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DEMOGRAPHIC AND HEALTH SURVEY - BANGLADESH 1999-2000 - MAN'S QUESTIONNAIRE (ENGLISH)

BANGLADESH

IDENTIFICATION

DIVISION:
DISTRICT:
THANA:
UNION OR WARD:
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 MAN:

INTERVIEWER VISITS

FIRST VISIT (REPEAT FOR SECOND AND THIRD VISITS)
DATE
INTERVIEWER'S NAME
RESULT*

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

NEXT VISIT
DATE
TIME

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
CODE
RESULT*

SUPERVISOR
NAME
DATE

FIELD EDITOR
NAME
DATE

OFFICE EDITOR
KEYED BY


SECTION 1. RESPONDENT'S BACKGROUND

INTRODUCTION AND CONSENT

INFORMED CONSENT

Hello. My name is ___. We came from the Mitra and Associates, a private research organization, is located at Dhaka. To assist in the implementation of socio-development programs in the country, we conduct different types of surveys. We are now conducting a national survey about man and the health of women and children under the authority of NIPORT of Ministry of Health and Family Welfare. We would very much appreciate your participation in this survey. This information will help the government to plan health services. The survey usually takes between 20 and 45 minutes to complete. Whatever information you provide will be kept strictly confidential and will not be shown to other persons.

Participation in this survey is voluntary and you can choose not to answer any individual question or all of the questions. However, we hope that you will participate in this survey since your views are important.

At this time, do you want to ask me anything about the survey? May I begin the interview now?

Signature or interviewer:
Date:

RESPONDENT AGREES TO BE INTERVIEWED 1 (GO TO 101)
RESPONDENT DOES NOT AGREE TO BE INTERVIEWED 2 (GO TO END)

101. RECORD THE TIME STARTED.

HOUR ___
MINUTES ___

102. First, I would like to ask some questions about you and your household. For most of the time until you were 12 years old, did you live in a city, in a town, or in the countryside?

CITY 1
TOWN 2
COUNTRYSIDE 3

103. In the last 12 months, have you been away from your home community for more than 1 month at a time?

YES 1
NO 2 (GO TO 105)

104. In the last 12 months, on how many separate occasions have you traveled away from your home community and slept away?

NUMBER OF TRIPS AWAY ___

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

NUMBER OF YEARS ___
ALWAYS 95 (GO TO 107)
VISITOR 96 (GO TO 107)

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

CITY 1
TOWN 2
COUNTRYSIDE 3

107. In what month and year were you born?

MONTH ___
DON'T KNOW MONTHS 98
YEAR ___
DON'T KNOW YEAR 9998

108. How old are you at your last birthday?

COMPARE AND CORRECT 107 AND/OR 108 IN INCONSISTENT.

AGE IN COMPLETED YEARS __
IF AGE IS NOT BETWEEN AGES 5 AND 49 (GO TO END)

108A. Are you now married, widowed, or divorced?

CURRENTLY MARRIED 1
SEPARATED 2 (GO TO END)
DESERTED 3 (GO TO END)
DIVORCED 4 (GO TO END)
WIDOWED 5 (GO TO END)
NEVER MARRIED 6 (GO TO END)

109. Have you ever attended school?

YES 1
NO 2 (GO TO 113)

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

PRIMARY 1
SECONDARY 2
COLLEGE OR UNIVERSITY 3

111. What is the highest class you completed?

CLASS ___

112. CHECK 110:

PRIMARY (GO TO 113)
SECONDARY OR HIGHER (GO TO 114)

113. 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 115)

114. Do you usually read a newspaper or magazine?

YES 1
NO 2 (GO TO 115)

114A. How often do you read newspaper or magazine: every day, at least once a week, or less than once a week?

EVERY DAY 1
AT LEAST ONCE A WEEK 2
LESS THAN ONCE A WEEK 3

115. Do you listen to the radio?

YES 1
NO 2 (GO TO 116)

115A. How often do you listen to the radio: every day, at least once a week, less than once a week?

EVERY DAY 1
AT LEAST ONCE A WEEK 2
LESS THAN ONCE A WEEK 3

116. Do you watch television?

YES 1
NO 2 (GO TO 117)

116A. How often do you watch television: every day, at least once a week, less than once a week?

