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DEMOGRAPHIC AND HEALTH SURVEY-BENIN 2001-MAN'S QUESTIONNAIRE

IDENTIFICATION

DEPARTMENT:

SUB-PREFECTURE/URBAN DISTRICT:

RURAL/URBAN MUNICIPALITY

URBAN 1
RURAL 2

TOWN/NEIGHBORHOOD:

CLUSTER NUMBER:

STRUCTURE NUMBER:

HOUSEHOLD NUMBER:

NAME OF HEAD OF HOUSEHOLD:

NAME AND LINE NUMBER OF MAN:

INTERVIEWER VISITS

FIRST VISIT (REPEAT FOR SECOND AND THIRD VISITS)
DATE___
INTERVIEWER'S NAME___
RESULT____

NEXT VISIT
DATE___
TIME___

FINAL VISIT
DAY____
MONTH___
YEAR 2001
NAME___
RESULT___

RESULT CODES:

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

TOTAL NUMBER OF VISITS____

QUESTIONNAIRE USED:

FRENCH 1

LANGUAGE OF INTERVIEW:

FRENCH 1
ADJA 2
BARIBA 3
FON 4
DENDI 5
DITAMARI 6
YORUBA 7
OTHER 8

INTERPRETER:

YES 1
NO 2

SUPERVISOR
NAME___
DATE___

FIELD EDITOR
NAME____
DATE____

OFFICE EDITOR____

KEYED BY____

SECTION 1. RESPONDENT'S BACKGROUND

INTRODUCTION AND CONSENT

Hello. My name is ____ and I work for the INSAE. We are conducting a national survey on men's, women's and children's health. We would very much appreciate your participation in this survey. I would like to ask you some questions about yourself and your family. This information will help the government to plan health services. The survey usually takes between 20 and 30 minutes. Whatever information you provide will be kept strictly confidential and will not be shared with anyone other than members of our survey team.

We hope that you will participate in the survey as your opinion is important to us.

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

Signature of interviewer:______
Date:______

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

101) RECORD TIME

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 Cotonou, in another city, in a rural location, or abroad?

NAME OF PLACE _______
COTONOU 1
MEDIUM SIZED CITY 2
OTHER CITY 3
RURAL 4
ABROAD 5

103) How long have you been living continuously in (NAME OF CURRENT PLACE OF RESIDENCE)?
RECORD LENGTH OF TIME IN YEARS COMPLETED. IF LESS THAN ONE YEAR, RECORD '00' YEARS.

YEARS ______

ALWAYS 95 (GO TO 105)
VISITOR 96 (GO TO 105)

104) Just before you moved here, did you live in Cotonou, in another city, in a rural location, or abroad?

NAME OF PLACE _______
COTONOU 1
MEDIUM SIZED CITY 2
OTHER CITY 3
RURAL 4
ABROAD 5

105) In what month and year were you born?

MONTH _____
DON'T KNOW MONTH 98
YEAR____
DON'T KNOW YEAR 9998

106) How old were you at your last birthday?
COMPARE AND CORRECT 105 AND/OR 106 IF INCONSISTENT.

AGE IN COMPLETED YEARS _____

107) Have you ever attended school?

YES 1
NO 2 (GO TO 111)

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

PRIMARY 1
SECONDARY 2
HIGHER 3

109) What is the highest (grade/form/year) you completed at this level?
RECORD '00' FOR NO GRADE COMPLETED AND '98' FOR DON'T KNOW.

GRADE ____

109A) CHECK 106:

AGE 24 OR YOUNGER (GO TO 109B)
AGE 25 OR OLDER (GO TO 110)

109B) Are you currently in school?

YES 1 (GO TO 110)
NO 2

109C) What is the main reason why you stopped attending school?

TO CARE FOR YOUNGER CHILDREN 03
FAMILY NEEDED HELP ON FARM OR IN BUSINESS 04
COULD NOT PAY SCHOOL FEES 05
NEEDED TO EARN MONEY 06
HAD ENOUGH SCHOOLING 07
FAILED AT SCHOOL 08
DID NOT LIKE SCHOOL 09
SCHOOL NOT ACCESSIBLE/TOO FAR 10
OTHER (SPECIFY)____ 96
DON'T KNOW 98

110) CHECK 108:

PRIMARY (GO TO 111)
SECONDARY OR HIGHER (GO TO 114)

111) Now I would like you to read this sentence to out loud to me; read as much as you can.
SHOW CARD TO RESPONDENT. IF RESPONDENT CANNOT READ WHOLE SENTENCE, PROBE: Can you read any part of the sentence to me?

CANNOT READ AT ALL 1
ABLE TO READ ONLY PART OF SENTENCE 2
ABLE TO READ WHOLE SENTENCE 3
NO CARD WITH REQUIRED LANGUAGE (SPECIFY LANGUAGE) _____ 4

112) Have you ever participated in a literacy program or any other program that involved learning to read or write (not including primary school)?

YES 1
NO 2

113) CHECK 111:

CODE '2', '3', OR '4' CIRCLED (GO TO 114)
CODE '1' OR '5' CIRCLED (GO TO 115)

114) Do you read a newspaper or magazine almost every day, at least once a week, less than once a week or not at all?

ALMOST EVERY DAY 1
AT LEAST ONCE A WEEK 2
LESS THAN ONCE A WEEK 3
NOT AT ALL 4

115) Do you listen to the radio almost every day, at least once a week, less than once a week or not at all?

ALMOST EVERY DAY 1
AT LEAST ONCE A WEEK 2
LESS THAN ONCE A WEEK 3
NOT AT ALL 4

116) Do you watch television almost every day, at least once a week, less than once a week, or not at all?

