Questionnaire - Measurement, Learning & Evaluation Project

PUBLIC SECTORGOVERNMENT HOSPITAL……..…….............11WOMEN AND CHILDREN’S HOSPITAL……..12CHILD WELFARE CLINIC…………………...…13GOVT. HEALTH CENTER…………………...…14GOVERNMENT POST/DISPENSARY………..15MATERNITY HOME…………………………….16MOBILE CLINIC…………………………………17OTHER PUBLIC_______________________18(SPECIFY)Q416What type of health facility did you go to for maternalhealth services at your last visit?Wanne wurin kiwon lafiya kika je kwanan nan, dominawon ciki ko kula bayan haihuwa ko jego?PRIVATE SECTORPRIVATEHOSPITAL/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…………….32OTHER SOURCEOTHER NGOHOSPITAL/CLINIC……………………..………41WORKSITE CLINIC…………….……………...42YOUTH CENTER……………………………....43OTHER _____________________________96(SPECIFY)DON'T KNOW . . . . . . . . . . . . . . ………………… . .98Q417Q418At your last visit, did you receive any information orcounseling on family planning/ child birth spacing?Zuwan ki asibiti na karshe nan, kin samu wannibayani ko shawara akan dabarun tsarin iyali /tazaratsakanin haihuwa?Did you receive a method or a referral for familyplanning/ contraceptive method at that time?Kin samu dabara ko an tura ki wajen dabarar tsariniyali/tazara tsakanin haihuwa/tazara tsakanin yara awancan lokacin?I don’t want to know the results, but In the last year,have you gone to a health facility for an HIV test?YES . . . . . . . . . . . . . . . . . . . . . . ………...…….1NO . . . . . . . . . . . . . . . . . . . . . . . ………………2YES, RECEIVED A METHOD. . . . . . . …………. . . 1YES, RECEIVED A PRESCRIPTION……………....2YES, RECEIVED A REFERRAL . . . . . . . . ……..….3NO, DID NOT RECEIVE ANY OF THESE………….4YES . . . . . . . . . . . . . . . . . . . . . . ……………….….1Q419Ba na son in san sakamakon,A cikin shekarar da tashige, kinje asibiti domin gwajin cuutar kanjamau(HIV)?NO . . . . . . . . . . . . . . . . . . . . . . . ……………….….2Q42324