1. What is your age?

a. Under 18

b. 19-25

c. 26-35

d. 36-45

e. 56+

f. I do not know

g. Prefer not to answer

2. What is your gender?

a. Female

b. Male

c. Prefer not to answer

3. What is your ethnicity?

a. Badawa

b. Bolewa

c. Butawa

d. Fa’awa

e. Fulani

f. Gerawa

g. Hausa

h. Jarawa

i. Kanuri

j. Karekare
 k. Sayawa

l. Warjawa

m. Zulawa

n. Other Nigerians

o. Non-Nigerians

p. Other

q. I do not know

r. Prefer not to answer

4. What language(s) do you speak? (Select all that apply)

a. Hausa

b. Jarawa

c. Sayawa

d. Fulani

e. English

f. Other

g. Prefer not to answer

5. What religion do you practice?

a. Islam

b. Christianity

c. Traditionalist

d. Not religious

e. Other

f. Prefer not to answer

6. Are you native to Bauchi?

a. Yes

b. No

c. Not born but grew up in Bauchi

d. Other

e. I do not know

f. Prefer not to answer

7. How long have you lived in Nigeria?

a. 0-1 years

b. 2-4 years

c. 5-10 years

d. 11+ years

e. All of my life

f. I do not know

g. Prefer not to answer

8. How often do you travel outside of Bauchi State?

a. Less than once a year

b. About 1-3 times per year

c. About 4-6 times per year

d. About 7-9 times per year

e. More than 9 times per year

f. Prefer not to answer

9. Are you currently employed?

 a. Yes

b. No

c. I do not know

d. Prefer not to answer

10. Do you currently receive income?

a. Yes

b. No

c. I do not know

d. Prefer not to answer

11. At what age did you stop living with your biological parents?

a. Never lived with biological parents

b. Before 5 years old

c. Between 5 and 10 years old

d. Between 11 and 15 years old

e. At 16 years old

f. Between 17 and 18 years old

g. Between 20 and 21 years old

h. 22+

i. I still live with my parents

j. Prefer not to answer

12. How many siblings do you have?

a. 0

b. 1-2
 c. 3-4

d. 5-6

e. 7+

f. I do not know

g. Prefer not to answer

13. How many people live in your household? (including self)

a. 1

b. 2-3

c. 4-6

d. 7-10

e. 11+

f. I do not know

g. Prefer not to answer

14. What is your current marital status?

a. Single

b. In a relationship but not married

c. Married

d. Widow/widower

e. Separated/divorced

f. Other

g. Prefer not to answer

15. How many wives does your husband have? (Female only) How many wives do you

have? (Males only)

 a. 0; Never been married

b. 1

c. 2

d. 3

e. 4

f. 5

g. 6+

h. Not applicable

i. Prefer not to answer

16. If you are or have been married, how old were you when you first married?

a. Under 13

b. 13-14

c. 15-16

d. 17-18

e. 19-20

f. 21-22

g. 23-24

h. 25-26

i. 27-28

j. 29-30

k. 31+

l. I have never been married

m. Prefer not to answer

17. How many children do you have?

a. 0

b. 1-2

c. 3-4

d. 5-6

e. 7+

f. Not applicable

g. Prefer not to answer

18. If you have children, what is/are the age range(s) of your children? (Select all that apply)

a. 0-1

b. 2-4

c. 5-10

d. 11-18

e. 19 or older

f. Not applicable

g. Prefer not to answer

19. If you have children, how are they educated?

a. In school

b. At work

c. By a parent

d. By siblings

e. In a religious setting

f. Other
 g. I do not know

h. Not applicable

i. Prefer not to answer

20. If you have siblings, did or do they attend school?

a. All of them did or currently do

b. Some of them did or currently do

c. None of them did or currently do

d. I do not have siblings

e. I do not know

f. Prefer not to answer

21. What is the highest level of education you completed?

a. None

b. Some primary school

c. Completed primary school

d. Some secondary school

e. Completed secondary school

f. Some university

g. Completed university

h. Some professional training (apprenticeship)

