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PMA2020 Nigeria Female Questionnaire - Round 4


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 1
[] No 0

001b. RETURN TO INTERVIEW THE CORRECT HOUSEHOLD.

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

[] Yes 1
[] No 0

Enter your name below. Please record your name
Interviewer's Name _____

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

[] Yes 1
[] No 0

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 State, LGA, Enumeration Area, Structure Number, and Household Number entered into the Household Questionnaire linked to this Female Questionnaire.]
Is the above information correct?

[] Yes 1
[] No 0

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 1
[] No 0

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

[] Yes 1
[] No 0

007. How well acquainted are you with the respondent?

[] Very well acquainted 1
[] Well acquainted 2
[] Not well acquainted 3
[] Not acquainted 4

008. Has this respondent previously participated in a PMA2020 survey before?

[] Yes 1
[] No 0
[] Don't know -88
[] No response -99

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:

009a. Hello. My name is ____________________________________ and I am working for Center for Research, Evaluation Resources, and Development and the Centre for Advance Medical Research. 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?

[] May I begin the interview now? Yes 1
[] No 0

010. Interviewer's name: [Interviewer name from Household Questionnaire]
Mark your name 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____ 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? Only record formal schooling. Do not record bible or koranic school or short courses.

[] Never Attended 0
[] Primary 1
[] Secondary 2
[] Higher 3
[] No response -99

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 1
[] Yes, living with a man 2

Not currently in union:

[] Divorced / separated 3
[] Not currently in union: Widow 4
[] No, never in union 5
[] No response -99

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

[] Only once 1
[] More than once 2
[] No response -99

106a. In what month and year did you start living with your FIRST husband / partner? Enter Jan 2020 for no response.

Month____ Year____

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 1
[] No 0

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____ Year____


107b. CHECK: Based on the response you entered in107a, the respondent was possibly 15 years old or younger at the time of her first marriage. Did you enter107a correctly?

[] Yes 1
[] No 0

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

[] Yes 1
[] No 0
[] Don't know -88
[] No response -99

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

[] Living with respondent 1
[] Staying elsewhere 2
[] No response -99

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 1
[] No 0
[] No response -99

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 1
[] No 0
[] No response -99

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 1
[] No 0
[] No response -99

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 ____

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 1
[] No 0
[] No response -99

202. 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 ____

CALCULATE: NUMBER OF CHILDREN EVER BORN. ODK will automatically calculate the total number of children ever born from FQ201-203:
(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] son(s) or daughter(s) born alive. Is that correct?

[] Yes 1
[] No 0

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____ 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____ 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____ Year____

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

[] Yes 1
[] No 0
[] Don't know -88
[] No response -99

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____ Year____

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

____ days ago
____ weeks ago
____ months ago
____ years ago
[] Menopausal / Hysterectomy 5
[] Before last birth 6
[] Never menstruated 7
[] No response -99

210a. Are you pregnant now?

[] Yes 1
[] No 0
[] Unsure 2
[] No response -99

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 1
[] No more/prefer no children 2
[] Says she can't get pregnant 3
[] Undecided / Don't know -88
[] No response -99

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 1
[] No more/prefer no children 2
[] Says she can't get pregnant 3
[] Undecided / Don't know -88
[] No response -99

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 3
[] Other 4
[] Says she can't get pregnant 5
[] Don't know -88
[] No response -99

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 3
[] Says she can't get pregnant 4
[] Other 96
[] Don't know -88
[] No response -99

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 1
[] Later 2
[] Not at all 3
[] No response -99

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 1
[] Later 2
[] Not at all 3
[] No response -99

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 1
[] No 0
[] No response. -99

301b. Have you ever heard of male sterilization? PROBE: Men can have an operation to avoid having any more children.

[] Yes 1
[] No 0
[] No response. -99

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 1
[] No 0
[] No response. -99

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 1
[] No 0
[] No response. -99

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 1
[] No 0
[] No response. -99

301f. Have you ever heard of the (birth control) pill? PROBE: Women can take a pill every day to avoid becoming pregnant.

[] Yes 1
[] No 0
[] No response. -99

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 1
[] No 0
[] No response. -99

301h. Have you ever heard of condoms? PROBE: Men can put a rubber sheath on their penis before sexual intercourse.

[] Yes 1
[] No 0
[] No response. -99

301i. Have you ever heard of female condoms? PROBE: Women can put a sheath in their vagina before sexual intercourse.

[] Yes 1
[] No 0
[] No response. -99

301j. Have you ever heard of the diaphragm? PROBE: Women can place a thin flexible disk in their vagina before sexual intercourse.

[] Yes 1
[] No 0
[] No response. -99

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 1
[] No 0
[] No response. -99

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 1
[] No 0
[] No response. -99


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

[] Yes 1
[] No 0
[] No response. -99

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 1
[] No 0
[] No response. -99

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

[] Yes 1
[] No 0
[] No response. -99

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

[] Yes 1
[] No 0
[] No response. -99

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

[] Yes 1
[] No 0
[] No response. -99

302b. Which method or methods are you using? Probe: Anything else? Select all methods mentioned. Be sure to scroll to bottom to see all choices.

