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_notestyperepeat_countnameread_onlyrelevantcalculationrequiredappearancedefaultconstraintlabel::Englishhint::Englishlabel::Swahilihint::Swahili
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S.E.L.F. Study: Quantitative Survey – Pregnancy Termination
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imeiimei
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startsurvey_start
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endsurvey_end
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todaysurvey_day
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deviceiddeviceid
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simserialsim_serial_number
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phonenumberphone_number
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calculateuuidconcat('uuid:', uuid())
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Consent
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select_one okayconsent_okyesquickInformed consent obtained for S.E.L.F. quantitative survey. Obtain informed consent from the participant.Makubaliano iliyo toka kwenyi utafiti inayo husu Idadi Ofisini S.E.L.F.Makubaliano kutokeya wauzuriaji
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A. Survey / RDS Details
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begin_groupsection_aA. Survey / RDS DetailsA. Utafiti
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textq_1yes1. Voucher Number1. Namba ya Mulengwa
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dateq_2yes.<=today()2. Date of interview2. Siku ya kujibu ku maswali ama maulizo
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end_group
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B. Demographics
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begin_groupsection_bDemographicsUtafiti kuhusu wakaaji
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integerq_5yes.>0 and .<=1005. What is your age?Age in years5. Una umri gani?# miaka
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begin_groupsubsection_b1${q_5} > 17
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select_one locationq_6yes6. In which part of South Kivu do you currently live?town/village6. Ni mahali gani una ishi kwa sasa ndani ya Jimbo la Kivu ya Kusini?mjini ao kijijini
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select_one locationq_7${q_6} != -1yes7. In which part of South Kivu is your hometown/village?7. Muji ama kijiji yako ni gani ndani ya Jimbo la Kivu ya Kusini?
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added v283textq_7s${q_7} = -1yesSpecify Other location.Ni gani
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select_one q8_optionsq_8${q_6} != -1yes8. Which ethnic group do you identify with most?8. Kabila yako ni gani?
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textq_8s${q_8} = -1 and ${q_6} != -1yesSpecify Other ethnic group.Ni gani
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select_one q9_optionsq_9${q_6} != -1yes9. What is your current marital status?PROBE: if married, ask: ‚Do you live with your husband now?‚ and if no, probe to determine if divorced/separated or just for economic reasons9. Je Umeolewa ao hapana?Kama amefanya ndowa, umuulize: “Unaishi na mume wako kwa sasa? Na kama hapana, fanya utafiti kusudi ujuwe kama dowa imevunjwa kiserkali / ama wameachana na hawaishi pamoja sababu ya ukosefu?”
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textq_9s${q_9} = -1 and ${q_6} != -1yesSpecify Other marital status.Ni gani
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select_one q10_optionsq_10${q_6} != -1yes10. What religion do you identify with most?10. Una Sali katika dini gani?
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textq_10s${q_10} = -1 and ${q_6} != -1yesSpecify Other religion.Ni gani
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select_one q11_optionsq_11${q_6} != -1yes11. What is your main occupation?11. Una fanya kazi gani?
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textq_11s${q_11} = -1 and ${q_6} != -1yesSpecify Other occupation.Ni gani
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select_one q12_optionsq_12${q_6} != -1yes12. What is the highest level of schooling that you have completed?12. Umesoma kiasi gani?
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textq_12s${q_12} = -1 and ${q_6} != -1yesSpecify Other level of schooling.Ni gani
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integerq_13${q_6} != -1yes.>=0 and .<1013. How many meals per day do you usually eat?not including tea or water only as meal13. Unakulaka mara ngapi kwa sikubila kutaja chai ama maji
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select_one q14_optionsq_14${q_6} != -1yes14. What material is your home or shelter primarily made of?14. Nyumba ama makao yako imejengwa zaidi na nini (chagua kati za majibu zifwatayo)?
