WARNING: You have opened a female respondent questionnaire that is not linked to a household roster.

A. Are you in the correct household?

EA: ${EA} Structure #: ${structure} Household #: ${household}

RETURN TO INTERVIEW THE CORRECT HOUSEHOLD.

Your Name

C. Is this your name?

D. Enter your name below.

Please record your name

Current Date-Time:

E. Is this date and time correct?

F. Record the correct date and time.

Location Detail - Not linked to a household roster.

Region:

Zone:

District:

Locality:

Enumeration area

Structure number

Household number

Location Detail

The following information is from the Household Questionnaire. Please review to make sure you are interviewing the correct respondent

Region:

Zone:

District:

Locality:

Enumeration area

Structure number

Household number

G. Is the above information correct?

Go to the right household or update the household Questionnaire if needed.

I. CHECK: You should be attempting to interview ${firstname}. Is that correct?

If misspelled, select "Yes" here and update the name in question "P"
If this is the wrong person, you have two options:
(1) exit and ignore changes to this form. Open the correct form.
Or
(2) find and interview the person whose name appears above

J. Is the respondent present and available to be interviewed today?

K. How well acquainted are you with the respondent?

L. Is this participant selected for the cross-section, panel, or both?

In the Household Questionnaire you noted that this woman is enrolled in the panel. If that is correct, please go back and correct response for L. Otherwise, please continue.

In the Household Questionnaire you noted that this woman is selected for cross section. If that is correct, please go back and correct response for L. Otherwise, please continue.

In the Household Questionnaire you noted that this woman was NOT selected for cross section. If that is correct, please go back and correct response for L. Otherwise, please continue.

CROSS-SECTION INFORMED CONSENT

Find the woman between the ages of 15-49 associated with this Female Questionnaire. The interview must have auditory privacy. Read the following greeting:

Hello. My name is ____________________________________ and I am working for the Addis Ababa University, and Federal Ministry of Health. We are conducting a local survey that asks women about various reproductive health issues, including family planning and pregnancy using a smartphone. The survey helps monitor the state of public health and questions will be used for research purposes. We would very much appreciate your participation in this survey. This information will help us inform the government to better plan health services. The survey usually takes between 30 and 40 minutes to complete. Whatever information you provide will be kept strictly confidential. Your data will not be linked to your identity when conducting analyses, presenting results, or sharing data.

Participation in this survey is entirely voluntary. If we should come to any question you don't want to answer, just let me know and I will go on to the next question; or you can stop the interview at any time. However, we hope that you will participate in this survey since your views are important. If you choose to participate in the survey, you will receive 25 birr airtime credit.

If you have any questions about the study and your rights as a research participant, you may ask me now or you may also contact the principal investigators of the study, [name] at [phone number] or [name] at [phone number]. For any ethical issues, please call [IRB chairperson's name] at [phone number] at the Addis Ababa University, College of Health Sciences.

At this time, do you want to ask me anything about the survey?

M. May I begin the interview now?

As a reminder this is a study about maternal and newborn health. We will be visiting you at four time points: now, 6 weeks postpartum, 6 months postpartum and 1 year postpartum. Do you still consent to be enrolled in this study?

For women not yet enrolled, ask: Based on your answers to the previous questions, you are qualified to participate in our study. The survey is about maternal and neonatal health and is being conducted with the support of the Ministry of Health. The information you give us will help to inform the government to better plan health services. We would very much appreciate your participation in this survey, but whether or not you choose to participate is completely up to you. There is no penalty for not participating.

The survey will take place over three study visits. These visits will take place at 6 weeks, 6 months, and one year after the delivery of your baby. We will return at each of the three visits and ask you questions about your health and the health of your baby. At each visit, we will ask similar questions, because we are trying to learn about how the health of you and your baby changes over time. Some of the questions will have to do with your health during and after pregnancy and what care you received and some of the questions will be about your baby's health and what care they received. Some of the questions may be sensitive but you do not have to answer any questions that you do not feel comfortable answering.

The first visit will take approximately 45 to 60 minutes to complete. The second and third interview will take approximately 20 to 30 minutes to complete.

There are minimal or no perceived risks or harm for participating in this survey. Keep in mind that you do not have to answer all of the questions and you may stop at any time.

Whatever information you provide will be kept strictly confidential and will not be shown to anyone other than members of our survey team. All research projects carry some risk that information about you may become known to people outside of the study. To protect against this, the phone and any applications with PMA Ethiopia data are password protected.

If you agree to participate today, we will give you an identification card with a bar code scan. This card will only be used to identify you for this study. At the last in-person visit, we will take the card away and destroy it.

There is no direct benefit to you from being in the study. You will receive 25 birr in phone credit at each visit as a thank you for your time.
If you agree to participate today, we will assume that you agree to each of the three study visits but you have the right to stop participation in the study at any time.

If you have any questions related to this study you may contact [name] at [phone number] or [name] at [phone number]. For any ethical issues, please call [name] at [phone number] at the Addis Ababa University, College of Health Sciences.

N. May I begin the interview now?

Scan QR Code

Record the number on the ID card

Enter 2 digit ID number from card

O. Interviewer's name: ${your_name}

Mark your name as a witness to the consent process.

O. Interviewer's name

Please record your name as a witness to the consent process. You previously entered "${name_typed}."

That is not what you entered for your name earlier in this survey.

P. Respondent's first name

You may correct the spelling here if it is not correct, but you must be interviewing the person whose name appears below.

Section 1 Respondent's Background, Marital Status, and Household Characteristics

Now I would like to ask about your background and socioeconomic conditions.

FFQ001. In what month and year were you born?
The age in the household roster is ${age}.

If respondent knows the year, but not month select the 'Does not know month' checkbox.
Select the 'Do not know' checkbox for month and '2030' for year to indicate 'No Response'.

Month and Year

Check here if respondent does not know month.

FFQ002. How old were you at your last birthday?

Must be more than 14 and less than 50. Must agree with FFQ001.

FFQ003a. Are you currently married or living together with a man as if married?

Probe: If no, ask whether the respondent is divorced, separated, widowed, or never in union/never married

FFQ003b. Have you been married or lived with a man only once or more than once?

FFQ004a. In what month and year did you start living with your FIRST husband / partner?

If respondent knows the year, but not month select the 'Does not know month' checkbox. Select the 'Do not know' checkbox for month and '2030' for year to indicate 'No Response'.

Month and Year

Check here if respondent does not know month.

FFQ004b. CHECK: Based on the response you entered in FFQ004a, the respondent was possibly 15 years old or younger at the time of her first marriage. Did you enter FFQ004a correctly?

FFQ005a. Now I would like to ask about when you started living with your CURRENT or MOST RECENT husband / partner. In what month and year was that?

Select 'Do not know' for month and '2030' for year to indicate 'No Response'.

Month and Year

Check here if respondent does not know month.

CHECK: Based on the response you entered in FFQ005a, the respondent was possibly 15 years old or younger at the beginning of her marriage or cohabitation. Did you enter FFQ005a correctly?

FFQ006. Does your husband / partner have other wives or does he live with other women as if married?

FFQ007. What is your religion?

FFQ008. What is the highest level of school you attended?

Only record formal schooling. Do not record bible or koranic school or short courses.

FFQ009. Can you read or write in any language?

Section 2 - Migration

Now I would like to ask about your recent migration to and from your current area of residence

FFQ010. What region were you born in?

FFQ011. Was the place where you were born rural or urban?

FFQ012. How long have you been living continuously in this district: ${district_name}?
If recently moved (less than 1 month to less 1 year), enter 'Months'. If a year or more, please enter in number of years on the following screen.

FFQ013. Enter number of ${region_duration_lab}
If the respondent has stayed for less than a year 0 is a possible answer. Write '0' in the Month if they have recently moved (less than 1 month).

Month, between 0 to 11
Year, between 1 and respondent's age
Do not know, -88
No response, -99

FFQ014. Before you moved here, which region or country did you live in most recently?

FFQ015. Just before you moved here, did you live in a rural, or an urban area?

FFQ016. Who did you move with?

Select all that apply

Cannot select 'no response' or 'No one' with other options.

FFQ17. Can you tell me the main reason why you moved to your current place of residence?

Select only one response

Cannot select 'no response' with other options.

Section 3 - Reproduction and Fertility Preferences

Now I would like to ask about all the births you have had during your life.

FFQ018. Now I would like to ask about all the pregnancies you have had during your life. Have you ever been pregnant?

FFQ019. How many times have you given birth to a baby that was born alive?

No response: -99

Between 0 to 30
No response, -99

FFQ020. When was your FIRST birth?

If respondent knows the year, but not month select the 'Does not know month' checkbox. Select the 'Do not know' checkbox for month and '2030' for year to indicate 'No Response'.

Month and Year

Check here if respondent does not know month.

FFQ021. When was your MOST RECENT birth?

Please record the date of the MOST RECENT live birth. The date should be found by calculating backwards from memorable events if needed.
Select 'Do not know' for month and '2030' for year to indicate 'No Response'.

Use visual aid to record dates of most recent birth

Day, Month and Year

Check here if respondent does not know month.

CALC FFQ021
ODK: Calculate how many weeks ago most recent birth was

FFQ022. Is the respondent enrolled in the panel study?

If NO: Explain the panel survey to the woman and attempt to enroll her. Even if she is enrolled in the panel study, she may also be eligible for the cross-section

FFQ023. Just before you moved here ${district_name}, did you have any sons or daughters whom you have given birth to?

FFQ024. How many children did you have just before you moved here?

No response: -99

Enter betewen 0 to previously entered number total births.

FFQ025. Are you pregnant now?

