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Demographic and Health Surveys
Individual questionnaire

IDENTIFICATION
SUBDISTRICT/SEGMENT

SUBDISTRICT/SEGMENT
DWELLING/PLOT
HOUSEHOLD NUMBER
ORDER NUMBER OF WOMAN

INTERVIEWER VISITS
FIRST VISIT
DATE
INTERVIEWER’S NAME
RESULT*

SECOND VISIT
DATE
INTERVIEWER’S NAME
RESULT*

THIRD VISIT
DATE
INTERVIEWER’S NAME
RESULT*

NEXT VISIT
DATE
TIME

FINAL VISIT
DAY
MONTH
INT. NUMBER
RESULT CODE

NO. OF VISITS

RESULTS CODES:

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

NAME
DATE
FIELD EDITED BY
OFFICE EDITED BY
KEYED BY
KEYED BY

SECTION 1. RESPONDENT’S BACKGROUND

101) RECORD THE NUMBER OF PERSONS LISTED IN THE HOUSEHOLD SCHEDULE

NUMBER OF PEOPLE _____

102) RECORD THE NUMBER OF CHILDREN AGED 5 AND UNDER LISTED IN THE HOUSEHOLD SCHEDULE WHO NORMALLY LIVE IN THE HOUSEHOLD.

NUMBER OF CHILDREN AGED 5 AND UNDER _____

103) RECORD THE TIME

HOUR _____
MINUTES _____

104) 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 Bujumbura, in another city, or in the countryside?

NAME OF DISTRICT/CITY (SPECIFY) ______
BUJUMBURA-CITY 1
OTHER URBAN CENTER 2
RURAL DISTRICT 3
OTHER COUNTRY 4

105) How long have you been continuously live in (name of district/village) (specify)?

YEARS _____
ALWAYS 95 (SKIP 107)
VISITOR 96 (SKIP TO 107)
DON’T KNOW 98

106) Just before you moved here, did you live in Bujumbura, in another city, or in the countryside?

NAME OF DISTRICT/CITY (SPECIFY) _____
BUJUMBURA-VILLE 1
AUTRE CENTRE URBAIN 2
COLLINE RURALE 3
AUTRE PAYS 4

107) In what month and year were you born?

MONTH _____
DON’T KNOW MONTH 98
YEAR _____
DON’T KNOW YEAR 98

108) How old are you?
INTERVIEWER: COMPARE AND CORRECT 107 AND/OR 108 IF INCONSISTENT

AGE IN YEARS COMPLETED ______

109) Are you Burundian?

YES 1 (SKIP TO 111)
NO 2

110) What is your nationality?

RWANDAN 1
ZAIREAN 2
TANZANIAN 3
OTHER AFRICAN 4
OTHER (SPECIFY) ______ 5

111) Have you ever attended school?

YES 1
NO 2 (SKIP TO 115)

112) What is the highest level of school you attended: Primary, Secondary, or Higher?

PRIMARY 1
SECONDARY 2
HIGHER 3

113) What is the highest (grade, form, year) you completed at this level?

GRADE ______

114) INTERVIEWER: CHECK 112

PRIMARY (GO TO 115)
SECONDARY OR HIGHER (SKIP TO 116)

115) Can you read a letter or newspaper easily, with difficulty, or not at all?

EASILY 1
WITH DIFFICULTY 2
NOT AT ALL 3

116) Do you usually listen to the radio at least once a week?

YES 1
NO 2 (SKIP TO 118)

117) Do frequently listen to the following programs:

NINDE?
YES 1
NO 2
IKIGANIRO C’INTUNGAMAGARA?
YES 1
NO 2
TUMARANE IRUNGU?
YES 1
NO 2
SANGA INSAMIRIZI?
YES 1
NO 2
PARTY PROGRAMS?
YES 1
NO 2
UJRB PROGRAMS?
YES 1
NO 2
UFB PROGRAMS?
YES 1
NO 2
UTB PROGRAMS?
YES 1
NO 2
INSAMIRIZI IWACU?
YES 1
NO 2

118) What is the major source of drinking water for members of your household?

PIPED INTO RESIDENCE 01
PIPED INTO YARD OR PLOT 02
PUBLIC TAP 03
WELL WITH HANDPUMP 04
WELL 05
WELL WITHOUT HANDPUMP 06
RIVER 07
LAKE 08
RAINWATER 09
OTHER (SPECIFY) ______ 10

119) What is the major source of non-drinking water for members of your household
(ex. For cooking, for washing hands…)?

PIPED INTO RESIDENCE 01-SKIP TO 121
PIPED INTO YARD OR PLOT 02-SKIP TO 121
PUBLIC TAP 03
WELL WITH HANDPUMP 04
WELL 05
WELL WITHOUT HANDPUMP 06
RIVER 07
LAKE 08
RAINWATER 09
OTHER (SPECIFY) ______ 10

120) How long does it take you to go there, get water, and come back?

MINUTES _____

121) What kind of toilet facility does your household have?

INSIDE DWELLING 1
OUTSIDE DWELLING
PRIVATE: WITH FLUSH 2
PRIVATE: WITHOUT FLUSH 3
OUTSIDE DWELLING
COMMUNAL: WITH FLUSH 4
COMMUNAL: WITHOUT FLUSH 5
NO TOILET 6 (SKIP TO 123)

122) At what age do the children start using the same toilet as the adults?

AGE IN YEARS _____
NO CHILDREN 96

123) Is there a piece of soap to use for personal washing?

YES 1
NO 2

124) What type of lighting do you use in this household?

ELECTRICITY 1
COLEMAN, ALADIN 2 [##TRANSLATOR NOTE: THIS IS THE ORIGINAL TEXT, COULDN’T FIND ITS MEANING]
HURRICANE LAMP 3
IKOROBOYI 4 [##TRANSLATOR NOTE: THIS IS THE ORIGINAL TEXT, COULDN’T FIND ITS MEANING]
CANDLES 5
WOOD FIRE 6
OTHER (SPECIFY) _____ 7

125) What do you use to cook food?

ELECTRICITY 1
GAS 2
PETROLEUM 3
PEAT 4
COAL 5
WOOD 6
OTHER (SPECIFY) ______ 7

126) Does your house have:

A STOVE?
YES 1
NO 2
A RADIO?
YES 1
NO 2
A TELEVISION?
YES 1
NO 2
A REFRIGERATOR?
YES 1
NO 2

127) Does any member of your household own:

A BICYCLE?
YES 1
NO 2
A MOTORCYCLE?
YES 1
NO 2
A CAR?
YES 1
NO 2
A LARGE OR SMALL TRUCK?
YES 1
NO 2

128) What are the walls of your dwelling made of?

