PMA2020 Nigeria Female Questionnaire - Round 3
A. Are you in the correct household?
This is the picture of the front of the home taken during the Household Questionnaire.
IF NOT, RETURN TO INTERVIEW THE CORRECT HOUSEHOLD.
[ODK will display the photo attached to the linked Household Questionnaire]
[] No
B. Your name:
[Interviewer name from Household Questionnaire]
Is this your name?
[] No
Please record your name
C. Current date and time. [ODK will display on screen]
Is this date and time correct?
[] No
D. Record the correct date and time.
Hours____ Min____ AM/PM____
E. The following information is from the Household Questionnaire. Please review to make sure you are interviewing the correct respondent.
[ODK will display the State, LGA, Enumeration Area, Structure Number, and Household Number entered into the Household Questionnaire linked to this Female Questionnaire.]
Is the above information correct?
[] No
If misspelled, select "yes" here and update the name in question "L."
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.
[] No
F. Is the respondent present and available to be interviewed today?
[] No
G. How well acquainted are you with the respondent?
[] Well acquainted
[] Not well acquainted
[] Not acquainted
G2. 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 Questionnaire. The interview must have auditory privacy. Read the following greeting:
Hello. My name is ____________________________________ and I am working for the Center for Research, Evaluation Resources, and Development and Bayero University Kano. 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?
H. May I begin the interview now?
[] No
I. Interviewer's name: [Interviewer name from Household Questionnaire]
Mark your name as a witness to the consent process.
J. Respondent's 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].
1. How old were you at your last birthday?
Must be more than 14. Must agree with FQ0.
2. What is the highest level of school you attended?
[] Primary
[] Secondary
[] Higher
[] 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, currently married
[] Yes, living with a man
[] Not currently in union: Divorced / separated
[] Not currently in union: Widow
[] No response
4. Have you been married or lived with a man only once or more than once?
[] More than once
[] No response
5a. In what month and year did you start living with your FIRST husband / partner?
Enter Jan 2020 for no response.
[If ?15 years old at marriage date ODK will display:]
CHECK: Based on the response you entered in FQ5a, the respondent was possibly 15 years old or younger at the time of her first marriage. Did you enter FQ5a correctly?
[] No
5b. 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.
[If ?15 years old at marriage date ODK will display:]
CHECK: Based on the response you entered in FQ5b, the respondent was possibly 15 years old or younger at the time of her first marriage. Did you enter FQ5b correctly?
[] No
[] 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.
8a. How many times have you given birth?
Enter -99 for no response. 0 is a possible answer.
Were all of those live births?
If no, go back and change FQ8 to record only live birth events.
[] No
8b. How many sons and daughters have you given birth to and who were born alive?
8c. Have you ever given birth to a boy or girl who was born alive but later died?
IF NO, PROBE: Any baby who cried or showed signs of life but did not survive?
[] No
8d. How many have died?
Enter -88 for do not know and -99 for No response.
Change FQ8c to 'No' if zero deaths.
during your life, resulting in ____ son(s) or daughter(s) born alive.
Is that correct?
[] No
8e. 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.
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.
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.
11. Is your last baby / child still alive?
[] No
[] Don't know
[] No response
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.
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
[] No response
14. Are you pregnant now?
[] No
[] Unsure
[] No response
15. 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.
[] No
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
[] 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.
Select "Years" if more than 36 months.
Years ____
[] Soon / now
[] Other
[] Says she can't get pregnant
[] 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.
Select "Years" if more than 36 months.
Years____
[] Soon / now
[] Says she can't get pregnant
[] Other
[] Don't know
[] No response
[] No
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.
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.
19. Have you ever heard of female sterilization?
PROBE: Women can have an operation to avoid having any more children.
[NO IMAGE]
[] No
[] No response.
19. Have you ever heard of male sterilization?
PROBE: Men can have an operation to avoid having any more children.
[NO IMAGE]
[] No
[] No response.
19. Have you ever heard of the contraceptive implant?
PROBE: Women can have one or several small rods placed in their upper arm by a doctor or nurse, which can prevent pregnancy for one or more years.
[IMAGE OF METHOD WILL APPEAR ON SCREEN]
[] No
[] No response.
19. Have you ever heard of the IUD?
PROBE: Women can have a loop or coil placed inside them by a doctor or a nurse.
[IMAGE OF METHOD WILL APPEAR ON SCREEN]
[] No
[] No response.
