Process Coverage Of Services
Variable Name
Field Label
Identifier?
record_id
Record ID
par_joindate
Install Date
par_joindate_utc
Install Date (UTC)
nurse_name
Field Nurse name
rch_id
1.1 RCH-ID / MCP card
receive_date
Date when received
other_district_name
Other district name
other_taluka_name
Other taluka name
name_of_the_asha
1.1.3 Name of the ASHA
name_of_the_mother
1.2 Name of the mother
age_mother
Age of the mother
name_of_the_spouse
1.3 Name of the husband
present_address
1.9 Present Address House Number and Street :
{house_number_and_street} City / Town / Village name:
{city_town_village_name} District: {district_address} Pin Code : {pin_code}
house_number_and_street
House Number and Street
city_town_village_name
City / Town / Village Name
district_address
District
other_district_name_1
Other district name
present_same_address
1.9.a Is the present address same as the permanent address?
permant_addr_2
Permanent address : [house_number_and_street]
[city_town_village_name] [district_address] [pin_code]
permanant_address
1.10 Permanent Address House Number and Street :
{house_number_and_street_2} City / Town / Village
name : {city_town_village_name_2} District :
{district_address_2} Pin Code : {pin_code_2}
house_number_and_street_2
House Number and Street
city_town_village_name_2
City / Town / Village Name
district_address_2
District
gravida
Section Header: Section 2 : Obstetric Details2.1 Gravida (number of pregnancies a woman has had)
mnth_occur
2.4.a Which month did the first abortion occur?
scnd_abort
2.4.b Which month did the second abortion occur?
stllbrth_1
2.5.a Which month did the first stillbirth occur?
stllbrth_2
2.5.b Which month did the second stillbirth occur?
neonatal_deaths
2.6 a. Which day of life did first neonatal death occur?
neontl_dths
2.6.c Which day of life did second neonatal death occur?
lmp
2.7.2 LMP
edd
2.7.3 EDD
another_smoke_inside_home
3.4 Another household member who smokes inside the
house
contracep_3
3.6 Did you use any contraception
(pills/natural/condom/IUCD) before pregnancy?
sm_high_dose_flic_acd_prec
3.8.1 High dose Folic acid (0.5g per day) prescribed
sm_took_medication
Medication was prescribed, then did you take the medication (folic acid)
sm_took_iron_medication
Medication was prescribed, then did you take the medication (Iron)
yes_howmny_anc
How many ANC visits did you have for this pregnancy?
why_no_anc
Why did you not go for any ANC?
obtained_previous_pregn_ancy_history_and_recorde_d
4.2 Was previous pregnancy history obtained andrecorded?[If Primi mothers choose not applicable]
opn_previous_preg_histry
4.2.0 Anything specific you want to highlight about the previous pregnancy history obtained and
recorded?
medical_problem_prev_pr_eg
4.3 Has been diagnosed with any medical problem before the present pregnancy?
specify_medical_prob_pr_ev_preg
4.3.1 IF YES, Specify medical problem during the previous pregnancy
other_medical_prob_prev_preg
Specify
date_anc_visits_a1
Date of 1st ANC visit
gestational_ages_a1
Gestational age at 1st ANC visit(in weeks)
breathles_tiredne_anc_vst_1
Any breathlessness / tiredness
rcrd_symp_1
Record symphysis fundal height (SFH) at the 1st ANC visit
rcrd_fhr_1
Record FHR [>22wks] at 1st Visit
hb_results_a1
Record Hb results at 1st ANC visit, if available
rbs_results_a1
Record Random Blood Sugar results at the 1st ANC visit if available
vdrl_results_a1
Record VDRL results at 1st ANC visit, if available
hiv_results_a1
Record HIV results at 1st ANC visit, if available
hbsag_results_a1
Record HBsAG results at 1st ANC visit, if available
tsh_results_a1
Record TSH results at 1st ANC visit, if available
bg_rh_results_a1
Record Blood group and Rh results at the 1st ANC visit, if
available
gtt_results_a1
Record Glucose Tolerance Test (GTT) results at 1st ANC visit, if available
aobt_results_a1
Record any other test results at the 1st ANC visit, if available
urine_albumin_results_a1
Record Urine Albumin test results at 1st ANC visit, if available
urine_sugar_test_results_a1
Record urine sugar test results at 1st ANC visit, if available
urine_microscopy_results_a1
Record urine microscopy results at 1st ANC visit, if available
usg_a1
Did ultrasonography on the 1st ANC visit?
