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Ghana round 6 - Female Questionnaire

Region:

District:

Enumeration Area:

Structure number:

Household number:

002. Your name:

Is this your name?

[] Yes
[] No

002. Enter your name below.

Please record your name

003a. Current date and time.

Is this date and time correct?

[] Yes
[] No

003b. Record the correct date and time.

The date must be between 2017-06-01 and 2018-06-01.

004a. The following info is from the household questionnaire. Please review to make sure you are interviewing the correct respondent.

004a. The following info is what you provided previously. Please review.

Region: {level1_unlinked}

District: {level2_unlinked}

Enumeration Area: {EA_unlinked}

Structure number: {structure_unlinked}

Household number: {household_unlinked}

004b. Is the above information correct?

Go to the right household or update the Household Roster if needed.

[] Yes
[] No

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

If misspelled, select "yes" 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.

You must interview the right person.

[] Yes
[] No

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

[] Yes
[] No

007. How well acquainted are you with the respondent?

[] Very well acquainted
[] Well acquainted
[] Not well acquainted
[] Not acquainted

008. Has the respondent previously participated in PMA 2020 surveys?

[] Yes
[] No
[] Do not know
[] No response

INFORMED CONSENT

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

Hello. My name is ____________________________________ and I am working for Kwame Nkrumah University of Science and Technology, and the Ghana Health Service. We are conducting a local survey that asks women about various reproductive health issues. We shall also ask you questions about your experiences seeking healthcare for yourself or your children. This information will help us understand how people use the health services available, for what purpose, and whether they are of high or low quality.

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 20 and 30 minutes to complete. Whatever information you provide will be kept strictly confidential and will not be shown to anyone other than members of our survey team.

Participation in this survey is voluntary, and 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.

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

009a. Provide a paper copy of the Consent Form to the respondent and explain it. Then, ask: May I begin the interview now?

[] Yes
[] No

009b. Respondent's signature

Please ask the respondent to sign or check the box in agreement of their participation.

010c. Interviewer's name: {your_name}

Mark your name as a witness to the consent process.

[] NA

011. 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, Household characteristics

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

101. In what month and year were you born?

Select 'Do not know' for month and '2020' for year to indicate 'No Response'.

Month:

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know

Year:

If entering '2020' for No Response, must select 'Do not know' for month.

102. How old were you at your last birthday?

Age must be less than 130.
Must agree with 101.

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

[] Never Attended
[] Primary
[] Middle / JSS
[] Secondary / SSS
[] Higher
[] No response

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

Probe: If no, ask whether the respondent is divorced, separated, or widowed.

[] Yes, currently married
[] Yes, living with a man
[] Not currently in union: Divorced / separated
[] Not currently in union: Widow
[] No, never in union
[] No response

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

[] Only once
[] More than once
[] No response

106a. In what month and year did you start living with your FIRST husband / partner?

Select 'Do not know' for month and '2020' for year to indicate 'No Response'.

Month:

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know

Year:

If entering '2020' for No Response, must select 'Do not know' for month.

107a. 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 '2020' for year to indicate 'No Response'.

Month:

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know

Year:

If entering '2020' for No Response, must select 'Do not know' for month.

107b. CHECK: Based on the response you entered in 107a, the respondent was possibly 15 years old or younger at the time of her current or most recent marriage.

Did you enter 107a correctly?

[] Yes
[] No

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

[] Yes
[] No
[] Do not know
[] No response

109. Is your husband / partner living with you now or is he staying elsewhere?

[] Living with respondent
[] Staying elsewhere
[] No response

Section 2 - Reproduction, Pregnancy and Fertility Preferences

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

200. Now I would like to ask about all the births you have had during your life. Have you ever given birth?

[] Yes
[] No
[] No response

LCL201. How many times have you given birth?

Enter -99 for no response.

201a. Do you have any sons or daughters to whom you have given birth who are now living with you?

[] Yes
[] No
[] No response

201b. How many sons live with you?

Zero is a possible response. Enter -99 for No response.

201c. How many daughters live with you?

Zero is a possible response. Enter -99 for No response.

The respondent said she has sons or daughters who are now living with her, but then she said zero sons and zero daughters live with her.

Go back and correct this inconsistency.

202a. Do you have any sons or daughters to whom you have given birth who are alive but do not live with you?

[] Yes
[] No
[] No response

202b. How many sons are alive but do not live with you?

Zero is a possible response. Enter -99 for No response.

202c. How many daughters are alive but do not live with you?

Zero is a possible response. Enter -99 for No response.