ALMOST EVERY DAY 1
AT LEAST ONCE A WEEK 2
LESS THAN ONCE A WEEK 3
NOT AT ALL 4

117) What is your religion?

TRADITIONAL 1
ISLAM 2
CATHOLIC 3
PROTESTANT METHODIST 4
OTHER CHRISTIAN 5
OTHER (SPECIFY)____ 6
NONE 7

118) What is your nationality?

BENINESE 1
OTHER (SPECIFY)______ 2 (GO TO 119A)

118B) What is your ethnicity?

NAME OF ETHNICITY _____
ADJA AND SIMILAR 1
BARIBA AND SIMILAR 2
DENDI AND SIMILAR 3
FON AND SIMILAR 4
YOA AND LOKPA AND SIMILAR 5
BETAMARIBE AND SIMILAR 6
PEULH AND SIMILAR 7
YORUBA AND SIMILAR 8
OTHER (SPECIFY)_________ 96

119A) Do you currently have a job of any kind?

YES 1 (GO TO 119C)
NO 2

119B) Have you had any kind of job in the last 12 months?

YES 1
NO 2 (GO TO 119L)

119C) What is (was) your occupation, that is, what kind of work do (did) you mainly do?

OCCUPATION ______

119D) CHECK 119C:

WORKS IN AGRICULTURE (GO TO 119E)
DOES NOT WORK IN AGRICULTURE (GO TO 119F)

119E) Do you work mainly on your own land or on family land, or do you work on land that you rent from someone else, or do you work on someone else's land?

OWN LAND 1
FAMILY LAND 2
RENTED LAND 3
SOMEONE ELSE'S LAND 4
OTHER (SPECIFY)______ 6 (GO TO 119G)

119F) 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

119G) Do you usually work at home or away from home?

HOME 1
AWAY 2

119H) Do you usually work throughout the year, seasonally, or only once in a while?

THROUGHOUT THE YEAR 1
SEASONALLY/PART OF THE YEAR 2
ONCE IN A WHILE 3

119I) Are you paid or do you earn in cash or in kind for this work or are you not paid at all?

CASH ONLY 1
CASH AND KIND 2
IN KIND ONLY 3 (GO TO 119L)
NOT PAID 4 (GO TO 119L)

119J) Who mainly decides how the money you earn will be used?

RESPONDENT 1
WIFE/PARTNER 2
RESPONDENT AND WIFE/PARTNER JOINTLY 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE JOINTLY 5

119K) On average, how much of your household's expenditures do your earnings pay for: almost none, less than half, about half, more than half, or all?

ALMOST NONE 1
LESS THAN HALF 2
ABOUT HALF 3
MORE THAN HALF 4
ALL 5
NONE, HIS INCOME IS SAVED 6

119L) Who in your household usually has the final say on the following decisions:

Your own health care?
RESPONDENT 1
WIFE/PARTNER 2
RESPONDENT AND WIFE/PARTNER JOINTLY 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE JOINTLY 5
DECISION NOT MADE/NOT APPLICABLE 6
Making large household purchases?
RESPONDENT 1
WIFE/PARTNER 2
RESPONDENT AND WIFE/PARTNER JOINTLY 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE JOINTLY 5
DECISION NOT MADE/NOT APPLICABLE 6
Making household purchases for daily needs?
RESPONDENT 1
WIFE/PARTNER 2
RESPONDENT AND WIFE/PARTNER JOINTLY 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE JOINTLY 5
DECISION NOT MADE/NOT APPLICABLE 6
Visits to family, friends, or relatives?
RESPONDENT 1
WIFE/PARTNER 2
RESPONDENT AND WIFE/PARTNER JOINTLY 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE JOINTLY 5
DECISION NOT MADE/NOT APPLICABLE 6
What food should be cooked every day?
RESPONDENT 1
WIFE/PARTNER 2
RESPONDENT AND WIFE/PARTNER JOINTLY 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE JOINTLY 5
DECISION NOT MADE/NOT APPLICABLE 6

119N) Sometimes a husband is annoyed or angered by things that his wife does. In your opinion, is a husband justified in hitting or beating his wife in the following situations:

If she goes out without telling him?
YES 1
NO 2
DON'T KNOW 8
If she neglects the children?
YES 1
NO 2
DON'T KNOW 8
If she talks about her opinions?
YES 1
NO 2
DON'T KNOW 8
If she refuses to have sex with him?
YES 1
NO 2
DON'T KNOW 8
If she burns the food?
YES 1
NO 2
DON'T KNOW 8

SECTION 2. REPRODUCTION

201) Now I would like to ask about any children you have had during your life. I am interested in all of the children that are biologically yours. Have you fathered any children?

YES 1
NO 2 (GO TO 206)
DON'T KNOW 8 (GO TO 206)

202) Do you have any sons or daughters that you have fathered 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 any sons or daughters who were born alive but later died?
IF NO, PROBE: Any baby who cried or showed signs of life at birth but who only survived a few days or hours?

YES 1
NO 2 (GO TO 208)
DON'T KNOW 8 (GO TO 208)

207) 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 makes sure that I have this right: you have had in TOTAL ____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 210A)
HAS NOT HAD ANY CHILDREN (GO TO 301)

210A) In what year was your youngest child born?

YEAR _____

210B) At the time you were expecting your youngest child, did you want to have a child then, did you want to wait until later, or did you not want to have any (more) children at all?

THEN 1
LATER 2
NOT AT ALL 3

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 AND ASK 302 FOR THIS METHOD. THEN READ THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 1 IF METHOD IS RECOGNIZED, AND ASK 302 FOR THIS METHOD. IF THE METHOD IS NOT MENTIONED SPONTANEOUSLY OR RECOGNIZED AFTER DESCRIPTION, CIRCLE CODE 2 FOR THIS METHOD AND GO TO THE NEXT METHOD.