You have identified this woman as a panel respondent, but said she is not pregnant or recently postpartum. Please confirm and go back and correct

FFQ026. When did your last menstrual period start?

Hint: Help the respondent to remember the approximate date by asking her usual menstrual cycle pattern and by using local languages which are equivalent to LMP

Enter 0 days for today

Enter in ${mens_period_lab}.

Days, between 0 to 6
Weeks, between 1 to 3
Months, between 1 to 11
Years, between 1 to respondent's age.

FFQ027. Is the respondent enrolled in the panel study?

If NO: Explain the panel survey to the woman and attempt to enroll her. Even if she is enrolled in the panel study, she may also be eligible for the cross-section

FFQ028a. Did she agree to enroll in the panel survey?

FFQ028b. If yes, go back to L and change response from 1 to 3. Administer consent in N

FFQ029a. How many months pregnant are you?

The most recent birth was: ${recent_birth_et_lab}

Please record the number of completed months.

No response: -99; Do not know: -88

Between 0 to 10

FFQ029b. At the time you became pregnant, did you want to become pregnant then, did you want to wait until later, or did you not want to have any / any more children at all?

Remind the respondent that we are asking about her most recent pregnancy, or if currently pregnant about the current pregnancy

FFQ030. Have you ever delivered in a health facility before?

FFQ031. Based on your previous delivery experience, would you recommend that your friends or family members deliver in a facility or at home?

FFQ032. Where would you like to deliver your baby?

FFQ033. Who would you like to have help deliver your baby?

FFQ034a. Thus far in your pregnancy, have you seen a health extension worker for antenatal care?

FFQ034b. At any point in your pregnancy, did you see a health extension worker for antenatal care?

FFQ035. Where did you see the HEW?

Cannot select 'no response' with other options.

FFQ036a. How many times have you received antenatal care during this pregnancy from a health extension worker, either at a health post or at home?

No response: -99; Do not know: -88

Between 1 to 10, or
Do not know: -88
No response: -99

FFQ036b. How many times did you receive antenatal care during this pregnancy from a health extension worker, either at a health post or at home?

No response: -99; Do not know: -88

Between 1 to 10, or
Do not know: -88
No response: -99

FFQ037. How many months pregnant were you when you first talked to a health extension worker about your pregnancy?

No response: -99; Do not know: -88

Between 0 to 10
Do not know, -88

FFQ038a. Have you seen a professional healthcare provider, other than an HEW, for antenatal care during this pregnancy?

FFQ038b. Did you see a professional healthcare provider, other than an HEW, for antenatal care during this pregnancy?

FFQ039. Whom did you see, not including an HEW? Anyone else?

Select all that apply
Probe to identify each type of person and record all mentioned.

Cannot select 'no response' with other options.

FFQ040a. How many times have you received antenatal care during this pregnancy from a professional healthcare provider, other than an HEW?

No response: -99; Do not know: -88

Between 1 to 10, or
Do not know: -88
No response: -99

FFQ040b. How many times did you receive antenatal care during this pregnancy from a professional healthcare provider, other than an HEW?

No response: -99; Do not know: -88

Between 1 to 10, or
Do not know: -88
No response: -99

FFQ041. How many months pregnant were you when you first received antenatal from a professional healthcare provider other than an HEW for this pregnancy?

No response: -99; Do not know: -88

Between 1 to 10
Do not know, -88
No response, -99

FFQ042. Where did you receive antenatal care for this pregnancy, not including from the HEW? Anywhere else?

Select all that apply

Probe to identify the type of source and record all mentioned

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ043. As part of your antenatal care during this pregnancy were any of the following measured at least once:

Hint: This includes any ANC from any provider

A) Was your blood pressure measured?

B) Was your weight taken?

C) Did you give a urine sample that was not for a pregnancy test?

D) Did you give a blood sample?

E) Did you give a stool sample?

FFQ044.I don't want to know the results, but as part of your antenatal care were you:

This includes any ANC from any provider

A) Tested for syphilis?

B) Did you receive the results of your test?

C) Did someone discuss the results with you after you were tested?

FFQ045. I don't want to know the results, but as part of your antenatal care were you:

This includes any ANC from any provider

A) Tested for HIV?

B) Did you receive the results of your test?

C) Did someone discuss the results with you after you were tested?

FFQ046a. During your antenatal care visit, did your provider discuss breastfeeding as a method to prevent pregnancy?

This includes any ANC from any provider

FFQ046b. During your antenatal care visit, did your provider talk with you about postpartum family planning?

This includes any ANC from any provider.

FFQ047. Which family planning method or methods did you discuss with the provider?

Select all that apply

Note: breastfeeding was included previously and is not part of this list

Cannot select 'no response' with other options.

FFQ048. Are you planning to breastfeed?

FFQ049. Are you planning to use breastfeeding to delay or avoid getting pregnant?

FFQ050. How long do you plan to breastfeed?

Enter in ${brfeeding_period_lab}.

Months, between 1 to 11
Years, between 1 to 4

FFQ051. Do you plan to feed your baby anything other than breastmilk in the first six months? This includes things like water, juice, oil, or tea.

FFQ052. Do you plan to use a method of family planning, other than breastfeeding, within a year of giving birth?

FFQ053a. When do you plan to start using the method?

FFQ053b. Enter value in ${start_method_lab}

Weeks, between 1 to 3
Months, >= 1

FFQ054. What method do you plan to use?

Hint: this does not include LAM/breastfeeding

FFQ055. During this pregnancy, were you given an injection in the arm to prevent the baby from getting tetanus, that is convulsions (locked jaw) after birth?

FFQ056. During this pregnancy, how many times have you gotten a tetanus injection?

Between 1 to 10
Do not know, -88
No response, -99

CHECK: You entered that the respondent received ${tetanus_inj_times} tetanus injections in question FFQ056. Confirm that these were received only during this pregnancy.

FFQ057. During this pregnancy have you consumed any multivitamins that contain iron, iron tablets, iron syrup, or folic acid/iron co-packs?

A photo of iron tablets/syrup will appear on the screen

FFQ058. During this pregnancy, have you consumed any drug for intestinal worms?

A photo of intestinal worms tablets will appear on the screen

FFQ059a. Have you experienced any of the following problems during this pregnancy:

A) Severe headache with blurred vision?

B) High blood pressure?

C) Edema (swelling) face/feet/body?

D) Convulsion/fits?

E) Vaginal bleeding before delivery?

F) High fever?

G) Abnormal vaginal discharge (foul smelling/dark)?

H) Lower abdominal pain?

I) Worsening vision, particularly at night?

FFQ059b. Did you experience any of the following problems during this pregnancy:

A) Severe headache with blurred vision?

B) High blood pressure?

C) Edema (swelling) face/feet/body?

D) Convulsion/fits?

E) Vaginal bleeding before delivery?

F) High fever?

G) Abnormal vaginal discharge (foul smelling/dark)?

H) Lower abdominal pain?

I) Worsening vision, particularly at night?

FFQ060A. Did you seek treatment at a health facility for Severe headache with blurred vision?

FFQ060B. Did you seek treatment at a health facility for High blood pressure?

FFQ060C. Did you seek treatment at a health facility for Edema face/feet/body?

FFQ060D. Did you seek treatment at a health facility for Convulsion/fits?

FFQ060E. Did you seek treatment at a health facility for Vaginal bleeding before delivery?

FFQ060F. Did you seek treatment at a health facility for High fever?

FFQ060G. Did you seek treatment at a health facility for Abnormal vaginal discharge (foul smelling/dark)?

FFQ060H. Did you seek treatment at a health facility for Lower abdominal pain?

FFQ060I. Did you seek treatment at a health facility for Difficulty seeing at night?

FFQ061. During your antenatal care visit(s) was there any discussion about the following:

A) Place of delivery?

B) Delivery by a skilled attendant?

C) Arrangement for transport for delivery?

D) Where to go if experience of pregnancy danger signs?

E) Severe headaches with blurred vision as a danger sign in pregnancy?

F) High blood pressure as a danger sign in pregnancy?

G) Edema/swelling of the face/feet/body as a danger sign in pregnancy?

H) Convulsions/fits as a danger sign in pregnancy?

I) Bleeding before delivery as a danger sign in pregnancy?

FFQ062. Did you receive any tablets that should be taken to prevent bleeding after delivery?

FFQ063. As part of your antenatal care visits, did a healthcare worker or HEW talk with you about your nutrition or diet?

FFQ064. What information or messages did you receive during your pregnancy about nutrition or diet?

Probe: From either a health provider at a facility or an HEW?

Select all that apply. Read all responses aloud.

Cannot select 'no response' or 'None of the above' with other options.

FFQ065. During this pregnancy, did you participate in a 1 to 5 meeting to discuss pregnancy-related issues with your team or team leader?

FFQ066. Do you know how to contact the HEW if you go into labor?

FFQ067a. Has your partner encouraged you to go to the clinic for antenatal care?

FFQ067b. Did your partner encourage you to go to the clinic for antenatal care?

FFQ068. Have you and your partner discussed where you are planning to deliver?

FFQ069. While you were pregnant, did you and your partner discuss where you planned to deliver?

FFQ070. Did you go to a maternity waiting home before going into labor?

This is a room or home where women go to live before they deliver. It is not the waiting room in the health center

FFQ071. How many months pregnant were you when the [pregnancy ended/baby was born]?

Between 0 to 10
Do not know, -88
No response, -99

FFQ072. How many children were in this pregnancy? (eg twin or triplet?)

I will now ask you some questions about the baby that was born. If there was more than one child, we will start with the first child born.

