Baseline Women's questionnaire - Yoruba/English

Q416In the last year, have you gone to a health facilityfor maternal health services, such as prenatal andpostpartum care?YES . . . . . . . . . . . . . . . . . . . . . . ………….NO . . . . . . . . . . . . . . . . . . . . . . . …………12 Q422Q417Niniu odun toja,nje e ti lo si ile iwosan fun itojualabiyamo gegebi itoju lakoko iloyun ati lehin ti aba ti bi omo?Where did you go most recently for maternalhealth services?Nibo le lo laipe yi fun itoju alabiyamo?NAME OF FACILITY_________________________________PROBE: What is the name of this place? Andwhere is it located?Kinni oruko ibe ? ati nibo ni agbegbe ti o wa?STREET NAME/ADDRESS______________________________________________LAND MARKDESCRIPTION_______________________Q418What type of facility is this?Iru ile iwosan wo ni eyi?PUBLIC SECTORGOVERNMENT HOSPITAL……..……......WOMEN AND CHILDREN’S HOSPITAL...GOVT. HEALTH CENTER…………………CHILD WELFARE CLINIC…………………GOVERNMENT POST/DISPENSARY…..OTHER PUBLIC____________________(SPECIFY)111213141516PRIVATE SECTORPRIVATE HOSPITAL………………………PRIVATE CLINIC…………………….........NURSING/MATERNITY HOME………….CHW/TBA……………………………………COMMUNITY MIDWIFE…………………..PHARMACY…………………………………PMS/CHEMIST…………………..…………OTHER PRIVATE___________________(SPECIFY)2122232425262728FAITH-BASED SECTORMISSION HOSPITAL…………….……......FAITH-BASED, CHURCH CLINIC……….3132Q419Why did you choose this facility?PROBE: ANY OTHER REASON?Kinni idi tie r fi yan ile iwosan yi?MULTIPLE RESPONSESOTHER SOURCEOTHER NGO HOSPITAL………………….OTHER NGO CLINIC………......................WORKSITE CLINIC…………….………….MOBILE CLINIC . . . . . . . . . . . . . . . ……...YOUTH CENTER…………………………...OTHER ___________________________(SPECIFY)DON'T KNOW . . . . . . . . . . . . . . …… . .SERVICES ARE FREE/ AFFORDABLE…….FACILITY OPEN/CONVENIENT HOURS OFOPERATION…..……………………..…………STAFF ARE POLITE AND RESPECTFUL…CONVENIENT TO MY HOME………………CONVENIENT TO MY WORK………………CONVENIENT TO WHERE I SHOP…………CONVENIENT USING AVAILABLETRANSPORT………………………………….GOOD QUALITY SERVICES………………OFFER SERVICES REQUIRED……………PROVIDERS AVAILABLE…………………ACCEPT INSURANCE…………………………OFFER CREDIT FACILITIES…………………FACILITY HAS A GOOD REPUTATION…….IT PROVIDES MULTIPLE SERVICES………REFERRED THERE……………………………41424344459698ABCDEFGHIJKLMNOOTHER___________________________(SPECIFY)XPage 35