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DEMOGRAPHIC AND HEALTH SURVEY - BANGLADESH 1993-94 - WOMEN'S QUESTIONNAIRE (ENGLISH)

BANGLADESH

IDENTIFICATION

DIVISION:
DISTRICT:
UPAZILA OR THANA:
VILLAGE OR MOHALLA OR BLOCK:
CLUSTER NUMBER:
HOUSEHOLD NUMBER:
DHAKA/CHITTAGONG OR SMALL CITY OR TOWN OR VILLAGE:

DHAKA OR CHITTAGONG 1
SMALL CITY 2
TOWN 3
VILLAGE 4

NAME OF HOUSEHOLD HEAD:
NAME AND LINE NUMBER OF WOMAN

INTERVIEWER VISITS

FIRST VISIT
DATE
INTERVIEWER'S NAME
RESULT*

1 COMPLETED
2 NOT AT HOME
3 POSTPONED
4 REFUSED
5 PARTLY COMPLETED
6 INCAPACITATED
7 OTHER (SPECIFY)

SECOND VISIT
DATE
INTERVIEWER'S NAME
RESULT*

NEXT VISIT
DATE
TIME

THIRD VISIT
DATE
INTERVIEWER'S NAME
RESULT*

FINAL VISIT
DAY
MONTH

01 JANUARY
02 FEBRUARY
03 MARCH
04 APRIL
05 MAY
06 JUNE
07 JULY
08 AUGUST
09 SEPTEMBER
10 OCTOBER
11 NOVEMBER
12 DECEMBER

YEAR 199_
NAME
RESULT

TOTAL NUMBER OF VISITS

NAME
DATE

FIELD EDITED BY
OFFICE EDITED BY
KEYED BY
KEYED BY

SECTION 1. RESPONDENT'S BACKGROUND
101. RECORD THE TIME.

HOUR ___
MINUTES ___

102. How long have you been living continuously in (NAME OF CURRENT PLACE OR RESIDENCE)?

YEARS ___
ALWAYS 95 (GO TO 103)
VISITOR 96 (GO TO 103)

102A. Just before you moved here, did you live in a city, in a town, or in the countryside?

CITY 1
TOWN 2
COUNTRYSIDE 3

103. In what month and year were you born?
USE CODES BELOW FOR MONTHS
IF SHE DOES NOT KNOW, WRITE 'DK' IN BOXES.

BENGALI 1

MONTH __
YEAR 13__
01 BAISHAK
02 JAISTHA
03 ASHAR
04 SRABAN
05 BADHRA
06 ASHWIN
07 KARTIK
08 AGRAHAYAN
09 POUSH
10 MAGH
11 FALGUN
12 CHOITRA

ENGLISH 2

MONTH __
YEAR 19__
01 JANUARY
02 FEBRUARY
03 MARCH
04 APRIL
05 MAY
06 JUNE
07 JULY
08 AUGUST
09 SEPTEMBER
10 OCTOBER
11 NOVEMBER
12 DECEMBER

104. How old are you?
COMPARE AND CORRECT 103 AND/OR 104 IF INCONSISTENT

AGE IN COMPLETED YEARS ___

104A. Are you now married, widowed, or divorced?

MARRIED 1
WIDOWED 2
DIVORCED OR DESERTED 3

105. Have you ever attended school?

YES 1
NO 2 (GO TO 109)

106. What is the highest level of school you attended: primary, secondary, or higher?

PRIMARY 1
SECONDARY 2
COLLEGE OR UNIVERSITY 3

107. What is the highest class you completed?

CLASS ___

108. CHECK 106:

PRIMARY (GO TO 109)
SECONDARY OR COLLEGE (GO TO 110)

109. Can you read and write a letter in any language easily, with difficulty, or not at all?

EASILY 1
WITH DIFFICULTY 2
NOT AT ALL 3 (GO TO 111)

110. Do you usually read a newspaper of magazine at least once a week?

YES 1
NO 2

111. Do you usually listen to the radio at least once a week?

YES 1
NO 2

112. Do you usually watch television at least once a week?

YES 1
NO 2

113. What is your religion?

ISLAM 1
CHRISTIANITY 2
HINDUISM 3
BUDDHISM 4
OTHER (SPECIFY) 5

114. Do you belong to any of the following organizations:

Grameen bank?
YES 1
NO 2
BRAC?
YES 1
NO 2
BRDP?
YES 1
NO 2
Mother's club?
YES 1
NO 2
Any other organization?
YES (SPECIFY) 1 ____
NO 2

115. CHECK QUESTION 7 IN THE HOUSEHOLD QUESTIONNAIRE.

THE WOMAN INTERVIEWED IS NOT A USUAL RESIDENT (GO TO 116)
THE WOMAN INTERVIEWED IS A USUAL RESIDENT (GO TO 201)

116. Now I would like to ask about the place in which you usually live. Do you usually live in a city, in a town, or in a village?
IF CITY: Which city do you live?

DHAKA OR CHITTAGONG 1
SMALL CITY 2
TOWN 3
VILLAGE 4

117. In which division is that located?

RAJSHAHI 1
DHAKA 2
CHITTAGONG 3
KHULNA 4
BARISHAL 5

118. Now I would like to ask about the household in which you usually live. What is the source of water you household uses for hand washing?

PIPED WATER
PIPED INSIDE DWELLING 11 (GO TO 120)
PIPED OUTSIDE DWELLING 12
WELL WATER
TUBE WELL 21
SURFACE WELL OR OTHER WELL 22
SURFACE WATER
POND OR TANK OR LAKE 31
RIVER OR STREAM 32
RAINWATER 41 (GO TO 120)
OTHER (SPECIFY) 51

119. How long does it take to go there?

MINUTES ___
ON PREMISES 996

119A. How long do you usually wait to get water?

MINUTES ___

120. Does your household get drinking water from the same source?

YES 1 (GO TO 122)
NO 2

121. What is the source of drinking water for members of your household?

PIPED WATER
PIPED INSIDE DWELLING 11
PIPED OUTSIDE DWELLING 12
WELL WATER
TUBE WELL 21
SURFACE WELL OR OTHER WELL 22
SURFACE WATER
POND OR TANK OR LAKE 31
RIVER OR STREAM 32
RAINWATER 41
OTHER (SPECIFY) 51

122. Where do adult women in your household usually defecate?

SEPTIC TANK OR MODERN TOILET 11
PIT TOILET OR LATRINE
WATER SEALED OR SLAB LATRINE 21
PIT LATRINE 22
OPEN LATRINE 23
HANGING LATRINE 24
NO FACILITY OR BUSH OR FIELD 31
OTHER (SPECIFY) 41

123. Where do children in your household usually defecate?

SEPTIC TANK OR MODERN TOILET 11
PIT TOILET OR LATRINE
WATER SEALED OR SLAB LATRINE 21
PIT LATRINE 22
OPEN LATRINE 23
HANGING LATRINE 24
NO FACILITY OR BUSH OR FIELD 31
OTHER (SPECIFY) 41
NO CHILDREN 51

124. Does your household have:

Almirah?
YES 1
NO 2
Table, chair, or bench?
YES 1
NO 2
A watch or clock?
YES 1
NO 2
A cot or bed?
YES 1
NO 2
Electricity?
YES 1
NO 2
A radio that is working?
YES 1
NO 2
A television that is working?
YES 1
NO 2
A bicycle?
YES 1
NO 2
Agricultural land?
YES 1
NO 2

125. How many rooms in your household are used for sleeping?

ROOMS ___

126. MAIN MATERIAL OF THE ROOF.
RECORD OBSERVATION.

NATURAL ROOF
KATCH (BAMBOO OR THATCH) 11
RUDIMENTARY ROOF
TIN 21
FINISHED ROOF
CEMENT OR CONCRETE 31
OTHER (SPECIFY) 41

127. MAIN MATERIAL OF THE WALLS.
RECORD OBSERVATION.

NATURAL WALLS
JUTE OR BAMBOO OR MUD (KATCHA) 11
RUDIMENTARY WALLS
WOOD 21
FINISHED WALLS
BRICK OR CEMENT 31
TIN 32
OTHER (SPECIFY) 41

128. MAIN MATERIAL OF THE FLOOR.
RECORD OBSERVATION.

NATURAL FLOOR
EARTH OR BAMBOO (KATCHA) 11
RUDIMENTARY FLOOR
WOOD 21
FINISHED FLOOR (PUKKA)
CEMENT OR CONCRETE 31
OTHER (SPECIFY) 41

SECTION 2. REPRODUCTION
201. Now I would like to ask about all the births you have had during your life. Have you ever given birth?

YES 1
NO 2 (GO TO 206)

202. Do you have any sons or daughters to whom you have given birth who are now living with you?

YES 1
NO 2 (GO TO 204)

203. How many sons live with you? And how many daughters live with you?
IF NONE RECORD '00'.

SONS AT HOME ___
DAUGHTERS AT HOME ___

204. Do you have any sons or daughters to whom you have given birth who are alive but do not live with you?

YES 1
NO 2 (GO TO 206)

205. How many sons are alive but do not live with you? And how many daughters are alive but do not live with you?
IF NONE RECORD '00'.

SONS ELSEWHERE ___
DAUGHTERS ELSEWHERE ___

206. Have you ever given birth to a boy or a girl who was born alive but later died?
IF NO, PROBE: Any baby who cried or showed any sign of life but only survived a few hours or days?

YES 1
NO 2 (GO TO 208)

207. In all, how many boys have died? And how many girls?
IF NONE RECORD '00'.

BOYS DEAD ___
GIRLS DEAD ___

208. SUM ANSWERS TO 203, 205, AND 207, AND ENTER TOTAL.
IF NONE RECORD '00'.

TOTAL ___

209. CHECK 208:
Just to make sure that I have this right: you have had in TOTAL ___ births during your life. Is that correct?

