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India/Rajasthan Female Questionnaire - Round 2

001a Are you in the correct household?
This is the picture of the front of the home taken during the Household Questionnaire.
[ODK will display the photo attached to the linked Household Questionnaire]

[] Yes
[] No

001b. RETURN TO INTERVIEW THE CORRECT HOUSEHOLD.

002 Your ID:
[Interviewer ID from Household Questionnaire]
Is this your ID?

[] Yes
[] No

Enter your ID below.
Please record your ID Interviewer's ID


003. Current date and time.
[ODK will display on screen]
Is this date and time correct?

[] Yes
[] No

Record the correct date and time.
Day ____ Month ____ Year ___ Hours ___ Min ____ AM/PM

004a The following information is from the Household Questionnaire. Please review to make sure you are interviewing the correct respondent.
[ODK will display the District, Tehsil/Taluk, City/Town/Village, Enumeration Area, Structure Number, and Household Number entered into the Household Questionnaire linked to this Female Questionnaire.]
Is the above information correct?

[] Yes
[] No

004b. GO TO THE RIGHT HOUSEHOLD OR UPDATE THE HOUSEHOLD ROSTER IF NEEDED

005. CHECK: You should be attempting to interview [Respondent's Name]. 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.

[] Yes
[] No

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:
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 this respondent previously participated in a PMA2020 survey before?

[] Yes
[] No
[] Don?t know
[] No response

009a. Namaskar! My name is ______________ and I am working for the IIHMR University Jaipur in collaboration with local Partners. I belong to this/nearby village. We are conducting a local survey that asks women about various reproductive health issues, the result of which would help to identify gaps in family planning and health services that affect regular availability and quality of information, services, and products. Some of these questions have been added expressly for research purposes. This survey is conducted across Rajasthan. From every enumeration area 35 households have been randomly selected your house was one of those households selected. Though we would very much appreciate your participation in the survey, your refusal to take part in this survey will have no repercussions on you. Information provided by you would help us inform the government to better plan health services. There is no physical risk associated with participating in this survey; however, some participants may experience distress in sharing information on personal and sometimes sensitive topics. If you agree to take part in this study, it will not benefit you directly. However, we believe that information gathered in this study will help us and other groups like us to develop programs that will improve the lives of men and women in communities in Rajasthan and around India, thus we hope that you would take part in this survey. Whatever information you provide will be kept confidential and only our research team will have access to it. We will never use your name while analyzing the data. The tracking sheet and the database with your responses will be kept on password-protected computers and on a secure server. Participation in this study is entirely voluntary, if you do not wish to answer any question feel free to inform me and I would skip to the next question. You can choose not to participate at all or to end the interview at any point. The survey usually takes between 20 to 30 minutes to complete. If you have any questions about the study and your right as a research participant, you may ask me now or you may also contact Dr. Anoop Khanna at IIHMR University, in Jaipur, Rajasthan at +91-141-3924738.

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 the paper copy of the Consent Form or give a thumbprint on the paper copy of the Consent Form and do likewise in the ODK form in agreement of their participation.
GATHER SIGNATURE:
Check box: ?

010. Interviewer's ID: [Interviewer ID from Household Questionnaire]
Mark your ID as a witness to the consent process.

011. Respondent's first name
[ODK will display the Respondent's name from linked Household Roster]
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.
101. In what month and year were you born? The age in the household roster is [AGE].
Month

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Don?t know

Year ____

102. How old were you at your last birthday?
Must be more than 14. Must agree with 101.

Age _____

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

[] Never Attended
[] Primary
[] Secondary
[] Higher Secondary
[] Graduate and Above
[] 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
[] Yes, married, gauna not performed
[] 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?
Enter Jan 2020 for no response.
Month

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Don?t know

Year _____

106b. CHECK: Based on the response you entered in 106a, the respondent was possibly 15 years old or younger at the time of her first marriage. Did you enter 106a correctly?

[] Yes
[] No

106c. RETURN TO 106A TO CORRECT BEFORE CONTINUING

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? Enter Jan 2020 for no response.
Month

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Don?t know

Year _____

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

107c. RETURN TO 107A TO CORRECT BEFORE CONTINUING

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

[] Yes
[] No
[] Don?t 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

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

201. How many times have you given birth? Enter -99 for no response. 0 is a possible answer.

Number _____

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.

Number _____

201c. How many daughters live with you?
Zero is a possible response. Enter -99 for No response.

Number _____

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.

Number _____

202c. How many daughters are alive but do not live with you?
Zero is a possible response. Enter -99 for No response.

Number _____

203. 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

How many times have you given birth?
Enter -99 for no response. 0 is a possible answer.

Number _____

203b. How many boys have died?
Zero is a possible response. Enter -99 for No response.