HARD MATERIAL 1
ADOBE 2
PATCH 3
PLANT MATERIAL 4
OTHER (SPECIFY) _____ 5

129) Nain material of the floor

TILE OR CEMENT 1
CLAY 2
EARTH 3
OTHER (SPECIFY) _____ 4

130) MAIN MATERIAL OF THE ROOF

CONCRETE 1
ETERNIT 2 [##TRANSLATOR NOTE: THIS IS THE ORIGINAL TEXT, I COULD NOT FIND A TRANSLATION OF THIS MATERIAL, ALTHOUGH IT SEEMS TO LIKELY COME IN PANEL FORM, BASED ON MY RESEARCH]
METAL 3
TILES 4
VEGETABLE MATERIALS 5
OTHER (SPECIFY) ______ 6

131) How many rooms are used in your household, including the living room?

NUMBER ______

132) What is the occupation status of your dwelling?

OWNER 1
RENTER 2
FREE USAGE 3
OTHER (SPECIFY) _____ 4

SECTION 2. REPRODUCTION

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

Yes 1
No 2 (skip 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 (skip to 204)

203) How many sons live with you?
And how many daughters live with you?
INTERVIEWER: IF NONE, RECORD ‘00’

SONS AT HOME _____
DAUGHTERS AT HOME _____

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

YES 1
NO 2 (SKIP 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?
INTERVIEWER: IF NONE, RECODE ‘00’

SONS ELSEWHERE _____
DAUGHTERS ELSEWHERE _____

206) Have you ever given birth to a boy or girl who was born alive but later died?
IF NO, PROBE: did you give birth to a boy or girl who only lived a few hours of a few days?

YES 1
NO 2 (SKIP TO 208)

207) How many boys have died?
And how many girls have died?
INTERVIEWER: IF NONE, RECORD ‘00’

BOYS DEAD _____
GIRLS DEAD ____

208) INTERVIEWER: SUM ANSWERS TO 203, 205, AND 207 AND ENTER TOTAL.

TOTAL _____

209) Just to makes sure that I have this right: you have had in total ____births during your life. Is that correct?

YES
NO (PROBE AND CORRECT 201-209 AS NECESSARY)

210) CHECK 208:

ONE OR MORE BIRTHS (GO TO 211)
NO BIRTHS (SKIP TO 220)

211) Now I would like to record the names of all your births, whether still alive or not, starting with the first one you had. INTERVIEWER: RECORD NAMES OF ALL THE BIRTHS IN 212. RECORD TWINS ON SEPARATE LINES AND MARK WITH A BRACKET, AND WRITING T IN THE LEFT MARGIN.

__________

212) What name was given to you (first/next) baby?
ORDER NUMBER AND NAME

________

213) Is (NAME) a boy or a girl?

BOY 1
GIRL 2

214) In what month and year was (NAME) born?

MONTH _____
YEAR 19__

215) Is (NAME) still alive?

YES 1
NO 2 (SKIP TO 217)

216) IF DEAD:
How old was (NAME) when he/she died?
INTERVIEWER: RECORD DAYS IF LESS THAN 1 MONTH; MONTHS IF LESS THAN TWO YEARS, OR YEARS IF TWO YEAR OR MORE.

DAYS 1
MONTHS 2
YEARS 3

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

AGE IN YEARS _____

218) IF ALIVE:
Is he/she living with you?

YES 1
NO 2

219) INTERVIEWER: COMPARE 208 WITH NUMBER OF BIRTHS IN TABLE 1 ABOVE AND MARK.

NUMBERS ARE THE SAME
NUMBERS ARE DIFFERENT (PROBE AND RECONCILE)

220) Now we are going to talk about other things regarding reproduction.
How old were you when you got your first period?

YEAR ______
NOT YET 95 (SKIP TO 228)
REFUSE TO RESPOND 96
DON’T KNOW 98

221) Are you pregnant?

YES 1
NO 2 (SKIP TO 227)
UNSURE, DON’T KNOW 98 (SKIP TO 227)

222) How many months pregnant are you?

MONTHS ______

223) Since you have been pregnant, have you been given any injection to prevent the baby from getting tetanus, that is, convulsions after birth?

YES 1
NO 2
DON’T KNOW 8

224) Did you see anyone for a check on this pregnancy?

YES 1
NO 2 (SKIP TO 226)

225) Where did you have your first consultation?

HOSPITAL/MATERNITY 1
HEALTH CENTER/MOTHER-INFANT CENTER 2
CLINIC 3
PRIVATE OFFICE 4
TRADITIONAL DOCTOR 5
OTHER (SPECIFY) ______ 6

226) In what month of your pregnancy did you have your first antenatal visit?

MONTH _____ (SKIP TO 228)
DON’T KNOW 98 (SKIP TO 228)

227) How long ago did your last menstrual period start?

DAYS 1
OR WEEKS 2
OR MONTHS 3
BEFORE LAST PREGNANCY 995
NEVER MENSTRUATED 996
DON’T KNOW 998

228) When during her monthly cycle do you think a woman has the greatest chance of becoming pregnant?
PROBE: What are the days during the month when a woman has to be careful to avoid becoming pregnant?

DURING HER PERIOD 1
RIGHT AFTER HER PERIOD HAS ENDED 2
IN THE MIDDLE OF THE CYCLE 3
JUST BEFORE HER PERIOD BEGINS 4
AT ANY TIME 5
OTHER (SPECIFY) _____ 6
DK 8

229) PRESENCE OF OTHERS AT THIS POINT

CHILDREN UNDER 3 YEARS
YES 1
NO 2
CHILDREN OVER 3 YEARS
YES 1
NO 2
HUSBAND
YES 1
NO 2
OTHER MEN
YES 1
NO 2
OTHER WOMEN
YES 1
NO 2

SECTION 3. CONTRACEPTION

301) Now I would like to talk about a different topic. There are different traditional or modern ways or methods that a couple can use to delay or avoid pregnancy. Do you know any of these methods or have you heard of them?

INTERVIEWER:
CIRCLE CODE 1 IN 301 FOR EACH METHOD MENTIONED SPONTANEOUSLY. FOR EACH METHOD NOT MENTIONED, READ THE DESCRIPTION, ASK 302 AND CIRCLE CODE 2 IF THE METHOD IS RECOGNIZED. ASK 303 TO 305 FOR EACH METHOD CODED 1 OR 2 IN 301-302.

Code for 304

01 PUBLIC HOSPITAL/MATERNITY
02 HEALTH CENTER/MOTHER-INFANT CENTER
03 PUBLIC CLINIC
04 AUTHORIZED CLINIC
05 PRIVATE OFFICE
06 PHARMACY
07 TRADITIONAL HEALER
08 ACQUAINTANCES
09 OTHER (SPECIFY) _____
98 DK

Codes for 305

01 NONE
02 NOT EFFECTIVE
03 HUSBAND/PARTNER DISAPPROVES
04 SIDE EFFECTS
05 ACCESS/AVAILABILITY
06 COST
07 INCONVENIENT TO USE
08 OTHER (SPECIFY) ______
98 DK

(301- 302) Have you ever heard of this method?