YES (GO TO 210)
NO (PROBE AND CORRECT 201-208 AS NECESSARY)

210. CHECK 208:

ONE OR MORE BIRTHS (GO TO 211)
NO BIRTHS (GO TO 225)

211. Now I would like to talk to you about all of your births, whether still alive or not, starting with the first one you had.
RECORD NAMES OF ALL THE BIRTHS IN 212. RECORD TWINS AND TRIPLETS ON SEPARATE LINES.

212. What name was given to you (FIRST OR NEXT) baby?

NAME ___

213. Were any of these births twins?

SINGLE 1
MULTIPLE 2

214. In what month and year was (NAME) born?
WRITE EITHER BENGALI OR ENGLISH DATES, BUT NOT BOTH.
USE CODES AT THE BOTTOM OF THE PAGE FOR MONTHS.

BENGALI 1

MONTH __
YEAR 1___
01 BAISHAK
02 JAISTHA
03 ASHAR
04 SRABAN
05 BADHRA
06 ASHWIN
07 KARTIK
08 AGRAHAYAN
09 POUSH
10 MAGH
11 FALGUN
12 CHOITRA

ENGLISH 2

MONTH __
YEAR 19__
01 JANUARY
02 FEBRUARY
03 MARCH
04 APRIL
05 MAY
06 JUNE
07 JULY
08 AUGUST
09 SEPTEMBER
10 OCTOBER
11 NOVEMBER
12 DECEMBER

216. Is (NAME) still alive?

YES 1
NO 2 (GO TO 220)

217. IF ALIVE: How old was (NAME) at his or her last birthday?
RECORD AGE IN COMPLETED YEARS.

AGE IN YEARS ___

218. IF ALIVE: Is (NAME) living with you?

YES 1 (GO TO NEXT BIRTH)
NO 2 (GO TO NEXT BIRTH)

220. IF DEAD: How old was he or she when he or she died?
IF "1 YEAR", PROBE: How many months old was (NAME)?
RECORD DAYS IF LESS THAN 1 MONTH, MONTHS IF LESS THAN TWO YEARS, OR YEARS.

DAYS 1 ___
MONTHS 2 ___
YEARS 3 ___

221. COMPARE 208 WITH NUMBER OF BIRTHS IN HISTORY ABOVE AND MARK:
NUMBERS ARE THE SAME

CHECK:
FOR EACH BIRTH: YEAR OF BIRTH IS RECORDED.
FOR EACH LIVING CHILD: CURRENT AGE IS RECORDED.
FOR EACH DEAD CHILD: AGE AT DEATH IS RECORDED.
FOR AGE AT DEATH 12 MONTH OR 1 YEAR: PROBE TO DETERMINE EXACT NUMBER OF MONTHS.
FOR BIRTH INTERVALS OF FOUR YEARS OR MORE: PROBE FOR UNREPORTED BIRTHS.

NUMBERS ARE DIFFERENT

PROBE AND RECONCILE

223. FOR EACH BIRTH SINCE BAISHAK 1395 OR APRIL 1988, ENTER "B" IN MONTH OF BIRTH IN COLUMN 1 OF CALENDAR AND "P" IN EACH OF THE 8 PRECEDING MONTHS. WRITE NAME TO THE LEFT OF THE "B" CODE.

225. Are you pregnant now?

YES 1
NO 2 (GO TO 228)
UNSURE 8 (GO TO 228)

226. How many month pregnant are you?
ENTER "P" IN COLUMN 1 OF CALENDAR IN MONTH OF INTERVIEW AND IN EACH PRECEDING MONTH PREGNANT.

MONTHS ___

227. At the time you became pregnant, did you want to become pregnant then, did you want to wait until later, or did you not want to become pregnant at all?

THEN 1
LATER 2
NOT AT ALL 3

228. Have you ever had a pregnancy that miscarried, was aborted, or ended in a stillbirth?

YES 1
NO 2 (GO TO 233A)

229. When did the last such pregnancy end?
USE CODES BELOW FOR MONTHS.

BENGALI 1

MONTH __
YEAR 1___
01 BAISHAK
02 JAISTHA
03 ASHAR
04 SRABAN
05 BADHRA
06 ASHWIN
07 KARTIK
08 AGRAHAYAN
09 POUSH
10 MAGH
11 FALGUN
12 CHOITRA

ENGLISH 2

MONTH __
YEAR 19__
01 JANUARY
02 FEBRUARY
03 MARCH
04 APRIL
05 MAY
06 JUNE
07 JULY
08 AUGUST
09 SEPTEMBER
10 OCTOBER
11 NOVEMBER
12 DECEMBER

230. CHECK 229:

LAST PREGNANCY ENDED SINCE BAISHAK 1395 OR APRIL 1988 (GO TO 231)
LAST PREGNANCY ENDED BEFORE BAISHAK 1395 OR APRIL 1988 (GO TO 233A)

231. How many months pregnant were you when the pregnancy ended?
ENTER "T" IN COLUMN 1 OF CALENDAR IN THE MONTH THAT THE PREGNANCY TERMINATED, AND "P" IN EACH PRECEDING MONTH PREGNANT.

MONTHS ___

232. Did you ever have any other such pregnancies?

YES 1
NO 2 (GO TO 233A)

233. ASK FOR DATES AND DURATIONS OF ANY OTHER PREGNANCIES BACK TO BAISHAK 1395 OR APRIL 1988. ENTER "T" IN COLUMN 1 OF CALENDAR IN MONTH PREGNANCY TERMINATED, AND "P" IN EACH PRECEDING MONTH PREGNANT.

233A. Have you ever become pregnant when you did not want to be?

YES 1
NO 2 (GO TO 234)

233B. Were any of those pregnancies ended by menstrual regulation or induced abortion?

YES 1
NO 2 (GO TO 234)

233C. The last time this happened, was the pregnancy ended by menstrual regulation or induced abortion?

MENSTRUAL REGULATION (MR) 1
INDUCED ABORTION OR D and C 2
OTHER (SPECIFY) 3

233D. When did the last such pregnancy end?
USE CODES BELOW FOR MONTHS.

BENGALI 1

MONTH __
YEAR 1___
01 BAISHAK
02 JAISTHA
03 ASHAR
04 SRABAN
05 BADHRA
06 ASHWIN
07 KARTIK
08 AGRAHAYAN
09 POUSH
10 MAGH
11 FALGUN
12 CHOITRA

ENGLISH 2

MONTH __
YEAR 19__
01 JANUARY
02 FEBRUARY
03 MARCH
04 APRIL
05 MAY
06 JUNE
07 JULY
08 AUGUST
09 SEPTEMBER
10 OCTOBER
11 NOVEMBER
12 DECEMBER

STILL PREGNANT 6

234. When did your last menstrual period start?

DAYS AGO 1 ___
WEEKS AGO 2 ___
MONTHS AGO 3 ___
YEARS AGO 4 ___
IN MENOPAUSE 994
BEFORE LAST BIRTH 995
NEVER MENSTRUATED 996

SECTION 3. CONTRACEPTION
301. Now I would like to talk about family planning - the various ways or methods that a couple can use to delay or avoid a pregnancy. Which ways have you heard about?

CIRCLE CODE 1 IN 302 FOR EACH METHOD MENTIONED SPONTANEOUSLY. THEN PROCEED DOWN THE COLUMN, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY.

CIRCLE CODE 2 IF METHOD IS RECOGNIZED, AND CODE 3 IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE 1 OR 2 CIRCLED IN 302, ASK 303-304 BEFORE PROCEEDING TO THE NEXT METHOD.

302. Have you ever heard of (METHOD)?
READ DESCRIPTION OF EACH METHOD.

01. PILL, MAYA: Women can take a pill every day.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
02. IUD, COPPER T: Women can have a loop or coil placed inside them by a doctor or a nurse.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
03. INJECTIONS: Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
04. CONDOM, RAJA: Men can use a rubber sheath during sexual intercourse.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
05. FEMALE STERILIZATION, TUBAL LIGATION, TL: Women can have an operation to avoid having any more children.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
06. MALE STERILIZATION, VASECTOMY: Men can have an operation to avoid having any more children.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
07. SAFE PERIOD, COUNTING DAYS, CALENDAR, RHYTHM METHOD: Couples can avoid having sexual intercourse on certain days of the month when the woman is more likely to become pregnant.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
08. WITHDRAWAL: Men can be careful and pull out before climax.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
09. Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
SPONTANEOUS YES (SPECIFY) 1 ___
NO 3

303. Have you ever used (METHOD)?

01. PILL, MAYA: Women can take a pill every day.
YES 1
NO 2
02. IUD, COPPER T: Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
03. INJECTIONS: Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
YES 1
NO 2
04. CONDOM, RAJA: Men can use a rubber sheath during sexual intercourse.
YES 1
NO 2
05. FEMALE STERILIZATION, TUBAL LIGATION, TL: Have you ever had an operation to avoid having any more children?
YES 1
NO 2
06. MALE STERILIZATION, VASECTOMY: Men can have an operation to avoid having any more children.
YES 1
NO 2
07. SAFE PERIOD, COUNTING DAYS, CALENDAR, RHYTHM METHOD: Couples can avoid having sexual intercourse on certain days of the month when the woman is more likely to become pregnant.
YES 1
NO 2
08. WITHDRAWAL: Men can be careful and pull out before climax.
YES 1
NO 2
09. Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1
NO 2

304. Do you know where a person could go to get (METHOD)?

01. PILL, MAYA: Women can take a pill every day.
YES 1
NO 2
02. IUD, COPPER T: Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
03. INJECTIONS: Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
YES 1
NO 2
04. CONDOM, RAJA: Men can use a rubber sheath during sexual intercourse.
YES 1
NO 2
05. FEMALE STERILIZATION, TUBAL LIGATION, TL: Have you ever had an operation to avoid having any more children?
YES 1
NO 2
06. MALE STERILIZATION, VASECTOMY: Men can have an operation to avoid having any more children.
YES 1
NO 2
07. SAFE PERIOD, COUNTING DAYS, CALENDAR, RHYTHM METHOD: Do you know where a person can obtain advice on how to use the safe period?
YES 1
NO 2

305. CHECK 303:

NOT A SINGLE "YES" (NEVER USED) (GO TO 306)
AT LEAST ONE "YES" (EVER USED) (GO TO 309)

306. Have you ever used anything or tried in any way to delay or avoid getting pregnant?

YES 1 (GO TO 308)
NO 2

307. ENTER "0" IN COLUMN 1 OF CALENDAR IN EACH BLANK MONTH (GO TO 328E).

308. What have you used or done?

CORRECT 303-305 (AND 302 IF NECESSARY).