ODK will repeat questions FFQ073-078 for each child born in this pregnancy

Each Child Info

ERROR: Too many groups added.

Remove this group by pressing your finger down on the small circle below and selecting 'remove group' from the menu that appears.

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FFQ073. What was the outcome of this pregnancy for the ${order_en} baby born?

FFQ074. Did the baby cry or show any signs of life?

CHECK: The outcome of this pregnancy is live birth. Go back and correct FFQ073.

FFQ075. What was the name given to the baby that was just born?

Write 'Baby' if no name given

FFQ076. Is ${baby_name} a boy or a girl?

FFQ077. Is ${baby_name} still alive?

FFQ078. IF DEAD: Exactly how many days or weeks old was ${baby_name} when (he/she) died?

If less than 1 week, select days.

FFQ078b. Enter the number of ${when_died_lab}

Days, between 0 and 6
Weeks, >= 1

FFQ079. Where did you give birth?

Probe to identify the type of facility.

FFQ080. What are the reasons you did not go to a health facility for delivery?

Any other reason?

Select all that apply

Cannot select 'no response' or 'Don't know' with other options.

FFQ081. Who assisted with the delivery?

If Respondent says 'No one assisted,' probe to determine whether any adults were present at the delivery. If Respondent says more than one person, ask who was the primary attendant.

FFQ082. Was your delivery by caesarean, that is, did they cut your belly open to take the baby out?

FFQ083. Was the baby weighed at birth?

FFQ084. Did you experience any of the following problems during the delivery:

A) Severe bleeding?

B) Leaking/rupture of membrane and no labor pain for >24 hours?

C) Leaking/rupture of membrane before 9 months?

D) Malpresentation (the feet/hand came out first) or malposition (baby lied transversely during pregnancy)

E) Prolonged labor (>12 hours)?

F) Convusions/fits

FFQ085. Where did you seek treatment for the complications you experienced during delivery?

Select all that apply.

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ086. Did you experience any of the following problems within the first 24 hours after the delivery:

A) Retained placenta? (more than 30 minutes)

B) High fever with foul/smelly discharge or lower abdominal pain?

C) Severe/heavy bleeding?

D) Convusions/fits

FFQ087A. Where did you seek treatment for Retained placenta? (more than 30 minutes)

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ087B. Where did you seek treatment for High fever with foul/smelly discharge or lower abdominal pain?

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ087C. Where did you seek treatment for Severe/heavy bleeding?

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ087D. Where did you seek treatment for Convulsions/fits?

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ088. Did you receive an injection in your thigh immediately after you delivered to prevent excess bleeding?

FFQ089. How long were you in labor before you left your home to seek care?

You will enter a number for x on the next screen.

Enter duration in ${how_long_labour_lab}

Minutes, between 0 to 59
Hours, >= 1

FFQ090. Did you receive blood transfusion for this delivery?

The next set of questions asks specifically about your experiences during labor, delivery and immediate postpartum care (FFQ091-FQ104).

FFQ091. Did the doctors, nurses, or other staff at the facility treat you with respect?

FFQ092. Did the doctors, nurses, and other staff at the facility treat you in a friendly manner?

FFQ093. Did the doctors or nurses explain to you why they were doing examinations or procedures on you?

FFQ094. Did the doctors, nurses or other staff at the facility ask your permission/consent before doing procedures or examinations on you?

FFQ095. Did the doctors or nurses explain to you why they were giving you any medicine?

FFQ096. Did you feel you could ask the doctors, nurses or other staff at the facility any questions you had?

FFQ097. During the delivery, do you feel like you were able to be in the position that you preferred?

FFQ098. Did you feel like the doctors or nurses at the facility involved you in decisions about your care?

FFQ099. When you needed help, did you feel the doctors, nurses or other staff at the facility paid attention?

FFQ100. Did the doctors or nurses at the facility talk to you about how you were feeling?

FFQ101. Did you feel the doctors, nurses or other staff at the facility took the best care of you?

FFQ102. During examinations in the labor room, were you covered up with a cloth or blanket or screened with a curtain so that you did not feel exposed?

FFQ103. Did the doctors, nurses, or other healthcare providers call you by your preferred name?

FFQ104. Were you allowed to have someone you wanted (outside of staff at the facility, such as family or friends) stay with you during labor?

FFQ105. Did anyone check on YOUR health after delivery, while you were still in the facility, other than a family member? For example did someone ask you questions about your health or examine you?

FFQ106. Who checked on your health?

FFQ107. How long after delivery did the first check take place?

Enter duration in ${first_check_post_lab}

Minutes, between 0 to 59
Hours, between 1 to 23
Days, >= 1

FFQ108. Before you left the facility after delivery, did a provider talk with you about using a family planning method?

FFQ109. Before you left the facility after delivery, did you receive a method of family planning or a referral for a method?

FFQ110. What method of family planning did you receive immediately after delivery?

Now we are going to ask you a few questions specific to the baby that was just born.

FFQ111a. Was the cord tied before it was cut?

FFQ111b. What was used to cut the cord?

FFQ112. Was the instrument boiled before cutting the cord?

FFQ113. Was anything applied to the cord after cutting it?

FFQ114. What was applied to the cord after cutting the cord?

Select all that apply.

Cannot select 'no response' or 'Don't know' with other options.

FFQ115. Was there any bleeding after the cord was cut and/or tied?

FFQ116. What did they do for the bleeding cord?

ERROR: Too many groups added.

Remove this group by pressing your finger down on the small circle below and selecting 'remove group' from the menu that appears.

#####

FFQ117. Did ${child_name} cry/breathe normally immediately after birth?

FFQ118. Was anything done to help ${child_name} cry or breathe immediately after birth?

Do not suggest any answers. Ask: Anything else?
Select all that apply.

FFQ119. Who took initiative to resuscitate or to help the baby cry?

FFQ120. Did the baby receive eye ointment following delivery?

FFQ121. Did someone place the baby naked on your chest against your skin, immediately after delivery of the baby?

FFQ122. After delivery, was ${child_name} wrapped with a cloth?

FFQ123. How many minutes after delivery of ${child_name} was he/she wrapped?

Between 0 to 1440
Do not know, -88
No response, -99

FFQ124. When was ${child_name} given a bath for the first time?

FFQ125. How long after birth did you first put ${child_name} to the breast?

Enter a number for Minutes, Hours, or Days on the next screen.

If less than 1 hour, record minutes. If less than 24 hours, record hours; otherwise, record days.
If immediately, record "0" minutes

FFQ126. Number of minutes, hours, or days baby first put to breast

If Immediately, record '0' minutes

Minutes, between 0 to 59
Hours, between 1 to 23
Days, >= 1

FFQ127. Did anyone check on ${child_name}'s health after delivery, while you were still in the facility, other than a family member? For example did someone ask you questions about ${child_name}'s health or examine him/her?

FFQ128. Who checked on ${child_name}'s health?

FFQ129. How long after delivery did the first check take place?

Enter ${how_child_chk_lab}:

FFQ130

FFQ130. Yesterday during the day or night, did ${child_name} receive any of the following?

Breast milk?

Vitamin, mineral supplements or medicine?

Plain water?

Sweetened, flavored water or fruit juice or tea or infusion?

Oral rehydration solution (ORS)?

Infant formula?

Tinned, powered or fresh milk?

Herbal tonic/drinks

Any other liquids?

Anything else?

FFQ131. Has ${child_name} ever received a BCG vaccination against tuberculosis, that is, an injection in the arm or shoulder that usually causes a scar?

FFQ132. Has ${child_name} ever received oral polio vaccine, that is, about two drops in the mouth to prevent polio?

FFQ133. Do you have a card where ${child_name} vaccinations are written down?

If yes: May I see it please?

FFQ134.
(1) Copy date from the card for each vaccine
(2) If any of the date record/s is/are missing or not legible, -88 for the day and month and 2022 for the year for specific missing or illegible records

One vaccine per screen

BCG

Day

Month

Year

BCG Error. The entry for days was invalid. Go back and correct.

Valid range: 1 - 30
You entered: ${vaccine_bcg_day}

BCG Error. The entry for months was invalid. Go back and correct.

Valid range: 1 - 13
You entered: ${vaccine_bcg_month}

BCG Error. The entry for years was invalid. Go back and correct.

Valid range: ${vaccine_year_min_et} - ${vaccine_year_max_et}
You entered: ${vaccine_bcg_year}

Error. Date entered is before date of birth. If an error was indeed made, please go back and correct.

Date of birth: ${recent_birth_et}.
You entered: ${vaccine_bcg_date_et}.

Polio 0

Day

Month

Year

Polio0 Error. The entry for days was invalid. Go back and correct.

Valid range: 1 - 30
You entered: ${vaccine_polio0_day}

Polio0 Error. The entry for months was invalid. Go back and correct.

Valid range: 1 - 13
You entered: ${vaccine_polio0_month}

Polio0 Error. The entry for years was invalid. Go back and correct.

Valid range: ${vaccine_year_min_et} - ${vaccine_year_max_et}
You entered: ${vaccine_polio0_year}

Error. Date entered is before date of birth. If an error was indeed made, please go back and correct.

Date of birth: ${recent_birth_et}.
You entered: ${vaccine_polio0_date_et}.

Polio 1

Day

Month

Year

Polio1 Error. The entry for days was invalid. Go back and correct.

Valid range: 1 - 30
You entered: ${vaccine_polio1_day}

Polio1 Error. The entry for months was invalid. Go back and correct.

Valid range: 1 - 13
You entered: ${vaccine_polio1_month}

Polio1 Error. The entry for years was invalid. Go back and correct.