EVERY DAY 1
AT LEAST ONCE A WEEK 2
LESS THAN ONCE A WEEK 3

117. What is your religion?

ISLAM 1
HINDUISM 2
BUDDHISM 3
CHRISTIANITY 4
OTHER (SPECIFY) 6

118. Do you belong to any of the following organizations?

Grameen Bank?
YES 1
NO 2
BRAC?
YES 1
NO 2
BRDB?
YES 1
NO 2
Any other organization (such as micro credit)?
YES 1
NO 2

119. Are you currently working?

YES 1
NO 2 (GO TO 128)

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

___

121. CHECK 120:

WORKS IN AGRICULTURE (GO TO 122)
WORKS IN OTHER SECTOR (GO TO 123)

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

OWN LAND 1
FAMILY LAND 2
RENTED LAND 3
SOMEONE ELSE'S LAND 4

123. Do you do this 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

124. Do you usually work throughout the year, or do you work seasonally, or only once in a while?

THROUGHOUT THE YEAR 1 (GO TO 126)
SEASONALLY OR PART OF THE YEAR 2
ONCE IN A WHILE 3

125. During the last 12 months, how many months did you work?

NUMBER OF MONTHS ___

126. Do you think that what you earn is sufficient to provide for you family's basic needs?

YES 1
NO 2

127. On average, how much of your family's expenditures do your earnings pay for: almost none, less than half, about half, more than half, or all?

ALMOST NONE 1 (GO TO 201)
LESS THAN HALF 2 (GO TO 201)
ABOUT HALF 3 (GO TO 201)
MORE THAN HALF 4 (GO TO 201)
ALL 5 (GO TO 201)
CANNOT ESTIMATE 8 (GO TO 201)

128. Have you done any work in the last 12 months?

YES 1 (GO TO 201)
NO 2

129. What have you been doing over the last 12 months?

GOING TO SCHOOL OR STUDYING 1
LOOKING FOR WORK 2
INACTIVE 3
COULD NOT WORK OR HANDICAPPED 4
OTHER (SPECIFY) 6

SECTION 2. REPRODUCTION

201. Now I would like to ask about your children. I am interested only in the children that are biologically yours. Have you ever had children?

YES 1
NO 2 (GO TO 206)

202. Do you have any sons or daughters 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 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 had a son or a daughter who was born alive but later died?

IF NO PROBE: Any baby who cried or showed signs of life but survived only a few hours or days?

YES 1
NO 2 (GO TO 208)

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

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 __ children during your life. Is that correct?

IF HE HAS NOT HAVE CHILDREN (208 IS "00"): Just to make sure that I have this right: you have not had any children during your life. Is that correct?

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

210. CHECK 208:

HAS HAD CHILDREN (GO TO 211)
HAS NOT HAD ANY CHILDREN (GO TO 301)

211. In what months and year your last child born?

MONTH ___
DON'T KNOW MONTH 98
YEAR ___
DON'T KNOW YEAR 9998

211A. Is your last child alive or dead?

ALIVE 1
DEAD 2 (GO TO 301)

211B. How old is your last child (in completed years)?

AGE ___

SECTION 3. CONTRACEPTION

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.

CIRCLE CODE 1 IN 301 FOR EACH METHOD MENTIONED SPONTANEOUSLY. THEN PROCEED DOWN COLUMN 301, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 2 IF METHOD IS RECOGNIZED, AND CODE 3 IF NOT RECOGNIZED IN 302. THEN, FOR EACH METHOD WITH CODE 1 OR CIRCLED IN 301 OR 302, ASK 303.

301. Which ways or methods have you heard about?
302. Have you ever heard or (METHOD)?

01. FEMALE STERILIZATION: Women can have an operation to avoid having any more children.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
02. MALE STERILIZATION, VASECTOMY: Men can have an operation to avoid having any more children.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
03. PILL, MAYA: Women can take a pill every day.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
04. IUD: Women can have a loop or coil placed inside them by a doctor or a nurse.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
05. INJECTIONS: Women can have an injection by a doctor or nurse which stops them for becoming pregnant for several months.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
06. IMPLANTS, NORPLANTS: Women can have several small rods placed in their upper arm by a doctor or nurse which can prevent pregnancy for several years.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
07. CONDOM, RAJA: Men can put a rubber sheath on their penis before sexual intercourse.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
08. MENSTRUAL REGULATION, MR: When a woman's menstrual period does not come on time, she can go to a health centre or to the FWV and have a tube put in her for a short while to bring her period.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
09. 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 get pregnant.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
10. WITHDRAWAL: Men can be careful and pull out before climax.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
11. LACTATIONAL AMENORRHEA METHOD (LAM): Up to 6 months after childbirth, a woman can use a method that requires that she breastfeeds frequently, day and night, and that her menstrual period has not returned.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
12. Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
SPONTANEOUS YES 1 (SPECIFY)
PROBED YES 2
NO 3

