : "EspenMDASupervisionCDD", "status" : "active", "experimental" : false, "subjectType" : ["Location"], "date" : "2026-07-05T20:56:14+00:00", "publisher" : "UNICEF", "contact" : [{ "name" : "UNICEF", "telecom" : [{ "system" : "url", "value" : "https://www.unicef.org" }] }], "description" : "ESPEN MDA demo Form 6 (CDD observation supervision): direct observation of a community drug distributor's technique and attitude during treatment, MDA-supplies availability, CDD training coverage, and free-text challenges/solutions/recommendations. No extraction templates: per ICRSupervisionReport (working doc §4.6) the QuestionnaireResponse itself is the supervision record.", "jurisdiction" : [{ "coding" : [{ "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm", "code" : "001", "display" : "World" }] }], "item" : [{ "linkId" : "s_supervisor", "text" : "Supervisor Team", "type" : "choice", "answerOption" : [{ "valueString" : "National" }, { "valueString" : "Regional" }, { "valueString" : "Partner" }, { "valueString" : "District" }, { "valueString" : "Health Facility" }] }, { "linkId" : "s_state", "text" : "Select region", "type" : "string", "required" : true }, { "linkId" : "s_district", "text" : "Select district", "type" : "string", "required" : true }, { "linkId" : "s_health_facility", "text" : "Health facility", "type" : "string", "required" : true }, { "linkId" : "s_location", "text" : "Village", "type" : "string", "required" : true }, { "linkId" : "s_date_start", "text" : "Campaign start date", "type" : "date", "required" : true }, { "linkId" : "s_date_end", "text" : "Campaign end date", "type" : "date", "required" : true }, { "linkId" : "s_disease", "text" : "Disease covered by the MDA", "type" : "choice", "required" : true, "repeats" : true, "answerValueSet" : "https://icr.healthcampaigns.org/ValueSet/icr-ntd-disease-vs" }, { "linkId" : "s_medicine", "text" : "Select the medicine package", "type" : "choice", "required" : true, "repeats" : true, "answerValueSet" : "https://icr.healthcampaigns.org/ValueSet/icr-mda-medicine-package-vs" }, { "linkId" : "s_medicine_sufficient", "text" : "Do the distributors have the medications in sufficient quantities?", "type" : "boolean", "required" : true }, { "linkId" : "s_total_dist_trained_male", "text" : "Total Distributor Male Trained for the campagne", "type" : "integer", "required" : true }, { "linkId" : "s_total_dist_trained_female", "text" : "Total Distributor Female Trained for the campagne", "type" : "integer" }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-hidden", "valueBoolean" : true }, { "url" : "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression", "valueExpression" : { "language" : "text/fhirpath", "expression" : "iif(%resource.repeat(item).where(linkId='s_total_dist_trained_male').answer.exists(), %resource.repeat(item).where(linkId='s_total_dist_trained_male').answer.value.first(), 0) + iif(%resource.repeat(item).where(linkId='s_total_dist_trained_female').answer.exists(), %resource.repeat(item).where(linkId='s_total_dist_trained_female').answer.value.first(), 0)" } }], "linkId" : "s_total_dist", "text" : "Total Distributor Trained", "type" : "integer", "readOnly" : true }, { "linkId" : "MDA_supplies", "text" : "Avaialability of MDA supplies", "type" : "group", "item" : [{ "linkId" : "s_hieght_chart", "text" : "Height chart", "type" : "boolean", "required" : true }, { "linkId" : "s_register", "text" : "Register", "type" : "boolean", "required" : true }, { "linkId" : "s_records_checklist", "text" : "Records/checklist", "type" : "boolean", "required" : true }, { "linkId" : "s_med_bag", "text" : "The CDD uses a medication bag", "type" : "boolean", "required" : true }] }, { "linkId" : "attitude_CDD", "text" : "Observe the actions, attitudes, and skills of the community health worker during the treatment of a family", "type" : "group", "item" : [{ "linkId" : "attitude_CDD-hint", "text" : "wearing a vest, wearing a mask, using hand sanitizer, standard greetings - introduction -, administering medication, data collection", "type" : "display" }, { "linkId" : "s_wear_vest", "text" : "Is the community health worker/healthcare worker team identifiable by a vest?", "type" : "boolean", "required" : true }, { "linkId" : "s_usual_greetings", "text" : "The CDD proceeds with the usual greetings", "type" : "boolean", "required" : true }, { "linkId" : "s_introduced_patient", "text" : "The CDD introduces the patient by specifying the reason for their visit and the treatment being administered.", "type" : "boolean", "required" : true }, { "linkId" : "s_used_height_chart_correctly", "text" : "The CDD uses the height chart correctly.", "type" : "boolean", "required" : true }, { "linkId" : "s_gave_write_dosage", "text" : "The CDD administers the medication correctly according to the height chart reading.", "type" : "boolean", "required" : true }, { "linkId" : "s_medicine_took_in_front_of_dc", "text" : "The medicine is taken in the presence of the DC", "type" : "boolean", "required" : true }, { "linkId" : "s_filled_form", "text" : "Does the CDD complete the data collection forms (checklist and register) correctly?", "type" : "boolean", "required" : true }, { "linkId" : "s_investigated_cases", "text" : "Does the CDD investigate and report cases of FL, Buruli ulcer, leishmaniasis and rumours of VG?", "type" : "boolean", "required" : true }, { "linkId" : "s_identified_ineligible", "text" : "Are ineligible individuals identified?", "type" : "boolean", "required" : true }, { "linkId" : "s_follow_side_effect_procedure", "text" : "Is the procedure to follow in the event of side events known?", "type" : "boolean", "required" : true }] }, { "linkId" : "s_date_training", "text" : "Date of training session", "type" : "date", "required" : true }, { "linkId" : "s_traning_duration", "text" : "Duration of training session (in days)", "type" : "integer", "required" : true, "item" : [{ "linkId" : "s_traning_duration-hint", "text" : "In days", "type" : "display" }] }, { "linkId" : "s_training_topic", "text" : "What topics were covered during the training?", "type" : "choice", "required" : true, "repeats" : true, "answerOption" : [{ "valueString" : "Using the measuring stick" }, { "valueString" : "Completing the checklists" }, { "valueString" : "Supervised taking" }, { "valueString" : "Marking concessions" }, { "valueString" : "Monitoring refusals" }, { "valueString" : "Revisit" }, { "valueString" : "Practical exercise" }, { "valueString" : "Interpersonal communication" }, { "valueString" : "Other" }] }, { "linkId" : "s_took_med_in_training", "text" : "Did you take the medication during the training?", "type" : "boolean", "required" : true }, { "linkId" : "s_complete_form", "text" : "Does the CDD complete the data collection forms (checklist and register) correctly?", "type" : "boolean", "required" : true }, { "linkId" : "s_case_mngt", "text" : "Does the CDD investigate and report cases of FL, Buruli ulcer, leishmaniasis and rumours of VG?", "type" : "boolean", "required" : true }, { "linkId" : "s_has_inegidible", "text" : "Are ineligible individuals identified?", "type" : "boolean", "required" : true }, { "linkId" : "s_follow_side_effect", "text" : "Is the procedure to follow in the event of adverse events known?", "type" : "boolean", "required" : true }, { "linkId" : "s_difficultes", "text" : "Challenges encountered", "type" : "text" }, { "linkId" : "s_solutions", "text" : "Proposed solutions", "type" : "text" }, { "linkId" : "s_recommandations", "text" : "Supervisor recommendations", "type" : "text" }] }