APPENDICES (KISH Tables, Vignettes, Cards) World Health Organization, Evidence and Information for Policy WORLD HEALTH SURVEY Short Questionnaire… [630297]

WORLD HEALTH SURVEY

2002
Short Questionnaire

APPENDICES (KISH Tables, Vignettes, Cards)

World Health Organization, Evidence and Information for Policy

WORLD HEALTH SURVEY

Short Questionnaire

KISH TABLES (S0450)

RESPONSE SCALES (2000 and 7000)

S0450
KISH TABLES
Tables A and B1
11
21314151
6 or + 1
11
21314152
6 or + 2If the number of eligible persons is: Interview the person numbered: Selection Table A
If the number of eligible persons is: Interview the person numbered:
Selection Table B1
WORLD HEALTH SURVEY – KISH TABLES – S S0450.1

S0450
KISH TABLES
Tables B2 and C
11
21314252
6 or + 2
11
21324253
6 or + 3If the number of eligible persons is: Interview the person numbered: Selection Table B2
If the number of eligible persons is: Interview the person numbered:
Selection Table C
WORLD HEALTH SURVEY – KISH TABLES – S S0450.2

S0450
KISH TABLES
Tables D and E1
11
22324354
6 or + 4
11
22334353
6 or + 5If the number of eligible persons is: Interview the person numbered: Selection Table D
If the number of eligible persons is: Interview the person numbered:
Selection Table E1
WORLD HEALTH SURVEY – KISH TABLES – S S0450.3

S0450
KISH TABLES
Tables E2 and F
11
22334455
6 or + 5
11
22334455
6 or + 6If the number of eligible persons is: Interview the person numbered: Selection Table E2
If the number of eligible persons is: Interview the person numbered:
Selection Table F
WORLD HEALTH SUREVEY – KISH TABLES – S S0450.4

RESPONSE SCALES
2000 – Health
1234 5
Very good Good Moderate Bad Very bad
1234 5
None Mild Moderate Severe Extreme/
Cannot do
7000 – Health System Responsiveness
1234 5
Very good Good Moderate Bad Very bad
1234 5
Extreme Serious Moderate Mild problem No problem
1234 5
Extremely Very Moderately Slightly Not
important important important important important
WORLD HEALTH SURVEY – RESPONSE SCALES – S A.1

WORLD HEALTH SURVEY

Short Questionnaire

Module 2000

HEALTH STATE DESCRIPTIONS

VIGNETTES

WORLD HEALTH SURVEY – HEALTH VIGNETTES (A) – S A2(A).1

VIGNETTES FOR HEALTH STATE DESCRIPTIONS: Set-A
..
Mobility and Affect
..

[Jan] feels nervous and anxious. He worries and thinks negativel y about the future, but feels better in the company of people o r when doing something that
really interests him. When he is alone he tends to feel useless and empty.
.
S2101 Overall in the last 30 days, how much of a problem did [name of person]
have with feeling sad, low, or depressed ? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme
.

[Mary] has no problems with walking, running or using her hands, arms and legs. She jogs 4 kilometres twice a week.
.
S2102 Overall in the last 30 days, how much of a problem did [name of person]
have with moving around ? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme/
Cannot do
.

[Anton] does not exercise. He cannot climb stairs or do other phys ical activities because he is obese. He is able to carry the groceries and do some light
household work.
.
S2103 Overall in the last 30 days, how much of a problem did [name of person]
have with moving around ? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme/
Cannot do
.
[David] is paralyzed from the neck down. He is unable to move hi s arms and legs or to shift body position. He is confined to be d.
.
S2104 Overall in the last 30 days, how much difficulty did [name of person]
have with moving around ? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme/
Cannot do
.

[Ken] loves life and is happy all the time. He never worries or gets upset about anything and deals with things as they come.
.
S2105 Overall in the last 30 days, how much of a problem did [name of person]
have with feeling sad, low, or depressed ? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme
.

