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QUESTIONNAIRE FOR DOOR TO DOOR SURVEY

     Panaji : April 12, 2020

                                                               Chaitra 12, 1941 

 

The Government of Goa has decided to conduct a door to door survey for the entire State to ascertain the symptom of ILI ( Influenza like illness). A four member team consisting of BLOs, Primary/ Secondary School Teachers, Aganwadi workers and Meter Readers/ Gram sewak/ Excises Guards is formed. The team will collect data regarding symptom of ILI from each household from April 13 to 15, 2020. Data collection and mapping will be done though a mobile app.

          The questions which will be asked during survey are Waddo/ward, Name and phone number of head of the household, health related questions like  whether anyone in the family is showing flu like symptom including fever, cough and difficulty in breathing has anyone in family has come in contact with any other person showing the above symptoms, whether any one in family has arrived in Goa after February 15, 2020, whether any one in family has come in contact with any other person who has arrived in Goa after February 15, 2020.

                The survey will also record whether anyone in family is suffering with diabetes, heart disease, high blood pressure, kidney disease or respiratory disease. The survey may also record the age of family member including head of the household.

         

          People are urged to co-operate with the team in order to get a valid data which will further help to curb COVID -19.

 

DI/NB/JA/KM/JS/SN/2020/1836


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