Valid range: ${vaccine_year_min_et} - ${vaccine_year_max_et}
You entered: ${vaccine_polio1_year}

Error. Date entered is before date of birth. If an error was indeed made, please go back and correct.

Date of birth: ${recent_birth_et}.
You entered: ${vaccine_polio1_date_et}.

Error. Date entered for 2nd polio vaccine was before the 1st polio vaccine. If an error was indeed made, please go back and correct.

1st polio vaccine entered: ${vaccine_polio0_date_et}.
2nd polio vaccine entred: ${vaccine_polio1_date_et}.

FFQ135. What illness, if any, has ${child_name} suffered from since birth?

Select all that apply.

Do not read aloud.

Cannot select 'no response' or 'No illness' with other options.

FFQ136. Where did you seek treatment for Poor feeding or unable to suck?

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ136. Where did you seek treatment for Diarrhea?

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ136. Where did you seek treatment for Pus in the umbilicus?

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ136. Where did you seek treatment for Redness of the umbilicus?

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ136. Where did you seek treatment for Red eye/passage of pus from eyes?

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ136. Where did you seek treatment for Hypothermia (temp 95.5-97.5 F)?

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ136. Where did you seek treatment for Jaundice?

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ136. Where did you seek treatment for Convulsion?

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ136. Where did you seek treatment for Skin rash/skin lesion?

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ136. Where did you seek treatment for Baby doesn't cry/breathe?

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ136. Where did you seek treatment for Fever (temp more than 101 F)?

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ136. Where did you seek treatment for Unconscious?

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ136. Where did you seek treatment for Fast breathing?

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ136. Where did you seek treatment for "Sore throat/Tonsillitis

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ136. Where did you seek treatment for Difficulty in breathing?

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ136. Where did you seek treatment for Chest in drawing?

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ136. Where did you seek treatment for Doesn't pass urine?

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ136. Where did you seek treatment for Doesn't pass stool?

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ136. Where did you seek treatment for Cold/cough?

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ136. Where did you seek treatment for Vomiting?

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ136. Where did you seek treatment for Reduced alertness (lethargy)?

Cannot select 'no response' or 'Nowhere, no treatment sought' with other options.

FFQ137. Has any health extension worker visited you since delivery?

FFQ138. How many days after birth did the health extension worker visit you?

If less than 24 hours, write 0 days
No response: -99; Do not know: -88

Between 0 to days since most recent birth.
Do not know, -88
No response, -99

FFQ139. Did you go visit a health extension worker since delivery, either for yourself or for the baby?

FFQ140. How many days after birth did you go visit the health extension worker?

If less than 24 hours, write 0 days
No response: -99; Do not know: -88

Between 0 to days since most recent birth.
Do not know, -88
No response, -99

FFQ141. Did you go visit another professional healthcare provider other than an HEW since delivery, either for yourself or for the baby?

FFQ142. How many days after birth did you go visit the other professional healthcare provider?

If less than 24 hours, write 0 days
No response: -99; Do not know: -88

Between 0 to days since most recent birth.
Do not know, -88
No response, -99

FFQ143. Whom did you see, not including an HEW? Anyone else?

Select all that apply

Probe to identify each type of person and record all mentioned.

Cannot select 'no response' with other options.

FFQ144. At your visit after delivery (either by a HEW or other professional healthcare provider) did the provider discuss:

A) Family planning?

B) Exclusive breastfeeding?

C) Immunization?

D) Infant feeding?

E) Infant growth?

F) Other infant development issues?

Sometimes a woman can have problems in holding urine and/or feces after delivering a baby. She may feel shy to talk about this problem in public. Now, with your kind permission I would like to ask you some questions regarding this. Your responses to these questions are private and will not be shared with anyone.

FIST01. Do you have problem in controlling urine, that is does your urine leak continuously, even when you are not urinating/ trying to urinate?

FIST02. Do you have problem in controlling feces, that is do you currently experience feces passing through the birth canal that you cannot stop, even when you are not defecating?

FIST03. Currently, does your clothing get wet with your urine during sleep every night?

FIST04. Did this problem (leakage of urine and/or feces) start after you delivered this baby?

FIST05. How many days after the delivery did this problem start?

Based on your answers, you may have a health condition that requires further attention. Health workers at the nearest health post or health center can screen you and provide more information on treatment options.

FFQ145. Are you currently breastfeeding?

FFQ146. Are you using breastfeeding as a family planning method to delay or avoid getting pregnant?

FFQ147. How long do you plan to breastfeed?

Enter the value in ${how_long_brfeed_lab}.

Months, between 0 to 11
Years, between 1 to 6

FFQ148a. You said you are currently pregnant

How many other pregnancies have you had since September 2017?

For each pregnancy in the last two years, add a group
Use New Year as a reference, Max # pregnancies are 4

Between 0 to 4
No response, -99

FFQ148b. How many pregnancies have you had since September 2017?

If the respondent is recently postpartum, i.e. had a birth in the last 8 weeks please record all other pregnancies that she has had in the last two years. Do not include the pregnancy that she has already told you about in FFQ071

Between 0 to 4
No response, -99

Remember to record all other pregnancies (other than the index pregnancy) that the respondent has had in the last 2 years

FFQ149. Thinking back to the previous pregnancy, can you tell me the month and year the pregnancy ended?

Only go back so far as September 2017
149-151 populated by the answer to P148a/b.

Month and Year

Check here if respondent does not know month.

Error. Date entered is not within the eligible period. If an error was indeed made, please go back and correct.

Date should be no earlier than: ${_2yr_ago_et_lab}
You entered: ${preg_end_date_et_lab}

FFQ150a. How many months pregnant were you when the [pregnancy ended/baby was born]?

Between 0 to 10
Do not know, -88
No response, -99

FFQ150b. How did this pregnancy end?

FFQ151. At the time you became pregnant, did you want to become pregnant then, did you want to wait until later, or did you not want to have any / any more children at all?

FFQ152. How many children were in this pregnancy? (eg twin or triplet?)

First Child

FFQ153. What was the outcome of this pregnancy for the first baby born?

FFQ154. Did the baby cry or show any signs of life?

CHECK: The outcome of this pregnancy is live birth. Go back and correct question FFQ153.

FFQ155. What was the name given to the first baby?

Write 'Baby' if no name given

FFQ156. Is ${past_baby_name_1st} a boy or a girl?

FFQ157. Is ${past_baby_name_1st} still alive?

FFQ158. IF DEAD: Exactly how many days old was ${past_baby_name_1st} when (he/she) died?

FFQ158b. Enter the number of ${past_when_died_1st_lab}

Days, between 0 to 11
Weeks, between 1 to 3
Months, >= 1

Second Child

FFQ153. What was the outcome of this pregnancy for the second baby born?

FFQ154. Did the baby cry or show any signs of life?

CHECK: The outcome of this pregnancy is live birth. Go back and correct question FFQ153.

FFQ155. What was the name given to the second baby?

Write 'Baby' if no name given

FFQ156. Is ${past_baby_name_2nd} a boy or a girl?

FFQ157. Is ${past_baby_name_2nd} still alive?

FFQ158. IF DEAD: Exactly how many days old was ${past_baby_name_2nd} when (he/she) died?

FFQ158b. Enter the number of ${past_when_died_2nd_lab}

Days, between 0 to 11
Weeks, between 1 to 3
Months, >= 1

Third Child

FFQ153. What was the outcome of this pregnancy for the third baby born?

FFQ154. Did the baby cry or show any signs of life?

CHECK: The outcome of this pregnancy is live birth. Go back and correct question FFQ153.

FFQ155. What was the name given to the third baby?

Write 'Baby' if no name given

FFQ156. Is ${past_baby_name_3rd} a boy or a girl?

FFQ157. Is ${past_baby_name_3rd} still alive?

FFQ158. IF DEAD: Exactly how many days old was ${past_baby_name_3rd} when (he/she) died?

FFQ158b. Enter the number of ${past_when_died_3rd_lab}

Days, between 0 to 11
Weeks, between 1 to 3
Months, >= 1

FFQ0159. During your pregnancy, did you see a health extension worker for antenatal care?

FFQ160. Where did you see the HEW?

Can select multiple

Cannot select 'no response' with other options.

FFQ161. How many months pregnant were you when you first talked to a health extension worker about your pregnancy?

Do not know: -88
No response: -99

Between 1 to 10

FFQ162. Did you see a professional healthcare provider, other than a HEW, for antenatal care during this pregnancy?

FFQ163. Whom did you see, not including an HEW? Anyone else?

Select all that apply
Probe to identify each type of person and record all mentioned.

Cannot select 'no response' with other options.

FFQ164. How many months pregnant were you when you first received antenatal care from a professional healthcare provider, other than an HEW?

Do not know: -88
No response: -99

Between 1 to 10

FFQ165. Where did you give birth?

Probe to identify the type of facility.

FFQ166. Who assisted with the delivery?

If Respondent says 'No one assisted,' probe to determine whether any adults were present at the delivery. If Respondent says more than one person, ask who was the primary attendant.

FFQ167. Was your delivery by caesarean, that is, did they cut your belly open to take the baby out?

Now think back to your most recent pregnancy (current pregnancy if currently pregnant).

FFQ169. In terms of becoming a mother (first time or again), you feel that your pregnancy happened at the......

Read the response options.

FFQ170a. Just before you became pregnant.......

Read the response options.

FFQ170b. Just before you became pregnant....

Read the response options.

FFQ171. Before you became pregnant....

Read the response options.

FFQ172. When you found out you were pregnant, how did you feel?

Read the response options

FFQ173. When your partner found out you were pregnant, how did he feel?

