Online Supplementary Material

IYCF and PMTCT in Malawi Study

Survey Questionnaire for women in PMTCT with children < 24 months

July 16, 2014

Study ID: S ______

Name of data collector: ______Date: ______

This survey is to be administered to women between 18 and 45 years of age. They should have been in PMTCT at least since the birth of their youngest child. We will select 40 women with children in each of the following age categories: 0-5 months, 6-11 months, 12-17 months, and 18-23 months. Use the Questionnaire Respondent Log to determine whether women with children in the age category are still required.

SCREENING MODULE

No. / QUESTIONS AND FILTERS / CODING CATEGORIES / SKIP
1 / In what month and year were you born? / Month………………. ______
If month is not known, enter 98
Year……..______
If year is not known, enter 9998
2 / Please tell me how old you are. What was your age at your last birthday?
RECORD AGE IN COMPLETED YEARS / Age in completed years ______
3 / CHECK Q1 AND Q2: IS THE RESPONDENT BETWEEN THE AGES OF 18 AND 45 YEARS? IF THE INFORMATION IN Q1 AND Q2 CONFLICTS, DETERMINE WHICH IS MOST ACCURATE. / Yes……………………………….1
No………………………………..0 / →END MODULE
4 / When was the last time you gave birth?
IF THE RESPONDENT DOES NOT KNOW THE BIRTHDATE ASK:
Do you have a health/vaccination card for the child with the birthdate recorded?
IF THE HEALTH/VACCINATION CARD IS SHOWN, RECORD THE DATE OF BIRTH AS DOCUMENTED ON THE CARD. IF THE HEALTH/VACCINATION CARD IS NOT AVAILABLE USE AN EVENT CALENDAR TO ESTIMATE THE CHILD’S BIRTH MONTH AND YEAR. / Date of last birth:
Day…………………. ______
If month is not known, enter 98
Month………………. ______
Year……..______/ If the woman has never given birth →END MODULE
5 / USE Q4 TO CALCULATE THE CHILD’S AGE IN MONTHS. TICK THE CHILD’S AGE CATEGORY:
____0-5 MONTHS
____6-11 MONTHS
____12-17 MONTHS
____18-23 MONTHS
CHECK THE QUESTIONNAIRE RESPONDENT LOG TO DETERMINE WHETHER YOU STILL NEED TO INTERVIEW WOMEN WITH CHILDREN IN THIS AGE CATEGORY. IF YES, RECORD THE RESPONDENTS NAME AND CHILD’S AGE ON THE LOG AND RECORD THE STUDY ID AT THE TOP OF THIS FORM, THEN CONTINUE TO Q6. IF YOU HAVE COMPLETED INTERVIEWS FOR THIS AGE CATEGORY, END THE MODULE.
6 / What is the name of the last child you gave birth to? / Name: ______
7 / Is (NAME) male or female? / Male……………………………...0
Female…………………………...1
8 / When were you diagnosed with HIV?
CIRCLE ONE RESPONSE. / During previous pregnancy………1
During most recent pregnancy……………………...…2
At birth of youngest child………..3
After birth of youngest child……..4
Not diagnosed with HIV.………..0 / →END MODULE
→END MODULE
9 / Who have you told about your HIV status?
DO NOT READ RESPONSES. CIRCLE ‘1’ FOR ALL MENTIONED AND CIRCLE ‘0’ FOR ALL NOT MENTIONED. / YES NO
No one…………………..1 0
Spouse/partner…………..1 0
Mother/mother-in-law…..1 0
Other relative/friend…….1 0
Other……………………..1 0
Specify:______
10 / What is the HIV status of (NAME)’s father? / HIV-positive…………………….1
HIV-negative……………………2
Don’t know……………………..98
11 / What is (NAME)’s HIV status? / HIV-positive…………………….1
HIV-negative……………………2
Don’t know……………………..98

