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Fields

Validation

Anthropometric (Optional)

 

Weight (Kgs) 

- 

Height (cms) 

- 

BMI=Weight/(Height/100) ²  

Should be auto calculated if height and weight details are entered

Vitals (Optional)

 

Temperature (Degree Fahrenheit) 

Give predefined options (Normal range= 97-99 F)

a) 97.5

b) 98.5

c) 99.5

d)>= 100

If option d)>= 100 is chosen, show alert "Refer to Health and Wellness Centre" and show such beneficiaries in "Referral" card in Home

Pulse Rate (beats per minute) 

Give predefined options (Normal range= 60-90 BPM)

a) less than 60

b) 60-70

c) 70-80

d) More than 90

If "less than 60" or "more than 90" option is chosen, show alert "Refer to Health and Wellness Centre" and show such beneficiaries in "Referral" card in Home

 

 

 

 

Referred for

Auto selection 
  • "Digital Chest X-ray",
  • True NAT
  • Default option "Digital Chest X-ray" will be selected for everyone except if "age=< 5 years" and "are you pregnant= yes".
  • "True NAT" will be the default option for "age=< 5 years" and "are you pregnant= yes".
  • Based on the option auto chosen, show beneficiaries in "Digital Chest X-ray", "True NAT" cards in Referral section.

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Name of data Field 

Field Type 

Value/ Options 

Validation/ Logic/ Condition 

Date 

Calendar 
Date Picker 

Mandatory 

  • Default value Today's Date 
  • Not greater than Today's Date 
  • Accept date greater or equal to Date of beneficiary registration 
  • should not allow to update in edit or once submitted 

Name 

Textbox 

 

Auto fill from Beneficiary details 
Show: First Name + Last Name 
Read only 

Age 

Textbox 

 

Auto fill from Beneficiary details 
Read only 

Gender

Textbox 

 

Auto fill from Beneficiary details 
Read only 

Nikshay ID 

Textbox 

 

  • Enable if "Yes" is selected for 'Is Sputum sample collected.
  • Enable if "Yes" is selected for "Digital Chest X-ray conducted"
  • Enable if "Yes" is selected for "NAAT conducted"

Is Digital Chest X-ray conducted

 

  • Yes
  • No 

 

  • To be enabled if "Referred for" = "Digital Chest X-ray"

Digital Chest X-Ray Test Result 

 

  • Positive
  • Negative
  • Enable only if "Digital Chest X-ray conducted"=“Yes”
  • If "Positive" is selected, move this case to Confirmed TB cases module.

Sputum Test

 

 
  • To be enabled in the following conditions-

a) If "Digital Chest X-Ray Test Result"= "Positive"

b) If "History of TB" = "Yes"

c) If "Age=< 5 years"

d) If "Are you pregnant= yes"

Is Sputum sample collected? 

radio button 

  • Yes 
  • No 
  • Single selection
  • Mandatory

Is TrueNAT conducted

radio button 

  • Yes
  • No 
  • To be enabled if "Referred for" = "TrueNAT" and "Sputum Sample Collected" = "Yes"

True NAT test result

 radio button 

  • Positive
  • Negative
  • Enable only if "TrueNAT conducted"=“Yes”
  • Option to edit/ select after submission of the form
  • If "Positive" is selected, move this case to Confirmed TB cases module.

Is Liquid culture conducted

radio button 

  • Yes
  • No 
  • To be enabled only if "History of TB" = "Yes", "Currently on Anti-TB drugs" = "Yes" "and "Sputum Sample Collected" = "Yes"

Liquid Culture

 radio button 

  • Positive
  • Negative
  • If "Positive" is selected, move this case to Confirmed TB cases module.
  • Option to edit/ select after submission of the form

Nikshay ID 

Textbox 

 

  • Enable if "Yes" is selected for 'Is Sputum sample collected.
  • Enable if "Yes" is selected for "Digital Chest X-ray conducted"
  • Enable if "Yes" is selected for "NAAT conducted"

Capture Geolocation



  • Capture

Capture Geolocation

  • Capture current location details (latitude, longitude, address)

Submit 

Button 

 

 

...

Should be enabled for beneficiaries aged 30 years and above

Optional Module. 

Name of data field

Field type

Options/ values

Validation/ Logic

Hypertension Screening




Have you ever been diagnosed with high blood pressure?


·       Yes

·       No

·       Don’t Know

·       Single selection allowed

·       Optional


Are you currently taking medication for blood pressure?


·       Yes

·       No

·       Stopped recently

·       To be enabled if “Have you ever been diagnosed with high blood pressure” = “Yes”

·       Optional

Does anyone in your family have high blood pressure


·       Yes

·       No

·       Don’t Know

·       Single selection allowed

·       Optional


Have you experienced any of the following symptom/ symptoms


·       Dizziness

·       Swollen legs

·       Frequent headaches

·       None

·       Optional

·       Multiple selection possible

·       'None' selection should deselect all others

Systolic BP

Number-

Values to be captured in (mmHg)

·       Optional

·       If "less than 90" or "more than 140", show alert "Refer to Health and Wellness Centre" and show such beneficiaries in "Referral" card in Home

Diastolic BP

Number

Values to be captured in (mmHg)

·       Optional

·       If "less than 60" or "more than 90", show alert "Refer to Health and Wellness Centre" and show such beneficiaries in "Referral" card in Home

Diabetes Screening




Have you been diagnosed with diabetes or pre-diabetes?


