Questionnaire - Measurement, Learning & Evaluation Project

Q310Q311Q312Who decided which type of family planning/ child birthspacing/child spacing method to use? Is it mainlyyour decision, mainly your partner's decision, or didyou both decide together?Shin wa ya ke yanke shawara wajen wane irindabarar tsarin iyali/tazara tsakanin haihuwa/tazaratsakanin yara za ku yi amfani da shi? Shin ra’ ayin kine ke kadai, ko na mijin ki /abokin zaman ki,ko ra’ayinku ne tare ?Were you ever told by a health or family planningworker about side effects or problems you might haveusing this family planning method [CIRCLED INQ309]?Shin ko jami’an kiwon lafiya ko na tsarin iyali sungaya miki illoli ko matsalolin da zasu iya faruwa idankin yi amfani da wannan hanyar tsarin iyali?Were you told by a health or family planning workerwhat to do if you experienced side effects orproblems with this method [CIRCLED IN Q309]?Shin ko jami’an kiwon lafiya ko ta tsarin iyali sun gayamiki abin da za ki yi idan illolin ko matsalolin sukafaru?MAINLY YOU..………..……………….……1MAINLY PARTNER………..…………….…2JOINTLY…………………….……………….3OTHER__________________________6(SPECIFY)YES . . . . . . . . . . . . . . ………… . . . . . . .NO . . . . . . . . . . . . . . . . . . . . . . ………….DON’T KNOW . . . . . . . . . . . . . ………….YES . . . . . . . . . . . . . . . . . . …………….. . . .1NO . . . . . . . . . . . . . . . . . . . . . ……………. . 2DON’T KNOW/CAN’T REMEMBER . .. .…. .8128Q313Q313Q313Have you experienced any problems with yourcurrent method?Kin ta ba samun wata matsala wajen amfani dawannan tsarin.YES . . . . . . . . . . . . . . . . . . . . …….…1NO . . . . . . . . .. . . . . . . . . ……….……2Were you ever told by a health or family planningworker about other methods of family planning(beside the one you are currently using)?Q314Shin ko jami’an kiwon lafiya ko ta tsarin iyali suntaba gaya miki wasu dabaraun tsarin iyali/tazaratsakanin haihuwa/tazara tsakanin yara, da za ki iyaamfani da su?(banda wanda ki ke amfani dashiyanzu)YES . . . . . . . . . . . . . . . ……………. . . . . . .1NO . . . . . . . . . . . . . . ……………. . . . . . . . .2DON’T KNOW . . . . . . . . ……………. . . . . .8CHECK Q309:Q315IF CIRCLED FEMALE STERILIZATION “01” MALESTERILIZATION “02”, IMPLANT “03”, IUCD “04”,INJECTABLE “05”, DAILY PILL “06”, EMERGENCYPILL “07”, MALE CONDOM “08”,FEMALE CONDOM “09”,OR OTHER PRODUCT “96”IF CIRCLED BREASTFEEDING/LAM “10”STANDARD DAYS/SAFE DAYS/CYCLE BEADS “11”RHYTHM METHOD “12” WITHDRAWAL“13” OR OTHER NATURAL METHOD “96”Q321Q316From where or whom did you obtain [CURRENTMETHOD] last time?A ina ko a gun wa ki ka samu wannan dabarar awancan lokacin?PROBE: What is the name of this place/person? Andwhere is it located?PROBE: Ya ya sunan wajen/mutumin? Kuma inaya/ta ke?NAME OF FACILITY /PERSON__________________________________________________________________STREET NAME/ADDRESS___________________________________________LAND MARK DESCRIPTION_______________________16