309. What was the first method you ever used?

PILL 01
IUD 02
INJECTIONS 03
CONDOM 04
FEMALE STERILIZATION 05
MALE STERILIZATION 06
SAFE PERIOD, COUNTING DAYS 07 (GO TO 311)
WITHDRAWAL 08 (GO TO 311)
OTHER (SPECIFY) 09 (GO TO 311)

310. Where did you get this method the first time?

PUBLIC SECTOR
HOSPITAL OR MEDICAL COLLEGE 11
FAMILY WELFARE CENTRE 12
THANA HEALTH COMPLEX 13
SATELLITE CLINIC 14
MEDICAL PRIVATE SECTOR
PRIVATE CLINIC OR DOCTOR 21
TRADITIONAL DOCTOR 22
PHARMACY 23
OTHER PRIVATE SECTOR
SHOP 31
FRIENDS OR RELATIVES 32
FIELDWORKER, FWA 41
OTHER (SPECIFY) 51
DOES NOT KNOW 98

311. How many living children did you have at that time if any?
IF NONE, RECORD '00'.

NUMBER OF CHILDREN ___

311A. CHECK 303:

WOMAN NOT STERILIZED (GO TO 312)
WOMAN STERILIZED (GO TO 315A)

312. CHECK 104A:

CURRENTLY MARRIED (GO TO 313)
WIDOWED OR DIVORCED (GO TO 322D)

313. CHECK 225:

NOT PREGNANT OR UNSURE (GO TO 314)
PREGNANT (GO TO 322D)

314. Are you currently doing something or using any method to delay or avoid getting pregnant?

YES 1
NO 2 (GO TO 322D)

315. Which method are you using?
315A. CIRCLE '05' FOR FEMALE STERILIZATION.

PILL 01
IUD 02
INJECTIONS 03
CONDOM 04
FEMALE STERILIZATION 05 (GO TO 321)
MALE STERILIZATION 06 (GO TO 321)
SAFE PERIOD, COUNTING DAYS 07
WITHDRAWAL 08
OTHER (SPECIFY) 09

316. At any time during the same month, do you regularly use any method other than (CURRENT METHOD)?

YES 1
NO 2 (GO TO 318)

317. Which method is that?

PILL 01
IUD 02
INJECTIONS 03
CONDOM 04
SAFE PERIOD, COUNTING DAYS 07
WITHDRAWAL 08
OTHER (SPECIFY) 09

318. CHECK 315:

USING PILL (GO TO 318A)
USING INJECTION (GO TO 319)
USING CONDOM (GO TO 320)
USING IUD OR OTHER MODERN METHOD (GO TO 323)
USING SAFE PERIOD (GO TO 322D)
USING WITHDRAWAL OR OTHER (GO TO 326)

318A. May I see the package of pills you are using now?
RECORD NAME OF BRAND.

PACKAGE SEEN 1
BRAND NAME ___
PACKAGE NOT SEEN 2 (GO TO 318D)

318B. CHECK PACKET FOR PILL USE AND MARK CORRECT CODE.

PILLS MISSING IN ORDER 1 (GO TO 318F)
PILLS MISSING OUT OF ORDER 2
NO PILLS MISSING 3

318C. Why is it that you have not taken the pills (IN ORDER)?

DOESN'T KNOW WHAT TO DO 01 (GO TO 318F)
HEALTH REASONS 02 (GO TO 318F)
FOLLOWING INSTRUCTIONS 03 (GO TO 318F)
NEW PACKET 04 (GO TO 318F)
MENSTRUATING 05 (GO TO 318F)
OTHER (SPECIFY) 06 (GO TO 318F)

318D. SHOW BRAND CHART FOR PILLS: Please tell me which of these is the brand of pills that you are now using.

BRAND NAME ___
DOES NOT KNOW 98

318E. Why don't you have a package of pills available/
CIRCLE ALL MENTIONED.

RAN OUT A
COST TOO MUCH B
HUSBAND AWAY C
HAS MENSTRUAL PERIOD D
NOT AVAILABLE AT HER SOURCE E
FWA HAS NOT BROUGHT RESUPPLY F
OTHER (SPECIFY) G

318F. When was the last time you took a pill?

DAYS AGO ___
MORE THAN ONE MONTH AGO 97

318G. CHECK 318F:

MORE THAN TWO DAYS AGO (GO TO 318H)
TWO DAYS OR LESS (GO TO 318I)

318H. Why aren't you taking the pill these days?

HUSBAND AWAY A
FORGOT B
HEALTH REASONS C
COST TOO MUCH D
NO NEED TO TAKE EVERY DAY E
RAN OUT F
FWA HAS NOT BROUGHT RESUPPLY G
MENSTRUATING H
OTHER (SPECIFY) I

318I. After you finish taking one package of pills do you sometimes wait before starting the next package?

YES 1
NO 2

318J. How much does one (packet/cycle) or pills cost you?

COST ___
FREE 9996
DON'T KNOW 9998

318K. Just about everyone forgets to take a pill sometime. What do you do when you forget to take a pill for two days in a row?

START TAKING AGAIN AS USUAL 1 (GO TO 323)
TAKE EXTRA OR MISSED PILLS 2 (GO TO 323)
USE ANOTHER METHOD 3 (GO TO 323)
TAKE EXTRA PILL AND USE ANOTHER METHOD 4 (GO TO 323)
OTHER (SPECIFY) 5 (GO TO 323)
NEVER FORGOT 6 (GO TO 323)

319. When did you last have an injection?

MONTHS AGO ___

319A. CHECK 319:

MORE THAN 3 MONTHS AGO (GO TO 319B)
THREE MONTHS AGO OR LESS (GO TO 323)

319B. Why haven't you had an injection recently?

HUSBAND AWAY 1 (GO TO 323)
FORGOT 2 (GO TO 323)
HEALTH REASONS 3 (GO TO 323)
COST TOO MUCH 4 (GO TO 323)
NOT AVAILABLE AT PROVIDER 5 (GO TO 323)
OTHER (SPECIFY) 6 (GO TO 323)

320. May I see the package of condoms that you are using?
RECORD THE NAME OF BRAND.

PACKAGE SEEN 1 (GO TO 320C)
BRAND NAME ___
PACKAGE NOT SEEN 2

320A. Why can't you show me the package of condoms that you are using?

HUSBAND KEEPS 1
RAN OUT 2
OTHER (SPECIFY) 3

320B. SHOW BRAND CHART FOR CONDOMS: Please tell me which of these is the brand of condoms that you are using.

BRAND NAME ___
DOES NOT KNOW 98

320C. Do you use a condom every time that you have sexual intercourse or only sometimes?

EVERY TIME 1
ONLY SOMETIMES 2

320D. How many times have you used condoms in the last month?

NUMBER OF TIMES ___ (GO TO 323)

321. In what month and year was the sterilization operation performed?
USE CODES BELOW FOR MONTHS.

BENGALI 1

MONTH __
YEAR 13__
01 BAISHAK
02 JAISTHA
03 ASHAR
04 SRABAN
05 BADHRA
06 ASHWIN
07 KARTIK
08 AGRAHAYAN
09 POUSH
10 MAGH
11 FALGUN
12 CHOITRA

ENGLISH 2

MONTH __
YEAR 19__
01 JANUARY
02 FEBRUARY
03 MARCH
04 APRIL
05 MAY
06 JUNE
07 JULY
08 AUGUST
09 SEPTEMBER
10 OCTOBER
11 NOVEMBER
12 DECEMBER

322. ENTER STERILIZATION METHOD CODE IN MONTH OF INTERVIEW IN COLUMN 1 OF CALENDAR AND IN EACH MONTH BACK TO DATE OF OPERATION OR TO BAISHAK 1395, IF OPERATION OCCURRED BEFORE 1395

322A. Do you regret that (you or your husband) had the operation not to have any more children?

YES 1
NO 2 (GO TO 323A)

322B. Why do you regret it?

RESPONDENT WANTS ANOTHER CHILD 1 (GO TO 323A)
PARTNER WANTS ANOTHER CHILD 2 (GO TO 323A)
SIDE EFFECTS 3 (GO TO 323A)
OTHER REASON ___ 4 (GO TO 323A)

322C. You told me that you use the safe period (calendar, rhythm) method. Please tell me which days of your monthly cycle are not safe.

DURING HER PERIOD 01 (GO TO 326)
RIGHT AFTER HER PERIOD ENDS 02 (GO TO 326)
IN THE MIDDLE OF HER CYCLE 03 (GO TO 326)
JUST BEFORE HER PERIOD BEGINS 04 (GO TO 326)
OTHER (SPECIFY) 96 (GO TO 326)
DOES NOT KNOW 98 (GO TO 326)

322D. Which method of family planning did you use most recently?

PILL 01
IUD 02
INJECTIONS 03
CONDOM 04
SAFE PERIOD, COUNTING DAYS 07 (GO TO 325J)
WITHDRAWAL 08 (GO TO 325J)
OTHER (SPECIFY) 09 (GO TO 325J)

323. Where did you obtain (METHOD) the last time?
323A. Where did the sterilization take place?

NAME OF PLACE ___
PUBLIC SECTOR
HOSPITAL OR MEDICAL COLLEGE 11
FAMILY WELFARE CENTRE 12
THANA HEALTH COMPLEX 13
SATELLITE CLINIC 14
MEDICAL PRIVATE SECTOR
PRIVATE CLINIC OR DOCTOR 21
TRADITIONAL DOCTOR 22
PHARMACY 23
OTHER PRIVATE SECTOR
SHOP 31
FRIENDS OR RELATIVES 32
FIELDWORKER, FWA 41 (GO TO 325E)
OTHER (SPECIFY) 51
DOES NOT KNOW 98

323B. Did you pay for the service you received there?