PILL: Women can take a pill every day to delay or avoid pregnancy.
YES, SPONT 1
YES, PROBED 2
NO 3 (GO TO NEXT METHOD)
IUD: Women can have a plastic or metal coil or device placed inside their uterus by a doctor.
YES, SPONT 1
YES, PROBED 2
NO 3 (GO TO NEXT METHOD)
INJECTIONS: Women can have an injection by a doctor or a nurse which stops them from becoming pregnant for several months.
YES, SPONT 1
YES, PROBED 2
NO 3 (GO TO NEXT METHOD)
DIAPHRAGM/FOAM/JELLY: Women can place a sponge, suppository, diaphragm, jelly, or cream inside themselves before intercourse to avoid pregnancy.
YES, SPONT 1
YES, PROBED 2
NO 3 (GO TO NEXT METHOD)
CONDOM: Men use a condom to avoid getting the woman pregnant.
YES, SPONT 1
YES, PROBED 2
NO 3 (GO TO NEXT METHOD)
FEMALE STERILIZATION: Women can have an operation to avoid having any more children
YES, SPONT 1
YES, PROBED 2
NO 3 (GO TO NEXT METHOD)
MALE STERILIZATION: Men can have an operation to avoid having any more children
YES, SPONT 1
YES, PROBED 2
NO 3 (GO TO NEXT METHOD)
WITHDRAWAL: Men can be careful and pull out before climax.
YES, SPONT 1
YES, PROBED 2
NO 3 (GO TO NEXT METHOD)
ABSTINENCE: Some couples, not including the post-natal period of abstinence, avoid sexual intercourse for months so that the woman doesn’t get pregnant.
YES, SPONT 1
YES, PROBED 2
NO 3 (GO TO NEXT METHOD)
PERIODIC ABSTINENCE: Some couples can avoid pregnancy by not having sexual intercourse on the days of the month she is most likely to get pregnant.
YES, SPONT 1
YES, PROBED 2
NO 3 (GO TO NEXT METHOD)
MEDICAL PLANTS (bark, roots, leaves) are used by some women to delay or space out pregnancies.
YES, SPONT 1
YES, PROBED 2
NO 3 (GO TO NEXT METHOD)
TALISMANS: (charm, cord with knot, etc) are used by some women to delay or space out pregnancies.
YES, SPONT 1
YES, PROBED 2
NO 3 (GO TO NEXT METHOD)
OTHER METHODS: Have you heard of any other ways or methods, including traditional methods, that women or men can use to avoid pregnancy?
YES, SPONT 1
NO 3

303) Have you ever used (method)?

PILL: Women can take a pill every day to delay or avoid pregnancy.
YES 1
NO 2
IUD: Women can have a plastic or metal coil or device placed inside their uterus by a doctor.
YES 1
NO 2
INJECTIONS: Women can have an injection by a doctor or a nurse which stops them from becoming pregnant for several months.
YES 1
NO 2
DIAPHRAGM/FOAM/JELLY: Women can place a sponge, suppository, diaphragm, jelly, or cream inside themselves before intercourse to avoid pregnancy.
YES 1
NO 2
CONDOM: Men use a condom to avoid getting the woman pregnant.
YES 1
NO 2
FEMALE STERILIZATION: Women can have an operation to avoid having any more children
YES 1
NO 2
MALE STERILIZATION: Men can have an operation to avoid having any more children
YES 1
NO 2
WITHDRAWAL: Men can be careful and pull out before climax.
YES 1
NO 2
ABSTINENCE: Some couples, not including the post-natal period of abstinence, avoid sexual intercourse for months so that the woman doesn’t get pregnant.
YES 1
NO 2
PERIODIC ABSTINENCE: Some couples can avoid pregnancy by not having sexual intercourse on the days of the month she is most likely to get pregnant.
YES 1
NO 2
MEDICAL PLANTS (bark, roots, leaves) are used by some women to delay or space out pregnancies.
YES 1
NO 2
TALISMANS: (charm, cord with knot, etc) are used by some women to delay or space out pregnancies.
YES 1
NO 2
OTHER METHODS: Have you heard of any other ways or methods, including traditional methods, that women or men can use to avoid pregnancy?
YES 1
NO 2

304) Where would you go to obtain (method)?

PILL: Women can take a pill every day to delay or avoid pregnancy.
01 PUBLIC HOSPITAL/MATERNITY
02 HEALTH CENTER/MOTHER-INFANT CENTER
03 PUBLIC CLINIC
04 AUTHORIZED CLINIC
05 PRIVATE OFFICE
06 PHARMACY
07 TRADITIONAL HEALER
08 ACQUAINTANCES
09 OTHER (SPECIFY) _____
98 DK
IUD: Women can have a plastic or metal coil or device placed inside their uterus by a doctor.
01 PUBLIC HOSPITAL/MATERNITY
02 HEALTH CENTER/MOTHER-INFANT CENTER
03 PUBLIC CLINIC
04 AUTHORIZED CLINIC
05 PRIVATE OFFICE
06 PHARMACY
07 TRADITIONAL HEALER
08 ACQUAINTANCES
09 OTHER (SPECIFY) _____
98 DK
INJECTIONS: Women can have an injection by a doctor or a nurse which stops them from becoming pregnant for several months.
01 PUBLIC HOSPITAL/MATERNITY
02 HEALTH CENTER/MOTHER-INFANT CENTER
03 PUBLIC CLINIC
04 AUTHORIZED CLINIC
05 PRIVATE OFFICE
06 PHARMACY
07 TRADITIONAL HEALER
08 ACQUAINTANCES
09 OTHER (SPECIFY) _____
98 DK
DIAPHRAGM/FOAM/JELLY: Women can place a sponge, suppository, diaphragm, jelly, or cream inside themselves before intercourse to avoid pregnancy.
01 PUBLIC HOSPITAL/MATERNITY
02 HEALTH CENTER/MOTHER-INFANT CENTER
03 PUBLIC CLINIC
04 AUTHORIZED CLINIC
05 PRIVATE OFFICE
06 PHARMACY
07 TRADITIONAL HEALER
08 ACQUAINTANCES
09 OTHER (SPECIFY) _____
98 DK
CONDOM: Men use a condom to avoid getting the woman pregnant.
01 PUBLIC HOSPITAL/MATERNITY
02 HEALTH CENTER/MOTHER-INFANT CENTER
03 PUBLIC CLINIC
04 AUTHORIZED CLINIC
05 PRIVATE OFFICE
06 PHARMACY
07 TRADITIONAL HEALER
08 ACQUAINTANCES
09 OTHER (SPECIFY) _____
98 DK
FEMALE STERILIZATION: Women can have an operation to avoid having any more children
01 PUBLIC HOSPITAL/MATERNITY
02 HEALTH CENTER/MOTHER-INFANT CENTER
03 PUBLIC CLINIC
04 AUTHORIZED CLINIC
05 PRIVATE OFFICE
06 PHARMACY
07 TRADITIONAL HEALER
08 ACQUAINTANCES
09 OTHER (SPECIFY) _____
98 DK
MALE STERILIZATION: Men can have an operation to avoid having any more children
01 PUBLIC HOSPITAL/MATERNITY
02 HEALTH CENTER/MOTHER-INFANT CENTER
03 PUBLIC CLINIC
04 AUTHORIZED CLINIC
05 PRIVATE OFFICE
06 PHARMACY
07 TRADITIONAL HEALER
08 ACQUAINTANCES
09 OTHER (SPECIFY) _____
98 DK
WITHDRAWAL: Men can be careful and pull out before climax.
01 PUBLIC HOSPITAL/MATERNITY
02 HEALTH CENTER/MOTHER-INFANT CENTER
03 PUBLIC CLINIC
04 AUTHORIZED CLINIC
05 PRIVATE OFFICE
06 PHARMACY
07 TRADITIONAL HEALER
08 ACQUAINTANCES
09 OTHER (SPECIFY) _____
98 DK
PERIODIC ABSTINENCE: Some couples can avoid pregnancy by not having sexual intercourse on the days of the month she is most likely to get pregnant.
01 PUBLIC HOSPITAL/MATERNITY
02 HEALTH CENTER/MOTHER-INFANT CENTER
03 PUBLIC CLINIC
04 AUTHORIZED CLINIC
05 PRIVATE OFFICE
06 PHARMACY
07 TRADITIONAL HEALER
08 ACQUAINTANCES
09 OTHER (SPECIFY) _____
98 DK
MEDICAL PLANTS (bark, roots, leaves) are used by some women to delay or space out pregnancies.
01 PUBLIC HOSPITAL/MATERNITY
02 HEALTH CENTER/MOTHER-INFANT CENTER
03 PUBLIC CLINIC
04 AUTHORIZED CLINIC
05 PRIVATE OFFICE
06 PHARMACY
07 TRADITIONAL HEALER
08 ACQUAINTANCES
09 OTHER (SPECIFY) _____
98 DK
TALISMANS: (charm, cord with knot, etc) are used by some women to delay or space out pregnancies.
01 PUBLIC HOSPITAL/MATERNITY
02 HEALTH CENTER/MOTHER-INFANT CENTER
03 PUBLIC CLINIC
04 AUTHORIZED CLINIC
05 PRIVATE OFFICE
06 PHARMACY
07 TRADITIONAL HEALER
08 ACQUAINTANCES
09 OTHER (SPECIFY) _____
98 DK