303. Have you ever used (METHOD)?

01. FEMALE STERILIZATION: Have you ever had a wife who had an operation to avoid having any more children?
YES 1
NO 2
02. MALE STERILIZATION, VASECTOMY: Have you ever had an operation to avoid having any more children?
YES 1
NO 2
03. PILL, MAYA: Women can take a pill every day.
YES 1
NO 2
04. IUD: Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
05. INJECTIONS: Women can have an injection by a doctor or nurse which stops them for becoming pregnant for several months.
YES 1
NO 2
06. IMPLANTS, NORPLANTS: Women can have several small rods placed in their upper arm by a doctor or nurse which can prevent pregnancy for several years.
YES 1
NO 2
07. CONDOM, RAJA: Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
08. MENSTRUAL REGULATION, MR: When a woman's menstrual period does not come on time, she can go to a health centre or to the FWV and have a tube put in her for a short while to bring her period.
YES 1
NO 2
09. 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 get pregnant.
YES 1
NO 2
10. WITHDRAWAL: Men can be careful and pull out before climax.
YES 1
NO 2
11. LACTATIONAL AMENORRHEA METHOD (LAM): Up to 6 months after childbirth, a woman can use a method that requires that she breastfeeds frequently, day and night, and that her menstrual period has not returned.
YES 1
NO 2
12. Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1
NO 2

303A. CHECK 303:

NOT A SINGLE 'YES' (NEVER USED) (GO TO 304)
AT LEAST ONE 'YES' (EVER USED) (GO TO 306A)

304. Have you or your wife ever used anything or tried in any way to delay or avoid a pregnancy?

YES 1
NO 2 (GO TO 401)

306. What have you used or done?

CORRECT 302 AND 303 (AND 301) IF NECESSARY).

306A. Now I would like to ask you about the first time that you or your wife did something or used a method to avoid getting pregnant. What was the first method that you ever used?

FEMALE STERILIZATION 01
MALE STERILIZATION 02
PILL 03
IUD 04
INJECTIONS 05
IMPLANTS 06
CONDOM 07
PERIODIC ABSTINENCE 09
WITHDRAWAL 10
LACTATIONAL AMENORRHEA METHOD 11
OTHER METHOD (SPECIFY) 96

307. How many living children did you have at that time, if any?

IF NONE, RECORD '00'.

NUMBER OF CHILDREN ___

308. CHECK 302 NUMBER 02:

MAN NOT STERILIZED (GO TO 310)
MAN STERILIZED (GO TO 311A)

310. Are you or your wife currently doing something or using any method to delay or avoid a pregnancy?

YES 1
NO 2 (GO TO 401)

311. Which method are you using?
311A. CIRCLE '2' FOR MALE STERILIZATION.

FEMALE STERILIZATION 01 (GO TO 313)
MALE STERILIZATION 02 (GO TO 313)
PILL 03 (GO TO 314)
IUD 04 (GO TO 314)
INJECTIONS 05 (GO TO 314)
IMPLANTS 06 (GO TO 314)
CONDOM 07
PERIODIC ABSTINENCE 09 (GO TO 314)
WITHDRAWAL 10 (GO TO 314)
LACTATIONAL AMENORRHEA METHOD 11 (GO TO 314)
OTHER METHOD (SPECIFY) 96 (GO TO 314)

312. May I see the package of condoms that you are using now?

RECORD NAME OF BRAND IF PACKAGE IS SEEN.

PACKAGE SEEN 1 (GO TO 314)
BRAND NAME ___
PACKAGE NOT SEEN 2

312A. SHOW BRAND CHART FOR CONDOMS: Please tell me which of these is the brand of condoms that you are using.