YES 1
NO 2
DOES NOT KNOW 8

323C. CHECK 322D OR 315:

USING (USED) PILLS OR CONDOMS (GO TO 325)
USING (USED) OTHER METHOD (GO TO 325J)

325. Who obtained the (PILL OR CONDOMS) the last time you got them?

RESPONDENT 1 (325B)
HUSBAND 2
SON OR DAUGHTER 3
OTHER RELATIVE 4
OTHER (SPECIFY) 5

325A. Have you yourself ever been to a health facility, a doctor, or a shop to get (PILLS OR CONDOMS)?

YES 1
NO 2 (GO TO 325J)

325B. Did anyone there ever tell you about side effects or other problems that you might have using this method?

YES 1
NO 2
CANNOT REMEMBER

8

325C. Did anyone there ever tell you about other methods that you might use?

YES 1 (GO TO 325H)
NO 2 (GO TO 325H)
CANNOT REMEMBER 8 (GO TO 325H)

325E. Did the family welfare assistant (fieldworker) ever tell you about side effects or problems you might have with this (CURRENT METHOD)?

YES 1
NO 2
CANNOT REMEMBER 8

325G. Did the family welfare assistant (fieldworker) ever tell you about other methods that you might use?

YES 1
NO 2
CANNOT REMEMBER 8

325H. Did you get the method that you wanted?

YES 1 (GO TO 325J)
NO 2

325I. Which method did you want?

PILL 01
IUD 02
INJECTIONS 03
CONDOM 04
FEMALE STERILIZATION 05
MALE STERILIZATION 06
SAFE PERIOD, COUNTING DAYS 07
WITHDRAWAL 08
OTHER (SPECIFY) 09

325J. When a couple is making a decision, sometimes the husband has more influence, sometimes the wife has more influence and sometimes other people have more influence. In your family, who had the most influence in deciding to use family planning the first time you used a method?

RESPONDENT HAD MORE INFLUENCE 1
HUSBAND HAD MORE INFLUENCE 2
BOTH HUSBAND AND WIFE EQUAL 3
OTHER RELATIVE 4
OTHER (SPECIFY) 5

325K. CHECK 315:

CURRENTLY USING A METHOD (GO TO 326)
NO USING A METHOD (BLANK) (GO TO 328E)

326. What is the main reason you decided to use (CURRENT METHOD FROM 315) rather than some other method of family planning?

FAMILY PLANNING WORKER RECOMMENDED 01
FRIEND OR RELATIVE RECOMMENDED 02
SIDE EFFECTS OF OTHER METHODS 03
METHOD EASY TO USE 04
ACCESS OR AVAILABILITY 05
COST 06
WANTED PERMANENT METHOD 07
HUSBAND PREFERRED 08
WANTED MORE EFFECTIVE METHOD 09
OTHER (SPECIFY) 10
DOES NOT KNOW 98

327. Are you having any health problems using (CURRENT METHOD)?

YES 1
NO 2 (GO TO 328C)

328. What health problems are you having with using (METHOD)?
CIRCLE ALL MENTIONED.

WEIGHT GAIN A
WEIGHT LOSS B
TOO MUCH BLEEDING C
HYPERTENSION D
HEADACHE E
NAUSEA F
NO MENSTRUATION G
WEAK OR TIRED H
DIZZINESS I
OTHER (SPECIFY) J
DOES NOT KNOW K

328A. When you first started having these problems, did anyone talk to you about these problems?

YES 1
NO 2 (GO TO 328C)

328B. Who talked to you about these problems?

FIELDWORKER, FWA 1
STAFF AT SATELLITE CLINIC 2
STAFF AT FAMILY WELFARE CLINIC 3
RELATIVE OR FRIEND 4
OTHER (SPECIFY) 5

328C. Are you having any other problems in using (CURRENT METHOD)?

YES 1
NO 2 (GO TO 329)

328D. What other problems are you having?
CIRCLE ALL MENTIONED.

HUSBAND DISAPPROVES A (GO TO 329)
OTHER RELATIVE DISAPPROVES B (GO TO 329)
RELIGION DISAPPROVES C (GO TO 329)
ACCESS OR AVAILABILITY D (GO TO 329)
COSTS TOO MUCH E (GO TO 329)
INCONVENIENT TO USE F (GO TO 329)
STERILIZED, WANTS MORE CHILDREN G (GO TO 329)
OTHER (SPECIFY) H (GO TO 329)
DOES NOT KNOW I (GO TO 329)

328E. CHECK 104A:

CURRENTLY MARRIED (GO TO 328F)
WIDOWED OR DIVORCED (GO TO 328J)

328F. CHECK 225:

NOT PREGNANT OR UNSURE (GO TO 328G)
PREGNANT (GO TO 328J)

328G. What is the main reason you are not using a method to delay or avoid pregnancy?

WANTS CHILDREN 01
LACK OF KNOWLEDGE 02
PARTNER OPPOSED 03
COST TOO MUCH 04
SIDE EFFECTS 05
HEALTH CONCERNS 06
HARD TO GET METHODS 07
RELIGION 08
OPPOSED TO FAMILY PLANNING 09
FATALISTIC 10
OTHER PEOPLE OPPOSED 11
INFREQUENT SEX OR HUSBAND AWAY 12
DIFFICULT TO GET PREGNANT 13
MENOPAUSAL OR HAD HYSTERECTOMY 14
INCONVENIENT 15
MENSTRUATION NOT RETURNED 16
BREASTFEEDING 17
OTHER (SPECIFY) 18
DON'T KNOW 98

328H. Do you know where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 328J)

328I. Where is that?
IF WOMAN SAYS MORE THAN ONE PLACE, ASK FOR THE PLACE SHE WOULD MOST LIKELY USE.

NAME OF PLACE ___
PUBLIC SECTOR
HOSPITAL OR MEDICAL COLLEGE 11
FAMILY WELFARE CENTRE 12
THANA HEALTH COMPLEX 13
SATELLITE CLINIC 14
MEDICAL PRIVATE SECTOR
PRIVATE CLINIC OR DOCTOR 21
TRADITIONAL DOCTOR 22
PHARMACY 23
OTHER PRIVATE SECTOR
SHOP 31
FRIENDS OR RELATIVES 32
FIELDWORKER, FWA 41 (GO TO 325E)
OTHER (SPECIFY) 51
DOES NOT KNOW 98

328J. CHECK 305 AND 306:

HAS USED A METHOD (GO TO 329)
HAS NEVER USED A METHOD (GO TO 347)

329. CHECK 315 AND 321:

CURRENT USER OTHER THAN STERILIZATION (GO TO 330)
STERILIZED BEFORE BAISHAK 1395 (GO TO 347)
STERILIZED SINCE BAISHAK 1395 (GO TO 331)
NOT CURRENTLY USING (GO TO 331)

330. ENTER METHOD CODE FROM 315 IN CURRENT MONTH IN COLUMN 1 OF CALENDAR. THEN DETERMINE WHEN SHE STARTED USING THIS METHOD THIS TIME. ENTER METHOD CODE IN EACH MONTH OF USE.
ILLUSTRATIVE QUESTIONS:

When did you start using this method continuously?
How long have you been using this method continuously?

331. I would like to ask some questions about all of the (OTHER) periods in the last few years during which you or your partner used a method to avoid getting pregnant.

USE CALENDAR TO PROBE FOR EARLIER PERIODS OF USE AND NONUSE, STARTING WITH THE MOST RECENT USE, BACK TO BAISHAK 1395.

USE NAMES OF CHILDREN, DATES OF BIRTH, AND PERIODS OF PREGNANCY AS REFERENCE POINTS.

IN EACH MONTH, ENTER CODE FOR METHOD OR "0" FOR NONUSE IN COLUMN1. IN COLUMN 2, ENTER CODES FOR DISCONTINUATION NEXT TO LAST MONTH OF USE.

NUMBER OF CODES ENTER IN COLUMN 2 MUST BE THE SAME AS THE NUMBER OF INTERRUPTIONS OF CONTRACEPTIVE US IN COLUMN 1.

ASK WHY SHE STOPPED USING THE METHOD. IF A PREGNANCY FOLLOWED, ASK WHETHER SHE BECAME PREGNANT UNINTENTIONALLY WHILE USING THE METHOD OR DELIBERATELY STOPPED TO GET PREGNANT.

ILLUSTRATIVE QUESTIONS:

COLUMN 1:

When was the last time you used a method? Which method was that?
When did you start using that method? How long after the birth of (NAME)?
How long did you use the method then?

COLUMN 2:

Why did you stop using the (METHOD)?
Did you become pregnant while using (METHOD), or did you stop to get pregnant, or stop for some other reason?

IF DELIBERATELY STOPPED TO BECOME PREGNANT, ASK:

"How many months did it take you to get pregnant after you stopped us (METHOD)?

AND ENTER '0' IN EACH SUCH MONTH IN COLUMN 1.

347. CHECK 310, 323, AND 328I:

SATELLITE CLINIC NOT MENTIONED (GO TO 347A)
SATELLITE CLINIC MENTIONED (GO TO 347B)

347A. In some places, there is a clinic set up for a day or part of a day in someone's house or in a school. This is called a satellite clinic. During the past 3 months was there any such clinic in your village or mohalla?

YES 1
NO 2 (GO TO 348)
DOES NOT KNOW 8 (GO TO 348)

347B. Did you ever visit such a clinic?

YES 1
NO 2 (GO TO 348)

347C. What services did they provide?

CIRCLE ALL MENTIONED.