doppler_date_a1
Date of Doppler at 1st ANC visit
oth_investigation_test_name_a1
Name of any other radiological test done at the 1st ANC visit
oth_investigation_test_date_a1
Date of the Radiological test at the 1st ANC visit
date_anc_visits_a2
Date of 2nd ANC visit
gestational_ages_a2
Gestational age at 2nd ANC visit(in weeks)
breathles_tiredne_anc_vst_2
Any breathlessness / tiredness
rcrd_symp_2
Record symphysis fundal height (SFH) at the 2nd ANC visit
rcrd_fhr_2
Record FHR [>22wks] at 2nd Visit
hb_results_a2
Record Hb results at 2nd ANC visit, if available
rbs_results_a2
Record Random Blood Sugar results at the 2nd ANC visit if available
vdrl_results_a2
Record VDRL results at 2nd ANC visit, if available
hiv_results_a2
Record HIV results at 2nd ANC visit, if available
hbsag_results_a2
Record HBsAG results at 2nd ANC visit, if available
tsh_results_a2
Record TSH results at 2nd ANC visit, if available
bg_rh_results_a2
Record Blood group and Rh results at the 2nd ANC visit, if
available
gtt_results_a2
Record Glucose Tolerance Test (GTT) results at 2nd ANC visit, if available
aobt_results_a2
Record any other test results at the 2nd ANC visit, if available
urine_albumin_results_a2
Record Urine Albumin test results at 2nd ANC visit, if available
urine_sugar_test_results_a2
Record urine sugar test results at 2nd ANC visit, if available
urine_microscopy_results_a2
Record urine microscopy results at 2nd ANC visit, if available
usg_a2
Did ultrasonography on the 2nd ANC visit?
usgda_a2
Date of ultrasonography at 2nd ANC visit
doppler_date_a2
Date of Doppler at 2nd ANC visit
oth_investigation_test_name_a2
Name of any other radiological test done at the 2nd ANC visit
oth_investigation_test_date_a2
Date of the Radiological test at the 2nd ANC visit
date_anc_visits_a3
Date of 3rd ANC visit
gestational_ages_a3
Gestational age at 3rd ANC visit(in weeks)
breathles_tiredne_anc_vst_3
Any breathlessness / tiredness
rcrd_symp_3
Record symphysis fundal height (SFH) at the 3rd ANC visit
rcrd_fhr_3
Record FHR [>22wks] at 3rd Visit
hb_results_a3
Record Hb results at 3rd ANC visit, if available
rbs_results_a3
Record Random Blood Sugar results at the 3rd ANC visit if available
vdrl_results_a3
Record VDRL results at 3rd ANC visit, if available
hiv_results_a3
Record HIV results at 3rd ANC visit, if available
hbsag_results_a3
Record HBsAG results at 3rd ANC visit, if available
tsh_results_a3
Record TSH results at 3rd ANC visit, if available
bg_rh_results_a3
Record Blood group and Rh results at the 3rd ANC visit, if
available
gtt_results_a3
Record Glucose Tolerance Test (GTT) results at 3rd ANC visit, if available
aobt_results_a3
Record any other test results at the 3rd ANC visit, if available
urine_albumin_results_a3
Record Urine Albumin test results at 3rd ANC visit, if available
urine_sugar_test_results_a3
Record urine sugar test results at 3rd ANC visit, if available
urine_microscopy_results_a3
Record urine microscopy results at 3rd ANC visit, if available
usg_a3
Did ultrasonography on the 3rd ANC visit?
