This toolkit was originally developed by PC Cameroon. The original has been revised by OPATS for wide use and to include global health indicators. Please revise to align with your programming as needed.

PROJECT PLAN BASELINE TOOL QUESTIONS

DIARRHEA Knowledge - What is diarrhea? - Are there different types of diarrhea? If so, what are they? - Who gets diarrhea most often in your family? community? - In what season(s) does diarrhea most often occur? - What causes diarrhea? - Is there treatment for diarrhea? If so, what? - How can diarrhea be prevented?

Attitude - Do you feel that you are capable of preventing diarrhea? - Is diarrhea dangerous? Why or why not? - If you feel diarrhea is dangerous, is it more dangerous for some than for others? For whom is it most dangerous? - Is diarrhea a problem in your community? Why or why not?

Practices - Did a child in your family have an episode of diarrhea in the last two weeks? If yes, What did you do for them? - When child was sick with diarrhea, what quantity of fluids did you offer him/her (more than usual, same as usual, less than usual)? - When child was sick with diarrhea, what quantity of food did you offer him/her (more than usual, same as usual, less than usual)? - Where do you get your drinking and cooking water? How do you preserve it in the household? - Do you keep soap where family members wash their hands? (interviewer needs to verify if soap is there). - How did you dispose of your child’s feces the last time s/he passed stool?

MALARIA Knowledge - What is malaria? - How does someone get malaria? What causes it? - How do you know that someone has malaria? - When was the last time someone in your family had malaria? - In what season does malaria most often occur? - What is the treatment for malaria? - Do you know anyone who has died from malaria? - How can malaria be prevented?

Attitude - Is malaria a problem in your community? - Is malaria dangerous? Are you scared of malaria? - Do you think that you are susceptible to getting malaria? - Do you feel that you are capable of preventing malaria?

Practice - Did a child in your family have an episode of malaria in the last two weeks? If yes, What did you do for them? - (If care was sought at the health center) How long after you noticed the symptoms of malaria did you seek care for him/her? - (If care was sought somewhere other than the health center) What treatment was provided to him/her? - Do you own one or more insecticide treated bed nets in your household? - (If own net) Who slept under the bed net the previous night? - Did mother in household attend antenatal care and take antimalarials during pregnancy with the youngest child?

VACCINATIONS Knowledge - When do infants and children need to be vaccinated? - What diseases can your children be vaccinated against? - What is the vaccination calendar/ schedule? - Can vaccines cause children to become sick? - What vaccine does a pregnant woman receive? - Is it ever too late to have a child vaccinated?

Attitude - Do you think that it is important to vaccinate children? If yes, why? If no, why not? - Are vaccines effective in preventing disease? - Do you think that vaccines can be dangerous or harmful? If so, what do you base this on? - Is it important that pregnant women get vaccinated? This toolkit was originally developed by PC Cameroon. The original has been revised by OPATS for wide use and to include global health indicators. Please revise to align with your programming as needed.

- Do you think that most people in your community believe that vaccinating their children is important? - Why do some parents not have their children vaccinated?

Practice - Have your children been vaccinated? - If so, how many vaccinations have your children received? Were you told if your child completed all his/her vaccinations? - When you were pregnant, were you vaccinated? If so, what was this vaccine protecting you against?

FAMILY PLANNING Knowledge - What is family planning (birth control)? - What are some different methods of family planning? - What can you do to prevent or space births? (Health Center or traditional methods) - How many years should there be between children?

Attitude - Do you think family planning is important, why or why not? - Who do you think should use family planning? - What method of family planning do you think is most accepted in your community? - Do you think that women who use family planning are looked down upon by others in the community? - Why do you think someone uses or doesn’t use family planning methods? - Do you think you could talk to your spouse or partner about family planning? - If you wanted to, could you get and use family planning? Why or why not? - How many children do you want to have? Why? - Do you think it is important to have space between children? If so, how many years? Practice - Do you use a method of family planning? If so, which method (modern or traditional). If not, do you desire another child in the next two years? - How many children do you have? - What are the ages of your children?

BREASTFEEDING/ NUTRITION Knowledge - How long should a woman breast feed? - When should babies first be given foods other than breast milk? - Do babies under the age of six months need water or other fluids in addition to breast milk to stay adequately hydrated? - What are weaning foods? What things are important to include in any weaning foods? - What are the first foods that should be given to infants? - Are you aware of the various food groups? If so, identify one food in each group. - Can you name some local foods that are particularly good for child growth and development? - What should a sick child eat or drink? What shouldn’t they eat or drink?

Attitude - Do you think babies need food in addition to breast milk before 6 months? - Can introducing foods and liquids other than breast milk to infants under the age of six months be dangerous? If so, how? - What do you consider to be a nutritious meal? - Do you think that it is difficult for families to prepare nutritious meal meals every day? If yes, explain. - During pregnancy, does the nutrition of a mother affect the health of the baby she is carrying?

Practice - Do you breastfeed your children? - How long after birth did you first put your youngest child to the breast? - (If child is no longer breastfeeding) For how many months did you breastfeed your youngest child? - What are the first foods that you give to infants when they begin eating? - How do you prepare these foods? This toolkit was originally developed by PC Cameroon. The original has been revised by OPATS for wide use and to include global health indicators. Please revise to align with your programming as needed.