[] Female sterilization
[] 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. -99

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 1
[] Male Sterilization 2
[] Implant 3
[] IUD 4
[] Injectables 5
[] Pill 7
[] Emergency Contraception 8
[] Male Condom 9
[] Female Condom 10
[] Diaphragm 11
[] Foam/Jelly 12
[] Std. Days/Cycle beads 13
[] LAM 14
[] Rhythm method 30
[] Withdrawal 31
[] Other traditional methods 39
[] No response. -99

301. PROBE: Was the injection administered via syringe or small needle? Show the image to the respondent.

[] Syringe 1
[] Small needle (Sayana Press) 2
[] No response. -99

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

[] Yes 1
[] No 0
[] No Response -99

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

[] Yes 1
[] No 0
[] No response. -99

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

[] Yes 1
[] No 0
[] No response. -99

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 1
[] No 0
[] No response. -99

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

[] Yes 1
[] No 0
[] No response. -99

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

[] Yes 1
[] No 0
[] No response. -99

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 3
[] IUD 4
[] Injectables 5
[] Pill 7
[] Emergency Contraception 8
[] Male Condom 9
[] Female Condom 10
[] Diaphragm 11
[] Foam/Jelly 12
[] Std. Days/Cycle beads 13
[] LAM 14
[] Sayana Press 16
[] Rhythm method 30
[] Withdrawal 31
[] Other traditional methods 39
[] No response. -99

302. PROBE: Was the injection administered via syringe or small needle? Show the image to the respondent.

[] Syringe 1
[] Small needle (Sayana Press) 2
[] No response. -99

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

[] Yes 1
[] No 0
[] Don't know -88
[] No response -99

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 1
[] Mainly husband/partner 2
[] Joint Decision 3
[] Other 96
[] No response -99

302. Besides you and your husband/partner, who else influences the decision to use a family planning method? PROBE:
Anybody else? Do not read options aloud. Select all that apply.

[] Mother
[] Mother in law
[] Sister(s)
[] Sister(s) in law
[] Grandmother
[] Friend(s)
[] Health worker
[] Community leader
[] Religious leader
[] Aunt
[] Other relatives
[] Other
[] No one -77
[] No response -99

302x. In the last 12 months, have you recommended any family planning method to your friends and/or relatives?

[] Yes 1
[] No 0
[] No response -99

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____ 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____ 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____ 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 1
[] No 0

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 your [MOST RECENT METHOD]?

[] Infrequent sex / husband away 1
[] Became pregnant while using 2
[] Wanted to become pregnant 3
[] Husband / partner disapproved 4
[] Wanted more effective method 5
[] No method available 6
[] Health concerns 7
[] Fear of side effects 8
[] Lack of access / too far 9
[] Costs too much 10
[] Inconvenient to use 11
[] Fatalistic 12
[] Difficult to get pregnant /menopausal 13
[] Interferes with body's processes 14
[] Other 96
[] Don't know -88
[] No response -99

311a. You first started using [CURRENT/MOST RECENT METHOD] on [DATE FROM 309a or 309c]. Where did you or your partner get it at that time? Scroll to bottom to see all choices.
Public sector

[] Govt. Hospital 11
[] Govt. Health center 12
[] Family planning clinic 13
[] Mobile clinic 14
[] TBA/Fieldworker 15

Private medical sector

[] Private hospital/clinic 21
[] Pharmacy 22
[] Chemist/Pms store 23
[] Private doctor 24
[] Mobile clinic 25
[] TBA/ Fieldworker 26

Other source

[] Shop 31
[] FBO/ Church 32
[] Friend / relative 33
[] NGO 34
[] Other 96
[] Don't know -88
[] No Response -99

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

[] Govt. Hospital
[] Govt. Health center
[] Family planning clinic
[] Mobile clinic
[] TBA/Fieldworker

Private medical sector

[] Private hospital/clinic
[] Pharmacy
[] Chemist/PMS store
[] Private doctor
[] Mobile clinic
[] TBA/Fieldworker

Other source

[] Shop
[] FBO/ Church
[] Friend / relative
[] NGO
[] 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 1
[] No 0
[] No response -99

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

[] Yes 1
[] No 0
[] No response -99

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 1
[] No 0
[] No response -99

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

[] Yes 1
[] No 0
[] No response -99

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

[] Yes 1
[] No 0
[] No response -99

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

[] Method out of stock that day 1
[] Method not available at all 2
[] Provider not trained to provide the method 3
[] Provider recommended a different method 4
[] Not eligible for method 5
[] Decided not to adopt a method 6
[] Too costly 7
[] Other 96
[] Don't know -88
[] No response -99

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

[] You alone 1
[] Provider 2
[] Partner 3
[] You and provider 4
[] You and partner 5
[] Other 96
[] Don't know -88
[] No response -99

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

[] You alone 1
[] Provider 2
[] Partner 3
[] You and provider 4
[] You and partner 5
[] Other 96
[] Don't know -88
[] No response -99

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

[] Yes 1
[] No 0
[] Don't know -88
[] No response -99

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

[] Yes 1
[] No 0
[] Don't know -88
[] No response -99

96. 318a In the last 12 months, have you paid any fees for family planning services (including the most current method)?

