15 2018 MCH Survey Juris Module_Palau_Palauan_Formatted

Title V Maternal and Child Health (MCH) Block Grant Jurisdictional MCH Survey Instrument-

Jurisdiction Module, Palau - Palaun

^Belau

1. [ONLY ASK THIS QUESTION IF CHILD IS 0-5 YEARS OLD] A ngelekem ng mla tal rellii a Ages and Stages Questionnaire (ASQ) ra toktang er ngii ma lechub tara brobesong el chad ra ureor?

1. ☐ Choi

77. ☐ Diak

1. Diak Kudengei

1. Diak a Nger

A ikang el teblong ra ker a oker er kirel a bullying. A bullying sel sekum ea tang ma lechub e te terung el ngalek a melemolem el omekakou, orrouk, omerk a telulchoid,mengelebed, oldubech, ma lechub e tomekringel ra tara ngalek. Ngdiak el bullying a lsekum ar terung el ngalek ra skuul el kmeed el osisiu a klisichir a kau mondai, kautoktok, ma lechub e te kaiukakou el teletelir ar terung el kausechelei el ngalek.

4. [ONLY ASK THIS QUESTION IF CHILD IS 12-17 YEARS OLD] A ngelekem ng mla tang el le bully er ngii ra kerensel a skuul?

1. ☐ Choi

77. ☐ Diak

1. Diak Kudengei

1. Diak a Nger

4. [ONLY ASK THIS QUESTION IF CHILD IS 12-17 YEARS OLD] A ngelekem ng mla tang el bully er ngii lokiu a, text, ma facebook (electronic)? (Ko mechur a ikel blel bully er ngii lokiu a texting, Instagram, Facebook, ma lechub eng kuk bebil ra bedengenel).

1. ☐ Choi

77. ☐ Diak

1. Diak Kudengei

1. Diak a Nger

4. Kau ma lechub eng kuk tara klou el chad ra delengchokl a mla tal mosaod oliu a violence malechub eng injury prevention el mora ngelkem?

1. ☐ Choi

77. ☐ Diak

1. Diak Kudengei

1. Diak a Nger

Aikal ker a mo oker a chisel a health er kau er tial dirke mlo merek el kldiull er kau.

4. [ONLY ASK THIS QUESTION IF CHILD IS 0-1 YEAR OLD AND IF BIOLOGICAL MOTHER] A chelsel tial dirke mlo merek el kldiull er kau, ea toktang, nurse ma lechub eng chad ra ukkeruul ngmal mengedecheduch er kau el kirel a ikang el tekoi el beldukl er iou? Komechur a ikel ngii e milsaod el merkau, ngdiak momechur a ikel mchiluiu, ma lechub e ke miles ra video. Ke loia tengetang ra bekl tekoi el dimlak a chad el smaod lekor kau ma lechub e ke loia tengetang ra Choi a lsekum eng milsaod lekor kau.

   	CHOI	DIAK	DIAK KUDENGEI	DIAK A NGER
   PA5a. Kall el ungil dongang a de dioll	1 ☐	2 ☐	77 ☐	99 ☐
   PA5b. Undo sel de dioll	1 ☐	2 ☐	77 ☐	99 ☐
   PA5c. Programs ma lechub eng ngesou el olengeseu er ngak meng di ungil a berredek ra kldiull er ngak	1 ☐	2 ☐	77 ☐	99 ☐
   PA5d. Programs ma lechub e ngesou el olengeseu er ngak el omeksengaked sel kmechell	1 ☐	2 ☐	77 ☐	99 ☐

5. [ONLY ASK THIS QUESTION IF CHILD IS 0-1 YEAR OLD AND IF BIOLOGICAL MOTHER] Ng telal bond a ngilasech ra berredem er tial dirke mlo merek el kldiull er kau?

lbs or kilos

1. ☐ Ng dimlak a ngmaseck el bendek er serak dioll

1. Diak Kudengei

1. Diak a Nger

1