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Abortion Incidence and Severity of Complications in Kenya 2022
Kenya - DDI-KEN-APHRC-KAS-HFS-2022-v1.0
When will you be available
Abortion Incidence and Severity of Complications in Kenya 2022
Kenya - DDI-KEN-APHRC-KAS-HFS-2022-v1.0
Do you agree to participate in the survey?
Abortion Incidence and Severity of Complications in Kenya 2022
Kenya - DDI-KEN-APHRC-KAS-HFS-2022-v1.0
There is a chance that we may also want to recontact you to clarify details or follow up on any answers you provide today. Do we have your consent to recontact you for that reason?
Abortion Incidence and Severity of Complications in Kenya 2022
Kenya - DDI-KEN-APHRC-KAS-HFS-2022-v1.0
Phone number
Abortion Incidence and Severity of Complications in Kenya 2022
Kenya - DDI-KEN-APHRC-KAS-HFS-2022-v1.0
Email address
Abortion Incidence and Severity of Complications in Kenya 2022
Kenya - DDI-KEN-APHRC-KAS-HFS-2022-v1.0
To confirm your consent, I am going to read a statement about the information I just provided. Please let me know if you agree or disagree.
I have been told about the Informed Consent for this study. I have received an explanation of the planned interview procedure, and associated risks and benefits. I have received an explanation of the procedures to attempt to ensure that my answers will be kept private and confidential. I understand that my participation in this study is voluntary. I understand that information obtained in this study will be kept as confidential as possible, and that only my contact information may be used to identify me.
Abortion Incidence and Severity of Complications in Kenya 2022
Kenya - DDI-KEN-APHRC-KAS-HFS-2022-v1.0
Gather initials
Abortion Incidence and Severity of Complications in Kenya 2022
Kenya - DDI-KEN-APHRC-KAS-HFS-2022-v1.0
Investigator or person who conducted Informed Consent discussion:
C5. I confirm that I have personally explained the nature and extent of the planned research, study procedures, potential risks and benefits, and confidentiality of personal information.
Abortion Incidence and Severity of Complications in Kenya 2022
Kenya - DDI-KEN-APHRC-KAS-HFS-2022-v1.0
Field interviewer to sign or insert initials
Abortion Incidence and Severity of Complications in Kenya 2022
Kenya - DDI-KEN-APHRC-KAS-HFS-2022-v1.0
How long have you worked in this facility?
Abortion Incidence and Severity of Complications in Kenya 2022
Kenya - DDI-KEN-APHRC-KAS-HFS-2022-v1.0
Does this facility offer patient services and care 24 hours per day, 7 days per week?
Abortion Incidence and Severity of Complications in Kenya 2022
Kenya - DDI-KEN-APHRC-KAS-HFS-2022-v1.0
If no, how many days a week does this facility offer patient services and care?
Abortion Incidence and Severity of Complications in Kenya 2022
Kenya - DDI-KEN-APHRC-KAS-HFS-2022-v1.0
On days the facility is open, approximately how many hours per day does this facility offer patient services and care?
Abortion Incidence and Severity of Complications in Kenya 2022
Kenya - DDI-KEN-APHRC-KAS-HFS-2022-v1.0
Please specify hours
Abortion Incidence and Severity of Complications in Kenya 2022
Kenya - DDI-KEN-APHRC-KAS-HFS-2022-v1.0
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