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DEMOGRAPHIC AND HEALTH SURVEY - BANGLADESH 1993-94 - HUSBAND QUESTIONNAIRE (ENGLISH)

BANGLADESH

IDENTIFICATION

DIVISION:
DISTRICT:
UPAZILA OR THANA:
UNION:
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 HUSBAND:
NAME AND LINE NUMBER OF WIFE:

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:

SECTION 1. RESPONDENT'S BACKGROUND

101. RECORD THE TIME.

HOUR ___
MINUTES ___

102. How long have you been living continuously in (NAME OF CURRENT PLACE OF 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 HE DOES NOT KNOW, WRITE 'D K' 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 ___

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 or 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. What kind of work do you mainly do?

___

115. CHECK 114:

WORKS IN AGRICULTURE (GO TO 116)
DOES NOT WORK IN AGRICULTURE (GO TO 201)

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

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

SECTION 2. REPRODUCTION

201. Do you have any sons or daughters who are now living with you?

YES 1
NO 2

202. How many sons live with you? And how many daughters live with you?

IF NONE ENTER '00'.

SONS AT HOME ___
DAUGHTERS AT HOME ___

203. Do you have any sons or daughters who do not live with you?

YES 1
NO 2 (GO TO 205)

204. 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 ENTER '00'.

SONS ELSEWHERE ___
DAUGHTERS ELSEWHERE ___

205. Have you ever had a son or daughter who was born alive but later died?

YES 1
NO 2 (GO TO 207)

206. In all, how many boys have died? And how many girls have died?

IF NONE ENTER '00'.

BOYS DEAD ___
GIRLS DEAD ___

207. SUM ANSWERS TO 202, 204, AND 206, AND ENTER TOTAL.

IF NONE ENTER '00'.

TOTAL ___

208. CHECK 207:

Just to make sure that I have this right: you have had TOTAL ___ children born alive during your life. Is that correct?

YES
NO (PROBE AND CORRECT 201-206 AS NECESSARY)

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 or methods have you heard about?

CIRCLE CODE 1 IN 3-2 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 months 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 med 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: Has your wife had an operation to avoid having any more children?
YES 1
NO 2
06. MALE STERILIZATION, VASECTOMY: Have you ever had 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 months 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 med 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: Has your wife had an operation to avoid having any more children?
YES 1
NO 2
06. MALE STERILIZATION, VASECTOMY: Have you ever had 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 or your wife ever used anything or tried in any way to delay or avoid getting pregnant?

YES __
NO (GO TO 386G)

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
WITHDRAWAL 08
OTHER (SPECIFY) 09

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

NUMBER OF CHILDREN ___

311A. CHECK 303:

MAN NOT STERILIZED (GO TO 314)
MAN STERILIZED (GO TO 315A)

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

YES 1
NO 2 (GO TO 322C)

315. Which method are you using?
315A. CIRCLE '06' FOR MALE 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 08
WITHDRAWAL 08
OTHER (SPECIFY) 09

318. CHECK 315:

USING CONDOM (GO TO 320)
USING PILL, IUD, OR INJECTION (GO TO 323)
USING SAFE PERIOD, WITHDRAWAL, OR OTHER TRADITIONAL METHOD (GO TO 326)

320. Please show me the package of condoms that you are using.

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?

WIFE 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. How much did the condom you last used cost?

COST ___
PARTNER OBTAINED 9995
FREE 9996
DOES NOT KNOW 9998

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

EVERY TIME 1
ONLY SOMETIMES 2

320E. How many times have you used condoms during the last one 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 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

322A. Do you regret that (you or your wife) 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 (SPECIFY) 4 (GO TO 323A)

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

PILL 01
IUD 02
INJECTIONS 03
CONDOMS 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 325A)
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 322C OR 315:

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

325. Who obtained the (pills or condoms) the last time you got them?

RESPONDENT 1 (GO TO 325B)
WIFE 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
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
WIFE HAD MORE INFLUENCE 2
BOTH HUSBAND AND WIFE EQUAL 3
OTHER RELATIVE 4
OTHER (SPECIFY) 5

325K. CHECK 314:

CURRENTLY USING A METHOD (GO TO 326)
NOT USING A METHOD (OR BLANK) (GO TO 328G)

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

FAMILY PLANNING WORKER RECOMMENDED 01 (GO TO 347)
FRIEND OR RELATIVE RECOMMENDED 02 (GO TO 347)
SIDE EFFECTS OF OTHER METHODS 03 (GO TO 347)
CONVENIENCE 04 (GO TO 347)
ACCESS OR AVAILABILITY 05 (GO TO 347)
COST 06 (GO TO 347)
WANTED PERMANENT METHOD 07 (GO TO 347)
HUSBAND PREFERRED 08 (GO TO 347)
WANTED MORE EFFECTIVE METHOD 09 (GO TO 347)
OTHER (SPECIFY) 10 (GO TO 347)
DOES NOT KNOW 98 (GO TO 347)

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 WIFE AWAY 12
DIFFICULT TO GET PREGNANT 13
MENOPAUSAL OR HAD HYSTERECTOMY 14
INCONVENIENT 15
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 347)

328I. Where is that?

