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DEMOGRAPHIC AND HEALTH SURVEY (EDSB-III, 2006)-BENIN 2006-MAN'S QUESTIONNAIRE

IDENTIFICATION

DEPARTMENT

MUNICIPALITY

DISTRICT

TOWN/NEIGHBORHOOD

CLUSTER NUMBER

HOUSEHOLD NUMBER

URBAN/RURAL:

URBAN 1
RURAL 2

NAME OF HEAD OF HOUSEHOLD

NAME AND LINE NUMBER OF MAN

CHECK HOUSEHOLD QUESTIONNAIRE:
ADDITIONAL QUESTIONS ON SEXUAL ACTIVITY (Q.542 AND Q.543 MUST BE ASKED TO THE MEN (1) OR THE WOMEN (2).

WOMEN 2

INTERVIEWER VISITS

FIRST VISIT (REPEAT FOR SECOND AND THIRD VISITS)
DATE______
INTERVIEWER NAME______
RESULT_____

RESULT ____

COMPLETED 1
NO HOUSEHOLD MEMBER AT HOME 2
POSTPONED 3
REFUSED 4
PARTLY COMPLETED 5
INCAPACITATED 6
OTHER (SPECIFY) ________ 7

NEXT VISIT:
DATE_____
TIME____

FINAL VISIT
DAY____
MONTH____
YEAR: 2006
INTERVIEWER NUMBER_____
RESULT___

TOTAL NUMBER OF VISITS _____

LANGUAGE OF QUESTIONNAIRE:

FRENCH 1

LANGUAGE OF INTERVIEW:

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

INTERPRETER USED:

YES 1
NO 2

SUPERVISOR
NAME____
DATE___

FIELD EDITOR
NAME____
DATE____

OFFICE EDITOR____

KEYED BY____

INTRODUCTION AND CONSENT

INFORMED 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.

Participation in this survey is voluntary, and if we should come to any question you don't want to answer, just let me know and I will go on to the next question, or you can stop the interview at any time. We hope that you will participate in this 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)

SECTION 1. RESPONDENT'S BACKGROUND

101) RECORD THE TIME

HOUR____
MINUTES____

102) First, I would like to ask you 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 IN COMPLETED YEARS. 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 1 2
SECONDARY 2 3
HIGHER 4
OTHER 7

109) What is the highest (grade/form/year) you completed at this level?
CODE '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 attending school?

YES 1 (GO TO 110)
NO 2

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

GOT MARRIED 02
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 me.
SHOW CARD TO RESPONDENT. IF RESPONDENT CANNOT READ THE 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
BLIND/VISUALLY IMPAIRED 5

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 (GO TO 113)

112A) In what language was the literacy program in which you participated?
PROBE: Any other?
RECORD ALL MENTIONED

ADJA A
BARIBA B
FON C
DENDI D
DITAMARI E
YORUBA F
OTHER (SPECIFY) ________ X

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 EVERYDAY 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 EVERYDAY 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 EVERYDAY 1
AT LEAST ONCE A WEEK 2
LESS THAN ONCE A WEEK 3
NOT AT ALL 4

117) Do you have a job of any kind, for which you earn money?

YES 1 (GO TO 120)
NO 2

118) Have you had any kind of job in the last 12 months for which you earned money?

YES 1 (GO TO 120)
NO 2

119) What have you done most of the time in the last 12 months?

SCHOOL 1 (GO TO 127)
LOOKED FOR WORK 2 (GO TO 127)
INACTIVE 3 (GO TO 127)
COULDN'T WORK/HANDICAPPED 4 (GO TO 127)
HOUSEWORK/CHILDCARE 5 (GO TO 127)
OTHER (SPECIFY) ________ 6 (GO TO 127)

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

OCCUPATION ________

121) CHECK 120:

WORKS IN AGRICULTURE (GO TO 122)
DOES NOT WORK IN AGRICULTURE (GO TO 123A)

122) 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
NOT APPLICABLE 6

123A) How many months have you worked in the last 12 months?

NUMBER OF MONTHS ________

123B) 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

123C) Do you usually work at home or away from home?

HOME 1
AWAY 2

123D) 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 WHILE 3

124) 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 127)
NOT PAID 4 (GO TO 127)

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

RESPONDENT 1
WIFE/PARTNER 2
RESPONDENT AND WIFE/PARTNER JOINTLY 3
FATHER/MOTHER 4
UNCLE 5
SOMEONE ELSE 6
RESPONDENT AND SOMEONE ELSE JOINTLY 7

126) 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 ALL SAVED 6

127) 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

128) 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 argues with him?
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
If she talks about protecting herself from AIDS?
YES 1
NO 2
DON'T KNOW 8

129) What is your religion?

VODOUN 11
OTHER TRADITIONAL 12
ISLAM 21
CATHOLIC 31
PROTESTANT METHODIST 41
OTHER PROTESTANT 42
CELESTIAL 51
OTHER CHRISTIAN 52
OTHER RELIGION 61
NONE 71

130) What is your nationality?

BENINESE 1
OTHER (SPECIFY) ________ 2 (GO TO 201)

130A) What is your ethnicity?

NAME OF ETHNICITY ________
ADJA AND SIMILAR 11
BARIBA AND SIMILAR 21
DENDI AND SIMILAR 31
FON AND SIMILAR 41
YOA AND LOKPA AND SIMILAR 51
BETAMARIBE AND SIMILAR 61
PEULH AND SIMILAR 71
YORUBA AND SIMILAR 81
OTHER (SPECIFY) ________ 96

SECTION 2. REPRODUCTION

201) Now, I would like to ask about any children you have had during your life. I am only interested in 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 did not survive?

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) (Other than the children you just listed), did you have any:

a) other boys or girls who are still alive, to whom you are the biological father, but who you wouldn't recognize or who don't have your name?

b) other boys or girls who were born alive but later died, to whom you are the biological father, but who you wouldn't have recognized or who don't have your name?

