Variables in Previous Pregnancy History FORM (PPH)
Question# Question Field name  Response nature Response options
1 PID Number     PID ###  
2 Initials of the Mother pph_A XX  
3 Field worker code  pph _B ##  
4 Date of Interview
(According to English calender)
pph _C ##-XXX-##  dd-mmm-yy 
5 Number of Gravida  pph _1 ##  
6 Number of Para  pph_2 ##  
7 H/O abortion/still birth /child death ? pph _3 1=Yes, 2=No 1=Yes, 2=No, 9=not applicable
8 If abortion, how many times?  pph_3_a ## 99 if pph_3=2
9 Specify weeks of gestation of last abortion. pph_3_b ## 99 if pph_3=2
10 Reason of abortion pph_3_c  1=Spontaneous, 2=Health reasons, 3=Personal choice, 4=Other  1=Spontaneous, 2=Health reasons, 3=Personal choice, 4=Other, 9= not applicable
11 If other, specify. pph_3_c_txt TEXT if pph_3_c=4
NA if pph_3_cǂ4
TEXT if pph_3_c=4
NA if pph_3_cǂ4
12 If still birth, how many times?  pph _3_d ## 99 if not applicable
13  If child death, how many child?  pph_3_e ## 99 if not applicable
14 Age of the last child who died? (in months)? pph_3_f ## 99 if not applicable
15 Specify reasons for the last child death pph_3_g TXT TEXT if last child death
NA if no last child death
16 Age of the older children in years?
Child1
Child2
Child3
pph _4i
pph_4ii
pph_4iii
##
##
##
## if older children
99 if no older children
17 Preterm labor in previous pregnancies?  pph _5 # 1=Yes, 2=No, 9=not applicable
18 Was any of your child born preterm? pph _6     lab _11 If other investigation, specify result  
19 Where was the last child born?  pph _7    
20 If other, specify.  pph _7 txt    
21 Was any child born preterm?  pph _6 # 1=Yes, 2=No, 9=not applicable
22 Where was the last child born?  pph_7 # 1=Home, 2=Health facility, 3=others, 9= not applicable
23 If others, specify pph_7txt TXT TEXT if pph_7=3
NA if pph_7ǂ3
24 Type of delivery of the last child  pph _8 # 1=Normal, 2=Caesarean section, 3=Vacuum forceps, 9=not applicable
25 Was the last child born full term?  pph_9 # 1=Full term, 2=Preterm, 3=Post-term, 9=not applicable
26 Birth weight of the last child (in kg) according to card/Mother’s recall  pph _10 #.## #.##
27 Has she taken folate regularly during last pregnancy?                                                              pph _11 # 1=Yes, 2=No, 9=not applicable
28 Has she taken iron regularly during last pregnancy? pph _12 # 1=Yes, 2=No, 9=not applicable
29 Has she taken calcium regularly during last pregnancy? pph _13 # 1=Yes, 2=No, 9=not applicable
30 Has she taken any vitamins during last pregnancy? pph _14 # 1=Yes, 2=No, 9=not applicable
31 If yes, specify.   pph _14 txt TEXT if pph_14=1
NA if pph_14ǂ1
TEXT if pph_14=1
NA if pph_14ǂ1
32 Has she taken any other medicines during last pregnancy? pph _15 1=Yes, 2=No 1=Yes, 2=No, 9=not applicable
33 If yes, specify.  pph _15 txt TEXT if pph_15=1
NA if pph_15ǂ1
TEXT if pph_15=1
NA if pph_15ǂ1
34 Has she suffered from any illness during last pregnancy?  pph _16 1=Yes, 2=No 1=Yes, 2=No, 9=not applicable
35 If yes, specify.  pph _16 txt TEXT if pph_16=1
NA if pph_16ǂ1
TEXT if pph_16=1
NA if pph_16ǂ1
36 Has she been hospitalized during last pregnancy?  pph _17 1=Yes, 2=No 1=Yes, 2=No, 9=not applicable
37 If yes, specify  pph _17txt TEXT if pph_17=1
NA if pph_74ǂ1
TEXT if pph_17=1
NA if pph_74ǂ1
38 Was there any other complication during previous deliveries? pph _18 1=Yes, 2=No 1=Yes, 2=No, 9=not applicable
39 If yes, specify.  pph _18 txt TEXT if pph_14=1
NA if pph_18ǂ1
TEXT if pph_14=1
NA if pph_18ǂ1
40 Remarks   TXT