IDENTIFICATION

A. Are you in the correct household?

EA - {EA}

Structure number - {structure}

Household number - {household}

C. Your name

Is this your name ?

D. Enter your name below.

Please record your name

E. Current date

E. Current time

Is this date and time correct?

F. Record the correct date and time

The date must be between 2021-10-01 and 2022-09-10..

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

Region

Zone

Is the above information correct?

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

If misspelled, select "yes" here and update the name in question "011." 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?

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 {re_name} 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 50 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, Solomon Shiferaw or Assefa Seme. For any ethical issues, please call Dr. Adamu Addise, the IRB chairperson 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?

N. May I begin the interview now?

O. Interviewer?s name: {re_name}

Mark your name as a witness to the consent process.

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?.

Does not know month

FFQ002. How old were you at your last birthday?

Age must be more than 14 and less than 50 and 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?.

Date cannot be in the future and before the respondent?s date of birth.

Does not know month

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?

Date cannot be in the future and before the respondent?s date of birth. Date cannot be before FFQ004a.

Does not know month

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

FFQ006a. What is the highest level of school your husband/partner attended?

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

FFQ006b. How old is your husband/partner?
Age(years)

If respondent is unsure, she can estimate his age. Do not know -88. No response -99.

Age cannot be less than 10 and cannot be more than 120.

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 ? 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?

Enter -99 for no response.

FFQ020. When was your FIRST birth?

Please record the date of the first live birth. Date should be found by calculating forward or backward from memorable events if needed.
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?

Date cannot be in the future.

Do 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?.
Note to RE: use visual aid to record dates of most recent birth

Date cannot be in the future and date of recent birth has to be same as or after first birth date.

Do not know month

FFQ025. Are you pregnant now?

FFQ029a. How many months pregnant are you?
The most recent birth was: {recent_birth_date_lab}

Please record the number of completed months. Do not know -88. No response -99.

Number of months cannot be lesser than 0 and more than 10.

FFQ026. When did your last menstrual period start?

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 the number of {last_period_lab}

Enter 0 days for today.

For days value must be greater than or equal to 0 and less than or equal to 6. For weeks value must be greater than 0 and less than 52. For months value must be greater than 0 and less than 12. For years value must be greater than 0 and less than 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 postpartum respondent that we are asking about her most recent pregnancy; or if currently pregnant respondent about the current pregnancy

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

Read the response options. Remind the postpartum respondent that we are asking about her most recent pregnancy, or if currently pregnant respondent about the current pregnancy.

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

Read the response options. Remind the postpartum respondent that we are asking about her most recent pregnancy, or if currently pregnant respondent about the current pregnancy.

FFQ22A. Is the respondent a usual household member or staying at her parental home temporarily?

FFQ022. Is the respondent enrolled in the panel study?

FFQ022b. 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 Panel consent script:
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 50 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 Drs. Solomon or Assefa Seme. For any ethical issues, please call Dr. Adamu Addise, the IRB chairperson at the Addis Ababa University, College of Health Sciences.

FFQ022c. Did she agree to enroll in the panel survey?

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

FFQ032. Where would you like to deliver your baby?

FFQ033.Who would you like to 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?

Select multiple

You cannot selected 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?

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?

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?

Do not know -88. No response -99.

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.

You cannot selected 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?

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?

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?

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

You cannot selected no response and nowhere, no treatment soughtwith other options.

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

This includes any ANC from any provider

Was your blood pressure measured?

Was your weight taken?

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

Did you give a blood sample?

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

Tested for syphilis?

Did you receive the results of your test?

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

Tested for HIV?

Did you receive the results of your test?

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

You cannot selected no response and not sure with other options.

FFQ048. Are you planning to breastfeed?

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

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 number of {when_start_fpm_lab}

If weeks or months

Number of weeks cannot be more than 52. Number of months cannot be more than 12.

FFQ054. What method do you plan to use?

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?

