Ministry of Territory Planning and Development
Republic of Cameroon
Peace-Work-Country

Confidential

IDENTIFICATION

PROVINCE__________
DEPARTMENT __________
URBAN DISTRICT/DISTRICT __________
CITY/COUNTY/GROUP __________
VILLAGE __________
NEIGHBORHOOD/TOWN __________
NAME OF HEAD OF HOUSEHOLD __________
WOMAN'S NAME________

PROVINCE ____
NUMBER OF LAYER _______
URBAN DISTRICT/DISTRICT _________
CLUSTER __________
STRUCTURE _________
HOUSEHOLD ________
WOMAN'S LINE NUMBER _________
NUMBER OF COUNTING ZONE ________

INTERVIEWER VISITS:

INTERVIEWER 1
(REPEAT FOR SECOND AND THIRD INTERVIEWERS)
DATE__
DAY__
MONTH__
YEAR__
INTERVIEWER NAME___

RESULTS___

NEXT VISIT [FOR INTERVIEWERS 1 AND 2]
DATE__
TIME__

FINAL VISIT
DAY__
MONTH__
YEAR 19__
INTERVIEWER__

RESULT__

LANGUAGE OF INTERVIEW

INTERPRETER

SUPERVISOR
NAME ___
DATE ___

FIELD EDITOR
NAME ___
DATE ___

OFFICE EDITOR ___

KEYED BY ___

SECTION 1. SOCIO-DEMOGRAPHIC CHARACTERISTICS OF THE RESPONDENT

101) RECORD TIME:

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 Yaounde/Douala or another capital, in another city, or in the countryside?

103) How long has you been living in (name of current place of residence)?

104) Just before you moved here, did you live in Yaounde/Douala or another capital, in another city, or in the countryside?

105) What is your date of birth?

106) How old are you?

COMPARE AND CORRECT 105 AND/OR 106 IF INCONSISTENT

107) Have you ever attended school?

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

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

CODES BASED OFF OF DIFFERENT EDUCATION SYSTEMS

ALL LEVELS

FOR POST-SECONDARY: SEE THE INSTRUCTION MANUAL

PRIMARY
ANGLOPHONE/FRANCOPHONE

SECONDARY
ANGLOPHONE/FRANCOPHONE

110) CHECK 108:

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

112) Do you typically listen to the radio at least once a week?

113) Do you usually listen to radio shows on the advancement of women or on health?
IF YES: Which ones?

RECORD ALL RESPONSES MENTIONED.

114) Do you usually watch television at least once a week?

115) On the television, do you typically watch:

116) What is your religion?

117) What is your nationality?

118) CHECK 4 IN THE HOUSEHOLD QUESTIONNAIRE:

119) Do you usually live in Yaounde/Douala, in another capital, in another city, or in the country?

120) Now I would like to ask you about the household in which you usually live. What is the source of water your household uses to wash the dishes, to wash clothes, and to bathe?

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

IF 90 MINUTES OR LESS, RECORD THE MINUTES. IN OTHER CASES, RECORD IN HOURS.

122) Does your household get drinking water from this same source?

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

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

IF 90 MINUTES OR LESS, RECORD IN MINUTES. IN OTHER CASES, RECORD IN HOURS.

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

126) Does your household have:
Electricity?
A radio?
A television?
A refrigerator?
A gas or electric stove?
A gas ring or hotplate?

127) How many rooms in your household are used for sleeping?

128) How many people sleep in the room that sleeps the most people?

129) Could you describe the main material of the floor in your home?

Is it mainly: Earth? Wood? Cement? Tile?

130) Does any member of your household own:
A bicycle?
A motorcycle?
A car?

SECTION 2. REPRODUCTION

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

202) Do you have any sons or daughters to whom you have given birth who are now living with you?

203) How many sons live with you?
How many daughters live with you?

IF NONE, RECORD '00'.

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

205) How many sons are alive but do not live with you?
How many daughters are alive but do not live with you?

IF NONE, RECORD '00'.

206) Have you ever given birth to a boy or a girl who was born alive but later died?

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

207) How many boys have died? And how many girls have died?

IF NONE, RECORD '00'.

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

209) CHECK 208: Just to make sure that I have this right: you have had in total ____ births during your life. Is that correct?

