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Rwekubo HCIV malaria knowledge and practice questionnaire

Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.

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Malaria knowledge and practice
1

Section A: Household Information

1.cell
2

Household size : adults, ______

Write here
3

Household size : adults, ______

Write here
4

children (<5 years)

5

Pregnant women in household

6

Children aged 6–11 months

Write here
Malaria knowledge and practice
7

How is malaria transmitted

Tick all that apply
8

Common symptoms

Select one or more answers
9

Prevention methods known

Select one or more answers
Malaria knowledge and practice
10

.Aware of malaria vaccine for children (6–11 months)?

Select one answer
11

If yes, where did you learn about it?:

Select one or more answers
Malaria knowledge and practice
12

. **Does your household own mosquito nets?

Select 1 answer
13

If yes how often do you use it?

Select 1 answer
14

If not used for sleeping, what are they used for?** ☐ Fencing ☐ Bathroom ☐ Chicken coop ☐ Other: ______ 11. *If no nets:* **Reason?** ☐ Not received ☐ Torn ☐ Sold ☐ Prefer other methods

Select one or more answers
15

If no nets:why ☐ Not received ☐ Torn ☐ Sold ☐ Prefer other methods

Select one or more answers
Malaria knowledge and practice
16

2. **Stagnant water near home?

Select one answer
17

If yes:

Select one or more answers
18

Waste disposal practices: - Plastics:

Select one or more answers
19

Waste disposal :organic waste:

Select one or more answers
Malaria knowledge and practice
20

Bushes cleared around home?

Select one answer
21

First action for malaria symptoms:

Select one or more answers
22

. Experienced drug shortages at Rwekubo HC IV?

Select one answer
23

Willing to vaccinate child (6–11 month) against malaria?

Select one answer
24

If no,why

Malaria knowledge and practice
25

Most needed malaria support_

Select one or more answers
26

Preferred education method

Select one or more answers
27

Suggestions to reduce malaria