Do not know -88. No response -99.

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 taken 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:

Severe headache with blurred vision?
High blood pressure?
Edema (swelling) face/feet/body?
Convulsion/fits?
Vaginal bleeding before delivery?
High fever?
Abnormal vaginal discharge (foul smelling/dark)?
Lower abdominal pain?
Worsening vision, particularly at night?

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

Severe headache with blurred vision?
High blood pressure?
Edema (swelling) face/feet/body?
Convulsion/fits?
Vaginal bleeding before delivery?
High fever?
Abnormal vaginal discharge (foul smelling/dark)?
Lower abdominal pain?
Worsening vision, particularly at night?

FFQ060. Did you seek treatment at a health facility for:

Severe headache with blurred vision?
High blood pressure?
Edema (swelling) face/feet/body?
Convulsion/fits?
Vaginal bleeding before delivery?
High fever?
Abnormal vaginal discharge (foul smelling/dark)?
Lower abdominal pain?
Worsening vision, particularly at night?

FFQ060. Did you seek treatment at a health facility for:

Severe headache with blurred vision?
High blood pressure?
Edema (swelling) face/feet/body?
Convulsion/fits?
Vaginal bleeding before delivery?
High fever?
Abnormal vaginal discharge (foul smelling/dark)?
Lower abdominal pain?
Worsening vision, particularly at night?

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

Place of delivery?
Delivery by a skilled attendant?
Arrangement for transport for delivery?
Where to go if experience of pregnancy danger signs?
Severe headaches with blurred vision as a danger sign in pregnancy?
High blood pressure as a danger sign in pregnancy?
Edema/swelling of the face/feet/body as a danger sign in pregnancy?
Convulsions/fits as a danger sign in pregnancy?
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.

You cannot select no response and none of the above with other options.

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 for days before they go into labor. It is not the waiting room in the health center where they stay while laboring before delivery.

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

Number of months has to be between 0 and 12.

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.

FFQ073. What was the outcome of this pregnancy for the {current_baby_pos_lab} born?

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

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 DECEASED: Exactly how many days or weeks old was {baby_name} when (he/she) died?

If less than 1 week, select days

Enter the number of {days_weeks_died_lab}

If less than 1 week, select days

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

You cannot select no response and do not 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:

Severe bleeding?
Leaking/rupture of membrane and no labor pain for >24 hours?
Leaking/rupture of membrane before 9 months?
Malpresentation (the feet/hand came out first) or malposition (baby lied transversely during pregnancy)
Prolonged labor (>12 hours)?
Convulsion/fits?

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

Select all that apply.

You cannot select no response and nowhere with other options.

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

Retained placenta (more than 30 minutes)?
High fever with foul/smelly discharge or lower abdominal pain?
Severe/heavy bleeding?
Convulsions/fits?

FFQ087. Where did you seek treatment for:

This question will be repeated for every health problem you said you experienced after delivery

Retained placenta (more than 30 minutes)?
High fever with foul/smelly discharge or lower abdominal pain?
Severe/heavy bleeding?
Convulsions/fits?

You cannot select no response and nowhere 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 the number of {labor_duration_lab}

Value has to be between 0 and 60 for minutes. Value has to be between 0 and 24 for hours.

The next set of questions asks specifically about your experiences during labor, delivery and immediate postpartum care.

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

The next set of questions asks specifically about your experiences during labor, delivery and immediate postpartum care.

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

The next set of questions asks specifically about your experiences during labor, delivery and immediate postpartum care.

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

The next set of questions asks specifically about your experiences during labor, delivery and immediate postpartum care.

FFQ094. Did the doctors or nurses ask your permission/consent before doing procedures or examinations on you?

The next set of questions asks specifically about your experiences during labor, delivery and immediate postpartum care.

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

The next set of questions asks specifically about your experiences during labor, delivery and immediate postpartum care.

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

The next set of questions asks specifically about your experiences during labor, delivery and immediate postpartum care.