BRAND NAME ___ (GO TO 314)
DOES NOT KNOW 98 (GO TO 314)

313. 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 OR EPI OUTREACH SITE 14
MATERNAL AND CHILD WELFARE CENTER (MCWC) 15
NGO SECTOR
NGO STATIC CLINIC 21
NGO SATELLITE CLINIC 22
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL OR CLINIC 31
QUALIFIED DOCTOR 32
OTHER (SPECIFY) 96
DON'T KNOW 98

314. CHECK 311 AND 311A:

CIRCLE METHOD CODE

NO CODE CIRCLED 00 (GO TO 401)
FEMALE STERILIZATION 01 (GO TO 401)
MALE STERILIZATION 02 (GO TO 401)
PILL 03
IUD 04
INJECTIONS 05
IMPLANTS 06
CONDOM 07
PERIODIC ABSTINENCE 09 (GO TO 401)
WITHDRAWAL 10 (GO TO 401)
LACTATIONAL AMENORRHEA METHOD 11 (GO TO 401)
OTHER METHOD (SPECIFY) 96 (GO TO 401)

315. Where did you obtain (CURRENT METHOD) the last time?

NAME OF PLACE ___
PUBLIC SECTOR
HOSPITAL OR MEDICAL COLLEGE 11
FAMILY WELFARE CENTRE 12
THANA HEALTH COMPLEX 13
SATELLITE CLINIC OR EPI OUTREACH SITE 14
MATERNAL AND CHILD WELFARE CENTER (MCWC) 15
GOVERNMENT FIELD WORKER (FWA) 16
NGO SECTOR
NGO STATIC CLINIC 21
NGO SATELLITE CLINIC 22
NGO DEPOT HOLDER 23
NGO FIELDWORKER 24
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL OR CLINIC 31
QUALIFIED DOCTOR 32
TRADITIONAL DOCTOR 33
PHARMACY 34
OTHER PRIVATE SECTOR
SHOP 41
FRIENDS OR RELATIVES 42
OTHER (SPECIFY) 96
DON'T KNOW 98

SECTION 4. MARRIAGE

401. WRITE THE LINE NUMBER FROM THE HOUSEHOLD QUESTIONNAIRE FOR HIS WIFE. IF SHE DOES NOT LIVE IN THE HOUSEHOLD, RECORD '00'.

LINE NUMBER ___

402. Have you been married only once or more than once?

ONCE 1
MORE THAN ONE 2

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

MONTH ___
DON'T KNOW MONTHS 98
YEAR ___ (GO TO 405)
DON'T KNOW YEAR 9998

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

AGE ___

405. Now I need to ask you some questions about sexual activity in order to gain a better understanding of some family life issues. How old were you when you first had sexual intercourse (if ever)?

NEVER 00 (GO TO 501)
AGE IN YEARS ___
FIRST TIME WHEN STARTED LIVING WITH (FIRST) WIFE 96

SECTION 5. FERTILITY PREFERENCES

501. CHECK 311 AND 311A:

NEITHER STERILIZED (GO TO 502)
SHE OR HE STERILIZED (GO TO 515)

502. Is your wife currently pregnant?

YES 1
NO 2 (GO TO 504A)
DOES NOT KNOW OR UNSURE 3 (GO TO 504A)

503. When she became pregnant, did you want her to become pregnant then, did you want her to have a child but wanted to wit or did you not want her to have a child at all?

THEN 1 (GO TO 504B)
WANTED TO WAIT 2 (GO TO 504B)
NOT AT ALL 3 (GO TO 504B)

504. CHECK 502:

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

B. WIFE IS PREGNANT: Now I have some questions about the future. After the child your wife is expecting now, would you like to have another child, or would you prefer not to have any more children?

HAVE (A OR ANOTHER) CHILD 1
NO MORE OR NONE 2 (GO TO 506)
SAYS SHE CAN'T GET PREGNANT 3 (GO TO 511)
SAYS HE CAN'T HAVE ANY MORE 4 (GO TO 511)
UNDECIDED OR DON'T KNOW 8 (GO TO 511)

505. CHECK 502:

WIFE IS NOT PREGNANT OR UNSURE: How long would you like to wit from now before the birth of (a or another) child?

WIFE IS PREGNANT: After the birth of child you are expecting now, how long would you like to wait before the birth of another child?

MONTHS 1 ___
YEARS 2 ___
SOON OR NOW 993 (GO TO 511)
SAYS WIFE CAN'T GET PREGNANT 994 (GO TO 511)
OTHER (SPECIFY) 996 (GO TO 511)
DON'T KNOW 998 (GO TO 511)

506. CHECK 502:

WIFE NOT PREGNANT OR UNSURE (GO TO 507)
WIFE IS PREGNANT (GO TO 512)

507. CHECK 310:

USING A METHOD?