[Rob] is able to walk distances of up to 200 metres without any problems but feels tired after walking one kilometre or climbin g up more than one flight of
stairs. He has no problems with day-to-day physical activities, such as carrying food from the mark
.
S2106 Overall in the last 30 days, how much difficulty did [name of person]
have with moving around ? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme/
Cannot do

WORLD HEALTH SURVEY – HEALTH VIGNETTES (A) – S A2(A).2
.

[Vincent] has a lot of swelling in his legs due to his health condition. He has to make an effort to walk around his home as hi s legs feel heavy.
.
S2107 Overall in the last 30 days, how much of a problem did [name of person]
have with moving around ? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme/
Cannot do
.
[Vivian] has already had five admissions into the hospital because she has attempted suicide twice in the past year and has har med herself on three other
occasions. She is very distressed every day for the most part of the day, and sees no hope of things ever getting better. She i s thinking of trying to end her life
again.
.
S2108 Overall in the last 30 days, how much of a problem did [name of person]
have with feeling sad, low, or depressed ? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme
.

[Roberta] feels depressed most of the time. She weeps frequently and feels hopeless about the future. She feels that she has be come a burden on others and
that she would be better dead.
.
S2109 Overall in the last 30 days, how much of a problem did [name of person]
have with feeling sad, low, or depressed ? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme
.

[Henriette] enjoys her work and social activities and is generally satisfied with her life. She gets depressed every 3 weeks fo r a day or two and loses interest in
what she usually enjoys but is able to carry on with her day to day activities.
.
S2110 Overall in the last 30 days, how much of a problem did [name of person]
have with feeling sad, low, or depressed ? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme

WORLD HEALTH S URVEY – HEALTH VIGNETTES (B) – S A2(B).1 VIGNETTES FOR HEALTH STATE DESCRIPTIONS: Set-B
..
Pain and Personal Relationships
..
[Mark] has pain in his knees, elbows, wrists and fingers, and the pain is present almost all the time. It gets worse during the first half of the day. Although
medication helps, he feels uncomfortable when moving around, holding and lifting things.
.
S2101 Overall in the last 30 days, how much of bodily aches or pains did [name
of person] have? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme
.

[Elizabeth] has difficulty climbing up and down the stairs and walking. She is not able to go out as much as she would like to but has many friends who come
and visit her at home. Her friends find her a source of great comfort.
.
S2102 Overall in the last 30 days, how much difficulty did [name of person]
have with personal relationships or participation in the community ? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme/
Cannot do
.
[Amala] suffered a stroke three months ago. Her friends do not come and visit anymore as Amala cannot communicate with them. Sh e is constantly upset and
shouts at her family members which causes them to avoid her.
.
S2103 Overall in the last 30 days, how much difficulty did [name of person]
have with personal relationship or participation in the community ? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme/
Cannot do
.
[Katie] cannot remember when she last felt pain as this has not happened for the last several years now. She does not experienc e any pain even after hard
physical labor or exercise.
.
S2104 Overall in the last 30 days, how much of bodily aches or pains did [name
of person] have? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme
.

[Charlie] can join in any community activities that interest him, whenever he wants to, without any restrictions. He gets on we ll with everybody and enjoys
meeting new people.
.
S2105 Overall in the last 30 days, how much difficulty did [name of person]
have with personal relationship or participation in the community ? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme/
Cannot do
.
[Steve] has pain in the neck radiating to the arms that is not relieved by any medicines or other treatment. The pain is sharp at all times and keeps him awake
most of the night. During the day the pain has made him completely incapacitated. It has necessitated complete confinement to t he bed and often makes him
think of ending his life.
.
S2106 Overall in the last 30 days, how much of bodily aches or pains did [name
of person] have? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme

WORLD HEALTH S URVEY – HEALTH VIGNETTES (B) – S A2(B).2 .

[Johanna] gets on well with the people she knows but has no close friends. She has not spoken to her mother in 5 years and does not want to see her. Because
of this tension, her family usually excludes her from family gatherings.
.
S2107 Overall in the last 30 days, how much difficulty did [name of person]
have with personal relationship or participation in the community ? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme/
Cannot do
.

