OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

A Sustainability Assessment of Community-based Interventions in Northwestern Tanzania

ICR 200705-0920-004 · OMB 0920-0749 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Health Facility Staff Discussion Form and Instruction New Available
Village Health Worker Interview Form and Instruction New Available
Key Informant Interview Form and Instruction New Repair queued
Community Assessment Survey Form and Instruction New Available
CDC Tanzania Memo.doc Supplementary Document Uploaded 2007-08-09 Available
Supporting Statement B.doc Supporting Statement B Uploaded 2007-04-26 Repair queued
Appendix H. Zonal records 4_26_2007-RM.doc Supplementary Document Uploaded 2007-04-26 Available
Appendix C. Jean-Public Letter.doc Supplementary Document Uploaded 2007-04-26 Repair queued
Appendix B. 60 day FRN.pdf Supplementary Document Uploaded 2007-04-26 Available
Appendix A. OMB301.pdf Supplementary Document Uploaded 2007-04-26 Available
Supporting Statement A.doc Supporting Statement A Uploaded 2007-04-26 Available
IC Document Collections
IC IDCollectionTypeStatusForm
180114 Health Facility Staff Discussion Form and Instruction New
180113 Village Health Worker Interview Form and Instruction New
180112 Key Informant Interview Form and Instruction New
180111 Community Assessment Survey Form and Instruction New
ICR Details
0920-0749 200705-0920-004
Historical Active
HHS/CDC
A Sustainability Assessment of Community-based Interventions in Northwestern Tanzania
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 08/10/2007
Retrieve Notice of Action (NOA) 05/11/2007
Approved consistent with clarifications included in CDC memo submitted to OMB and incorporated into the public docket as a supplemental file.
  Inventory as of this Action Requested Previously Approved
08/31/2008 12 Months From Approved
314 0 0
267 0 0
0 0 0
This project is a community-based approach to improve maternal and newborn health (MNH) and reduce preventable maternal and prenatal deaths, implemented by CARE, with CDC support from 1997-2002. This approach used a community-based surveillance system to identify preventable deaths during pregnancy, prenatal and newborn periods, and developing a community mobilization program utilizing community volunteers to assist women and families with obstetrical emergencies to get to functioning health faciliites. We propose to examine long-term viability of these community efforts in Tanzania.
US Code: 42 USC 301 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  71 FR 8586 02/17/2006
72 FR 20850 04/26/2007
Yes
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 314 0 0 314 0 0
Annual Time Burden (Hours) 267 0 0 267 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new data collection.
$22,846
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected
Saleda Perryman
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
05/11/2007