NO IN BOTH CASES (GO TO 209)
YES TO AT LEAST ONE (PROBE AND CORRECT 201-207 AS NECESSARY)

209) SUM ANSWERS TO 203, 205, AND 207 AND ENTER TOTAL.
IF NONE, ENTER '00'.

TOTAL ________

209A) CHECK 209:
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 201-209 AS NECESSARY)

210) CHECK 209:

HAS HAD MORE THAN ONE CHILD (GO TO 210A)
HAS HAD ONLY ONE CHILD (GO TO 213)
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

211) Do all of the children you have fathered have the same biological mother?

YES 1 (GO TO 213)
NO 2

212) In all, with how many women have you fathered children?

NUMBER OF WOMEN ________

213) How old were you when your (first) child was born?

AGE IN YEARS _________

SECTION 3. CONTRACEPTION

Now I would like to talk about family planning, or 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 THE METHOD IS RECOGNIZED. 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 to avoid becoming pregnant.
YES 1
NO 2
04) IUD: Women can have a loop or coil placed inside them by a doctor, a midwife, or a nurse.
YES 1
NO 2
05) INJECTABLES: Women can have an injection by a heath provider that stops them from becoming pregnant for one or more months.
YES 1
NO 2
06) IMPLANTS: Women can have one or more 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 diaphragm in their vagina before sexual intercourse.
YES 1
NO 2
10) SUPPOSITORY/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, and when her menstrual period has not returned, a woman can use a method that requires that she breastfeeds frequently, day and night, without giving him any other food.
YES 1
NO 2
11A) CYCLE BEADS: A method which involves moving beads each day to count from the first day of the menstrual period (red bead).
YES 1
NO 2
12) RHYTHM OR 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)?

02) MALE STERILIZATION: Men can have an operation to avoid having any more children: Have you ever had an operation to avoid having more children?
YES 1
NO 2
07) CONDOM: Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
12) RHYTHM OR 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
DON'T KNOW 8
13) WITHDRAWAL: Men can be careful and pull out before climax.
YES 1
NO 2

303) Now I would like to ask you about a woman's risk of pregnancy. From one menstrual period to the next, are there certain days when a woman is more likely to become pregnant if she has sexual intercourse?

YES 1
NO 2 (GO TO 305)
DON'T KNOW 8 (GO TO 305)

304) Is this time just before her period begins, during her period, right after her period had ended, or halfway between two periods?

JUST BEFORE HER PERIOD BEGINS 1
DURING HER PERIOD 2
RIGHT AFTER HER PERIOD HAS ENDED 3
IN THE MIDDLE OF HER CYCLE 4
OTHER (SPECIFY) __________ 6
DON'T KNOW 8

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

YES 1
NO 2 (GO TO 305)

304B) What did you do or use?
RECORD ALL METHODS MENTIONED ON THE FOLLOWING LINES:

METHODS USED____

304C) CHECK 302 (02):

MAN NOT STERILIZED (GO TO 304D)
MAN STERILIZED (GO TO 304F)

304D) Are you currently doing something or using any method to delay or avoid pregnancy?

YES 1
NO 2 (GO TO 401)

304E) Which method are you using?
304F) CIRCLE 'B' FOR MALE STERILIZATION.
IF MORE THAN ONE METHOD MENTIONED, FOLLOW SKIP INSTRUCTION FOR THE HIGHEST METHOD ON THE LIST.

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
CYCLE BEADS N
OTHER (SPECIFY) ___________ X

305) Do you think that a woman who is breastfeeding her baby can become pregnant?

YES 1
NO 2
DEPENDS 3
DON'T KNOW 8

306) Now I would like to read you some statements about contraception. Please tell me if you agree or disagree with each one.

a) Contraception is a woman's business and a man should not have to worry about it.
AGREE 1
DISAGREE 2
DON'T KNOW 8
b) Women who use contraception may become promiscuous.
AGREE 1
DISAGREE 2
DON'T KNOW 8
c) The woman is the one who gets pregnant, so she is the one who should use contraception.
AGREE 1
DISAGREE 2
DON'T KNOW 8

SECTION 4. MARRIAGE AND SEXUAL ACTIVITY

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

YES, CURRENTLY MARRIED 1
YES, LIVING WITH A WOMAN 2
NO, NOT IN UNION 3 (GO TO 406)

401A) CHECK 401:

CURRENTLY MARRIED (GO TO 402)
LIVING WITH A WOMAN (GO TO 404)

402) Do you currently have one wife, or several?
IF ONE WIFE, RECORD '01'. IF MORE THAN ONE WIFE, ASK: How many wives do you currently have?

NUMBER OF WIVES ________

403) Are there other women with whom you live as if you were married?

YES 1
NO 2 (GO TO 405)

404) Do you only have one more (other) wife/partner, or several, with whom you live as if married?
IF ONLY ONE OTHER SPOUSE/PARTNER, RECORD '01'. IF MORE THAN ONE OTHER SPOUSE/PARTNER, ASK: How many wives/partners do you live with as if married?

TOTAL NUMBER OF WIVES AND LIVE-IN PARTNERS ________

405) Other than the wives/partners that you just mentioned, are there currently any other women with whom you have regular or occasional sexual intercourse?

REGULAR PARTNER(S) ONLY 1 (GO TO 409)
OCCASIONAL PARTNER(S) ONLY 2 (GO TO 409)
REGULAR AND OCCASIONAL PARTNER(S) 3 (GO TO 409)
NO OTHER SEXUAL PARTNER 4 (GO TO 409)

406) Do you currently have a regular or occasional sexual partner, or no sexual partner at all?

