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Section 1: Demographics (Part 1)
R1. Please confirm which province/state you live in?
Nigeria Kenya South Africa 9 North Central 1
Nairobi 46 Western Cape
10 North East 2 Central
47 Eastern Cape
11 North West 3 Eastern
48 Northern Cape
12 South East 4 Coast 49 Free State
13 South South 5 North-Eastern
50 Kwazulu-Natal
14 South West 6 Nyanza
51 North West
7 Rift Valley
52 Gauteng
8 Western
53 Mpumalanga
54 Limpopo
R1_5. Nigeria State
9 Abia 10 Adamawa
11 Akwa Ibom
12 Anambra 13 Bauchi
14 Bayelsa 15 Benue
16 Borno 17 Cross River
18 Delta
19 Ebonyi 20 Edo
21 Ekiti 22 Enugu
23 Federal Capital Territory (Abuja) 24 Gombe
25 Imo
26 Jigawa 27 Kaduna
28 Kano
29 Katsina 30 Kebbi
31 Kogi 32 Kwara
33 Lagos 34 Nasarawa
35 Niger
36 Ogun 37 Ondo
38 Osun 39 Oyo
40 Plateau 41 Rivers
42 Sokoto
43 Taraba 44 Yobe
45 Zamfara R2. [IF COUNTRY IS NIGERIA]
Please confirm which LGA you live in?
1 Aba North 102 Katagum
104 Misau
105 Ningi 107 Tafawa-Balewa
108 Toro 11 Osisioma Ngwa
114 Nembe 117 Southern Ijaw
118 Yenagoa
119 Ado 123 Gboko
128 Konshisha 131 Makurdi
134 Ohimini 135 Oju
136 Okpokwu
137 Oturkpo 139 Ukum
146 Biu 15 Umuahia North
150 Gubio 152 Gwoza
153 Hawul
154 Jere 158 Kukawa
162 Maiduguri 17 Umu-Nneochi
170 Akamkpa 171 Akpabuyo
176 Calabar Municipal 177 Calabar South
179 Ikom
18 Demsa 182 Obudu
185 Yakurr 187 Aniocha North
193 Ika North East 195 Isoko North
199 Okpe
2 Aba South 200 Oshimili North
201 Oshimili South 203 Sapele
204 Udu 205 Ughelli North
206 Ughelli South
208 Uvwie 209 Warri North
21 Girei 210 Warri South
212 Abakaliki 213 Afikpo North
215 Ebonyi
217 Ezza South 22 Gombi
222 Ohaozara 223 Ohaukwu
224 Onicha 225 Akoko-Edo
226 Egor
229 Esan South East 23 Guyuk
230 Esan West 233 Etsako West
234 Igueben 235 Ikpoba-Okha
236 Oredo
240 Owan East 243 Ado Ekiti
245 Efon 247 Ekiti South West
248 Ekiti West 25 Jada
250 Ido-Osi 252 Ikere
256 Ise/Orun 258 Oye
26 Lamurde
261 Enugu East 262 Enugu North
263 Enugu South 265 Igbo-Etiti
269 Nkanu East 271 Nsukka
275 Uzo-Uwani
277 Abuja Municipal Area Council 278 Bwari
279 Gwagwalada 28 Maiha
282 Akko 284 Billiri
286 Funakaye
287 Gombe 288 Kaltungo
293 Abo-Mbaise 294 Ahiazu-Mbaise
296 Ezinihitte 3 Arochukwu
30 Michika
303 Mbaitoli 304 Ngor-Okpala
316 Owerri Municipal 317 Owerri North
32 Mubi South 321 Babura
325 Dutse
335 Kaugama 348 Chikun
350 Igabi 354 Kachia
355 Kaduna North 356 Kaduna South
361 Kubau
369 Zaria 370 Ajingi
374 Bichi 376 Dala
378 Dawakin Kudu 38 Yola South
381 Fagge 387 Gwale
39 Abak 390 Kano Municipal
394 Kumbotso
400 Nasarawa 407 Tarauni
41 Eket 411 Ungogo
418 Bindawa 421 Danja
423 Daura
426 Faskari 431 Kaita
434 Katsina 439 Mani
44 Etim Ekpo 443 Rimi
445 Safana
446 Sandamu 449 Arewa-Dandi
45 Etinan 453 Birnin Kebbi
455 Dandi 463 Sakaba
464 Shanga
47 Ibesikpo Asutan 470 Ajaokuta
477 Ijumu 478 Kabba/Bunu
480 Lokoja 484 Okehi
485 Okene
490 Asa 496 Ilorin South
497 Ilorin West 50 Ikono
502 Offa 506 Agege
507 Ajeromi-Ifelodun
508 Alimosho 509 Amuwo-Odofin
