Baseline Women's questionnaire - Yoruba/English

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(Q217C)Lineno.15161718(Q218)What name was given to your(first/next) baby?Oruko wo ni e fun (akobi/atele) omoyin?NAME:_____________________________NAME:__________________________NAME:_____________________________NAME:_____________________________(Q219)Were any ofthese birthstwins/triplets?Nje ikankanninu awonibimo yi jeibeji/ibeta?CIRCLESING………1MULT……..2SING………1MULT……..2SING………1MULT……..2SING………1MULT……..2(Q220)Is(NAME)a boy ora girl?Seokunrintabiobinrinni(ORUKO)?CIRCLEBOY…1GIRL...2BOY…1GIRL...2BOY…1GIRL...2BOY…1GIRL...2(Q221)In what month andyear was (NAME)born? PROBE:What is her/hisbirthday? (otherprobes: whatseason was it)Ninu osu ati odunwo ni a bi(ORUKO)?PROBE: Igba woni ojo ibi re?(OTHER PROBES:igba wo ni ninuodun)MONTH [__|__]DK……..98YEAR[__|__][__|__]DK….9998MONTH [__|__]DK……..98YEAR[__|__][__|__]DK….9998MONTH [__|__]DK……..98YEAR[__|__][__|__]DK….9998MONTH [__|__]DK……..98YEAR[__|__][__|__]DK….9998(Q222)Is(NAME)stillalive?Se(ORUKO) si walaaye?YES….1NO……2Q225YES….1NO……2Q225YES….1NO……2Q225YES….1NO……2Q225(Q223)IF ALIVE:How old was(NAME) at his/herlast birthday?Omo odun melo ni(ORUKO) nigba tio se ojo-ibi kehin?RECORD AGE INCOMPLETEDYEARS; IF LESSTHAN ONE YEAR,RECORD “00”.AGE IN YEARS[__|__]AGE IN YEARS[__|__]AGE IN YEARS[__|__]AGE IN YEARS[__|__](Q224)IF ALIVE:Is (NAME) livingwith you?Se (ORUKO)ngbe pelu yin?YES….1NEXT BIRTHNO……2Q226YES….1NO……2ALL SKIP TOQ226YES….1NO……2ALL SKIP TOQ226YES….1NO……2ALL SKIP TOQ226(Q225)IF DEAD:How old was (NAME) whenshe/he died?IF LESS THAN 2 YEARS,PROBE:How many months old was(NAME)?Omo odun melo ni (ORUKO)nigba ti o salaisi?IF 1 YR, PROBE:Omo osu melo ni (ORUKO)?IF LESS THAN 1 MONTHOLD, RECORD DAYS; IFLESS THAN 2 YEARS,RECORD MONTHSDAYS…….1 [__|__]MONTHS…2 [__|__]YEARS…….3[__|__]DK………….998DAYS…….1 [__|__]MONTHS…2 [__|__]YEARS…….3[__|__]DK………….998DAYS…….1 [__|__]MONTHS…2 [__|__]YEARS…….3[__|__]DK………….998DAYS…….1 [__|__]MONTHS…2 [__|__]YEARS…….3[__|__]DK………….998(Q226)Were there any otherlive births between(NAME OFPREVIOUS BIRTH)and (NAME),including any childrenwho died after birth?N je e bi abiye laarin(NAME OFPREVIOUS BIRTH)ati (ORUKO), eyi peluawon omo ti o ku lehinti e bi?YES...1ADD BIRTHNO….2NEXT BIRTHYES...1ADD BIRTHNO….2NEXT BIRTHYES...1ADD BIRTHNO….2NEXT BIRTHYES...1ADD BIRTHNO….2NEXT BIRTHPage 10
Q227Q228Q229Have you had any live births since the birth of (NAME OF LASTBIRTH)?N je e ni abiye lehin ti e bi (NAME OF LAST BIRTH)?Before the birth of (NAME OF FIRST BIRTH), did you have anyother live births?Ki e to bi (NAME OF FIRST BIRTH), nje e ni abiye miran?YES………………………………NO………………………………..YES………………………………NO………………………………..COMPARE Q208 WITH NUMBER OF BIRTHS IN HISTORY ABOVE AND MARK:NUMBERSNUMBERS AREARE SAME DIFFERENT (PROBE AND RECONCILE)1212RECORDBIRTH(S)IN BIRTHHISTORYTABLERECORDBIRTH(S)IN BIRTHHISTORYTABLECHECK: FOR EACH BIRTH: YEAR OF BIRTH IS RECORDED.FOR EACH LIVING CHILD: CURRENT AGE IS RECORDED.FOR EACH DEAD CHILD: AGE AT DEATH IS RECORDED.Q230FOR AGE AT DEATH 12 MONTHS OR 1 YEAR: PROBE TO DETERMINE EXACTNUMBER OF MONTHS.CHECK Q221 AND ENTER THE NUMBER OF BIRTHS SINCE 2008. IF NONE, RECORD “0”.Q231 CHECK Q230:YES, HAS ONE OR MORE NO BIRTHS SINCE 2008BIRTHS SINCE 2008Q235Q232ENTER NAME AND LINE NUMBEROF YOUNGEST