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textq_14s${q_14} = -1yesSpecify Other material used for housing.Ni gani
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end_groupsubsection_b1
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end_group
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C. Obstetric & Gynecologic History
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begin_groupsection_c${q_5} > 17 and ${q_6} != -1C. Obstetric & Gynecologic HistoryC. Historia ya uzazi
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integerq_15yes.>=0 and .<3015. How many pregnancies have you had in your lifetime that resulted in a child that was born alive?15. Kati ya mimba ambazo ume pata, ngapi zime fikiliya watoto walio zaliwa wazima?
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integerq_16yes.>=0 and .<3016. How many pregnancies have you had in your lifetime that resulted in a child that was born dead?16. Kati ya mimba ambazo ume pata, ngapi zime fikiliya watoto walio zaliwa wana kufa?
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integerq_17yes.>=0 and .<3017. How many pregnancies have you had in your lifetime that resulted in spontaneous miscarriage?17. Kati ya mimba ambazo ume pata, ngapi zime fikiliya mimba iliotoka bila kutaka?
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integerq_18yes.>=0 and .<3018. How many pregnancies have you had in your lifetime that resulted in intentional termination?18. Kati ya mimba ambazo ume pata, ngapi zime fikiliya mimba iliotoka kwa kutaka?
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end_group
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D. Sexual Violence History
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begin_groupsection_d${q_5} > 17 and ${q_6} != -1 and ${q_18} > 0D. Sexual Violence HistoryD. Historia kuhusu ujeuri (ubakaji)
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noten_19The following questions are to learn more about your experience of sexual violence, which includes forced intercourse against your will, being forced to undress, molestation, and Other unwanted sexual acts. I am particularly interested in your experience of sexual violence since the beginning of the war (~1996).
Please feel free to take your time in responding to these questions. We can stop or take a break at any time if you need to. I appreciate that these are sensitive questions.
Read to respondentMaulizo yafwatayo yata turuhusu kuelewa vizuri maisha yako kuhusu shida za ujeuri kwa wa mama na wabinti inayo lingana na kuingiliwa kupitiya viungo vya uzazi bila wewe kutaka, kuondolewa mavazi kwa kingufu, kuguswa, na zingine njia. Ningependa kujuwa zaidi kuhusu shida ulizo zipata kuhusu ubakaji tangu vita vya mwaka wa 1996.
Tafadhali, ujisikie huru kwa kujibu kwa maswali haya. Nafikiri maulizo haya labda yanagusa zamiri zako.
Kusoma
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integerq_19yes19. How many times have you experienced sexual violence since the beginning of the war in 1996?19. Marangapi ume bakwa tangu vita vya 1996 ?
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integerq_20${q_19} > 0yes20. How many pregnancies have resulted from sexual violence since the beginning of the war in 1996? 20. Umebeba mimba ngapi kutokana na ubakaji tangu vita vya 1996?
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select_one yes_noq_21${q_20} > 0yes21. Were any of the pregnancy/pregnancies which resulted from sexual violence terminated? 21. Kumekuwa mimba ambazo zime tokana na ubakaji ambazo zimetoka?
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integerq_22selected(${q_21}, '1') and ${q_20} > 0yes.>0 and .<=${q_20}22. Please specify the number of terminations.22. Ujulishe ni mimba ngapi zimetoka.
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calculatetermination_nbif(${q_20}=1, 1, int(${q_22}))
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end_group
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E. Sexual Violence & Pregnancy
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begin_grouppart_1${termination_nb} > 0 and ${q_6} != -1 and selected(${q_21}, '1')II
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begin_groupsection_eE. Sexual Violence & PregnancyE. Ubakaji na mimba
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noten_23THE FOLLOWING QUESTIONS REFER TO THE (SEE ABOVE NUMBER) TERMINATION OF SEXUAL VIOLENCE RELATED PREGNANCIES SINCE THE BEGINNING OF THE WAR IN 1996.

Please feel free to take your time in responding to these questions. You may stop or take a break at any time if you need to. I appreciate that these are sensitive questions.
Read to respondentMaulizo zifwatayo zina gusa (ona idadi yenyi kuwa juu) mimba na mtoto ama watoto wanao tokana na Maswali yafwatayo yana husu ubakaji uliyo pelekeya kubeba mimba tangu vita ya 1996.