Read the response options

FFQ174. Before you became pregnant, did you do any of the following in preparation for pregnancy?

Read the response options
Select multiple

Cannot select 'no response' or 'None of the above' with other options.

Now I have some questions about the future

FFQ175a. Would you like to have a/another child or would you prefer not to have any / any more children?

FFQ175b. After the child you are expecting now, would you like to have another child, or would you prefer not to have any more children?

FFQ176a. How long would you like to wait from now before the birth of a/another child?

If you select months or years, you will enter a number for x on the next screen.
Select 'Years' if more than 36 months.
Please check that you correctly entered the value for months/years.

Enter in ${birth_gap_lab}

Months, between 1 to 36
Year, between 0 to 20

FFQ176b. After the birth of the child you are expecting now, how long would you like to wait before the birth of another child?

If you select months or years, you will enter a number for x on the next screen.
Select 'Years' if more than 36 months.
Please check that you correctly entered the value for months/years.

Enter in ${current_birth_gap_lab}

Months, between 0 to 36
Years, between 1 to 20

FFQ177. If you got pregnant now, how would you feel?

Section 4 - Contraception
Now I would like to talk about family planning - the various ways or methods that a couple can use to delay or avoid a pregnancy.

An image will appear on the screen for some methods. If the respondent says that she has not heard of the method or if she hesitates to answer, read the probe aloud and show her the image, if available.

FFQ178a. Have you ever heard of female sterilization?

PROBE: Women can have an operation to avoid having any more children.

FFQ178b. Have you ever heard of male sterilization?

PROBE: Men can have an operation to avoid having any more children.

FFQ178c. Have you ever heard of the contraceptive implant?

PROBE: Women can have one or several small rods placed in their upper arm by a doctor or nurse, which can prevent pregnancy for one or more years

FFQ178d. Have you ever heard of the IUD?

PROBE: Women can have a loop or coil placed inside them by a doctor or a nurse.

FFQ178e. Have you ever heard of injectables?

PROBE: Women can have an injection by a health provider that stops them from becoming pregnant for one or more months.

FFQ178f. Have you ever heard of the (birth control) pill?

PROBE: Women can take a pill every day to avoid becoming pregnant.

FFQ178g. Have you ever heard of emergency contraception?

PROBE: As an emergency measure after unprotected sexual intercourse women can take special pills at any time within five days to prevent pregnancy.

FFQ178h. Have you ever heard of condoms?

PROBE: Men can put a rubber sheath on their penis before sexual intercourse.

FFQ178i. Have you ever heard of female condoms?

PROBE: Women can put a sheath in their vagina before sexual intercourse.

FFQ178j. Have you ever heard of the standard days method or Cycle Beads?

PROBE: A Woman can use a string of colored beads to know the days she can get pregnant. On the days she can get pregnant, she and her partner use a condom or do not have sexual intercourse.

FFQ178k. Have you ever heard of the Lactational Amenorrhea Method or LAM?

FFQ178L. Have you ever heard of the rhythm method?

PROBE: Women can avoid pregnancy by not having sexual intercourse on the days of the month they think they can get pregnant.

FFQ178M. Have you ever heard of the withdrawal method?

PROBE: Men can be careful and pull out before climax.

FFQ178n. Have you ever heard of any other ways or methods that women or men can use to avoid pregnancy?

FFQ179a. Are you or your partner currently doing something or using any method to delay or avoid getting pregnant?

FFQ179b. Which method or methods are you using?

Probe: Anything else?
Select all methods mentioned. Be sure to scroll to bottom to see all choices.

Cannot select 'no response' with other options.

CALCULATE: CURRENT METHOD
THIS WILL NOT APPEAR ON THE SCREEN
ODK will identify the most effective method currently being used by the respondent by selecting the highest method in the choice list

FFQ180. Since what months and years have you been using ${current_recent_method_lab} without stopping?

Calculate backwards from memorable events if needed.

#####

Most Recent Birth: ${recent_birth_et_lab}.

#####

Current Marriage: ${current_marriage_date_et_lab}.

#####

Must be before today.
Respondent must be at least 10 years old.
Select 'Do not know' for month and '2030' for year to indicate 'No Response'.

For RE: Mark start date and all months until now as current use on the visual aid

Month and Year

Check here if respondent does not know month.

WARNING: Date overlaps with current pregnancy

Date entered: ${start_mtd_date_et_lab}.

Current pregnancy start: ${current_preg_start_et_lab}

WARNING: Date overlaps with most recent birth

Date entered: ${start_mtd_date_et_lab}.

Most recent birth: ${recent_birth_start_et_lab} - ${recent_birth_et_lab}

WARNING: Date overlaps with first birth

Date entered: ${start_mtd_date_et_lab}.

First birth: ${first_birth_start_et_lab} - ${first_birth_et_lab}

WARNING: Date overlaps with pregnancy

Date entered: ${start_mtd_date_et_lab}.

Pregnancy: ${rec_preg_start_et_lab1} - ${rec_preg_end_et_lab1}

WARNING: Date overlaps with pregnancy

Date entered: ${start_mtd_date_et_lab}.

Pregnancy: ${rec_preg_start_et_lab2} - ${rec_preg_end_et_lab2}

WARNING: Date overlaps with pregnancy

Date entered: ${start_mtd_date_et_lab}.

Pregnancy: ${rec_preg_start_et_lab3} - ${rec_preg_end_et_lab3}

WARNING: Date overlaps with pregnancy

Date entered: ${start_mtd_date_et_lab}.

Pregnancy: ${rec_preg_start_et_lab4} - ${rec_preg_end_et_lab4}

WARNING: Date overlaps with pregnancy

Date entered: ${start_mtd_date_et_lab}.

Pregnancy: ${rec_preg_start_et_lab5} - ${rec_preg_end_et_lab5}

FFQ181. Did you or your partner use any other methods between September 2017 and when you started using ${current_method_lab_cs}?

Interviewer notes: [Since September 2017; use New Year as a reference]. Probe to see if she has used the same method at a previous time.

CS1. Have you or your partner done anything or used a method to delay or avoid getting pregnant in the last 2 years (since September 2017)?

Interviewer note: [Since September 2017; use New Year as a reference]

Please swipe forward and select 'ADD GROUP' to Start and Stop Dates for this method.

Contraceptive Methods

ERROR: Too many groups added.

Remove this group by pressing your finger down on the small circle below and selecting 'remove group' from the menu that appears.

#####

CS2. Which method did you use just before ${current_method_lab_cs}?

Do not include the current method of use. Only select the current method if the woman used it continuously, stopped and restarted during the two year period.

CS2. Which method did you use?

Do not include the current method of use. Only select the current method if the woman used it continuously, stopped and restarted during the two year period.

#####

FFQ182. When did you stop using your ${cs2_method_lab}?

If respondent knows the year, but not month select the 'Does not know month' checkbox. Select the 'Do not know' checkbox for month and '2030' for year to indicate 'No Response'

Month and Year

Check here if respondent does not know month.

WARNING: Date overlaps with current method

Date entered: ${when_stop_date_et_lab}.

Current method start: ${start_mtd_date_et_lab}

WARNING: Date overlaps with current pregnancy

Date entered: ${when_stop_date_et_lab}.

Current pregnancy start: ${current_preg_start_et_lab}

WARNING: Date overlaps with most recent birth

Date entered: ${when_stop_date_et_lab}.

Most recent birth: ${recent_birth_start_et_lab} - ${recent_birth_et_lab}

WARNING: Date overlaps with first birth

Date entered: ${when_stop_date_et_lab}.

First birth: ${first_birth_start_et_lab} - ${first_birth_et_lab}

WARNING: Date overlaps with pregnancy

Date entered: ${when_stop_date_et_lab}.

Pregnancy: ${rec_preg_start_et_lab1} - ${rec_preg_end_et_lab1}

WARNING: Date overlaps with pregnancy

Date entered: ${when_stop_date_et_lab}.

Pregnancy: ${rec_preg_start_et_lab2} - ${rec_preg_end_et_lab2}

WARNING: Date overlaps with pregnancy

Date entered: ${when_stop_date_et_lab}.

Pregnancy: ${rec_preg_start_et_lab3} - ${rec_preg_end_et_lab3}

WARNING: Date overlaps with pregnancy

Date entered: ${when_stop_date_et_lab}.

Pregnancy: ${rec_preg_start_et_lab4} - ${rec_preg_end_et_lab4}

WARNING: Date overlaps with pregnancy

Date entered: ${when_stop_date_et_lab}.

Pregnancy: ${rec_preg_start_et_lab5} - ${rec_preg_end_et_lab5}

FFQ183. When did you start using ${cs2_method_lab}?

Please indicate the year and month you started using it.

Calculate backwards from memorable events if needed.

#####

Most Recent Birth: ${recent_birth_et_lab}.

#####

Current Marriage: ${current_marriage_date_et_lab}.

#####

If respondent knows the year, but not month select the 'Does not know month' checkbox. Select the 'Do not know' checkbox for month and '2030' for year to indicate 'No Response'.

Month and Year

Check here if respondent does not know month.

ERROR: Date entered for 'start using' was after the date for 'stop using'. If this is indeed an error, please go back and correct.

Ethiopian Dates
Start date entered: ${when_start_date_et_lab}.
Stop date entered: ${when_stop_date_et_lab}.

Gregorian Dates
Start date entered: ${when_start_date_et_lab}.
Stop date entered: ${when_stop_date_et_lab}.

WARNING: Date overlaps with current method

Date entered: ${when_start_date_et_lab}.

Current method start: ${start_mtd_date_et_lab}

WARNING: Date overlaps with current pregnancy

Date entered: ${when_start_date_et_lab}.