REGULAR PARTNER(S) ONLY 1
OCCASIONAL PARTNER(S) ONLY 2
REGULAR AND OCCASIONAL PARTNER(S) 3
NO SEXUAL PARTNER 4

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

YES, FORMERLY MARRIED 1
YES, LIVED WITH WOMAN 2
YES, BOTH 3
NO 4 (GO TO 416)

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

WIDOWED 1 (GO TO 411)
DIVORCED 2 (GO TO 411)
SEPARATED 3 (GO TO 411)

409) BASED ON THE HOUSEHOLD QUESTIONNAIRE, RECORD THE NAME AND LINE NUMBER OF EACH WIFE/PARTNER MENTIONED IN QUESTIONS 402 AND 404 ONLY. IF A WIFE/PARTNER DOESN'T LIVE IN THE HOUSEHOLD, RECORD '00' IN THE SPACE CORRESPONDING TO THAT WIFE/PARTNER. THE NUMBER OF SPACES FILLED OUT SHOULD BE EQUAL TO THE TOTAL NUMBER OF WIVES AND PARTNERS.

410) CHECK 402 AND 404:

SUM OF 402 AND 404 EQUALS 1: Please tell me the name of your wife/partner.

SUM OF 402 AND 404 EQUALS 2 OR MORE: Please tell me the name of each of your current wives and women you are living with as if married. Start with the one who you lived with first.

NAME OF WIFE/PARTNER____
LINE NUMBER FROM HOUSEHOLD QUESTIONNAIRE ________
WIFE 1
PARTNER 2
AGE AT LAST BIRTHDAY ________

410B) CHECK 410:

ONLY ONE WIFE/PARTNER (GO TO 411)
2 OR MORE WIVES/PARTNERS (GO TO 414)

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

ONCE 1
MORE THAN ONCE 2

414) CHECK 410 AND 411:

MARRIED/LIVED WITH 1 WOMAN ONLY ONCE AND 411 = 1: In what month and year did you start living with your wife/partner?

OTHER: Now I would like to talk about the first time that you were married or lived with a woman as if married. In what month and year did you get married or start living with a woman as if married for the first time?

MONTH ________
DON'T KNOW MONTH 98
YEAR ________ (GO TO 416)
DON'T KNOW YEAR 9998

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

AGE ________

416) 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
AGE IN YEARS ________ (GO TO 416B)
FIRST TIME WHEN STARTED LIVING WITH (FIRST) WIFE/PARTNER 95 (GO TO 416B)

416A) Do you intend to wait until you get married to have sexual intercourse for the first time?

YES 1 (GO TO 439)
NO 2 (GO TO 439)
DON'T KNOW/NOT SURE 8 (GO TO 439)

416B) CHECK 108:

AGE 15-24 (GO TO 416C)
AGE 25-64 (GO TO 417)

416C) Was a condom used the first time you had sexual intercourse?

YES 1
NO 2

416D) How old was the person you first had sexual intercourse with?

AGE OF PARTNER ________ (GO TO 417)
DON'T KNOW 98

416E) Was this person older than you, younger than you, or about the same age as you?

OLDER 1
YOUNGER 2 (GO TO 417)
ABOUT THE SAME AGE 3 (GO TO 417)
DON'T KNOW/DON'T REMEMBER 8 (GO TO 417)

416F) Would you say this person was ten or more years older than you or less than ten years older than you?

TEN OR MORE YEARS OLDER 1
LESS THAN TEN YEARS OLDER 2
OLDER, UNSURE HOW MUCH 3

417) When was the last time you had sexual intercourse?
IF TWELVE 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 436A)

418) The last time you had sexual intercourse (with this second/third) person, was a condom used?

YES 1
NO 2 (GO TO 421)

419) 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 8

420) Did you use a condom every time you had sexual intercourse with this person in the last 12 months?

YES 1
NO 2

420A) What was your relationship to this woman with whom you had sexual intercourse?
IF GIRLFRIEND OR FIANCÉE, ASK: Were you living together as if married when you last had sexual intercourse with her?
IF YES, CIRCLE '02'. IF NO, CIRCLE '03'.

WIFE 01
LIVE-IN PARTNER 02
GIRLFRIEND NOT LIVING WITH RESPONDENT 03
CASUAL ACQUAINTANCE 04
PROSTITUTE 05
OTHER (SPECIFY) ________ 96

421) CHECK 302 (02):

RESPONDENT NOT STERILIZED (GO TO 422)
RESPONDENT STERILIZED (GO TO 426)

422) CHECK 419:

CONDOM USED TO AVOID PREGNANCY ('2' OR '3' CIRCLED): The last time you had sexual intercourse with this woman, did you or your partner do something or use a method other than a condom to avoid pregnancy?

OTHER ('1', '4', '5', '6' OR '8') CIRCLED, OR QUESTION NOT ASKED: The last time you had sexual intercourse with this woman, did you or your partner do something or use a method to avoid pregnancy?

YES 1
NO 2 (GO TO 425)
DON'T KNOW 8 (GO TO 426)

423) What method was used?
IF MORE THAN ONE METHOD USED, CIRCLE THE CODE FOR THE HIGHEST METHOD ON THE LIST.

FEMALE STERILIZATION 01 (GO TO 426)
PILL 03 (GO TO 426)
IUD 04 (GO TO 426)
INJECTABLES 05 (GO TO 426)
IMPLANTS 06 (GO TO 426)
FEMALE CONDOM 08 (GO TO 426)
DIAPHRAGM 09 (GO TO 426)
FOAM/JELLY 10 (GO TO 426)
LACTATIONAL AMENORRHEA METHOD (LAM) 11 (GO TO 426)
PERIODIC ABSTINENCE 12 (GO TO 426)
WITHDRAWAL 13 (GO TO 426)
OTHER METHOD 96 (GO TO 426)
DON'T KNOW 98 (GO TO 426)

425) What is the main reason you did not use a contraceptive method to avoid pregnancy?