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

The next set of questions asks specifically about your experiences during labor, delivery and immediate postpartum care.

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

The next set of questions asks specifically about your experiences during labor, delivery and immediate postpartum care.

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

The next set of questions asks specifically about your experiences during labor, delivery and immediate postpartum care.

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

The next set of questions asks specifically about your experiences during labor, delivery and immediate postpartum care.

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

The next set of questions asks specifically about your experiences during labor, delivery and immediate postpartum care.

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?

The next set of questions asks specifically about your experiences during labor, delivery and immediate postpartum care.

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

The next set of questions asks specifically about your experiences during labor, delivery and immediate postpartum care.

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?

The next set of questions asks specifically about your experiences during labor, delivery and immediate postpartum care.

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?

The next set of questions asks specifically about your experiences during labor, delivery and immediate postpartum care.

FFQ106. Who checked on your health?

The next set of questions asks specifically about your experiences during labor, delivery and immediate postpartum care.

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

Enter the number of {delivery_first_check_lab}

For minutes value must be greater than 0 and less then 60. For hours value must be greater than 0 and less than 24. For days value must be greater than 0 and less than 60.

The next set of questions asks specifically about your experiences during labor, delivery and immediate postpartum care.

FFQ107a. Has your menstrual cycle returned since delivery?

The next set of questions asks specifically about your experiences during labor, delivery and immediate postpartum care.

FFQ107c. Have you resumed sexual activity since the birth of your most recent child?

The next set of questions asks specifically about your experiences during labor, delivery and immediate postpartum care.

FFQ107d. How long after the delivery did you wait before resuming sexual activity?

If less than a month record 0 for number of months. No response -99.

Value has to be between 0 and 62. For 5-8 weeks postpartum number of months cannot be more than 3.

The next set of questions asks specifically about your experiences during labor, delivery and immediate postpartum care.

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

The next set of questions asks specifically about your experiences during labor, delivery and immediate postpartum care.

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

The next set of questions asks specifically about your experiences during labor, delivery and immediate postpartum care.

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 {baby_name_bsrg}?s cord tied before it was cut?

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

FFQ111b. What was used to cut the cord?

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

FFQ112. Was the instrument boiled before cutting the cord?

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

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

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

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

Select all that apply.

You cannot select no response and do no know with other options.

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

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

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

FFQ116. What did they do for the bleeding cord?

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

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

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

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

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

You cannot select Nothing done, No response and Do no know with other options.

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

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

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

FFQ120. Did the {baby_name_bsrg} receive eye ointment following delivery?

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

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

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

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

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

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

Do not know -88. No response -99.

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

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

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

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

FFQ126. Number of {first_breast_lab} baby first put to breast

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

For minutes value must be equal to or greater than 0 and less then 60. For hours value must be greater than 0 and less than 24. For days value must be greater than 0 and less than 60.

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

FFQ128. Who checked on {baby_name_bsrg} health?

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

Enter the number of {when_first_check_lab}

For minutes, enter between 0 and 59. For hours, enter between 1 and 23. For days, enter between 1 and 6.

Please enter the correct value corresponding to FFQ129.

FFQ130. Yesterday during the day or night, did {baby_name_bsrg} 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 {baby_name_bsrg} ever received a BCG vaccination against tuberculosis, that is, an injection in the arm or shoulder that usually causes a scar?

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

FFQ133. Do you have a formal vaccination card with an official Ministry of Health logo where {baby_name_bsrg} vaccinations are written down?

If yes: May I see it please?

FFQ133a. Did you ever have a formal vaccination card for {baby_name_bsrg}?

FFQ133b. What happened to {baby_name_bsrg}?s formal vaccination card?

FFQ133c. Do you have any paper or card with vaccination information of {baby_name_bsrg} written down?

This does not have to be an official vaccination card, but please make sure it has a list of vaccines and the dates that they were given.
If yes: May I see it please?