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

347. CHECK 310, 323, AND 328G:

SATELLITE CLINIC NOT MENTIONED (GO TO 347A)
SATELLITE CLINIC MENTIONED (GO TO 348)

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 you 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 month, 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 pill?
YES 1
NO 2
Condoms?
YES 1
NO 2
Injections?
YES 1
NO 2
IUDs (coil or 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
NO 2
DOES NOT KNOW 8

351. Has a family planning worker 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
WIFE GOT INJECTION 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 method of avoiding pregnancy did they discuss with you?

CIRCLE ALL MENTIONED.

PILLS A
IUD, LOOP B
INJECTIONS C
CONDOMS D
FEMALE STERILIZATION E
MALE STERILIZATION F
NEVER DISCUSSED G

358. Do you think that most of the men 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?

YES 1
NO 2

SECTION 4. MARRIAGE
401. Have you been married only once or more than once?

ONCE 1
MORE THAN ONCE 2

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

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

403. How old were you when you started living with her?

AGE ___
DOES NOT KNOW AGE 98

406. Now we need some details about you 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

408. PRESENCE OF OTHERS AT THIS POINT.

CHILDREN UNDER 10
YES 1
NO 2
WIFE
YES 1
NO 2
OTHER MALES
YES 1
NO 2
OTHER FEMALES
YES 1
NO 2

SECTION 5. FERTILITY PREFERENCES
501. CHECK 315:

NEITHER STERILIZED (GO TO 502)
SHE OR HE STERILIZED (GO TO 510)

502. 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?

HAVE A (ANOTHER) CHILD 1
NO MORE OR NONE 2 (GO TO 504)
SAYS WIFE CAN'T GET PREGNANT 3 (GO TO 504)
UNDECIDED OR DON'T KNOW 8 (GO TO 504)

503. How long would you like to wait from now before the birth of a (another) child?

MONTHS 1 ___
YEARS 2 ___
SOON OR NOW 995
OTHER (SPECIFY) 996
DON'T KNOW 998

504. CHECK 314: USING A METHOD?

NO (GO TO 505)
YES (GO TO 510)

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

YES 1 (GO TO 507)
NO 2
DON'T KNOW 8

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

YES 1
NO 2 (GO TO 509)
DON'T KNOW 8 (GOT O 509)

507. 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 510)
WITHDRAWAL 08 (GO TO 510)
OTHER (SPECIFY) 09 (GO TO 510)
UNSURE 98 (GO TO 510)

508. Where can you get (METHOD MENTIONED IN 507)?

NAME OF PLACE ___
PUBLIC SECTOR
HOSPITAL OR MEDICAL COLLEGE 11 (GO TO 510)
FAMILY WELFARE CENTRE 12 (GO TO 510)
THANA HEALTH COMPLEX 13 (GO TO 510)
SATELLITE CLINIC 14 (GO TO 510)
MEDICAL PRIVATE SECTOR
TRADITIONAL DOCTOR 21 (GO TO 510)
QUALIFIED DOCTOR 22 (GO TO 510)
PHARMACY 23 (GO TO 510)
OTHER PRIVATE SECTOR
SHOP 31 (GO TO 510)
FRIENDS OR RELATIVES 32 (GO TO 510)
FIELDWORKER, FWA 41 (GO TO 510)
OTHER (SPECIFY) 51 (GO TO 510)
DOES NOT KNOW 98 (GO TO 510)

509. 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

510. Do you think that your wife approves or disapproves of couples using a method to avoid pregnancy?

APPROVES 1
DISAPPROVES 2
DOES NOT KNOW 8

511. How often have you talked to you wife about family planning in the last year?

NEVER 1
ONCE OR TWICE 2
MORE OFTEN 3

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

YES 1
NO 2

513. Do you think your wife wants the same number of children that you want, or does she want more or fewer than you want?

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

514. Do you allow your wife to go out alone (or with your children) to buy household items or visit relatives?

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

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

APPROVES 1
DISAPPROVES 2

516. CHECK 216:

HAS LIVING CHILD(REN): 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 CHILD(REN): 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

517. 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

518. 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 ___