OCCASIONAL SEXUAL PARTNER/NOT HIS RESPONSIBILITY 11
CONTRACEPTION IS A WOMAN'S BUSINESS 12
NO NEED, A CONDOM WAS USED TO AVOID STDs/AIDS 13
FERTILITY RELATED REASONS
WIFE/PARTNER MENOPAUSAL/HYSTERECTOMY 23
COUPLE SUBFECUND/INFECUND 24
WIFE/PARTNER PREGNANT 25
WIFE/PARTNER POSTPARTUM AMENORRHEIC 26
WIFE/PARTNER BREASTFEEDING 27
WANTS (OTHER) CHILDREN 28
OPPOSITION TO USE
RESPONDENT OPPOSED 31
WIFE/PARTNER OPPOSED 32
OTHERS OPPOSED 33
RELIGIOUS PROHIBITION 34
LACK OF KNOWLEDGE
KNOWS NO METHOD 41
KNOWS NO SOURCE 42
METHOD-RELATED REASONS
HEALTH CONCERNS 51
FEAR OF SIDE EFFECTS 52
LACK OF ACCESS/TOO FAR 53
COSTS TOO MUCH 54
INCONVENIENT TO USE 55
INTERFERES WITH BODY'S NORMAL PROCESSES 56
OTHER (SPECIFY) ________ 96
DON'T KNOW 98

426) The last time you had sexual intercourse with this (second, third) person, did either you or your partner drink alcohol?

YES 1
NO 2 (GO TO 428)

427) Were you or your partner drunk at that time?
IF YES: Who was drunk?

RESPONDENT ONLY 1
PARTNER ONLY 2
RESPONDENT AND PARTNER BOTH 3
NEITHER 4

427A) CHECK 418:

NO (GO TO 428)
YES (GO TO 429)

428) What was your relationship to this person with whom you had sexual intercourse?
IF GIRLFRIEND: Were you living together as if married?
IF YES, CIRCLE '02'. IF NO, CIRCLE '03'.

WIFE 01 (GO TO 434)
LIVE-IN PARTNER 02 (GO TO 434)
GIRLFRIEND NOT LIVING WITH RESPONDENT 03
CASUAL ACQUAINTANCE 04
PROSTITUTE 05
OTHER (SPECIFY) ________ 96

429) For how long (have you had/did you have) sexual relations with this person?
IF ONLY HAD SEXUAL RELATIONS WITH THIS PERSON ONLY ONCE, RECORD '01' DAYS.

DAYS 1___________
WEEKS 2___________
MONTHS 3________
YEARS 4__________

434) Apart from (this person/these two people), have you had sexual intercourse with any other person in the last 12 months?

YES 1 (GO BACK TO 418 IN NEXT COLUMN)
NO 2 (GO TO 436)

435) In total, with how many different people have you had sexual intercourse with in the last 12 months?
IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE. IF NUMBER OF PARTNERS IS GREATER THAN 95, WRITE '95'.

NUMBER OF PARTNERS ________
DON'T KNOW 98

436) CHECK 428 ALL COLUMNS:

NO PARTNERS ARE PROSTITUTES (NO '05' CIRCLED) (GO TO 436A)
AT LEAST ONE PARTNER IS A PROSTITUTE (AT LEAST ONE '05' IS CIRCLED) (GO TO 438)

436A) In the last 12 months, did you pay anyone in exchange for having sexual intercourse?

YES 1
NO 2 (GO TO 438)

436B) The last time you paid someone in exchange for having sexual intercourse, was a condom used?

YES 1
NO 2 (GO TO 438)

436C) Was a condom used during sexual intercourse every time you paid someone in exchange for having sexual intercourse in the last 12 months?

YES 1
NO 2
DON'T KNOW/UNSURE 8

438) In total, with how many different people have you had sex in your lifetime?
IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE. IF NUMBER IS MORE THAN 95, WRITE '95'.

NUMBER OF PARTNERS IN LIFETIME ________
DON'T KNOW 98

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

YES 1
NO 2 (GO TO 441)

440) 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
MATERNITY CENTER D
COMMUNITY PHARMACY E
STRAT AV HEALTH WORKER F
HEALTH WORKER G
OTHER PUBLIC (SPECIFY) ________ I
PRIVATE MEDICAL SECTOR
HOSPITAL/CLINIC/OFFICE J
PHARMACY K
DOCTOR'S OFFICE L
HEALTH AGENT M
OTHER PRIVATE MEDICAL (SPECIFY) ________ N
OTHER SOURCE
SHOP/MARKET O
BAR/SALOON P
SCHOOL Q
RELIGIOUS INSTITUTION R
RELATIVES/FRIENDS S
VENDOR T
OTHER (SPECIFY) ________ X

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

YES 1
NO 2
DON'T KNOW/UNSURE 8

442) CHECK 418 ALL COLUMNS:

AT LEAST ONE 'YES' (GO TO 443)
OTHER (GO TO 501)

443) Where did you get condoms the last time?
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 11
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MATERNITY CENTER 14
COMMUNITY PHARMACY 15
STRAT AV HEALTH WORKER 16
HEALTH WORKER 17
OTHER PUBLIC (SPECIFY) ________ 18
PRIVATE MEDICAL SECTOR
HOSPITAL/CLINIC/OFFICE 21
PHARMACY 22
DOCTOR'S OFFICE 23
HEALTH AGENT 24
OTHER PRIVATE MEDICAL (SPECIFY) ________ 25
OTHER SOURCE
SHOP/MARKET 31
BAR/SALOON 32
SCHOOL 33
RELIGIOUS INSTITUTION 34
RELATIVES/FRIENDS 35
VENDOR 36
OTHER (SPECIFY) ________ 96

444) Do you know the brand name of the condoms that you used last time?

