IDENTIFICATION
Please record the following identifying information prior to beginning the interview.
A. 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]
[] No
B. How many times have you visited this household to interview this female respondent?
[] 2nd time
[] 3rd time
C. Your name: [ODK will display the interviewer's name from the linked Household Questionnaire]
Is this your name?
[] No
Please record your name
D Current date and time: [ODK will display the device's preset date and time on the screen]
Is this date and time correct?
[] No
E. Record the correct date and time.
Time____ Hours____ Minutes____ AM/PM____
F. The following information is from the Household Questionnaire. Please review to make sure you are interviewing the correct respondent.
[ODK will display the geographic location information, Structure Number, and Household Number from the linked Household Questionnaire.]
Is the above information correct?
Go to the right household or update the Household Roster if needed.
G. Is the respondent present and available to be interviewed today?
[] No
[] Don?t know
[] No response
H. How well acquainted are you with the respondent?
[] Well acquainted
[] Not well acquainted
[] Not acquainted
H2. Has this woman participated in a PMA2020 survey before?
[] No
[] Don?t know
[] No response
INFORMED CONSENT Find the woman between the ages 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 the International Center for Reproductive Health in Kenya, in collaboration with the Ministry of Health and the Kenya National Bureau of Statistics. We are conducting a local survey that asks women about various reproductive health issues. 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 15 and 20 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?
I. Provide a paper copy of the Consent Form to the respondent and explain it. Then, ask: May I begin the interview now?
[] No
K. Interviewer's name:
[ODK will display the Interviewer's name from linked Household Questionnaire]
Mark your name as a witness to the consent process.
L. 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, HH characteristics
Now I would like to ask about your background and socioeconomic conditions
0. In what month and year were you born? The age in the household roster is [AGE].
Year____
[pg. 3]
1. How old were you at your last birthday?
Must agree with FQ0.
2. What is the highest level of school you attended?
[] Primary
[] Post-Primary/Vocational
[] Secondary/'A' Level
[] College (Middle Level)
[] University
[] No response
3. 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, living with a man
[] Not currently in union: Divorced / separated
[] Not currently in union: Widow
[] No, never in union
[] No response
4. Have you been married or lived with a man only once or more than once?
[] More than once
[] No response
5a. FQ5a. In what month and year did you start living with your FIRST husband / partner?
Enter Jan 2020 for no response.
Year____
5b. Now I would like to ask about when you I started living with your CURRENT or MOST RECENT husband / partner? In what month and year was that?
Enter Jan 2020 for no response.
Year____
[] No
6. Does your husband / partner have other wives or does he live with other women as if married?
[] No
[] Don?t know
[] No response
7. Is your husband / partner living with you now or is he staying elsewhere?
[] 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.
8. How many times have you given birth?
Enter -88 for do not know and -99 for no response. 0 is a possible answer.
If no, go back and change FQ8 to record only live birth events.
[] No
[pg. 4]
8a. 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. Enter Jan 2020 for no response.
Year____
9. 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. Enter Jan 2020 for no response.
Year____
10. 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.
Year____
11. Is your last baby / child still alive?
[] No
[] Don?t know
12. 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
Year____
13. 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.
Weeks ago____
Months ago____
Years ago_____
[] Menopausal / Hysterectomy
[] Before last birth
[] Never menstruated
14. Are you pregnant now?
[] No
[] Unsure
[] No response
[pg. 5]
15. How many months pregnant are you?
Please record the number of completed months. Enter -88 for do not know, -99 for no response.The most recent birth was: [Date of FQ9
[] No
[] Unsure
[] No response
16a. 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?
[] No more/prefer no children
[] Says she can't get pregnant 3
[] Undecided / Don?t know
[] No response
16b. 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?
[] No more/prefer no children
[] Says she can't get pregnant
[] Undecided / Don?t know
[] No response
17a. 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.
Years____
[] Soon / now
[] Says she can't get pregnant
[] Other
[] Don?t know
[] No response
17b. 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.