Tafadhali, ujisikie huru kwa kujibu kwa maswali haya. Nafikiri maulizo haya labda yanagusa zamiri zako.
Kusoma
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check SW stringbegin_repeatterm_loopPREGNANCY TERMINATION#ZIMETOKA #
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select_one q23_optionsq_23yes23. During the sexual assault that led to this pregnancy, how many different assailants would you estimate raped you? )23. Wakati ulipata shida ya ubakaji na kubeba mimba, niwabakaji wa ngapi waliokutenda hiyo kitendo?
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select_one yes_no_dnq_24yes24. Was this pregnancy conceived while the assailant(s) held you in captivity for > 24 hours?24. Ulikuwa ukishikwa na mubakaji (wabakaji) zaidi ya saa makumi mbili na ine?
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begin_groupdate_assaultfield-list
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notenote_assaultminimal25. If known, what was the date of the sexual assault?25. Ubakaji lifanyika wakati gani?
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select_one calendarYearsassault_yyyyyesminimalYearMwaka
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select_one calendarMonthsassault_mmmyesminimalMonthMwezi
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select_one calendarDaysassault_ddyesminimalDaySiku
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end_groupdate_assault
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select_multiple q26_optionsq_26yes26. How would you best describe the perpetrator(s)Do NOT read options; select all that apply26. Unaweza kusema machache kuhusu wale wabakaji/mubakaji ?Usisome majibu, una weza kuchaguwa yote kama ina wezekana
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textq_26sselected(string(${q_26}), '-1') or selected(string(${q_26}), '32')yesSpecify Other.Ni gani
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select_one calendarYearsq_27yes27. What year did the pregnancy occur in?27. Mwaka gani umebeba mimba ?
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integerq_28yes.>=0 and .<928. At how many months gestation, did you find out that you were pregnant?Input zero (0) if unknown.28. Kisha myezi ngapi umetambua kama uko na mimba?Hakuna kitu (0) kama sababu haijulikane
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noten_29I would like to speak with you more about the process of seeking a termination for pregnancies resulting from sexual violence. I understand that these are sensitive questions.

Please feel free to take your time in responding to these questions. You may stop or take a break at any time if you need to.
Read to respondentNinge penda tuzungumuze na wewe kuhusu namna mimba imefika kutoka kisha kubakiwa. Najua kama maulizo haya ni mazito.

Tafazali ujisikiye huru kwa ku jibu kwa maulizo haya. Ukiya sikiya mazito una weza kuto endeleya kujibu.
Kusoma
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integerq_29yes29. How many months gestation were you at the time of the termination?Input zero (0) if unknown.29. Ulikuwa na miezi ngapi ya mimba wakati ilitoka? Hakuna kitu (0) kama sababu haijulikane
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select_multiple q30_optionsq_30yes30. How did you find out where to go for a pregnancy terminationDo NOT read options; select all that apply30. Namna gani ulijuwa nafasi pa kwenda kuondosha mimbaUsisome majibu, una weza kuchaguwa yote kama ina wezekana
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textq_30sselected(string(${q_30}), '-1')yesSpecify Other.Ni gani
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integerq_31yes(. >= 0) and (.<= 100)31. How many times did you try to terminate the pregnancy?number of times31. Mara ngapi ume jaribu kutosha mimba?mara ngapi
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select_multiple q32_optionsq_32${q_31} > 0yes32. What method of termination did you use?Do NOT read options; select all that apply32. Umetumiya njia gani?Usisome majibu, una weza kuchaguwa yote kama ina wezekana
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textq_32s${q_31} > 0 and selected(string(${q_32}), '-1')yesSpecify Other method of terminationNi gani
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textq_32s_name${q_31} > 0 and not(selected(string(${q_32}), '8')) and not(selected(string(${q_32}), '9')) and not(selected(string(${q_32}), '-1'))yesPlease specify the name of the medicine/herb usedKama ndiyo, taja jina ya dawa /muti uliyo ingiza