usgda_a3
Date of ultrasonography at 3rd ANC visit
doppler_date_a3
Date of Doppler at 3rd ANC visit
oth_investigation_test_name_a3
Name of any other radiological test done at the 3rd ANC visit
oth_investigation_test_date_a3
Date of the Radiological test at the 3rd ANC visit
date_anc_visits_a4
Date of 4th ANC visit
gestational_ages_a4
Gestational age at 4th ANC visit(in weeks)
breathles_tiredne_anc_vst_4
Any breathlessness / tiredness
rcrd_symp_4
Record symphysis fundal height (SFH) at the 4th ANC visit
rcrd_fhr_4
Record FHR [>22wks] at 4th Visit
hb_results_a4
Record Hb results at 4th ANC visit, if available
rbs_results_a4
Record Random Blood Sugar results at the 4th ANC visit if available
vdrl_results_a4
Record VDRL results at 4th ANC visit, if available
hiv_results_a4
Record HIV results at 4th ANC visit, if available
hbsag_results_a4
Record HBsAG results at 4th ANC visit, if available
tsh_results_a4
Record TSH results at 4th ANC visit, if available
bg_rh_results_a4
Record Blood group and Rh results at the 4th ANC visit, if
available
gtt_results_a4
Record Glucose Tolerance Test (GTT) results at 4th ANC visit, if available
aobt_results_a4
Record any other test results at the 4th ANC visit, if available
urine_albumin_results_a4
Record Urine Albumin test results at 4th ANC visit, if available
urine_sugar_test_results_a4
Record urine sugar test results at 4th ANC visit, if available
urine_microscopy_results_a4
Record urine microscopy results at 4th ANC visit, if available
usg_a4
Did ultrasonography on the 4thANC visit?
usgda_a4
Date of ultrasonography at 4th ANC visit
doppler_date_a4
Date of Doppler at 4th ANC visit
oth_investigation_test_name_a4
Name of any other radiological test done at the 4th ANC visit
oth_investigation_test_date_a4
Date of the Radiological test at the 4th ANC visit
date_anc_visits_a5
Date of 5th ANC visit
gestational_ages_a5
Gestational age at 5th ANC visit(in weeks)
breathles_tiredne_anc_vst_5
Any breathlessness / tiredness
rcrd_symp_5
Record symphysis fundal height (SFH) at the 5th ANC visit
rcrd_fhr_5
Record FHR [>22wks] at 5th Visit
hb_results_a5
Record Hb results at 5th ANC visit, if available
rbs_results_a5
Record Random Blood Sugar results at the 5th ANC visit if available
vdrl_results_a5
Record VDRL results at 5th ANC visit, if available
hiv_results_a5
Record HIV results at 5th ANC visit, if available
hbsag_results_a5
Record HBsAG results at 5th ANC visit, if available
tsh_results_a5
Record TSH results at 5th ANC visit, if available
bg_rh_results_a5
Record Blood group and Rh results at the 5th ANC visit, if
available
gtt_results_a5
Record Glucose Tolerance Test (GTT) results at 5th ANC visit, if available
aobt_results_a5
Record any other test results at the 5th ANC visit, if available
urine_albumin_results_a5
Record Urine Albumin test results at 5th ANC visit, if available
urine_sugar_test_results_a5
Record urine sugar test results at 5th ANC visit, if available
urine_microscopy_results_a5
Record urine microscopy results at 5th ANC visit, if available
usg_a5
Did ultrasonography on the 5th ANC visit?
usgda_a5
Date of ultrasonography at 5th ANC visit
doppler_date_a5
Date of Doppler at 5th ANC visit
oth_investigation_test_name_a5
Name of any other radiological test done at the 5th ANC visit
oth_investigation_test_date_a5
Date of the Radiological test at the 5th ANC visit
date_anc_visits_a6
Date of 6th ANC visit
gestational_ages_a6
Gestational age at 6th ANC visit(in weeks)
breathles_tiredne_anc_vst_6
Any breathlessness / tiredness
rcrd_symp_6
Record symphysis fundal height (SFH) at the 6th ANC visit
rcrd_fhr_6
Record FHR [>22wks] at 6th Visit
hb_results_a6
Record Hb results at 6th ANC visit, if available
rbs_results_a6
Record Random Blood Sugar results at the 6th ANC visit if available
vdrl_results_a6
Record VDRL results at 6th ANC visit, if available
hiv_results_a6
Record HIV results at 6th ANC visit, if available
hbsag_results_a6
Record HBsAG results at 3rd ANC visit, if available
tsh_results_a6
Record TSH results at 6th ANC visit, if available
bg_rh_results_a6
Record Blood group and Rh results at the 6th ANC visit, if
available
gtt_results_a6
Record Glucose Tolerance Test (GTT) results at 6th ANC visit, if available
aobt_results_a6
Record any other test results at the 6th ANC visit, if available
urine_albumin_results_a6
Record Urine Albumin test results at 6th ANC visit, if available
urine_sugar_test_results_a6
Record urine sugar test results at 6th ANC visit, if available
urine_microscopy_results_a6
Record urine microscopy results at 6th ANC visit, if available
usg_a6
Did ultrasonography on the 6th ANC visit?