INITIATION OF BREASTFEEDING AND CURRENT BREASTFEEDING

No. / QUESTIONS AND FILTERS / CODING CATEGORIES / SKIP
12 / Did you ever breastfeed (NAME)? / Yes……………………………….1
No………………………………..0 / SKIP to Q22
13 / How long after birth did you first put (NAME) to the breast?
IF RESPONDENT REPORTS SHE PUT THE INFANT TO THE BREAST IMMEDIATELY AFTER BIRTH, CIRCLE ‘000’ FOR ‘IMMEDIATELY’.
IF LESS THAN 1 HOUR, CIRCLE ‘1’ FOR HOURS AND RECORD ‘00’ HOURS.
IF LESS THAN 24 HOURS, CIRCLE ‘1’ AND RECORD NUMBER OF COMPLETED HOURS, FROM 01 TO 23.
OTHERWISE, CIRCLE ‘2’ AND RECORD NUMBER OF COMPLETED DAYS. / Immediately……………………000
OR
Hours…………………1 ______
OR
Days………………….2 ______
14 / During the first three days after delivery, did you give (NAME) the thick, yellow liquid that came from your breasts? / Yes……………………………….1
No………………………………..0 / SKIP to Q16
15 / What did you do with the thick, yellowish liquid that came from your breasts? / Discard after baby was born……..1
Other ______...2
16 / In the first three days after delivery was (NAME) given anything to drink other than the thick, yellowish liquid that came from your breasts or breastmilk? / Yes……………………………….1
No………………………………..0 / SKIP to Q18
17 / What was (NAME) given to drink during the first three days after delivery? Anything else?
DO NOT READ THE LIST. RECORD ALL MENTIONED BY CIRCLING 1. RECORD THOSE NOT MENTIONED BY CIRCLING 0. / YES NO
Other milk, not breastmilk...1……0
Plain water………………...1...….0
Tea/herbal water…………..1……0
Sugar or glucose water…….1……0
Infant formula………………1……0
Watery porridge……………1…….0
Other……………………….1…….0
Specify:______
18 / Are you still breastfeeding (NAME)? / Yes……………………………….1
No………………………………..0 / SKIP to Q20
19 / For how many months did you breastfeed (NAME)? / Months………….….______/ SKIP to Q22
20 / Was (NAME) breastfed yesterday during the day or at night? / Yes……………………………….1
No………………………………..0
21 / Sometimes babies are fed breastmilk in different ways, for example by spoon, cup or bottle. This can happen when the mother cannot always be with her baby. Sometimes babies are breastfed by another woman, or given breastmilk from another woman by spoon, cup or bottle or some other way. This can happen if a mother cannot breastfeed her own baby.
Did (NAME) consume breastmilk in any of these ways yesterday during the day or at night? / Yes……………………………….1
No………………………………..0

FEEDING PRACTICES ON THE PREVIOUS DAY

READ THE QUESTIONS BELOW. READ THE LIST OF LIQUIDS ONE BY ONE AND MARK YES OR NO, ACCORDINGLY. AFTER YOU HAVE COMPLETED THE LIST, CONTINUE BY ASKING QUESTION 23 (SEE FAR RIGHT HAND COLUMN) FOR THOSE ITEMS (23B, 23C AND/OR 23D) WHERE THE RESPONDENT REPLIED ‘YES’.

