Questionnaire - Measurement, Learning & Evaluation Project

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CHECK Q305, Q218, Q245(01)-Q245(03)ANY BIRTH OR PREGNANCY TERMINATION AFTERMONTH AND YEAR OF START OF USE OFCONTRACEPTION IN 305?YESNOQ306FOR METHODS OTHER THAN MALESTERILIZATION: GO BACK TO 305, PROBE AND RECORDMONTH AND YEAR AT START OF CONTINUOUS USE OF CURRENT METHOD (MUST BE AFTERLAST BIRTH OR PREGNANCY TERMINATION)FOR MALE STERILIZATION: GO BACK TO 305, PROBE AND RECORD MONTH AND YEAR OFSTERILIZATIONQ307CCHECK 305:YEAR IS JANUARY 2010 ORLATERENTER CODE FOR METHOD USED IN MONTH OFINTERVIEW IN COLUMN 1 OF THE CALENDAR AND INEACH MONTH BACK TO THE DATE STARTED USINGYEAR IS 2009 OR EARLIERENTER CODE FOR METHOD USED IN MONTH OFINTERVIEW IN COLUMN 1 OF THE CALENDAR ANDEACH MONTH BACK TO JANUARY 2010THEN CONTINUE WITH 308THEN SKIP TOQ30914
Q308CI would like to ask you some questions about the times you or your partner may have used a method to avoid gettingpregnant since January 2010.Yanzu ina so in tambayeki gameda da lokutan da ke da abokin zamanki ku ka ta ba amfani da wata hanya domin hanadaukar ciki tun daga Janaury r 2010?USE CALENDAR TO PROBE FOR EARLIER PERIODS OF USE AND NONUSE, STARTING WITH MOST RECENTUSE, BACK TO JANUARY 2010.USE NAMES OF CHILDREN, DATES OF BIRTH, AND PERIODS OF PREGNANCY AS REFERENCE POINTS.IN COLUMN 1, ENTER METHOD USE CODE OR ‘0’ FOR NONUSE IN EACH BLANK MONTHILLUSTRATIVE QUESTIONS: When was the last time you used a method? Which method was that? Wannene lokacin karshen da ki ka yi amfani da wani tsari? Wanne irin tsari ne?When did you start using that method? How long after the birth of (NAME)?Yaushe ki ka fara amfani da wannan tsarin? Yaushe bayan haihuwar (NAME)?How long did you use the method then?Menene tsawon lokacin da ki ka yi amfanin da wannan tsarin?IN COLUMN 2, ENTER CODES FOR DISCONTINUATION NEXT TO THE LAST MONTH OF USE. NUMBEROF CODES IN COLUMN 2 MUST BE SAME AS NUMBER OF INTERRUPTIONS OF METHOD USE INCOLUMN 1.ASK WHY SHE STOPPED USING THE METHOD. IF A PREGNANCY FOLLOWED, ASK WHETHER SHEBECAME PREGNANT UNINTENTIONALLY WHILE USING THE METHOD OR DELIBERATELY STOPPEDTO GET PREGNANT.ILLUSTRATIVE QUESTIONS: Why did you stop using the (METHOD)? Don me ki ka daina amfani da wannan (METHOD)?Did you become pregnant while using (METHOD), or did you stop to get pregnant, or did you stop forsome other reason?Kin dauki ciki da kina amfani da (METHOD), ko ba ki dauki ciki ba, ko baki dauki ciki ba domin wasudalilai?IF DELIBERATELY STOPPED TO BECOME PREGNANT, ASK: How many months did it take you to get pregnant after you stopped using (METHOD)?Wata nawa ya dauke ki samun ciki bayan kin daina amfani da wannan(METHOD)AND ENTER ‘0’ IN EACH SUCH MONTH IN COLUMN 1.Q309CHECK Q304:CIRCLE METHOD CODE:IF MORE THAN ONE METHOD CODE CIRCLED IN304, CIRCLE CODE FOR HIGHEST METHOD INLIST.NO CODE CIRCLED………………………00FEMALE STERILIZATION………………..01MALE STERILIZATION…………………...02IMPLANT…………………………………...03IUCD…………………………………….…..04INJECTABLE... . . . . . . . . . …..……….…05DAILY PILL……….……………………......06EMERGENCY PILL (Postnor2, etc.)….…07MALE CONDOM . . . . . . . . ………….......08FEMALE CONDOM . .. …. . . …………....09BREASTFEEDING/LAM . . . . . …..……..10STANDARD DAYS METHOD/ SAFE DAYS/CYCLE BEADS……………………….……11RHYTHM METHOD………………………..12WITHDRAWAL …………………………...13OTHER __________________________96(SPECIFY)Q31815
Page 1 and 2: OFFICE USE ONLY: QUESTIONNAIRE NO:
Page 3 and 4: Kuma babu mamaki wani yazo wurinmu
Page 5 and 6: Q110As you know, some women take up
Page 7 and 8: Since January 2010,Tun da ga Januar
Page 10 and 11: From which type of facility did you
Page 12 and 13: SECTION 3: CONTRACEPTIONCHECK FOR P
Page 16 and 17: Q310Q311Q312Who decided which type
Page 18 and 19: FERTILITY RELATED REASONS:A. NO SEX
Page 20 and 21: Quality of Care - Services and Trea
Page 22 and 23: When you came to the facility for d
Page 24 and 25: PUBLIC SECTORGOVERNMENT HOSPITAL…
Page 26 and 27: Q424In the past year, did you recei
Page 28 and 29: Q508Q509Q510Including yourself, in
Page 30 and 31: CHECK Q602:Q604NOT PREGNANT ORUNSUR
Page 32 and 33: SECTION 7: SPOUSAL AND INTERPERSONA
Page 34 and 35: Please tell me how you would agree
Page 39 and 40: Q831Q832Q833Q834Q835Q836Where did y
Page 41 and 42: Q846Q847Q848Q849Q850In the past thr
Page 43 and 44: Which rural area did you visit most
Page 45 and 46: OFFICE USE ONLY: QUESTIONNAIRE NO:

Questionnaire - Measurement, Learning & Evaluation Project

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