DV01) CHECK FOR PRESENCE OF OTHERS:
DO NOT CONTINUE UNTIL EFFECTIVE PRIVACY IS ENSURED.
PRIVACY NOT POSSIBLE 2 (GO TO DV28)
Now I would like to ask you questions about some important aspects of a woman's life. I know that some of these questions are very personal. However, your answers are crucial for helping to understand the condition of women in (COUNTRY). Let me assure you that your answers are completely confidential and will not be told to anyone.
DV02) CHECK 501, 502, AND 504:
SEPARATED/DIVORCED ___ (READ IN PAST TENSE)
WIDOWED/NEVER MARRIED/NEVER LIVED WITH A MAN ___ (GO TO DV14)
DV03) When two people marry or live together, they share both good and bad moments. In your relationship with your (last) husband/partner do (did) the following happen frequently, only sometimes, or never?
a) He usually (spends/spent) his free time with you?
b) He (consults/consulted) you on different household matters?
c) He (is/was) affectionate with you?
d) He (respects/respected) you and your wishes?
SOMETIMES 2
NEVER 3
SOMETIMES 2
NEVER 3
SOMETIMES 2
NEVER 3
SOMETIMES 2
NEVER 3
DV04) Now I am going to ask you about some situations which happen to some women. Please tell me if these apply to your relationship with your (last) husband/partner?
a) He (is/was) jealous or angry if you (talk/talked) to other men?
b) He frequently (accuses/accused) you of being unfaithful?
c) He (does/did) not permit you to meet your girl friends?
d) He (tries/tried) to limit your contact with your family?
e) He (insists/insisted) on knowing where you (are/were) at all times?
f) He (does/did) not trust you with any money?
NO 2
DK 8
NO 2
DK 8
NO 2
DK 8
NO 2
DK 8
NO 2
DK 8
NO 2
DK 8
DV05) Now if you will permit me, I need to ask some more questions about your relationship with your (last) husband/partner.
5A. (Does/did) your (last) husband/partner ever:
5B. How many times did this happen during the last 12 months?
a) say or do something to humiliate you in front of others?
NO 2
TIMES IN THE LAST 12 MONTHS ___
b) threaten you or someone close to you with harm?
NO 2
TIMES IN THE LAST 12 MONTHS ___
DV06)
6A. (Does/did) your (last) husband/partner ever:
6B. How many times did this happen during the last 12 months?
a) push you, shake you, or throw something at you?
NO 2
TIMES IN THE LAST 12 MONTHS ___
b) slap you or twist your arm?
NO 2
TIMES IN THE LAST 12 MONTHS ___
c) punch you with his fist or something that could hurt you?
NO 2
TIMES IN THE LAST 12 MONTHS ___
d) kick you or drag you?
NO 2
TIMES IN THE LAST 12 MONTHS ___
e) try to strangle or burn you?
NO 2
TIMES IN THE LAST 12 MONTHS ___
f) threaten you with a knife, gun, or other type of weapon?
NO 2
TIMES IN THE LAST 12 MONTHS ___
g) attack you with a knife, gun, or other type of weapon?
NO 2
TIMES IN THE LAST 12 MONTHS ___
h) physically force you to have sexual intercourse with him even when you did not want to?
NO 2
TIMES IN THE LAST 12 MONTHS ___
i) force you to perform other sexual acts you did not want to?
NO 2
TIMES IN THE LAST 12 MONTHS ___
NOT A SINGLE 'YES' ___ (GO TO DV09)
DV08) How long after you first got married to/started living with your (last) husband/partner did (this/any of these things) first happen?
IF LESS THAN ONE YEAR, RECORD '00'.
BEFORE MARRIAGE/BEFORE LIVING TOGETHER 95
AFTER SEPARATION/DIVORCE 96
DV09) Did the following ever happen to you because of something your (last) husband/partner did to you?
DV8B) How many times did this happen during the last 12 months?
a) You had bruises and aches?
NO 2
TIMES IN THE LAST 12 MONTHS ___
b) You had an injury or a broken bone?
NO 2
TIMES IN THE LAST 12 MONTHS ___
c) You went to the doctor or health center as a result of something your husband/partner did to you?
NO 2
TIMES IN THE LAST 12 MONTHS ___
DV10) Have you ever hit, slapped, kicked or done anything else to physically hurt your (last) husband/partner at times when he was not already beating or physically hurting you?
NO 2 (GO TO DV12)
DV11) In the last 12 months, how many times have you hit, slapped, kicked or done something to physically hurt your (last) husband/partner at a time when he was not already beating or physically hurting you?
DV12) Does (did) your husband/partner drink (alcohol)?*
*OTHER INTOXICANTS CAN BE SUBSTITUTED/ADDED AS RELEVANT.
NO 2 (GO TO DV14)
DV13) How often does (did) he get drunk: very often, only sometimes, or never?
SOMETIMES 2
NEVER 3
ASK: From the time you were 15 years old has anyone other than your (current/last) husband/partner hit, slapped, kicked, or done anything else to hurt you physically?
NO 2 (GO TO DV19)
NO ANSWER 6 (GO TO DV19)
ASK: From the time you were 15 years old has anyone ever hit, slapped, kicked, or done anything to hurt you physically?
NO 2 (GO TO DV19)
NO ANSWER 6 (GO TO DV19)
DV15) Who has physically hurt you in this way?