i. Completed professional training (apprenticeship)

j. I do not know

k. Prefer not to answer

22. In the last wee, how many days did you speak to someone outside of your community?
 a. 0 days

b. 1-2 days

c. 3-5 days

d. 6-7 days

e. I do not know

f. Prefer not to answer

23. Do you feel safe in your household?

a. Yes

b. No

c. I do not know

d. Prefer not to answer

24. Do you feel safe in your community?

a. Yes

b. No

c. I do not know

d. Prefer not to answer

25. Do you rust the authorities and law enforcement in your community?

a. Yes

b. No

c. I do not know

d. Prefer not to answer

26. Are you legally registered to vote?

a. Yes
 b. No

c. I do not know

d. Prefer not to answer

27. During the past 12 months, did you engage in any work

a. Yes

b. No

c. I do not know

d. Prefer not to answer

28. If yes, did you engage in any work of at least one hour during the past week? (as an

employee, self-employed or unpaid family worker)

a. Yes

b. No

c. Not applicable

d. Prefer not to answer

29. If Yes, where did you carry out your main work during the past week?

a. At a family dwelling

b. Formal office

c. Factory or workshop

d. Farm or garden

e. Construction site

f. Mine or quarry

g. Shop or kiosk

h. Restaurant, hotel, or café

 i. Different places or mobile work

j. Fixed street or market stall

k. Pond, lake, or river

l. Other

m. Not applicable

n. Prefer not to answer

30. In Naira, what is your average monthly income?

a. 0-5000

b. 5000-10000

c. 10000-15000

d. 15000-20000

e. 20000-30000

f. 30000-40000

g. 40000-50000

h. 50000-60000

i. 60000+

j. I do not know

k. Prefer not to answer

31. How much is reliable transportation to and from a clinic when needed?

a. 1,000-5,000 NGN

b. 5,000-10,000 NGN

c. 11,000-15,000 NGN

d. 16,000-20,000 NGN
 e. 21,000-25,000 NGN

f. 26,000-30,000 NGN

g. 31,000+ NGN

h. I do not know

i. Prefer not to answer

32. How far is the nearest hospital/clinic from your home?

a. 0-10 minutes

b. 11-20 minutes

c. 21-30 minutes

d. 31-40 minutes

e. 41-50 minutes

f. More than 50 minutes

g. I do not know

h. Prefer not to answer

33. If you needed to get to the hospital or medical clinic, how would you get there?

a. Walk

b. Bicycle

c. Car

d. Bus

e. Family member

f. Friend

g. Taxi

h. I do not know
 i. Prefer not to answer

34. When you ened medical care, is your doctor the same sex as you?

a. Always

b. Sometimes

c. Not often

d. Never

e. I do not know

f. Prefer not to answer

35. I am about to afford medical care at a hospital or a clinic.

a. Strongly agree

b. Somewhat agree

c. Neither agree nor disagree

d. Somewhat disagree

e. Strongly disagree

f. I do not know

g. Prefer not to answer

36. I am confident that my household has all the resources to lead a healthy life

a. Confident

b. Somewhat confident

c. Not confident

d. I do not know

e. Prefer not to answer

37. How would you describe your health?

 a. Excellent

b. Very good

c. Good

d. Fair

e. Poor

f. I do not know

g. Prefer not answer

38. Has your family ever faced financial troubles from paying for medical treatments?

a. Yes

b. No

c. I do not know

d. Prefer not to answer

39. Do you have access to healthcare facilities such as clinics, hospitals, pharmacies, etc.?

a. Yes

b. No

c. I do not know

d. Prefer not to answer

40. I am very aware of the healthcare services my community offers.

a. Strongly agree

b. Somewhat agree

c. Neither agree not disagree

d. Somewhat disagree

e. Strongly disagree
 f. I do not know

g. Prefer not to answer

41. Have you heard of Tetanus before today?

a. Yes

b. No

c. I do not know

d. Prefer not to answer

42. Which of the following do you believe are common symptoms of Tetanus? (Check all

that apply)