The respondent said she has sons or daughters who are now alive and do not live with her, but then she said zero sons and zero daughters are alive and live away from her.

Go back and correct this inconsistency.

203a. Have you ever given birth to a boy or girl who was born alive but later died?

IF NO, PROBE: Any baby who cried, who made any movement, sound, or effort to breathe, or who showed any other signs of life even if for a very short time?

[] Yes
[] No
[] No response

LCL202. How many times have you given birth?

Enter -99 for no response.

203b. How many boys have died?

Zero is a possible response. Enter -99 for No response.

203c. And how many girls have died?

Zero is a possible response. Enter -99 for No response.

The respondent said she has sons or daughters who were born alive and later died, but then she said zero sons and zero daughters were born alive and later died.

Go back and correct this inconsistency.

STOP: The respondent said she has had fewer children than birth events. The number of children born must be equal to or greater than the number of birth events. All recorded birth events and children born must be live births.

Children born: {children_born}
Birth events: {birth_events}

Go back and change your numbers.

204. Just to make sure I have this right: you had a total of [BIRTH EVENTS] birth(s) during your life, resulting in [CHILDREN BORN] son(s) or daughter(s) born alive.

Is that correct?

Go back and change your numbers

[] Yes
[] No

205. When was your FIRST birth?

Please record the date of the FIRST birth. The date should be found by calculating backwards from memorable events if needed.

Select 'Do not know' for month and '2020' for year to indicate 'No Response'.

Month:

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know

Year:

If entering '2020' for No Response, must select 'Do not know' for month.

Cannot be in future.

Date cannot be in the future.

You entered: {first_birth_lab}
Today: {today}

First birth cannot be before respondent was 10 years old. You entered: {first_birth_lab}

Respondent's birth date: {birthdate_lab}

206. When was your MOST RECENT birth?

Select 'Do not know' for month and '2020' for year to indicate 'No Response'.

Month:

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know

Year:

If entering '2020' for No Response, must select 'Do not know' for month.

Cannot be in future.

Date cannot be in the future.

You entered: {recent_birth_lab}
Today: {today}

Date of most recent birth cannot be before respondent was 10 years old. You entered: {recent_birth_lab}

Respondent's birth date: {birthdate_lab}

Date of most recent birth must be at least 6 months after the first birth. You entered: {recent_birth_lab}

First birth: {first_birth_lab}

Year of most recent birth cannot be before first birth. You entered: {rb_y_lab}

Year of first birth: {fb_y_lab}

207. When did you give BIRTH BEFORE the most RECENT ONE?

Select 'Do not know' for month and '2020' for year to indicate 'No Response'.

Month:

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know

Year:

If entering '2020' for No Response, must select 'Do not know' for month.

Cannot be in future.

208a. Is your last baby / child still alive?

[] Yes
[] No
[] Do not know
[] No response

208b. When did your last baby / child die?

Please record the date of the child's death. The date should be found by calculating backwards from memorable events if needed.

Select 'Do not know' for month and '2020' for year to indicate No Response.

Month:

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know

Year:

If entering '2020' for No Response, must select 'Do not know' for month.

Cannot be in future.

Date cannot be in the future.

You entered: {child_death_lab}
Today: {today}

209. When did your LAST menstrual period start?

If you select days, weeks, months, or years, you will enter a number for X on the next screen.

[] X days ago
[] X weeks ago
[] X months ago
[] X years ago
[] Menopausal / Hysterectomy
[] Before last birth
[] Never menstruated
[] No response

You entered "Never menstruated" in 209 but the respondent 206 indicates she previously gave birth. Is that what she said?

If no, return to the previous screen and change the response.

Invalid. Go back

[] Yes
[] No

209a. Enter {menstrual_period_lab}

Enter 0 days for today, not 0 weeks/months/years.

Must be 0 days or larger. Must be 1 week/month/year or larger.

210a. Are you pregnant now?

[] Yes
[] No
[] Unsure
[] No response

You entered "Never menstruated" in 209 but 210a indicates that the respondent is pregnant currently. Is that what she said?

If no, return to the previous screen and change the response.

Invalid. Go back

[] Yes
[] No

210b. How many months pregnant are you?

Now I have some questions about the future.

211a. Would you like to have a child or would you prefer not to have any children?

[] Have a child
[] Prefer no children
[] Says she can't get pregnant
[] Undecided / Don't know
[] No response

211a. Would you like to have another child or would you prefer not to have any more children?

[] Have another child
[] No more
[] Says she can't get pregnant
[] Undecided / Don't know
[] No response

211b. After the child you are expecting now, would you like to have another child or would you prefer not to have any more children?

