DHS Women’s Model Questionnaire: |
434 Immediately after the birth, was (NAME) put on your chest? |
434A Was (NAME)’s bare skin touching your bare skin?
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DHS Optional Newborn Module: |
NB1 Was (NAME) wiped dry within a few minutes after birth? |
NB2 How long after the birth was (NAME) bathed for the first time? |
NB3 CHECK PLACE OF DELIVERY |
NB4 What was used to cut the cord? (non–institutional births only) |
NB5 Was it new or had it ever been used before? (non–institutional births only) |
NB5A Was it boiled before it was used to cut the cord? (non–institutional births only) |
NB6 Was anything applied to the stump of the cord at any time? |
NB7 What was applied? |
CH1 CHECK SUBSTANCES APPLIED TO CORD |
CH2 Was chlorhexidine applied to the stump at any time? |
CH3 How long after the cord was cut was chlorhexidine fist applied? |
CH4 For how many days was chlorhexidine applied to the stump? |
CH5 How many times per day was chlorhexidine applied to the stump: once a day, twice a day, three times a day, or four or more times a day?
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MICS6 Questionnaire for Individual Women: |
MN23 Immediately after the birth, was (name) put directly on the bare skin of your chest? [WITH PHOTO OF SKIN–TO–SKIN POSITION]
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MN24 Before being placed on the bare skin of your chest, was the baby wrapped up? |
MN25 Was (name) dried or wiped soon after birth? |
MN26 How long after the birth was (name) bathed for the first time? |
Recommended only for countries with high NMR, large programs on cord care, large proportion of non–facility births: |
MN27 Check MN20: Was the child delivered in a health facility? |
MN28 What was used to cut the cord? (non–institutional births only) |
MN29 Was the instrument used to cut the cord boiled or sterilised prior to use? (non–institutional births only) |
MN30 After the cord was cut and until it fell off, was anything applied to the cord? |
MN31 What was applied to the cord? |