a. Stiffness in jaw muscles (lockjaw)

b. Difficulty swallowing

c. Red, watery eyes

d. Stiffness in neck muscles

e. Loss of taste and smell

f. Fever and sweating

g. I do not know

h. Prefer not to answer

43. Which of the following do you believe is the way Tetanus is primarily transmitted?

a. Through mosquito bites

b. Through respiratory droplets in the air

c. Through contact with soil or surfaces contaminated with Tetanus spores

d. I do not know

e. Prefer not to answer

44. What types of wounds do you believe are most at risk for Tetanus infection?

a. Clean, minor cuts

b. Burns

c. Puncture wounds or injuries with contaminated objects

d. I do not know

e. Prefer not to answer

45. Do you believe Tetanus is a serious health issue in your community?

a. Yes

b. No

c. I do not know

d. Prefer not to answer

46. Have you or a member of your household ever had Tetanus?

a. Yes

b. No

c. I do not know

d. Prefer not to answer

47. I know someone, outside of my household who has had Tetanus in the past 12 months.

a. Yes

b. No

c. I do not know

d. Prefer not to answer

48. Where do you usually seek medical treatment for Tetanus?

a. Local health center

 b. Traditional healer

c. Pharmacy

d. I do not know

e. Prefer not to answer

49. How important do you think cleaning the wound is?

a. Very important

b. Somewhat important

c. Not important

d. I do not know

e. Prefer not to answer

50. Do you think there is an effective vaccine to prevent Tetanus?

a. Yes

b. No

c. I do not know

d. Prefer not to answer

51. Do you have any clinics or medical centers near you that offer Tetanus vaccines?

a. Yes

b. No

c. I do not know

d. Prefer not to answer

52. How likely would you be to receive a tetanus vaccine if you are not already vaccinated

against Tetanus?

a. Very likely
 b. Somewhat likely

c. Not likely

d. I do not know

e. Prefer not to answer

53. Have you or your family members ever received a vaccination?

a. Yes

b. No

c. I do not know

d. Prefer not to answer

54. Which vaccinations do you think ar the most important for children in your community?

(Check all that apply)

a. Polio

b. Meningitis

c. Measles

d. Tetanus

e. Influenza

f. Yellow Fever

g. I do not know

h. Prefer not to answer

55. How confident are you in the safety and effectiveness of vaccinations?

a. Very confident

b. Somewhat confident

c. Not confident
 d. I do not know

e. Prefer not to answer

56. What sources of information do you trust most for learning about vaccinations?

a. Healthcare professionals

b. Community leaders

c. Friends and family

d. I do not know

e. Prefer not to answer

57. How concerned are you about to potential side effects of vaccinations?

a. Very concerned

b. Somewhat concerned

c. Not concerned

d. I do not know

e. Prefer not to answer

58. What is the biggest barrier, if any, do you think people in your community face in

accessing vaccinations?

a. Lack of awareness

b. Distance to healthcare facilities

c. Cultural beliefs

d. Cost

e. Access to vaccination

f. No barrier

g. I do not know
 h. Prefer not to answer

59. In your opinion, what if anything, could be done to improve vaccination coverage in your

community?

a. Increase awareness through education campaigns

b. Improve accessibility to vaccination services

c. Address cultural concerns and misconceptions

d. Involve community leaders in promoting vaccinations

e. Nothing can be done

f. Vaccinations are not an issue in my community

g. I do not know

h. Prefer not to answer

60. Immunizations are accessible in my area.

a. Strongly agree

b. Somewhat agree

c. Neither agree not disagree

d. Somewhat disagree

e. Strongly disagree

f. I do not know

g. Prefer not to answer

61. How confident are you about the effectiveness of immunizations?

a. Very confident

b. Confident

c. Somewhat confident
 d. Not confident

e. I do not know

62. Would you find educational workshops or materials on immunization helpful?

a. Yes

b. No

c. I do not know

d. Prefer not to answer

63. On a scale of 1-5 (1 being excellent and 5 being poor), how would you rate the

communication and information provided by healthcare providers regarding

vaccinations?