305) In your opinion, what is the main problem, if any, with using (method)? (Codes below)
(Other)

PILL: Women can take a pill every day to delay or avoid pregnancy.
01 NONE
02 NOT EFFECTIVE
03 HUSBAND/PARTNER DISAPPROVES
04 SIDE EFFECTS
05 ACCESS/AVAILABILITY
06 COST
07 INCONVENIENT TO USE
08 OTHER (SPECIFY) ______
98 DK
IUD: Women can have a plastic or metal coil or device placed inside their uterus by a doctor.
01 NONE
02 NOT EFFECTIVE
03 HUSBAND/PARTNER DISAPPROVES
04 SIDE EFFECTS
05 ACCESS/AVAILABILITY
06 COST
07 INCONVENIENT TO USE
08 OTHER (SPECIFY) ______
98 DK
INJECTIONS: Women can have an injection by a doctor or a nurse which stops them from becoming pregnant for several months.
01 NONE
02 NOT EFFECTIVE
03 HUSBAND/PARTNER DISAPPROVES
04 SIDE EFFECTS
05 ACCESS/AVAILABILITY
06 COST
07 INCONVENIENT TO USE
08 OTHER (SPECIFY) ______
98 DK
DIAPHRAGM/FOAM/JELLY: Women can place a sponge, suppository, diaphragm, jelly, or cream inside themselves before intercourse to avoid pregnancy.
01 NONE
02 NOT EFFECTIVE
03 HUSBAND/PARTNER DISAPPROVES
04 SIDE EFFECTS
05 ACCESS/AVAILABILITY
06 COST
07 INCONVENIENT TO USE
08 OTHER (SPECIFY) ______
98 DK
CONDOM: Men use a condom to avoid getting the woman pregnant.
01 NONE
02 NOT EFFECTIVE
03 HUSBAND/PARTNER DISAPPROVES
04 SIDE EFFECTS
05 ACCESS/AVAILABILITY
06 COST
07 INCONVENIENT TO USE
08 OTHER (SPECIFY) ______
98 DK
FEMALE STERILIZATION: Women can have an operation to avoid having any more children
01 NONE
02 NOT EFFECTIVE
03 HUSBAND/PARTNER DISAPPROVES
04 SIDE EFFECTS
05 ACCESS/AVAILABILITY
06 COST
07 INCONVENIENT TO USE
08 OTHER (SPECIFY) ______
98 DK
MALE STERILIZATION: Men can have an operation to avoid having any more children
01 NONE
02 NOT EFFECTIVE
03 HUSBAND/PARTNER DISAPPROVES
04 SIDE EFFECTS
05 ACCESS/AVAILABILITY
06 COST
07 INCONVENIENT TO USE
08 OTHER (SPECIFY) ______
98 DK
WITHDRAWAL: Men can be careful and pull out before climax.
01 NONE
02 NOT EFFECTIVE
03 HUSBAND/PARTNER DISAPPROVES
04 SIDE EFFECTS
05 ACCESS/AVAILABILITY
06 COST
07 INCONVENIENT TO USE
08 OTHER (SPECIFY) ______
98 DK
ABSTINENCE: Some couples, not including the post-natal period of abstinence, avoid sexual intercourse for months so that the woman doesn’t get pregnant.
01 NONE
02 NOT EFFECTIVE
03 HUSBAND/PARTNER DISAPPROVES
04 SIDE EFFECTS
05 ACCESS/AVAILABILITY
06 COST
07 INCONVENIENT TO USE
08 OTHER (SPECIFY) ______
98 DK
PERIODIC ABSTINENCE: Some couples can avoid pregnancy by not having sexual intercourse on the days of the month she is most likely to get pregnant.
01 NONE
02 NOT EFFECTIVE
03 HUSBAND/PARTNER DISAPPROVES
04 SIDE EFFECTS
05 ACCESS/AVAILABILITY
06 COST
07 INCONVENIENT TO USE
08 OTHER (SPECIFY) ______
98 DK
MEDICAL PLANTS (bark, roots, leaves) are used by some women to delay or space out pregnancies.
01 NONE
02 NOT EFFECTIVE
03 HUSBAND/PARTNER DISAPPROVES
04 SIDE EFFECTS
05 ACCESS/AVAILABILITY
06 COST
07 INCONVENIENT TO USE
08 OTHER (SPECIFY) ______
98 DK
TALISMANS: (charm, cord with knot, etc) are used by some women to delay or space out pregnancies.
01 NONE
02 NOT EFFECTIVE
03 HUSBAND/PARTNER DISAPPROVES
04 SIDE EFFECTS
05 ACCESS/AVAILABILITY
06 COST
07 INCONVENIENT TO USE
08 OTHER (SPECIFY) ______
98 DK

306) INTERVIEWER:

NOT A SINGLE ‘YES’ IN 301-302 (DOESN’T KNOW ANY METHOD) (SKIP TO 309)
AT LEAST ONE ‘YES’ (KNOWS AT LEAST ONE METHOD) (GO TO 307)

307) From whom or how did you get information contraception for the first time?

