Literal question
611) READ THE CONSENT STATEMENT FOR ANEMIA AND MALARIA TEST TO PARENT/OTHER ADULT IDENTIFIED IN 610 AS RESPONSIBLE FOR CHILD.
REQUEST FOR CONSENT FOR THE ANEMIA AND MALARIA TEST.
As part of this survey, we are asking people all over the country to take an anemia test. Anemia is a serious health problem that usually results from poor nutrition, infection, or chronic disease. The results of this survey will allow the government to develop and put in place programs to prevent and treat anemia and malaria.
We ask that all children born in 2006 or later take part in anemia and malaria testing in this survey and give a few drops of blood from a finger or heel. The equipment used to take the blood for this test is clean and completely safe. It has never been used before and will be thrown away after each test.
The blood will be tested for anemia and malaria immediately, and the result will be told to you right away. The result will be kept strictly confidential and will not be shared with anyone other than member of our survey team.
Do you have any questions?
You can say yes to the test, or you can say no. It is up to you to decide.
611A) ASK FOR CONSENT FOR THE ANEMIA TEST FROM THE PARENT/OTHER ADULT IDENTIFIED IN 610 AS RESPONSIBLE FOR CHILD.
ASK FOR CONSENT FOR THE ANEMIA TEST
Will you allow (NAME OF CHILD(REN)) to participate in the anemia test?
611B) CIRCLE THE APPROPRIATE CODE FOR THE ANEMIA TEST AND SIGN YOUR NAME.
GRANTED 1 (SIGN________)
REFUSED 2 (SIGN________)