Years____
[] Soon / now
[] Other
[] Says she can't get pregnant
[] Don?t know
[] No response
[] No
[] Unsure
[] No response
[pg. 6]
18a. 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?
[] Later
[] Not at all
[] No response
18b. 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?
[] 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.
OBSERVE: CHECK FOR THE PRESENCE OF OTHERS.
BEFORE CONTINUING MAKE EVER EFFORT TO ENSURE PRIVACY.
19. Have you ever used anything or tried in any way to delay or avoid getting pregnant?
[] No
[] No response
20. How old were you when you first used a method to delay or avoid getting pregnant?
The respondent said she was [age from FQ1] 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 have been younger than 9.
20a. 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 FQ8.
Enter -99 for no response
21. 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.
[] Male sterilization
[] IUD
[] Injectables
[] Implants
[] Pill
[] Condom
[] Female condom
[] Emergency Contraception
[] Standard Days/Cycle Beads
[] Lactational Amen. Method (LAM)
[] Other modern method
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response
CHECK 14: Currently pregnant?
[] No
[] Unsure
[] No response
22. Are you/your partner currently doing something or using any method to delay or avoid getting pregnant?
[] No
[] No response
23. Which method or methods are you using?
Probe: Anything else?
Select all methods mentioned. Be sure to SCROLL TO THE BOTTOM to see all choices
[] Male sterilization
[] Implants
[] IUD
[] Injectables
[] Pill
[] Condom
[] Female condom
[] Emergency Contraception
[] Standard Days/Cycle Bead
[] Lactational Amen. Method (LAM)
[] Other modern method
[] Rhythm method
[] Withdrawal
[] Other traditional method
[] No response
24. Did the provider tell you or your partner that this method was permanent?
[] No
25. Do you know of a place where you can obtain a method of family planning?
[] No
[] No response
[] No
[] Unsure
[] No response
26a. 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?
[] No
[] No response
26b. Do you think you will use a contraceptive method to delay or avoid getting pregnant at any time in the future?
[] No
[] No response
[] No
27. In the last 12 months, have you ever done something or used a method to delay or avoid getting pregnant?
[] No
[] No response
[pg. 8]
28. 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.
[] IUD
[] Injectables
[] Pill
[] Emergency Contraception
[] Male Condom
[] Female Condom
[] Diaphragm
[] Foam/Jelly
[] Std. Days/Cycle beads
[] LAM
[] Rhythm method
[] Withdrawal
[] Other traditional methods
[] No response
29. When did you begin using your [MOST RECENT / CURRENT METHOD]?
Calculate backwards from memorable events if needed
Age at first use: [Age from FQ20]
Most Recent Birth: [mm-yyyy]
Current Marriage: [mm-yyyy]
Must be at least the age she started using a contraceptive method.
Must be before today. Respondent must have been at least 10 years old.
Enter Jan 2020 for no response
Year____
[] No
30. 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. Must be after FQ29.
Enter Jan 2020 for no response.
Year____
31. Why did you stop using your (MOST RECENT METHOD)?
[] Became pregnant while using
[] Wanted to become pregnant
[] Husband / partner disapproved
[] Want to use better 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 natural processes
[] Other
[] Don?t know
[] No response
[pg. 9]
32. Where did you obtain your [MOST RECENT / CURRENT METHOD] when you started using it?
Scroll to bottom to see all choices.
[] GOVT HEALTH CENTER
[] GOVERNMENT DISPENSARY
[] OTHER PUBLIC
[] FHOK/FPAK HEALTH CENTER/CLINIC
[] PRIVATE HOSPITAL/CLINIC
[] PHARMACY/CHEMIST
[] NURSING/MATERNITY HOME
[] COMMUNITY-BASED DISTRIBUTOR
[] SHOP
[] FRIEND/RELATIVE
[] DON?T KNOW
[] NO RESPONSE
33. In the last 12 months, have you paid any fees for family planning services (including the most current method)?
[] No
34. How much did you pay?
Enter all prices in Kenyan Shillings. Enter -88 if respondent does not know, -99 for no response.
35. 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 getting pregnant?