[] Have another child
[] No more
[] Says she can't get pregnant
[] Undecided / Don't know
[] No response

212a. How long would you like to wait from now before the birth of a 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.

[] X months
[] X years
[] Soon/now
[] Says she can't get pregnant
[] Other
[] Don't know
[] No response

212a. How long would you like to wait from now 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.

[] X months
[] X years
[] Soon/now
[] Says she can't get pregnant
[] Other
[] Don't know
[] No response

212b. 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.

[] X months
[] X years
[] Soon/now
[] Says she can't get pregnant
[] Other
[] Don't know
[] No response

212c. Enter the number of {waitchild} you would like to wait:

Use years if more than 36 months.

213a. Now I would like to ask a question about your last birth.

213b. Now I would like to ask a question about your current pregnancy.

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 more children at all?

[] Then
[] Later
[] Not at all
[] No response

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 children at all?

[] Then
[] Later
[] Not at all
[] No response

Section 3 - 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.

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.

301a. Have you ever heard of female sterilization?

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

[] Yes
[] No
[] No response

301b. Have you ever heard of male sterilization?

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

[] Yes
[] No
[] No response

301c. Have you ever heard of the contraceptive implant?

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

[] Yes
[] No
[] No response

301d. Have you ever heard of the IUD?

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

[] Yes
[] No
[] No response

301e. 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.

[] Yes
[] No
[] No response

301f. Have you ever heard of the (birth control) pill?

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

[] Yes
[] No
[] No response

301g. 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.

[] Yes
[] No
[] No response

301h. Have you ever heard of condoms?

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

[] Yes
[] No
[] No response

301i. Have you ever heard of female condoms?

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

[] Yes
[] No
[] No response

301j. Have you ever heard of the diaphragm?

PROBE: Women can place a thin flexible disk in their vagina before sexual intercourse.

[] Yes
[] No
[] No response

301k. Have you ever heard of foam or jelly as a contraceptive method?

PROBE: Women can place a suppository, jelly, or cream in their vagina before sexual intercourse to prevent pregnancy.

[] Yes
[] No
[] No response

301l. 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.

[] Yes
[] No
[] No response

301m. Have you ever heard of the Lactational Amenorrhea Method or LAM?

[] Yes
[] No
[] No response

301n. 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.

[] Yes
[] No
[] No response

301o. Have you ever heard of the withdrawal method?

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

[] Yes
[] No
[] No response

301p. Have you ever heard of any other ways or methods that women or men can use to avoid pregnancy?

[] Yes
[] No
[] No response

302a. Are you or your partner currently doing something or using any method to delay or avoid getting pregnant?

[] Yes
[] No
[] No response

302b. Which method or methods are you using?

PROBE: Anything else?

Select all methods mentioned. SCROLL TO THE BOTTOM to see all choices.

You selected no response with another option.

[] Female sterilization
[] Male sterilization
[] Implant
[] IUD
[] Injectables - 3 months
[] Injectables - 1 month
[] Pill
[] Emergency Contraception
[] Male condom
[] Female condom
[] Diaphragm
[] Foam/Jelly
[] Standard Days/Cycle beads
[] LAM
[] N-Tablet
[] Rhythm method
[] Withdrawal
[] Washing
[] Other traditional method
[] No response

302c. Are you breastfeeding to delay or avoid getting pregnant?

[] Yes
[] No
[] No response

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

[] Yes
[] No
[] No response

304. Do you know of a place where you can obtain a method of family planning?

[] Yes
[] No
[] No response

305a. You said that you are not currently using a contraceptive method. Do you think you will use a contraceptive method to delay or avoid getting pregnant at any time in the future?

[] Yes
[] No
[] No response

305b. Do you think you will use a contraceptive method to delay or avoid getting pregnant at any time in the future?

[] Yes
[] No
[] No response

306a. In the last 12 months, have you ever done something or used a method to delay or avoid getting pregnant?

[] Yes
[] No
[] No response

306b. Which method did you use most recently?

PROBE: Anything else?

Select most effective method (highest method in list). Scroll to bottom to see all choices.

[] Implant
[] IUD
[] Injectables - 3 months
[] Injectables - 1 month
[] Pill
[] Emergency Contraception
[] Male condom
[] Female condom
[] Diaphragm
[] Foam/Jelly
[] Standard Days/Cycle beads
[] LAM
[] N-Tablet
[] Rhythm method
[] Withdrawal
[] Washing
[] Other traditional method
[] No response

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

[] Yes
[] No
[] Do not know
[] No response

308. Would you say that using contraception is mainly your decision, mainly your husband/partner's decision or did you both decide together?