301) Which ways or methods have you heard about?
FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK:
Have you ever heard of (METHOD)?

01) FEMALE STERILIZATION: Women can have an operation to avoid having any more children.
YES 1
NO 2
02) MALE STERILIZATION: Men can have an operation to avoid having any more children.
YES 1
NO 2
03) PILL: 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) INJECTABLES: Women can have an injection by a heath provider which stops them from becoming pregnant for one or more months.
YES 1
NO 2
06) IMPLANTS: Women can have several small rods placed in their upper arm by a doctor or nurse which can prevent pregnancy for one or more years.
YES 1
NO 2
07) CONDOM: Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
08) FEMALE CONDOM: Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
09) DIAPHRAGM: Women can place a thin flexible disk in their vagina before intercourse.
YES 1
NO 2
10) FOAM/JELLY: Women can place a suppository, jelly, or cream inside themselves before intercourse.
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, to delay the return of her menstrual period.
YES 1
NO 2
12) RHYTHM/PERIODIC ABSTINENCE: Every month that a woman is sexually active she 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
13) WITHDRAWAL: Men can be careful and pull out before climax.
YES 1
NO 2
14) EMERGENCY CONTRACEPTION: Women can take pills up to three days after sexual intercourse to avoid becoming pregnant.
YES 1
NO 2
15) Have you heard of any other ways or methods that women or men can use to avoid pregnancy? LIST UP TO TWO DIFFERENT METHODS.
SPECIFY_____
YES 1
NO 2

302) Have you ever used (METHOD)?

01) FEMALE STERILIZATION: Women can have an operation to avoid having any more children: Have you ever had a partner who had an operation to avoid having any more children?
YES 1
NO 2
02) MALE STERILIZATION: Men can have an operation to avoid having any more children: Have you ever had an operation to avoid having any more children?
YES 1
NO 2
03) PILL: 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) INJECTABLES: Women can have an injection by a heath provider which stops them from becoming pregnant for one or more months.
YES 1
NO 2
06) IMPLANTS: Women can have several small rods placed in their upper arm by a doctor or nurse which can prevent pregnancy for one or more years.
YES 1
NO 2
07) CONDOM: Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
08) FEMALE CONDOM: Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
09) DIAPHRAGM: Women can place a thin flexible disk in their vagina before intercourse.
YES 1
NO 2
10) FOAM/JELLY: Women can place a suppository, jelly, or cream inside themselves before intercourse.
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, to delay the return of her menstrual period.
YES 1
NO 2
12) RHYTHM/PERIODIC ABSTINENCE: Every month that a woman is sexually active she 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
13) WITHDRAWAL: Men can be careful and pull out before climax.
YES 1
NO 2
14) EMERGENCY CONTRACEPTION: Women can take pills up to three days after sexual intercourse to avoid becoming pregnant.
YES 1
NO 2
15) Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1
NO 2

303) CHECK 302:

NOT A SINGLE 'YES' (NEVER USED) (GO TO 304)
AT LEAST ONE 'YES' (EVER USED) (GO TO 307)

304) Have you ever used anything or tried in any way to delay or avoid pregnancy?

YES 1
NO 2 (GO TO 401)

305) What did you do or use?
RECORD ALL METHODS MENTIONED ON THE FOLLOWING LINES.
CORRECT 302 AND 303 (AND 301 IF NECESSARY).

METHODS USED_______

306) CHECK 302 (02):

MAN NOT STERILIZED (GO TO 307)
MAN STERILIZED (GO TO 308A)

307) Are you currently doing something or using any method to delay or avoid pregnancy?

YES 1
NO 2 (GO TO 401)

308) Which method are you using?
308A) CIRCLE 'B' FOR MALE STERILIZATION.

FEMALE STERILIZATION A
MALE STERILIZATION B
PILL C
IUD D
INJECTABLES E
IMPLANTS F
CONDOM G
FEMALE CONDOM H
DIAPHRAGM I
FOAM/JELLY J
LACTATIONAL AMENORRHEA METHOD (LAM) K
RHYTHM METHOD L
WITHDRAWAL M
OTHER (SPECIFY)______ X

SECTION 4. MARRIAGE AND SEXUAL ACTIVITY

401) Are you currently married or living with a woman?

YES, CURRENTLY MARRIED 1 (GO TO 405)
YES, LIVING WITH A WOMAN 2 (GO TO 405)
NO, NOT IN UNION 3

402) Have you ever been married or lived with a woman?

YES, HAS BEEN MARRIED 1
YES, LIVED WITH A WOMAN 2 (GO TO 407)
NO 3 (GO TO 410)

404) What is your marital status now: are you widowed, divorced, or separated?

WIDOWED 1 (GO TO 407)
DIVORCED 2 (GO TO 407)
SEPARATED 3 (GO TO 407)

405) How many spouses/partners do you currently have?

NUMBER OF SPOUSES_____

406) RECORD THE LINE NUMBER FROM THE HOUSEHOLD SHEET FOR EACH OF THESE SPOUSES/PARTNERS.
IF A WOMAN IS NOT LISTED IN THE HOUSEHOLD, RECORD '00'. THE NUMBER OF SPACES FILLED SHOULD BE EQUAL TO THE NUMBER OF SPOUSES/PARTNERS RECORDED IN 405.

LINE NUMBER____

407) Have you been married or lived with a woman only once, or more than once?

ONLY ONCE 1
MORE THAN ONCE 2

408) CHECK 407:

MARRIED/LIVED WITH A WOMAN ONLY ONCE: In what month and year did you start living with your wife/partner?