DOCTOR 01
OTHER HEALTHCARE PROFESSIONAL 02
SOCIAL ORGANIZER 03
UFB MEETING 04
PARTY MEETINGS 05
HUSBAND 06
FRIENDS/ACQUAINTANCES 07
RELIGIOUS PERSONNEL 08
RADIO/TELEVISION 09
NEWSPAPER 10
OTHER (SPECIFY) ____ 11
DON’T KNOW 98

308) INTERVIEWER: SEE TABLE 2

NO “YES” IN 303 (NEVER USED) (GO TO 309)
AT LEAST ONE ‘YES’ IN 303 (USED AT LEAST ONCE) (SKIP TO 311)

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

YES 1
NO 2 (SKIP TO 318)

310) What have you used or done?
INTERVIEWER: CORRECT 302-303 AND OBTAIN INFORMATION FOR 304-308 IF NECESSARY

(SPECIFY) _______

311) CHECK 303:

USED PERIODIC ABSTINENCE (GO TO 312)
NEVER USED PERIODIC ABSTINENCE (SKIP TO 313)

312) When you last used periodic abstinence, how did you measure the days where you needed to abstain?

BASED ON MENSTRUAL CYCLE 1
BASED ON BODY TEMPERATURE 2
BASED ON CERVICAL MUCUS (BILLINGS) METHOD 3
BASED ON BODY TEMPERATURE AND MUCUS 4
OTHER (SPECIFY) _____ 5

313) How many living children did you have when you first did something or used a method to avoid getting pregnant?
INTERVIEWER: IF NONE, ENTER 00

NUMBER OF CHILDREN ______

314) INTERVIEWER: CHECK 221 AND 303

PREGNANT (SKIP TO 318)
STERILIZED (SKIP TO 322)
OTHER (GO TO 315)

315) Are you currently doing something or using any method to delay or avoid getting pregnant?

YES 1 (GO TO 316)
NO 2 (SKIP TO 318)

316) Which method are you using?

PILL 01
IUD 02
INJECTIONS 03
DIAPHRAGM, FOAM, JELLY 04
CONDOM 05
WITHDRAWAL 08-SKIP TO 322
ABSTINENCE 09-SKIP TO 322
PERIODIC ABSTINENCE 10
MEDICAL PLANTS 11
TALISMANS 12
OTHER (SPECIFY) 13 (SKIP TO 322)

317) Where did you obtain (advice on) (current method) the last time?

HOSPITAL/MATERNITY 01 (SKIP TO 322)
HEALTH CENTER/MOTHER-INFANT CENTER 02 (SKIP TO 322)
PUBLIC CLINIC 03 (SKIP TO 322)
AUTHORIZED CLINIC 04 (SKIP TO 322)
PRIVATE OFFICE 05 (SKIP TO 322)
PHARMACY 06 (SKIP TO 322)
TRADITIONAL HEALER 07 (SKIP TO 322)
ACQUAINTANCES 08 (SKIP TO 322)
OTHER (SPECIFY) _____ 09 (SKIP TO 322)
DK 98 (SKIP TO 322)

318) Do you intend to use a method to avoid pregnancy at any time in the future?

YES 1
NO 2 (SKIP TO 322)
DON’T KNOW 8 (SKIP TO 322)

319) Among the methods we just discussed, which method would you prefer to use?

PILL 01
IUD 02
INJECTIONS 03
DIAPHRAGM, FOAM, JELLY 04
CONDOM 05
FEMALE STERILIZATION 06
MALE STERILIZATION 07
WITHDRAWAL 08 (SKIP TO 321)
ABSTINENCE 09 (SKIP TO 321)
PERIODIC ABSTINENCE 10 (SKIP TO 321)
MEDICAL PLANTS 11
TALISMANS 12
OTHER (SPECIFY) _____ 13 (SKIP TO 321)
UNSURE OR DON’T KNOW 98 (SKIP TO 322)

320) Where do you plan to obtain supplies for (preferred method)?

HOSPITAL/MATERNITY 01
HEALTH CENTER/MOTHER-INFANT CENTER 02
PUBLIC CLINIC 03
AUTHORIZED CLINIC 04
PRIVATE OFFICE 05
PHARMACY 06
TRADITIONAL HEALER 07
ACQUAINTANCES 08
OTHER (SPECIFY) _____ 09
DK 98

321) Do you plan to use (preferred method) in the next 12 months?

YES 1
NO 2
DON’T KNOW 8

322) Do you think it’s acceptable or not to have information about family planning on the radio or television?

ACCEPTABLE 1
NOT ACCEPTABLE 2
DON’T KNOW 8

SECTION 4. HEALTH AND BREASTFEEDING

401) INTERVIEWER: CHECK 214:

ONE OR MORE LIVE BIRTHS SINE JAN. 1982 (GO TO 402)
NO LIVE BIRTHS SINCE JAN. 1982 (SKIP TO SECTION 5)

402) INTERVIEWER: ENTER THE LINE NUMBER, THE NAME, AND THE SURVIVAL STATUS OF EACH BIRTH SINCE JAN 1982 IN TABLE 3, STARTING WITH THE LAST BIRTH. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS, EVEN IF DECEASED.

NAME ______
LINE NUMBER_______
ALIVE
DEAD

403) 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, ONCE 1
YES, 2 OR MORE TIMES 2
NO 3
DK 8

404) When you were pregnant with (name), did you have an antenatal consultation?
If yes, where did you have your first consultation?

HOSPITAL/MATERNITY 1
HEALTH CENTER/MOTHER-INFANT CENTER 2
CLINIC 3
PRIVATE OFFICE 4
TRADITIONAL PRACTITIONER 5
OTHER (SPECIFY) ______ 6
NO CONSULTATION 7

405) Who assisted with the delivery of (name)?
Interviewer: Probe and circle the code for the most qualified person

DOCTOR 1
OTHER MEDICAL PERSONNEL 2
TRADITIONAL BIRTH ATTENDANT 3
MOTHER/MOTHER-IN-LAW/NEIGHBOR 4
HUSBAND 5
OTHER (SPECIFY) _____ 6
NO ASSISTANCE 7

406) Have you ever feed (name) at the breast?

YES 1 (SKIP TO 409)
NO 2 (SKIP TO 409)

407) Are you still breastfeeding (name)?

YES 1 (SKIP TO 409)
NO 2
CHILD DEAD 3

408) How many months did you breastfeed (name)?

MONTHS ______
UNTIL DEATH 96

409) How many months after the birth of (name) did your period return?

MONTHS ______
NOT RETURNED 96

410) How many months after the birth of (name) did you resume sexual relations?

MONTHS ______
NOT RESUMED 96

411) INTERVIEWER: CHECK 407 FOR LAST BIRTH

LAST CHILD STILL BREASTFEEDING (GO TO 412)
NO, NOT BREASTFEEDING LAST CHILD (SKIP TO 417)
DEAD (SKIP TO 418)
NO, NOT YET BREASTFEEDING (NEWBORN) (SKIP TO 418)

412) How many times did you breastfeed last night between sundown and sunrise?