[] Yes 1
[] No 0
[] No response -99

318b. How much did you pay? Enter all prices in Nigerian Naira. 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 1
[] No 0
[] No response -99

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. Be sure to scroll to bottom to see all choices.

[] Female sterilization 1
[] Male sterilization 2
[] Implant 3
[] IUD 4
[] Injectables 5
[] Pill 7
[] Emergency Contraception 8
[] Male Condom 9
[] Female Condom 10
[] Diaphragm 11
[] Foam/Jelly 12
[] Std. Days/Cycle beads 13
[] LAM 14
[] Rhythm method 30
[] Withdrawal 31
[] Other traditional methods 39
[] No response. -99

307. PROBE: Was the injection administered via syringe or small needle? Show the image to the respondent.
[IMAGES OF BOTH INJECTION SYSTEMS WILL APPEAR ON SCREEN]

[] Syringe 1
[] Small needle (Sayana Press) 2
[] No response. -99

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 -88
[] No response -99

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 1
[] Mainly husband/partner 2
[] Joint Decision 3
[] Other 96
[] No response -99

304. Besides you and your husband/partner, who else influences the decision not to use a family planning method?
PROBE: Any other reasons? Do not read options aloud. Select all that apply.

[] Mother
[] Mother in law
[] Sister(s)
[] Sister(s) in law
[] Grandmother
[] Friend(s)
[] Health worker
[] Community leader
[] Religious leader
[] Aunt
[] Other relatives
[] Other
[] No one -77
[] No response -99

304x. In the last 12 months, has a friend and/or relative recommended that you use a family planning method?

[] Yes 1
[] No 0
[] No response -99

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

[] Yes 1
[] No 0
[] No response -99

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

[] Yes 1
[] No 0
[] No response -99

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

[] Yes 1
[] No 0
[] No response -99

305. Have you attended a community event in the last year where family planning was favorably discussed?

[] Yes 1
[] No 0
[] No response -99

306. Do you think there are some people within this community who will call you bad names or avoid your company if they knew that you were using a family planning method?

[] Yes 1
[] No 0
[] Do not know -88
[] No response -99

307. Do you think there are some people within this community who will praise, encourage, or talk favorably about you if they knew that you were using a family planning method?

[] Yes 1
[] No 0
[] Do not know -88
[] No response -99

308. In the past 12 months, have you heard any of the following people speaking publicly IN FAVOR of family planning? Read all options out loud and select all that apply.

[] National government official
[] State, LGA, or local leaders
[] Religious leader
[] None of the above -77
[] No response -99

309. In the past 12 months, have you heard any of the following people speaking publicly AGAINST family planning? Read all options out loud and select all that apply.

[] National government official
[] State, LGA, or local leaders
[] Religious leader
[] None of the above -77
[] No response -99

309x. How many of your close friends and relatives do you think use family planning: none, some, most, or all?

[] None 1
[] Some 2
[] Most 3
[] All 4
[] Do not know -88
[] No response -99

326. 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
[] Read about family planning in a brochure, leaflet, or flyer?
[] Seen a poster or billboard with a family planning message?

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:
Number of 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.

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 1
[] No 0

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 702-704 for each child under age 5.

702. In what month and year was this child born? Enter Jan 2020 for no response.

Month____ 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 1
[] Leave waste where it is 2
[] Bury waste in field/yard 3
[] Dispose of waste in latrine/toilet 4
[] Dispose of waste with rubbish/garbage 5
[] Dispose of waste with waste water 6
[] Use it as manure 7
[] Burn it 8
[] Don't know -88
[] No response -99

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 1
[] No 0
[] No response -99

Section 8- Follow-up Consent

Thank you for the time you have kindly granted us. Would you agree to participate in another survey on this or any other topic in the future?

[] Yes 1
[] No 0
[] No response -99

802. How many phone numbers do you have?

[] None 0
[] One 1
[] Two 2
[] Three 3
[] More than 3 96
[] No response -99

803. Can I have your primary phone number? Enter number digits only. Enter -99 for no response. Must be 5+ digits.

Primary phone number ______
[] No response -99

803. b To confirm, here is the number you gave me:
[FWL_803a]. Is it correct? If not, return to 803a to correct it.

[] Yes 1
[] No 0
[] No response -99

99. 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. 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. LOCATION

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

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

097. In what language was this interview conducted?

[] English 1
[] Hausa 2
[] Igbo 3
[] Yoruba 4
[] Pidgin 5
[] Other 96

098. Questionnaire result Record the result of the Female Questionnaire

[] Completed 1
[] Not at home 2
[] Postponed 3
[] Refused 4
[] Partly completed 5
[] Incapacitated 6