510 Apapa 511 Badagry
512 Epe 514 Ibeju/Lekki
515 Ifako-Ijaye 516 Ikeja
517 Ikorodu 518 Kosofe
519 Lagos Island
52 Ikot Ekpene 520 Lagos Mainland
521 Mushin 522 Ojo
523 Oshodi-Isolo 524 Shomolu
525 Surulere
526 Akwanga 529 Karu
531 Keffi 532 Kokona
533 Lafia 534 Nasarawa
535 Nasarawa-Eggon
54 Itu 541 Bida
542 Borgu 543 Bosso
544 Chanchaga 547 Gurara
549 Kontagora
552 Magama 555 Mokwa
56 Mkpat Enin 560 Shiroro
561 Suleja 563 Wushishi
564 Abeokuta North
565 Abeokuta South 566 Ado-Odo/Ota
568 Ifo 57 Nsit Atai
572 Ijebu Ode 573 Ikenne
576 Obafemi-Owode
583 Yewa South (Egbado South) 584 Akoko North East
587 Akoko South West 588 Akure North
589 Akure South 591 Idanre
592 Ifedore 593 Ilaje
594 Ile-Oluji-Okeigbo 596 Odigbo
598 Ondo East
599 Ondo West 604 Atakunmosa East
607 Boripe 608 Ede North
610 Egbedore 612 Ife Central
62 Onna
628 Olorunda 630 Orolu
631 Osogbo 633 Akinyele
640 Ibadan South East 641 Ibadan South West
645 Ido
651 Lagelu 656 Oluyole
657 Ona-Ara 666 Bassa
669 Jos North 67 Uruan
670 Jos South
675 Mangu 682 Abua - Odual
684 Ahoada West 686 Andoni
688 Bonny 69 Uyo
694 Ikwerre
695 Khana 696 Obio/Akpor
697 Ogba - Egbema - Ndoni 7 Isiala-Ngwa South
70 Aguata 700 Omumma
703 Port-Harcourt
707 Dange Shuni 712 Illela
714 Kebbe 72 Anambra West
720 Sokoto North 721 Sokoto South
725 Wamakko 73 Anaocha
733 Gassol 734 Ibi
735 Jalingo
736 Karim-Lamido 742 Wukari
747 Damaturu 75 Awka South
750 Geidam 751 Gujba
758 Potiskum
76 Ayamelum 766 Bungudu
767 Gummi 768 Gusau
769 Kaura Namoda 774 Tsafe
79 Idemili North
80 Idemili South 82 Njikoka
87 Onitsha South 89 Orumba South
90 Oyi 91 Alkaleri
92 Bauchi
93 Bogoro 96 Dass
98 Ganjuwa
R3. What is the name of the town/village you live in? ____
R4. Gender (from observation)
Male 1
Female 2
Prefer not to Answer 99
R5. What is your age in years? __________
R6. What is your marital status?
Single, Never married 1 Married 2
Partner/Common Law/ Open Union 3 Separated or Divorced 4
Widowed 5 Other 96
No Response 99
R7. Which ethnic group do you belong to?
Nigeria Kenya South Africa
13 Fulani 1 Kikuyu 24 Black African
14 Hausa 2 Luhya 25 Coloured
15 Ibibio 3 Luo 26 Indian or Asian
16 Igala 4 Kalenjin 27 White
17 Igbo 5 Kamba 96 Other (Fill in)
18 Ijaw/Izon 6 Turkana 99 No Response
19 Kanuri/BeriBeri 7 Somali 20 Tiv 8 Meru
21 Yoruba 9 Kisii
22 Urhobo/Irobo 11 Borana
23 Nupe 96 Other (Fill in)
96 Other (Fill in) 99 No Response
99 No Response
R7.5. What is your religious affiliation?
Muslim 1 Christian 2
Animism 3
Other 96 None 97
(No Response) 99
R8. How many years of education (primary, secondary, tertiary) have you attained? _______
R9. On average, in the last six months, how many members usually live in your household counting
yourself?
Hint: A household is defined as a person or a group of persons, related or unrelated, who live together in
the same dwelling unit, who make common provisions for food and regularly take their food from the same pot or share the same grain store, or who pool their income for the purpose of purchasing food.
