PACKARD WESTERN KENYA BASELINE SURVEY 2010

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Q410 Q411 What types of services did you receive during this/these child health visit(s) Ulipata huduma za aina gani wakati ulipoenda CIRCLE ALL MENTIONED. Where did you go most recently for child services PROBE: What is the name of this place And where is it located Ni wapi ulipokwenda hivi majuzi kupata huduma za watoto ULIZA: paitwaje mahali hapo Na ni wapi IMMUNIZATION…………………………....... DISEASE PREVENTION……………………… DEWORMING…………………………………. TREATMENT FOR CHILD (FOR DIARRHEA, MALARIA, RESPIRATORY INFECTION)……. GROWTH MONITORING OF CHILD……… HEALTH CHECK-UP . . . . . . . . . . . …….. .. OTHER___________________________ (SPECIFY) NAME OF FACILITY___________________________________ PHYSICAL LOCATION_________________________________ LAND MARK________________________________________ A B C D E F X Q412 What type of facility is this Ni kituo cha aina gani hicho PUBLIC SECTOR GOVERNMENT HOSPITAL . …………………... . . . GOVT. HEALTH CENTER . . . . . . …………………. GOVERNMENT DISPENSARY . . …………………. OTHER PUBLIC___________________________ (SPECIFY) 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…………………………….. PHARMACY…………………………………………… CHEMIST/DUKA LA DAWA…………………………. OTHER PRIVATE ________________________ (SPECIFY) OTHER FACILITY WORKSITE CLINIC………………………………….. MOBILE CLINIC . . . . . . . . . . . . . . . . ……………… YOUTH CENTER……………………….................... OTHER _________________________________ (SPECIFY) 21 22 23 24 25 26 27 28 29 30 31 32 33 96 Q413 Why did you choose this facility Kwa nini ulichagua kituo hiki CIRCLE ALL MENTIONED. PROBE: ANY OTHER REASON DON'T KNOW . . . . . . . . . . . . . . …… . . ………………… SERVICES ARE FREE/ AFFORDABLE…… A FACILITY OPEN/CONVENIENT HOURS OF OPERATION…..……………………..……… B STAFF ARE POLITE AND RESPECTFUL… C CONVENIENT TO MY HOME……………… D CONVENIENT TO MY WORK……………… E CONVENIENT TO WHERE I SHOP………… F CONVENIENT USING AVAILABLE TRANSPORT………………………………….. G GOOD QUALITY SERVICES………………… H OFFER SERVICES REQUIRED…………… I PROVIDERS AVAILABLE…………………… J ACCEPT INSURANCE……………………… K OFFER CREDIT FACILITIES………………… L FACILITY HAS A GOOD REPUTATION……. M IT PROVIDES MULTIPLE SERVICES……… N REFERRED THERE…………………………… O 98 OTHER_____________________________ (SPECIFY) X Page 36
Q414 Did you receive any information or counseling on family planning/birth spacing/child spacing during this visit YES . . . . . . . . . . . . . . . . . . . . . . NO . . . . . . . . . . . . . . . . . . . . . . . 1 2 Q416 Je ulipata habari zozote ama ushauri wowote kuhusu upangaji wa uzazi/kuweka nafasi baina ya mimba/kuweka nafasi kati ya mtoto hadi mwingine ulipokwenda Q415 Did you receive a method or a referral for family planning/birth spacing/child spacing method at that time Je! Ulipata njia ya kupanga uzazi ama ulitumwa kupata huduma ya mpango wa uzazi/ kuweka nafasi baina ya mimba/kuweka nafasi kati ya mtoto hadi mwingine wakati huo YES, RECEIVED A METHOD. . . . . . . . . . YES, RECEIVED A PRESCRIPTION…….. YES, RECEIVED A REFERRAL . . . . . . . . NO, DID NOT RECEIVE ANY OF THESE..