ID

16415

Descripción

Form provided by Binyam Tilahun. Source: http://www.moh.gov.et/ (Ministry of Health, Ethiopia)

Link

http://www.moh.gov.et/

Palabras clave

Versiones (3)
  1. 15/7/16 15/7/16 -
  2. 15/7/16 15/7/16 -
  3. 15/7/16 15/7/16 -
Subido en

15 de julio de 2016

DOI

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Licencia

Creative Commons BY-NC 3.0 Legacy
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Ministry of Health, Ethiopia- Family Planning Register

Inglés

Family Planning Register

1 formularios  
Facility information
Descripción

Facility information

Region where the facility is located
Descripción

Facility location

Tipo de datos

text

Alias
UMLS CUI [1]
C0806106
Address:Woreda/Sub-City
Descripción

Facility Address

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0421449
UMLS CUI [1,2]
C0018704
If Health post, write the name of the kebele where the health post is located
Descripción

Facility Address: Kebele

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0421449
UMLS CUI [1,2]
C0018704
Name of health facility
Descripción

Facility name

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0018704
UMLS CUI [1,2]
C0027365
Register Start date
Descripción

Enter the date of the first entry in this register

Tipo de datos

date

Alias
UMLS CUI [1,1]
C0034975
UMLS CUI [1,2]
C0808070
Register End date
Descripción

Enter the date of the last entry in this register

Tipo de datos

date

Alias
UMLS CUI [1,1]
C0034975
UMLS CUI [1,2]
C0806020
Personal information
Descripción

Personal information

Serial number
Descripción

Serial number

Tipo de datos

integer

Alias
UMLS CUI [1]
C2348188
Sex
Descripción

Sex

Tipo de datos

text

Alias
UMLS CUI [1]
C0079399
Medical Record Number
Descripción

Medical Record Number

Tipo de datos

text

Alias
UMLS CUI [1]
C1301894
Family Planning and Contraceptive Services
Descripción

Family Planning and Contraceptive Services

Registration date
Descripción

Registration date

Tipo de datos

date

Alias
UMLS CUI [1,1]
C0421512
UMLS CUI [1,2]
C0011008
New acceptor at registration
Descripción

New acceptor at registration

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0000902
UMLS CUI [1,2]
C0585648
Repeat acceptor at registration
Descripción

Repeat acceptor at registration

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0000903
UMLS CUI [1,2]
C0585648
HIV testing offered
Descripción

HIV test

Tipo de datos

boolean

Alias
UMLS CUI [1]
C1321876
HIV Test performed
Descripción

HIV Test

Tipo de datos

boolean

Alias
UMLS CUI [1]
C1321876
HIV Test result
Descripción

HIV Test

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C1321876
UMLS CUI [1,2]
C1274040
HIV counseling and methods offered
Descripción

HIV counseling

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0730426
TT vaccination status checked
Descripción

TT vaccination status

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0474241
UMLS CUI [1,2]
C0305062
Contraindication for hormonal method
Descripción

Tick if one of following conditions present - Breastfeeding babb < 6 weeks old - Bleeding /spotting etween periods or after intercourse - Jaundice (abnormal yellow skin or eyes) - Smoke - Diabetes - Severe headache or blurred vision - Severe pain in calves, thighs or ehest, or swollen legs (edema) - High blood pressure (history of ) - Heart attack, strake or heart disease (history an - Breast cancer or suspicious (firm, contender , or fixed) lump in the breast - Taking drugs for epilepsy (phenytoin and barbiturates) or tuberculosis (rifampicin) - other

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C1301624
UMLS CUI [1,2]
C0700589
Contraindication for IUD
Descripción

Tick if one of following conditions present - Client (or partner) has other sex partners - Sexually transmitted genital tract infections (GTI) within the last 3 months or other chronic STI (eg HBV, HIV/AIDS). - Pelvic infection (PID) or ectopic pregnancy (within the last 3 months) - Heavy menstrual bleeding (twice as much or twice as long as normal) - Severe menstrual cramping (dysmenorrhea) requiring analgesics and/or bed rest. - Bleeding/spottin between periods or after intercourse - Symptomatic va vular heart disease - other

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C1301624
UMLS CUI [1,2]
C0021900
Contraceptive methods permanent
Descripción

Contraceptive methods permanent

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0700589
UMLS CUI [1,2]
C2985333
Visit number
Descripción