R10. During December – February, what was your personal average income in a month? ____
(No Response) 99
R11. Since March, what was your personal average income in a month? ____
(No Response) 99
R12. Have you had financial hardship (not enough money for food or other basic needs) due to the
current COVID-19 pandemic and/or associated efforts to manage it (lockdown, curfew, and other social
distancing efforts)?
Yes 1
No 2
(No Response) 99
R13. [If R4=2] Are you currently pregnant, or have you been pregnant or given birth in the last six
months?
Yes 1
No 2
(No Response) 99
R14. How many children have you given birth to? ____
R15. [If R4=2 AND R13=2] How long would you like to wait from now before the birth of a/another child?
I want to have a/another child soon 1 I want to have a/another child later 2 Undecided whether I want a/another child 3 I don’t want more children 4 I am not able to have a/another child 96
No response 99
R16. [If R4=2 AND R13=2] Since March, has your desire for children changed?
Yes 1
No 2
(No Response) 99
R17. [If R16=1] How has your desire for children changed since March?
I no longer want a/another child 1 I am now undecided 2
I now want a/another child 3 I want to have a/another child but later than I did before
4
I want to have a/another child but sooner than I did before
5
No Response 99
R18. How many children under the age of 18 do you have? ________
(No Response) 99
R19. [If R18>0] [Ask if R4=2] Are you currently the caregiver for any children under the age of two (2)?
Yes 1
No 2
(No Response) 99
Section 2: Health Care Use
H1. During December-February, did you have a need to see a health provider?
Yes 1
No 2
No Response 99
H2. [If H1=1]: What health condition(s) required you to see a health provider during December -
February? [Check all that apply] [DO NOT READ OPTIONS; select from precodes]
Heart disease H2_Heartdisease
Stroke H2_Stroke Cancer H2_Cancer
Diabetes H2_Diabetes Kidney disease H2_Kidneydisease
Asthma H2_Asthma
Tuberculosis H2_Tuberculosis COVID-19 H2_COVID19
Pneumonia H2_Pneumonia Other Lung disease H2_OtherLungdisease
HIV H2_HIV Malaria H2_Malaria
Liver disease H2_Liverdisease
Depression, anxiety or other mental health H2_Mentalhealth Injury H2_Injury
Hearing or vision problems H2_HearingVision Bone, joint or other muscle problems H2_BoneJoint
Sexual and reproductive health H2_SexualHealth Alcohol or drug problems H2_Alcohol
High cholesterol H2_HighCholesterol
High blood pressure H2_Highbloodpressure Preventive or routine care H2_PreventiveCare
Minor health conditions H2_MinorHealthConditions Typhoid H2_Typhoid
Other H2_Other No Response H2_NoResponse
H3. [If H1=1]: Were you able to see a health provider during December - February?
Yes, I saw a provider each time I needed to
1
Partly – I saw a provider during this time, but not every time I needed
2
No – I did not see a provider 0
No Response 99
H4. [If H3 = 1 or 2] How many times did you see a health care provider during December-February?
___
H5. [If H3=0]: What was the reason you were not able to see a health provider during December-
February? [Select all that apply] [DO NOT READ OPTIONS; select from precodes]
Health facility closed H5_1 Turned away from health facility H5_2
Treatment or tests unavailable H5_3 No transportation H5_4
Lack of money H5_5 Partner or family does not approve H5_6
Did not need to see provider H5_7
Other H5_96 No Response H5_99
H6. Since March, did you have a need to see a health provider?
Yes 1
No 2 No Response 99
H7. [If H6=1]: What health condition(s) required you to see a health provider since March? [Select all
that apply] [DO NOT READ OPTIONS; select from precodes]
Heart disease H7_Heartdisease Stroke H7_Stroke
Cancer H7_Cancer
Diabetes H7_Diabetes Kidney disease H7_Kidneydisease
Asthma H7_Asthma Tuberculosis H7_Tuberculosis
COVID-19 H7_COVID19 Pneumonia H7_Pneumonia
Other Lung disease H7_OtherLungdisease
HIV H7_HIV Malaria H7_Malaria
Liver disease H7_Liverdisease Depression, anxiety or other mental health H7_Mentalhealth
Injury H7_Injury Hearing or vision problems H7_HearingVision
Bone, joint or other muscle problems H7_BoneJoint
Sexual and reproductive health H7_SexualHealth Alcohol or drug problems H7_Alcohol
High cholesterol H7_HighCholesterol High blood pressure H7_Highbloodpressure
Preventative or routine care H7_PreventiveCare Minor health conditions H7_MinorHealthConditions
Typhoid H7_Typhoid
Other H7_Other No Response H7_NoResponse
H8. [If H6=1]: Were you able to see a health provider since March?