Current pregnancy start: ${current_preg_start_et_lab}

WARNING: Date overlaps with most recent birth

Date entered: ${when_start_date_et_lab}.

Most recent birth: ${recent_birth_start_et_lab} - ${recent_birth_et_lab}

WARNING: Date overlaps with first birth

Date entered: ${when_start_date_et_lab}.

First birth: ${first_birth_start_et_lab} - ${first_birth_et_lab}

WARNING: Date overlaps with pregnancy

Date entered: ${when_start_date_et_lab}.

Pregnancy: ${rec_preg_start_et_lab1} - ${rec_preg_end_et_lab1}

WARNING: Date overlaps with pregnancy

Date entered: ${when_start_date_et_lab}.

Pregnancy: ${rec_preg_start_et_lab2} - ${rec_preg_end_et_lab2}

WARNING: Date overlaps with pregnancy

Date entered: ${when_start_date_et_lab}.

Pregnancy: ${rec_preg_start_et_lab3} - ${rec_preg_end_et_lab3}

WARNING: Date overlaps with pregnancy

Date entered: ${when_start_date_et_lab}.

Pregnancy: ${rec_preg_start_et_lab4} - ${rec_preg_end_et_lab4}

WARNING: Date overlaps with pregnancy

Date entered: ${when_start_date_et_lab}.

Pregnancy: ${rec_preg_start_et_lab5} - ${rec_preg_end_et_lab5}

FFQ184. You said you did not know when you started using ${cs2_method_lab}.

Can you remember about how long you used ${cs2_method_lab} for?

Number of months:

More than 1

FFQ185. Before ${cs2_method_lab}, did you or your partner use anything else to delay or avoid getting pregnant since September 2017?

ODK will keep repeating these questions until the start and stop dates for a given method are both before September 2017 OR until response is 'NONE'

There are other method used. Move forward and select "Add Group"

There are no other method used. Move forward and select "Do Not Add"

If there are any more methods to add, move forward and select "Add Group". Otherwise, select "Do not Add.

Warning: The respondent indicated that she or her partner did something or used a method to delay or avoid getting pregnant in the last 2 years (since September 2017). But you did not add a "Contraceptive Methods" group. Please go back to CS1 and check your response.

SUMMARY

Please review with the respondent that all information is correct.

Current pregnancy start: ${current_preg_start_et_lab}

Most recent birth: ${recent_birth_start_et_lab} - ${recent_birth_et_lab}

Pregnancy: ${rec_preg_start_et_lab1} - ${rec_preg_end_et_lab1}

Pregnancy: ${rec_preg_start_et_lab2} - ${rec_preg_end_et_lab2}

Pregnancy: ${rec_preg_start_et_lab3} - ${rec_preg_end_et_lab3}

Pregnancy: ${rec_preg_start_et_lab4} - ${rec_preg_end_et_lab4}

Pregnancy: ${rec_preg_start_et_lab5} - ${rec_preg_end_et_lab5}

First birth: ${first_birth_start_et_lab} - ${first_birth_et_lab}

No previous births

Current method: ${current_method_lab_cs}.
Start date: ${start_mtd_date_et_lab}.

${full_summary_et}

Method 1: ${cs_summary_mtd_name1}.
Start Date: ${cs_summary_mtd_start1}.
Stop Date: ${cs_summary_mtd_stop1}.

Method 2: ${cs_summary_mtd_name2}.
Start Date: ${cs_summary_mtd_start2}.
Stop Date: ${cs_summary_mtd_stop2}.

Method 3: ${cs_summary_mtd_name3}.
Start Date: ${cs_summary_mtd_start3}.
Stop Date: ${cs_summary_mtd_stop3}.

Method 4: ${cs_summary_mtd_name4}.
Start Date: ${cs_summary_mtd_start4}.
Stop Date: ${cs_summary_mtd_stop4}.

Method 5: ${cs_summary_mtd_name5}.
Start Date: ${cs_summary_mtd_start5}.
Stop Date: ${cs_summary_mtd_stop5}.

No current or past method use

CURRENT/RECENT USERS:
I will ask you a few more questions on the method that you are currently using or the method you used most recently.

FFQ186. Did the provider tell you or your partner that this method was permanent?

FFQ187. You first started using ${current_recent_method_lab} in ${start_mtd_date_et_lab}. Where did you or your partner get it at that time?

Scroll to bottom to see all choices.

Cannot select 'no response' or 'Do not know' with other options.

FFQ188. When you obtained your ${current_recent_method_lab}, did the provider ask you about your prior experience with contraception?

FFQ189. When you obtained your ${current_recent_method_lab}, did you obtain the method you wanted to use to delay or avoid getting pregnant?

FFQ190. Why did you choose the implant?

Select multiple

Cannot select 'no response' with other options.

FFQ191. At the visit when the implant was inserted, were you told for how long the implant would protect you from pregnancy?

FFQ192. Were you told where you could go to have the implant removed?

FFQ193. Were you told how much it would cost to get your implant removed?

FFQ194. When you obtained your ${current_recent_method_lab}, were you told by the provider about side effects or problems you might have with a method to delay or avoid pregnancy?

FFQ195. According to the provider what are the possible side effects or problems related to use of ${current_recent_method_lab}?

Cannot select 'no response', 'Do not know' with other options.

FFQ196. Were you told what to do if you experienced these side effects or problems?

FFQ197. At that time, were you told by a family planning provider about methods of family planning other than ${current_recent_method_lab} that you could use?

FFQ198. What methods were you told about?

Select multiple

Cannot select 'no response' with other options.

FFQ199. At that time, were you told that you could switch to a different method in the future?

FFQ200. During that visit, who made the final decision about what method you got?

FFQ201. Would you return to this provider?
Provider: ${recent_mth_source_en}

FFQ202. Would you refer your relative or friend to this provider / facility?

Provider: ${recent_mth_source_en}

FFQ203. Are you/did you experience any of the following changes in your menstrual cycle due to ${current_recent_method_lab}?

Read all options out loud. Select all that apply.

Cannot select 'No change' or 'Do not know' or 'no response' with other options.

FFQ204. How worried are/were you about these changes?

FFQ205. Are you experiencing any side effects?

FFQ205. Did you experience any side effects?

FFQ206. What are the side effects you are currently experiencing?

Do not read option choices aloud

Cannot select 'no response' or 'do not know' with other options.

FFQ206. What were the side effects that you EXPERIENCED while using the method?

Do not read option choices aloud

Cannot select 'no response' or 'do not know' with other options.

FFQ207. Are there any side effects that you are WORRIED ABOUT EXPERIENCING while using this method, but are not actually experiencing?

FFQ207. Were there any side effects that you WERE WORRIED ABOUT EXPERIENCING while using this method, but did not actually experience?

FFQ208. What are the side effects that you ARE WORRIED ABOUT EXPERIENCING while using this method, but are not actually experiencing?

Do not read option choices aloud

Cannot select 'no response' with other options.

FFQ208. What were the side effects that you WERE WORRIED ABOUT EXPERIENCING while using this method, but did not actually experience?

Do not read option choices aloud

Cannot select 'no response' with other options.

FFQ209. The last time you received your ${current_recent_method_lab}, did you have to pay out of pocket for:

A. Medical Card?

B. Supplies (like gloves or syringes)

C. The method itself?

D. Transportation?

FFQ210. Do you want to have your implant removed?

FFQ211a. In the past 12 months, did you try to have your current implant removed?

FFQ211b. Where did you go to try to have your implant removed?

FFQ211c. Who tried to remove the implant?

FFQ212. Why were you not able to have your implant removed?

Select all that apply

FFQ213. When you stopped using the implant, where did you go to have your implant removed?

Scroll to bottom to see all choices.

FFQ214. Who removed the implant?

Now I would like to ask you some questions about why you stopped using your recent family planning methods. We still start with the one that you used most recently.

RE: Use visual aid to show different methods and dates. Start with the most recently used method and work backwards.
FFQ215 is repeated for all previous methods listed in CS2

ERROR: Too many groups added.

Remove this group by pressing your finger down on the small circle below and selecting 'remove group' from the menu that appears.

#####

FFQ215. Did you stop using ${cs2_method_name} because of any of the following reasons?

RECORD ALL REASONS MENTIONED.
Cannot select 'Do Not Know' or 'No response' with other options.

Cannot select 'no response' or 'Do not know' with other options.

RE: For contraceptive use history, this method (number ${MSR_pos} entered) was marked as 'No response'. Therefore FFQ215 will be skipped for this method.

Please proceed to the next screen.

CURRENT NON-USERS

FFQ217. Have you ever done anything or tried in any way to delay or avoid getting pregnant?

FFQ218. You said that you do not want any / anymore children and that you are not using a method to avoid pregnancy.
Can you tell me the reason why you are not using a method to prevent pregnancy?

PROBE: Any other reason?
RECORD ALL REASONS MENTIONED.
Cannot select 'Do Not Know' or 'No response' with other options.
Cannot select 'Not married' if 104 is 'Yes, currently married'.
Scroll to the bottom to see all choices.

Cannot select 'no response' with other options.

FFQ219. Would you say that NOT using contraception is mainly your decision, mainly your husband/partner's decision or do you both decide together?

FFQ220. Do you think you will use a contraceptive method to delay or avoid getting pregnant in the future?

FFQ221. When do you think you will start using a method?

Enter in ${when_willuse_lab}

Enter the age in ${when_willuse_lab}.

Months, between 0 to 11
Years, between 1 to 15

All women in the cross-section

FFQ222. How old were you when you first used a method to delay or avoid getting pregnant?
The respondent said she was ${age} years old at her last birthday.