PRUDENCE PLUS 01
SULTAN 02
INNOTEX 03
PROTECTOR 04
GOLD CIRCLE 05
MANIX 06
FEMALE CONDOM 07
NO BRAND/FREE 08
REMEMBERS BOX BUT NOT BRAND 09
DON'T REMEMBER 10
OTHER (SPECIFY) ________ 96
DON'T KNOW 98

445) The last time you bought condoms, how many did you buy?

NUMBER OF CONDOMS ________

DON'T KNOW 98
NEVER BOUGHT CONDOMS 99 (GO TO 501)

446) How much did you pay?

COST ________
DON'T KNOW 9998

SECTION 5. FERTILITY PREFERENCES

501) CHECK 410:

HAS WIFE/PARTNER (GO TO 502)
HAS 2 OR MORE WIVES/PARTNERS (GO TO 502)
NOT ASKED (GO TO 504E)

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

YES 1
NO 2 (GO TO 503)
DON'T KNOW 8 (GO TO 503)

502A) 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
LATER 2
NOT AT ALL 8

503) CHECK 502:

NO WIFE/PARTNER PREGNANT/DON'T KNOW: 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?

YES, WIFE/PARTNER IS 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 505)
WIFE/PARTNER CAN'T GET PREGNANT/STERILIZED 3 (GO TO 505)
UNDECIDED/DON'T KNOW 8 (GO TO 505)

504) CHECK 503:

NO WIFE/PARTNER PREGNANT/DON'T KNOW: How long would you like to wait from now before the birth of (a/another) child?

YES, WIFE/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
AFTER MARRIAGE 995
OTHER (SPECIFY) ________ 996
DON'T KNOW 998

504A) CHECK 503:

NO WIFE/PARTNER PREGNANT/DON'T KNOW (GO TO 504B)
YES, WIFE/PARTNER PREGNANT (GO TO 504E)

504B) CHECK 304D:
CURRENTLY USING A CONTRACEPTIVE METHOD

NOT ASKED (GO TO 504C)
NO, NOT CURRENTLY USING (GO TO 504C)
YES, CURRENTLY USING (GO TO 504D)

504C) CHECK 504:

NOT ASKED (GO TO 504D)
2 YEARS OR MORE (GO TO 504D)
LESS THAN 24 MONTHS (GO TO 504F)

504D) In the next few weeks, if you discovered that one of your spouses/partners was 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

504E) CHECK 304D:
CURRENTLY USING CONTRACEPTIVE METHOD

NOT ASKED (GO TO 504F)
NO, NOT CURRENTLY USING (GO TO 504F)
YES, CURRENTLY USING (GO TO 505)

504F) 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 504H)
DON'T KNOW 8 (GO TO 504H)

504G) Which method would you prefer to use?

FEMALE STERILIZATION 01 (GO TO 505)
MALE STERILIZATION 02 (GO TO 505)
PILL 03 (GO TO 505)
IUD 04 (GO TO 505)
INJECTABLES 05 (GO TO 505)
IMPLANTS 06 (GO TO 505)
CONDOM 07 (GO TO 505)
FEMALE CONDOM 08 (GO TO 505)
DIAPHRAGM 09 (GO TO 505)
FOAM/JELLY 10 (GO TO 505)
LACTATIONAL AMENORRHEA METHOD (LAM) 11 (GO TO 505)
RHYTHM METHOD 12 (GO TO 505)
WITHDRAWAL 13 (GO TO 505)
CYCLE BEADS 14 (GO TO 505)
OTHER (SPECIFY) ________ 96 (GO TO 505)
UNSURE 98 (GO TO 505)

504H) 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 21 (GO TO 505)
INFREQUENT SEX 22 (GO TO 505)
MENOPAUSAL/HYSTERECTOMY 23 (GO TO 505)
SUBFECUND/INFECUND 24 (GO TO 505)
WANTS AS MANY CHILDREN AS POSSIBLE 25 (GO TO 505)
OPPOSITION TO USE
RESPONDENT OPPOSED 31 (GO TO 505)
SPOUSE/PARTNER OPPOSED 32 (GO TO 505)
OTHERS OPPOSED 33 (GO TO 505)
RELIGIOUS PROHIBITION 34 (GO TO 505)
LACK OF KNOWLEDGE
KNOWS NO METHOD 41 (GO TO 505)
KNOWS NO SOURCE 42 (GO TO 505)
METHOD-RELATED REASONS
HEALTH CONCERNS 51 (GO TO 505)
FEAR OF SIDE EFFECTS 52 (GO TO 505)
LACK OF ACCESS/TOO FAR 53 (GO TO 505)
COSTS TOO MUCH 54 (GO TO 505)
INCONVENIENT TO USE 55 (GO TO 505)
INTERFERES WITH BODY'S NORMAL PROCESSES 56 (GO TO 505)
OTHER (SPECIFY) ________ 96 (GO TO 505)
DON'T KNOW 98 (GO TO 505)

504I) Would you ever use a contraceptive method if you were married?

YES 1
NO 2
DON'T KNOW 8

505) 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 NUMERIC RESPONSE.

NONE 00 (GO TO 507)
NUMBER ________
OTHER (SPECIFY) ________ 96 (GO TO 507)

506) 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

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

APPROVE 1
DISAPPROVE 2
DON'T KNOW/UNSURE 8

508) 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 or brochure?
YES 1
NO 2
In cultural/educational cartoons?
YES 1
NO 2
At school?
YES 1
NO 2

508A) 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 or brochure?
ACCEPTABLE 1
UNACCEPTABLE 2
In cultural/educational cartoons?
ACCEPTABLE 1
UNACCEPTABLE 2
At school?
ACCEPTABLE 1
UNACCEPTABLE 2

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

YES 1
NO 2 (GO TO 512)

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

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

512) In the last few months, have you discussed the practice of family planning with a health worker or health care professional?

