Integrated Campaign Registry (ICR) Implementation Guide
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Questionnaire: ESPEN MDA — 2. Medicine Receipt Form

Official URL: https://icr.healthcampaigns.org/Questionnaire/espen-mda-drug-receipt Version: 0.1.0
Active as of 2026-08-07 Computable Name: EspenMDADrugReceipt

ESPEN MDA demo Form 2 (medicine receipt at health facility): disease and medicine-package scope, per-medicine received totals. Template-based extraction: one ICRSupplyDelivery per answered medicine total (espen-forms).

LinkIDTextCardinalityTypeDescription & Constraintsdoco
.. EspenMDADrugReceiptESPEN MDA demo Form 2 (medicine receipt at health facility): disease and medicine-package scope, per-medicine received totals. Template-based extraction: one ICRSupplyDelivery per answered medicine total (espen-forms).Questionnairehttps://icr.healthcampaigns.org/Questionnaire/espen-mda-drug-receipt#0.1.0
... p_recorder_idSelect the recorder ID0..1stringValue Set:
... p_stateSelect State / Region / Province1..1stringValue Set:
... p_districtSelect District / LGA / County1..1stringValue Set:
... p_diseaseDisease covered by the MDA1..*choiceValue Set: ICR NTD Disease
... p_medicineSelect the medicine package1..*choiceValue Set: ICR MDA Medicine Package
... p_total_pzqTotal Praziquantel received1..1integerEnable When:
  • p_medicine = PZQ (praziquantel) (ICR MDA Medicine Package#pzq)
  • p_medicine = PZQ + ALB (ICR MDA Medicine Package#pzq-alb)
  • p_medicine = PZQ + MEB (ICR MDA Medicine Package#pzq-meb)

Value Set:
... p_total_albTotal Albendazole received1..1integerEnable When:
  • p_medicine = ALB (albendazole) (ICR MDA Medicine Package#alb)
  • p_medicine = IVM + ALB (ICR MDA Medicine Package#ivm-alb)
  • p_medicine = IVM + ALB + DEC (ICR MDA Medicine Package#ivm-alb-dec)
  • p_medicine = PZQ + ALB (ICR MDA Medicine Package#pzq-alb)

Value Set:
... p_total_mebTotal Mebendazole received1..1integerEnable When:
  • p_medicine = MEB (mebendazole) (ICR MDA Medicine Package#meb)
  • p_medicine = PZQ + MEB (ICR MDA Medicine Package#pzq-meb)

Value Set:
... p_total_ivmTotal Ivermectin received1..1integerEnable When:
  • p_medicine = IVM (ivermectin) (ICR MDA Medicine Package#ivm)
  • p_medicine = IVM + ALB (ICR MDA Medicine Package#ivm-alb)
  • p_medicine = IVM + ALB + DEC (ICR MDA Medicine Package#ivm-alb-dec)

Value Set:
... p_total_decTotal Diethylcarbamazine received1..1integerEnable When: p_medicine = IVM + ALB + DEC (ICR MDA Medicine Package#ivm-alb-dec)
Value Set:
... p_total_az_susTotal Azithromycin suspension (in l) received1..1integerEnable When: p_medicine = AZM suspension (azithromycin) (ICR MDA Medicine Package#azm-susp)
Value Set:
... p_total_az_tabTotal Azithromycin tablets received1..1integerEnable When: p_medicine = AZM tablets (azithromycin) (ICR MDA Medicine Package#azm-tab)
Value Set:
... p_total_tetraTotal Tetracycline received1..1integerEnable When: p_medicine = TETRA (tetracycline eye ointment) (ICR MDA Medicine Package#tetra)
Value Set:
... p_add_noteAdditional Note0..1textValue Set:

doco Documentation for this format