questionnaire no: [__|__|__|__|__|__|__|__|__] - Measurement ...

Q813
In the past 12 months, have you visited a rural area in
Nigeria in order to visit family or friends?
Laarin osu mejila sehin, nje eti be igberiko kan wo ni orile
ede Nigeria lati be ebi tabi awon ore wo?
Q814 Which rural area did you visit most often in the past 12
months?
YES………………………………………………….…1
NO……………………………………………………..2
NAME OF VILLAGE_______________________
END
Q815
Q816
Q817
Q818
Q819
Igberiko wo ni e ti be wo lopolopo igba laarin osu mejila
sehin?
GIVE THE NAME OF THE VILLAGE, LGA AND STATE
How often did you visit this rural area [NAME OF PLACE
IN Q814 in the last 12 months?
Bawo ni ibewo yin si awon ilu kekere se wopio to laarin
osu mejila tio koja?
How long do you usually stay when you visit [NAME OF
PLACE)?
Bawo ni akoko ibewo yin se ma npe to?
During your visit(s), do you ever discuss family
planning/child birth spacing/child spacing with anybody?
Ni awon asiko abewo yin, nje e jiroro lori ifeto somo
bibi/fi aye si ibimo pelu eni kankan?
During your visits, do you ever seek family planning/child
birth spacing services?
Ni awon asiko yi, nje e beere fun eto ifeto somo bibi yi?
Do friends or family from this rural area [MENTIONED IN
Q814] ever come to visit you?
LOCAL GOVERNMENT
AREA:__________________________________
CODE BOXES: OFFICE ONLY [__|__|__]
STATE___________________________
CODE BOXES: OFFICE ONLY [__|__|__]
PER WEEK……………………..………………...…1
PER MONTH…………………………………..……2
PER YEAR……………………………………..……3
[__|__]
[__|__]
[__|__]
DAYS………………………………………….…..1 [__|__]
WEEKS ……………………………………...…. 2 [__|__]
MONTHS …………………..…………………......3 [__|__]
YES……………………………………………………
NO……………………………………………………..
YES……………………………………………………
NO……………………………………………………..
DON’T KNOW………………………………………
YES……………………………………………………1
1
2
1
2
8
Q820
Nje awon ore tabi ebi lati igberiko [MENTIONED IN
Q814] yi ti fi igba kan be yin wo?
Do you ever talk about family planning with your friends
and family who are visiting you here?
NO……………………………………………………..2
YES……………………………………………………1
END
Q821
Nje e ba awon ore tabi ebi to wa yin wa soro
ifetosomobibi ?
Do your friends and family who visit ever seek family
planning services when they are visiting?
Nje e ti fi igba kan soro nipa ifeto somo bibi pelu awon
ore ati ebi ti o n beyin wo ni biyi?
NO……………………………………………………..2
YES……………………………………………………1
NO……………………………………………………..2
DON’T KNOW………………………………...………8
RECORD END TIME.
HOUR……………………………….[__|__]
MINUTES…………………………..[__|__]
COMMENTS:
END THE INTERVIEW AND THANK THE RESPONDENT FOR HIS TIME AND PARTICIPATION!
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