[Laura] has a headache once a month that is relieved one hour after taking a pill. During the headache she can carry on with he r day to day affairs.
.
S2108 Overall in the last 30 days, how much of bodily aches or pains did [name
of person] have? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme
.

[Nobu] is blind and lives in a remote rural area. His family does not allow him to leave the house because they fear he will ge t hurt. His family tells him that
he is a burden to them. Their criticism upsets him and he cries.
.
S2109 Overall in the last 30 days, how much difficulty did [name of person]
have with personal relationships or participation in the community ? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme/
Cannot do
.

[Isabelle] has pain that radiates down her right arm and wrist du ring her day at work. This is slightly relieved in the evening s when she is no longer working
on her computer.
.
S2110 Overall in the last 30 days, how much of bodily aches or pains did [name
of person] have? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme/
Cannot do

WORLD HEALTH S URVEY – HEALTH VIGNETTES (B) – S A2(B).3

WORLD HEALTH SU RVEY – HEALTH VIGNETTES (C) – S A2(C ).1
VIGNETTES FOR HEALTH STATE DESCRIPTIONS: Set-C
..
Vision, Sleep and Energy
..

[Jennifer] only reads if the text is in very large print, such as 10 lines per page. Otherwise she does not read anything. Even when people are close to her, she
sees them blurred.
.
S2101 In the last 30 days, how much difficulty did you think [name of person]
have in seeing and recognizing a person she knows across the road ( i.e.
from a distance of about 20 meters)? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme/
Cannot do
.
[Paolo] has no trouble falling asleep at night and does not wake up during the night, but every morning he finds it difficult t o wake up. He uses an alarm clock
but falls back asleep after the alarm goes off. He is late to wo rk on four out of five days and feels tired in the mornings.
.
S2102 In the last 30 days, how much difficulty do you think [name of person]
had with sleeping, such as falling asleep , waking up frequently during the
night or waking up too early in the morning? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme

.

[Hector] can read words in newspaper articles (and can recognize faces on a postcard size photograph). He can recognize familia r people’s faces all the time
and picks out most details in pictures from across 20 metres.
.
S2103 In the last 30 days, how much difficulty did you think [name of person]
have in seeing and recognizing a person she knows across the road ( i.e.
from a distance of about 20 meters)? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme/
Cannot do
.
[Damien] wakes up almost once every hour during the night. When she wakes up in the night, it takes around 15 minutes for her t o go back to sleep. In the
morning she does not feel well-rested and feels slow and tired all day.
.
S2104 In the last 30 days, how much difficulty do you think [name of person]
had with sleeping, such as falling asleep, waking up frequently during the
night or waking up too early in the morning ? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme

.
[Daniel] takes about two hours every night to fall asleep. He wakes up once or twice a night feeling panicked and takes more th an one hour to fall asleep
again. Three to four nights a week he wakes up in the middle of the night and cannot go back to sleep for the rest of the night . He is fatigued all day, every day
and misses work several times a week. He cannot take part in sports or social activities.
.
S2105 In the last 30 days, how much difficulty do you think [name of person]
had with sleeping, such as falling asleep , waking up frequently during the
night or waking up too early in the morning? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme

WORLD HEALTH SU RVEY – HEALTH VIGNETTES (C) – S A2(C ).2
.

[Norman] needs a magnifying glass to read small print and look at details on pictures. He also takes a while to recognize objec ts if they are too far from him.
.
S2106 In the last 30 days, how much difficulty did you think [name of person]
have in seeing and recognizing a person she knows across the road ( i.e.
from a distance of about 20 meters)? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme/
Cannot do
.

[Antonio] can read words in newspaper articles (and can recogni ze faces on a postcard size photograph). He can recognize shapes and colours from across 20
metres but misses out the fine details.
.
S2107 In the last 30 days, how much difficulty did you think [name of person]
have in seeing and recognizing a person she knows across the road ( i.e.
from a distance of about 20 meters)? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme/
Cannot do
.
[Noemi] falls asleep easily at night, but two nights a week she wakes up in the middle of the night and cannot go back to sleep for the rest of the night. On
these days she is exhausted at work and cannot concentrate on her job.
.
S2108 In the last 30 days, how much difficulty do you think [name of person]
had with sleeping, such as falling asleep , waking up frequently during the
night or waking up too early in the morning? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme

.