210) In addition, have you had any pregnancies that did not lead to the birth of a live baby?

211) How many pregnancies have you had that did not lead to the birth of a live baby?

212) CHECK 208:

213) Now I would like to talk to you about all of your births, whether still alive or not, starting with the first one you had.

RECORD IN 214 THE NAMES OF ALL THE BIRTHS. RECORD TWINS AND TRIPLETS ON SEPARATE LINES.

214) What name was given to your (first, next) child?

(214-222 IN TABLE FORMAT, SPACE FOR EACH CHILD)

215) ASK THE RESPONDENT IF ONE OF HER BIRTHS WAS A MULTIPLE AND RECORD THE TYPE OF BIRTH: SINGLE OR MULTIPLE.

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

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

PROBE: What is his/her birthday? OR: In what season was he/she born?

218) Is (NAME) still alive?

219) IF ALIVE: How old was (NAME) at his/her last birthday?

RECORD THE AGE IN COMPLETED YEARS.

220) IF ALIVE: Does (NAME) live with you?

221) IF LESS THAN 15 YEARS OF AGE: With whom does he/she live?
(IF 15 +: GO TO THE NEXT BIRTH)

222) IF DEAD: How old was he/she when he/she died?

IF "1 YEAR," PROBE: How many months old was (NAME)?

RECORD IN:
DAYS IF LESS THAN ONE MONTH
MONTHS IF LESS THAN 2 YEARS
YEARS IF 2 YEARS OR OLDER
IF DECEASED ON DAY OF BIRTH, RECORD '00' DAYS.

223) COMPARE 208 WITH NUMBER OF BIRTHS IN HISTORY ABOVE AND MARK:

224) CHECK 217 AND ENTER THE NUMBER OF BIRTHS SINCE JANUARY 1986.
IF NONE, RECORD '00'.

225) Are you pregnant now?

226) How many months pregnant are you?

227) At the time you became pregnant:
Did you want to become pregnant then?
Did you want to wait until later?
Or did you not want to become pregnant at all?

228) Do you have your period at this time?

229) How many days ago did your period start?

230) When did your last menstrual period start?

TIME IN:

231) At what age did you have your first period?

232) Between the first day of a woman's period and the first day of her next period, are there certain times when she has a greater chance of becoming pregnant than other times?

233) During which times of the monthly cycle does a woman have the greatest chance of becoming pregnant?

SECTION 3. CONTRACEPTION

301) Now I would like to talk about family planning, the various ways or methods that a couple can use to delay or avoid a pregnancy. Which ways or methods have you heard about?

CIRCLE CODE 1 IN 302 FOR EACH METHOD MENTIONED SPONTANEOUSLY.
THEN PROCEED DOWN THE COLUMN READING THE NAME AND THE DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY.

CIRCLE CODE 2 IF THE WOMAN HAS HEARD OF IT AND CODE 3 IF SHE HAS NOT HEARD OF THE METHOD.

THEN, FOR EACH METHOD WITH CODE 1 OR 2 CIRCLED IN 302, ASK 303-305 BEFORE CONTINUING TO THE NEXT METHOD.

302) Which methods of contraception have you heard about?

303) Have you ever used (METHOD)?

304) Do you know where a person could go to get (METHOD)?

305) CHECK 303

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

307) What have you used or done?

CORRECT 303-305 (AND 302 IF NECESSARY)

308) Now I would like to ask you about the first time that you did something or used a method to avoid getting pregnant.

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

IF NONE, RECORD '00'.

309) CHECK 225:

310) CHECK 303:

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

312) Which method are you using?

312A) CIRCLE '06' FOR FEMALE STERILIZATION.

313) The last time you used the periodic abstinence method, how did you determine the days when you had to avoid having sexual relations?

314) At the time you started using the pill for the first time, did you consult a doctor, a midwife, or a nurse?

315) At the time you last got pills, did you consult a doctor, a midwife, or a nurse?

316) May I see the package of pills that you are using now?

(RECORD NAME OF BRAND)

317) Do you know the brand name of the pills you are now using?

(RECORD NAME OF BRAND)

318) How much does one packet of pills cost you?

(RECORD THE PRICE)

318a) How many months do you use this box of pills?

(RECORD NUMBER OF CYCLES)

319) CHECK 312:

IF SHE/HE IS STERILIZED:
Is it easy or difficult to get sterilized?