YES 1
NO 2

512A) CHECK 401:

YES, CURRENTLY MARRIED (GO TO 512B)
YES, CURRENTLY LIVING WITH A WOMAN (GO TO 512B)
NO, NOT IN UNION OR 1ST UNION NOT CONSUMMATED (GO TO 512F)

512B) CHECK 304E/304F:

AT LEAST ONE CODE CIRCLED (GO TO 512C)
NO CODES CIRCLED (GO TO 512F)

512C) 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

512D) Now I want to ask you about your spouse's/live-in partners' views on family planning. Do you think (your spouse(s)/live-in partner(s)) approve or disapprove of couples using a contraceptive method to avoid pregnancy?

APPROVE 1
DISAPPROVE 2
INDIFFERENT 3
DON'T KNOW 8

512E) 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

512F) CHECK 304E/304F:

CODE 'B' NOT CIRCLED, NOT STERILIZED (GO TO 512G)
CODE 'B' CIRCLED, STERILIZED (GO TO 512H)

512G) Do you think (your spouse(s)/live-in partner(s)) want the same number of children that you want, or (does/do) (she/they) want more or fewer than you want?

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

512H) Husbands and wives do not always get along. Do you think it is okay for a woman to refuse to have sexual intercourse 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 that her husband/partner has sexual relations with women other than his spouse(s)?
YES 1
NO 2
DON'T KNOW 8
She knows that her husband/partner 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 635)

601A) How can you get AIDS? Any other way?
RECORD ALL MENTIONED.

SEXUAL INTERCOURSE A
SEXUAL INTERCOURSE WITH SEVERAL PARTNERS B
SEXUAL INTERCOURSE WITH PROSTITUTES C
NOT USING A CONDOM D
SEXUAL INTERCOURSE WITH HOMOSEXUALS E
BLOOD TRANSFUSIONS F
INJECTIONS G
KISSING H
MOSQUITO BITES I
DIRTY OBJECTS J
OTHER (SPECIFY) ________ X

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

YES 1
NO 2
DON'T KNOW 8

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

YES 1
NO 2
DON'T KNOW 8

604) 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

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

YES 1
NO 2
DON'T' KNOW 8

606) 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

607) Can people get the AIDS virus because of witchcraft or other supernatural means?

YES 1
NO 2
DON'T KNOW 8

608) Is there anything (else) a person can do to avoid or reduce his/her risk of getting the virus that causes AIDS?

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

609) 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 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 SYRINGES/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

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

YES 1
NO 2
DON'T KNOW 8

611) 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
By breastfeeding?
YES 1
NO 2
DON'T KNOW 8

612) CHECK 611:

AT LEAST ONE 'YES' (GO TO 613)
OTHER (GO TO 614)

613) Are there any special drugs that a doctor or a nurse can give to a woman infected with the AIDS virus to reduce the risk of transmission to the baby?

YES 1
NO 2
DON'T KNOW 8

614) Are there any special drugs that people infected with the AIDS virus can get from a doctor or a nurse?

YES 1
NO 2
DON'T KNOW 8

614A) CHECK 401:

CURRENTLY MARRIED/LIVING WITH A WOMAN (GO TO 614B)
NO/NOT IN UNION OR 1ST UNION NOT CONSUMMATED (GO TO 614C)

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

YES 1
NO 2

614C) Do you think it's acceptable or unacceptable to talk about AIDS:

On the radio?
ACCEPTABLE 1
NOT ACCEPTABLE 2
On the television?
ACCEPTABLE 1
NOT ACCEPTABLE 2
In a newspaper or magazine?
ACCEPTABLE 1
NOT ACCEPTABLE 2
On a poster?
ACCEPTABLE 1
NOT ACCEPTABLE 2
In a leaflet or brochure?
ACCEPTABLE 1
NOT ACCEPTABLE 2
In cultural/educational cartoons?
ACCEPTABLE 1
NOT ACCEPTABLE 2
At school?
ACCEPTABLE 1
NOT ACCEPTABLE 2

614D) 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

614E) 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 CONTINUE WORKING 2
DON'T KNOW/UNSURE/DEPENDS 3

614F) Would you like to have a test for the AIDS virus?

YES 1
NO 2
DON'T KNOW/UNSURE 8

615) I don't want to know the results, but have you ever been tested to see if you have the AIDS virus?

YES 1
NO 2 (GO TO 620)

616) When was the last time you were tested?

LESS THAN 12 MONTHS AGO 1
12-23 MONTHS AGO 2
2 OR MORE YEARS AGO 3

617) The last time you had the test, did you yourself ask for the test, was if offered to you and you accepted, or was it required?

ASKED FOR TEST 1
OFFERED AND ACCEPTED 2
REQUIRED 3

618) I don't want to know the results, but did you get the results of the test?

YES 1
NO 2

619) Where was the test done?
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 11 (GO TO 622)
GOVERNMENT HEALTH CENTER 12 (GO TO 622)
FAMILY PLANNING CLINIC 13 (GO TO 622)
SCREENING CENTER 14 (GO TO 622)
STRAT AV HEALTH WORKER/MOBILE CLINIC 15 (GO TO 622)
HEALTH WORKER 16 (GO TO 622)
OTHER PUBLIC (SPECIFY) ________ 17 (GO TO 622)
PRIVATE MEDICAL SECTOR
HOSPITAL/CLINIC/OFFICE 21 (GO TO 622)
PHARMACY 22 (GO TO 622)
DOCTOR'S OFFICE 23 (GO TO 622)
HEALTH AGENT 24 (GO TO 622)
OTHER PRIVATE MEDICAL (SPECIFY) 26 (GO TO 622)
OTHER (SPECIFY) ________ 96 (GO TO 622)

620) Do you know of a place where people can go to get tested for the AIDS virus?