usgda_a6
Date of ultrasonography at 6th ANC visit
doppler_date_a6
Date of Doppler at 6th ANC visit
oth_investigation_test_name_a6
Name of any other radiological test done at the 6th ANC visit
oth_investigation_test_date_a6
Date of the Radiological test at the 6th ANC visit
date_anc_visits_a7
Date of 7th ANC visit
gestational_ages_a7
Gestational age at 7th ANC visit(in weeks)
breathles_tiredne_anc_vst_7
Any breathlessness / tiredness
rcrd_symp_7
Record symphysis fundal height (SFH) at the 7th ANC visit
rcrd_fhr_7
Record FHR [>22wks] at 7th Visit
hb_results_a7
Record Hb results at 7th ANC visit, if available
rbs_results_a7
Record Random Blood Sugar results at the 7th ANC visit if available
vdrl_results_a7
Record VDRL results at 7th ANC visit, if available
hiv_results_a7
Record HIV results at 7th ANC visit, if available
hbsag_results_a7
Record HBsAG results at 7th ANC visit, if available
tsh_results_a7
Record TSH results at 7th ANC visit, if available
bg_rh_results_a7
Record Blood group and Rh results at the 7th ANC visit, if
available
gtt_results_a7
Record Glucose Tolerance Test (GTT) results at 7th ANC visit, if available
aobt_results_a7
Record any other test results at the 7th ANC visit, if available
urine_albumin_results_a7
Record Urine Albumin test results at 7th ANC visit, if available
urine_sugar_test_results_a7
Record urine sugar test results at 7th ANC visit, if available
urine_microscopy_results_a7
Record urine microscopy results at 7th ANC visit, if available
usg_a7
Did ultrasonography on the 6th ANC visit?
usgda_a7
Date of ultrasonography at 7th ANC visit
doppler_date_a7
Date of Doppler at 7th ANC visit
oth_investigation_test_name_a7
Name of any other radiological test done at the 7th ANC visit
oth_investigation_test_date_a7
Date of the Radiological test at the 7th ANC visit
date_anc_visits_a8
Date of 8th ANC visit
gestational_ages_a8
Gestational age at 8th ANC visit(in weeks)
breathles_tiredne_anc_vst_8
Any breathlessness / tiredness
rcrd_symp_8
Record symphysis fundal height (SFH) at the 8th ANC visit
rcrd_fhr_8
Record FHR [>22wks] at 8th Visit
hb_results_a8
Record Hb results at 8th ANC visit, if available
rbs_results_a8
Record Random Blood Sugar results at the 8th ANC visit,
if available
vdrl_results_a8
Record VDRL results at 8th ANC visit, if available
hiv_results_a8
Record HIV results at 8th ANC visit, if available
hbsag_results_a8
Record HBsAG results at 8th ANC visit, if available
tsh_results_a8
Record TSH results at 8th ANC visit, if available
bg_rh_results_a8
Record Blood group and Rh results at the 8th ANC visit, if
available
gtt_results_a8
Record Glucose Tolerance Test (GTT) results at 8th ANC visit, if available
aobt_results_a8
Record any other test results at the 8th ANC visit, if available
urine_albumin_results_a8
Record Urine Albumin test results at 8th ANC visit, if
available
urine_sugar_test_results_a8
Record urine sugar test results at 8th ANC visit, if available
urine_microscopy_results_a8
Record urine microscopy results at 8th ANC visit, if available
usg_a8
Did ultrasonography on the 8th ANC visit?
