Kenya Disease Surveillance FHIR Implementation Guide.
0.1.0 - ci-build Kenya flag

Kenya Disease Surveillance FHIR Implementation Guide., published by Kenya National Public Health Institute. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IntelliSOFT-Consulting/Surveillance-FHIR-IG/ and changes regularly. See the Directory of published versions

Questionnaire: Mpox Supervisor Checklist

Official URL: http://example.org/Questionnaire/MpoxSupervisorChecklist Version: 0.1.0
Active as of 2025-08-09 Computable Name:

Mpox Supervisor Checklist questionnaire for disease surveillance

Record all supervisor related activities

Profile: http://hl7.org/fhir/4.0/StructureDefinition/Questionnaire

Structure
LinkIDTextCardinalityTypeFlagsDescription & Constraintsdoco
.. Mpox Supervisor Checklist questionnaire for disease surveillanceQuestionnairehttp://example.org/Questionnaire/MpoxSupervisorChecklist#0.1.0
... 151479012557Reporting Site0..1groupValue Set:
.... 546255966914Hospital/Facility Location0..1displayValue Set:
.... user_roleUser Role0..1stringiconiconValue Set:
.... user_facilityUser Facility0..1stringiconiconValue Set:
.... user_wardUser Ward0..1stringiconiconValue Set:
.... user_sub_countyUser Sub County0..1stringiconiconValue Set:
.... user_countyUser County0..1stringiconiconValue Set:
.... facility_levelnull0..1groupEnable When: user_role = VACCINATOR
Value Set:
..... 294367770999County1..1referenceValue Set:
..... 819946803642Sub County1..1referenceValue Set:
..... 819943434Ward1..1referenceValue Set:
..... 819946803677Health Facility1..1referenceValue Set:
..... 438862163919Type of health facility1..1choiceValue Set:
Options: 3 options
.... sub_county_levelnull0..1groupEnable When: user_role = SUBCOUNTY_DISEASE_SURVEILLANCE_OFFICER
Value Set:
..... 294367770999_sub_countyCounty1..1referenceValue Set:
..... 819946803642_sub_countySub County1..1referenceValue Set:
..... 819943434_sub_countyWard1..1referenceValue Set:
..... 819946803677_sub_countyHealth Facility1..1referenceValue Set:
..... 438862163919_sub_countyType of health facility1..1choiceValue Set:
Options: 3 options
.... county_levelnull0..1groupEnable When: user_role = COUNTY_DISEASE_SURVEILLANCE_OFFICER
Value Set:
..... 294367770999_countyCounty1..1referenceValue Set:
..... 819946803642_countySub County1..1referenceValue Set:
..... 819943434_countyWard1..1referenceValue Set:
..... 819946803677_countyHealth Facility1..1referenceValue Set:
..... 438862163919_countyType of health facility1..1choiceValue Set:
Options: 3 options
.... national_levelnull0..1groupEnable When: user_role = ADMINISTRATOR
Value Set:
..... 294367770999_nationalCounty1..1referenceValue Set:
..... 819946803642_nationalSub County1..1referenceValue Set:
..... 819943434_nationalWard1..1referenceValue Set:
..... 819946803677_nationalHealth Facility1..1referenceValue Set:
..... 438862163919_nationalType of health facility1..1choiceValue Set:
Options: 3 options
.... site_nameVaccination Site Name1..1stringValue Set:
.... site_typeVaccination Site Type1..1choiceValue Set:
Options: 3 options
.... 728034137219Date1..1dateValue Set:
.... location_widgetGPS Coordinate0..1groupValue Set:
..... latitudeLatitude0..1decimalValue Set:
..... longitudeLongitude0..1decimalValue Set:
.... supervisor_nameSupervisor Name1..1stringValue Set:
.... supervisor_levelSupervisor Level1..1choiceValue Set:
Options: 4 options
... planningPlanning0..1groupValue Set:
.... team_movement_plan_availableTeam Movement Plan Available?1..1choiceiconiconValue Set:
Options: 2 options
.... rcce_strategy_in_placeRisk communication & community engagement (RCCE) strategy in place?1..1choiceiconiconValue Set:
Options: 2 options
... healthcare_worker_preparednessHealthcare Worker Preparedness0..1groupValue Set:
.... trained_on_mpox_vaccine_adminVaccinators trained on Mpox vaccine administration?1..1choiceiconiconValue Set:
Options: 2 options
.... trained_on_aefi_recognition_reportingVaccinators trained on AEFI recognition & reporting?1..1choiceiconiconValue Set:
Options: 2 options
.... trained_on_infection_preventionVaccinators trained on infection prevention (hard hygiene, waste disposal)?1..1choiceiconiconValue Set:
Options: 2 options
.... vaccines_with_valid_vvmVaccines carrier with foam pad?1..1choiceiconiconValue Set:
Options: 2 options
.... cold_chain_maintained_temp_logsCold chain maintained (2–8°C) with temperature logs?1..1choiceiconiconValue Set:
Options: 2 options
.... sufficient_supplies_availableSufficient AD syringes, safety boxes?1..1choiceiconiconValue Set:
Options: 2 options
.... emergency_stock_reservedEmergency stock reserved for high-risk areas?1..1choiceiconiconValue Set:
Options: 2 options