[] Mainly respondent
[] Mainly husband / partner
[] Joint decision
[] Other
[] No response

309a. Since what month and year have you been using [CURRENT/RECENT METHOD] without stopping?

Calculate backwards from memorable events if needed.

Most Recent Birth: {rec_birth_date}

Current Marriage: {rec_husband_date}

Month:

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know

Year:

If entering '2020' for No Response, must select 'Do not know' for month.

Cannot be in future.

Date cannot be in the future.

You entered: {begin_using_full_lab}
Today: {today}

Date of starting {current_recent_label} cannot be before 10 years of age. You entered: {begin_using_full_lab}

Respondent's birth date: {birthdate_lab}

Date of starting {current_recent_label} without stopping cannot be before most recent birth. You entered: {begin_using_full_lab}

Most recent birth: {recent_birth_lab}

Date of starting {current_recent_label} without stopping cannot be before most recent birth. You entered: {bus_y_lab}

Most recent birth: {rb_y_lab}

309b. When did you stop using {current_recent_label}?

Please record the date.
The date should be found by calculating backwards from memorable events if needed.

Select 'Do not know' for month and '2020' for year to indicate No Response.

Month:

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know

Year:

If entering '2020' for No Response, must select 'Do not know' for month.

Cannot be in future.

Date cannot be in the future.

You entered: {stop_using_full_lab}
Today: {today}

Date of stopping {current_recent_label} must be within the last 12 months. Otherwise, the answer to 306a should be no. You entered: {stop_using_full_lab}

Today: {today}

Date of stopping {current_recent_label} must be within the last 12 months. Otherwise, the answer to 306a should be no. You entered: {spu_y_lab}

Today: {today}

309c. In what month and year had you started using {current_recent_label} before stopping?

Calculate backwards from memorable events if needed.

Select 'Do not know' for month and '2020' for year to indicate No Response.

Month:

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Do not know

Year:

If entering '2020' for No Response, must select 'Do not know' for month.

Cannot be in future.

309d. CHECK: Just to make sure I have this correct, you used {current_recent_label} continuously between {ante_start_using_full_lab} and {stop_using_full_lab} without stopping, is that correct?

[] Yes
[] No

GO BACK TO THE PREVIOUS SCREEN AND PROBE TO DETERMINE THE PERIOD OF MOST RECENT CONTINUOUS USE.

Suggested probes:
- When was the last time you used [METHOD]?
- How long had you been using [METHOD] without stopping

310. Why did you stop using {current_recent_label}?

[] Infrequent sex / husband away
[] Became pregnant while using
[] Wanted to become pregnant
[] Husband / partner disapproved
[] Wanted a more effective method
[] No method available
[] Health concerns
[] Fear of side effects
[] Lack of access / too far
[] Costs too much
[] Inconvenient to use
[] Fatalistic
[] Difficult to get pregnant / menopausal
[] Interferes with body's processe
[] Other
[] Don't know
[] No response

311a. You first started using {current_recent_label} on {start_date_lab}.

Where did you or your partner get it at that time?

Scroll to bottom to see all choices.

[] Govt. Hospital/polyclinic
[] Govt. Health center
[] Govt. Health post
[] Public family planning clinic
[] Mobile clinic
[] Fieldworker/outreach/peer educator
[] CHPS
[] Private hospital/clinic
[] Private doctor
[] Pharmacy
[] Chemical/drug store
[] Private FP or PPAG clinic
[] Maternity home
[] NGO
[] Shop/market
[] Church
[] Community volunteer
[] Friend / relative
[] Herbal clinic
[] Other
[] Don't know
[] No response

311b. Where did you learn how to use rhythm method?

Scroll to bottom to see all choices.

[] Govt. Hospital/polyclinic
[] Govt. Health center
[] Govt. Health post
[] Public family planning clinic
[] Mobile clinic
[] Fieldworker/outreach/peer educator
[] CHPS
[] Private hospital/clinic
[] Private doctor
[] Pharmacy
[] Chemical/drug store
[] Private FP or PPAG clinic
[] Maternity home
[] NGO
[] Shop/market
[] Church
[] Community volunteer
[] Friend / relative
[] Herbal clinic
[] Other
[] Don't know
[] No response

311b. Where did you learn how to use lactational amenorrhea method?

Scroll to bottom to see all choices.