MARRIED/LIVED WITH A WOMAN MORE THAN ONCE: Now I would like to talk about your first spouse/partner. In what month and year did you start living with her?

IF "FIRST UNION NOT CONSUMMATED", GO BACK TO 401, CIRCLED CODE '3' AND GO TO 410.

MONTH ____
DON'T KNOW MONTH 98
YEAR _____ (GO TO 410)
DON'T KNOW YEAR 9998

409) How old were you when you started living with her?

AGE _____

410) Now I need to ask you some questions about your 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 420)
AGE IN YEARS _____
FIRST TIME WHEN STARTED LIVING WITH FIRST WIFE/PARTNER 95

411) When was the last time you had sexual intercourse?
RECORD IN 'YEARS AGO' ONLY IF THE LAST TIME WAS OVER A YEAR AGO. IF 12 MONTHS OR MORE, ANSWER MUST BE CONVERTED AND RECORDED IN YEARS.

DAYS AGO 1_____
WEEKS AGO 2_____
MONTHS AGO 3_______
YEARS AGO 4 (GO TO 420)

412) The last time you had sexual intercourse, was a condom used?

YES 1
NO 2 (GO TO 413)

412A) What is the main reason you used a condom that time?

RESPONDENT WANTED TO AVOID STDs/AIDS 1
RESPONDENT WANTED TO AVOID PREGNANCY 2
RESPONDENT WANTED TO AVOID BOTH STDs/AIDS AND PREGNANCY 3
DIDN'T TRUST PARTNER/SUSPECTS PARTNER HAS OTHER PARTNERS 4
PARTNER INSISTED 5
OTHER (SPECIFY)_____ 6
DON'T KNOW 7

413) What is your relationship to this woman with whom you had sexual intercourse?
IF 'GIRLFRIEND' OR 'FIANCÉE', ASK: Were you living together when you last had sexual intercourse with her?
IF 'YES', CIRCLE '1'. IF 'NO', CIRCLE '2'.

WIFE/LIVE-IN PARTNER 1 (GO TO 415)
GIRLFRIEND/FIANCÉE 2
ANOTHER FEMALE FRIEND 3
CASUAL ACQUAINTANCE 4
RELATIVE 5
PROSTITUTE 6
OTHER (SPECIFY) _____ 7

414) For how long have you had sexual relations with this woman? Or for how long did you have sexual relations with this woman?

DAYS 1____
WEEKS 2_____
MONTHS 3____
YEAR 4______

415) Have you had sexual intercourse with any other woman in the last 12 months?

YES 1
NO 2 (GO TO 420)

416) The last time you had sexual intercourse with another woman, was a condom used?

YES 1
NO 2 (GO TO 417)

416A) What is the main reason you used a condom that time?

RESPONDENT WANTED TO AVOID STDs/AIDS 1
RESPONDENT WANTED TO AVOID PREGNANCY 2
RESPONDENT WANTED TO AVOID BOTH STDs/AIDS AND PREGNANCY 3
DIDN'T TRUST PARTNER/SUSPECTS PARTNER HAS OTHER PARTNERS 4
PARTNER INSISTED 5
OTHER (SPECIFY)_____ 6
DON'T KNOW 7

417) What is your relationship to this other woman?
IF 'GIRLFRIEND' OR 'FIANCÉE', ASK: Were you living together when you last had sexual intercourse with her?
IF 'YES', CIRCLE '1'. IF 'NO', CIRCLE '2'.

WIFE/LIVE-IN PARTNER 1 (GO TO 418A)
GIRLFRIEND/FIANCÉE 2
ANOTHER FEMALE FRIEND 3
CASUAL ACQUAINTANCE 4
RELATIVE 5
PROSTITUTE 6
OTHER (SPECIFY) _____ 7

418) For how long have you had sexual relations with this woman? Or for how long did you have sexual relations with this woman?

DAYS 1_____
WEEKS 2______
MONTHS 3_____
YEAR 4_______

418A) Apart from these two women, have you had sexual intercourse with any other person in the last 12 months?

YES 1
NO 2 (GO TO 420)

418B) The last time you had sexual intercourse with this other woman, was a condom used?

YES 1
NO 2 (GO TO 418D)

418C) What is the main reason you used a condom this time?

RESPONDENT WANTED TO AVOID STDs/AIDS 1
RESPONDENT WANTED TO AVOID PREGNANCY 2
RESPONDENT WANTED TO AVOID BOTH STDs/AIDS AND PREGNANCY 3
DIDN'T TRUST PARTNER/SUSPECTS PARTNER HAS OTHER PARTNERS 4
PARTNER INSISTED 5
OTHER (SPECIFY)_____ 6
DON'T KNOW 7

418D) What is your relationship to this woman?
IF 'GIRLFRIEND' OR 'FIANCÉE', ASK: Were you living together when you last had sexual intercourse with her?
IF 'YES', CIRCLE '1'. IF 'NO', CIRCLE '2'.

WIFE/LIVE-IN PARTNER 1 (GO TO 419)
GIRLFRIEND/FIANCÉE 2
ANOTHER FEMALE FRIEND 3
CASUAL ACQUAINTANCE 4
RELATIVE 5
PROSTITUTE 6
OTHER (SPECIFY) _____ 7

418E) For how long have you had sexual relations with this woman? Or for how long did you have sexual relations with this woman?

DAYS 1_____
WEEKS 2_____
MONTHS 3_____
YEARS 4_____

419) In total, with how many different women (other than your spouses) have you had sexual intercourse with in the last 12 months?

NUMBER OF PARTNERS_____

420) Do you know of a place where a person can get condoms?