[Sebastian] cannot detect any movement close to the eyes or even the presence of a light.
.
S2109 In the last 30 days, how much difficulty did you think [name of person]
have in seeing and recognizing a person she knows across the road ( i.e.
from a distance of about 20 meters)? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme/
Cannot do
.
[Mark] falls asleep every night within five minutes of going to bed. He sleeps soundly during the whole night and wakes up in t he morning feeling well-rested
and feels full of energy all day.
.
S2110 In the last 30 days, how much difficulty do you think [name of person]
had with sleeping, such as falling asleep , waking up frequently during the
night or waking up too early in the morning ? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme

WORLD HEALTH SU RVEY – HEALTH VIGNETTES (C) – S A2(C ).3
.

WORLD HEALTH SURVEY – HEALTH VIGNETTES (D) – S A2(D).1 VIGNETTES FOR HEALTH STATE DESCRIPTIONS: Set-D
..
Cognition and Self Care
..
[Helena] pays a lot of attention to the way she looks. She requires no assistance with cleanliness, dressing and eating.
.
S2101 Overall in the last 30 days, how much difficulty did [name of person]
have with self-care , such as washing or dressing himself/herself? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme/
Cannot do
.
[Sue] can find her way around the neighborhood and know where her own belongings are kept, but str uggles to remember how to get to a place she has only
visited once or twice. She is keen to learn new recipes but find s that she often makes mistakes and has to reread several times before she is able to do them
properly.
.
S2102 Overall in the last 30 days overall how much difficulty did [name of the
person] have with concentrating or remembering things ? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme/
Cannot do
.
[Sue] is quadriplegic and must be washed, groomed, dressed and fed by somebody else.
.
S2103 Overall in the last 30 days, how much difficulty did [name of person]
have with self-care , such as washing or dressing himself/herself? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme/
Cannot do
.
[Malcolm] can concentrate while watching TV, reading a magazine or playing a game of cards or chess. He can learn new variation s in these games with
small effort. Once a week he forgets where his keys or glasses are, but finds them within five minutes.
.
S2104 Overall in the last 30 days overall how much difficulty did [name of the
person] have with concentrating or remembering things ? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme/
Cannot do
.
[Rob] is very quick to learn new skills at his work. He can pay attention to the task at hand for long uninterrupted periods of time. He can remember names of
people, addresses, phone numbers and such details that go back several years.
.
S2105 Overall in the last 30 days overall how much difficulty did [name of the
person] have with concentrating or remembering things ? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme/
Cannot do
.
[Theo] cannot concentrate for more than 15 minutes and has difficulty paying attention to what is being said to him. Whenever h e starts a task, he never
manages to finish it and often forgets what he was doing. He is able to learn the names of people he meets but cannot be truste d to follow directions to a store
by himself.
.
S2106 Overall in the last 30 days overall how much difficulty did [name of the
person] have with concentrating or remembering things ? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme
Cannot do

WORLD HEALTH SURVEY – HEALTH VIGNETTES (D) – S A2(D).2 .

[Anne] takes twice as long as others to put on and take off clothes, but needs no help with this. Although it requires an effor t, she is able to bathe and groom
herself, though less frequently than before. She does not require help with feeding.
.
S2107 Overall in the last 30 days, how much difficulty did [name of person]
have with self-care , such as washing or dressing himself/herself? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme/
Cannot do
.
[Peter] does not recognize even close relatives and gets lost when he leaves the house unaccompanied. Even when prompted, he sh ows no recollection of
events or recognition of relatives. It is impossible for him to acq uire any new knowledge as even simple instructions leave him confused.
.
S2108 Overall in the last 30 days overall how much difficulty did [name of the
person] have with concentrating or remembering things ? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme/
Cannot do
.