- Are these foods different then the ones you prepare for older children? If so, how are they different? - What is a typical meal in your home? What did you prepare for lunch, dinner yesterday? - What foods did you eat when you were pregnant with your youngest child? Did you change what you ate? ( ate more, same amount or less while you were pregnant?) - What did you feed your infant the last time s/he was sick? - Do you give him/her more, same or less fluids? - Did you give him/her more, same or less food?

GROWTH MONITORING Knowledge - What is growth monitoring? - What can be learned from regular weighing of infants and young children? - How often do infants need to be weighed? - Can you explain what the growth chart means? - If you have taken your child to be weighed, can you explain the result? - What could cause an infant or young child not to gain weight regularly?

Attitude - Is weighing a child regularly important? Why or why not? - If a child is healthy, does he/she still need to be weighed regularly? - Why do you take your child to be weighed? - If a child does not gain weight regularly, is this a problem? - Can you do anything to make sure your child gains weight regularly?

Practice - Have you ever taken your child to be weighed? If so, when was the last time your youngest child was weighed? - If so, where did you take them? - How often do you take your child to be weighed? - What have the results of weighing your child been? Were you given any advice, and if so, were you able to follow this advice? - What do you do to make sure that your child is gaining weight regularly? - Are there other methods (traditional)/ things you do to keep track of your child’s growth? STDs & HIV/AIDS Knowledge - What do you know about HIV/AIDS? - Can you get the HIV virus from mosquitoes? - Do you know how HIV is contracted? - Do you believe HIV/AIDS exists? - Does HIV/AIDS exist in Cameroon? (Do you know of anyone who has or had HIV/AIDS?) - Do you think that people in your community believe that HIV/AIDS does not exist? - If yes, why would people believe that HIV/AIDS is not a real disease? - Who can contract HIV? - How can someone get HIV? Can someone contract HIV by shaking hands? Sharing a meal? Using a needle? Etc.? - How do you know someone has HIV/AIDS? What are some symptoms of HIV/AIDS? - Is there a cure for AIDS? - What can you do to prevent HIV/AIDS? - What do you know about STIs? - Can you name one or more STIs? - What are some symptoms of STIs? - Do you know anyone who has had an STI? - Who is susceptible to contracting an STI? - Can a pregnant woman pass on the HIV virus or an STI to her unborn child?

Attitude - Do you think that you are at risk for contracting an STI or HIV? - Who do you think is most at risk for contracting HIV or an STI? - Are you scared of HIV/AIDS or of STIs? Why or why not? - Is HIV/AIDS or STIs a problem in your community? - Do you think that you would be able to talk with your spouse or partner about HIV/AIDS or STIs? - Do people in your community believe that condoms protect a person against getting either STIs or HIV? - Would you have sex with someone who did not want to wear a condom? This toolkit was originally developed by PC Cameroon. The original has been revised by OPATS for wide use and to include global health indicators. Please revise to align with your programming as needed.

Practices - Have you ever used a condom? If so, did you use a condom during your last sexual contact with a non-regular partner? - How often to you use condoms? (every time you have sex, half the time, when you have sex with someone other than your regular partner) - Do you have more than one sexual partner? i.e. regular partner and other (s)? Do you know if your spouse/regular partner has other sexual partners? - In your community, is commercial sex or sex in exchange for money or other benefits common practice? - Do you discuss HIV/AIDS, STIs, condom use, monogamy with your spouse/partner? With your friends?

AT THE HEALTH CENTER FIND OUT: - In what season do they see the most cases of diarrhea, malaria, STIs? Etc…… - How many cases of diarrhea, malaria STIs, etc… were treated during the last month? During the last 6 months? - Does the health center receive updated information on treatment protocols from the Ministry of health? How many deaths have they documented due to diarrhea, malaria, STIs, etc…)? - What are the most frequent diseases seen in infants and young children? What is being done by health center staff to prevent these, if anything? - Does the health center have adequate supplies of essential drugs to treat common cases? Have they had stock-outs?

- Is there a growth monitoring program? Are there adequate materials/supplies? - Does the program include nutritional counseling? Are results of the weighing explained to the mothers? - How often are babies weighed? - How often are cases of malnutrition identified? How are they treated? Is there follow-up for these cases?

- Is there a vaccination program? Are there adequate materials/supplies? Have they had stock-outs? Problems with the cold chain? - How often are vaccinations administered to the community? - How often are vaccinations administered in surrounding villages? - What is the percentage of children who have been completely vaccinated in this community?

- Are family planning contraceptive methods available? Which ones? - What percentage of women of reproductive age in the health center catchment area are using FP? - Per the health provider’s knowledge, are most postnatal mothers coming in for family planning services? - What method is utilized most frequently? - Are long term and permanent methods fairly accessible to clients, e.g. IUD, implant, tubiligation, vasectomy? - Have they had stock-outs? - How many new family planning clients did you have last month? In the last 6 months? - How are new clients followed-up? - Who utilizes family planning? Postnatal mothers, young women, women who already have several children, etc.?