YES 1
NO 2 (GO TO 422)

421) Where is that? Any other place?
IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
RECORD ALL MENTIONED.

NAME OF PLACE______
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
FIELD WORKER D
COMMUNITY CENTER E
OTHER PUBLIC (SPECIFY)_____ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
RELIGIOUS HOSPITAL H
PHARMACY I
ABPF (BENIN FAMILY ADVOCACY ASSOCIATION) J
DOCTOR'S OFFICE K
FIELDWORKER L
OTHER PRIVATE MEDICAL (SPECIFY)_____ M
OTHER SOURCE
SHOP/MARKET N
CHURCH/MOSQUE O
RELATIVES/FRIENDS P
GAS STATION Q
OTHER (SPECIFY)_____ X

422) If you wanted to, could you yourself get a condom?

YES 1
NO 2
DON'T KNOW/UNSURE 8

422A) What are the condom brands you know?

PRUDENCE A
SULTAN B
NO BRAND C
OTHER (SPECIFY) _____ X

422B) CHECK IF YES TO 412 OR 416 OR 418B AND ASK:
What are the brands of condom you have already used?

PRUDENCE A
SULTAN B
OTHER (SPECIFY) ____ X
DON'T KNOW Z

SECTION 5. FERTILITY PREFERENCES

501) CHECK 401:

NOT IN UNION OR FIRST UNION NOT CONSUMMATED (GO TO 501A)
CURRENTLY MARRIED/LIVING WITH A WOMAN (GO TO 501B)

501A) CHECK 411:

LAST SEXUAL RELATIONS LESS THAN 12 MONTHS AGO: CODE '1' OR '2' OR '3' CIRCLED (GO TO 501B)
LAST SEXUAL RELATIONS MORE THAN 12 MONTHS AGO: CODE '4' CIRCLED OR Q.411 NOT ASKED (GO TO 502A)

501B) Is your wife/partner (Are any of your wives/partners) currently pregnant?

YES 1
NO 2 (GO TO 502A)
UNSURE 8 (GO TO 502A)

501C) At the time she became pregnant, did you want her to become pregnant then, did you want to wait until later, or did you not want to have any (more) children at all?

THEN 1 (GO TO 502B)
LATER 2 (GO TO 502B)
NOT AT ALL 3 (GO TO 502B)

502A) SPOUSE/PARTNER NOT PREGNANT OR NOT SURE OR NO SPOUSE/PARTNER: Now I have some question about the future. Would you like to have (a/another) child, or would you prefer not to have any (more) children?

502B) SPOUSE/PARTNER PREGNANT: Now I have some questions about the future. After the child your wife/partner is expecting now, would you like to have another child, or would you prefer not to have any more children?

HAVE (A/ANOTHER) CHILD 1
NO MORE/NONE 2 (GO TO 504)
WIFE/PARTNER CAN'T GET PREGNANT 3 (GO TO 514)
UNDECIDED/DON'T KNOW 4 (GO TO 510)
NOT PREGNANT OR NOT SURE 5 (GO TO 504)

503) CHECK 502:

SPOUSE/PARTNER NOT PREGNANT OR NOT SURE OR NO SPOUSE/PARTNER: How long would you like to wait from now before the birth of (a/another) child?

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

RECORD TIME IN MONTHS IF LESS THAN TWO YEARS

MONTHS 1_____
YEARS 2_____

SOON/NOW 993
SAYS WIFE CAN'T GET PREGNANT 994
AFTER MARRIAGE 995
OTHER (SPECIFY) _____ 996
DON'T KNOW 998

504) CHECK 502:

SPOUSE/PARTNER NOT PREGNANT OR NOT SURE OR NO SPOUSE/PARTNER (GO TO 505)
SPOUSE/PARTNER PREGNANT (GO TO 510)

505) CHECK 307:
CURRENTLY USING A CONTRACEPTIVE METHOD

NOT ASKED (GO TO 506)
NO, NOT CURRENTLY USING (GO TO 506)
YES, CURRENTLY USING (GO TO 508)

506) CHECK 503:

NOT ASKED (GO TO 508)
2 YEARS OR MORE (GO TO 508)
LESS THAN 24 MONTHS (GO TO 510)

508) In the next few weeks, if you discovered that one of your spouses/partners were pregnant, would that be a big problem, a small problem, or no problem at all?

BIG PROBLEM 1
SMALL PROBLEM 2
NO PROBLEM 3
SAYS SHE CAN'T GET PREGNANT/NOT HAVING SEX 4

509) CHECK 307:
CURRENTLY USING CONTRACEPTIVE METHOD

NOT ASKED (GO TO 510)
NO, NOT CURRENTLY USING (GO TO 510)
YES, CURRENTLY USING (GO TO 514)

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

YES 1
NO 2 (GO TO 512)
DON'T KNOW 8 (GO TO 512)

511) Which method would you prefer to use?

FEMALE STERILIZATION 01 (GO TO 514)
MALE STERILIZATION 02 (GO TO 514)
PILL 03 (GO TO 514)
IUD 04 (GO TO 514)
INJECTABLES 05 (GO TO 514)
IMPLANTS 06 (GO TO 514)
CONDOM 07 (GO TO 514)
FEMALE CONDOM 08 (GO TO 514)
DIAPHRAGM 09 (GO TO 514)
FOAM/JELLY 10 (GO TO 514)
LACTATIONAL AMENORRHEA METHOD (LAM) 11 (GO TO 514)
RHYTHM METHOD 12 (GO TO 514)
WITHDRAWAL 13 (GO TO 514)
OTHER (SPECIFY) _____ 96 (GO TO 514)
UNSURE 98 (GO TO 514)

512) What is the main reason that you think you will never use a contraceptive method at any time in the future?