NOT ASKED (GO TO 508)
NOT CURRENTLY USING (GO TO 508)
CURRENTLY USING (GO TO 515)

508. CHECK 505:

NOT ASKED (GO TO 509)
24 OR MORE MONTHS OR 02 OR MORE YEARS (GO TO 509)
00-23 MONTHS OR 00-01 YEAR (GO TO 512)

509. CHECK 504:

WANTS A OR ANOTHER CHILD(REN): You have said that you do not want (a or another child soon, but you are not using any method to avoid pregnancy. Can you tell me why?

RECORD ALL MENTIONED.

FERTILITY-RELATED REASONS
NOT HAVING SEX A
INFREQUENT SEX B
MENOPAUSAL OR HYSTERECTOMY C
SUB FECUND OR INFECUND D
POST PARTUM AMENORRHEIC E
BREASTFEEDING F
FATALISTIC G
OPPOSITION TO USE
RESPONDENT OPPOSED H
WIFE OPPOSED I
OTHERS OPPOSED J
RELIGIOUS PROHIBITION K
LACK OF KNOWLEDGE
KNOW NO METHOD L
KNOWS NO SOURCE M
METHOD-RELATED REASONS
HEALTH CONCERNS N
FEAR OF SIDE EFFECTS O
LACK OF ACCESS OR TOO FAR P
COST TOO MUCH Q
INCONVENIENT TO USE R
INTERFERES WIT BODY'S NORMAL PROCESSES S
OTHER (SPECIFY) X
DON'T KNOW Z

511. CHECK 310:

USING A METHOD?

NOT ASKED (GO TO 512)
NOT CURRENTLY USING (GO TO 512)
CURRENTLY USING (GO TO 515)

512. Do you think you will use a method to delay or avoid a pregnancy at any time in the future?

YES 1
NO 2 (GO TO 514)
DON'T KNOW 8 (GO TO 514)

513. Which method would you prefer to use?

NO CODE CIRCLED 00 (GO TO 515)
FEMALE STERILIZATION 01 (GO TO 515)
MALE STERILIZATION 02 (GO TO 515)
PILL 03 (GO TO 515)
IUD 04 (GO TO 515)
INJECTIONS 05 (GO TO 515)
IMPLANTS 06 (GO TO 515)
CONDOM 07 (GO TO 515)
PERIODIC ABSTINENCE 09 (GO TO 515)
WITHDRAWAL 10 (GO TO 515)
LACTATIONAL AMENORRHEA METHOD 11 (GO TO 515)
OTHER METHOD (SPECIFY) 96 (GO TO 515)

514. What is the main reason that you think you will not use a method at any time in the future?

FERTILITY-RELATED REASONS
NOT HAVING SEX 11
INFREQUENT SEX 12
MENOPAUSAL OR HYSTERECTOMY 13
SUB FECUND OR INFECUND 14
POST PARTUM AMENORRHEIC 15
BREASTFEEDING 16
FATALISTIC 17
OPPOSITION TO USE
RESPONDENT OPPOSED 21
WIFE OPPOSED 22
OTHERS OPPOSED 23
RELIGIOUS PROHIBITION 24
LACK OF KNOWLEDGE
KNOW NO METHOD 31
KNOWS NO SOURCE 32
METHOD-RELATED REASONS
HEALTH CONCERNS 41
FEAR OF SIDE EFFECTS 42
LACK OF ACCESS OR TOO FAR 43
COST TOO MUCH 45
INCONVENIENT TO USE 46
INTERFERES WIT BODY'S NORMAL PROCESSES 47
OTHER (SPECIFY) 96
DON'T KNOW 98

515. CHECK 203 AND 205:

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?

PROBE FOR A NUMERIC RESPONSE.

NUMBER ___
OTHER (SPECIFY) 96 (GO TO 601)

516. How many of these children would you like to be boys, how many would you like to be girls and for how many would it not matter?

NUMBER OF BOYS ___
NUMBER OF GIRLS ___
EITHER ___
OTHER (SPECIFY) 96

SECTION 6. PARTICIPATION IN HEALTH CARE

601A. Now we talk about possible problems that women might face when she is going to have a child. Do you know any complications during pregnancy, childbirth and after delivery that need medical attention?

PROBE: Any other complication?

RECORD ALL MENTIONED.

SEVERE HEADACHE OR BLURRY VISION OR SWOLLEN ARMS AND LEGS A
VAGINAL BLEEDING DURING PREGNANCY B
LABOR MORE THAN 18 HOURS C
EXCESSIVE BLEEDING DURING OR AFTER DELIVERY D
CONVULSIONS E
FEVER MORE THAN 3 DAYS DURING PREGNANCY OR AFTER DELIVERY F
BAD SMELLING VAGINAL DISCHARGE G
OTHER (SPECIFY) X

601B. Do you think that women should have a medical checkup when they are pregnant even if they are not sick?

