Data collection tools (forms) | Description | Responsible Person/Method | Potential Source(s) of Data |
---|---|---|---|
Married women surveillance form | List of all households, married women and their pregnancy status in the community. | Surveillance workers conduct census of all households in the registry clusters in two monthly rounds. | Household census |
Pregnancy Registry Log (MN00): | Registry of all women who are pregnant in the community. | Surveillance workers report identified pregnant women to the Registry Administrator (RA) via electronic record sharing | Household surveillance of married women likely to become pregnant |
Enrollment Form (MN01) | Demographics: basic demographic information of women | RAs collect data through interview of the pregnant women identified by surveillance workers | Interview with pregnant women |
Perinatal Form (MN02) | Delivery outcome: outcome of all pregnant women on registry and coverage of interventions to be reported at delivery/discharge | RAs collect data through interview with participant, and/or family, reviewing health records at household and/or at health facility during 1st post partum visit | Interview with registry participants and review of health records (where available) |
Follow-up (MN03) | Follow-up outcome: status of all mothers (to day 42) and neonates (to day 28) who are on the registry, post-partum complications | RAs collect data through interview with participant, and/or family, reviewing health records at household and/or health facility visits | Interview with mother/mother-in-law, birth attendant, and review of health records |
Protocol Deviation (MN04) | Protocol Deviation: used to report all protocol deviations which occur during the registry | RA and the Senior Foreign Investigator (SFI) and/or Study Coordinator or their designee complete after reviewing the report | RA and Study Coordinator |
Perinatal Cause of Death (COD) (MN05) | Perinatal COD: used to collect information of all fetal deaths > 20 weeks gestation and neonatal deaths (0 to day 28 days) which occur in the registry | Project Research Physicians collect data and the SFI and/or Study Coordinator or their designee reviews | Interview with mother/mother-in-law/family, birth attendant, and review of health records |
Maternal COD (MN06) | Maternal COD: collect data on all maternal deaths for any reason during pregnancy or up to 42 days post-partum to determine a COD | Project Research Physicians collect data and the SFI and/or Study Coordinator or their designee reviews | Interview with family, birth attendant, and review of health records |
Ultrasound dating worksheet (MN17) | Used to collect information on date of ultrasound and expected date of delivery | RAs collect the data at enrolment or perinatal (1st post partum) visit if women had received ultrasound any time during pregnancy | Ultrasound report and Interview with the participant |
Socioeconomic status variable (MN18) | Used to collect information on household possession of assets, housing characteristics and water and sanitation access | RAs collect the information during enrollment visit at household | Interview with registry participants or other adult household member |