NUMBER OF TIMES ______
AS OFTEN AS THE CHILD WANTED, WHEN CHILD CRIED 96
DON’T KNOW 98

413) How many times did you breastfeed yesterday during the daylight hours?

NUMBER OF TIMES _____
AS OFTEN AS THE CHILD WANTED, WHEN CHILD CRIED 96
DON’T KNOW 98

414) At any time yesterday or last night, was (name of last child) given any of the following:

PLAIN WATER
YES 1
NO 2
JUICE?
YES 1
NO 2
POWDERED MILK?
YES 1
NO 2
COW’S MILK?
YES 1
NO 2
GOAT’S MILK?
YES 1
NO 2
BANANA OR SORGHUM BEER?
YES 1
NO 2
BROTH?
YES 1
NO 2
OTHER LIQUID?
YES 1
NO 2
SOLID FOODS?
YES 1
NO 2

415) INTERVIEWER: CHECK 414

WAS GIVEN LIQUID OR FOOD (GO TO 416)
NO FOOD OR LIQUID GIVEN (SKIP TO 418)

416) Were any of these given in a bottle with a nipple?

YES 1 (SKIP TO 418)
NO 2 (SKIP TO 418)

417) Why did you stop breastfeeding (name of last birth)?

WEANING 01
CHILD SICK 02
REFUSE TO SUCKLE 03
MOTHER SICK 04
NO MILK 05
PREGNANT 06
PREFER ARTIFICIAL MILK 07
MOTHER WORKS 08
OTHER (SPECIFY) _____ 09

418) At the time you became pregnant with (name of last birth), did you want to have that child then, did you want to wait until later, or did you want no (more) children at all?

THEN 01
LATER 02
NO MORE 03

419) INTERVIEWER:
ENTER THE ORDER NUMBER, THE NAME, AND THE SURVIVAL STATUS OF EACH BIRTH SINCE JANUARY 1982 IN TABLE 4, STARTING WITH THE LAST BIRTH. THE HEADINGS IN TABLE 4 SHOULD BE EXACTLY THE SAME AS THOSE IN TABLE 3. ASK THE QUESTIONS ONLY FOR LIVING CHILDREN.

ORDER NUMBER______________________
NAME ______
ALIVE
DEAD

420) Do you have a health card for (name)? If yes, may I see it, please? If code 2, record reasons in observations.

YES, SEEN 1 (SKIP TO 422)
YES, NOT SEEN 2 (SKIP TO 422)
NO CHART 3 (SKIP TO 422)

421) Interviewer:
Record dates of immunizations from health card

BCG
NAME _____
DAY _____
MONTH _____
YEAR _____
Polio
NAME _____
DAY _____
MONTH _____
YEAR _____
DTC
NAME _____
DAY _____
MONTH _____
YEAR _____
Measles
NAME _____
DAY _____
MONTH _____
YEAR _____

422) Has (name) ever had a vaccination to prevent him/her from getting diseases?

YES 1
NO 2
DON’T KNOW 8

423) Has (name) had diarrhea in the last 24 hours?

YES 1 (SKIP TO 425)
NO 2
DON’T KNOW 8

424) Has (name) had diarrhea in the last two weeks?

YES 1 (SKIP TO NEXT COLUMN)
NO 2 (SKIP TO NEXT COLUMN)
DON’T KNOW 8 (SKIP TO NEXT COLUMN)

425) Was (name) taken to a hospital, a health center, or a clinic to treat the last episode of diarrhea? IF YES, Where was he/she taken?

HOSPITAL 1
HEALTH CENTER 2
CLINIC 3
NO 4

426) The last time (name) had diarrhea, was he/she given a RVO to treat the diarrhea? [##translator note: the RVO was listed in the original text, and I could not find what it means. The standard English uses the “sugar-salt-water” packet. It also may be the local name for the ORS]

YES 1
NO 2
DON’T KNOW 8

427) Was there anything (else) you or somebody did to treat the diarrhea (the last time)? IF YES: What was done? INTERVIEWER: CIRCLE CODE 1 FOR ALL MENTIONED.

HOME SOLUTION OF SUGAR, SALT, AND WATER 1
SYRUP AND OTHER PHARMACEUTICAL PRODUCTS 1
MEDICINAL PLANTS 1
LEMON JUICE 1
CARBONATED DRINKS 1
INCREASE LIQUID 1
INCREASE FOOD 1
DECREASE LIQUID 1
DECREASE FOOD 1
OTHER (SPECIFY) _____ 1
NOTHING 1

428) CHECK 426

AT LEAST ONE CHILD RECEIVED RVO (SKIP TO 430)
NO CHILD RECEIVED RVO (GO TO 429)

429) Have you ever head of a special product called (local name) you can get for children with diarrhea?

YES 1
NO 2

430) Have you ever seen this packet (show RVO packet from UNICEF)?

YES 1
NO 2

431) Has (name) had a fever in the last four weeks?

YES 1 (SKIP TO 434)
NO 2 (SKIP TO 434)
DON’T KNOW 8 (SKIP TO 434)

432) Was (name) taken to a hospital, a health center, or a clinic to treat the fever? If yes, where was he/she taken first?

HOSPITAL 1
HEALTH CENTER 2
CLINIC 3
NO 4

433) Was there anything (else) you or someone else did to treat the fever?
IF YES, what was done?
CIRCLE CODE 1 FOR ALL MENTIONED

ANTIMALARIAL (PILLS OR INJECTION) 1
ANTIBIOTIC (PILLS OR INJECTION) 1
PILLS (OTHER/DON’T KNOW) 1
INJECTION (OTHER/DON’T KNOW) 1
LIQUID OR SYRUP 1
MEDICINAL PLANTS 1
TALISMAN 1
OTHER (SPECIFY) _____ 1
NOTHING 1

434) Has (name) suffered from severe cough or difficult or rapid breathing in the last four weeks?

YES 1 (SKIP TO NEXT COLUMN)
NO 2 (SKIP TO NEXT COLUMN)
DON’T KNOW 8 (SKIP TO NEXT COLUMN)

435) Was (name) taken to a hospital, a health center, or a clinic to treat the problem? If yes, where was he/she taken first?

HOSPITAL 1
HEALTH CENTER 2
CLINIC 3
NO 4

436) Was there anything (else) you or someone else did to treat the fever?
IF YES, what was done?
CIRCLE CODE 1 FOR ALL MENTIONED

ANTIBIOTIC 1
COUGH SYRUP 1
PILLS 1
INJECTION 1
LEMON JUICE 1
OTHER (SPECIFY) _____ 1
NOTHING 1

437) What is a vaccine for?

PREVENTION 1
CURE 2
PREVENTION AND CURE 3
OTHER (SPECIFY) 4
DON’T KNOW 8

SECTION 5. MARRIAGE

501) Are you currently married or living together with a man?

YES 1
NO 2 (SKIP TO 514)

502) Are you currently married, widowed, separated, divorced, or single?