Yes, I saw a provider each time I needed to
1
Partly – I saw a provider during this time, but not every time I needed
2
No – I did not see a provider 0
No Response 99
H9. [If H3 = 1 or 2] How many times have you seen a health care provider since March?
___
H10. [If H8=0] What was the reason you were not able to see a health provider since March? [DO NOT
READ OPTIONS; select from precodes]
Health facility closed H10_1 Turned away from health facility H10_2
Treatment or tests unavailable H10_3
No transportation H10_4 Lack of money H10_5
Unable to access due to lockdown restrictions H10_6 Fear of being infected with COVID-19 H10_7
Partner or family does not approve H10_8 Other H10_96
No Response H10_99
H11. In the last 6 months, did you have a health condition that required you to take medication?
Yes 1
No 2 No Response 99
H12. [If H11=1]: What health condition(s) did you require medication for in the past six months? [Select
all that apply] [DO NOT READ OPTIONS; select from precodes]
Heart disease H12_Heartdisease Stroke H12_Stroke
Cancer H12_Cancer
Diabetes H12_Diabetes Kidney disease H12_Kidneydisease
Asthma H12_Asthma Tuberculosis H12_Tuberculosis
COVID-19 H12_COVID19 Pneumonia H12_Pneumonia
Other Lung disease H12_OtherLungdisease
HIV H12_HIV Malaria H12_Malaria
Liver disease H12_Liverdisease Depression, anxiety or other mental health H12_Mentalhealth
Injury H12_Injury Hearing or vision problems H12_HearingVision
Bone, joint or other muscle problems H12_BoneJoint
Sexual and reproductive health H12_SexualHealth Alcohol or drug problems H12_Alcohol
High cholesterol H12_HighCholesterol High blood pressure H12_Highbloodpressure
Preventive or routine care H12_PreventiveCare Minor health conditions H12_MinorHealthConditions
Typhoid H12_Typhoid Other H12_Other
No Response H12_NoResponse
H13. [If H11=1]: During December-February, did you miss any doses of medication?
Yes 1 No 2
Don’t know 88
No Response 99
H14. [If H13=1]: On average during a week, how many doses did you miss during December - February?
Less than once a week 1 1 2
2 3
3 4 4 5
5 6 6 7
7 8 8 9
9 10
10 or more 11 No Response 99
H15. [If H13=1]: What was the reason you missed a dose of your medication during December -
February? [Select all that apply] [DO NOT READ OPTIONS; select from precodes]
Health facility or pharmacy was closed H15_1 Turned away from health facility or pharmacy H15_2
Medication unavailable at facility H15_3 No transportation H15_4
Lack of money H15_5
Partner or family does not approve H15_6 Forgot to take H15_7
Other H15_96 No Response H15_99
H16. [If H11=1]: Since March, did you miss any doses of medication?
Yes 1
No 2
Don’t know 88 No Response 99
H17. [If H16=1]: On average during a week, how many doses did you miss since March?
Less than once a week 1 1 2
2 3 3 4
4 5 5 6
6 7
7 8 8 9
9 10 10 or more 11
No Response 99
H18. [If H16=1]: What was the reason you missed a dose of your medication since March? [Select all
that apply] [DO NOT READ OPTIONS; select from precodes]
Health facility or pharmacy closed H18_1
Turned away from health facility or pharmacy H18_2 Medication unavailable at health facility or pharmacy H18_3
No transportation H18_4
Lack of money H18_5 Unable to access due to lockdown restrictions H18_8
Fear of being infected with COVID-19 H18_9 Partner or family does not approve H18_6
Forgot to take H18_7 Other (specify) H18_96
No Response H18_99
Section 3: Contraception Use [CAN ONLY COMPLETE IF FEMALE AND 18-49 YEARS OLD]
C1. In the last six months, have you or your partner used any contraceptive method to delay or avoid
getting pregnant?
Yes 1 No 2
No Response 99
C2. [IF C1=1] Indicate which type of contraception method you or your partner have used in the last six
months. [Select all that apply] [DO NOT READ OPTIONS; select from precodes]
Female sterilization C2_1
Male sterilization C2_2
Implant C2_3 IUD C2_4
Injectables C2_5 Pill C2_6
Male Condom C2_7 Female Condom C2_8
Diaphragm C2_9
Foam/Jelly C2_10 Std Days/Cycle beads C2_11
LAM C2_12 Rhythm method C2_13
Withdrawal C2_14 Other method C2_96
No Response C2_99
C3. During December-February, did you experience any difficulties in accessing your method of
contraception?