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select_multiple q33_optionsq_33${q_31} > 0 and (selected(string(${q_32}),'1') or selected(string(${q_32}), '2') or selected(string(${q_32}),'3') or selected(string(${q_32}), '4') or selected(string(${q_32}), '5') or selected(string(${q_32}), '6') or selected(string(${q_32}),'7')) or count-selected(${q_32}) > 1yes33. Who gave you the medication or told you what medication to takeDo NOT read options; select all that apply33. Ni nani aliye kupatiya dawa hiyo ao ni nani aliye kujulisha kuhusu dawa hiyo?Usisome majibu, una weza kuchaguwa yote kama ina wezekana
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textq_33s${q_31} > 0 and selected(string(${q_34}), '-1')yesSpecify Other medication provider.Ni gani
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select_multiple q34_optionsq_34${q_31} > 0 and (selected(string(${q_32}),'3') or selected(string(${q_32}), '4') or selected(string(${q_32}), '5') or selected(string(${q_32}), '6') or selected(string(${q_32}),'7') or selected(string(${q_32}),'8')) or count-selected(${q_32}) > 1yes34. Who performed the procedure or injected the medication?Do NOT read options; select all that apply34. Ni nani aliye husika na kuku tosha ile mimba ao ni nani aliyekupatiya dawa ya kuitosha?Usisome majibu, una weza kuchaguwa yote kama ina wezekana
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textq_34s${q_31} > 0 and selected(string(${q_35}), '-1')yesSpecify Other.Ni gani
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select_multiple q34_optionsq_35${q_31} > 0 and ${q_32}= 9 or count-selected(${q_32}) > 1yes35. Who performed the ritual or ceremony?Do NOT read options; select all that apply35. Ni nani aliyehusika na nambo ya kiasili kwa kukutosha mimba hiyo? Usisome majibu, una weza kuchaguwa yote kama ina wezekana
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textq_35s${q_31} > 0 and selected(string(${q_36}), '-1')yesSpecify Other.Ni gani
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select_one q36_optionsq_36${q_31} > 0yes36. What did you pay for your termination?36. Ni nini ulilipa kwa kuondowa mimba?
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select_one q36_pricesq_36_price${q_36} = 1yesHow much?Pesa ngapi?
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textq_36s${q_36} = -1yesSpecify Other means of payment.Ni gani
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check SW stringselect_multiple q37_optionsq_37${q_31} > 0 and ${q_36} = 1yes37. How did you pay for the termination?Do NOT read options; select all that apply37. Kama ni hapana, umefanya je kwaku pata franka ya kulipa kwa kuondowa mimba. Usisome majibu, una weza kuchaguwa yote kama ina wezekana
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textq_37s${q_31} > 0 and selected(string(${q_37}), '-1')yesSpecify Other.Ni gani
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select_one yes_noq_38${q_31} > 0 and ${q_31} > 0yes38. Did you have any physical symptoms or complications from the termination?38. Je ulipata alama kwa mwili ama magumu kuhusu kutoka kwa mimba?
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select_multiple q39_optionsq_39${q_31} > 0 and ${q_38} = 1yes39. What were the physical symptoms or complications?Do NOT read options; select all that apply39. Alama gani uliyopata kwa mwili ama magumu? Usisome majibu, una weza kuchaguwa yote kama ina wezekana
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textq_39s${q_31} > 0 and selected(string(${q_39}), '-1')yesSpecify Other.Ni gani
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select_one yes_noq_40${q_31} > 0 and ${q_38} = 1yes40. Did you seek care for the complication(s)? 40. Ulitafuta matunzo sababu ya ile magumu?
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select_multiple q41_optionsq_41${q_31} > 0 and ${q_40} = 1yes41. Where did you seek care for the complication(s) or symptoms?41. Wapi umepewa matunzo kwa matokeo/alama ulizo zipata?
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textq_41s${q_31} > 0 and selected(string(${q_41}), '-1')yesSpecify Other.Ni gani
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select_multiple q42_optionsq_42${q_31} > 0yes42. How were you affected emotionally and socially after the termination?42. Umesikiya je kimawazo ama ki jirani kisha kutowa mimba ?
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textq_42s${q_31} > 0 and selected(string(${q_42}), '-1')yesSpecify Other.Ni gani
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end_repeat
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