FAMILY PLANNING METHODS A
IMMUNIZATION B
CHILD GROWTH MONITORING C
OTHER (SPECIFY) D
DOES NOT KNOW E

348. In the last months, have you heard or seen a message about family planning on:

The radio?
YES 1
NO 2
Television?
YES 1
NO 2
A billboard?
YES 1
NO 2
A poster?
YES 1
NO 2

349. Is it acceptable or not acceptable to you for information to be provided on the radio about:

The pills?
YES 1
NO 2
Condoms?
YES 1
NO 2
Injections?
YES 1
NO 2
IUDS (coil, loop)?
YES 1
NO 2
Sterilization (TL)?
YES 1
NO 2

350. During the last six months has anyone visited you in your house to talk to you about family planning or to give you any family planning method?

YES 1 (GO TO 352)
NO 2
DOES NOT KNOW 8

351. Has a family planning working visited you in the last six months for another reason?

YES 1
NO 2 (GO TO 358)
DOES NOT KNOW 8 (GO TO 358)

352. How many times did a family planning worker visit you in the last six months?

TIMES ___
DOES NOT KNOW 98

353. When was the last visit?

IF LESS THAN ONE MONTH AGO, WRITE '00'.

MONTHS AGO ___
DOES NOT KNOW 98

354. Did you receive any family planning supplies from the fieldworker during the last visit?

YES 1
NO 2 (GO TO 357)

355. What supplies did you receive?

PILLS 1
CONDOMS 2
INJECTIONS 3 (GO TO 357)
OTHER (SPECIFY) 4 (GO TO 357)

356. How many cycles or condoms?

CYCLES OR CONDOMS ___

357. Thinking back to all the visits you have ever had from family planning workers, which methods of avoiding pregnancy did they discuss with you?
CIRCLE ALL MENTIONED.

PILLS A
IUD B
INJECTION C
CONDOMS D
FEMALE STERILIZATION E
MALE STERILIZATION F
NEVER DISCUSSED G

357A. Did the family planning worker who came to your house ever refer you to a clinic for any reason?

YES 1
NO 2 (GO TO 358)
DOES NOT KNOW 8 (GO TO 358)

357B. Why did she refer you to a clinic?

FOR STERILIZATION 1
TO GET AN IUD INSERTED 2
TO GET INJECTION 3
TO GET OTHER FAMILY PLANNING METHODS 4
FOR TREATMENT OF SIDE EFFECTS 5
FOR OTHER HEALTH REASONS 6
OTHER (SPECIFY) 7

358. Do you think that most of the women you know use some kind of family planning method?

YES 1
NO 2
DOES NOT KNOW 8

359. Have you ever recommended family planning to a friend, relative, or anyone else?

YES 1
NO 2

360. In the past 12 months, have you visited a health facility for any reason?

YES 1
NO 2 (GO TO 401)

361. Did anyone at the health facility speak to you about family planning methods during any of your visits this year?

YES 1
NO 2

SECTION 4A. PREGNANCY AND BREASTFEEDING
401. CHECK 215:

ONE OR MORE BIRTHS SINCE BAISHAK 1397 (APRIL 1990) (GO TO 402)
NO BIRTHS SINCE BAISHAK 1397 (SKIP TO 501)

402. ENTER THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTHS SINCE BAISHAK 1397 OR APRIL 1990 IN THE TABLE. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 3 BIRTHS USE ADDITIONAL FORMS).

Now I would like to ask you some more questions about the health of all your children born in the past 3 years. (We will talk about one child at a time.)

LINE NUMBER FROM QUESTION 212 ___

FROM QUESTION 212:

NAME ___

FROM QUESTION 216:

ALIVE __
DEAD __

403. At the time you became pregnant with (NAME), did you want to become pregnant then, did you want to wait until later, or did you want no (MORE) children at all?

THEN 1
LATER 2
NO MORE 3

405. When you were pregnant with (NAME), did you see anyone for antenatal care for this pregnancy?
IF YES: Whom did you see? Anyone else?
RECORD ALL PERSONS SEEN.

HEALTH PROFESSIONAL
DOCTOR A
NURSE OR MIDWIFE B
FAMILY WELFARE VISITOR C
OTHER PERSON
TRAINED (TRADITIONAL) BIRTH ATTENDANT D
TRADITIONAL BIRTH ATTENDANT E
OTHER (SPECIFY) F
NO ONE G (GO TO 409)

407. How many months pregnant were you when you first saw someone for an antenatal check on this pregnancy?

MONTHS ___
DON'T KNOW 98

408. How many antenatal visits did you have during this pregnancy?

NUMBER OF VISITS ___
DON'T KNOW 98

409. When you were pregnant with (NAME) were you given an injection in the arm to prevent the baby from getting tetanus, that is, convulsions after birth?

YES 1
NO 2 (GO TO 411)
DON'T KNOW 8 (GO TO 411)

410. During this pregnancy how many times did you get this injection?

TIMES ___
DON'T KNOW 8

411. Where did you give birth to (NAME)?

HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21
THANA HEALTH COMPLEX 22
PRIVATE SECTOR
PRIVATE HOSPITAL OR CLINIC 31
OTHER (SPECIFY) 41

412. Who assisted with the delivery of (NAME)? Anyone else?
PROBE FOR THE TYPE OF PERSON AND RECORD ALL PERSONS ASSISTING.

HEALTH PROFESSIONAL
DOCTOR A
NURSE OR MIDWIFE B
FAMILY WELFARE VISITOR C
OTHER PERSON
TRAINED (TRADITIONAL) BIRTH ATTENDANT D
TRADITIONAL BIRTH ATTENDANT E
RELATIVE F
OTHER (SPECIFY) G
NO ONE H

418. Has you period returned since the birth of (NAME)?
(MOST RECENT BIRTH WITHIN THE LAST FOUR YEARS)

YES 1 (GO TO 420)
NO 2 (GO TO 421)

419. Did your period return between the birth of (NAME) and your next pregnancy?
(REPEAT QUESTIONS FOR ALL CHILDREN BORN IN THE LAST FOUR YEARS, EXCLUDING THE MOST RECENT BIRTH)

YES 1
NO 2 (GO TO 423)

420. For how many months after the birth of (NAME) did you not have a period?

MONTHS ___
DON'T KNOW 98

421. CHECK 223:
RESPONDENT PREGNANT?
(MOST RECENT BIRTH WITHIN THE LAST FOUR YEARS)

NOT PREGNANT (GO TO 422)
PREGNANT OR UNSURE (GO TO 423)

422. Have you resumed sexual relations since the birth of (NAME)?
(MOST RECENT BIRTH WITHIN THE LAST FOUR YEARS)

YES 1
NO 2 (GO TO 424)

423. For how many months after the birth of (NAME) did you not have sexual relations?

MONTHS ___
DON'T KNOW 98

424. Did you ever breastfeed (NAME)?

YES 1 (GO TO 428)
NO 2

425. Why did you not breastfeed (NAME)?

MOTHER ILL OR WEAK 01
CHILD ILL OR WEAK 02
CHILD DIED 03
NIPPLE OR BREAST PROBLEM 04
INSUFFICIENT MILK 05
MOTHER WORKING 06
CHILD REFUSED 07
OTHER (SPECIFY) (GO TO 434A)

428. How long after birth did you fist put (NAME) to the breast?
(MOST RECENT BIRTH WITHIN THE LAST FOUR YEARS)
IF LESS THAN 1 HOUR, RECORD '00' HOURS. IF LESS THAN 24 HOURS, RECORD HOURS. OTHERWISE, RECORD DAYS.

IMMEDIATELY 000
HOURS 1 ___
DAYS 2 ___

429. CHECK 216:

CHILD ALIVE?

ALIVE (GO TO 430)
DEAD (GO TO 431)

430. Are you still breastfeeding (NAME)?
(MOST RECENT BIRTH WITHIN THE LAST FOUR YEARS)

YES 1 (GO TO 432A)
NO 2

431. For how many months did you breastfeed (NAME)?

MONTHS___

432. Why did you stop breastfeeding (NAME)?

MOTHER ILL OR WEAK 01 (GO TO 434A)
CHILD ILL OR WEAK 02 (GO TO 434A)
CHILD DIED 03 (GO TO 434A)
NIPPLE OR BREAST PROBLEM 04 (GO TO 434A)
INSUFFICIENT MILK 05 (GO TO 434A)
MOTHER WORKING 06 (GO TO 434A)
CHILD REFUSED 07 (GO TO 434A)
WEANING AGE 08 (GO TO 434A)
BECAME PREGNANT 09 (GO TO 434A)
STARTED USING CONTRACEPTION 10 (GO TO 434A)
OTHER (SPECIFY) 11 (GO TO 434A)

432A. How many times did you breastfeed last night between sunset and sunrise?
(MOST RECENT BIRTH WITHIN THE LAST FOUR YEARS)
IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER.

NUMBER OF NIGHTTIME FEEDINGS ___

433. How many times did you breastfeed yesterday during the daylight hours?
(MOST RECENT BIRTH WITHIN THE LAST FOUR YEARS)
IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER.

NUMBER OF DAYLIGHT FEEDINGS ___

434. At any time yesterday or last night was (NAME) given any of the following:
(MOST RECENT BIRTH WITHIN THE LAST FOUR YEARS)

Plain water?
YES 1
NO 2
Sugar water or honey?
YES 1
NO 2
Juice?
YES 1
NO 2
Tea?
YES 1
NO 2
Baby formula?
YES 1
NO 2
Cow's milk?
YES 1
NO 2
Other liquids?
YES 1
NO 2
Meat?
YES 1
NO 2
Other solid or mushy food?
YES 1
NO 2

434A. GO BACK TO 403 FOR NEXT BIRTH; OR, IF NO MORE BIRTHS, GO TO 435.

435. CHECK 215:

LAST BIRTH WAS BORN SINCE BAISHAK 1399 (APRIL 1992) (GO TO 436)
NO BIRTH SINCE BAISHAK 1399 (GO TO 442L)

436. CHECK 216:

CHILD STILL ALIVE (GO TO 437)
CHILD DIED (GO TO 442L)

437. CHECK 424:

BREASTFED CHILD?