MARRIED 1 (SKIP TO 504)
WIDOWED 2
SEPARATED 3
DIVORCED 4
SINGLE 5

503) Are you living in a union with someone?

YES 1
NO 2 (SKIP TO 507)

504) Does your husband/partner live with your or is he now stay elsewhere?

LIVING WITH HER 1
STAYING ELSEWHERE 2

505) Does your husband/partner have any other wives besides yourself?

YES 1
NO 2 (SKIP TO 507)

506) How many other wives does he have?

NUMBER _____
DON’T KNOW 8

507) Have you been married or lived with a man only once, or more than once?

ONCE 1 (GO TO 508)
MORE THAN ONCE 2 (SKIP TO 509)

508) Interviewer: check 502

MARRIED, WIDOWED OR SEPARATED (SKIP TO 510)
DIVORCED OR SINGLE (GO TO 509)

509) If your first husband or partner still alive?

YES 1
NO 2
DON’T KNOW 8

510) In what month and year did you starting living with your (first) husband or partner?

MONTH _____
DON’T KNOW MONTH 98
YEAR _____ (SKIP TO 512)
DON’T KNOW YEAR 98

511) How old where you when you started living with him?

AGE ______

512) When you started with your (first) husband or partner, did he have wives other than yourself?

YES 1
NO 2 (SKIP TO 514)

513) What was your rank: were you the first, second, third…spouse?

RANK _____
DON’T KNOW 8

514) Is your father still living?

YES 1 (SKIP TO 516)
NO 2
DON’T KNOW 8 (SKIP TO 516)

515) For how many years has he been dead?

NUMBER OF YEARS _____
DON’T KNOW 98

516) Is your mother still living?

YES 1 (SKIP TO 518)
NO 2
DON’T KNOW 8 (SKIP TO 518)

517) For how many years has she been dead?

NUMBER OF YEARS _____
DON’T KNOW 98

518) INTERVIEWER: CHECK 501

YES, MARRIED OR LIVING IN A UNION (GO TO 519)
NO, NEVER MARRIED OR LIVED IN A UNION (SKIP TO 527)

519) Are your (first) husband/partner’s father and mother still alive?

FATHER OF FIRST HUSBAND
YES 1
NO 2
DON’T KNOW 8
MOTHER OF FIRST HUSBAND
YES 1
NO 2
DON’T KNOW 8

520) INTERVIEWER: CHECK 514, 516, AND 519

ALL ALIVE (YES TO ALL QUESTIONS) (SKIP TO 523)
NO ALL ALIVE OR DON’T KNOW (GO TO 521)

521) Was (mention parents not alive now) alive at the time you began living with your (first) husband or partner?

FATHER OF WIFE
YES 1
NO 2
DON’T KNOW 8
MOTHER OF WIFE
YES 1
NO 2
DON’T KNOW 8
FATHER OF (1ST) HUSBAND
YES 1
NO 2
DON’T KNOW 8
MOTHER OF (1ST) HUSBAND
YES 1
NO 2
DON’T KNOW 8

522) INTERVIEWER: CHECK 521

AT LEAST ONE PARENT ALIVE AT MARRIAGE (GO TO 523)
NO PARENT ALIVE AT MARRIAGE (SKIP TO 526)

523) At the time you began living together, did you and your (first) husband/partner live with any of these parents for at least six months?

YES 1
NO 2 (SKIP TO 525)

524) For about how many years did you live together with a parent at that time?

YEARS COMPLETED ______
UP TO THE PRESENT 96 (SKIP TO 526)
DON’T KNOW 98

525) Are you now living either with your parents or your husband’s parents?

YES 1
NO 2

526) In how many localities have you lived for six months or more since you were first married (started living together) including this place?

NUMBER OF LOCALITIES _____ (SKIP TO 528)
DON’T KNOW 98 (SKIP TO 528)

527) Now we need some details about your sexual activity in order to get a better understanding of contraception and fertility.
Have you ever had sexual intercourse?

YES 1 (SKIP TO 529)
NO 2 (SKIP TO 537)

528) Now we need some details about your sexual activity in order to get a better understanding of contraception and fertility.

529) How old were when you first had sexual intercourse?

AGE _____

530) Have you had sexual intercourse in the last four weeks?

YES 1
NO 2 (SKIP TO 532)

531) How many times?

TIMES ____

532) When was the last time you had sexual intercourse?

DAYS AGO 1 (CHECK 530)
OR WEEKS AGO 2 (CHECK 530)
OR MONTHS AGO 3
OR YEARS AGO 4 (SKIP TO 537)
BEFORE LAST BIRTH 996 (SKIP TO 537)

533) INTERVIEWER: CHECK 221

PREGNANT (SKIP TO 537)
NOT PREGNANT/NOT SURE (GO TO 534)

534) INTERVIEWER: CHECK 303 AND 315

CURRENTLY USING A METHOD (SKIP TO 537)
NOT CURRENTLY USING A METHOD (GO TO 535)

535) If you became pregnant in the next few weeks, would you feel happy, unhappy, or would it not matter very much?

HAPPY 1 (SKIP TO 537)
UNHAPPY 2
INDIFFERENT 3

536) What is the main reason that you are not using a method to avoid pregnancy?

LACK OF KNOWLEDGE 01
OPPOSED TO FAMILY PLANNING 02
HUSBAND DISAPPROVES 03
FAMILY DISAPPROVES 04
INFREQUENT SEX 05
STILL BREASTFEEDING 06
STERILIZED/MENOPAUSE 07
HEALTH PROBLEMS 08
METHOD NOT AVAILABLE 09
COSTS TO HIGH 10
RELIGION 11
FATALISTIC 12
AVAILABLE METHODS ARE INCONVENIENT 13
OTHER (SPECIFY) ______ 14
DON’T KNOW 98

537) PRESENCE OF OTHERS AT THIS POINT

CHILDREN UNDER 3
YES 1
NO 2
CHILDREN OVER 3
YES 1
NO 2
HUSBAND
YES 1
NO 2
OTHER MEN
YES 1
NO 2
OTHER WOMEN
YES 1
NO 2

SECTION 6. FERTILITY PREFERENCES

601) INTERVIEWER: CHECK 502-503:

CURRENTLY IN UNION (GO TO 602)
ALL OTHERS (SKIP TO 611)

602) Now I have some questions about the future.
INTERVIEWER: CHECK 221

NOT PREGNANT OR NOT SURE: Would you like to have a (another) child?

PREGNANT: After the child you are expecting, would you like to have other children?

YES (MORE) CHILDREN 1 (SKIP TO 605)
NO (NO MORE CHILDREN) 2 (SKIP TO 605)
SAYS SHE CAN’T GET PREGNANT 3 (SKIP TO 605)
DON’T KNOW OR UNDECIDED 8 (SKIP TO 605)

603) How long would you like to wait from now before the birth of a (another) child (aside from your current pregnancy)?