[] Govt. Hospital/polyclinic
[] Govt. Health center
[] Govt. Health post
[] Public family planning clinic
[] Mobile clinic
[] Fieldworker/outreach/peer educator
[] CHPS
[] Private hospital/clinic
[] Private doctor
[] Pharmacy
[] Chemical/drug store
[] Private FP or PPAG clinic
[] Maternity home
[] NGO
[] Shop/market
[] Church
[] Community volunteer
[] Friend / relative
[] Herbal clinic
[] Other
[] Don't know
[] No response

312a. When you obtained your {current_recent_label}, were you told by the provider about side effects or problems you might have with a method to delay or avoid getting pregnant?

[] Yes
[] No
[] No response

312b. Were you told what to do if you experienced side effects or problems?

[] Yes
[] No
[] No response

313. At that time, were you told by the family planning provider about methods of family planning other than the {current_recent_label} that you could use?

[] Yes
[] No
[] No response

314a. During that visit, did you obtain the method you wanted to delay or avoid getting pregnant?

[] Yes
[] No
[] No response

314b. When you began using rhythm was this the method you wanted to use to delay or avoid getting pregnant?

[] Yes
[] No
[] No response

314b. When you began using LAM was this the method you wanted to use to delay or avoid getting pregnant?

[] Yes
[] No
[] No response

314c. Why didn't you obtain the method you wanted?

[] Method out of stock that day
[] Method not available at all
[] Provider not trained to provide the method
[] Provider recommended a different method
[] Not eligible for method
[] Decided not to adopt a method
[] Too costly
[] Other
[] No response

315a. During that visit, who made the final decision about what method you got?

[] You alone
[] Provider
[] Partner
[] You and provider
[] You and partner
[] Other
[] Do not know
[] No response

315b. Who made the final decision to use rhythm?

[] You alone
[] Provider
[] Partner
[] You and provider
[] You and partner
[] Other
[] Do not know
[] No response

315b. Who made the final decision to use LAM?

[] You alone
[] Provider
[] Partner
[] You and provider
[] You and partner
[] Other
[] Do not know
[] No response

316. Would you return to this provider?

Provider: {provider_label}

[] Yes
[] No
[] Do not know
[] No response

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

Provider: {provider_label}

[] Yes
[] No
[] Do not know
[] No response

318a. In the last 12 months, have you paid any fees for family planning services (including the most current method)?

[] Yes
[] No
[] No response

318b. How much did you pay?

Enter all prices in Ghana Cedis. Enter -88 if respondent does not know, -99 for no response.

Must be larger than 0, -88, or -99

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

[] Yes
[] No
[] No response

320. 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 the respondent does not know.
Enter -99 if there is no response.
Cannot be younger than 9.

Cannot be older than the current age of the respondent. Cannot be younger than 9. Cannot be after recent/current use.

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

Note: the respondent said that she gave birth {birth_events} times in 204.

Enter -99 for no response.

Must be zero or larger, or -99.

322. Which method did you first use to delay or avoid getting pregnant?

Do not read the method choices. Scroll to bottom to see all choices.

You said you are currently pregnant.

[] Female sterilization
[] Male sterilization
[] Implant
[] IUD
[] Injectables - 3 months
[] Injectables - 1 month
[] Pill
[] Emergency Contraception
[] Male condom
[] Female condom
[] Diaphragm
[] Foam/Jelly
[] Standard Days/Cycle beads
[] LAM
[] N-Tablet
[] Rhythm method
[] Withdrawal
[] Washing
[] Other traditional method
[] No response

The respondent said she first used female sterilization, but she did not say that is her current method. Go back to 302a and 302b and update the selection for current method.

323a. You said that you do not want a child soon and that you are not using a method to avoid pregnancy.

Can you tell me 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 bottom to see all choices.

Cannot select "Do not know" or "No response" with other options.

Cannot select "Not Married" if 104 is "Yes, currently married".

[] Not married
[] Infrequent sex / Not having sex
[] Menopausal / Hysterectomy
[] Subfecund / Infecund
[] Not menstruated since last birth
[] Breastfeeding
[] Husband away for multiple days
[] Up to God / fatalistic
[] Respondent opposed
[] Husband / partner opposed
[] Others opposed
[] Religious prohibition
[] Knows no method
[] Knows no source
[] Fear of side effects
[] Health concerns
[] Lack of access / too far
[] Costs too much
[] Preferred method not available
[] No method available
[] Inconvenient to use
[] Interferes with body's processes
[] Other
[] Don't know
[] No response

323b. Would you say that not using contraception is mainly your decision, mainly your husband/partner's decision or did you both decide together?

[] Mainly respondent
[] Mainly husband / partner
[] Joint decision
[] Other
[] No response

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

[] Yes
[] No
[] No response

325a. In the last 12 months, have you visited a health facility or camp for care for yourself?