Yes 1 No 2
Did not need contraception 0 No Response 99
C4. [If C3=1]: What were the reason(s) you were not able to access your method of contraception during
December - February? [Select all that apply] [DO NOT READ OPTIONS; select from precodes]
Health facil ity closed C4_1 Turned away from health facil ity C4_2 Contraception not available C4_3 No transportation C4_4 Lack of money C4_5 Partner or family does not approve C4_6 Other (fill-in): _______ C4_96
No response C4_99
C5. Since March, did you experience any difficulties in accessing your method of contraception?
Yes 1 No 2
Did not need contraception 0 No Response 99
C6. [If C5=1]: What were the reason(s) you could not access your method of contraception since March?
[Select all that apply] [DO NOT READ OPTIONS; select from precodes]
Health facil ity closed C6_1 Turned away from health facil ity C6_2 Contraception not available C6_3 No transportation C6_4 Lack of money C6_5 Unable to access due to lockdown restrictions C6_6 Fear of being infected with COVID-19 C6_7 Partner or family does not approve C6_8 Other (fill-in): _______ C6_96
No response C6_99
Section 4. Gender Issues [CAN ONLY COMPLETE IF FEMALE AND 18-49 YEARS OLD]
G1. Are you alone right now? [SKIP ALL OTHER QUESTIONS IN THIS SECTION IF RESPONSE IS 2]
Note for interviewer: The following section can only be completed if the respondent is alone. There can
be others in the home, but the respondent must be alone in a room to complete the following section.
Yes 1 No 2
No Response 99
G2. How safe do you feel in your home, where you currently sleep?
Very safe 1
Pretty safe 2 A little unsafe 3
Very unsafe 4 No Response 99
G3. Since March, have you felt more or less safe in your home?
More safe 1 Less safe 2
About the same 3 No Response 99
G4. Is there a place that you could go if something happened that made you feel unsafe in your home?
Yes 1 No 2
No Response 99
G5. [If G4=1] During December – February, how often did you need to go to this place? Every day 1
Once a week 2
Once a month 3 Rarely 4
Never 5 No Response 99
G6. [If G4=1] Since March, how often did you need to go to this place?
Every day 1
Once a week 2 Once a month 3
Rarely 4
Never 5 No Response 99
G7. [If G4=1] Since March, did you intend to go to this safe place but were prevented from doing so?
Yes 1
No 2
No Response 99
G8. [If G7=1] What was the main reason that prevented you from going to this place? [DO NOT READ OPTIONS; select from precodes]
Unable to access place due to lockdown G8_1
Place was close or unavailable for reason other than lockdown
G8_2
Afraid of consequences G8_3 No transportation G8_4
Fear of being infected with COVID-19 G8_5 Other (fill in):_________ G8_96
No Response G8_99 G9. During the December - February, have you sought the services of a women’s help organization (e.g. crisis center, shelter, hotline)?
Yes 1 No 2
No Response 99
G10. Since March, have you sought the services of a women’s help organization (e.g. crisis center, shelter, hotline)?
Yes 1 No 2
No Response 99
G10b. Since March, have you wanted to seek the services of a women’s help organization but did not?
Yes 1 No 2
No Response 99
G11. [If G10=1] What was the main reason you were unable to seek the services of a women’s help organization? [DO NOT READ OPTIONS; select from precodes]
Did not know where to go G11_1
Too far from services G11_2 Could not afford transport or service fees G11_3
Services unavailable due to COVID-19 restrictions G11_4 Unable to travel due to COVID-19 restrictions G11_5
Fear of threats/consequences/getting into trouble
G11_6
Embarrassed for myself or my family G11_7
Other (fill in):_________ G11_96 No Response G11_99
FINALOUTCOME. What is the final outcome for this household? INCLUDE IN FINAL DATASET
Completed interview (contact made) 1.
Number not working (ineligible) 2. InterimOutcome=3
Refusal 3. S1=2
No contact made after 5 visits (non-contact) 4.
Unable to confirm eligibility as the contact doesn’t speak the languages
(non-contact)
5.
Further information refused by contact (household refusal) 6.
Broken connection/appointment – no re-contact (contact made) 7. If ‘Break up’
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