Enter the age in years.
Enter -88 if respondent does not know.
Enter -99 if there is no response.

Between 9 and respondent's age.
Do not know, -88
No response, -99

FFQ223. How many living children did you have at that time, if any?

Note: the respondent said that she gave birth ${total_births} times in FFQ019.

Enter -99 for no response

Between 0 and total number of live births.

FFQ224. Have you used emergency contraception at any time in the last 12 months?

PROBE: As an emergency measure after unprotected sexual intercourse women can take special pills at any time within three to five days to prevent pregnancy.

FFQ225. In the last 12 months, were you visited by a health extension worker who talked to you about family planning?

FFQ226. In the last 12 months, have you attended a group family planning counseling session with a provider?

FFQ227. In the last 12 months, have you visited a health facility for care for yourself or your children?

For any health services

FFQ228. Did any staff member at the health facility speak to you about family planning methods?

FFQ229. In the last few months have you:

A. Heard about family planning on the radio?

B. Seen anything about family planning on the television?

C. Read about family planning in a newspaper or magazine?

D. Received text message about family planning on a mobile phone

E. Seen anything on social media about family planning (Facebook, Viber, Twitter, WhatsApp etc)

FFQ230. Do you know if there is a law on abortion in Ethiopia?

FFQ231. Under which circumstances it is legal to have an abortion in Ethiopia?

Read out the responses

Cannot select 'no response' or 'Don't know' with other options.

FFQ232. Do you know where a woman can access facility-based abortion services in the community where you live?

Section 4 - Contraception
Now I would like to talk about family planning - the various ways or methods that a couple can use to delay or avoid a pregnancy.

FFQ235. Are you currently using a method of family planning?

FFQ236. Which method or methods are you using?

Probe: Anything else?
Select all methods mentioned. Be sure to scroll to bottom to see all choices.

Cannot select 'no response' with other options.

FFQ237. When did you start using ${current_method_lab_pn}?

Enter ${when_start_method_lab}

Days, between 0 to 6
Weeks, >= 1

WARNING: Date overlaps with current pregnancy

Date entered: ${when_start_mtd_et_lab}.

Current pregnancy start: ${current_preg_start_et_lab}

WARNING: Date overlaps with most recent birth

Date entered: ${when_start_mtd_et_lab}.

Most recent birth: ${recent_birth_start_et_lab} - ${recent_birth_et_lab}

WARNING: Date overlaps with first birth

Date entered: ${when_start_mtd_et_lab}.

First birth: ${first_birth_start_et_lab} - ${first_birth_et_lab}

WARNING: Date overlaps with pregnancy

Date entered: ${when_start_mtd_et_lab}.

Pregnancy: ${rec_preg_start_et_lab1} - ${rec_preg_end_et_lab1}

WARNING: Date overlaps with pregnancy

Date entered: ${when_start_mtd_et_lab}.

Pregnancy: ${rec_preg_start_et_lab2} - ${rec_preg_end_et_lab2}

WARNING: Date overlaps with pregnancy

Date entered: ${when_start_mtd_et_lab}.

Pregnancy: ${rec_preg_start_et_lab3} - ${rec_preg_end_et_lab3}

WARNING: Date overlaps with pregnancy

Date entered: ${when_start_mtd_et_lab}.

Pregnancy: ${rec_preg_start_et_lab4} - ${rec_preg_end_et_lab4}

WARNING: Date overlaps with pregnancy

Date entered: ${when_start_mtd_et_lab}.

Pregnancy: ${rec_preg_start_et_lab5} - ${rec_preg_end_et_lab5}

FFQ238. Before you were pregnant, did you or your partner do anything or use a method to delay or avoid getting pregnant in the last 2 years (since September 2017)?

Interviewer note: [Since September 2017; use New Year as a reference]

Please swipe forward and select 'ADD GROUP' to Start and Stop Dates for this method.

Contraceptive Methods

ERROR: Too many groups added.

Remove this group by pressing your finger down on the small circle below and selecting 'remove group' from the menu that appears.

#####

FFQ239. Which method did you use?

If you were using more than one method at the same time, please let us know all of the methods you used.
Scroll to bottom to see all choices.

FFQ240. When did you stop using your ${non_method_name}?

Please record the date. Must be before today. The date should be found by calculating backwards from memorable events. If respondent knows the year, but not month select the 'Does not know month' checkbox. Select the 'Do not know' checkbox for month and '2030' for year to indicate 'No Response'.

Month and Year

Check here if respondent does not know month.

WARNING: Date overlaps with current method

Date entered: ${non_when_stop_et_lab}.

Current method start: ${when_start_mtd_et_lab}

WARNING: Date overlaps with current pregnancy

Date entered: ${non_when_stop_et_lab}.

Current pregnancy start: ${current_preg_start_et_lab}

WARNING: Date overlaps with most recent birth

Date entered: ${non_when_stop_et_lab}.

Most recent birth: ${recent_birth_start_et_lab} - ${recent_birth_et_lab}

WARNING: Date overlaps with first birth

Date entered: ${non_when_stop_et_lab}.

First birth: ${first_birth_start_et_lab} - ${first_birth_et_lab}

WARNING: Date overlaps with pregnancy

Date entered: ${non_when_stop_et_lab}.

Pregnancy: ${rec_preg_start_et_lab1} - ${rec_preg_end_et_lab1}

WARNING: Date overlaps with pregnancy

Date entered: ${non_when_stop_et_lab}.

Pregnancy: ${rec_preg_start_et_lab2} - ${rec_preg_end_et_lab2}

WARNING: Date overlaps with pregnancy

Date entered: ${non_when_stop_et_lab}.

Pregnancy: ${rec_preg_start_et_lab3} - ${rec_preg_end_et_lab3}

WARNING: Date overlaps with pregnancy

Date entered: ${non_when_stop_et_lab}.

Pregnancy: ${rec_preg_start_et_lab4} - ${rec_preg_end_et_lab4}

WARNING: Date overlaps with pregnancy

Date entered: ${non_when_stop_et_lab}.

Pregnancy: ${rec_preg_start_et_lab5} - ${rec_preg_end_et_lab5}

FFQ241. When did you start using ${non_method_name}?

Please indicate the year and month you started using it.

Calculate backwards from memorable events if needed.

Most Recent Birth: ${recent_birth_et_lab}.
Current Marriage: ${current_marriage_date_lab}.

If respondent knows the year, but not month select the 'Does not know month' checkbox. Select the 'Do not know' checkbox for month and '2030' for year to indicate 'No Response'.

Month and Year

Check here if respondent does not know month.

ERROR: Date entered for 'start using' was after the date for 'stop using'. If this is indeed an error, please go back and correct.

Ethiopian Dates
Start date entered: ${non_when_start_et_lab}.
Stop date entered: ${non_when_stop_et_lab}.

Gregorian Dates
Start date entered: ${non_when_start_et_lab}.
Stop date entered: ${non_when_stop_et_lab}.

WARNING: Date overlaps with current method

Date entered: ${non_when_start_et_lab}.

Current method start: ${start_mtd_date_et_lab}

WARNING: Date overlaps with current pregnancy

Date entered: ${non_when_start_et_lab}.

Current pregnancy start: ${current_preg_start_et_lab}

WARNING: Date overlaps with most recent birth

Date entered: ${non_when_start_et_lab}.

Most recent birth: ${recent_birth_start_et_lab} - ${recent_birth_et_lab}

WARNING: Date overlaps with first birth

Date entered: ${non_when_start_et_lab}.

First birth: ${first_birth_start_et_lab} - ${first_birth_et_lab}

WARNING: Date overlaps with pregnancy

Date entered: ${non_when_start_et_lab}.

Pregnancy: ${rec_preg_start_et_lab1} - ${rec_preg_end_et_lab1}

WARNING: Date overlaps with pregnancy

Date entered: ${non_when_start_et_lab}.

Pregnancy: ${rec_preg_start_et_lab2} - ${rec_preg_end_et_lab2}

WARNING: Date overlaps with pregnancy

Date entered: ${non_when_start_et_lab}.

Pregnancy: ${rec_preg_start_et_lab3} - ${rec_preg_end_et_lab3}

WARNING: Date overlaps with pregnancy

Date entered: ${non_when_start_et_lab}.

Pregnancy: ${rec_preg_start_et_lab4} - ${rec_preg_end_et_lab4}

WARNING: Date overlaps with pregnancy

Date entered: ${non_when_start_et_lab}.

Pregnancy: ${rec_preg_start_et_lab5} - ${rec_preg_end_et_lab5}

FFQ242. You said you did not know when you started using ${non_method_name}.

Can you remember about how long you used ${non_method_name} for?

Number of months

More than 0

FFQ243a. Before ${non_method_name}, did you or your partner use anything else to delay or avoid getting pregnant since September 2017?

FFQ243b. Did you stop using ${non_method_name} because of any of the following reasons?

There are other method used. Move forward and select "Add Group"

There are no other method used. Move forward and select "Do Not Add"

If there are any more methods to add, move forward and select "Add Group". Otherwise, select "Do not Add.

Warning: The respondent indicated that she or her partner did something or used a method to delay or avoid getting pregnant in the last 2 years (since September 2017). But you did not add a Contraceptive Methods" group. Please go back to FFQ238 and check your response."

SUMMARY

Please review with the respondent that all information is correct.