IF USING ANOTHER METHOD:
Is it easy or difficult to obtain (method)?

320) CHECK 312:

IF SHE/HE IS STERILIZED:
Where did the sterilization take place?/Where did your husband/spouse's sterilization take place?

IF USING ANOTHER METHOD:
Where did you obtain (method) the last time?

321) How long does it take you to travel from your home to (NAME OF LOCATION)?

IF 90 MINUTES OR LESS, RECORD IN MINUTES. IN OTHER CASES, RECORD IN HOURS, OR IN DAYS.

322) Is it easy or difficult to get to (NAME OF LOCATION)?

323) CHECK 312:

324) In what month and what year did you (did he) get sterilized?

325) For how many months have you used (CURRENT METHOD) continuously?

IF LESS THAN ONE MONTH, RECORD '00'.

326) Do you intend to use a method to avoid becoming pregnant in the future?

327) Which method would you prefer to use?

328) When do you plan to start using (PREFERRED METHOD)?

IF 1 MONTH OR MORE, RECORD THE NUMBER OF MONTHS.
IF NOT, CIRCLE THE APPROPRIATE CODE.

329) Why don't you use (PREFERRED METHOD) starting right now?

330) What is that main reason you do not intend to use a method?

331) CHECK 327 FOR THE PREFERRED METHOD

332) Where can you obtain (METHOD LISTED ON 327) most easily?

333) Do you know of a place where one can obtain a method of family planning?

334) Where is that?

335) How long does it take to travel from your home to (NAME OF LOCATION)?

IF 90 MINUTES OR LESS, RECORD MINUTES.
IN OTHER CASES, RECORD IN HOURS, OR IN DAYS.

336) Is it easy or difficult to get to (NAME OF LOCATION)?

337) In the last month, have you heard or read a message about family planning:
On the radio?
On television?
In a newspaper/magazine or on a poster?

338) Are you for or against family planning information being provided on the radio or on television?

SECTION 4.A. PREGNANCY AND BREASTFEEDING

401) CHECK 224:

402) ENTER THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH SINCE JANUARY 1986 ON THE TABLE.

ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH.
(IF THERE ARE MORE THAN THREE BIRTHS, USE ADDITIONAL FORMS)

Now I would like to ask you some more questions about the health of all your children born in the past five years. We'll start with the last birth you had.

CHECK 214 AND 218:

403) At the time you became pregnant with (NAME), did you want to become pregnant then, did you want to wait for later, or did you want no children at all?

404) How much longer would you like to have waited?

405) When you were pregnant with (NAME), did you see anyone for prenatal care for this pregnancy?

If yes, whom did you see? Anyone else?

INSIST ON THE TYPE OF PERSON AND RECORD ALL THE PEOPLE SEEN.

406) Were you given a prenatal card for this pregnancy?

IF YES: Can I see it, please?

407) How many months pregnant were you when you first saw someone for a prenatal check on this pregnancy?

CHECK THE PRENATAL CARD

408) How many prenatal visits did you have during your pregnancy?

CHECK THE PRENATAL CARD

409) When you were pregnant with (NAME) were you given an injection in the arm to prevent the baby from getting tetanus, that is, convulsions after birth?

CHECK THE PRENATAL CARD

410) During your pregnancy how many times did you get this injection?

CHECK THE PRENATAL CARD

411) Where did you give birth to (NAME)?

412) Who assisted with the delivery of (NAME)?

PROBE FOR THE TYPE OF PERSON AND RECORD ALL PERSONS ASSISTING.

413) Was (NAME) born on time or prematurely?

414) How many months pregnant were you when you gave birth?

415) Was (NAME) delivered by caesarian section, meaning did they opened your stomach to take the baby out?

416) Was (NAME) weighed at birth?

417) How much did (NAME) weigh?

418) When (NAME) was born, was he/she:
Larger than average, average, smaller than average, or very small?

FOR MOST RECENT BIRTH ONLY. ALL OTHER BIRTHS GO TO 420:

419) Has your period returned since the birth of (NAME)?

420) Did your period return between the birth of (NAME) and your next pregnancy?

421) For how many months after the birth of (NAME) did you not have your period?

422) CHECK 225: WOMAN PREGNANT?