YES 1
NO 2 (GO TO 601D)
DON'T KNOW 8 (GO TO 601D)

601C. At what months of pregnancy do you think that women should have first checkup for pregnancy?

MONTH ___
DON'T KNOW 98

601D. During the pregnancy do you think women should eat more, same or less?

MORE 1
SAME 2
LESS 3
DON'T KNOW 8

601E. CHECK 211:

LAST CHILD BORN SINCE APRIL 1994 (GO TO 602)
HAS NO CHILDREN OR THE LAST CHILD WAS BORN BEFORE APRIL 1994 (GO TO 616)

602. What is the name of your last child, that is the one who was born in (DATE AS INDICATED IN 211)?

NAME OF LAST CHILD ___

603. Did you wife go to a health facility to receive antenatal care when she was pregnant with (NAME OF LAST BORN CHILD)?

YES 1 (GO TO 604)
NO 2
DON'T KNOW 8

603A. Did any health professional such as doctor, nurse, FWV or others come for your wife's antenatal care when she was pregnant with (NAME OF LAST BORN CHILD)?

YES 1
NO 2 (GO TO 607)

604. Were you present anytime during the antenatal care visit?

YES 1
NO 2

605. At any time while she was pregnant with (NAME OF LAST BORN CHILD), did any health professional such as doctor, nurse, or FWV talk to you about this particular pregnancy?

YES 1
NO 2

606. During this pregnancy, did you ever talk with your wife about what the health professional such as doctor, nurse, or FWV told her about her own health and the baby's health?

YES 1
NO 2

607. Where did your wife give birth to (NAME OF LAST BORN CHILD)?

HOME
OWN HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21
THANA HEALTH COMPLEX 22
MATERNAL AND CHILD WELFARE CENTER (MCWC) 23
NGO SECTOR
NGO STATIC CLINIC 31
PRIVATE SECTOR
PRIVATE HOSPITAL OR CLINIC 41
OTHER (SPECIFY) 96

608. When she gave birth to (NAME OF LAST BORN CHILD), were you present (NAME OF THE PLACE IN 607) at that time?

YES 1
NO 2

609. In the first two months after (NAME OF LAST BORN CHILD) was born, did your wife visit a health facility to have her own health or the child's health checked or did someone such as doctor, nurse or FWV from the health facility come to your place to check your wife's or child's health?

YES, VISITED 1
YES, CAME 2
NO 8 (GO TO 611)

610. Were you present at that time?

YES 1
NO 2

601. CHECK 211A:

LAST CHILD IS ALIVE (GO TO 612)
LAST CHILD IS DEAD (GO TO 616)

612. Did (NAME OF LAST BORN CHILD) ever receive any vaccinations to prevent him or her from getting diseases?

YES 1
NO 2 (GO TO 614)
DON'T KNOW 8 (GO TO 614)

613. When (NAME OF LAST BORN CHILD) was vaccinated in a health facility, did you take him or her anytime to the health facility?

YES 1
NO 2

614. Was (NAME OF LAST BORN CHILD) suffered from any health problem in the last four weeks that a health professional (such as doctor, nurse, FWV) visit was needed?

YES 1
NO 2 (GO TO 616)

615. Were you present when (NAME OF LAST BORN CHILD) was seen by the health professional such as doctor, nurse, or FWV for such health problem?

YES 1
NO 2

616. Now tell me about your health. Have you ever, at any time in your life, had any of the following health problems?

Tuberculosis?
YES 1
NO 2
Asthma?
YES 1
NO 2
Diabetes?
YES 1
NO 2
High blood pressure?
YES 1
NO 2
Heart problem?
YES 1
NO 2
Malaria?
YES 1
NO 2
Hepatitis or Jaundice?
YES 1
NO 2

617. CHECK 616 (ALL HEALTH PROBLEMS):

AT LEAST ONE 'YES' (GO TO 618)
NOT A SINGLE 'YES' (GO TO 701)

618. Did you receive any treatment for this (these) disease(s)?

YES 1
NO 2

619. At any time during the last 3 months, did (this or these) health problem(s) prevent you from doing your work?

YES 1
NO 2 (GO TO 701)

620. For how many days in the last 3 months were you unable to do your work due to this (these) health problem(s)?

DAYS ___

SECTION 7. AIDS AND OTHER SEXUALLY TRANSMITTED DISEASES

701. Now I would like to talk about something else. Have you ever heard of an illness called AIDS?

YES 1
NO 2 (GO TO 718)

701A. From which sources of information have you learned most about AIDS? Any other sources?