… 1 2 3 4 Q416 In the last year, have you gone to a health facility for maternal health services, such as prenatal and postpartum care Katika mwaka mmoja uliopita, umewahi kwenda katika kituo cha afya kupata huduma ya akina mama wajawazito kama vile, huduma kabla ya kuzaa na baada ya kuzaa YES . . . . . . . . . . . . . . . . . . . . . . …………. NO . . . . . . . . . . . . . . . . . . . . . . . ………… 1 2 Q422 Q417 Where did you go most recently for maternal health services PROBE: What is the name of this place And where is it located Ni wapi ulikokwenda hivi karibuni kupata huduma ya akina mama wajawazito ULIZA: Mahali hapo paitwaje Na ni wapi NAME OF FACILITY___________________________ PHYSICAL LOCATION____ ____________________ LAND MARK_________________________________ Q418 What type of facility is this Kituo hiki ni cha aina gani PUBLIC SECTOR GOVERNMENT HOSPITAL . . . . . GOVT. HEALTH CENTER . . . . . . GOVERNMENT DISPENSARY . . OTHER PUBLIC______________ (SPECIFY) 11 12 13 16 PRIVATE MEDICAL SECTOR FAITH-BASED, CHURCH, MISSION HOSPITAL/CLINIC………………...... PRIVATE HOSPITAL/CLINIC........... NURSING/MATERNITY HOME…… CHW/TBA…………………………….. TRADITIONAL HEALER…………… PHARMACY………………………… CHEMIST/DUKA LA DAWA……….. OTHER PRIVATE ______________ (SPECIFY) 21 22 23 24 25 26 27 29 OTHER SOURCE WORKSITE CLINIC…………….…… MOBILE CLINIC . . . . . . . . . . . . . . . . YOUTH CENTER…………………… VCT/CCC………………….……….... OTHER ______________________ (SPECIFY) 31 32 33 34 96 DON'T KNOW . . . . . . . . . . . . . . …… . . 98 Page 37
Page 1 and 2: QUESTIONNAIRE NO: [__|__|__|__|__|_
Page 3 and 4: Costs and Payment for Participation
Page 5 and 6: Q109 Please read for me the sentenc
Page 7 and 8: Q212 Q213 Have you ever had a pregn
Page 9 and 10: (Q21 7C) Line no. (Q218) What name
Page 11 and 12: (Q21 7C) Line no. (Q218) What name
Page 13 and 14: Q239 What type of facility did you
Page 15 and 16: SECTION 3: CONTRACEPTION CHECK FOR
Page 17 and 18: Q303 CHECK 301 (KNOWLEDGE OF ANY CO
Page 19 and 20: Q309 CHECK Q235 CURRENTLY PREGNANT
Page 21 and 22: KQ5 How many living children did yo
Page 23 and 24: Q330 FOR A WOMAN WHO HAS BEEN STERI
Page 25 and 26: Q337 What method(s) did you use (th
Page 27 and 28: KQ10 Before you started using last
Page 29 and 30: Q350 Which is this place or person
Page 31 and 32: Q371 Q372 Why did/do you prefer to
Page 33 and 34: SECTION 4: MATERNAL AND CHILD HEALT
Page 35: KQ19 KQ20 Where did [NAME] receive
Page 39 and 40: Q424 What type of facility is this
Page 41 and 42: Q507 In the last twelve (12) months
Page 43 and 44: Q601 SECTION 6: FERTILITY PREFERENC
Page 45 and 46: Q610 Does your husband/partner want
Page 47 and 48: Q701 SECTION 7: SPOUSAL AND INTERPE
Page 49 and 50: Q720 Do you think there are some pe
Page 51 and 52: Q730 Q731 Q732 Q733 Q734 Q735 RECOR
Page 53 and 54: SECTION 8: GENDER INEQUITY MEASURES
Page 55 and 56: Q819 CHECK Q510 AND Q511: EVER MARR
Page 57 and 58: Now I am going to read some stateme
Page 59 and 60: Q903 Which newspaper(s) do you read
Page 61 and 62: Q920 Q921 What time of the day do y
Page 63 and 64: Q936 In the past three months, have
Page 65 and 66: Q938. What are the names and types
Page 67 and 68: Q1008 How long do you usually stay
Page 69 and 70: FOLLOW-UP CONTACTS Q1100 Q1101 WOMA

PACKARD WESTERN KENYA BASELINE SURVEY 2010

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