Questionnaire - Measurement, Learning & Evaluation Project

From which type of facility did you obtain (A CHECK UP)last time?Daga wacce cibiyar kiwo lafia ki ka yi awon karshe?PUBLIC SECTORGOVT HOSPITAL……………………….…11WOMEN AND CHILDREN’SHOSPITAL……………………………….....12CHILD WELFARE CLINIC………………..13GOVT. HEALTH CENTER……………......14GOVERNMENT POST/DISPENSARY.....15MATERNITY HOME……………..........…..16MOBILE CLINIC……….……………...…...17OTHER PUBLIC___________________18(SPECIFY)Q234PRIVATESECTORPRIVATE HOSPITAL/CLINIC..................21PRIVATE DOCTOR’S OFFICE……..…..22NURSING/MATERNITY HOME……...…23PHARMACY…………………..………...…24PMS/CHEMIST…………………….…..….25MOBILE CLINIC………….…………...…...26CHW/TBA……………………………...…..27TRADITIONAL HEALER……………...….28OTHER PRIVATE__________________29(SPECIFY)FAITH-BASED SECTORMISSION HOSPITAL…………….............31FAITH-BASED, CHURCH CLINIC…..…32Q235At the time you became pregnant, did you want to becomepregnant then, did you want to wait until later, or did younot want to have any more children at all?A lokacin da ki ka sami ciki, kin so dauka ne, ko kin so kijinkirta sai zuwa gaba, ko kuma ba kida sha’awar sakehaihuwar ko kadan?OTHER SOURCEOTHER NGO HOSPITAL/CLINIC……….41WORKSITE CLINIC…………….…………42OTHER________________________________96(SPECIFY)DON'T KNOW . . . . . . . . . . . . . . …..………... .98THEN……………………………...….……1LATER……………………….………....… 2NOT AT ALL………………………….…3Q237Q237Q236How much longer would you have liked to wait?Har tsawon wane lokaci ki ka so ki jira?IF RESPONSE IS A DECIMAL FOR MONTHS & YEARS(2.5YRS), THEN CONVERT IN MONTH AND FILL INONLY MONTHS.MONTHS………..1 [__|__]ORYEARS..………...2 [__|__]OROTHER (SPECIFY)__________________996ORDON’T KNOW…………………………….…998Q237When did your last menstrual period start?Yaushe ki ka fara ganin hailar ki ta karshe?______________________________________(DATE, IF GIVEN)IF LESS THAN ONE DAY, CIRCLE “1” AND WRITE “00”DAYS AGO.DAYS AGO…………………………..……1 [__|__]WEEKS AGO………………………...……2 [__|__]MONTHS AGO……………………...…… 3 [__|__]YEARS AGO………………………...…….4 [__|__]IN MENOPAUSE/HAS HADHYSTERECTOMY……………………….….994BEFORE LAST BIRTH……………………......995NEVER MENSTRUATED…………………..…996CANT REMEMBER………………………..…..998Q238From one menstrual period to the next, are there certaindays when a woman is more likely to get pregnant if shehas sex?Shin dagahailar zuwa wata hailar da akwairana kun damace zata iya daukan ciki idan ta yi jima’i?YES…………………………….……………1NO…………………………….……………..2DON’T KNOW……………….……………..8Q240Q24010