FOR MOST RECENT BIRTH ONLY. ALL OTHER BIRTHS GO TO 424:

423) Have you resumed sexual relations since the birth of (NAME)?

424) For how many months after the birth of (NAME) did you not have sexual relations?

425) Did you ever breastfeed (NAME), even for a short amount of time?

426) Why did you not breastfeed (NAME)?

NOTE: COMPLETE 427 - 433 FOR MOST RECENT BIRTH ONLY.

427) How long after birth did you first put (NAME) to the breast?

IF LESS THAN 1 HOUR, RECORD '00'.
IF LESS THAN 24 HOURS, RECORD IN HOURS.
IN OTHER CASES, RECORD DAYS.

428) CHECK 218: CHILD ALIVE?

429) Are you still breastfeeding (NAME)?

430) How many times did you breastfeed last night between sunset and sunrise?

(IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER)

431) How many times did you breastfeed yesterday between sunrise and sunset?

(IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER)

432) At any time yesterday or last night was (NAME) given any of the following:

Mineral water?
Water from the house?
Sugar water?
Juice?
Herbal tea?
Baby formula?
Fresh milk?
Tinned or powdered milk?
Other liquids?
Solid or bottled food?

433) CHECK 432: LIQUID OR FOOD GIVEN YESTERDAY OR LAST NIGHT?

434) For how many months did you breastfeed (NAME)?

IF LESS THAN 1 MONTH, MARK '00'.

435) Why did you stop breastfeeding (NAME)?

436) CHECK 218: CHILD ALIVE?

437) Was (NAME) ever given water or anything else to drink or eat other than breast milk?

438) How many months old was (NAME) when you started giving one or several of the following drinks or foods regularly:

Formula or milk other than breast milk?
Water?
Other liquids?
Solid or bottled food?

IF LESS THAN ONE MONTH, MARK '00'.

NOTE: 439-441 FOR MOST RECENT BIRTH ONLY.

439) CHECK 218: CHILD ALIVE?

440) Did (NAME) drink anything from a bottle with a nipple yesterday or last night?

441) According to you, how long should a woman breastfeed her child?

IF LESS THAN 1 MONTH, RECORD '00'.

442) GO BACK TO 403 FOR NEXT BIRTH; OR IF THERE ARE NO MORE BIRTHS, GO TO 443.

SECTION 4.B. IMMUNIZATION AND HEALTH

443) ENTER LINE NUMBER, NAME AND SURVIVAL STATE OF EACH BIRTH SINCE JANUARY 1986 IN THE TABLE.
ASK EACH QUESTION ABOUT ALL OF THE BIRTHS STARTING WITH THE LAST BIRTH.
(IF THERE ARE MORE THAN THREE BIRTHS, USE ADDITIONAL FORMS)

444) Do you have a card where (NAME)'s vaccinations are written down?
IF YES: May I see it please?

445) Did you ever have a vaccination card for (NAME)?

446)
1. COPY VACCINATION DATES FOR EACH VACCINE FROM THE CARD.

2. WRITE '44' IN 'DAY' COLUMN IF CARD SHOWS THAT VACCINATION WAS GIVEN, BUT NO DATE IS RECORDED.

3. IF VACCINE WAS NOT GIVEN, DO NOT MARK ANYTHING.

BCG?
POLIO 1?
POLIO 2?
POLIO 3?
DPT 1?
DPT 2?
DPT 3?
Measles?
Yellow Fever?

447) Has (NAME) received any vaccinations that are not recorded on this card?
IF YES: which vaccine?

RECORD 'YES' ONLY IN RESPONDENT MENTIONED: BCG, POLIO, DPT, MEASLES, AND/OR YELLOW FEVER.

448) Did (NAME) ever receive any vaccination to prevent him/her from getting diseases?

449) Please tell me if (NAME) has received one of the following vaccines:

A vaccination of BCG, that is, an injection in the arm that caused a scar?

Polio vaccine, that is, drops in the mouth?

IF YES: how many times?

A vaccine of DPT (or Dtcoq-polio), meaning a shot in the shoulder?

IF YES: how many times?

An injection against measles?

A vaccine against yellow fever, meaning a shot in the shoulder?

450) CHECK 218: CHILD ALIVE?