YES (GO TO 439)
NO (GO TO 442A)

439. Did anyone talk to you and give you specific advice about how long to breastfeed (NAME OF YOUNGEST)?

YES 1
NO 2 (GO TO 442A)

440. Among the persons with whom you talked about breastfeeding, who would you say helped you the most with your decision about how long to breastfeed?

DOCTOR 01
NURSE OR MIDWIFE 02
PHARMACIST 03
TRADITIONAL BIRTH ATTENDANT 04
FIELDWORKER, FWA 05
HUSBAND 06
MOTHER 07
SISTER 08
MOTHER-IN-LAW 09
SISTER-IN-LAW 10
OTHER RELATIVE 11
OTHER (SPECIFY) 12

441. For how long did he or she advise you to breastfeed?

MONTHS ___
OTHER (SPECIFY) 95
DID NOT DISCUSS 96
DOES NOT KNOW OR CANNOT REMEMBER 98

442A. Since you became pregnant with (NAME OF BABY), did anyone give you specific advice about using family planning after (NAME OF BABY) was born?

YES 1
NO 2

ASK QUESTION 442B AND ENTER THE NAME OF EACH PERSON GIVING ADVICE IN COLUMN 1. RECORD A CODE FOR EACH PERSON USING THE LIST AT THE BOTTOM OF THE GRID. THEN ASK QUESTIONS 442C-442F. GO TO QUESTION 442G AFTER COMPLETING FOR ALL PERSONS WHO GAVE ADVICE.

442B. Who gave you specific advice about using family planning?

PROBE: Anyone else?

NAME OF PERSON ___

DOCTOR 01
NURSE OR MIDWIFE 02
PHARMACIST 03
TRADITIONAL BIRTH ATTENDANT 04
FIELDWORKER, FWA 05
HUSBAND 06
MOTHER 07
SISTER 08
MOTHER-IN-LAW 09
SISTER-IN-LAW 10
OTHER RELATIVE 11
OTHER (SPECIFY) 12

NO ONE ELSE 12 (12 GO TO 442G)

442C. Did he or she ask how you planned to feed your baby?

YES 1
NO 2
DON'T KNOW 8

442D. Which methods if any did he or she talk to you about?

RECORD ALL MENTIONED

PILL A
IUD B
INJECTIONS C
CONDOM D
FEMALE STERILIZATION E
MALE STERILIZATION F
CALENDAR, COUNTING G
WITHDRAWAL H
PROLONGED BREASTFEEDING I
OTHER (SPECIFY) J
NONE K

442E. Which method(s) did he or she recommend?
RECORD METHOD NAME AND CODE FROM 442D FOR ALL MENTIONED.

METHOD __

442F. How long after the birth of baby did he or she recommend you begin (METHOD IN 442E)?
ASK FOR EACH METHOD RECORDED IN 442E.

MONTHS ___
AFTER MENSTRUATION BEGINS 95
NOT DISCUSSED 96
FORGOT OR DON'T KNOW 98

442G. CHECK CALENDAR:
USED CONTRACEPTION SINCE LAST BIRTH?

YES (GO TO 442H)
NO (GO TO 442L)

442H. Among the persons with whom you talked about family planning, who would you say helped you the most with your decision about when to begin using family planning after the birth of your baby?

DOCTOR 01
NURSE OR MIDWIFE 02
PHARMACIST 03
TRADITIONAL BIRTH ATTENDANT 04
FIELDWORKER, FWA 05
HUSBAND 06
MOTHER 07
SISTER 08
MOTHER-IN-LAW 09
SISTER-IN-LAW 10
OTHER RELATIVE 11
OTHER (SPECIFY) 12

442I. What else influenced your decision about when to begin using family planning after the birth of you baby?

CIRCLE ALL MENTIONED.

RESUMED SEXUAL RELATIONS A
RESUMED MONTHLY PERIODS B
BREASTFEEDING C
CHILDBEARING DESIRES D
RADIO OR TV MESSAGES E
OTHER (SPECIFY) F
NOTHING ELSE G

442J. Among the persons with whom you talked about family planning, who would you say helped you the moths with your decision about which method to use?

DOCTOR 01
NURSE OR MIDWIFE 02
PHARMACIST 03
TRADITIONAL BIRTH ATTENDANT 04
FIELDWORKER, FWA 05
HUSBAND 06
MOTHER 07
SISTER 08
MOTHER-IN-LAW 09
SISTER-IN-LAW 10
OTHER RELATIVE 11
OTHER (SPECIFY) 12

442K. What else influenced your decision about which method to use?

EFFICACY OF METHOD A
PREVIOUS EXPERIENCE B
SAFETY OF METHOD C
COMFORT OR DISCOMFORT D
RADIO OR TV METHODS E
OTHER (SPECIFY) F

442L. Are there any family planning methods that are not good for a woman who is breastfeeding to use?

YES 1
NO 2 (GO TO 442N)
DOES NOT KNOW 3 (GO TO 442N)

442M. Which method(s) are not good for a breastfeeding woman to use?

CIRCLE ALL MENTIONED.

PILL A
IUD B
INJECTIONS C
CONDOM D
FEMALE STERILIZATION E
MALE STERILIZATION F
SAFE PERIOD, COUNTING DAYS G
WITHDRAWAL H
OTHER (SPECIFY) I

442N. After childbirth, if a woman is giving only breast milk to her child and she has not resumed her periods, do you think she does not have any risk of getting pregnant?

NO RISK 1
HAS RISK 2 (GO TO 451)
DOES NOT KNOW 8 (GO TO 451)

442O. For how many months would she be protected against pregnancy?

MONTHS ___

SECTION 4B. IMMUNIZATION AND HEALTH
451. ENTER THE LINE NUMBER AND NAME OF EACH BIRTH SINCE BAISHAK 1397 (APRIL 1990) IN THE TABLE. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 3 BIRTHS, USE ADDITIONAL FORMS).

LINE NUMBER FROM QUESTION 212 ___

FROM QUESTION 212 AND 216:

NAME ___
ALIVE (GO TO 452)
DEAD (GO TO 451 FOR NEXT BIRTH; IF NO MORE, 501)

452. Do you have a card where (NAME'S) vaccinations are written down?
IF YES: May I see it, please?

YES, SEEN 1 (GO TO 454)
YES, NO SEEN 2 (GO TO 456)
NO CARD 3

453. Did you ever have a vaccination card for (NAME)?

YES (GO TO 456)
NO 2 (GO TO 456)

454. COPY VACCINATION DATES FOR EACH VACCINE FROM THE CARD.
WRITE '44' IN 'DAY' COLUMN IF CARD SHOWS THAT A VACCINATION WAS GIVEN, BUT NO DATE WAS RECORDED.

BCG
DAY__
MONTH __
YEAR __
POLIO 1
DAY__
MONTH __
YEAR __
POLIO 2
DAY__
MONTH __
YEAR __
POLIO 3
DAY__
MONTH __
YEAR __
DPT 1
DAY__
MONTH __
YEAR __
DPT 2
DAY__
MONTH __
YEAR __
DPT 3
DAY__
MONTH __
YEAR __
MEASLES
DAY__
MONTH __
YEAR __

455. Has (NAME) received any vaccinations that are not recorded on this card?
RECORD 'YES' ONLY IF RESPONDENT MENTIONS BCG, DPT 1-3, POLIO 1-3 AND/OR MEASLES VACCINE(S).

YES 1 (PROBE FOR VACCINATIONS AND WRITE '66' IN THE CORRESPONDING DAY COLUMN IN 454)
NO 2 (GO TO 461)
DON'T KNOW 8 (GO TO 461)

456. Did (NAME) ever receive any vaccinations to prevent him or her from getting diseases?

YES 1
NO 2 (GO TO 461)
DON'T KNOW 8 (GO TO 461)

457. Has (NAME) received any of the following vaccinations:

A BCG vaccinations against tuberculosis, that is, an injection in the left shoulder that caused a scar?
YES 1
NO 2
DON'T KNOW 8
Polio vaccine, that is, drops in the mouth?
IF YES: How many times?
YES 1
NUMBER OF TIMES ___
NO 2
DON'T KNOW 8
DPT vaccination, that is, and injection, usually given at the same time as polio drops?
IF YES: How many times?
YES 1
NUMBER OF TIMES ___
NO 2
DON'T KNOW 8
An injection to prevent measles?
YES 1
NO 2
DON'T KNOW 8

461. Has (NAME) been ill with a cough at any time in the last 2 weeks?

YES 1
NO 2 (GO TO 470)
DON'T KNOW 8 (GO TO 470)

464. When (NAME) had the illness with a cough, did he or she breathe faster than usual with short, rapid breaths?

YES 1
NO 2
DOES NOT KNOW 8

468. Did you seek advice or treatment for the cough?

YES 1
NO 2 (GO TO 470)

469. Where did you seek advice or treatment? Anywhere else?
RECORD ALL MENTIONED.

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
FAMILY WELFARE CENTER B
THANA HEALTH COMPLEX C
SATELLITE CLINIC D
COMMUNITY HEALTH WORKER E
MEDICAL PRIVATE SECTOR
PRIVATE HOSPITAL OR CLINIC F
PHARMACY G
PRIVATE DOCTOR H
OTHER PRIVATE SECTOR
SHOP I
TRADITIONAL DOCTOR J
OTHER (SPECIFY) K

470. Has (NAME) had diarrhea in the last two weeks?

YES 1
NO 2 (GO TO 483)
DON'T KNOW 8 (GO TO 483)

474. Was there any blood in the stools?

YES 1
NO 2
DON'T KNOW 8

478. Was he or she given the same about to drink as before the diarrhea, or more, or less?

SAME 1
MORE 2
LESS 3
DON'T KNOW 8

478A. Was (NAME) given khabar saline made from a special packet?