YES 1
NO 2 (GO TO 622)

621) 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
SCREENING CENTER D
STRAT AV HEALTH WORKER/MOBILE CLINIC E
HEALTH WORKER F
OTHER PUBLIC (SPECIFY) ________ G
PRIVATE MEDICAL SECTOR
HOSPITAL/CLINIC/OFFICE H
PHARMACY I
DOCTOR'S OFFICE J
HEALTH AGENT K
OTHER PRIVATE MEDICAL (SPECIFY) ________ L
OTHER (SPECIFY) ________ X

622) Would you buy fresh vegetables from a shopkeeper or vendor if you knew that this person had the AIDS virus?

YES 1
NO 2
DON'T KNOW 8

623) If a member of your family got infected with the AIDS virus, would you want it to remain a secret or not?

YES, REMAIN A SECRET 1
NO 2
DON'T KNOW/UNSURE/DEPENDS 8

624) 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/UNSURE/DEPENDS 8

625) In your opinion, if a teacher has the AIDS virus but is not sick, should he/she be allowed to continue teaching in the school?

SHOULD BE ALLOWED 1
SHOULD NOT BE ALLOWED 2
DON'T KNOW/UNSURE/DEPENDS 8

625A) If a health agent has the AIDS virus but is not sick, should he/she be allowed to continue healing the sick?

ALLOWED TO HEAL 1
NOT ALLOWED TO HEAL 2
DON'T KNOW/NOT SURE/DEPENDS 8

626) Do you personally know someone who has been denied health services in the last 12 months because he or she has or is suspected to have the AIDS virus?

YES 1
NO 2
DON'T KNOW ANYONE WITH AIDS 3 (GO TO 631)
DON'T KNOW 8

627) Do you personally know someone who has been denied involvement in social events, religious services, or community events in the last 12 months because he or she has or is suspected to have the AIDS virus?

YES 1
NO 2
DON'T KNOW 8

628) Do you personally know someone who has been verbally abused or teased in the last 12 months because he or she has or is suspected to have the AIDS virus?

YES 1
NO 2
DON'T KNOW 8

629) CHECK 626, 627, AND 628:

NOT A SINGLE 'YES' (GO TO 630)
AT LEAST ONE 'YES' (GO TO 631)

630) Do you personally know someone who has or is suspected to have the AIDS virus?

YES 1
NO 2

631) Do you agree or disagree with the following statement: People with the AIDS virus should be ashamed of themselves.

AGREE 1
DISAGREE 2
DON'T KNOW/NO OPINION 8

632) Do you agree or disagree with the following statement: People with the AIDS virus should be blamed for bringing the disease into the community.

AGREE 1
DISAGREE 2
DON'T KNOW/NO OPINION 8

633) 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

634) Should children age 12-14 be taught to wait until they get married to have sexual intercourse in order to avoid getting AIDS?

YES 1
NO 2
DON'T KNOW/UNSURE/DEPENDS 8

634A) In the last 6 months, how many times have you heard an ad on the radio about AIDS and how to avoid it?
IF NONE, CIRCLE '00'.

NONE 00
TOTAL ________

634B) In the last 6 months, how many times have you seen an ad on TV about AIDS and how to avoid it?
IF NONE, CIRCLE '00'.

NONE 00
TOTAL ________

634C) In the last 6 months, how many times have you seen an ad poster about AIDS and how to avoid it?
IF NONE, CIRCLE '00'.

NONE 00
TOTAL ________

634D) In the last 6 months, how many times have you participated in a discussion about AIDS and how to avoid it?
IF NONE, CIRCLE '00'.

NONE 00
TOTAL ________

635) Do you think that young men should wait until marriage to have sexual intercourse?

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

636) Do you think that young women should wait until marriage to have sexual intercourse?

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

637) Do you think that married men should avoid having sexual intercourse with people other than their spouse(s)?

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

638) Do you think that most of the men you know only have sexual intercourse with their spouse(s)?

YES 1
NO 2
DON'T KNOW/UNSURE/DEPENDS 8

639) Do you think that married women should avoid having sexual intercourse with people other than their spouse(s)?

YES 1
NO 2
DON'T KNOW/UNSURE/DEPENDS 8

640) Do you think that most of the women you know only have sexual intercourse with their spouse(s)?

YES 1
NO 2
DON'T KNOW/UNSURE/DEPENDS 8

641) CHECK 601:

HEARD ABOUT AIDS: Apart from AIDS, have you heard about other infections that can be transmitted through sexual contact?

NOT HEARD ABOUT AIDS: Have you heard about infections that can be transmitted through sexual contact?

YES 1
NO 2 (GO TO 644)

642) If a man has a sexually transmitted disease, what symptoms might he have? Any other 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

643) If a woman has a sexually transmitted disease, what symptoms might she have? Any other 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
HARD TO GET PREGNANT/HAVE A CHILD L
OTHER (SPECIFY) ________ W
OTHER (SPECIFY) ________ X
NO SYMPTOMS Y
DON'T KNOW Z

644) CHECK 416:

HAS HAD SEXUAL INTERCOURSE (GO TO 645)
HAS NOT HAD SEXUAL INTERCOURSE (GO TO 654)

645) CHECK 641:

HAS HEARD OF SEXUALLY TRANSMITTED INFECTIONS (GO TO 646)
HAS NOT HEARD OF SEXUALLY TRANSMITTED INFECTIONS (GO TO 647)

646) 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

647) Sometimes men have an 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

648) 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

649) CHECK 646, 647, AND 648:

HAS HAD AN INFECTION (ANY 'YES') (GO TO 650)
HAS NOT HAD AN INFECTION OR DOES NOT KNOW (GO TO 653A)

650) The last time you had (PROBLEM FROM 646/647/648), did you seek any kind of advice or treatment?

YES 1
NO 2 (GO TO 651B)

651) Where did you go? Any other place?