No. / QUESTIONS AND FILTERS / CODING CATEGORIES / QUESTIONS AND CODING CATEGORIES
22 / Next I would like to ask you about some liquids that (NAME) may have had yesterday during the day or at night.
Did (NAME) have any (ITEM FROM LIST):
READ THE LIST OF LIQUIDS STARTING WITH ‘PLAIN WATER’. / YES / NO / DK / 23. How many times yesterday during the day or at night did (NAME) consume any (ITEM FROM LIST):
READ QUESTION 23 FOR ITEMS B, C, AND D IF CHILD CONSUMED THE ITEM. RECORD ‘98’ FOR DON’T KNOW.
A / Plain water? / A… / 1 / 0 / 98
B / Infant formula, such as Lactogen? / B… / 1 / 0 / 98 / B. Times ______
C / Milk, such as tinned, powdered, or fresh animal milk? / C… / 1 / 0 / 98 / C. Times ______
D / Yogurt? / D… / 1 / 0 / 98 / D. Times ______
E / Juice or juice drinks? / E… / 1 / 0 / 98
F / Tea or coffee? / F… / 1 / 0 / 98
G / Soft drink? / G… / 1 / 0 / 98
H / Soup or broth? / H… / 1 / 0 / 98
I / Thin porridge? / I… / 1 / 0 / 98
J / Thobwa? / J… / 1 / 0 / 98
K / Any other liquids? / K… / 1 / 0 / 98
No. / QUESTIONS AND FILTERS / CODING CATEGORIES / SKIP
24 / Did (NAME) drink anything from a bottle with a nipple yesterday during the day or at night? / Yes……………………………….1
No………………………………..0
25 / Please describe everything that (NAME) ate yesterday during the day or night, whether at home or outside the home.
a)  Think about when (NAME) first woke up yesterday. Did (NAME) eat anything at that time? IF YES: Please tell me everything (NAME) ate at that time. PROBE: Anything else? UNTIL RESPONDENT SAYS NOTHING ELSE. IF NO, CONTINUE TO QUESTION b).
b)  What did (NAME) do after that? Did (NAME) eat anything at that time?
IF YES: Please tell me everything (NAME) ate at that time. PROBE: Anything else? UNTIL RESPONDENT SAYS NOTHING ELSE.
REPEAT QEUSTION b) ABOVE UNTIL RESPONDENT SAYS THE CHILD WENT TO SLEEP UNTIL THE NEXT DAY.
IF RESPONDENT MENTIONS MIXED DISHES LIKE PORRIDGE OR RELISH, PROBE:
c)  What ingredients were in that (MIXED DISH)? PROBE: Anything else? UNTIL THE RESPONDENT SAYS NOTHING ELSE.
AS THE RESPONDENT RECALLS FOODS, UNDERLINE THE CORRESPONDING FOOD AND CIRCLE ‘1’ IN THE COLUMN NEXT TO THE FOOD GROUP. IF THE FOOD IS NOT LISTED IN ANY OF THE FOOD GROUPS BELOW, WRITE THE FOOD IN THE BOX LABELED ‘OTHER FOODS’. IF FOODS ARE USED IN SMALL AMOUNTS FOR SEASONING OR AS A CONDIMENT, INCLUDE THEM UNDER THE CONDIMENTS FOOD GROUP.
ONCE THE RESPONDENT FINISHES RECALLING FOODS EATEN, READ EACH FOOD GROUP WHERE ‘1’ WAS NOT CIRCLED, ASK THE FOLLOWING QUESTION AND CIRCLE ‘1’ IF RESPONDENT SAYS YES, ‘2’ IF NO AND ‘98’ IF DON’T KNOW.
Yesterday during the day or night, did (NAME) drink/eat any (FOOD GROUP ITEMS)?
OTHER FOODS: PLEASE WRITE DOWN OTHER FOODS IN THIS BOX THAT RESPONDENT MENTIONED BUT ARE NOT IN THE LIST BELOW:
No. / QUESTIONS AND FILTERS / CODING CATEGORIES
YES / NO / DK
A / Bread, scone, maize meal (mgaiwa), maize flour (ufa woyera), millet, rice, sorghum, noodles, or other food made from grains / A…… / 1 / 2 / 98
B / Pumpkin, carrots, squash, or sweet potatoes that are yellow or orange inside / B…… / 1 / 2 / 98
C / Cocoyams, irish potatoes, white sweet potatoes, white yams, cassava, or other local roots or tubers / C…… / 1 / 2 / 98
D / Any dark green leafy vegetables such as amaranth, bonongwe, pumpkin leaves, Chinese cabbages, greens, kale, cassava leaves, fresh bean leaves, fresh cowpea leaves, fresh sweet potato leaves / D…… / 1 / 2 / 98
E / Dried leaves of bean, cowpea or sweet potato / E…… / 1 / 2 / 98
F / Ripe mangoes, ripe papaya, or ripe guava / F…… / 1 / 2 / 98
G / Any other fruits or vegetables (for example, bananas, apples, green beans, tomatoes, avocadoes, okra) / G…… / 1 / 2 / 98
H / Liver, kidney, heart, or other organ meats / H…… / 1 / 2 / 98
I / Any meat, such as beef, pork, lamb, goat, chicken, duck, rabbit or rodents (such as mice or moles) / I……. / 1 / 2 / 98
J / Eggs / J……. / 1 / 2 / 98
K / Fresh or dried fish, nhkanu, crabs, or other seafood / K…… / 1 / 2 / 98
L / Any foods made from beans, soybeans, lentils, nuts, pigeon peas, cowpeas, or groundnut flour (nsinjiro) / L…… / 1 / 2 / 98
M / Cheese, yogurt, or other milk products / M…… / 1 / 2 / 98
N / Any oil, fats, or butter, or foods made with any of these / N…… / 1 / 2 / 98
O / Any sugary foods such as chocolates, sweets, candies, sugar cane, honey, pastries, cakes, or biscuits / O…… / 1 / 2 / 98
P / Condiments for flavor, such as chilies or spices / P…… / 1 / 2 / 98
Q / Grubs, snails, or insects / Q…… / 1 / 2 / 98
Check categories A-Q / IF ALL ‘NO’: GO TO Q26
IF AT LEAST ONE
‘YES’ OR ALL ‘DK’:
GO TO Q27
No. / QUESTIONS AND FILTERS / CODING CATEGORIES / SKIP
26 / Did (NAME) eat any solid, semi-solid, or soft foods yesterday during the day or at night?
IF ‘YES’ PROBE: What kind of solid, semi-solid, or soft foods did (NAME) eat? / Yes……………………………….1
GO BACK TO Q25 AND RECORD FOODS EATEN. THEN CONTINUE WITH Q27.
No………………………………..0
Don’t know……………………..98 /
GO to Q28
GO to Q28
27 / How many times did (NAME) eat solid, semi-solid, or soft foods other than liquids yesterday during the day or at night? / Number of times ______
Don’t know…………………….98