451) GO BACK TO 444 FOR THE NEXT BIRTH, OR IF THERE ARE NO MORE BIRTHS, GO TO 479.

452) Has (NAME) been ill with a fever in the last 2 weeks?

453) Has (NAME) been ill with a cough in the last 2 weeks?

454) For how many days (has the cough lasted/did the cough last)?

IF LESS THAN ONE DAY, RECORD '00'.

455) When (NAME) had the illness with a cough, did he/she breath faster than usual, with short, rapid breaths?

456) CHECK 452 AND 453: FEVER OR COUGH?

457) Did you bring (NAME) to the doctor or to see someone when he/she had the fever/cough?

458) Did you seek advice or treatment for the fever/cough?

459) Where did you bring (NAME)?

459A) Where did you get advice or a treatment for (NAME)'s fever/cough?

Anywhere else?

(CIRCLE ALL THAT ARE LISTED)

460) Was anything given to treat the fever/cough?

IF YES: What was it? Anything else?

(CIRCLE ALL THAT ARE LISTED)

461) Has (NAME) had diarrhea in the last two weeks?

462) GO BACK TO 444 FOR THE NEXT CHILD; OR IF THERE ARE NO MORE CHILDREN, GO TO 479.

463) Has (NAME) had diarrhea in the last 24 hours?

464) For how many days (has the diarrhea lasted/did the diarrhea last)?

IF LESS THAN 1 DAY, RECORD '00'.

465) Was there any blood in the stools?

NOTE: 466-468 FOR MOST RECENT BIRTH ONLY.

466) CHECK 425/429: LAST CHILD STILL BREASTFEEDING?

467) During (NAME)'s diarrhea, did you change the frequency of breastfeeding?

468) Did you increase the number of breastfeeds or reduce them, or did you stop completely?

469) (Aside from breast milk) Was he/she given the same amount to drink as before the diarrhea, or more, or less?

470) Did (NAME) get a liquid prepared from a special anti-diarrhea packet?

471) Did (NAME) receive a liquid recommended by the health personnel and prepared at home using sugar, salt, and water for the treatment of diarrhea?

472) CHECK 470 AND 471: CHILD RECEIVED LIQUID FROM PACKET (470) AND/OR RECOMMENDED LIQUID MADE AT HOME (471).

473) For how many days did (NAME) get this liquid?

IF LESS THAN ONE DAY, RECORD '00'.

474) Did he/she receive something for the diarrhea (other than this liquid)?

475) What was given (made) to treat (NAME)'s diarrhea?
Something else?

(CIRCLE EACH THING MENTIONED)

476) Did you seek advice or treatment for the diarrhea?

477) Where did you seek advice or treatment?
Anywhere else?

(CIRCLE ALL THOSE LISTED)

478) GO BACK TO 444 FOR THE NEXT CHILD; OR, IF THERE ARE NO MORE CHILDREN, GO TO 479.

479) CHECK 470:

480) Have you heard of a special product called an ORS packet/UNICEF packet/salt packet for the treatment of diarrhea?

481) Have you ever seen a packet like this before?

(SHOW PACKET)

482) Have you ever prepared a solution with one of these packets to treat diarrhea in yourself or in someone else?

(SHOW PACKET)

483) How much water do you use to prepare the ORS packet/UNICEF packet/salt packet for the treatment of diarrhea?

484) Where can you get an ORS packet/UNICEF packet/salt packet for the treatment of diarrhea?

PROBE: Somewhere else?

(CIRCLE ALL LOCATIONS MENTIONED)

485) CHECK 471:

486) Have you heard of a liquid recommended by health personnel and made at home with salt, sugar, and water for the treatment of diarrhea?

487) Have you prepared at home a liquid recommended by health personnel with salt, sugar, and water for the treatment of diarrhea?

488) Where did you learn to prepare at home the liquid recommended by health personnel with salt, sugar, and water for the treatment of diarrhea?

489) How much water do you use to prepare at home the liquid recommended by health personnel with salt, sugar and water for the treatment of diarrhea?

490) How many sugar cubes do you use to prepare at home the liquid recommended by health personnel for treatment of diarrhea, when you use (QUANTITY OF WATER FROM 489)?

491) How many teaspoons of salt do you use at home to prepare the liquid recommended by health personnel for the treatment of diarrhea, when you use (QUANTITY OF WATER FROM 489 AND NUMBER OF SUGAR CUBES FROM 490)?

