PACKARD WESTERN KENYA BASELINE SURVEY 2010

SECTION 4: MATERNAL AND CHILD HEALTH
Q401 CHECK Q230:
ONE OR MORE BIRTHS
NO BIRTHS
SINCE 2008 SINCE 2008 Q408
Q402 ENTER NAME AND LINE NUMBER OF YOUNGEST CHILD BORN SINCE 2008 FROM Q217C AND Q218:
___________________________
NAME
[__|__]
LINE NUMBER
Now I would like to ask you about the delivery of [NAME OF YOUNGEST CHILD].
Sasa ningetaka kukuuliza kuhusu vile (JINA LA MTOTO WA MWISHO) alivyozaliwa
Q403
Q404
Q405
Who assisted with the delivery of [NAME]
Ni nani aliyekusaidia kujifungua (JINA)
CIRCLE ALL MENTIONED.
Was the place you delivered in this city, in another city, or
in a rural area
Mahali ambapo ulijifunguwa ni katika jiji hili, katika jiji
lingine au ni kakita eneo la mashambani
Where did you give birth to [NAME]
Ulijifunguwa/ulizalia (JINA) wapi
NO ONE………………………………………..
DOCTOR/ CLINICAL OFFICER ……………
NURSE/ MIDWIFE……………………………
TBA . . . . . . . . . . . . . ………………………..
COMMUNITY HEALTH WORKER …………
FRIEND/RELATIVE…………………………..
OTHER (SPECIFY)___________________
THIS CITY/TOWN………….………………
ANOTHER CITY OR TOWN………….…….
A RURAL AREA……………………….……..
PUBLIC SECTOR
GOVERNMENT HOSPITAL . . . . .
GOVT. HEALTH CENTER . . . . . .
GOVERNMENT DISPENSARY. .
OTHER PUBLIC______________
(SPECIFY)
Y
A
B
C
D
E
X
1
2
3
11
12
13
16
PRIVATE MEDICAL SECTOR
FAITH-BASED, CHURCH, MISSION
HOSPITAL/CLINIC........
PRIVATE HOSPITAL/CLINIC...........
NURSING/MATERNITY HOME……
TRADITIONAL BIRTH ATTENDANT…
COMMUNITY MIDWIFE…………
COMMUNITY HEALTH WORKER..
TRADITIONAL HEALER……………
OTHER PRIVATE ______________
(SPECIFY)
21
22
23
24
25
26
27
28
Q407
OTHER FACILITY
WORKSITE CLINIC…………………..
MOBILE CLINIC . . . . . . . . . . . . . . . .
YOUTH CENTER……………………….
OTHER FACILITY ______________
(SPECIFY)
AT HOME……………………………………
OTHER _________________________
(SPECIFY)
31
32
33
34
41
96
Q406
Q406
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