19. Have you ever heard of injectables?
PROBE: Women can have an injection by a health provider that stops them from becoming pregnant for one or more months.
[IMAGE OF METHOD WILL APPEAR ON SCREEN]
[] No
[] No response.
19. Have you ever heard of the (birth control) pill?
PROBE: Women can take a pill every day to avoid becoming pregnant.
[IMAGE OF METHOD WILL APPEAR ON SCREEN]
[] No
[] No response.
19. Have you ever heard of emergency contraception?
PROBE: As an emergency measure after unprotected sexual intercourse women can take special pills at any time within five days to prevent pregnancy.
[NO IMAGE]
[] No
[] No response.
19. Have you ever heard of condoms?
PROBE: Men can put a rubber sheath on their penis before sexual intercourse.
[IMAGE OF METHOD WILL APPEAR ON SCREEN]
[] No
[] No response.
19. Have you ever heard of female condoms?
PROBE: Women can put a sheath in their vagina before sexual intercourse.
[IMAGE OF METHOD WILL APPEAR ON SCREEN]
[] No
[] No response.
19. Have you ever heard of the intravag/diaphragm?
PROBE: Women can place a thin flexible disk in their vagina before sexual intercourse.
[IMAGE OF METHOD WILL APPEAR ON SCREEN]
[] No
[] No response.
19. 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.
[IMAGE OF METHOD WILL APPEAR ON SCREEN]
[] No
[] No response.
19. Have you ever heard of the standard days method or Cycle Beads?
PROBE: A Woman can use a string of colored beads to know the days she can get pregnant. On the days she can get pregnant, she and her partner use a condom or do not have sexual intercourse.
[IMAGE OF METHOD WILL APPEAR ON SCREEN]
[] No
[] No response
19. Have you ever heard of the Lactational Amenorrhea Method or LAM?
[NO DESCRIPTION; NO IMAGE]
[] No
[] No response.
19. Have you ever heard of the rhythm method?
PROBE: Women can avoid pregnancy by not having sexual intercourse on the days of the months they think they can get pregnant.
[NO IMAGE]
[] No
[] No response.
19. Have you ever heard of the withdrawal method?
PROBE: Men can be careful and pull out before climax.
[NO IMAGE]
[] No
[] No response.
19. Have you ever heard of any other ways or methods that women or men can use to avoid pregnancy?
[] No
[] No response.
[] No
20. Are you or your partner currently doing something or using any method to delay or avoid getting pregnant?
[] No
21. Which method or methods are you using?
Probe: Anything else?
Select all methods mentioned. Be sure to scroll to bottom to see all choices.
[] No
Male Sterilization
[] No
Implant
[] No
IUD
[] No
Injectables
[] No
Pill
[] No
Emergency Contraception
[] No
Male Condom
[] No
Female Condom
[] No
Diaphragm
[] No
Foam/Jelly
[] No
Std. Days/Cycle beads
[] No
LAM
[] No
Rhythm method
[] No
Withdrawal
[] No
Other traditional methods
[] No
[] No response
21b. Are you breastfeeding to delay or avoid becoming pregnant?
[] No
[] No response
[] No
Male Sterilization
[] No
[] None of the above
22. Did the provider tell you or your partner that this method was permanent?
[] No
[] No response.
23. Do you know of a place where you can obtain a method of family planning?
[] No
[] No response.
CHECK 14: Currently pregnant?
[] No
[] No
[] No response.
24b. Do you think you will use a contraceptive method to delay or avoid getting pregnant at any time in the future?
[] No
[] No response.
25. In the last 12 months, have you ever done something or used a method to delay or avoid getting pregnant?
[] No
[] No response.
26. 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
27. 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 ages she started using a contraceptive method (FQ20).
Must be before today. Respondent must be at least 10 years old.
Enter Jan 2020 for no response.
[] No
28. 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 FQ27.
Enter Jan 2020 for no response.
29. Why did you stop using your (MOST RECENT METHOD)?
[] 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
30. You first started using [CURRENT/MOST RECENT METHOD] in [DATE FROM FQ27]. Where did you get it at that time?
Scroll to bottom to see all choices.