SECTION 5. CAUSES OF DEATH

501) CHECK 214, 218, AND 224

502) RECORD LINE NUMBER, NAME, AND THE SURVIVAL STATE OF EACH BIRTH SINCE JANUARY 1986 ON THE TABLE.

ASK THE QUESTIONS ONLY REGARDING THE DEAD CHILDREN. IF MORE THAN 3 BIRTHS SINCE JANUARY 1986, USE A 2ND QUESTIONNAIRE.

ACCORDING TO 214 AND 218:

LAST BIRTH

NEXT TO LAST BIRTH

SECOND TO LAST BIRTH

Now I would like to ask you a few questions about your children who have died among the births you've had over the last five years.

503) Was the death of (NAME) caused by an accident or an illness?

IF THE WOMAN REPLIES "ACCIDENT", INSIST:
Was it an accident or an accident linked to childbirth?

504) What type of accident?

505) What is the illness that caused (NAME)'s death?

RECORD THE NAME OF THE ILLNESS LISTED BY THE RESPONDENT.

506) During the illness that caused (NAME)'s death, did you take him/her somewhere for a consultation?

IF YES: Where did you take him/her?
Anywhere else?

RECORD ALL THE RESPONSES LISTED

507) Where did (NAME) die?

508) During the first days of his/her life, was (NAME) suckling or drinking well?

CHECK 502, RECORD LINE NUMBER AND THE NAME OF THE LAST BIRTH (IF DECEASED), OR THE NEXT TO LAST BIRTH (IF DECEASED), THEN ASK 509 TO 513.

509) During the illness that lead to death, did (NAME) have (SYMPTOM)?

CIRCLE THE APPROPRIATE CODE FOR EACH SYMPTOM, THEN ASK 510-513, OR GO TO THE NEXT SYMPTOM.

510) Was the (SYMPTOM) serious?

511) How much time before his/her death did (SYMPTOM) start?

RECORD THE RESPONSE WITH THE UNIT OF TIME USED BY THE RESPONDENT

512) Did the (SYMPTOM) last until death?

513) How much time before death did the (SYMPTOM) stop?

RECORD THE RESPONSE WITH THE UNIT OF TIME USED BY THE RESPONDENT.

SECTION 6. MARRIAGE

601) Have you ever been married to or lived with a man?

602) Are you now married or currently living with a man, or are you a widow, divorced, or no longer living together?

603) Is your husband or partner living with you now or is he staying elsewhere?

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

605)How many other wives does he have?

606) Are you the first, second, third?wife?

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

608) Counting your current marriage/partnership, how many times have you been married or lived with a man?

609) How old were you when you started living with your (first) husband/partner?

610) In what month and year did you start living with your (first) husband/partner?

COMPARE AND CORRECT 609 AND/OR 610 IF INCOMPATIBLE

611) IF NEVER IN A UNION: Have you ever had sexual intercourse?

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

How many times have you had sexual intercourse in the last four weeks?

613) How many times a month do you usually have sexual relations?

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

615) How old were you the first time you had sexual intercourse?

616) PRESENCE OF OTHERS AT THIS TIME:

SECTION 7. FERTILITY PREFERENCES

701) CHECK 312:

702) CHECK 602:

703) CHECK 225:

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

PREGNANT:
Now I have some questions about the future. After the child you are expecting, would you like to have another child, or would you prefer not to have any more children?

704) CHECK 225:

NOT PREGNANT OR UNSURE:
How long would you like to wait from now before the birth of (a/another) child?

PREGNANT:
How long would you like to wait after the birth of the child you are expecting and the birth of another child?

705) CHECK 218 AND 225:

HAS LIVING CHILD(REN) OR IS PREGNANT

706) CHECK 225:

PREGNANT OR UNSURE:
How old would you like your youngest child to be when your next child is born?

PREGNANT:
How old would you like the child you are expecting to be when your next child is born?

707) Do you regret that (you/your husband) had the operation not to have any (more) children?

708) Why do you regret it?

709) Given your present circumstances, if you had to do it over again, do you think (you/your husband) would make the same decision to have an operation not to have any more children?

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

711) Have you ever spoken to your husband/partner about the methods to avoid becoming pregnant and their usage?