NOT MARRIED 11
FERTILITY-RELATED REASONS
NO SEX/INFREQUENT SEX 22 (GO TO 514)
MENOPAUSAL HYSTERECTOMY 23 (GO TO 514)
SUBFECUND/INFECUND 24 (GO TO 514)
WANTS AS MANY CHILDREN AS POSSIBLE 26 (GO TO 514)
OPPOSITION TO USE
RESPONDENT OPPOSED 31 (GO TO 514)
SPOUSE/PARTNER OPPOSED 32 (GO TO 514)
OTHERS OPPOSED 33 (GO TO 514)
RELIGIOUS PROHIBITION 34 (GO TO 514)
LACK OF KNOWLEDGE
KNOWS NO METHOD 41 (GO TO 514)
KNOWS NO SOURCE 42 (GO TO 514)
METHOD-RELATED REASONS
HEALTH CONCERNS 51 (GO TO 514)
FEAR OF SIDE EFFECTS 52 (GO TO 514)
LACK OF ACCESS/TOO FAR 53 (GO TO 514)
COSTS TOO MUCH 54 (GO TO 514)
INCONVENIENT TO USE 55 (GO TO 514)
INTERFERES WITH BODY'S NORMAL PROCESSES 56 (GO TO 514)
OTHER (SPECIFY) ______ 96 (GO TO 514)
DON'T KNOW 98 (GO TO 514)

513) Would you ever use a contraceptive method if you were married?

YES 1
NO 2
DON'T KNOW 8

514) 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. IF 'NONE', CIRCLE '00' AND GO TO 516.

NONE 00 (GO TO 516)
NUMBER _____
OTHER (SPECIFY) _____ 96 (GO TO 516)

515) 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____
OTHER (SPECIFY)____ 96
NUMBER OF GIRLS____
OTHER (SPECIFY)_____ 96
NUMBER OF EITHER SEX____
OTHER (SPECIFY)____ 96

516) Would you say that you approve or disapprove of couples using a contraceptive method to avoid getting pregnant?

APPROVE 1
DISAPPROVE 2
NO OPINION 8

517) In the last few months have you heard about family planning:

On the radio?
YES 1
NO 2
On the television?
YES 1
NO 2
In a newspaper or magazine?
YES 1
NO 2
On a poster?
YES 1
NO 2
In a leaflet/brochure?
YES 1
NO 2
In cultural/educational cartoons?
YES 1
NO 2
At school?
YES 1
NO 2

518) Do you think it's acceptable or unacceptable to talk about family planning:

On the radio?
ACCEPTABLE 1
UNACCEPTABLE 2
On the television?
ACCEPTABLE 1
UNACCEPTABLE 2
In a newspaper or magazine?
ACCEPTABLE 1
UNACCEPTABLE 2
On a poster?
ACCEPTABLE 1
UNACCEPTABLE 2
In a leaflet/brochure?
ACCEPTABLE 1
UNACCEPTABLE 2
In cultural/educational cartoons?
ACCEPTABLE 1
UNACCEPTABLE 2
At school?
ACCEPTABLE 1
UNACCEPTABLE 2

519) In the last 12 months, have you discussed the practice of family planning with your friends, your neighbors, or your relatives?

YES 1
NO 2 (GO TO 521)

520) With whom? Anyone else?
RECORD ALL MENTIONED.

SPOUSE/PARTNER A
MOTHER B
FATHER C
SISTER(S) D
BROTHER(S) E
COUSIN(S) F
DAUGHTER G
SON H
MOTHER-IN-LAW I
FATHER-IN-LAW G
FRIEND(S)/NEIGHBOR(S) K
OTHER (SPECIFY) ______ X

521) CHECK 401:

YES, CURRENTLY MARRIED (GO TO 522)
YES, CURRENTLY LIVING WITH A WOMAN (GO TO 522)
NO, NOT IN UNION OR FIRST UNION NOT CONSUMMATED (GO TO 528)

522) CHECK 308/308A:

AT LEAST ONE CODE CIRCLED (GO TO 523)
NO CODES CIRCLED (GO TO 524)

523) You've told me that you are currently using contraception. Would you say that using contraception is mainly your decision, mainly your spouse's/live-in partner's decision, or did you both decide together?

MAINLY RESPONDENT 1
MAINLY SPOUSE/PARTNER 2
JOINT DECISION 3
OTHER (SPECIFY) ____ 6

524) Now I want to ask you about your spouse's/live-in partner's views on family planning. Do you think (your spouse(s)/live-in partner(s)) approve(s) or disapprove(s) of couples using a contraceptive method to avoid pregnancy?

APPROVE 1
DISAPPROVE 2
DON'T KNOW 8

525) How often have you talked to your spouse(s)/live-in partner(s) about family planning in the last twelve months?

NEVER 1
ONCE OR TWICE 2
MORE OFTEN 3

526) CHECK 308/308A:

CODE 'B' NOT CIRCLED-HE IS NOT STERILIZED (GO TO 527)
CODE 'B' CIRCLED- HE IS STERILIZED (GO TO 528)

527) Do/Does (your spouse(s)/live-in partner(s)) want the same number of children that you want, or do/does she/they want more or fewer than you want?

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

528) Husbands and wives do not always get along. Do you think it is okay for a woman to refuse to have sexual relations with her husband/partner when:

She is tired or not in the mood?
YES 1
NO 2
DON'T KNOW 8
She recently gave birth?
YES 1
NO 2
DON'T KNOW 8
She knows her husband has sex with women other than his wives?
YES 1
NO 2
DON'T KNOW 8
She knows her husband has a sexually transmitted infection?
YES 1
NO 2
DON'T KNOW 8

SECTION 6. AIDS AND OTHER SEXUALLY TRANSMITTED INFECTIONS

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

YES 1
NO 2 (GO TO 617)

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

YES 1
NO 2 (GO TO 609)
DON'T KNOW 8 (GO TO 609)

603) What can a person do? Anything else?
RECORD ALL MENTIONED.

