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Village Health Worker Interview
A Sustainability Assessment of Community-based Interventions in Northwestern Tanzania
OMB: 0920-0749
IC ID: 180113
OMB.report
HHS/CDC
OMB 0920-0749
ICR 200705-0920-004
IC 180113
( )
Documents and Forms
Document Name
Document Type
Village Health Worker Interview
Form and Instruction
Village Health Worker Open-Ended Interview Guide
Appendix F. Village Health Worker Guide 4_11_2007_IA.doc
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Village Health Worker Interview
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
None
Village Health Worker Open-Ended Interview Guide
Appendix F. Village Health Worker Guide 4_11_2007_IA.doc
No
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
44
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
44
0
44
0
0
0
Annual IC Time Burden (Hours)
22
0
22
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.