FFQ133d. Looking at the vaccine card, does {baby_name_bsrg} have:

BCG
Polio-0
Polio-1

FFQ134.BCG

Vaccine Card (1) Copy date from the card for each vaccine (2) If either the day or month are illegible select the respective checkbox to indicate which date is not legible

Date
Day illegible

Month illegible

FFQ134. Polio-0

Vaccine Card (1) Copy date from the card for each vaccine (2) If either the day or month are illegible select the respective checkbox to indicate which date is not legible

Date

Day illegible

Month illegible

FFQ134. Polio-1

Vaccine Card (1) Copy date from the card for each vaccine (2) If either the day or month are illegible select the respective checkbox to indicate which date is not legible

Date

Day illegible

Month illegible

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

Select all that apply.
Do not read aloud.

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

FFQ136. This question will be repeated for every illness you said that {baby_name_bsrg} experienced since birth. Where did you seek treatment for:

Poor feeding or unable to suck?
Diarrhea
Pus in the umbilicus
Redness of the umbilicus
Red eye/passage of pus from eyes
Hypothermia
Jaundice
Convulsion
Skin rash/skin lesion
Baby doesn?t cry/breathe
Fever
Unconscious
Fast breathing
Sore throat/Tonsillitis
Difficulty in breathing
Chest in drawing
Doesn?t pass urine
Doesn?t pass stool
Cold/cough
Vomiting
Reduced alertness (lethargy)

Select all that apply

Cannot select ?no response? or ?No illness? 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

Value has to be more than 0 or lesser than 60.

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

Value has to be more than 0 or lesser than 60.

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

Value has to be more than 0 or lesser than 60.

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.

You 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:

Family planning?
Exclusive breastfeeding?
Immunization?
Infant feeding?
Infant growth?
Other infant development issues?

FFQ145. Are you currently breastfeeding?

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

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 the number of {how_long_wait_lab} you would like to wait

FFQ176b. 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 the number of {how_long_wait_preg_lab} you would like to wait

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

SECTION 3 - COVID Related Questions

The next series of questions are about COVID-19, also called Coronavirus

COV4.How concerned are you about the spread of Coronavirus (COVID-19) in your community?

Read all options

COV5.How concerned are you about getting infected yourself?

Read all options

COV5a.Will you take vaccination against Coronavirus (COVID-19) if it is offered to you?

COV8.Since the Coronavirus (COVID-19) restrictions began, how much of a loss of income has your household experienced?

Read all options

COV9.Since the Coronavirus (COVID-19) restrictions began, how much of a loss of income have you personally experienced?

Read all options

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. [NO IMAGE]

FFQ178b. Have you ever heard of male sterilization?

PROBE: Men can have an operation to avoid having any more children. [NO IMAGE]

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. [IMAGE OF METHOD WILL APPEAR ON SCREEN]

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. [IMAGE OF METHOD WILL APPEAR ON SCREEN]

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. [IMAGE OF METHOD WILL APPEAR ON SCREEN]

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

PROBE: Women can take a pill every day to avoid becoming pregnant. [IMAGE OF METHOD WILL APPEAR ON SCREEN]

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. [NO IMAGE]

FFQ178h. Have you ever heard of condoms?

PROBE: Men can put a rubber sheath on their penis before sexual intercourse. [IMAGE OF METHOD WILL APPEAR ON SCREEN]

FFQ178i. Have you ever heard of female condoms?

PROBE: Women can put a sheath in their vagina before sexual intercourse. [IMAGE OF METHOD WILL APPEAR ON SCREEN]

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. [IMAGE OF METHOD WILL APPEAR ON SCREEN]

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

PROBE: Up to six months after childbirth, before the menstrual period has returned, women use a method requiring frequent breastfeeding day and night.

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. [NO IMAGE]

FFQ178m. Have you ever heard of the withdrawal method?