ABSTAIN FROM SEX A
USE CONDOMS B
LIMIT SEX TO ONE PARTNER/STAY FAITHFUL TO ONE PARTNER C
LIMIT NUMBER OF SEXUAL PARTNERS 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 BLOOD TRANSFUSIONS I
AVOID INJECTIONS J
AVOID SHARING BLADES/RAZORS K
AVOID KISSING L
AVOID MOSQUITO BITES M
SEEK PROTECTION FROM TRADITIONAL PRACTITIONER N
OTHER (SPECIFY) ____ W
OTHER (SPECIFY)____ X
DON'T KNOW Z

604) Can people reduce their chance of getting the AIDS virus by having just one sex partner who has no other sex partners?

YES 1
NO 2
DON'T KNOW 8

605) Can people get the AIDS virus from mosquito bites?

YES 1
NO 2
DON'T KNOW 8

606) Can people reduce their chance of getting the AIDS virus by using a condom every time they have sex?

YES 1
NO 2
DON'T KNOW 8

607) Can people get the AIDS virus by sharing food with a person who has AIDS?

YES 1
NO 2
DON'T KNOW 8

608) Can people reduce their chance of getting the AIDS virus by not having sexual intercourse at all?

YES 1
NO 2
DON'T KNOW 8

609) Is it possible for a healthy-looking person to have the AIDS virus?

YES 1
NO 2
DON'T KNOW 8

610) Do you personally know someone who has the AIDS virus or who died of AIDS?

YES 1
NO 2

611) Can the virus that causes AIDS be transmitted from a mother to a child?

YES 1
NO 2 (GO TO 613)
DON'T KNOW 8 (GO TO 613)

612) Can the virus that causes AIDS be transmitted from a mother to a child:

During pregnancy?
YES 1
NO 2
DON'T KNOW 8
During delivery?
YES 1
NO 2
DON'T KNOW 8
During breastfeeding?
YES 1
NO 2
DON'T KNOW 8

613) CHECK 401:

CURRENTLY MARRIED/LIVING WITH A WOMAN (GO TO 614)
NO, NOT IN UNION OR FIRST UNION NOT CONSUMMATED (GO TO 615A)

614) Have you ever talked with (your spouse(s)/live-in partner(s)) about ways to avoid getting the AIDS virus?

YES 1
NO 2

615A) Do you think it's acceptable or unacceptable to talk about AIDS:

On the radio?
ACCEPTABLE 1
UNACCEPTABLE 2
On the television?
ACCEPTABLE 1
UNACCEPTABLE 2
In a newspaper or magazine?
ACCEPTABLE 1
UNACCEPTABLE 2
On a poster?
ACCEPTABLE 1
UNACCEPTABLE 2
In a leaflet/brochure?
ACCEPTABLE 1
UNACCEPTABLE 2
In cultural/educational cartoons?
ACCEPTABLE 1
UNACCEPTABLE 2
At school?
ACCEPTABLE 1
UNACCEPTABLE 2

615B) If a person learns that he/she is infected with the virus that causes AIDS, should this person be allowed to keep that a secret or should he/she communicate this information to the community?

CAN BE KEPT SECRET 1
COMMUNICATE TO COMMUNITY 2
DON'T KNOW/UNSURE 8

616) If a relative of yours became sick with the virus that causes AIDS, would you be willing to care for her or him in your own household?

YES 1
NO 2
DON'T KNOW/NOT SURE/DEPENDS 8

616A) Should people with the AIDS virus who work with other people in shops, offices, or on farms be allowed to keep their jobs or not?

CONTINUE WORKING 1
NOT CONTINUING WORKING 2
DON'T KNOW/UNSURE/DEPENDS 8

616B) Should children age 12-14 be taught about using a condom to avoid getting AIDS?

YES 1
NO 2
DON'T KNOW/NOT SURE/DEPENDS 8

616C) Have you ever been tested to see if you have the AIDS virus?

YES 1 (GO TO 616FX)
NO 2

616D) Would you like to have a test for the AIDS virus?

YES 1
NO 2
DON'T KNOW/UNSURE 8

616E) Do you know of a place where you can go to have a test for the AIDS virus?

YES 1
NO 2 (GO TO 617)

616F) Where can you go for this test? Anywhere else?
RECORD ALL MENTIONED

616FX) Where did you go for this test?
IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

NAME OF PLACE______
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
MATERNITY D
MOBILE CLINIC E
FIELDWORKER F
OTHER (SPECIFY) ____ G
PRIVATE MEDICAL SECTOR
CLINIC H
PHARMACY I
PRIVATE DOCTOR J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY) _____ L
COMMUNITY SECTOR
HEALTH CENTER M
HEALTH WORKER N
ADBC/MATRON/MIDWIFE/NURSE'S AIDE O
PARA-PUBLIC SECTOR
INPS/CMIE P
MUTEC Q
OTHER SOURCE
SHOP/MARKET S
TRADITIONAL PRACTITIONER T
CHURCH U
RELATIVES/FRIENDS V
OTHER (SPECIFY) ______ X

617) Apart from AIDS, have you heard about (other) infections that can be transmitted through sexual contact?

YES 1
NO 2 (GO TO 620A)

618) If a man has a sexually transmitted disease, what symptoms might he have? Any other signs or symptoms?
RECORD ALL MENTIONED.

