Questionnaire - Measurement, Learning & Evaluation Project

Which days are these? Would you say that this time is JUST BEFORE HER PERIODjust before her period begins, during her period, right BEGINS………………………….....1after her period has ended, or halfway between two DURING HER PERIOD.………….….2periods??RIGHT AFTER IT ENDS..…….......…3Q239HALFWAY BETWEEN TWOShin wannan lokacin yana iya faruwa dab da ta fara PERIODS……………………………...4haila ne, lokacin da take haila ne, dab da ta gama haila OTHER_______________________6ne ko kuma tsakanin haila da haila?(SPECIFY)SINGLE MENTIONDON’T KNOW……………….………...8CHECK FOR PRESENCE OF OTHERS. BEFORE CONTINUING, MAKE EVERY EFFORT TO ENSURE PRIVACY.Have you ever had a pregnancy that ended in amiscarriage, abortion or stillbirth?By miscarriageI mean a pregnancy that ended just byitself.Q240Q241Q242By abortion, I mean a pregnancy that ended, becauseyou did something or used something.By still birth, I mean a baby that was born at full termand did not show any sign of life.Kin yi cikin da ki kayi barin cikin?Abun nufi da bari ko zubar da ciki, ina nufin cikin da yazube da wuri, ko don kin yi wani abu ki chire ko dan yazuba da kansaHow many miscarriages have you ever had?Sau nawa ki ka ta ba yin bari?How many abortions have you ever had?Sau nawa ki ka ta ba zubda ciki tareda amfani da waniabu ko hakanan kawai?YES………………………………1NO………………………………..2.NUMBEROFMISCARRAIGES………….[__]__]NUMBER OFABORTIONS…………..….[__]__]Q301C(01)(02)(03)PREGNANCYOUTCOMESINCE JANUARY2010Stillbirth (pregnancywas full term but thebaby showed nosigns of life)Haihuwar da danbaizo da rai baMiscarriage(pregnancy endedjust by itself)Cikin day a zube dakanshiAbortion (pregnancyended by somethingyou did or used, e.g.manual vacuumaspiration)Cikin da ya zubedomin kin yi wani abuko amfani da waniabu,misali aka ciremaki.243. Since January2010, have youhad a pregnancythat ended in a(PREGNANCYOUTCOME)?Tun Janaury2010, Kin ta badaukar cikin da kika haihu?YES…..………..1NO………..……2(02)YES…..………..1NO………..……2(03)YES…………....1NO…..…………2Q301244. How manytimes has thisoccurred sinceJanuary 2010?Sau nawa hakanya faru tun dagaJanaury 2010?NUMBER OFTIMES……..[__|__]NUMBER OFTIMES……..[__|__]NUMBER OFTIMES……..[__|__]245. When did the lastsuch pregnancy end?Yaushe kika yi haihuwarkarshe?MONTH…….[__|__]YEAR…..[__|__|__|__].MONTH…………….[__|__]YEAR………..[__|__|__|__]MONTH…………….[__|__]YEAR………..[__|__|__|__]246. How many months pregnantwere you when the last suchpregnancy ended?Cikin wan shi nawa lokacinhaihuwarki ta karshe?RECORD THE NUMBER OFCOMPLETED MONTHS. INCOLUMN 1 OF THE CALENDAR,ENTER ‘T’ IN THE MONTH THATTHE PREGNANCY TERMINATEDAND ‘P’ FOR THE NUMBER OFCOMPLETED MONTHS. FOLLOWTHIS PROCEDURE FOR THENUMBER OF TIMES THE EVENTHAPPENED ACCORDING TOQ244.MONTHS….…[__|__]MONTHS….…[__|__]MONTHS….…[__|__]11