For any health services.

[] Yes
[] No
[] No response

325a. In the last 12 months, have you visited a health facility or camp for care for yourself or your children?

For any health services.

[] Yes
[] No
[] No response

325b. Did any staff member at the health facility speak to you about family planning methods?

[] Yes
[] No
[] No response

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 a voice or text message about family planning on a mobile phone?

Section 4 - Sexual Activity

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

401a. How old were you when you FIRST had SEXUAL INTERCOURSE?

Enter the age in years.

Enter -77 if she has never had sex.
Enter -99 for no response.
Enter -88 for do not know.

Answer must agree with the current age and date of first birth.

WARNING: you entered -77, but the respondent is currently pregnant or has given birth before. Go back and fix.

The timing of the number of births should agree with 401a

WARNING: the respondent gave birth {birth_events} times, but first had sex at the age of {age_at_first_sex}, only {years_since_first_sex} years ago. Is that correct?

The timing of the number of births should agree with 401a.

You must reconcile 401a with the respondent's pregnancy history.

[] Yes
[] No

You entered that the respondent was {age_at_first_sex} years old the first time she had sexual intercourse. Is that what the she said?

Go back and change 401a if it is not correct.

Invalid. Go back

[] Yes
[] No

You entered that the respondent's age at first sex was {age_at_first_sex}. Previously the respondent said she has given birth at an earlier age: {age_first_birth}. Is that correct?

Go back and change "age at first sex" if it is not correct

You must reconcile 401a with the respondent's pregnancy history.

[] Yes
[] No

402. When was the LAST TIME you had SEXUAL INTERCOURSE?

Answer must be in days or weeks up to 4 weeks or 30 days

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.

Must agree with the pregnancy status.

[] X days ago
[] X weeks ago
[] X months ago
[] X years ago
[] No response

402. Enter {last_time_sex_lab}.

If today, enter zero days only, not zero weeks/months/years.

Must agree with the age of first sexual intercourse and the pregnancy status.

Days must be greater or equal to 0. Weeks/months/years must be greater than 0.

The respondent is pregnant. The time since last sex must not be earlier than one month prior to the start of pregnancy.

If number of months pregnant is unknown, then the time since last sex must be less than 11 months.

Months pregnant: {months_pregnant}
Last time sex units: {last_time_sex}
Last time sex value: {last_time_sex_value}

The respondent cannot enter a time since last sex that would be before her age at first sex.

Age at first sex: {age_at_first_sex}
Current age: {age}
Last time sex units: {last_time_sex}
Last time sex value: {last_time_sex_value}

Section 5 - Water

Now I would like to ask about your water practices

501. On a typical day in the DRY season, how much time do you spend collecting water?

Only record respondent's time; not anyone else's time.

If you select minutes or hours you will enter a number for X on the next screen

[] X minutes per day
[] X hours per day
[] No time, someone else collects water
[] No time, No one collects water
[] Don't know
[] No response

501. Enter {dry_label}:

Either: 1-24 hours or 1-180 minutes.

502. On a typical day in the WET season, how much time do you spend collecting water?

Only record respondent's time; not anyone else's time.

If you select minutes or hours you will enter a number for X on the next screen

[] X minutes per day
[] X hours per day
[] No time, someone else collects water
[] No time, No one collects water
[] Don't know
[] No response

502. Enter {wet_label}:

Either: 1-24 hours or 1-180 minutes.

Primary Health Care Module

Primary Health Care Module: Section 1

PHC_101. In general, would you say your health is:

Read the question and answer choices out loud and ask the respondent to pick the best answer.

[] Excellent
[] Very good
[] Good
[] Fair
[] Poor
[] No response

PHC_102. In general, how would you rate your mental health, including your mood and your ability to think?

Read the question and answer choices out loud and ask the respondent to pick the best answer.

[] Excellent
[] Very good
[] Good
[] Fair
[] Poor
[] No response

PHC_103a. Have you visited a health facility for yourself or a family member in the last six months?

[] Yes
[] No
[] No response

PHC_103b. Why not?

Do not read options aloud. Select all that are mentioned.

[] Not sick/did not need care
[] Facility is too far away
[] Too expensive
[] Too difficult to get to
[] Distrust of provider / facility
[] Negative prior experience
[] Lack of privacy or confidentiality
[] Did not know where to go
[] Health care worker provided needed services in house / community
[] Did not have health insurance / insurance was expired
[] Other
[] Do not know
[] No response

PHC_104. During your most recent visit to the health facility, for whom were you seeking care?

Do not read out loud.