[Sandra] lives on her own and has no relatives or friends near by. Because of her arthritis, she is house-bound. She often stays all day in the same clothes that
she has slept in as changing clothes is too painful. A neighbour helps her wash herself.
.
S2109 Overall in the last 30 days, how much difficulty did [name of person]
have with self-care , such as washing or dressing himself/herself? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme/
Cannot do
.

[Victor] requires no assistance with cleanliness, dressing and eati ng. He occasionally suffers from back pain and when this hap pens he needs help with bathing
and dressing. He always keeps himself tidy.
.
S2110 Overall in the last 30 days, how much difficulty did [name of person]
have with self-care , such as washing or dressing himself/herself? 1. None 2. Mild 3. Moderate 4. Severe 5. Extreme/
Cannot do

WORLD HEALTH SURVEY

Short Questionnaire

Module 7000

HEALTH SYSTEM RESPONSIVENESS

VIGNETTES

WORLD HEAL TH SURVEY – RESPONSIVENESS VIGNETTES (A) – S A7(A ).1 VIGNETTES FOR HEALTH SYSTEM RESPONSIVENESS: Set A
..

I am now going to read you stories about people’s experiences wi th health care services. I want you to think about these people ’s experiences as if
they were your own. Once I have fi nished reading each story, I will ask you to ra te what happened in the story as very good, go od, moderate, bad or
very bad.
..
Respectful Treatment and Prompt Attention
..

[Niels] woke up with a sore back so he decided to go to the clinic. It took 30 minutes to travel to the clinic and he was seen within 5 minutes .
.
S7401 How would you rate the amount of time he waited before being attended
to? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

[Anya] took her baby for a vaccination. The nurse said hello and but did not ask for [Anya’s] or the baby’s name. The nurse als o examined [Anya] and made
her remove her shirt in the waiting room.
.
S7402 How would you rate her experience of being greeted and talked to
respectfully? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

[Stan] broke his leg. It took an hour to be driven to the nearest hospital. He was in pain but had to wait an hour for the surg eon and was only operated on the
next day.
.
S7403 How would you rate the amount of time he waited before being attended
to? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

[Conrad] had bad flu. He went to the clinic. The nurse expressed concern about [Conrad]’s cough and called the doctor, who gave [Conrad] a full chest
examination behind a large screen that hid him from the view of other patients.
.
S7404 How would you rate his experience of being greeted and talked to
respectfully? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

[Aitor] broke his hand. He walked to the c linic because there was no transport and the journey took him several hours. He had t o sleep near the clinic for two
days before seeing the doctor.
.
S7405 How would you rate the amount of time he waited before being attended
to? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad

WORLD HEAL TH SURVEY – RESPONSIVENESS VIGNETTES (A) – S A7(A ).2 .

[Julia] was pregnant and went to the hospital coughing bl ood. A nurse welcomed her gently and helped her to a private room. A female doctor came to
examine her and gave her a clean gown to replace her blood-st ained clothes.
.
S7406 How would you rate her experience of being greeted and talked to
respectfully? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

[Carla]’s child became seriously sick. [Carla] called an ambulance that arrived after 10 minutes and within 5 minutes they were at the hospital and the doctors
were treating the child.
.
S7407 How would you rate the amount of time she waited before being attended
to? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

[Patricia] went to a crowded clinic. At first, no-one greeted her but after waiting for 5 minutes a nurse called her to the exa mination area where she was
examined behind a small screen that mostly hid her from the other patients.
.
S7408 How would you rate her experience of being greeted and talked to
respectfully? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

[Karen] needed a blood test. It took her 45 minutes by bus to get to the clinic and she waited for 30 minutes to see the nurse.
.
S7409 How would you rate the amount of time she waited before being attended
to? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

[Said] has AIDS. When he goes to his health centre the nurses do not talk to him and deliberately ignore him. During examinatio ns, his clothes are removed
and he is made to wait, half-naked in the waiting room.
.
S7410 How would you rate his experience of being greeted and talked to
respectfully? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad

WORLD HEAL TH SURVEY – RESPONSIVENESS VIGNETTES (A) – S A7(A ).3

WORLD HEALTH SURVEY – RESPONSIVENESS VIGNETTES (B) – S A7(B).1 VIGNETTES FOR HEALTH SYSTEM RESPONSIVENESS: Set B
..