TIMING OF STARTING FOODS AND FLUIDS

No. / QUESTIONS AND FILTERS / CODING CATEGORIES / SKIP
28 / Have you or another relative ever given (NAME) herbal medicines to drink to keep him/her healthy? / Yes……………………………….1
No………………………………..0 / SKIP to Q30
29 / At what age did you first give (NAME) herbal medicines to drink? / Hours……………….______1
Days…………….….______2
Months………….….______3
30 / At what age did you start to give (NAME) plain water? / Hours……………….______1
Days…………….….______2
Months………….….______3
Have not started yet…………….0
31 / At what age did you start to give (NAME) drinks other than breastmilk or plain water? / Hours……………….______1
Days…………….….______2
Months………….….______3
Have not started yet…………….0 / SKIP to Q33
32 / What was the first fluid other than breastmilk or plain water you gave to (NAME)?
DO NOT READ THE LIST. RECORD THE FIRST FLUID BY CIRCLING 1 FOR THAT ITEM. CIRCLE 0 FOR ALL OTHER ITEMS. / YES NO
Other milk, not breastmilk...1……0
Tea/herbal water…………..1……0
Sugar or glucose water…….1……0
Infant formula………………1……0
Watery porridge……………1…….0
Other……………………….1…….0
Specify:______
33 / At what age did you start to give (NAME) anything to drink from a bottle with a nipple? / Hours……………….______1
Days…………….….______2
Months………….….______3
Do not give drinks by bottle…….0 / SKIP to Q35
34 / How frequently did/do you give (NAME) anything to drink from a bottle with a nipple? / One or more times per day……….1
A few times per week…………….2
Once per week……………………3
Less than once per week..………..4
35 / At what age did you start to give (NAME) soft or watery food? / Hours……………….______1
Days…………….….______2
Months………….….______3
Have not started yet…………….0 / SKIP to Q37
36 / What was the first type of soft or watery food you fed to (NAME)? / Mgaiwa gruel……………………1
Ufa woyera gruel………………..2
Gruel from other flour………….3
Soup from relish………………..4
Other……………………………5
Specify:______
37 / At what age did you start to give (NAME) solid food? / Hours……………….______1
Days…………….….______2
Months………….….______3
Have not started yet…………….0 / SKIP to Q37
***CHECK RESPONSES TO Q35 and Q37 – IF ‘0’ WAS CIRCLED FOR BOTH, SKIP TO Q46.***
38 / What was the first type of solid food you fed to (NAME)? / Porridge………………………….1
Nsima and relish…………………2
Rice………………………………3
Bananas………………………….4
Macaroni…………………………5
Other……………………………..6
Specify:______

OTHER FEEDING PRACTICES AND ATTITUDES