YES 1
NO 2
DON'T KNOW 8

479. Was anything (else) given to treat the diarrhea?

YES 1
NO 2 (GO TO 481)
DON'T KNOW 8 (GO TO 481)

480. What was given to treat the diarrhea? Anything else?
RECORD ALL MENTIONED.

RECOMMENDED HOME FLUID A
PILL OR SYRUP B
INJECTION C
(I.V.) INTRAVENOUS D
HOME REMEDIES OR HERBS E
OTHER (SPECIFY) F

481. Did you seek advice or treatment for the diarrhea?

YES 1
NO 2 (GO TO 483)

482. Where did you seek advice or treatment? Anywhere else?
RECORD ALL MENTIONED.

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
FAMILY WELFARE CENTER B
THANA HEALTH COMPLEX C
SATELLITE CLINIC D
COMMUNITY HEALTH WORKER E
MEDICAL PRIVATE SECTOR
PRIVATE HOSPITAL OR CLINIC F
PHARMACY G
PRIVATE DOCTOR H
OTHER PRIVATE SECTOR
SHOP I
TRADITIONAL DOCTOR J
OTHER (SPECIFY) K

483. In the past 6 months, has (NAME) taken a Vitamin A capsule?
SHOW CAPSULE.

YES 1
NO 2
NOT SURE OR DOES NOT KNOW 8

489. GO BACK TO 452 FOR NEXT BIRTH; OR, IF NO MORE BIRTHS, GO TO 501.

SECTION 5. MARRIAGE
501. Have you been married only once or more than once?

ONCE 1
MORE THAN ONCE 2

502. In what month and year did you start living with your (first) husband?

BENGALI 1

MONTH __
YEAR 13__ (GO TO 504)
01 BAISHAK
02 JAISTHA
03 ASHAR
04 SRABAN
05 BADHRA
06 ASHWIN
07 KARTIK
08 AGRAHAYAN
09 POUSH
10 MAGH
11 FALGUN
12 CHOITRA

ENGLISH 2

MONTH __
YEAR 19__ (GO TO 504)
01 JANUARY
02 FEBRUARY
03 MARCH
04 APRIL
05 MAY
06 JUNE
07 JULY
08 AUGUST
09 SEPTEMBER
10 OCTOBER
11 NOVEMBER
12 DECEMBER

503. How old were you when you started living with him?

AGE ___
DOES NOT KNOW AGE 98

504. DETERMINE MONTHS MARRIED SINCE BAISHAK 1395. ENTER "X" IN COLUMN 3 OF CALENDAR FOR EACH MONTH MARRIED OR IN UNION, AND ENTER "0" FOR EACH MONTH NOT MARRIED OR NOT IN UNION SINCE BAISHAK 1395.

FOR WOMEN NOT CURRENTLY MARRIED OR WITH MORE THAN ONE MARRIAGE, PROBE FOR DATE THAT THE COUPLE STOPPED LIVING TOGETHER OR DATE WIDOWED, AND FOR STARTING DATE OF ANY SUBSEQUENT MARRIAGE.

505. CHECK 104A:

CURRENTLY MARRIED (GO TO 506)
WIDOWED OR DIVORCED (GO TO 508)

506. Now we need some details about your sexual activity in order to get a better understanding of family planning and fertility.

When was the last time you had sexual intercourse?

NEVER 000
DAYS AGO 1 ___
WEEKS AGO 2 ___
MONTHS AGO 3 ___
YEARS AGO 4 ___
BEFORE LAST BIRTH 996

507. Is your husband living with you now or is he staying elsewhere?

LIVING WITH HER 1
STAYING ELSEWHERE 2

508. PRESENCE OF OTHERS AT THIS POINT.

CHILDREN UNDER 10?
YES 1
NO 2
HUSBAND?
YES 1
NO 2
OTHER MALES?
YES 1
NO 2
OTHER FEMALES?
YES 1
NO 2

SECTION 6. FERTILITY PREFERENCES
601. CHECK 104A:

CURRENTLY MARRIED (GO TO 602)
NOT CURRENTLY MARRIED (GO TO 619)

602. CHECK 315:

NEITHER STERILIZED (GO TO 603)
SHE OR HE STERILIZED (GO TO 611)

603. CHECK 225:

NOT PREGNANT OR UNSURE: Now I have some questions about the future. Would you like to have (a/another) child or would you prefer not to have any (more) children?

PREGNANT: Now I have some questions about the future. After the child you are expecting, would you like to have another child or would you prefer no to have any more children?

HAVE A (ANOTHER) CHILD 1
NO MORE OR NONE 2 (GO TO 604A)
SAYS SHE CAN'T GET PREGNANT 3 (GO TO 604A)
UNDECIDED OR DON'T KNOW 8 (GO TO 604A)

604. CHECK 225:
NOT PREGNANT OR UNSURE: How long would you like to wait from now before the birth of (a/another) child?
PREGNANT: How long would you like to wait after the birth of the child you are expecting before the birth of another child?

MONTHS 1 ___
YEARS 2 ___
SOON OR NOW 994
SAYS SHE CAN'T GET PREGNANT 995
OTHER (SPECIFY) 996
DON'T KNOW 998

604A. If you became pregnant in the next few weeks, would you be happy, unhappy, or would it not matter very much?

HAPPY 1
UNHAPPY 2
WOULD NOT MATTER 3

605. CHECK 314:
USING A METHOD?

NO (GO TO 606)
YES (GO TO 611)

606. Do you intend to use a method to delay or avoid pregnancy within the next 12 months?

YES 1 (GO TO 608)
NO 2
DON'T KNOW 8

607. Do you intend to use a method at any time in the future?

YES 1
NO 2 (GO TO 610)
DON'T KNOW 8 (GO TO 610)

608. When you use a method, which method would you prefer to use?

PILL 01
IUD 02
INJECTIONS 03
CONDOM 04
FEMALE STERILIZATION 05
MALE STERILIZATION 06
CALENDAR, COUNTING DAYS 07 (GO TO 611)
WITHDRAWAL 08 (GO TO 611)
OTHER (SPECIFY) 09 (GO TO 611)
UNSURE 98 (GO TO 611)

609. Where can you get (METHOD MENTIONED IN 608)?

NAME OF PLACE ___
PUBLIC SECTOR
HOSPITAL OR MEDICAL COLLEGE 11 (GO TO 611)
FAMILY WELFARE CENTRE 12 (GO TO 611)
THANA HEALTH COMPLEX 13 (GO TO 611)
SATELLITE CLINIC 14 (GO TO 611)
MEDICAL PRIVATE SECTOR
TRADITIONAL DOCTOR 21 (GO TO 611)
QUALIFIED DOCTOR 22 (GO TO 611)
PHARMACY 23 (GO TO 611)
OTHER PRIVATE SECTOR
SHOP 31 (GO TO 611)
FRIENDS OR RELATIVES 32 (GO TO 611)
FIELDWORKER, FWA 41 (GO TO 611)
OTHER (SPECIFY) 51 (GO TO 611)
DOES NOT KNOW 98 (GO TO 611)

610. What is the main reason you do not intend to use a method?

WANTS CHILDREN 01
LACK OF KNOWLEDGE 02
PARTNER OPPOSED 03
COST TOO MUCH 04
SIDE EFFECTS 05
HEALTH CONCERNS 06
HARD TO GET METHODS 07
RELIGION 08
OPPOSED TO FAMILY PLANNING 09
FATALISTIC 10
OTHER PEOPLE OPPOSED 11
INFREQUENT SEX 12
DIFFICULT TO GET PREGNANT 13
MENOPAUSAL OR HAD HYSTERECTOMY 14
INCONVENIENT 15
OTHER (SPECIFY) 16
DON'T KNOW 98

611. Do you think that your husband is in favor or not in favor of couples using a method to avoid pregnancy?

APPROVES 1
DISAPPROVES 2
DOES NOT KNOW 8

612. How often have you talked to your husband about family planning in the last year?

NEVER 1
ONCE OR TWICE 2
MORE OFTEN 3

613. Have you and your husband ever discussed the number of children you would like to have?

YES 1
NO 2

614. Do you think your husband want the same number of children that you want, or does he want more or fewer than you want?

SAME NUMBER 1
MORE CHILDREN 2
FEWER CHILDREN 3
DON'T KNOW 8

615. Can you go outside the village or town or city alone (or with your young children)?

YES, ALONE 1
YES, WITH CHILDREN 2
NOT ALLOWED TO GO OUT 3
OTHER (SPECIFY) 4

616. Since you have been married, how frequently do you go to another part of your village or town or city?

ONCE A MONTH OR MORE 1
SEVERAL TIMES YEAR 2
LESS THAN ONCE A YEAR 3
NEVER 4

617. Since you have been married, how frequently do you go shopping or marketing?

ONCE A MONTH OR MORE 1
SEVERAL TIMES A YEAR 2
LESS THAN ONCE A YEAR 3
NEVER 4

618. Can you go to a health center or hospital alone (or with your young children)?

YES, ALONE 1
YES, WITH CHILDREN 2
NOT ALLOWED TO GO OUT 3
OTHER (SPECIFY) 4

619. In general, do you approve or disapprove of couples using a method to avoid pregnancy?

APPROVES 1
DISAPPROVES 2

620. CHECK 216:
HAS LIVING CHILDREN: If you could go back to the time you did not have any children and could choose exactly the number of children to have in your whole life, how many would that be?
NO LIVING CHILDREN: If you could choose exactly the number of children to have in your whole life, how many would that be?
RECORD SINGLE NUMBER OR OTHER ANSWER.

NUMBER ___
OTHER ANSWER (SPECIFY) 96

621. How many of these would you like to be boys and how many would you like to be girls?

BOYS __
GIRLS __
EITHER __
UP TO GOD 95
OTHER (SPECIFY) 96

SECTION 7. HUSBAND'S BACKGROUND, RESIDENCE AND WOMAN'S WORK
701. ASK QUESTIONS ABOUT CURRENT OR MOST RECENT HUSBAND.