[] Yourself
[] Your child
[] Another family member
[] No response

PHC_105. During your most recent visit to the health facility, for what reasons were you seeking care?

Do not read out loud. Select all that apply.

[] Family planning
[] Maternal health services
[] Vaccination
[] Malaria / fever
[] Feel sick (undifferentiated symptoms)
[] CHW told me to go
[] Snake bite
[] Injury
[] Blood pressure
[] Diabetes
[] HIV testing / treatment
[] Eye issue
[] Breathing issue / cough
[] Abdominal pain / issue (including diarrhea)
[] Check-up for preventive or routine care
[] Worried about a new symptom or feeling
[] Other
[] No response

PHC_106a. During your most recent visit to the health facility, what TYPE of health facility did you visit?

This also refers to the most recent visit the respondent made. Do not read out loud. Select the one that best applies

[] Govt. Hospital / polyclinic
[] Govt. Health center
[] Govt. Health post
[] CHPS
[] Family planning clinic
[] Mobile clinic
[] Private hospital / clinic
[] Private doctor
[] Private pharmacy
[] Chemical / drug store
[] FP / PPAG clinic
[] Maternity home
[] NGO
[] Herbal clinic
[] Other
[] Do not know
[] No response

PHC_106b. During your most recent visit to the health facility, what was the NAME of the facility you visited?

PHC_106c. Is this facility the closest facility to your place of residence?

[] Yes
[] No
[] Do not know
[] No response

PHC_106d. Why did you choose not to seek care at the closest facility?

[] Closest facility did not offer services I needed
[] Closest facility was closed
[] Had already gone to closest facility for same problem
[] Closest facility was too expensive
[] Closest facility was too difficult to get to
[] Distrust of provider/facility
[] Negative prior experience at closest facility
[] Lack of privacy or confidentiality at closest facility
[] Other
[] Do not know
[] No response

PHC_107. During your most recent visit, how long did you wait before being seen by your provider?

Record in unit respondent provides.

[] X Minutes
[] X Hours
[] Gave up without seeing provider
[] Do not know
[] No response

Now I want to ask some questions about your impressions of your most recent visit for health care. I would like you to rate your experiences using the following questions.

For your last visit to a health care provider, how would you rate the following:

Read the question and answer choices out loud and ask the respondent to pick the best answer.

PHC_108. The length of wait time at the facility before you were seen?

[] Excellent
[] Very good
[] Good
[] Fair
[] Poor
[] No response

PHC_109. Whether the provider listened carefully to you?

[] Excellent
[] Very good
[] Good
[] Fair
[] Poor
[] No response

PHC_110. Provider's medical knowledge and skills?

[] Excellent
[] Very good
[] Good
[] Fair
[] Poor
[] No response

Read the question and answer choices out loud and ask the respondent to pick the best answer.

PHC_111. The level of respect the provider showed you?

[] Excellent
[] Very good
[] Good
[] Fair
[] Poor
[] No response

PHC_112. The provider's ability to explain things in a way that you could understand?

[] Excellent
[] Very good
[] Good
[] Fair
[] Poor
[] No response

PHC_113. The amount of time the provider spent with you in the visit?

[] Excellent
[] Very good
[] Good
[] Fair
[] Poor
[] No response

Read the question and answer choices out loud and ask the respondent to pick the best answer.

PHC_114. Your experience of being involved in making decisions for your treatment?

[] Excellent
[] Very good
[] Good
[] Fair
[] Poor
[] No response

PHC_115. The way the health services ensured that you could talk privately to providers?

[] Excellent
[] Very good
[] Good
[] Fair
[] Poor
[] No response

PHC_116. The ease with which you could see a health care provider you were happy with?

[] Excellent
[] Very good
[] Good
[] Fair
[] Poor
[] No response

PHC_117. The cleanliness in the health facility?

[] Excellent
[] Very good
[] Good
[] Fair
[] Poor
[] No response

Read the question and answer choices out loud and ask the respondent to pick the best answer.

PHC_118. How much do you trust the skills and abilities of the health workers at this facility?

[] Very much
[] Quite a bit
[] Some
[] Very little
[] Not at all
[] No response

PHC_119. How easy or difficult was it for you to follow the provider's advice?

[] Very difficult
[] Difficult
[] Easy
[] Very easy
[] No response

PHC_120. Overall, thinking about your entire last visit, please rate how well the care you received met your health needs. That is, how much did the visit help solve your health problem or help you feel better?

[] Excellent
[] Very good
[] Good
[] Fair
[] Poor
[] No response

Read the question and answer choices out loud and ask the respondent to pick the best answer.