PROBE: Men can be careful and pull out before climax. [NO IMAGE]

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?

FFQ179aa. Just to check, are you or your partner doing any of the following to avoid pregnancy: deliberately avoiding sex on certain days, using a condom, using withdrawal or using emergency contraception?

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.

You cannot select no response with other options

FFQ180. Since what month and year have you been using {curr_mthd_calc_lab} without stopping? Most Recent Birth: {recent_birth_date_lab} Current Marriage: {living_start_cmy_lab}

Calculate backwards from memorable events if needed. 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

Date cannot be in the future and respondent must be at least 10 years old.

Do not know month

FFQ181. Did you or your partner use any other methods between November 2019 and when you started using {curr_mthd_calc_lab} which was {curr_mthd_my_lab}?

Interviewer notes: [Since November 2019]. Probe to see if she has used the same method at a previous time.

FFQ182. Have you or your partner done anything or used a method to delay or avoid getting pregnant in the last 2 years (since November 2019)?

CS2. Which method did you use just before {curr_mthd_calc_lab}?"

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.

Cal001. Have you completed the paper Calendar Visual aid form?

FFQ 182a. What Method Were You using in (MMYY)?

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 {rec_cur_method_lab} in {rec_cur_method_my_lab}. Where did you or your partner get it at that time?

Scroll to bottom to see all choices.

You cannot select no response with do not know.

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

Now I am going to ask you some questions about the family planning consultation you had WHEN YOU RECEIVED YOUR MOST RECENT/CURRENT METHOD. Please tell me how much you agree with each statement based on your experiences WHEN YOU RECEIVED YOUR MOST RECENT/CURRENT METHOD.

QCC001. During the family planning visit, I felt encouraged to ask questions and express my concerns

Read all options

QCC002. During the family planning visit, the provider made efforts to ensure there were no interruptions during our session

Read all options

QCC003. During the family planning visit, the provider asked me questions in order to provide counseling that fit me personally

Read all options

QCC004. During the family planning visit, I received all of the information I wanted to know about my options for contraceptive methods

Read all options

QCC005. During the family planning visit, the provider gave me the time I needed to consider the contraceptive options we discussed

Read all options

QCC006. After the family planning visit, I could understand how my body might react to using contraception

Read all options

QCC007. After the family planning visit, I understood how to use the method(s) we talked about during the consultation

Read all options

QCC008. During the family planning visit, I was able to give my opinion about what I needed

Read all options

QCC009. During the family planning visit, I felt pressured by the healthcare provider to use the method they wanted me to use

Read all options

QCC010. During the family planning visit, I felt scolded because of my marital status.

Read all options

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

PNL 012. How satisfied are you with the method you are currently using?

PNL012a. Would you prefer to be using a different method?

PBL012b. What method would you prefer to use?

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 {rec_cur_method_lab} , were you told by the provider about side effects or problems you might have with a method to delay or avoid pregnancy?

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 {rec_cur_method_lab} that you could use?

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: {curr_mthd_src_lab}

FFQ202. Would you refer your relative or friend to this provider / facility? Provider: {curr_mthd_src_lab}

FFQ205. Have you experienced any side effects while using this method?

FFQ205. Did you experience any side effects while using this method?

FFQ206. What side effects have you experienced?

Do not read option choices aloud Multiple select

You cannot select no response and 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 Multiple select

You cannot select no response and do not know with other options.

PNL017. Did you talk with anyone about any of the side effects you experienced?

PNL017b. Who have you talked to about any of the side effects you experienced?

Anyone else?
SELECT ALL THAT APPLY

You cannot select do not know and no response with other options.

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

Medical card
Supplies (like gloves or syringes)
The method itself
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

Cannot select ?no response? with other options.

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

Scroll to bottom to see all choices.

Cannot select ?no response? with other options.

FFQ214. Who removed the implant?

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 "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?