I am now going to read you stories about people’s experiences wi th health care services. I want you to think about these people ’s experiences as if
they were your own. Once I have fi nished reading each story, I will ask you to ra te what happened in the story as very good, go od, moderate, bad or
very bad.
..
Communication and Quality of Basic Amenities
..

[Thomas] couldn’t see well so he went to the doctor and explained the problem. [Thomas] had time to ask the doctor some questio ns, which the doctor
answered until [Thomas] understood almost everything.
.
S7401 How would you rate his experience of how clearly health care providers
explained things to him? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

[Wing] had his own room in the hospital and shared a bathroom with two others. The room and bathroom were cleaned frequently an d had fresh air.
.
S7402 How would you rate the cleanliness of the rooms inside the facility,
including toilets? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

[Pia] went to the emergency clinic with a stomach pain. The doctor explained to [Pia] her condition and the treatment. [Pia] as ked him some questions and the
doctor explained things using examples that were familiar to her until she understood everything.
.
S7403 How would you rate her experience of how clearly health care providers
explained things to her? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

[Shedra] was hospitalized last year for a hip operation. Her private room had its own bathroom and was comfortable and spacious . It was cleaned by the
hospital staff daily. The bed was comfortable and the sheets were changed daily.
.
S7404 How would you rate the cleanliness of the rooms inside the facility,
including toilets? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

[Akiko] is in hospital after a car accident. She has lots of scratches, bruises and some broken bones. When the doctor visited her he asked to see her medical
records. He asked the nurse some questions and then he said that [Akiko] was making good progress. [Akiko] supposes that she wi ll still stay there for another
week but is unsure.
.
S7405 How would you rate her experience of how clearly health care providers
explained things to her? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad

WORLD HEALTH SURVEY – RESPONSIVENESS VIGNETTES (B) – S A7(B).2 .

[Kamal] has a nervous breakdown and had to spend 3 months in the past year in the local hospital. He had to sleep on an uncomfo rtable mattress with no
sheets. There were 30 other patients in the same dormitory style ward and the toilets would smell, because they were not cleane d. He came back with a skin
infection, because he couldn’t wash regularly and there were insects in the bed.
.
S7406 How would you rate the cleanliness of the rooms inside the facility,
including toilets? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

[Rose] cannot write or read. She went to the doctor because she was feeling dizzy. The doctor didn’t have time to answer her qu estions or to explain anything.
He sent her away with a piece of paper without telling her what it said.
.
S7407 How would you rate her experience of how clearly health care providers
explained things to her? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

[Hans] shared his small hospital room with five other patients with no partitions between beds. The five patients shared a toil et, which was cleaned every
second day and sometimes smelt.
.
S7408 How would you rate the cleanliness of the rooms inside the facility,
including toilets? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

[Mario] has been told that he has epilepsy and that he needs to take medication. The doctor has very briefly explained what the condition is. He is very busy
and there is a queue of patients waiting to see him. Mario would like to know more about what he has, but feels that there is n o time to ask questions. The
doctor says goodbye to Mario, and Mario leaves the office.
.
S7409 How would you rate his experience of how clearly health care providers
explained things to him? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

[José] shared a hospital room with four other persons. There was a toilet for his ward located along the outside corridor. The room was only occasionally dusty
and hot, but without any fan.
.
S7410 How would you rate the cleanliness of the rooms inside the facility,
including toilets? 1. Very good 2. good 3. Moderate 4. Bad 5. Very bad

WORLD HEALTH SURVEY – RESPONSIVENESS VIGNETTES (B) – S A7(B).3 .

WORLD HEALTH SURVEY – RES PONSIVENESS VIGNETTES(C) – S A7(C). 1 VIGNETTES FOR HEALTH SYSTEM RESPONSIVENESS: Set C
..

I am now going to read you stories about people’s experiences wi th health care services. I want you to think about these people ’s experiences as if
they were your own. Once I have fi nished reading each story, I will ask you to ra te what happened in the story as very good, go od, moderate, bad or
very bad.
..
Confidentiality and Choice
..

