Adolescent Sexual and Reproductive Health Toolkit for - UNFPA

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No Questions Coding Categories Skip to:
Q105
What was the reason for your most recent visit
to a health facility for sexual or reproductive
health services?
Circle All Mentioned
1 = mentioned 2 = not mentioned
Education and counseling regarding SRH 1 2
VCT for HIV 1 2
Miscarriage/Post-abortion care services 1 2
Family planning services 1 2
STI treatment and counseling 1 2
Pregnancy care and delivery 1 2
Vaccination 1 2
To get condoms 1 2
To get mental health and psychosocial support 1 2
Other (specify) ___________ 1 2
No response 88
Don’t know 99
Q106 Would you return to the health facility again? Yes 1
No 2
No response 88
Don’t know 99
: Q108
: Q108
: Q108
Q107
Q108
What is the reason that you won’t return to the
health facility?
Circle All Mentioned
1 = mentioned 2 = not mentioned
Whom did you talk to or see at the health
facility the last time you went?
Circle All Mentioned
1 = mentioned 2 = not mentioned
Takes too much time 1 2
Too difficult to get there 1 2
Costs too much 1 2
Too embarrassing 1 2
Not enough privacy 1 2
Mistreated by staff 1 2
No staff of the same sex available 1 2
Other (specify)___________________ 1 2
No answer 88
Don’t know 99
Doctor 1 2
Nurse 1 2
Health Aid 1 2
Peer educator/counselor 1 2
Other (specify)________________ 1 2
No answer 88
Don’t know 99
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Assessment Tools
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