Variable | Survey Question (s) | Source |
---|---|---|
Socio-demographic Characteristics | ||
Age (Range: 18–42) | How old are you? | Woman’s self report |
Education | What is your highest level of education? | Woman’s self report |
No education | ||
Primary | ||
Secondary or higher | ||
Marital status | What is your current marital status? | Woman’s self report |
Married | ||
Separated/Divorced | ||
Widowed | ||
Unmarried | ||
MR, PAC and Family Planning Service Integration Indicators | ||
Uterine Evacuation Service Type | What kind of care did this woman receive at the facility today? | Provider’s report |
Menstrual Regulation (MR) | ||
Postabortion Care (PAC) | ||
Provider Type | What type of health provider treated you? | Woman’s self report |
Doctor (Obstetrician-Gynecologist or Medical Officer) | ||
Midlevel provider (Family Welfare Visitor or Nurse) | ||
Counseled on Post-abortion Family Planning | Were you told about family planning during your visit today? | Woman’s self report |
Yes | ||
No | ||
Post-abortion Family Planning Accepted | Did you receive a family planning method today? | Woman’s self report |
Yes | ||
No | ||
Type of Family Planning Method Accepted | Which method did you receive? | Woman’s self report |
Short-acting method (Condoms, Pills, Injectables) | ||
Long-acting method (Intrauterine Device, Implant, Sterilization) | ||
No method | ||
Reason for Not Accepting a Family Planning Method | Why do you think that you did not receive a method? | Woman’s self report |
Did not want a method | ||
Not offered a method | ||
Did not have method she wanted | ||
Will accept a method later | ||
Have not decided on a method yet | ||
Other | ||
Quality of Care Indicators | ||
Procedure Type | What UE method was used to provide this woman with MR/PAC? | Provider’s report |
Manual Vacuum Aspiration (MVA) | ||
Dilation and Curettage | ||
Pain Management Provided | Did the woman receive anything for pain? | Provider’s report |
Yes | ||
No | ||
Time Waited before Being Seen by a Provider | How long did you wait in this facility before you were firstseen by a health care worker today? | Woman’s self report |
Less than 1 h | ||
1–2 h | ||
3–6 h | ||
6 or more hours | ||
Satisfaction with Amount of Time Waited | How do you feel about the amount of time you had to wait for your procedure? | Woman’s self report |
Acceptable | ||
Too long | ||
Satisfaction with Privacy during Treatment | Were you satisfied with the level of privacy that you had during your treatment at this facility? | Woman’s self report |
Satisfied | ||
Not satisfied | ||
Provider Communication Score (Range: 0–11) | 1. Did the health provider talk to you and explain the different procedure options you had for treating your condition? | Woman’s self report |
2. Did the provider introduce him/herself to you by name? | ||
3. Did the provider ask you if you had any questions about the procedure? | ||
4. Did the provider give you enough info about your care so that you felt comfortable with the procedure? | ||
5. Did you provider tell you how to care for yourself once you get home? | ||
6. Did the health provider tell you about the need to avoid sexual intercourse until a few days after bleeding stops? | ||
7. Did the provider tell you about warning signs or complications you should look for after leaving the facility that mean you should go to the nearest health center or hospital right away? | ||
8. Did the provider tell you that without using a family planning method you could get pregnant again quickly, even before your next menstruation? | ||
9. Did the provider say anything to you during the procedure to make you more comfortable? | ||
10. Did the health provider assure you that the information that you shared would be kept confidential? | ||
11. Were you told about family planning during your visit today? | ||
Rating of Care Received | Overall, how would you rate the care you received today? Was the care excellent, good, fair or poor? | Woman’s self report |
Excellent or good | ||
Fair or poor |