·       Yes

·       No

·       Don’t Know

·       Single selection allowed

·       Optional


Are you currently on medication or insulin for diabetes?


·       Yes

·       No

·       Stopped recently

·       To be enabled if “Have you been diagnosed with diabetes or pre-diabetes?” = “Yes”

·       Optional

Have you experienced any of the following symptom/ symptoms in the past 3 months


·       Excessive thirst

·       Frequent urination

·       Unexplained weight loss

·       Blurred vision

·       Tingling/numbness in feet

·       Fatigue

·       Slow-healing wounds

·       None

·       Optional

·       Multiple selection possible

·       'None' selection should deselect all others

Random Blood Sugar

Number

Values to be captured in (mg/dl)

·       Optional

·       If >= 100 mg/dl then show alert "Refer to Health and Wellness Centre" and show such beneficiaries in "Referral" card in Home


2.2.4 Module - Referrals

This module should contain the list of names/ cases referred to health facilities.

...

  1. Time Period- based on "today and previous months" This filter should show all the data cards in the dashboard pertaining to the time period selected. (eg: today, Jan, Feb etc)
  2. Village Name- Dropdown options to be populated with names of village/ hamlets



Field Name

Field Type

Options

Validation

Filter/ Selection option

Dropdown

The Dropdown Values are

  • Today
  • January
  • February
  • March
  • April
  • May
  • June
  • July
  • August
  • September
  • October
  • November
  • December

If this filter is selected, then show all the values of the dashboard indicators pertaining to the time period selected.

Filter/ Selection option

Dropdown

Village/ Hamlet names to be put here

If this filter is selected, then show all the values of the dashboard indicators pertaining to the particular village selected.

Total TB screenings

Total Positives/ Negatives 

Male- Positives/ Negatives 
Female- Positives/ Negatives 
Children (<15 yrs)- Positives/ Negatives 
Others


Card must be yellow in colour

It must auto populate based on the filter selected.

Total number should be shown in bold with sex aggregated data- male, female, Children, others

Total TB suspected cases

Total Positives/ Negatives 

Male- Positives/ Negatives 
Female- Positives/ Negatives 
Children (<15 yrs)- Positives/ Negatives 
Others


Card must be yellow in colour

It must auto populate based on the filter selected.

Total number should be shown in bold with sex aggregated data- male, female, Children, others

Total TB confirmed cases

Total Positives/ Negatives 

Male- Positives/ Negatives 
Female- Positives/ Negatives 
Children (<15 yrs)- Positives/ Negatives 
Others


Card must be yellow in colour

It must auto populate based on the filter selected.

Total number should be shown in bold with sex aggregated data- male, female, Children, others

Total Digital Chest X-Rays conducted

Male Male 
Female

Total Positives/ Negatives

Male- Positive/ Negative
Female- Positive/ Negative
Children (5-15 years)- Positives/ Negatives
Others

Age>= 60 years- Positives/ Negatives


 

 It must auto populate based on the filter selected.

Total number should be shown in bold with sex aggregated data- male, female, Children, others

Total Sputum collection conducted

Total- Positives/ Negatives

Male- Positives/ Negatives
Female- Positives/ Negatives


Children (<15 yrs)- Positives/ Negatives
Others

Age>= 60 years- Positives/ Negatives


 

 It must auto populate based on the filter selected.

Total number should be shown in bold with sex aggregated data- male, female, Children, others

Total True NAT tests conducted

Male 

Male- Positives/ Negatives
Female- Positives/ Negatives
Children (<15 yrs)- Positives/ Negatives
Others

Age>= 60 years- Positives/ Negatives


 

It must auto populate based on the filter selected.

Total number should be shown in bold with sex aggregated data- male, female, Children, others

Total sputum samples sent for liquid culture

Male 

Male- Positives/ Negatives
Female- Positives/ Negatives
Children (<15 yrs)- Positives/ Negatives
Others

Age>= 60 years- Positives/ Negatives


 

It must auto populate based on the filter selected.

Total number should be shown in bold with sex aggregated data- male, female, Children, others

Total cases referred to Health and Wellness Centres

Male 
Female
Children (<15 yrs)
Others

Age>= 60 years


 

 It must auto populate based on the filter selected.

Total number should be shown in bold with sex aggregated data- male, female, Children, others

NIKSHAY IDs


Card must be yellow in colour

Total number of NIKSHAY IDs made in the selected time period or Village

ABHA IDs


Card must be yellow in colour

Total number of ABHA IDs made in the selected time period or Village