ASSESSMENT AT THE FAMILY LEVEL OF CARE:

DATA TO COLLECT SOURCES OF DATA METHODS OF DATA TOOLS FOR DATA

COLLECTION COLLECTION

1.Family size and composition- size of 1. Head of the family 1.Interview of the head 1.Physical
household, names of members and relationship and other responsible of the family, the examination tools-
of the head of the family. family members. spouse and other thermometer, Blood
responsible members. pressure apparatus,
2. Socio-demographic characteristics of 2. Close and relevant stethoscope, tape
members- Age, Sex, Marital Status, Education, friends and neighbors. 2. Physical examination measure, weighing
Occupation, Income, Religion. of members of the scale.
3. Other members of family.
3.Health Status of members: the health and/or inter- 2. Clinical
sectoral teams who 3. Direct observation of history/record forms.
a. Member of the family with signs and have had previous family interaction and
symptoms of disease/illness, injury, disability, contact or provided relationship. 3. Interview schedule
developmental delays/deficits which need to be services to the family. or questionnaire.
diagnosed and treated; history of each 4. Inspection of home
condition, if any. 4. Health agency environment and 4. Observation
b. Members with disease condition, injury, records and reports. surrounding premises. schedule.
disability and or developmental deficit which
have been diagnosed by a legitimate Medical 5. Community leaders- 5. Interview of close
Practitioner, history of condition, past and formal and informal. and relevant relatives,
current treatment, if any. friends and or
neighbors.
4. Family health habits and lifestyle-
eating/nutrition, personal hygiene, exercise and 6. Review of health
leisure/recreation of family as a unit, any agency records and
smoking, alcohol drinking or drug use of reports.
member (.s).
7. Interview of relevant
5. Family relationship- Quality of interaction, members of the health
characteristic communication pattern and and inter - sectoral
relationship of household: presence of conflict teams.
between family members.
8. Interview of relevant
6. Decision-makers in the family, particularly formal and informal
in health matters. community leaders.

7. Quality of housing, facilities and immediate

surroundings/environment:

a. Housing- Type and ownership of

house/dwelling: adequacy of living space,
bedrooms/sleeping quarters and sleeping
arrangement: lighting facility, cooking facility.
b. Water supply- sources, portability,
storage
c. Food storage facility
d. Toilet-type, sanitary condition
e. Garbage disposal- type sanitary
condition
f. Drainage system- type, adequacy
h. Presence of insects and rodents
i. State of cleanliness and order in the
home and yard/surroundings.

8. Quality and neighborhood/community where

Family is residing:
a. Kind and socioeconomic class of
neighbor/community.
b. Communication and transportation
facilities available.
c. Support system, welfare and health
care facilities available ( i.
 Government, ii. Semi government, iii.
Non- government/private
9. Ability to provide for basic needs of
members – foods, clothing, shelter, and
education.

10. Ability to provide nursing care to it’s

dependents, sick or disabled numbers.

11. Family’s utilization of available

community health resources and related social
and welfare services: preventive care services,
curative care services, material/financial and
psychosocial support system.

12. Family’s relationship with community and

participation in community activities.