Anyone else?
RECORD ALL MENTIONED.
FATHER B
STEP MOTHER C
STEP FATHER D
SISTER E
BROTHER F
DAUGHTER G
SON H
LATE/EX-HUSBAND/EX-PARTNER I
CURRENT BOYFRIEND J
FORMER BOYFRIEND K
MOTHER-IN-LAW L
FATHER-IN-LAW M
OTHER FEMALE RELATIVE/IN-LAW N
OTHER MALE RELATIVE/IN-LAW O
FEMALE FRIEND/ACQUAINTANCE P
MALE FRIEND/ACQUAINTANCE Q
TEACHER R
EMPLOYER S
STRANGER T
OTHER (SPECIFY) ___________ X
ONLY ONE PERSON MENTIONED ___ (GO TO DV18)
DV17) Who has hit, slapped, kicked, or done something to physically hurt you most often?
FATHER B
STEP-MOTHER C
STEP-FATHER D
SISTER E
BROTHER F
DAUGHTER G
SON H
LATE/EX-HUSBAND/EX-PARTNER I
CURRENT BOYFRIEND J
FORMER BOYFRIEND K
MOTHER-IN-LAW L
FATHER-IN-LAW M
OTHER FEMALE RELATIVE/IN-LAW N
OTHER MALE RELATIVE/IN-LAW O
FEMALE FRIEND/ACQUAINTANCE P
MALE FRIEND/ACQUAINTANCE Q
TEACHER R
EMPLOYER S
STRANGER T
OTHER (SPECIFY) ___________ X
DV18) In the last 12 months, how many times has this person hit, slapped, kicked, or done anything else to physically hurt you?
NOT LIVE BIRTHS, NO NON-LIVE BIRTHS, AND IS NOT CURRENTLY PREGNANT ___ (GO TO DV21)
DV20) Has anyone ever hit, slapped, kicked, or done anything else to physically hurt you while you were pregnant?
Anyone else?
RECORD ALL MENTIONED.
MOTHER B
FATHER C
STEP-MOTHER D
STEP-FATHER E
SISTER F
BROTHER G
DAUGHTER H
SON I
LATE/EX-HUSBAND/EX-PARTNER J
CURRENT BOYFRIEND K
FORMER BOYFRIEND L
MOTHER-IN-LAW M
FATHER-IN-LAW N
OTHER FEMALE RELATIVE/IN-LAW O
OTHER MALE RELATIVE/IN-LAW P
FEMALE FRIEND/ACQUAINTANCE Q
MALE FRIEND/ACQUAINTANCE R
TEACHER S
EMPLOYER T
STRANGER U
OTHER (SPECIFY) ___________ X
DV22) CHECK DV06, DV09, DV14, AND DV20:
NOT A SINGLE 'YES' ___ (GO TO DV26)
DV23) Have you ever tried to get help to prevent or stop (this person/these persons) from physically hurting you?
NO 2 (GO TO DV25)
DV24) From whom have you sought help?
Anyone else?
RECORD ALL MENTIONED.
FATHER B (GO TO DV26)
SISTER E (GO TO DV26)
BROTHER F (GO TO DV26)
CURRENT/LAST/LATE HUSBAND/PARTNER E (GO TO DV26)
CURRENT/FORMER BOYFRIEND F (GO TO DV26)
MOTHER-IN-LAW G (GO TO DV26)
FATHER-IN-LAW H (GO TO DV26)
OTHER FEMALE RELATIVE/IN-LAW I (GO TO DV26)
OTHER MALE RELATIVE/IN-LAW J (GO TO DV26)
FRIEND K (GO TO DV26)
NEIGHBOR L (GO TO DV26)
TEACHER M (GO TO DV26)
EMPLOYER N (GO TO DV26)
RELIGIOUS LEADER O (GO TO DV26)
DOCTOR/MEDICAL PERSONNEL P (GO TO DV26)
POLICE Q (GO TO DV26)
LAWYER R (GO TO DV26)
OTHER (SPECIFY): _______ X (GO TO DV26)
DV25) What is the main reason you have never sought help?
NO USE 02
PART OF LIFE 03
AFRAID OF DIVORCE/DESERTION 04
AFRAID OF FURTHER BEATINGS 05
AFRAID OF GETTING PERSON BEATING HER INTO TROUBLE 06
EMBARRASSED 07
DON'T WANT TO DISGRACE FAMILY 08
OTHER (SPECIFY): _________ 96
DV26) As far as you know, did your father ever beat your mother?
NO 2
DK 8
THANK THE RESPONDENT FOR HER COOPERATION AND REASSURE HER ABOUT THE CONFIDENTIALITY OF HER ANSWERS. FILL OUT THE QUESTIONS BELOW WITH REFERENCE TO THE DOMESTIC VIOLENCE MODULE ONLY.
DV 27) DID YOU HAVE TO INTERRUPT THE INTERVIEW BECAUSE SOME ADULT WAS TRYING TO LISTEN, OR CAME INTO THE ROOM, OR INTERFERED IN ANY OTHER WAY?
YES, MORE THAN ONCE 2
NO 3
YES, MORE THAN ONCE 2
NO 3
YES, MORE THAN ONCE 2
NO 3
DV28) INTERVIEWER'S COMMENTS/EXPLANATION FOR NOT COMPLETING THE DOMESTIC VIOLENCE MODULE