Current pregnancy start: ${current_preg_start_et_lab}

Most recent birth: ${recent_birth_start_et_lab} - ${recent_birth_et_lab}

Pregnancy: ${rec_preg_start_et_lab1} - ${rec_preg_end_et_lab1}

Pregnancy: ${rec_preg_start_et_lab2} - ${rec_preg_end_et_lab2}

Pregnancy: ${rec_preg_start_et_lab3} - ${rec_preg_end_et_lab3}

Pregnancy: ${rec_preg_start_et_lab4} - ${rec_preg_end_et_lab4}

Pregnancy: ${rec_preg_start_et_lab5} - ${rec_preg_end_et_lab5}

First birth: ${first_birth_start_et_lab} - ${first_birth_et_lab}

No previous births

Current method: ${current_method_lab_pn}.
Start date: ${when_start_method_val} ${when_start_method_units_lab} ago

${pn_full_summary_et}

Method 1: ${pn_summary_mtd_name1}.
Start Date: ${pn_summary_mtd_start1}.
Stop Date: ${pn_summary_mtd_stop1}.

Method 2: ${pn_summary_mtd_name2}.
Start Date: ${pn_summary_mtd_start2}.
Stop Date: ${pn_summary_mtd_stop2}.

Method 3: ${pn_summary_mtd_name3}.
Start Date: ${pn_summary_mtd_start3}.
Stop Date: ${pn_summary_mtd_stop3}.

Method 4: ${pn_summary_mtd_name4}.
Start Date: ${pn_summary_mtd_start4}.
Stop Date: ${pn_summary_mtd_stop4}.

Method 5: ${pn_summary_mtd_name5}.
Start Date: ${pn_summary_mtd_start5}.
Stop Date: ${pn_summary_mtd_stop5}.

No current or past method use

FFQ244a. In the month that you became pregnant......

Read the response options

FFQ244b. Have you ever done something or used a method to delay or avoid getting pregnant?

FFQ245. Do you plan to use a contraceptive method to delay or avoid getting pregnant in the next year?

FFQ246. During your postpartum care, did you feel pressured to use a method?

FFQ247. Who did you feel pressured by?

READ ALL OPTIONS, SELECT ALL THAT APPLY

FFQ248. During your postpartum care, did any of the health service providers force you to accept or insisted that you should accept to use a SPECIFIC method?

FFQ249. Which method did you feel pressured to use?

Select all that apply

Section 5 - Partner

Now I would like to ask you some questions about your husband/partner.

FFQ250. Before you started using ${current_recent_method_lab}, had you discussed the decision to delay or avoid pregnancy with your husband/partner?

FFQ251. How does your husband/partner feel about family planning?

FFQ252. Does/did your husband/partner know that you are/were using ${current_recent_method_lab}?

FFQ253. Did you talk with your partner about using your ${current_recent_method_lab} before you started using, after you started using, or you have not talked about it?

FFQ254. Why have you not discussed your family planning use with your husband/partner?

Select all that apply - do not read options aloud

FFQ255. In the past 12 months, has your husband/partner:

A.Told you not to use any family planning

B. Said he would leave you if you didn't get pregnant

C. Told you he would have a baby with someone else if you didn't get pregnant

D. Took away your family planning or kept you from going to the clinic to get family planning

E. Hurt you physically because you did not agree to get pregnant

Section 6 - Empowerment/Norms

Now I'm going to ask you a series of statements about family planning. For each, please tell me how strongly you agree or disagree with the statement. Some will seem similar but we would like you to consider each one as different.

We can pause at any time. If you do not feel comfortable answering any of the statements, let me know and I will move onto the next statement.

FFQ256. If I use family planning, my husband/partner may seek another sexual partner.

FFQ257. If I use family planning, I may have trouble getting pregnant the next time I want to.

FFQ258. There could be/will be conflict in my relationship/marriage if I use family planning.

FFQ259. If I use family planning, my children may not be born normal.

FFQ260. If I use family planning, my body may experience side effects that will disrupt my relations with my husband/partner.

FFQ261. It is acceptable for a woman to use family planning before she has children

FFQ262. Women who use family planning are considered promiscuous

FFQ263. Couples who use family planning are financially responsible

FFQ264. Women should be the ones to decide about family planning

Now I'm going to ask you a series of statements about pregnancy and childbearing. For each, please tell me how strongly you agree or disagree with the statement. Some will seem similar but we would like you to consider each one as different.

We can pause at any time. If you do not feel comfortable answering any of the statements, let me know and I will move onto the next statement.

FFQ265. I could not delay having children or else I would have been considered infertile

FFQ266. I would have felt pressured if it took a long time for me to get pregnant after marriage

FFQ267. I will have no one to take care of me when I am old if I do not produce enough children

FFQ268. I wanted to complete my education before I have/had a child

FFQ269. If I rest between pregnancies, I can take better care of my family

Now, I'd like to ask a few questions about your community.

FFQ270. Do most, some, few, or no people in your community encourage women to deliver at a facility?

FFQ271. Do most, some, few, or no people in your community think it is acceptable to deliver with a traditional birth attendant?

FFQ272. Do most, some, few, or no people in your community encourage going to antenatal care?

FFQ273. Do most, some, few, or no people in your community encourage women to seek postnatal care?

Section 7. Sexual Activity
Now I'm going to ask you a few sensitive questions about sexual activity. You do not have to answer these questions if you do not want to. We can pause at any time. If you do not feel comfortable answering any of the questions, let me know and I will either move onto the next statement or skip this section entirely.

CHECK FOR THE PRESENCE OF OTHERS. BEFORE CONTINUING, MAKE EVERY EFFORT TO ENSURE PRIVACY.

FFQ277. You stated that you were not currently married or living with a man, but are you currently in a relationship?

FFQ278. How long have you been in a relationship with your current partner?

Enter in ${inreship_duration_lab}

FFQ279a. How old were you when you first had sexual intercourse?

The respondent said she was ${age} years old at her last birthday.
She has had ${total_births} live births.
Enter the age in years.
Enter -77 if she never had sex.
Enter -88 if respondent does not know.
Enter -99 for no response.

Between 1 and respondent's age.
Never, -77
Do not know, -88
No response, -99

FFQ279b. You have entered that the respondent was ${first_intercourse_age} years old when she first had sexual intercourse. Is this what she said?

Go back and correct FFQ279a if it is not correct.

FFQ280. Have you resumed sexual activity since the birth of your most recent child?

FFQ281. When was the last time you had sexual intercourse?

If less than 12 months ago, answer must be recorded in months, weeks, or days.
Enter 0 days for today.
You will enter a number for X on the next screen.
Enter -99 for no response

Enter in ${last_intercourse_lab}

Days, between 0 to 6
Weeks, between 1 to 3
Months, between 1 to 11
Years, between 1 and respondent's age.

FFQ282. Sometimes conflict can occur in relationships. At any time during your pregnancy, did your husband/partner do any of the following things to you:

A. Push you, shake you, or throw something at you?

B. Slap you?

C. Twist your arm or pull your hair?

D. Punch you with his fist or with something that could hurt you?

E. Kick you, drag you, or beat you up?

F. Try to choke you or burn you on purpose?

G. Threaten or attack you with a knife, gun, or other weapon?

H. Physically force you to have sexual intercourse with him when you did not want to?

I. Physically force you to perform any other sexual acts you did not want to?

J. Used threats or pressure to make you have sex when you didn't want to, but did not use physical force?

We understand that this interview may have raised some difficult issues. How are you feeling after we've asked these questions? Would you like to speak with a trained care provider further? We can connect you to the local health center for follow-up care.

END OF SURVEY
Thank the respondent for her time

The respondent is finished, but there are still 3 more questions for you to complete outside the home

END OF SURVEY
Thank the respondent for her time and update the ID card

Before you leave, update the ID card with the respondent's name, baby's name (if given), the outcome of the birth (live birth, still birth, miscarriage), whether there were multiple births, and whether the baby is still alive.

FOLLOW UP INTERVIEW DATES

Check dates within ODK and update the woman

FU6W. Date of six-weeks interview

If pregnant: Enter no more than 3 months past estimated due date ${estimated_delivery_date_et}.
If less than 5 weeks postpartum: Enter no more than 8 weeks from now ${birth_plus_6w_max_et}.
Enter Jan 1, 2030 if no date scheduled for upcoming interview.

If pregnant: No more than 3 months past estimated due date
If less than 5 weeks postpartum: No more than 8 weeks from now

FU6Wb. Did the respondent refuse future follow-up?

FU6M. Date of six-month interview

The 6-month follow-up should occur 2 weeks before or 2 weeks after ${birth_plus_6m_et}.
Enter Jan 1, 2030 if woman refuses to schedule upcoming interview.

Should be around 6 months past date of most recent birth, + or - 14 days.

FU6Mb. Did the respondent refuse future follow-up?

FU1Y. Date of one-year interview

The 1-Year follow-up should occur 2 weeks before or 2 weeks after ${birth_plus_1y_et}.
Enter Jan 1, 2030 if woman refuses to schedule upcoming interview.

Should be around 1 year past date of most recent birth, + or - 14 days.

Q. Did the interview take place at the respondent's home or her family home?

R. Do you intend to move to your parent's or relative's home right before or after delivery of this pregnancy?

S. Do you intend to remain in your family's house for one year post-partum?

T. Do they live in the same kebele to your home?

U. Location

Take a GPS point near the entrance to the household. Record location when the accuracy is smaller than 6m.
GPS coordinates can only be collected when outside.

V. Did you have to step away from the respondent's home to take the GPS reading?

QUESTIONNAIRE RESULT

W. How many times have you visited this household to interview this female respondent?

X. What language was this interview conducted in?

Y. Was a translator used for this interview?

Z. Questionnaire result

Record the result of the Female Questionnaire

Check answers to H, and the consent (K).