a. 1-excellent

b. 2-good

c. 3-neutral

d. 4-not great

e. 5-very poor

f. I do not know

g. Prefer not to answer

64. Have you heard of Tdap immunization before today?

a. Yes

b. No

c. I do not know

65. Which of the following diseases do you believe the Tdap vaccine protects against?

a. Tetanus
 b. Diphtheria

c. Pertussis (Whooping Cough)

d. All of the above

e. I do not know

f. Prefer not to answer

66. Are there any clinics or healthcare centers in your community that provide Tdap

immunization services?

a. Yes

b. No

c. I do not know

d. Prefer not to answer

67. Have you or your family members received the Tdap vaccine?

a. Yes, for all eligible family members

b. Yes, but not for everyone

c. No

d. I do not know

e. Prefer not to answer

68. How important do you think it is for individuals, especially pregnant women and

caregivers of infants, to receive the Tdap vaccine?

a. Very important

b. Somewhat important

c. Not important

d. I do not know
 e. Prefer not to answer

69. How important do you think childhood vaccinations are for a child?

a. Very important

b. Somewhat important

c. Not important

d. I do not know

e. Prefer not to answer

70. I trust the healthcare system and healthcare workers near me.

a. Strongly agree

b. Somewhat agree

c. Neither agree or disagree

d. Somewhat disagree

e. Strongly disagree

f. I do not know

g. Prefer not to answer

71. Children in my family have access to vaccines.

a. Strongly agree

b. Somewhat agree

c. Neither agree nor disagree

d. Somewhat disagree

e. Strongly disagree

f. I do not know

g. Prefer not to answer

72. Children should receive vaccinations to prevent different illnesses.

a. Strongly agree

b. Somewhat agree

c. Neither agree not disagree

d. Somewhat disagree

e. Strongly disagree

f. I do not know

g. Prefer not to answer

73. Which vaccines have your child taken. (Check all that apply)

a. BCG (Bacilli Calmette Guerin)

b. OPV (Oral Polio Virus)

c. DPT (Diphtheria, Pertussis, Tetanus)

d. Hepatitis B

e. Other

f. None

g. I do not know

h. Prefer not to answer

i. Not applicable

74. How far is your nearest medical clinic?

a. 1-5 kilometers

b. 6-10 kilometers

c. 11-15 kilometers

d. More than 15 kilometers

 e. I do not know

f. Prefer not to answer

75. I have reliable transportation to and from a clinic when needed.

a. Strongly agree

b. Somewhat agree

c. Neither agree nor disagree

d. Somewhat disagree

e. Strongly disagree

f. I do not know

g. Prefer not to know

76. In the past 6 months, how many times have you visited the hospital or clinic for

preventative medical care?

a. 0 times

b. 1-2 times

c. 3-4 times

d. 5+ times

e. I do not know

f. Prefer not to answer

77. I believe it is important for children under five years old to get vaccinated.

a. Strongly agree

b. Somewhat agree

c. Neither agree nor disagree

d. Somewhat disagree
 e. Strongly disagree

f. I do not know

g. Not applicable

h. Prefer not to answer

78. Religious beliefs prevent those around me from getting vaccinated.

a. Yes

b. No

c. I do not know

d. Prefer not to answer

79. How confident are you that immunizations will protect your child from diseases?

a. Strongly confident

b. Somewhat confident

c. Neither confident nor unconfident

d. Somewhat unconfident

e. Strongly unconfident

f. I do not know

g. Prefer not to answer

h. Not applicable

80. People in my community are hesitant to get vaccinated.

a. Strongly agree

b. Somewhat agree

c. Neither agree not disagree

d. Somewhat disagree
 e. Strongly disagree

f. I do not know

g. Prefer not to answer

81. I believe that financial concern is a common reason for not vaccinating children in my

community.