Visit number

Tipo de datos

integer

Alias
UMLS CUI [1]
C1549755
Visit Date
Descripción

Visit Date

Tipo de datos

date

Alias
UMLS CUI [1]
C1320303
Contraceptive selected
Descripción

Contraceptive method

Tipo de datos

text

Alias
UMLS CUI [1]
C0700589
Remarks
Descripción

Remarks

Tipo de datos

text

Alias
UMLS CUI [1]
C0947611
Appointment
Descripción

Appointment

Tipo de datos

date

Alias
UMLS CUI [1]
C0586344
Total count
Descripción

Total count

Count new acceptors
Descripción

Count new acceptors

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0750480
UMLS CUI [1,2]
C0000902
Count repeat acceptors
Descripción

Count repeat acceptors

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0750480
UMLS CUI [1,2]
C0000903
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Similar models

Family Planning Register

1 formularios
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Facility information
Facility location
Item
Region where the facility is located
text
C0806106 (UMLS CUI [1])
Facility Address
Item
Address:Woreda/Sub-City
text
C0421449 (UMLS CUI [1,1])
C0018704 (UMLS CUI [1,2])
Facility Address: Kebele
Item
If Health post, write the name of the kebele where the health post is located
text
C0421449 (UMLS CUI [1,1])
C0018704 (UMLS CUI [1,2])
Facility name
Item
Name of health facility
text
C0018704 (UMLS CUI [1,1])
C0027365 (UMLS CUI [1,2])
Register Start date
Item
Register Start date
date
C0034975 (UMLS CUI [1,1])
C0808070 (UMLS CUI [1,2])
Register End date
Item
Register End date
date
C0034975 (UMLS CUI [1,1])
C0806020 (UMLS CUI [1,2])
Item Group
Personal information
Serial number
Item
Serial number
integer
C2348188 (UMLS CUI [1])
Item
Sex
text
C0079399 (UMLS CUI [1])
Sex
Code List
Sex
CL Item
Male (1)
CL Item
Female (2)
Medical Record Number
Item
Medical Record Number
text
C1301894 (UMLS CUI [1])
Item Group
Family Planning and Contraceptive Services
Registration date
Item
Registration date
date
C0421512 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
New acceptor at registration
Item
New acceptor at registration
boolean
C0000902 (UMLS CUI [1,1])
C0585648 (UMLS CUI [1,2])
Repeat acceptor at registration
Item
Repeat acceptor at registration
boolean
C0000903 (UMLS CUI [1,1])
C0585648 (UMLS CUI [1,2])
HIV test
Item
HIV testing offered
boolean
C1321876 (UMLS CUI [1])
HIV Test
Item
HIV Test performed
boolean
C1321876 (UMLS CUI [1])
Item
HIV Test result
integer
C1321876 (UMLS CUI [1,1])
C1274040 (UMLS CUI [1,2])
HIV Test
Code List
HIV Test result
CL Item
R (1)
CL Item
NR (2)
CL Item
I (3)
HIV counseling
Item
HIV counseling and methods offered
boolean
C0730426 (UMLS CUI [1])
TT vaccination status
Item
TT vaccination status checked
boolean
C0474241 (UMLS CUI [1,1])
C0305062 (UMLS CUI [1,2])
Contraindication for hormonal method
Item
Contraindication for hormonal method
boolean
C1301624 (UMLS CUI [1,1])
C0700589 (UMLS CUI [1,2])
Contraindication for IUD
Item
Contraindication for IUD
boolean
C1301624 (UMLS CUI [1,1])
C0021900 (UMLS CUI [1,2])
Item
Contraceptive methods permanent
integer
C0700589 (UMLS CUI [1,1])
C2985333 (UMLS CUI [1,2])
Contraceptive methods permanent
Code List
Contraceptive methods permanent
CL Item
Tubal ligation (1)
CL Item
Vasectomy (2)
Item
Visit number
integer
C1549755 (UMLS CUI [1])
Visit number
Code List
Visit number
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
4 (4)
CL Item
5 (5)
Visit Date
Item
Visit Date
date
C1320303 (UMLS CUI [1])
Item
Contraceptive selected
text
C0700589 (UMLS CUI [1])
Contraceptive method
Code List
Contraceptive selected
CL Item
Male Condom (MaC)
CL Item
Female Condom (FeC)
CL Item
Oral Contraceptive (OC)
CL Item
Injectable (Inj)
CL Item
Emergency Contraception (EC)
CL Item
Diaphragm (Diaph)
CL Item
Intrauterine Contraceptive Device (IUCD)
CL Item
Implant (Imp)
Remarks
Item
Remarks
text
C0947611 (UMLS CUI [1])
Appointment
Item
Appointment
date
C0586344 (UMLS CUI [1])
Item Group
Total count
Count new acceptors
Item
Count new acceptors
integer
C0750480 (UMLS CUI [1,1])
C0000902 (UMLS CUI [1,2])
Count repeat acceptors
Item
Count repeat acceptors
integer
C0750480 (UMLS CUI [1,1])
C0000903 (UMLS CUI [1,2])
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