Baseline Women's questionnaire - Yoruba/English

Q420At your last visit, did you receive any informationor counseling on family planning/birth spacing?Nje e gba ifitonileti / amoran lori ifetosomobibilakoko abewo yi?YES . . . . . . . . . . . . . . . . . . . . . . ………….NO . . . . . . . . . . . . . . . . . . . . . . . …………12 Q422Q421Did you receive a method or a referral for familyplanning/ contraceptive method at that time?Nje e gba ona kan tabi itokasi fun onaifetosomobibi / fifi aye sarin ibimo/fifi aye si arinomolakoko yi?YES, RECEIVED A METHOD. . . . . . . ….. . .YES, RECEIVED A PRESCRIPTION………...YES, RECEIVED A REFERRAL . . . . . . . . ….NO, DID NOT RECEIVE ANY OF THESE…….1234Q422In the last year, have you gone to a health facilityfor an HIV test?Niniu odun toja,nje e ti lo si ile iwosan fun ayewoaarun HIV?YES . . . . . . . . . . . . . . . . . . . . . . …………….NO . . . . . . . . . . . . . . . . . . . . . . . …………….12 Q427Q423Where did you go most recently for an HIV test?Nibo le lo laipe yi fun ayewo HIV?PROBE: What is the name of this place? Andwhere is it located?NAME OF FACILITY__________________________________________________________________Kinni oruko ibe? Ati nibo ni agbegbe ti o wa?STREET NAME/ADDRESS______________________________________________LAND MARKDESCRIPTION_______________________Q424What 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……….3132OTHER SOURCEVCT…………………………………………..OTHER NGO HOSPITAL………………….OTHER NGO CLINIC………......................WORKSITE CLINIC…………….………….MOBILE CLINIC . . . . . . . . . . . . . . . ……...YOUTH CENTER…………………………...414243444546OTHER ___________________________(SPECIFY)DON'T KNOW . . . . . . . . . . . . . . …… . .9698Page 36