[] Govt. Health Center
[] Family Planning Clinic
[] Mobile Clinic
[] Fieldworker
PRIVATE MEDICAL SECTOR
[] Pharmacy
[] Chemist/PMS Store
[] Private Doctor
[] Mobile Clinic
[] Fieldworker
OTHER SOURCE
[] Church/Place of worship
[] Friend/Relative
[] NGO
[] Other
[] Don't Know
[] No Response
31. 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
32. Were you told what to do if you experienced side effects or problems?
[] No
[] No response
33. 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
34. During that visit, did you obtain the method you wanted to delay or avoid getting pregnant?
[] No
[] No response
35. 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
[] No response
36. 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 30: You first started using [CURRENT/MOST RECENT METHOD] in [DATE FROM FQ27]. Where did you get it at that time?
[] Govt. Health Center
[] Family Planning Clinic
[] Mobile Clinic
[] Fieldworker
PRIVATE MEDICAL SECTOR
[] Pharmacy
[] Chemist/PMS Store
[] Private Doctor
[] Mobile Clinic
[] Fieldworker
OTHER SOURCE
[] Church/Place of worship
[] Friend/Relative
[] NGO
[] Other
[] Don't Know
[] No Response
Provider: [Type of Provider from FQ30]
[] No
[] No response
38. Would you refer your relative or friend to this provider / facility?
[] No
[] No response
39. In the last 12 months, have you paid any fees for family planning services (including the most current method)?
[] No
40. How much did you pay?
Enter all prices in Nigerian Naira. Enter -88 if respondent does not know, -99 for no response.
41. Have you ever done anything or tried in any way to delay or avoid getting pregnant?
[] No
[] No response
41b. 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 be younger than 9.
41c. 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
42. Which method did you first use to delay or avoid getting pregnant?
Do not read the method choices. Be sure to scroll to bottom to see all choices.
[] Male Sterilization
[] Implant
[] 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
[] No more/none
[] Says she can't get pregnant
[] Undecided / Don't know
CHECK 17: 2 or more years before next child?
[] Less than 2 years
[] 2. or more years
[] No, not using contraceptive
43. You said that you do not want any / anymore children and that you are not using a method to avoid pregnancy.
Can you tell me the reason why you are not using a method to prevent pregnancy?
PROBE: Any other reason?
RECORD ALL REASONS MENTIONED.
Cannot select "Do Not Know" or "No response" with other options.
Cannot select "Not married" if FQ3 is "Yes, currently married".
Scroll to the bottom to see all choices.
[] Infrequent sex / husband away
[] Menopausal/Hysterectomy
[] Subfecund / infecund
[] Not menstruated since last birth
[] Breastfeeding
[] 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 community 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
47. In the last few months have you:
[] No
[] No response
Seen anything about family planning on the television?
[] No
[] No response
Read about family planning in a newspaper or magazine?
[] No
[] No response
CHECK FOR THE PRESENCE OF OTHERS. BEFORE CONTINUING, MAKE EVERY 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.
[She has had x live births.]
Enter the age in years.
Enter -77 if she never had sex.
Enter -88 if respondent does not know.
Enter -99 for no response.
[If age at first sex LT 10 years:]
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 FQ48 if it is not correct.
[] No
49. 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.
[] X. Weeks
[] X. Months
[] X. Years
[] No Response
Days Ago____
Weeks Ago____
Months Ago____
Years Ago____
Section 4 - Diarrheal Disease Among Children
Now I would like to ask about your water practices.
50. How many children under age 5, if any, live in this household for which you are the primary caregiver?
Starting with the youngest child, I'd like to ask you some questions.
ODK Will repeat the FQ51-FQ53 each child under age 5.
51. In what month and year was this child born?
ENTER JAN 2020 FOR NO RESPONSE.
52. The last time this child passed stools, what was done to dispose of the stools?
FOR ALL FECES, NORMAL OR DIARRHEA.
[] Bury waste in field / yard
[] Dispose of waste with rubbish / garbage
[] Dispose of waste in latrine / toilet
[] Children use a latrine / toilet
[] Leave waste where it is
[] Use it as manure
[] Dispose of waste with waste water
[] No response
53. 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."
[] No
[] No Response
The respondent is finished, but there are still 2 more questions for you to complete outside the home.
LOCATION
K. 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
L. How many times have you visited this household to interview this female respondent?
[] 2nd time
[] 3rd time
M. Questionnaire result
Record the result of the Female Questionnaire
[] Not at home
[] Postponed
[] Refused
[] Partly completed
[] Incapacitated