a. Strongly agree

b. Somewhat agree

c. Neither agree nor disagree

d. Somewhat disagree

e. Strongly disagree

f. I do not know

g. Prefer not to answer

82. Do you believe that the benefits of getting vaccinated outweigh any possible risks/side

effects?

a. Yes

b. No

c. I do not know

d. Prefer not to answer

83. Immunizations are not safe for children.

a. Strongly agree

b. Somewhat agree

c. Neither agree nor disagree

d. Somewhat disagree
 e. Strongly disagree

f. I do not know

84. Are vaccines in my community hard to access.

a. Yes

b. No

c. I do not know

d. Prefer not to answer

e. Not applicable

85. Have your children received all recommended vaccinations?

a. Yes

b. No

c. I do not know

d. Prefer not to answer

e. Not applicable

86. I would encourage my family members to get vaccinated.

a. Strongly agree

b. Somewhat agree

c. Neither agree nor disagree

d. Somewhat disagree

e. I do not know

f. Prefer not to answer

g. Not applicable

87. Medical professionals should be trusted.

 a. Strongly agree

b. Somewhat agree

c. Neither agree nor disagree

d. Somewhat disagree

e. Strongly disagree

f. I do not know

g. Prefer not to answer

h. Not applicable

88. I trust and agree with my traditional healer’s medicine and practices.

a. Strongly agree

b. Somewhat agree

c. Neither agree nor disagree

d. Somewhat disagree

e. Strongly disagree

f. I do not know

g. I do not have a traditional healer

h. Prefer not to answer

89. Have you ever been prescribed traditional herbal remedies by a traditional healer?

a. Yes

b. No

c. I do not know

d. Prefer not to answer

e. I do not have a traditional healer

90. How often do you seek out your traditional healer when you feel sick?

a. Very frequently

b. Frequently

c. Sometimes

d. Rarely

e. Never

f. I do not know

g. Prefer not to answer

91. Do you believe that there is a need for increased awareness and education regarding safe

healthcare practices in your community?

a. Yes

b. No

c. I do not know

d. Prefer not to answer

92. How would you describe your community’s attitude towards medicine or doctors?

a. Trusting

b. Weary

c. Western medicine/doctors are inaccessible

d. I do not know

e. Prefer not to answer

93. What is the prominent reason people in your community use traditional medicine?

a. It takes away illness quickly

b. It is easily accessible
 c. It is more affordable

d. It is more trusted

e. I do not know

94. I have faith in the Nigerian Healthcare system.

a. Strongly agree

b. Somewhat agree

c. Neither agree nor disagree

d. Somewhat disagree

e. Strongly disagree

f. I do not know

g. Prefer not to answer

95. I trust that what doctors tell me will be best for my health.

a. Strongly agree

b. Somewhat agree

c. Neither agree nor disagree

d. Somewhat disagree

e. Strongly disagree

f. I do not know

g. Prefer not to answer

96. My experiences in healthcare locations have been welcoming and positive.

a. Strongly agree

b. Somewhat agree

c. Neither agree nor disagree

 d. Somewhat disagree

e. Strongly disagree

f. Unsure or I do not know

g. Prefer not to answer

97. How confident are you in the local hospital’s ability to provide proper care for you?

a. Confident

b. Somewhat confident

c. Not confident

d. I do not know

e. Prefer not to answer

98. If you were ill, would you visit a public or private hospital?

a. Public

b. Private

c. Either

d. Neither

e. I do not know

f. Prefer not to answer

99. When you need medical care, do you visit the same doctor each time?

a. Yes

b. No

c. I do not know

d. Prefer not to answer

100. If my own physical health is declining, I am willing to go to receive medical care.

 a. Strongly agree

b. Somewhat agree

c. Neither agree nor disagree

d. Somewhat disagree

e. Strongly disagree

f. I do not know

g. Prefer not to answer

101. When determining whether I should seek medical help, cost influences my decision.

a. Strongly agree

b. Somewhat agree

c. Neither agree nor disagree

d. Somewhat disagree

e. Strongly disagree

f. I do not know

g. Prefer not to answer