The following questionnaire was developed by the Ministry of Health of
Honduras with Technical support from a variety of agencies supported by
USAID: Population Council, The Latin American Health and Nutrition
Sustainability Project (LAC/HNS), Wellstart, and the Breastfeeding League of
Honduras. The questionnaire was developed based on risk factors for
abandoning exclusive breastfeeding identified in a study on the Cost
Effectiveness of Breastfeeding Promotion in Hospitals carried out in Brazil,
Honduras, and Mexico by LAC/HNS. If you want a copy of the summary of the
report, please email Chessa Lutter <[log in to unmask]> or Fax her at
202-298-7988. The report is available in English, Spanish, and Portuguese.
The survey is not copyrighted but people who use materials developed under
USAID contracts are requested to acknowledge them. This survey is currently
being used by 26 hospitals. It is an exit survey and may be used
periodically to monitor the quality of support being provided to women in
the hospital. The following is in both Spanish and English. The Survey is
called MADLAC: Monitoreo de Apoyo Directo a la Lactancia en los
Hospitales/Monitoring of Direct Support to Breastfeeding in Hospitals. If
you have any questions, please email me at <[log in to unmask]>
Exit Interview to Mothers
After Greeting the mother, ask her if it is possible to ask her some
questions. The time is about 10 minutes.
No. Survey__ Type of Hospital_____Ward____ Day of Interview ______ Time
of Interview_____
Name of the Mother ________, Date of Birth_____ Time of Birth______, Sex of
Newborn___ Type of Birth Vaginal___Cesarean___ Gestation: FT_____ PT____
Product: Single Birth___ Multiple Birth___, Mother's Age
Ms.___, Do you:
1. Work outside of the home? Y___, N___; Study? Y__ N__
2. Plan to BF your baby? Y___, N___, DK____
3. At what age do you plan to give the baby water, teas, juices or other
milks to the baby? Days_____ Weeks _____ Months_____ DK____, Haven't
thought about it ______
4. How long do you think you will breastfeed your baby? Days____, Weeks____
Months_____, Years___, Haven't thought about it____, Until the baby wants to
stop_____
5. Did you receive Prenatal Care? Y___, N)____, If Yes, ask where _________
5a. Were you informed during your prenatal visits why bf was good for you
and for the baby? Y___ N____, DR, If Y, could you tell me two reasons?
_______________
5b. Were your breasts and nipples checked during your prenatal care? Y___ N___
Ms_____: The questions that I will ask you now refer to what happened here
in the hospital after the birth of this baby (Except for Questions 16, 21 & 22)
6. Where were you when you breastfed your baby for the first time?
Delivery room ____? Recovery room_____, Ward/Your room______, Newborn
Nursery_____, DK___
Other_____ (Where?_______)
7. How much time had gone by after your baby's birth before you bf for the
first time? <30 minutes____; 30min-1 hour____; 1-4 hours____; 4-12
hours___, >12 Hrs__
8. Since the baby came to this ward/room has s/he been with you at all
times? Y___, No___, DR___ If No, Where & why________________________
9. Since the baby was born, has anyone on the staff explained to you how to bf?
Y___, N____ DR______
10. Has anyone on the staff helped you to put the baby to breast to bf well?
Y___ N___, DR____
11. Have they given any liquid, water, or milk to your baby in the hospital?
Y___ N____, DK______
12. Did they tell you that you could/should bf your baby every time s/he
wants to day and night? Y____ N____, DR______
13. Did they tell you to wake your baby to nurse him/her if s/he sleeps more
than 3 hours? Y____ N_____ DR_____
14. Has someone in this hospital taught you how to express your milk (in
Honduras this is hand expression) Y____ N____ DR______
15. Has anyone in this hospital explained to you how many wet diapers your
baby should have every day in order to know if s/he is receiving enough
milk? Y___
N____, DR____, If Y, how many______?
15a. Has anyone in this hospital explained to you how many dirty diapers
you can expect your baby to have to know if s/he is receiving enough milk?
Y___ N___, DR____. If Y, how many_______?
16. What do you think that you can do in order to increase your milk supply?
Correct___________, Incorrect__________ (Correct only if includes MORE
FREQUENT NURSING among responses).
17. Did anyone on the staff tell you at what age you should begin to give
water, teas, juice or food to this baby? Y____, N___, DR_____ If Y, At
what age did they tell you Correct______, Incorrect_____ (Response is
Correct only if mother responds at ABOUT 6 MOS.
18.Did anyone on the staff tell you where to go for your postpartum check-up
Y___ N____ , DR____
19. Did anyone on the staff tell you where you could go if you had concerns
about breastfeeding? Y____ N_____, DR_______
20. Since your baby was born, did anyone on the staff explain to you the
minimum time you should wait before becoming pregnant again? Y_____
N_____, If Y____, How much time? ________
21. When do you plan to start using a method of child spacing? I had PP
sterilization ____; Husband had vasectomy____; IUD PP_____ < 15 days____ At
6 weeks_____, When I start to menstruate ____, Weeks____; Months___ Y____,
DK_____ If response is s/he already sterilized or IUD PP, conclude interview.
22. What method do you think you will use to space your next pregnancy? LAM___,
Rythm____, Withdrawal____ Billings_____ BF______ Condom_____, Pills____
Injections ________, IUD______; Sterilization_____, Vasectomy______,
Diaphragm_______, Norplant______, Other_____ DK_____, None_____
Thank you for your cooperation.
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"The future is not some place we are going to, but one we are
creating. The paths are not to be found, but made, and the
activity of making them changes both the maker and the
destination." Attributed to John Schaar, University of California.
Judy Canahuati
email: [log in to unmask]
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