RECORD ALL MENTIONED.

RADIO A
TV B
NEWSPAPER OR MAGAZINES C
PAMPHLETS OR POSTERS D
HEALTH WORKERS E
MOSQUES OR TEMPLES OR CHURCHES F
SCHOOLS OR TEACHERS G
COMMUNITY MEETINGS H
FRIENDS OR RELATIVES I
WORK PLACE J
BILL BOARD OR SIGN BOARD K
OTHER (SPECIFY) X

702. Is there anything a person can do to avoid getting AIDS or the virus that causes AIDS?

YES 1
NO 2 (GO TO 710)
DON'T KNOW 8 (GO TO 710)

703. What can a person do? Anything else?

RECORD ALL MENTIONED.

ABSTAIN FROM SEXT A
USE CONDOMS B
LIMIT SEX WITHIN MARRIAGE C
LIMIT SEX WITH TRUSTED PARTNER D
AVOID SEX WITH PROSTITUTES E
AVOID SEX WITH PERSONS WHO HAVE MANY PARTNERS F
AVOID SEX WITH HOMOSEXUALS G
AVOID SEX WITH PERSONS WHO INJECT DRUGS INTRAVENOUSLY H
AVOID UNSAFE BLOOD TRANSFUSIONS I
AVOID UNSTERILIZED NEEDLES OR SYRINGE J
AVOID KISSING K
AVOID MOSQUITO BITES L
SEEK PROTECTION FROM TRADITIONAL HEALER M
AVOID SHARING RAZORS OR BLADES N
OTHER (SPECIFY) W
OTHER (SPECIFY) X
DON'T KNOW Z

704. CHECK 703:

NEITHER CODE 'C' NOR CODE 'D' CIRCLED (GO TO 705)
CODE 'C' AND/OR CODE 'D' CIRCLED (GO TO 707)

705. In your opinion, is there any chance of getting AIDS from a person with multiple sexual partners?

YES 1
NO 2 (GO TO 707)
DON'T KNOW 8 (GO TO 707)

706. If a person has sex with only one partner, does this person have a greater or a lesser chance of getting AIDS than a person who has sex with many partners?

GREATER CHANCE OF AIDS 1
LESSER CHANCE OF AIDS 2
DON'T KNOW 8

707. CHECK 703:

DID NOT MENTION USE OF CONDOMS DURING SEX (CODE 'B' NOT CIRCLED) (GO TO 709)
MENTIONED USE OF CONDOMS DURING SEX (CODE 'B' CIRCLED) (GO TO 710)

709. If a person uses a condom every time he or she has sexual intercourse, does this person have a greater or a lesser chance of getting AIDS than someone who doesn't use a condom?

GREATER CHANCE OR AIDS 1
LESSER CHANCE OF AIDS 2
DON'T KNOW 8

710. Is it possible for a healthy-looking person to have the AIDS virus?

YES 1
NO 2
DON'T KNOW 8

715. Have you ever talked with your wife about ways to prevent getting the virus that causes AIDS?

YES 1
NO 2

718. (Apart from AIDS), have you heard about (other) diseases that can be transmitted through sexual contact?

YES 1
NO 2 (GO TO 721)

719. In a man, what signs and symptoms would lead you to think that he has such a disease? Any others?

RECORD ALL MENTIONED.

LOWER ABDOMINAL PAIN A
DISCHARGE FROM PENIS OR DRIPPING B
FOUL SMELLING DISCHARGE C
BURNING PAIN ON URINATION D
REDNESS OR INFLAMMATION IN GENITAL AREA E
SWELLING IN GENITAL AREA F
GENITAL SORES OR ULCERS G
GENITAL WARTS H
BLOOD IN URINE I
LOSS OF WEIGHT J
IMPOTENCE K
NO SYMPTOMS L
OTHER (SPECIFY) W
OTHER (SPECIFY) X
DON'T KNOW Z

720. In a woman, what signs and symptoms would lead you to think that she has such a disease? Any others?

RECORD ALL MENTIONED.