.... backup_generator_or_solar_availableBackup generator/solar system available?1..1choiceiconiconEnable When: site_type = Static (static)
Value Set:
Options: 2 options
... vaccination_site_setupVaccination Site Setup0..1groupValue Set:
.... site_meets_infection_standardsSite meets infection prevention standards (handwashing, distancing)?1..1choiceiconiconValue Set:
Options: 2 options
.... separate_zones_presentSeparate zones: Registration, Screening, Vaccination, Observation?1..1choiceiconiconValue Set:
Options: 2 options
.... privacy_ensuredPrivacy ensured (e.g., curtains for undressing if intradermal)?1..1choiceiconiconValue Set:
Options: 2 options
.... emergency_kit_availableEmergency kit with adrenaline, 2ml Syringe and needle available?1..1choiceiconiconValue Set:
Options: 2 options
... vaccination_processVaccination Process0..1groupValue Set:
.... correct_siteDid the vaccinators administer Mpox vaccine in the correct site as per the guidelines (Observation)?1..1choiceiconiconValue Set:
Options: 2 options
.... correct_route_usedVaccine administered via correct route?1..1choiceiconiconValue Set:
Options: 2 options
.... aseptic_technique_followedAseptic technique (Dry cotton swap, sterile syringe and needle)?1..1choiceiconiconValue Set:
Options: 2 options
... reportingReporting0..1groupValue Set:
.... data_entered_in_nphiisVaccination data entered in National Public Health Intelligence platform daily (NPHIIS)?1..1choiceiconiconValue Set:
Options: 2 options
.... any_aefisWas there an AEFI?1..1choiceiconiconValue Set:
Options: 2 options
.... aefi_reported_immediatelyAEFIs reported immediately to the team supervisor?1..1choiceiconiconEnable When: any_aefis = Yes (yes)
Value Set:
Options: 2 options
.... data_collection_tools_availableData Collection tools available and adequate?1..1choiceiconiconValue Set:
Options: 2 options
.... which_toolWhich Tool?1..*choiceEnable When: data_collection_tools_available = Yes (yes)
Value Set:
Options: 2 options
... infection_prevention_and_wasteInfection Prevention & Waste Disposal0..1groupValue Set:
.... ppe_usedPPE used by all vaccinators (gowns)?1..1choiceiconiconValue Set:
Options: 2 options
.... sharps_in_safety_boxesSharps in WHO-approved safety boxes?1..1choiceiconiconValue Set:
Options: 2 options
.... biomedical_waste_disposed_correctlyIs the generated healthcare waste properly segregated?1..1choiceiconiconValue Set:
Options: 2 options
... community_engagementCommunity Engagement0..1groupValue Set:
.... rumors_addressedRumors addressed via hotline/community leaders?1..1choiceiconiconValue Set:
Options: 2 options
.... sensitization_materials_local_languagesSensitization materials in local languages (Swahili, vernacular)?1..1choiceiconiconValue Set:
Options: 2 options
... post_vaccinationPost-Vaccination0..1groupValue Set:
.... observation_after_vaccinationRecipients observed for 15+ minutes post-vaccination?1..1choiceiconiconValue Set:
Options: 2 options
.... aefi_forms_readyHave the AEFI forms been filled at the facility level and cascaded to the sub-county?1..1choiceiconiconEnable When: any_aefis = Yes (yes)
Value Set:
Options: 2 options
... rumour_trackingRumor Tracking0..1groupValue Set:
.... mpox_rumor_heardHave you heard any rumors / hesitancy on Mpox vaccine?1..1choiceiconiconValue Set:
Options: 2 options
.... mpox_rumor_optionsIf yes, select all that apply1..*choiceEnable When: mpox_rumor_heard = yes (yes)
Value Set:
Options: 6 options
.... mpox_rumor_other_specifyIf other kindly specify1..1stringEnable When: mpox_rumor_options = other (other)
Value Set:
.... mpox_rumor_actionState what you did with the rumor1..1stringEnable When: mpox_rumor_heard = yes (yes)
Value Set:
.... mpox_rumor_source_trustedDid you trust the source of the rumor?1..1choiceiconiconEnable When: mpox_rumor_heard = yes (yes)
Value Set:
Options: 2 options
.... mpox_rumor_investigatedWas the rumor investigated?1..1choiceiconiconEnable When: mpox_rumor_heard = yes (yes)
Value Set:
Options: 2 options
.... mpox_rumor_steps_takenWhich steps did you take to address the rumor?1..1textEnable When: mpox_rumor_heard = yes (yes)
Value Set:
... supervisors_final_assessmentSupervisor's Final Assessment0..1groupValue Set:
.... any_challengesWere there any challenges?1..1choiceiconiconValue Set:
Options: 2 options
.... key_challengesKey challenges:1..1stringEnable When: any_challenges = yes (yes)
Value Set:
.... corrective_actions_takenCorrective actions taken for gaps.1..1stringEnable When: key_challenges exists true
Value Set:
.... recommendations_for_next_phaseRecommendations for next phase1..1stringValue Set:

doco Documentation for this format

Options Sets

Answer options for 438862163919

  • null#Private ("Private")
  • null#Public ("Public")
  • null#Faith Based ("Faith Based")