usgda_a8
Date of ultrasonography at 8th ANC visit
doppler_date_a8
Date of Doppler at 8th ANC visit
oth_investigation_test_name_a8
Name of any other radiological test done at the 8th ANC
visit
oth_investigation_test_date_a8
Date of the Radiological test at the 8th ANC visit
prescribe_folic_acid_iron
5.1.1. Iron & Folic acid(only in 1st trimester)
took_iron_folic_acid
Took the medication (Iron & Folic acid)
folic_acid_details
How many tablets were bought/given
pih_hyp_names
Name
date_1st_tt
Date of 1st dose
date_2nd_tt
Date of 2nd dose
date_of_booster_dose
Date of Booster Dose
date_inj_iron
Date
date_antibiotics
Date
name_diab_medication
Name
thyroid_medication_prescribed
5.1.9 Thyroid supplement
took_thyroid_medication
Then specify if you took the medication
name_thyroid_medication
Name
details_thyroid_medication
Details
name_oth_medication
Name
oth_inj_name
Name
counseling_information_given
Check if any counseling/information was given and recorded during ANC visit Source (MCP/report/ CI)
sleep_side_right_or_left
b. Sleep on a side (right or left side)
when_admitted_during_preg
5.3.2 When was she admitted
same_health_facility
5.3.5 Did she go to the same health facility?[If admitted once, choose not applicable]
no_where_why
5.3.6 Where did she go? and why?
labour_admit_confir
Section Header: Management of a Woman during Labour Part 3
Section 6: Details of Admission
6.1 was the mother admitted?
name_taluk_hosp
Name of the taluk hospital
name_comm_hlth
Name of community health center
name_prim_hlth
Name of primary health center
name_priv_mtrnty
Name of private maternity home
name_sdh
Name of SDH
dt_admis_6
6.2 Date of admission
mode_trans_6
6.4 How did she get to the hospital (Mode of transport)?
asha_6
6.5 Did the ASHA accompany her?
value_ga_6
Value of gestational age
rsn_drtadmsn_6
6.9 If YES, management for this admission
yes_history
For History of major medical illness
date_refer_6
6.10.2 Date of referral
initi_refer_facili
6.11 Was the initial management given at the referral facility?
para_reordrd_6_11
6.11.1 Were the following parameters recorded
ga_6_1
Value of mother's gestational age in weeks
dose_drug_6
If YES specify dose and name of drug?
eclamp_dose_drug_6
Specify dose and name of drug
spec_6
If YES specify dose and name of drug?
no_histry
If History of major medical illness
labourcarecard_maintained
(Section Header: Section 7.1: Woman with NO Complications Active management at the admitting facility Complete the following [SourceCR / CI])7.1.1. Was Labour Care Card maintained
fhr_recorded_half_hourly
Was FHR recorded every half hour
pr_mothr_half_hourly
Was the pulse rate of the mother recorded every half hour
contra_half_hourly
Were contractions recorded every half hour
amniotic_fluid_colour
Was amniotic fluid color recorded every 4th hour
cervical_dilatation
Was cervical dilatation recorded every 4th hour
yes_date
Date
yes_date_augm
Date of start of augmentation
name_of_drugs
Name of the drugs
dosage_of_drug
Dosage of drug
name_dose_drug
Name of drug (E.g Epidural )
dose_of_drug_e_g_epidural
Dose of drug (E.g Epidural )
immed_interven
(Section Header: Section 7.2: Active management at the admitting facility Pregnant Woman with Bleeding per VaginaComplete the following (Source: CI/RR-Case Sheet) and then Section 4, 5, 6)7.2.1 Immediate intervention at the facility
iv_fluids_given
i. Was IV fluids given
yes_declartns
Were decelerations recorded
obset_mngnt
7.2.2 Obstetric management
yes_date_obst
Date
date_augmen_obst
Date of start of augmentation
name_drug_obst
Name drug used and dosage
namedrug_obst
Name drug used and dosage
immed_interven_7_3
(Section Header: Section 7.3: Active management at the admitting facility for a Pregnant Woman with Fever Complete the following(Source: CI/RR-Case Sheet) and then Section 9-11)7.3.1 Immediate intervention at the facility
iv_fluids_given_7_3
i. Was IV fluids given
obst_mngmt_7_3
7.3.2 Obstetric management
date_8_7_2
Date
date_augmem_7_3_2
Date of start of augmentation
name_drug_7_3_2
Name drug used and dosage
name_drug_7_3_2_2
Name drug used and dosage
immed_interv_7_4
(Section Header: Section 7.4: Active management at the admitting facility for a Pregnant Woman with Preeclampsia / EclampsiaComplete the following (Source: CI/RR-Case Sheet) and then Section 9-11)7.4.1 Immediate intervention at the facility
iv_given_7_4
i. Was IV fluids given
dosage_7_4
Dosage
name_drug_7_4
Name of drug and dosage
reflex_mgso4_7_4
Reflexes checked for MgSO4 toxicity
obsct_mnmgt_7_4_2
7.4.2 Obstetric management
date_7_4_2
Date
date_augmen_7_4_2
Date of start of augmentation
augmen_drug_7_4_2
Name drug used and dosage
yes_dosge
Dosage
oth_medi_drug_dose_7_4_2
Name drug used and dosage.