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

619) If a woman has a sexually transmitted disease, what symptoms might she have? Any other signs or symptoms?
RECORD ALL SYMPTOMS MENTIONED.

ABDOMINAL PAIN A
GENITAL DISCHARGE B
FOUL SMELLING DISCHARGE C
BURNING PAIN ON URINATION D
REDNESS/INFLAMMATION IN GENITAL AREA E
SWELLING IN GENITAL AREA F
GENITAL SORES/ULCERS G
GENITAL WARTS H
GENITAL ITCHING I
BLOOD IN URINE J
LOSS OF WEIGHT K
HARD TO GET PREGNANT/HAVE A CHILD L
OTHER (SPECIFY) _____ W
OTHER (SPECIFY)_____ X
NO SYMPTOMS Y
DON'T KNOW Z

620A) CHECK 410:

HAS HAD SEXUAL INTERCOURSE (GO TO 620AA)
HAS NOT HAD SEXUAL INTERCOURSE (GO TO 701)

620AA) CHECK 617:

YES, HAS HEARD OF SEXUALLY TRANSMITTED INFECTIONS (GO TO 620B)
NO, HAS NOT HEARD OF SEXUALLY TRANSMITTED INFECTIONS (GO TO 620C)

620B) Now I would like to ask you some questions about your health in the last 12 months. During the last 12 months, have you had a disease which you got through sexual contact?

YES 1
NO 2
DON'T KNOW 8

620C) Sometimes men have abnormal discharge from their penis. Have you had any abnormal discharge from your penis in the last 12 months?

YES 1
NO 2
DON'T KNOW 8

620D) Sometimes men have a sore or ulcer near their penis. During the last 12 months, have you had a sore or ulcer near your penis?

YES 1
NO 2
DON'T KNOW 8

620E) CHECK 620B, 620C, 620D:

HAS HAD AN INFECTION (GO TO 620F)
HAS NOT HAD AN INFECTION (GO TO 701)

620F) The last time you had (INFECTION FROM 620B, 620C, 620D), did you seek any kind of advice or treatment?

YES 1
NO 2 (GO TO 620H)

620G) The last time you had (INFECTION 620B, 620C, 620D), did you do any of the following thing? Did you…

Seek advice from a health worker in a clinic or a hospital?
YES 1
NO 2
Seek advice or treatment from a traditional practitioner?
YES 1
NO 2
Seek advice or purchase drugs from a shop or a pharmacy?
YES 1
NO 2
Seek advice from friends or relatives?
YES 1
NO 2

620H) When you had (INFECTION FROM 620B, 620C, 620D), did you inform the woman/women you were having sexual intercourse with?

YES 1
NO 2
SOME WOMEN/NOT ALL 3

620I) When you had (INFECTION FROM 620B, 620C, 620D), did you do something to avoid infecting your sexual partner(s)?

YES 1
NO 2 (GO TO 701)
PARTNER(S) ALREADY INFECTED 3 (GO TO 701)

620J) What did you do to prevent infection in your partner(s)? Did you…

Stop sexual intercourse?
YES 1
NO 2
Use a condom during sexual intercourse?
YES 1
NO 2
Take drugs?
YES 1
NO 2

SECTION 7. FEMALE GENITAL CUTTING

701) Have you ever heard of female circumcision?

YES 1 (GO TO 703)
NO 2

702) In a number of countries, there is a practice in which a girl may have part of her genitals cut. Have you ever heard of this practice?

YES 1
NO 2 (GO TO 709)

703) What benefits do girls get if they undergo this genital cutting?
PROBE: Any other benefits?
RECORD ALL MENTIONED.

BETTER HYGIENE A
SOCIAL ACCEPTANCE B
BETTER MARRIAGE PROSPECTS C
PRESERVE VIRGINITY/PREVENT PREMARITAL SEX D
MORE SEXUAL PLEASURE FOR HUSBAND E
RELIGIOUS REQUIREMENT F
OTHER (SPECIFY) _____ X
NO BENEFITS Y

704) What benefits do girls get if they do not undergo this genital cutting?
PROBE: Anything else?
RECORD ALL MENTIONED.

FEWER MEDICAL PROBLEMS A
AVOID PAIN B
MORE SEXUAL PLEASURE FOR HER C
MORE SEXUAL PLEASURE FOR THE MAN D
FOLLOWS RELIGION E
OTHER (SPECIFY)_____ X
NO ADVANTAGES Y

705) Would you say that this practice is a way to prevent a girl from having sex before marriage or does it have no effect on premarital sex?

PREVENTS SEX 1
NO EFFECT 2
DON'T KNOW 8

706) Do you believe that this practice is required by your religion?

YES 1
NO 2
DON'T KNOW 8

707) Do you think that this practice should be continued, or should it be discontinued?

CONTINUED 1
DISCONTINUED 2
DEPENDS 3
DON'T KNOW 8

708) Do you think that women want this practice to be continued, or discontinued?

CONTINUED 1
DISCONTINUED 2
DEPENDS 3
DON'T KNOW 8

709) RECORD THE TIME AT THE END OF THE INTERVIEW AND THANK THE RESPONDENT FOR HIS AVAILABILITY.

HOUR _____
MINUTES _____

INTERVIEWER'S OBSERVATIONS

TO BE FILLED IN AFTER COMPLETING INTERVIEW

COMMENTS ABOUT RESPONDENT:__________________

COMMENTS ON SPECIFIC QUESTIONS:_________________________

ANY OTHER COMMENTS:_________________________

FIELD EDITOR'S OBSERVATIONS:___________________________

NAME OF FIELD EDITOR_______
DATE_______

SUPERVISOR'S OBSERVATIONS:__________________________

NAME OF SUPERVISOR______
DATE______