Please enter the number of {when_future_use_lab}

For months value has to be more than 0 and less than 12. For years value has to be more than 0 and less than 10.

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 {last_dob_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. Cannot be younger than 9.

First use age has to be lesser than or equal to the respondent?s age.

FFQ223. How many living children did you have at that time, if any?
Note: the respondent said that she gave birth {no_live_birth} times in FFQ019.

Enter -99 for no response

Value has to be lesser than or equal to the number of live births the repspondent had.

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:

Heard about family planning on the radio?

Seen anything about family planning on the television?

Read about family planning in a newspaper or magazine?

Received text message about family planning on a mobile phone?

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

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

FFQ248. During your postpartum care, did any of the health service providers pressure you to accept a SPECIFIC method?

FFQ249. Which method did you feel pressured to use?

Section 5-Partner

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

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

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

FFQ253. Did you talk with your partner about using your {rec_cur_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

You cannot select no response with other options.

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

Made you feel bad or treated you badly for wanting to use a FP method to delay or prevent pregnancy?

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

Tried to force or pressure you to become pregnant?

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

Said he would leave you if you did not get pregnant?

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

Told you he would have a baby with someone else if you did not get pregnant?

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

Taken away your family planning or kept you from going to the clinic to get family planning?

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

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, but are you currently in a relationship?

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

Please enter the number of {how_long_in_rshp_lab}

FFQ279a. How old were you when you first had sexual intercourse? The respondent said she was {last_dob_age} years old at her last birthday. She has had {no_live_birth} 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.

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

Please enter the number of {when_last_intercourse_lab}

For days value must be greater than or equa to 0 and less than or equal to 365. For weeks value must be greater than 0 and less than 52. For months value must be greater than 0 and less than 12. For years value must be greater more than when the respondent was 9 years old.

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?

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:

B. Slap you?

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:

C. Twist your arm or pull your hair?

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:

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

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:

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

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:

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

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:

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

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:

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

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:

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

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:

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

Future Follow-up Consent (Cross-section only)

Thank you for the time you have kindly granted us. Would you be willing to participate in another survey in the future?

802a. Do you own a phone?

To select yes, the phone should be equipped with a mobile or fixed voice subscription.

802b. Do you have access to a phone owned by members of your household or other people that you can be easily reached over the phone?

802c. Would you please tell me your relationship to the owner of the phone?

We are asking here only about the primary phone number.

Can I have your primary phone number in case we would like to follow up with you in the future?

Enter an 10-digit number without the country code. Do not include spaces or dashes. Enter 0 for no response.

Can you repeat the number again?

Enter an 10-digit number without the country code. Do not include spaces or dashes. Enter 0 for no response.

Number entered must match previously entered number.

Can I have your secondary phone number in case we would like to follow up with you in the future?

Enter an 10-digit number without the country code. Do not include spaces or dashes. Enter 0 for no response.

Can you repeat the number again?

Enter an 10-digit number without the country code. Do not include spaces or dashes.

Number entered must match previously entered number.

P1. Have you participated in a previous survey with PMA Ethiopia in 2019 to 2021, where we asked you questions about your health and the health of your baby at three different times before?

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-week interview. Enter Jan 1, 2030 if no date scheduled for upcoming interview

FU6Wi. Did the respondent refuse follow-up for the six-week survey?

FU6Wj. Did the respondent refuse future follow-up?

FU6Ma. Date of six-month interview

The six-month follow-up should occur 3 weeks after {birth_plus_6m_lab} Enter Jan 1, 2030 if no date scheduled for upcoming interview

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_lab}

Location

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?

Va. Take a photo of the QR code. Make sure you have taken a picture of the full page and not just the QR code image and number

QUESTIONNAIRE RESULT

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

X. What language was this interview conducted in?

If you have used a translator while interviewing, please select the language that the respondent speaks.

Y. Was a translator used for this interview?

Z. Questionnaire result

Result must agree with J ( availability ) and M or N ( consent ).