interven_7_5
Section Header: Section 7.5: Active management at the admitting facility for a Pregnant Woman withPROM/PPROM Complete the following(Source: CI/RR-Case Sheet) and then Section 4, 5, 67.5.1 Immediate intervention at the facility
iv_given_7_5
i. Was IV fluids given
anten_cortico_7_5
ii. Were antenatal corticosteroids given
name_dos_7_5
Name and Dosage
name_dos_anti_7_5
Antibiotic 1 Name and Dosage
name_dos_anti_7_6
Antibiotic 2 Name and Dosage
amnio_flu_7_5
Color of amniotic fluid noted
obsct_mnmgt_7_5_2
7.5.2 Obstetric management
date_augmen_7_5_2
Date of start of augmentation
labour_augmen_drug_7_5_2
Name drug used and dosage
yes_dsge
Dosage(drops /minute)
oth_medi_drug_dose_7_5_2
Name drug used and dosage
immed_interven_7_6
(Section Header: Section 7.6: Active management at the admitting facility for a Pregnant Woman with Other Obstetric or Fetal Complications Complete the following(Source: CI/RR-Case Sheet) and then Section 9-11)7.6.1 Immediate intervention at the facility
iv_given_7_6
i. Was IV fluids given
yes_acclrtns
Were accelerations recorded
amnio_fld_7_6
Color of amniotic fluid noted
lbr_care_guide
iii. Was Labour Care Guide / Partograph used
duration_frst_lbr
Duration of first stage of labour
duration_scnd_lbr
Duration of second stage of labour
date_augmen_7_6
Date of start of augmentation
labour_augmen_drug_7_6
Name drug used
yes_dosage_6
Dosage(drops/min)
oth_medi_drug_7_6
Name drug used and dosage.
immed_interven_7_7
(Section Header: Section 7.7: Active management at the admitting facility for a Pregnant Woman with Medical Conditions (Asthma / COPD / Heart disease /Bleeding disorder /Gestational diabetes / Any other specify) Complete the following (Source: CI/RR-Case Sheet) and then Section 9-11)7.7.1 Immediate intervention at the facility
iv_7_7
i. Was IV fluids given
date_augmen_7_7
Date of start of augmentation
drug_used_7_7
Name drug used and dosage
drug_dos_used_7_7
Name drug used and dosage.
date_deliv_8
Section Header: Section 8 : Mode of Delivery8.1 Date of delivery
baby_cry_birth
9.4 Did the baby cry at birth?
baby_req_resuscitation
9.4.2 If NO, Did the baby receive resuscitation?
baby_cry_birth_1
9.4 Did the baby cry at birth?
baby_req_resuscitation_1
9.4.2 If NO, Did the baby receive resuscitation?
baby_cry_birth_2
9.4 Did the baby cry at birth?
baby_req_resuscitation_2
9.4.2 If NO, Did the baby receive resuscitation?
what_birth_compan
10.1.1 IF YES, what did the birth companion do?
if_died_dt
Date
uuid
UUID
startdate
Start Date
enddate
End Date
scheduledate
Schedule Date
process_coverage_of_services_complete
Complete?