712) How often have you talked to your husband/partner about this subject in the past year?

713) Have you and your husband/partner ever discussed the number of children you would like to have?

714) Do you think your husband/partner wants to have the same number of children that you want, or does he want more or fewer than you want?

715) How long should a couple wait before starting sexual intercourse after the birth of a baby?

716) Should a mother wait until she has completely stopped breastfeeding before starting to have sexual relations, or does it not matter?

717) Do you think that couples should use a method to delay or avoid pregnancy?

718) CHECK 218:

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

NO LIVING CHILD(REN):
If you could choose exactly the number of children to have in your whole life, how many would that be?

RECORD SINGLE NUMBER OR OTHER ANSWER.

719) How many boys and how many girls?

720) According to you, what are the main advantages of having a lot of children?

RECORD THE CODES IN THE ORDER THAT THE RESPONSES ARE GIVEN.
IF THERE IS NO 2ND AND 3RD ADVANTAGE, MARK '00'.

721) According to you, what are the main disadvantages to having a lot of children?

RECORD THE CODES IN THE ORDER THAT THE RESPONSES ARE GIVEN.
IF THERE IS NO 2ND AND 3RD ADVANTAGE, MARK '00'.

722) According to you, starting with how many children, at what point can one consider a woman to have a lot of children?

723) For yourself, do you prefer to have a lot of children or a few children?

SECTION 8. HUSBAND'S BACKGROUND AND WOMAN'S WORK

801) CHECK 601:

802) Did your husband/partner ever attend school?

803) What was the highest level of school he attended: primary, secondary, or higher?

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

805) What kind of work does (did) your (last) husband/partner mainly do?

806) CHECK 805:

807) (Does/did) your husband/partner work mainly on his own land or family land, or (does/did) he rent land or (does/did) he work on someone else's land?

808) What (is/was) your (last) husband/partner's religion?

809) What (is/was) your (last) husband/partner's nationality?

810) As you know, many women work outside of their own housework. Some take up jobs for which they are paid in cash or in kind. Others have a boutique or a small business at home or elsewhere, others farm family fields or work in the family business.

Are you currently doing any of these things or any other work?

811) What kind of work do you do?

812) In your current work, are you an employee, are you self-employed, are you an employer, or do you work for someone in your family?

813) Do you earn cash for this work?

814) Do you do this work at home or away from home?

815) CHECK 217/218/220:

HAS A CHILD BORN SINCE JANUARY 1986 AND LIVING AT HOME?

816) While you are working, do you usually have (name of youngest child at home) with you, sometimes have him/her with you, or never have him/her with you?

817) Who usually takes care of (name of youngest child in house) while you are working?

818) Record the time

SECTION 9. HEIGHT AND WEIGHT

901) CHECK 217, 218:

IN 902-904, RECORD THE LINE NUMBER, NAME, AND BIRTH DATE OF EACH LIVING CHILD BORN SINCE JANUARY 1986, STARTING WITH THE YOUNGEST CHILD. RECORD THE HEIGHT AND WEIGHT ON 906 AND 908. IF THERE WERE MORE THAN THREE BIRTHS SINCE JANUARY STILL ALIVE, USE ADDITIONAL FORMS.

902) LINE NUMBER FROM 214

903) NAME FROM 214

904) DATE OF BIRTH FROM 217, AND ASK FOR DAY OF BIRTH.

905) BCG SCAR ON TOP LEFT OF SHOULDER?

906) HEIGHT (IN CENTIMETERS).

907) WAS THE HEIGHT/LENGTH OF CHILD MEASURED LYING DOWN OR STANDING UP?

908) WEIGHT (IN KILOGRAMS).

909) DATE WEIGHED AND MEASURED.

910) RESULT (WEIGHT AND HEIGHT).

911)

INTERVIEWER'S OBSERVATIONS:

(TO BE FILLED IN AFTER COMPLETING INTERVIEW)

COMMENTS ABOUT RESPONDENT _________
COMMENTS ON SPECIFIC QUESTIONS _________
ANY OTHER COMMENTS _________

SUPERVISOR'S OBSERVATIONS__________
NAME OF THE SUPERVISOR: ______
DATE: ________

EDITOR'S OBSERVATIONS: ____________

NAME OF EDITOR: ______
DATE: ________