PHC_121. Overall, taking everything into account, how would you rate the quality of care you received at this facility?

[] Excellent
[] Very good
[] Good
[] Fair
[] Poor
[] No response

PHC_122. How likely are you to return or bring your children to this facility for health care in the future?

[] Very likely
[] Somewhat likely
[] Somewhat unlikely
[] Very unlikely
[] No response

PHC_123. How likely are you to recommend this facility to others?

[] Very likely
[] Somewhat likely
[] Somewhat unlikely
[] Very unlikely
[] No response

PHC_124. Were your services covered by insurance?

[] Yes
[] No
[] No response

PHC_125. Which insurance program covered these services?

Do not read out loud. Record all that are mentioned.

[] National / District Health Insurance
[] Health insurance through employer
[] Mutual health organization / community based insurance
[] Other privately purchased commercial health insurance

PHC_126a. Was the cost to you lower because you had insurance?

[] Yes
[] No
[] Do not know
[] No response

PHC_126b. How much did you have to pay out of pocket?

Record amount in GHC.

Enter -99 for no response

At most two decimal digits

PHC_127. How easy or difficult was it for you to pay for this visit?

Read the question and answer choices out loud and ask the respondent to pick the best answer.

[] Very difficult
[] Difficult
[] Easy
[] Very easy
[] No response

PHC_128. Did you have to borrow money or sell something to afford the costs of this visit, including all costs such as transportation and lost wages?

[] Yes
[] No
[] No response

Now I would like to ask you some questions about health care in general.

PHC_129a. Please tell me the most important things that influence your decision about where to seek health services.

PROBE: Anything else?

Do not read options aloud. Select all that are mentioned.

[] Waiting time to see doctor
[] Travel time to facility
[] Cleanliness of facility
[] Being treated with respect
[] Competence / knowledge of provider
[] Confidentiality / privacy
[] Availability / supply of medicines
[] Cost of treatment, including medicines
[] Cost of visit
[] Being able to choose health care provider
[] Personally know health care provider
[] Prefer traditional healers
[] Other
[] No response

PHC_129b. You mentioned that: {visit_factor_choices} are important to you in deciding where to seek health care services. Can you tell me which of these things is the most important to you?

You did not select that in the previous question

[] Waiting time to see doctor
[] Travel time to facility
[] Cleanliness of facility
[] Being treated with respect
[] Competence / knowledge of provider
[] Confidentiality / privacy
[] Availability / supply of medicines
[] Cost of treatment, including medicines
[] Cost of visit
[] Being able to choose health care provider
[] Personally know health care provider
[] Prefer traditional healers
[] Other
[] No response

Read the question and answer choices out loud and ask the respondent to pick the best answer.

PHC_130. How confident are you that if you became very sick tomorrow, you would be able to receive effective treatment from the health system?

[] Not at all confident
[] Not very confident
[] Somewhat confident
[] Very confident
[] No response

PHC_131. When you seek health care, how often do you see the same health care provider?

[] Always
[] Frequently
[] Rarely
[] Never
[] Do not know
[] No response

PHC_132. Which of the following statements comes closest to expressing your overall view of the health care system in this country?

[] Our health care system has so much wrong with it that we need to completely rebuild it.
[] There are some good things in our health care system, but major changes are needed to make it work better.
[] On the whole, the system works pretty well and only minor changes are necessary to make it work better.

Followup Consent

FLW_801. Thank you for the time you have kindly granted us.

Would you be willing to participate in another survey on this or any other topic either by phone or in person at some point in the future?

[] Yes
[] No
[] No response

FLW_802. Do you own a phone?

[] Yes
[] No
[] No response

FLW_803. Can I have your primary phone number in case we would like to follow up with you in the future?

Enter a 10-digit number with leading 0 and without the country code. Do not include spaces or dashes.
Enter -99 for no response.

FLW_804. To confirm, here is the number you gave me: {flw_number_typed}. Is that correct?

If not, return to 803 and correct it.

You must answer yes.

[] Yes
[] No

End of Survey

Thank the respondent for her time.

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

Thank you.

There are still more questions for you to complete outside the home.

095. Location

Take a GPS point near the entrance to the household. Record location when the accuracy is smaller than 6 m.

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

[] 1st time
[] 2nd time
[] 3rd time

097. In what language was this interview conducted?

[] English
[] Akan
[] Ga
[] Ewe
[] Nzema
[] Dagbani
[] Other

098. Questionnaire result

Record the result of the female respondent survey

Check answer to 006 and consent.

[] Completed
[] Not at home
[] Postponed
[] Refused
[] Partly completed
[] Incapacitated