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
FIELDWORKER D
COMMUNITY CENTER E
HEALTH WORKER F
HEALTH WORKER/COMMUNITY LIAISON G
VENDING MACHINE H
OTHER PUBLIC (SPECIFY) ________ I
PRIVATE MEDICAL SECTOR
HOSPITAL/CLINIC/PRIVATE OFFICE J
RELIGIOUS HOSPITAL K
PHARMACY L
ABPF (BENIN FAMILY ADVOCACY ASSOCIATION) M
DOCTOR'S OFFICE N
HEALTH AGENT (NON-GOVERNMENTAL ORGANIZATION) O
OTHER PRIVATE MEDICAL (SPECIFY) ________ P
OTHER SOURCE
SHOP Q
TRADITIONAL PRACTITIONER R
RELATIVES/FRIENDS/NEIGHBORS S
VENDOR T
OTHER (SPECIFY) ________ X

651A) The last time you had (INFECTION FROM 646/647/648), did you do any of the following things? Did you…

Seek advice from a health worker in a clinic or 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 pharmacy?
YES 1
NO 2
Seek advice from friends or relatives?
YES 1
NO 2

651B) When you had (INFECTION FROM 646/647/648), did you inform the woman/women you were having sexual intercourse with?

YES 1
NO 2
SOME WOMEN/NOT ALL 3

651C) When you had (INFECTION FROM 646/647/648), did you do something to avoid infecting your sexual partner(s)?

YES 1
NO 2 (GO TO 652)
PARTNER(S) ALREADY INFECTED 3 (GO TO 652)

651D) What did you do to avoid infecting your partner(s)? Did you…

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

652) The last time you had (PROBLEM FROM 646/647/648), did your partner seek any kind of advice or treatment?

YES 1
NO 2 (GO TO 653A)
PARTNER NOT INFORMED 3 (GO TO 653A)
DON'T KNOW 8 (GO TO 653A)

653) Where did she go? Any other place?
RECORD ALL MENTIONED.

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
FIELDWORKER D
COMMUNITY CENTER E
HEALTH WORKER F
HEALTH WORKER/COMMUNITY LIAISON G
VENDING MACHINE H
OTHER PUBLIC (SPECIFY) ________ I
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC J
RELIGIOUS HOSPITAL K
PHARMACY L
ABPF (BENIN FAMILY ADVOCACY ASSOCIATION) M
DOCTOR'S OFFICE N
HEALTH AGENT (NON-GOVERNMENTAL ORGANIZATION) O
OTHER PRIVATE MEDICAL (SPECIFY) ________ P
OTHER SOURCE
SHOP Q
TRADITIONAL PRACTITIONER R
RELATIVES/FRIENDS/NEIGHBOR S
VENDOR T
OTHER (SPECIFY) ________ X

653A) Do you know of any organizations that are fighting AIDS in your town?

YES 1
NO 2 (GO TO 654)

653B) Which ones?

NATIONAL COMMITTEE FOR THE FIGHT AGAINST AIDS/DEPARTMENTAL COMMITTEE FIGHTING AGAINST AIDS/COMMUNAL COMMITTEE FIGHTING AGAINST AIDS (CNLS/CDLS/CCLS) A
NATIONAL PROGRAM AGAINST AIDS (PNLS) B
POPULATION AND AIDS CONTROL PROJECT (PPLS) C
AIDS 3 D
BENIN HIV/AIDS PREVENTION PROGRAM (BHAPP) E
ID/RACINES F
WORLD BANK WEST AFRICAN REGIONAL HIV PROJECT (CORRIDOR) G
HEALTH CENTER/HOSPITAL H
POPULATION SERVICES INTERNATIONAL/BENINESE ASSOCIATION FOR HEALTH SOCIAL MARKETING AND COMMUNICATION (PSI/ABMS) I
OTHER (SPECIFY) _________ X

653C) Have you ever solicited at least once of the organizations that are fighting against AIDS?

YES 1
NO 2 (GO TO 654)

653D) The last time you went, which organization did you go to?

NATIONAL COMMITTEE FOR THE FIGHT AGAINST AIDS/DEPARTMENTAL COMMITTEE FIGHTING AGAINST AIDS/COMMUNAL COMMITTEE FIGHTING AGAINST AIDS (CNLS/CDLS/CCLS) 11
NATIONAL PROGRAM AGAINST AIDS (PNLS) 12
POPULATION AND AIDS CONTROL PROJECT (PPLS) 13
AIDS 3 14
BENIN HIV/AIDS PREVENTION PROGRAM (BHAPP) 15
ID/RACINES 16
WORLD BANK WEST AFRICAN REGIONAL HIV PROJECT (CORRIDOR) 17
HEALTH CENTER/HOSPITAL 18
POPULATION SERVICES INTERNATIONAL/BENINESE ASSOCIATION FOR HEALTH SOCIAL MARKETING AND COMMUNICATION (PSI/ABMS) 19
OTHER (SPECIFY) _________ 96

653E) What was your main reason?

STI 1
INFORMATION 2
ADVICE 3
SCREENING 4
OTHER (SPECIFY) ________ 9

654) Some men are circumcised. Are you circumcised?

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 711)

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
DON'T KNOW Z

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 F
OTHER (SPECIFY) ________ X
NO ADVANTAGES Y
DON'T KNOW Z

705) CHECK 703:

CODE 'D' NOT CIRCLED (GO TO 706)
CODE 'D' CIRCLED (GO TO 707)

706) 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

707) CHECK 703 AND 704:

CODE 'F' NOT CIRCLED IN 703 AND 704 (GO TO 708)
CODE 'F' CIRCLED IN 703 OR 704 (GO TO 709)

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

YES 1
NO 2
DON'T KNOW 8

708A) Do you believe that this practice is required by your traditions or your customs?

YES 1
NO 2
DON'T KNOW 8

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

CONTINUED 1
DISCONTINUED 2
DEPENDS 3
DON'T KNOW 8

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

CONTINUED 1
DISCONTINUED 2
DEPENDS 3
DON'T KNOW 8

711) RECORD THE TIME

HOURS____
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____________________
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