[Simon] was speaking to his doctor about an embarrassing problem. There was a friend and a neighbour of his in the crowded wait ing room and because of the
noise the doctor had to shout when telling [Simon] the treatment he needed.
.
S7401 How would you rate the way the health services ensured [Simon] could
talk privately to health care providers? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

When the clinic is not busy, [Mamadou] can choose which doctor he sees. But most often it is busy and then he gets sent to whoe ver is free.
.
S7402 How would you rate [Mamadou’s] freedom to choose his health care
provider? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.
.
.

[Rebecca] usually spoke to her doctor about her illness in comple te privacy. Once [Rebecca] heard that the doctor spoke to [Reb ecca’s] friend about her
illness. She asked her doctor not to do it again. He did not do it again.
.
S7403 How would you rate the way the health services ensured [Rebecca] could
talk privately to health care providers? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

In [William] ’s town there is a large day clinic where there are several doctors and nurses. When [William] has a sensitive hea lth problem he can see a male
rather than a female doctor or nurse.
.
S7404 How would you rate [William’s] freedom to choose his health care
provider? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.
.
.

[Elma] was asked to describe a serious health problem to the doctor in the middle of the waiting room. The doctor repeated ever ything to the nurse and all the
other patients, many of whom knew her family, could overhear everything.
.
S7405 How would you rate the way the health services ensured [Elma] could talk
privately to health care providers? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

When [Penelope] had fertility problems, she had to travel from her small village to the closest town where they only had one ma le doctor. [Penelope] wanted
to see a female doctor but she had no choice.
.
S7406 How would you rate [Penelope’s] freedom to choose her health care
provider? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad

WORLD HEALTH SURVEY – RES PONSIVENESS VIGNETTES(C) – S A7(C). 2 .
.
.

[Alouine] had his consultation in a small private room. During th e consultation, a nurse occasiona lly walked in and listened to the conversation. Sometimes
she forgot to close the door so people in the waiting room could overhear parts of their conversation.
.
S7407 How would you rate the way the health services ensured [Alouine] could
talk privately to health care providers? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

The national health service assigns all the people in [Ibrahim’s] community to the local clinic. At the clinic they have a choi ce of 3 doctors. If they want to
change clinics, they need to get permission.
.
S7408 How would you rate [Ibrahim’s] freedom to choose his health care
provider? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.
.
.

[Ken] visited the doctor regularly. His doctor always took [Ken] to a private room before discussing his illness. The doctor wa s aware that [Ken] was very
sensitive about his health condition and would never talk about it to anyone or in front of anyone without Ken’s permission.
.
S7409 How would you rate the way the health services ensured [Ken] could talk
privately to health care providers? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

[Nathan] lives in a town where there are lots of doctors and clinics. He tried one doctor but he didn’t like him so he changed doctors. This was easy to do
because he could go where he wanted.
.
S7410 How would you rate [Nathan’s] freedom to choose his health care
provider? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad

WORLD HEALTH SURVEY – RES PONSIVENESS VIGNETTES(C) – S A7(C). 3 .

WORLD HEALTH SURVEY – RESPONSIVENESS VIGNETTES (D) – S A7(D).1 VIGNETTES FOR HEALTH SYSTEM RESPONSIVENESS: Set D
..

I am now going to read you stories about people’s experiences wi th health care services. I want you to think about these people ’s experiences as if
they were your own. Once I have fi nished reading each story, I will ask you to ra te what happened in the story as very good, go od, moderate, bad or
very bad.
..
Social Support to Patient and Autonomy
..