CHILD BORN FROM Q217C AND Q218: ______________________________NAMECHECK Q222;[___|___]LINE NUMBERDEADLIVINGQ233Q234Q235Q236Q237Q238At the time you became pregnant with [NAME ABOVE], did you wantto become pregnant then, did you want to wait until later, or did younot want to have any more children at all?Lasiko ti e loyun, n je e fe loyun nigba naa, tabi e fe duro di igba mirantabi e ko fe bimo miran mo rara?How much longer would you have liked to wait?Igba wo ni e ba fe duro da?IF RESPONSE IS A DECIMAL FOR YEARS (2.5YRS), THENCONVERT INTO MONTHS AND FILL IN ONLY MONTHS.Are you pregnant now?Nje e loyun bayi?How many months pregnant are you?Oyun yin ti di osu melo bayi?RECORD IN COMPLETE MONTHS OF PREGNANCYAt any time during this pregnancy, have you gone for an antenatalcheck up?Ni asiko ti e loyun yi, nje e lo fun ayewo aboyun?From where or whom did you obtain (A CHECK UP) last time?PROBE: What is the name of this place/person? And where isit/he/she located?Nibo ni e lo laipe yi fun eto ilera omode?PROBE: Kini oruko lbe? Nibo ni o wa?THEN……………………………LATER…………………………NOT AT ALL……………………123MONTHS………..1 [__|__]ORYEARS..………...2 [__|__]OROTHER(SPECIFY)__________________996ORDON’T KNOW……………………….998YES………………………………NO………………………………..UNSURE……………………… .MONTHS…………………..[__|__]DON’T KNOW…………….98YES………………………………1NO………………………………..2NAME OF FACILITY /PERSON128__________________________________________________________________Q235Q235Q243Q243Q241WRITE NAME OF PERSON ONLY IF PROVIDER WORKS AS ANINDIVIDUALSTREET NAME/ADDRESS______________________________________________LAND MARKDESCRIPTION_______________________Page 11
Page 1 and 2: OFFICE USE ONLY: QUESTIONNAIRE NO:
Page 3: SECTION 1: BACKGROUND CHARACTERISTI
Page 6 and 7: Q209 CHECK 208:Just to make sure th
Page 8 and 9: (Q217C)Line no.0506070809(Q218)What
Page 12 and 13: Q239What type of facility is this?I
Page 14 and 15: SECTION 3: CONTRACEPTIONCHECK FOR P
Page 16 and 17: Now I would like to talk about fami
Page 18 and 19: Q309CHECK Q235 CURRENTLY PREGNANTNO
Page 20 and 21: NQ6How many living children did you
Page 22 and 23: Q330FOR A WOMAN WHO HAS BEEN STERIL
Page 24: NQ9Why did you switch from [PREVIOU
Page 27 and 28: Q346What are the main reasons why y
Page 29 and 30: EMERGENCY CONTRACEPTIONNow I would
Page 31 and 32: Quality of Care - Services and Trea
Page 33 and 34: Q406Q407Why didn’t you deliver in
Page 35 and 36: Q416In the last year, have you gone
Page 37 and 38: Q425At the time of your last test,
Page 39 and 40: Now I would like to ask you some qu
Page 41 and 42: Q606If it would be a problem, why?T
Page 43 and 44: Q617What are the impacts on the mot
Page 45 and 46: Q709Besides yourself (or your husba
Page 47 and 48: Q729Excluding your husband/partner,
Page 49 and 50: Q730 Q731 Q732 Q733 Q734 Q735RECORD
Page 51 and 52: SECTION 8: GENDER INEQUITY MEASURES
Page 53 and 54: Q822CHECK Q807 AND Q810:IF HE IS CU
Page 55 and 56: Now I am going to read some stateme
Page 57 and 58: Q905Which magazine(s) do you read m
Page 59 and 60: Q921Q922Where do you normally watch
Page 61 and 62:
Q934Would you be comfortable receiv
Page 63 and 64:
Q938. What are the names and types
Page 65 and 66:
Q1008Q1009Q1010Q1011How long do you
Page 67 and 68:
OFFICE USE ONLY: QUESTIONNAIRE NO:
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