[] No
[] No response
36. Were you told what to do if you experienced side effects or problems?
[] No
37. At that time, were you told by the family planning provider about methods of family planning other than the [MOST RECENT/CURRENT METHOD] that you could use?
[] No
[] No response
[pg. 10]
38. During that visit, did you obtain the method you wanted to delay or avoid getting pregnant?
[] No
[] No response
39. If not, why not?
(Why didn't you obtain the method you wanted?)
[] 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
40. During that visit, who made the final decision about what method you got?
[] Provider
[] Partner
[] You and provider
[] You and partner
[] Other
[] No response
CHECK 32: Where did you obtain your [MOST RECENT / CURRENT METHOD]?
[] GOVT HEALTH CENTER
[] GOVERNMENT DISPENSARY
[] OTHER PUBLIC
[] FHOK/FPAK HEALTH CENTER/CLINIC
[] PRIVATE HOSPITAL/CLINIC
[] PHARMACY/CHEMIST
[] NURSING/MATERNITY HOME
[] COMMUNITY-BASED DISTRIBUTOR
[] SHOP
[] FRIEND/RELATIVE
[] DO NOT KNOW
[] NO RESPONSE
41. Would you return to this provider?
Provider: [Type of Provider from FQ32]
[] No
[] No response
42. Would you refer your relative or friend to this provider / facility?
Provider: [Type of Provider from FQ32]
[] No
[] No response
[] No more/none
[] Says she can't get pregnant
[] Undecided / Don?t know
[] No response
[] Less than 2 years
[] 2 or more years
[] No, not using contraceptive
43. You have said that you do not want [(a/another) child soon]/[any (more) children], but you are not using any method to avoid pregnancy. Can you tell me why you are not using a method?
Probe: Any other reason?
Hint: RECORD ALL REASONS MENTIONED
Cannot select ?Do Not Know? or ?No response? with other options.
Cannot select ?Not married? if FQ3 is ?Yes, currently married?.
Scroll to the bottom to see all choices. Check to acknowledge you considered all options.
[] 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
44. In the last 12 months, were you visited by a health worker who talked to you about family planning?
[] No
[] No response
45. In the last 12 months, have you visited a health facility for care for yourself (or your children)?
For any health services
[] No
[] No response
46. Did any staff member at the health facility speak to you about family planning methods?
[] No
[] No response
[pg. 12]
47. In the last few months have you:
[] No
[] No
[] No
OBSERVE: CHECK FOR THE PRESENCE OF OTHERS.
BEFORE CONTINUING MAKE EVER EFFORT TO ENSURE PRIVACY.
Verbally prepare the respondent for sexual activity questions.
48. How old were you when you first had sexual intercourse?
The respondent said she was [age from FQ1] years old at her last birthday.
[If pregnant: The respondent is pregnant]
[If FQ: She has had X live births]
Enter the age in years.
Enter 0 if she never had sex.
Enter -88 if respondent does not know.
Enter -99 for no response.
HAS NEVER HAD SEX. ENTER -99 FOR NO RESPONSE. ENTER -88 FOR DO NOT KNOW
CHECK: You have entered that the respondent was X years old when she first had sexual intercourse. Is this what she said?
IF NO, GO BACK AND CORRECT FQ48
[] No
49. When was the last time you had sexual intercourse?
[If pregnant: Respondent is X months pregnant. If FQ=0, answer must be in days or weeks up to 4 weeks or 30 days]
If 12 months (one year) or more ago, answer must be recorded in years. If less than 12 months ago, answer must be recorded in days, weeks or months.
Enter 0 days for today.
You will enter a number for X on the next screen.
WEEKS AGO____
MONTHS AGO____
YEARS AGO____
Thank the respondent for her time
The respondent is finished, but there are still 2 more questions for you to complete outside the home.
[pg. 13]
LOCATION
M. 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.
QUESTIONNAIRE RESULT
N. RECORD THE RESULT OF THE FEMALE RESPONDENT SURVEY
[] Not at home
[] Postponed
[] Refused
[] Partly completed
[] Incapacitated