LOWER ABDOMINAL PAIN A
GENITAL DISCHARGE B
FOUL SMELLING DISCHARGE C
BURNING PAIN ON URINATION D
REDNESS OR INFLAMMATION IN GENITAL AREA E
SWELLING IN GENITAL AREA F
GENITAL SORES OR ULCERS G
GENITAL WARTS H
BLOOD IN URINE I
LOSS OF WEIGHT J
INABILITY TO GIVE BIRTH K
NO SYMPTOMS L
OTHER (SPECIFY) W
OTHER (SPECIFY) X
DON'T KNOW Z

721. CHECK 405:

HAS HAD SEXUAL INTERCOURSE (GO TO 722)
HAS NOT HAD SEXUAL INTERCOURSE (GO TO 801)

722. During the last 12 months, have you had a sexually-transmitted disease?

YES 1
NO 2
DON'T KNOW 8

723. Now I would like to ask you some questions about your health in the last 12 months. Sometimes, men experience a discharge from their penis. During the last 12 months, have you had a discharge from your penis?

YES 1
NO 2
DON'T KNOW 8

724. Sometimes, men experience a sore or ulcer on or near their penis. During the last 12 months, have you had a sore or ulcer on or near your penis?

YES 1
NO 2
DON'T KNOW 8

724A. During the last 12 months, have you had pain or burning sensation during urination?

YES 1
NO 2
DON'T KNOW 8

725. CHECK 722, 723, 724, 724A:

AT LEAST ONE 'YES' (GO TO 726)
NOT A SINGLE 'YES' (GO TO 801)

726. The last you had (INFECTION OR DISEASE FROM 722 OR 723 OR 724 OR 724A), did you seek any kind of advice or treatment?

YES 1
NO 2 (GO TO 728)

727. The last time you had (INFECTION OR DISEASE FROM 722 OR 723 OR 724 OR 724A) did you do any of the following? Did you:

Seek advice from a health professional such as doctor, nurse in a clinic or hospital?
YES 1
NO 2
Seek advice or medicine from a traditional healer?
YES 1
NO 2
Seek advice or buy medicines in a shop or pharmacy?
YES 1
NO 2
Seek treatment from a homeopath doctor?
YES 1
NO 2
Ask for advice from friends or relatives?
YES 1
NO 2

728. When you had (INFECTION OR DISEASE FROM 722 OR 723 OR 724 OR 724A), did you inform your wife?

YES 1
NO 2
SOME OR NOT ALL 3

SECTION 8. ATTITUDES TOWARDS WOMEN

Now I would like to ask you a few questions regarding men and women in couples. People have many different opinions on this subject and we would like to know what it is that you think about it.

801. If the husband can provide enough money, do you believe that it is acceptable for married women to work outside the home to earn any income or do you think they should stay home and take care of the household?

WORK OUTSIDE THE HOUSE 1
STAY HOME 2
NO OPINION 8

802. If for some reason the husband cannot provide enough money for the family, do you believe that it is acceptable for married women to work outside the home to earn an income or do you think they should stay home and take care of the household?

WORK OUTSIDE THE HOUSE 1
SAY HOME 2
NO OPINION 8

803. In a couple, do you think the woman should have a say about:

Large household expenses, that require a lot of money?
YES 1
NO 2
NO OPINION 8
Minor daily household expenses?
YES 1
NO 2
NO OPINION 8
When to visit family, friends, or relatives?
YES 1
NO 2
NO OPINION 8
What to do with the money she earns with her work?
YES 1
NO 2
NO OPINION 8

804. It is normal for couples to have quarrels and disagreements. During those quarrels some husbands occasionally severely reprimand or even beat their wives. In your opinion, do you think a man would be justified to beat his wife:

If she goes out without telling him?
YES 1
NO 2
NO OPINION 8
If she neglects the children?
YES 1
NO 2
NO OPINION 8
If she argues with her husband?
YES 1
NO 2
NO OPINION 8
If she fails to provide food on time?
YES 1
NO 2
NO OPINION 8

805. In a couple, who do you think should have the main responsibility to maintain the discipline among the children, the husband, the wife or both?

HUSBAND 1
WIFE 2
BOTH 3
ANY RELATIVE 4
OTHER (SPECIFY) 6
NO OPINION 8

806. In a couple, who do you think has the main responsibility to take care of the children, the husband, the wife or both?

HUSBAND 1
WIFE 2
BOTH 3
NO OPINION 8

807. In a couple, who do you think has the main responsibility to take care of the house, the husband, the wife or both?

HUSBAND 1
WIFE 2
BOTH 3
NO OPINION 8

808. RECORD THE TIME.

HOUR ___
MINUTES ___