Number _____

203c. And how many girls have died? Zero is a possible response. Enter -99 for No response.

Number _____

CALC CEB CALCULATE: NUMBER OF CHILDREN EVER BORN. ODK will automatically calculate the total number of children ever born from 201-203:
(201b+201c+202b+202c+203b+203c)

Number _____

204. Just to make sure I have this right: you had a total of [LCL_201] birth(s) during your life, resulting in [CALC CEB] son(s) or daughter(s) born alive. Is that correct?

[] Yes
[] No

205. When was your FIRST birth?
Please record the date of the FIRST birth. Date should be found by calculating forward or backward from memorable events if needed. Enter Jan 2020 for no response.
Month

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Don?t know

Year ____

206. When was your MOST RECENT birth?
Please record the date of the MOST RECENT birth. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.
Month

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Don?t know

Year ____

207. When did you give birth before the most recent one?
Please record the date of the birth before the last. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.
Month

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Don?t know

Year ____

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

[] Yes
[] No
[] Don?t 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. Enter Jan 2020 for no response.
Month

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Don?t know

Year ____

209a. 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. Enter 0 days for today, not 0 weeks/months/years.

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

209b. Some women undergo an operation to remove the uterus. Have you undergone such an operation?

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

210a. Are you pregnant now?

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

210b. How many months pregnant are you? The most recent birth was: [Date of most recent birth]
Please record the number of completed months. Enter
-88 for do not know, -99 for no response.
Number of months ____

211a. Now I have some questions about the future. Would you like to have a/another child or would you prefer not to have any / any more children?

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

211b. Now I have some questions about the future. 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 a/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/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.

Months ____
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.

Months ____
Years _____
[] Soon / now
[] Says she can't get pregnant
[] Other
[] Don?t know
[] No response

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

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

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 / any more 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. 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 their 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/PPIUD?
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 male condoms/Nirodh?
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 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

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

[] Yes
[] No
[] No response

301l. 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

301m. Have you ever heard of the withdrawal method?
PROBE: Men can be careful and pull out before climax.

[] Yes
[] No
[] No response

301n. 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.

[] Female sterilization
[] Male sterilization
[] Implant
[] IUD/PPIUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male Condom/Nirodh
[] Female Condom
[] Std.Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional methods
[] No response

Have you ever been sterilized?

[] Yes
[] No
[] No response

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

[] Female sterilization
[] Male sterilization
[] Implant
[] IUD/PPIUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male Condom/Nirodh
[] Female Condom
[] Std.Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional methods
[] No response

302c. Are you breastfeeding to delay or avoid becoming 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 on list). Scroll to bottom to see all choices.

[] Implant
[] IUD/PPIUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male Condom/Nirodh
[] Female Condom
[] Std. Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional methods
[] No response

307. Before you started using [MOST RECENT / CURRENT METHOD], had you discussed the decision to delay or avoid pregnancy with your husband/partner?

[] Yes
[] No
[] Don?t 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 METHOD] without stopping? Calculate backwards from memorable events if needed.
Most Recent Birth: [mm-yyyy]
Current Marriage: [mm-yyyy]
Must be before today. Respondent must be at least 10 years old. Enter Jan 2020 for no response.
Month

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Don?t know

Year

309b. When did you stop using your [MOST RECENT METHOD]?
Please record the date. The date should be found by calculating backwards from memorable events if needed. Enter Jan 2020 for no response.
Month

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Don?t know

Year _____

309c. In what month and year had you started using [MOST RECENT METHOD] before stopping?
Calculate backwards from memorable events if needed.
Most Recent Birth: [mm-yyyy]
Current Marriage: [mm-yyyy]
Must be before today. Respondent must be at least 10 years old. Enter Jan 2020 for no response.
Month

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Don?t know

Year ____

309d. CHECK: Just to make sure I have this correct, you used [RECENT METHOD]
continuously between [START DATE] and [END DATE] 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 [MOST RECENT METHOD]?

[] Infrequent sex /husband away
[] Became pregnant while using
[] Wanted to become pregnant
[] Husband /partner disapproved
[] Wanted 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 processes
[] Other
[] Don?t know
[] No response

311a. You first started using [CURRENT/MOST RECENT METHOD] in [DATE FROM 310a or 310. c]. Where did you or your partner get it at that time? Scroll to bottom to see all choices.
Public Health Sector

[] Govt./Municipal Hospital
[] Govt. Dispensary
[] UFWC/UHC/UHP
[] CHC/Rural Hospital/Block PHC
[] Sub-Centre/ANM
[] Govt. Mobile Clinic
[] Camp
[] Anganwadi/ICDS Centre
[] ASHA
[] Other Community-Based Worker

(NGO)