Answer options for 438862163919_sub_county

  • null#Private ("Private")
  • null#Public ("Public")
  • null#Faith Based ("Faith Based")

Answer options for 438862163919_county

  • null#Private ("Private")
  • null#Public ("Public")
  • null#Faith Based ("Faith Based")

Answer options for 438862163919_national

  • null#Private ("Private")
  • null#Public ("Public")
  • null#Faith Based ("Faith Based")

Answer options for site_type

  • null#static ("Static")
  • null#temporary_fixed ("Temporary Fixed")
  • null#mobile_sites ("Mobile sites")

Answer options for supervisor_level

  • null#National ("National")
  • null#County ("County")
  • null#Sub County ("Sub County")
  • null#Partner ("Partner")

Answer options for team_movement_plan_available

  • null#yes ("Yes")
  • null#no ("No")

Answer options for rcce_strategy_in_place

  • null#yes ("Yes")
  • null#no ("No")

Answer options for trained_on_mpox_vaccine_admin

  • null#yes ("Yes")
  • null#no ("No")

Answer options for trained_on_aefi_recognition_reporting

  • null#yes ("Yes")
  • null#no ("No")

Answer options for trained_on_infection_prevention

  • null#yes ("Yes")
  • null#no ("No")

Answer options for vaccines_with_valid_vvm

  • null#yes ("Yes")
  • null#no ("No")

Answer options for cold_chain_maintained_temp_logs

  • null#yes ("Yes")
  • null#no ("No")

Answer options for sufficient_supplies_available

  • null#yes ("Yes")
  • null#no ("No")

Answer options for emergency_stock_reserved

  • null#yes ("Yes")
  • null#no ("No")

Answer options for backup_generator_or_solar_available

  • null#yes ("Yes")
  • null#no ("No")

Answer options for site_meets_infection_standards

  • null#yes ("Yes")
  • null#no ("No")

Answer options for separate_zones_present

  • null#yes ("Yes")
  • null#no ("No")

Answer options for privacy_ensured

  • null#yes ("Yes")
  • null#no ("No")

Answer options for emergency_kit_available

  • null#yes ("Yes")
  • null#no ("No")

Answer options for correct_site

  • null#yes ("Yes")
  • null#no ("No")

Answer options for correct_route_used

  • null#yes ("Yes")
  • null#no ("No")

Answer options for aseptic_technique_followed

  • null#yes ("Yes")
  • null#no ("No")

Answer options for data_entered_in_nphiis

  • null#yes ("Yes")
  • null#no ("No")

Answer options for any_aefis

  • null#yes ("Yes")
  • null#no ("No")

Answer options for aefi_reported_immediately

  • null#yes ("Yes")
  • null#no ("No")

Answer options for data_collection_tools_available

  • null#yes ("Yes")
  • null#no ("No")

Answer options for which_tool

  • null#Tally_Sheet ("Tally Sheet")
  • null#AEFI_form ("AEFI form")

Answer options for ppe_used

  • null#yes ("Yes")
  • null#no ("No")

Answer options for sharps_in_safety_boxes

  • null#yes ("Yes")
  • null#no ("No")

Answer options for biomedical_waste_disposed_correctly

  • null#yes ("Yes")
  • null#no ("No")

Answer options for rumors_addressed

  • null#yes ("Yes")
  • null#no ("No")

Answer options for sensitization_materials_local_languages

  • null#yes ("Yes")
  • null#no ("No")

Answer options for observation_after_vaccination

  • null#yes ("Yes")
  • null#no ("No")

Answer options for aefi_forms_ready

  • null#yes ("Yes")
  • null#no ("No")

Answer options for mpox_rumor_heard

  • null#yes ("Yes")
  • null#no ("No")

Answer options for mpox_rumor_options

  • null#death ("Mpox vaccine can cause death")
  • null#infertility ("Mpox vaccine can cause infertility")
  • null#depopulation ("Mpox vaccine is Bill and Melinda depopulation agenda")
  • null#unsafe ("Mpox vaccine is not safe and can cause serious side effects")
  • null#covid_finish ("Mpox vaccine is a way of finishing the COVID-19 vaccine")
  • null#other ("Other")

Answer options for mpox_rumor_source_trusted

  • null#yes ("Yes")
  • null#no ("No")

Answer options for mpox_rumor_investigated

  • null#yes ("Yes")
  • null#no ("No")

Answer options for any_challenges

  • null#yes ("Yes")
  • null#no ("No")