NUMBER OF MONTHS 1
OR NUMBER OF YEARS 2
IMMEDIATELY (AS SOON AS POSSIBLE) 994
UP TO GOD 995
OTHER (SPECIFY) ____ 996
UNDECIDED, DON’T KNOW 998

604) What sex would you like your next child to be?

BOY 1
GIRL 2
NO PREFERENCE 3
UP TO GOD 4
OTHER (SPECIFY) ____ 5

605) In your opinion, what is the best amount of time to wait between two births?

NUMBER OF MONTHS ______
OTHER (SPECIFY) 96 (SKIP TO 607)
DON’T KNOW 98 (SKIP TO 607)

606) Why is this interval the best?

REST, HEALTH OF MOTHER 1
HEALTH OF CHILD 1
CHILDREN’S EDUCATION 1
ECONOMIC DIFFICULTIES 1
CUSTOMS 1
OTHER (SPECIFY) _____ 1
DON’T KNOW 1

607) For how long should a couple wait before starting sexual intercourse after the birth of a baby?

NUMBER OF DAYS 1
OR NUMBER OF MONTHS 2
OR NUMBER OF YEARS 3
OTHER (SPECIFY) _____ 996
DON’T KNOW 998

608) Should a mother wait until she has completely stopped breastfeeding before starting to have sexual relations again?

YES 1
NO 2
DON’T KNOW 8

609) Do you think that your husband/partner approves or disapproves of couples using a method to avoid pregnancy?

APPROVES 1
DISAPPROVES 2
DON’T KNOW 8

610) How often have you talked to your husband/partner about contraception in the past year?

NEVER 1
ONCE OR TWICE 2
THREE TIMES OR MORE 3
IN UNION LESS THAN A YEAR 4

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

APPROVE 1
DISAPPROVE 2 (SKIP TO 613)
DON’T KNOW 8 (SKIP TO 614)

612) Why do you approve?

REST, HEALTH OF MOTHER 1 (SKIP TO 614)
HEALTH OF CHILD 1 (SKIP TO 614)
CHILDREN’S EDUCATION 1 (SKIP TO 614)
ECONOMIC DIFFICULTIES 1 (SKIP TO 614)
OTHER (SPECIFY) _____ 1 (SKIP TO 614)
DON’T KNOW 1 (SKIP TO 614)

613) Why do you disapprove?

CUSTOMS 1
RELIGION 1
SIDE EFFECTS 1
INFANT MORTALITY 1
ECONOMIC ADVANTAGES 1
OTHER (SPECIFY) _____ 1
DON’T KNOW 1

614) INTERVIEWER: CHECK 202 AND 204
NO LIVING CHILDREN: If you could choose exactly the number of children to have in your whole life, how many would that be?

HAS LIVING CHILDREN: If you could go back to the time you did not have any children and choose exactly the number of children to have in your whole life, how many would that be?

BETWEEN __ AND __
UP TO GOD 95
OTHER ANSWER (SPECIFY) _____ 96
DON’T KNOW 98

615) How many boys would you want and how many girls would you want?

NUMBER OF BOYS ____
NUMBER OF GIRLS ____
UP TO GOD 95
OTHER (SPECIFY) ____ 96
DON’T KNOW 98

SECTION 7. HUSBAND’S BACKGROUND AND WOMAN’S WORK

701) INTERVIEWER: CHECK 501

EVER MARRIED OR LIVED WITH A MAN (ASK QUESTIONS ABOUT CURRENT OR MOST RECENT HUSBAND/PARTNER)
ALL OTHERS (SKIP TO 715)

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

YES 1
NO 2 (SKIP TO 706)
DON’T KNOW 8 (SKIP TO 706)

703) What is the highest level of school he attended?

PRIMARY 1
SECONDARY 2
HIGHER 3
DON’T KNOW 8 (SKIP TO 706)

704) What was the highest (grade/form/year) he completed at that level?

LAST GRADE COMPLETED _____
DON’T KNOW 8

705) INTERVIEWER: CHECK 703

PRIMARY
SECONDARY OR HIGHER –(SKIP TO 707)

706) Can (could) he read a letter or newspaper easily, with difficulty, or not at all?

EASILY 1
WITH DIFFICULTY 2
NOT AT ALL 3
DON’T KNOW 88

707) What kind of work does (did) your husband/partner mainly do? (Record the response)

_________

708) INTERVIEWER: VIEW 707

DOES NOT WORK IN AGRICULTURE (GO TO 709)
WORKS IN AGRICULTURE (SKIP TO 710)
HAS NEVER WORKED (SKIP TO 712)

709) Does (did) he receive a regular weekly or monthly salary?

YES 1 (SKIP TO 712)
NO 2 (SKIP TO 712)
DON’T KNOW 8 (SKIP TO 712)

710) Does (did) your husband/partner work mainly on his or family land, or on someone else’s land?

HIS/FAMILY LAND 1 (SKIP TO 712)
SOMEONE ELSE’S LAND 2

711) Did he mainly work to be paid in cash or in kind?

IN CASH 1
IN KIND 2
DON’T KNOW 8

712) Before you married (for the first time) (Before regularly living with your partner) did you yourself ever work regularly to earn money, other than on a farm or in a business run by your family?

YES 1
NO 2 (SKIP TO 714)

713) When you were earning money then, did you turn most of it over to your family or did you keep most of it yourself?

FAMILY 1
SELF 2
EQUAL 3

714) Since you’ve been married (for the first time) (since you started regularly living with a partner), have you ever worked regularly to earn money other than on a farm or in a business run by your family?

YES 1 (SKIP TO 717)
NO 2 (SKIP TO 718)

715) Have you ever worked regularly to earn money, other than on a farm or in a business run by your family?

YES 1
NO 2 (SKIP TO 718)

716) During the time when you have earned money, have you turned most of it over to your family or have you kept most of it for yourself?

FAMILY 1
SELF 2
EQUAL 3

717) Are you now working to earn money other than on a farm or in a business run by your family?

YES 1
NO 2

718) RECORD THE TIME

HOUR ____
MINUTES _____

SECTION 8. WEIGHT AND LENGTH

801) WOMAN’S FIRST AND LAST NAME

802) INTERVIEWER:
SEE TABLE 1
FOR EACH LIVING CHILD, AGE 3 TO 36 MONTHS, RECORD THE ORDER NUMBER, THE BIRTH DATE, THE WEIGHT AND THE LENGTH.

RECORD THE NAMES STARTING WITH THE YOUNGEST CHILD.

ORDER NUMBER
NAME
MONTH OF BIRTH
YEAR OF BIRTH 19
WEIGHT IN KG
LENGTH IN CM
NOT MEASURED (SPECIFY REASON)

INTERVIEWER’S OBSERVATIONS
(TO BE FILLED IN AFTER COMPLETING INTERVIEW)

INTERVIEWER’S OBSERVATIONS

NAME OF INTERVIEWER
DATE

SUPERVISOR’S OBSERVATIONS

SUPERVISOR
DATE

FIELD EDITOR’S AND INPUT AGENT’S OBSERVATIONS
FIELD EDITOR
DATE
INPUT AGENT
DATE