[] NGO or Trust Hospital/Clinic

Private Health Sector

[] Pvt. Hospital
[] Pvt.Doctor/Clinic
[] Pvt. Mobile Clinic
[] Vaidya/Hakim/Homeopath (Ayush)
[] Traditional Healer
[] Pharmacy/Drugstore
[] Dai (TBA)

Other Source

[] Shop
[] Friend/Parent/Relative
[] Other
[] Don?t know
[] No response

311b. Where did you learn how to use [RHYTHM / LACTATIONAL AMENORRHEA METHOD]?
Scroll to bottom to see all choices.
Public Health Sector

[] Govt. / Municipal Hospital
[] Govt. Dispensary
[] UFWC/UHC/UHP
[] CHC/Rural Hospital/Block PHC
[] Sub-Centre/ANM
[] Govt. Mobile Clinic
[] Camp
[] Anganwadi/ICDS Centre
[] ASHA
[] Other Community-Based Worker

(NGO)

[] NGO or Trust Hospital/Clinic

Private Health Sector

[] Pvt. Hospital
[] Pvt.Doctor/Clinic
[] Pvt. Mobile Clinic
[] Vaidya/Hakim/Homeopath (Ayush)
[] Traditional Healer
[] Pharmacy/Drugstore
[] Dai (TBA)

Other Source

[] Shop
[] Friend/Parent/Relative
[] Other
[] Don't know
[] No Response

312a. When you obtained your [MOST RECENT / CURRENT METHOD], were you told by the provider about side effects or problems you might have with a method to delay or avoid pregnancy?

[] 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 a family planning provider about methods of family planning other than [MOST RECENT/CURRENT METHOD] 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 [LAM/Rhythm] 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
[] Don?t know
[] 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
[] Don?t know
[] No response

315b. Who made the final decision to use [LAM/Rhythm]?

[] You alone
[] Provider
[] Partner
[] You and provider
[] You and partner
[] Other
[] Don?t know
[] No response

316. Would you return to this provider?
Provider: [Type of Provider from Q 311a]

[] Yes
[] No
[] Don?t know
[] No response

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

[] Yes
[] No
[] Don?t 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 Rupees. Enter -88 if respondent does not know, -99 for no response.

Fee _____

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 from 102] 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.

Age ____

321. How many living children did you have at that time, if any? Note: the respondent said that she gave birth [number of live births] times in 204.
Enter -99 for no response

Number ____

322. Which method did you first use to delay or avoid getting pregnant?
Do not read the method choices. Scroll to the bottom to see all choices.

[] Female Sterilization
[] Male Sterilization
[] Implant
[] IUD/PPIUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male Condom/Nirodh
[] Female Condom
[] Std.Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional methods
[] No response

323a. 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.

[] 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 anganwadi worker, ASHA, or other 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 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

326 In the last few months have you:
a. Heard about family planning on the radio?

[] Yes
[] No

b. Seen anything about family planning on the television?

[] Yes
[] No

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

[] Yes
[] No

d. Received a voice or text message about family planning on a mobile phone

[] Yes
[] No

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?
Current age: [AGE FROM 103]
Number of live births: [ CALC_CEB]
Enter the age in years. Enter -77 if she never had sex. Enter -88 if respondent does not know. Enter -99 for no response.

Age ____

401b. You have entered that the respondent was X years old when she first had sexual intercourse. Is this what she said? Go back and correct 401a if it is not correct.

[] Yes
[] No

402. 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.
____ days ago
____ weeks ago
____ months ago
____ years ago

Section 7- Diarrheal Disease Among Children

Now I would like to ask you about your water practices.
701. How many children under age 5, if any, live in this household for which you are the primary caregiver? Enter 0 if there are none, enter -99 for no response.

Number ____

Starting with the youngest child, I'd like to ask you some questions. ODK will repeat FQ702-704 for each child under age 5.
702. In what month and year was this child born? Enter Jan 2020 for no response. ?????/Month

[] January
[] February
[] March
[] April
[] May
[] June
[] July
[] August
[] September
[] October
[] November
[] December
[] Don?t know

Year ____

703. The last time this child passed stools, what was done to dispose of the stools? For all feces, normal or diarrhea.

[] Children use a latrine/toilet
[] Leave waste where it is
[] Bury waste in field/yard
[] Dispose of waste in latrine/toilet
[] Dispose of waste with rubbish/garbage
[] Dispose of waste with waste water
[] Use it as manure
[] Burn it
[] Don?t know
[] No response

704. In the past 7 days, has this child had diarrhea? Diarrhea is determined as perceived by mother/caretaker. If the respondent is not sure what we mean by diarrhea, tell her it means "three or more runny stools per day."

[] Yes
[] No
[] No response

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.

095. 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.
LOCATION
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
[] Hindi
[] Other

098 Questionnaire result
Record the result of the Female Questionnaire

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