[Sally]’s husband could only visit her in hospital in the evenings because of the visiting hours and because he had to look aft er their children. Once he brought
the children with him and the nurse, who was reading a newspaper, said she could not watch them for him. This meant [Sally] had fewer visits from her
husband.
.
S7401 For[Sally’s] last hospital stay, how would you rate the ease of having
family and friends visit her? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

When [Jasmina’s] had treatment for infertility, the doctor gave her some pills and asked her to return in two weeks. He didn’t ask her whether she wanted to
know anything about her health condition nor suggest different alternatives that might have suited her better.
.
S7402 How would you rate [Jasmina’s] experience of being involved in making
decisions about her health care or treatment? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

When [Joseph] was in hospital he could have no visitors nor could he receive any presents from friends or relatives. The hospit al had no telephones and he
could not get any news from outside.
.
S7403 For [Joseph’s] last hospital stay, how would you rate the ease of having
family and friends visit him? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

[Mark] had a serious health problem. The doctor prescribed the best treatment for Mark but without telling him the implications on his quality of life or the
cost. [Mark] felt powerless and was not given any information to help him to feel more in control.
.
S7404 How would you rate [Mark’s] experience of being involved in making
decisions about his health care or treatment? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

When [Tamara] was in hospital for two weeks, her family visited her every few days during the evening visiting hours, but she w as alone the rest of the day.
There was little to read or do in the hospital . Every few days, the nurses brought her a portable radio to listen to for a few hours.
.
S7405 For[Tamara’s] last hospital stay, how would you rate the ease of having
family and friends visit her? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad

WORLD HEALTH SURVEY – RESPONSIVENESS VIGNETTES (D) – S A7(D).2 .

[Bob] had a broken arm. The doctor explained different ways of fixing it and then ordered some blood tests. [Bob] didn’t know w hy he needed blood tests and
was worried until the doctor explained what they were for.
.
S7406 How would you rate [Bob’s] experience of being involved in making
decisions about his health care or treatment? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

When [Carol] was in hospital, she was allowed visitors at any tim e of the day. Whenever she needed to contact her family, work or friends, she could easily
get a message delivered to them.
.
S7407 For [Carol’s] last hospital stay, how would you rate the ease of having
family and friends visit her? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

When [Sarah] wanted treatment for her swollen limbs, the nurses at her clinic discussed many possible treatments with her. They discussed all the pro’s and
con’s of each treatment with her and then recommended one to her.
.
S7408 How would you rate [Sarah’s] experience of being involved in making
decisions about her health care or treatment? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

[Jane] gave birth in hospital. Her husband was permitted to visit her every morning and evening. [Jane] was able to contact her family and friends once a day.
.
S7409 For [Jane’s] last hospital stay, how would you rate the ease of having
family and friends visit her? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad
.

[Tara] is unhappy and has no energy. She gave birth to a baby girl two months ago and the doctor has told her that she may be s uffering from depression. The
doctor discussed her condition with her and then suggested that sh e could either try some medication or, if she prefers, talk t o a counsellor.
.
S7410 How would you rate [Tara’s] experience of being involved in making
decisions about her health care or treatment? 1. Very good 2. Good 3. Moderate 4. Bad 5. Very bad

WORLD HEALTH SURVEY

Short Questionnaire

Module 8000

HEALTH GOALS

CARDS

WORLD HEALTH SURVEY 2002 – HEALTH GOALS CARDS – S A8.1

Health (HTH)

Improving the health of the population

Population lives longer and with less illness

Health Inequalities (HIN)

Minimizing differences in health between people

All people should have equal chances of being
healthy

WORLD HEALTH SURVEY 2002 – HEALTH GOALS CARDS – S A8.2

Responsiveness Inequalities (REI)

Minimizing Inequalities / Disparities
in Responsiveness

The health system is equally responsive to all people,
no matter their wealth, social status, sex, age or
religious or other beliefs

Responsiveness (RES)

Improving Responsiveness of the Health System

This involves things like: /G120/G3How quickly people are attended to;
/G120/G3How respectfully people are spoken to by medical
staff;
/G120/G3How clearly things are explained;
/G120/G3How convenient it is to reach different health
services;
/G120/G3How clean they are; and
/G120/G3How much freedom there is to choose to see the
doctor one wants.

WORLD HEALTH SURVEY 2002 – HEALTH GOALS CARDS – S A8.3

Fairness in Financial Contribution (FFC)

Every household should pay a fair share
towards the health system