702. Now I have some questions about your (most recent) husband. Did your (last) husband ever attend school?

YES 1
NO 2 (GO TO 705)

703. What was the highest level of school he attended: primary, secondary, or higher?

PRIMARY 1
SECONDARY 2
HIGHER 3
DOES NOT KNOW 8 (GO TO 705)

704. What was the highest (grade or form or year) he completed?

GRADE ___
DOES NOT KNOW 98

705. What kind of work does (did) your (last) husband or partner mainly do?

___

706. CHECK 705:

WORKS (WORKED) IN AGRICULTURE (GO TO 707)
DOES (DID) NOT WORK IN AGRICULTURE (GO TO 708)

707. (Does or did) your husband or partner work mainly on his own land or family land, or (does or did) he rent land, or (does or did) he work on someone else's land?

HIS OR FAMILY LAND 1
RENTED LAND 2
SOMEONE ELSE'S LAND 3

708. As you know, women do all kinds of work. Some work on farms, others sell things in a market, or work in a business, or for the government. Some women are paid in cash or in kind for their work; others are not paid. Are you currently doing any of these things or any other work?

YES 1
NO 2 (GO TO 719)

709. What is your occupation, that is, what kind of work do you mainly do?

___

710. CHECK 709:

WORKS IN AGRICULTURE (GO TO 711)
DOES NOT WORK IN AGRICULTURE (GO TO 712)

711. Do you work mainly on your own land or family land, or do you rent land, or work on someone else's land?

OWN OR FAMILY LAND 1
RENTED LAND 2
SOMEONE ELSE'S LAND 3

712. In your current work, do you work for a member of your family, for someone else, or are you self-employed?

FOR FAMILY MEMBER 1
FOR SOMEONE ELSE 2
SELF-EMPLOYED 3

713. Do you earn cash for this work?
PROBE: Do you make money for working?

YES 1
NO 2 (GO TO 715)

714. Most of the time when you work for cash, do you decide how the money you earn will be used, or does someone else decide how your earnings are used?

RESPONDENT DECIDES 1
SOMEONE ELSE DECIDES 2
JOINTLY 3

715. Do you work all of the year or only during certain times of the year?
PROBE: Is the work seasonal?

ALL OF THE YEAR 1
ONLY SOME TIMES (SEASONAL) 2

716. Do you work at home or away from home?

HOME 1
AWAY 2

717. CHECK 215 AND 216 AND 218:
HAS CHILD BORN SINCE BAISHAK 1395 AND LIVING AT HOME?

YES (GO TO 718)
NO (GO TO 719)

718. Who usually takes care of (NAME OF YOUNGEST CHILD AT HOME) while you are working?

RESPONDENT 01
HUSBAND OR PARTNER 02
OLDER CHILD(REN) 03
OTHER RELATIVES 04
NEIGHBORS 05
FRIENDS 06
SERVANTS OR HIRED HELP 07
CHILD IS IN SCHOOL 08
INSTITUTIONAL CHILDCARE 09
OTHER (SPECIFY) 10

719. RECORD THE TIME

HOUR ___
MINUTES ___

INTERVIEWER'S OBSERVATIONS

(TO BE FILLED IN AFTER COMPLETING THE INTERVIEW)
COMMENTS ABOUT RESPONDENT: ___
COMMENTS ON SPECIFIC QUESTIONS: ___
ANY OTHER COMMENTS: ___
SUPERVISOR'S OBSERVATIONS ___
NAME OF SUPERVISOR: ___
DATE: ___
EDITOR'S OBSERVATIONS ___

CALENDAR

INSTRUCTIONS: ONLY ONE CODE SHOULD APPEAR IN ANY BOX. FOR COLUMNS 1, AND 3 ALL MONTHS SHOULD BE FILLED IN.
INFORMATION TO BE CODED FOR EACH COLUMN

COLUMN 1: BIRTHS, PREGNANCIES, CONTRACEPTIVE USE

B BIRTHS
P PREGNANCIES
T TERMINATIONS
0 NO METHOD
1 PILL
2 IUD
3 INJECTIONS
4 CONDOM
5 FEMALE STERILIZATION
6 MALE STERILIZATION
7 PERIODIC ABSTINENCE
8 WITHDRAWAL
W OTHER (SPECIFY)

COLUMN 2: DISCONTINUATION OF CONTRACEPTIVE USE

1 BECAME PREGNANT WHILE USING
2 WANTED TO BECOME PREGNANT
3 HUSBAND OPPOSED
4 SIDE EFFECTS
5 HEALTH CONCERNS
6 ACCESS OR AVAILABILITY
7 WANTED MORE EFFECTIVE METHOD
8 INCONVENIENT TO USE
9 INFREQUENT SEX OR HUSBAND AWAY
C COST
F FATALISTIC
A DIFFICULT TO GET PREGNANT OR MENOPAUSE
D MARITAL DISSOLUTION OR SEPARATION
W OTHER (SPECIFY)
K DON'T KNOW

COLUMN 3: MARRIAGE

X MARRIED
0 NOT MARRIED

1400

12 CHOITRA 01 _ _ _
11 FALGUN 02 _ _ _
10 MAGH 03 _ _ _
09 POUSH 04 _ _ _
08 AGRAHAYAN 05 _ _ _
07 KARTIK 06 _ _ _
06 ASHWIN 07 _ _ _
05 BADHRA 08 _ _ _
04 SRABAN 09 _ _ _
03 ASHAR 10 _ _ _
02 JAISTHA 11 _ _ _
01 BAISHAK 12 _ _ _

1399

12 CHOITRA 13 _ _ _
11 FALGUN 14 _ _ _
10 MAGH 15 _ _ _
09 POUSH 16 _ _ _
08 AGRAHAYAN 17 _ _ _
07 KARTIK 18 _ _ _
06 ASHWIN 19 _ _ _
05 BADHRA 20 _ _ _
04 SRABAN 21 _ _ _
03 ASHAR 22 _ _ _
02 JAISTHA 23 _ _ _
01 BAISHAK 24 _ _ _

1398

12 CHOITRA 25 _ _ _
11 FALGUN 26 _ _ _
10 MAGH 27 _ _ _
09 POUSH 28 _ _ _
08 AGRAHAYAN 29 _ _ _
07 KARTIK 30 _ _ _
06 ASHWIN 31 _ _ _
05 BADHRA 32 _ _ _
04 SRABAN 33 _ _ _
03 ASHAR 34 _ _ _
02 JAISTHA 35 _ _ _
01 BAISHAK 36 _ _ _

1397

12 CHOITRA 37 _ _ _
11 FALGUN 38 _ _ _
10 MAGH 39 _ _ _
09 POUSH 40 _ _ _
08 AGRAHAYAN 41 _ _ _
07 KARTIK 42 _ _ _
06 ASHWIN 43 _ _ _
05 BADHRA 44 _ _ _
04 SRABAN 45 _ _ _
03 ASHAR 46 _ _ _
02 JAISTHA 47 _ _ _
01 BAISHAK 48 _ _ _

1396

12 CHOITRA 49 _ _ _
11 FALGUN 50 _ _ _
10 MAGH 51 _ _ _
09 POUSH 52 _ _ _
08 AGRAHAYAN 53 _ _ _
07 KARTIK 54 _ _ _
06 ASHWIN 55 _ _ _
05 BADHRA 56 _ _ _
04 SRABAN 57 _ _ _
03 ASHAR 58 _ _ _
02 JAISTHA 59 _ _ _
01 BAISHAK 60 _ _ _

1395

12 CHOITRA 61 _ _ _
11 FALGUN 62 _ _ _
10 MAGH 63 _ _ _
09 POUSH 64 _ _ _
08 AGRAHAYAN 65 _ _ _
07 KARTIK 66 _ _ _
06 ASHWIN 67 _ _ _
05 BADHRA 68 _ _ _
04 SRABAN 69 _ _ _
03 ASHAR 70 _ _ _
02 JAISTHA 71 _ _ _
01 BAISHAK 72 _ _ _

1994

03 MAR _ _ _
02 FEB _ _ _
01 JAN _ _ _

1993

12 DEC _ _ _
11 NOV _ _ _
10 OCT _ _ _
09 SEP _ _ _
08 AUG _ _ _
07 JUL _ _ _
06 JUN _ _ _
05 MAY _ _ _
04 APR _ _ _
03 MAR _ _ _
02 FEB _ _ _
01 JAN _ _ _

1992

12 DEC _ _ _
11 NOV _ _ _
10 OCT _ _ _
09 SEP _ _ _
08 AUG _ _ _
07 JUL _ _ _
06 JUN _ _ _
05 MAY _ _ _
04 APR _ _ _
03 MAR _ _ _
02 FEB _ _ _
01 JAN _ _ _

1991

12 DEC _ _ _
11 NOV _ _ _
10 OCT _ _ _
09 SEP _ _ _
08 AUG _ _ _
07 JUL _ _ _
06 JUN _ _ _
05 MAY _ _ _
04 APR _ _ _
03 MAR _ _ _
02 FEB _ _ _
01 JAN _ _ _

1990

12 DEC _ _ _
11 NOV _ _ _
10 OCT _ _ _
09 SEP _ _ _
08 AUG _ _ _
07 JUL _ _ _
06 JUN _ _ _
05 MAY _ _ _
04 APR _ _ _
03 MAR _ _ _
02 FEB _ _ _
01 JAN _ _ _

1989

12 DEC _ _ _
11 NOV _ _ _
10 OCT _ _ _
09 SEP _ _ _
08 AUG _ _ _
07 JUL _ _ _
06 JUN _ _ _
05 MAY _ _ _
04 APR _ _ _
03 MAR _ _ _
02 FEB _ _ _
01 JAN _ _ _

1988

12 DEC _ _ _
11 NOV _ _ _
10 OCT _ _ _
09 SEP _ _ _
08 AUG _ _ _
07 JUL _ _ _
06 JUN _ _ _
05 MAY _ _ _
04 APR _ _ _