GOVERNORATE __________
PSU/SEGMENT NO. _____________
KISM/MARKAZ __________
BUILDING NO. ________________
SHIAKHA/VILLAGE __________
HOUSE NO. ___________

HOUSEHOLD NUMBER ___________

MATERNAL MRT/ANTHROPOMETRY SUBSAMPLE

NAME OF HOUSEHOLD HEAD _______________
ADDRESS IN DETAIL ______________
NAME OF WOMAN__________
LINE NUMBER OF WOMAN_________

GOVERNORATE_______
PSU/SEGMENT NO._______
HOUSEHOLD NO.______
SUBSAMPLE______
LINE NUMBER______

INTERVIEWER VISITS 1
DATE _____
TEAM _____
INTERVIEWER'S NAME _____
RESULT* ______
NEXT VISIT: DATE _____ TIME ________

INTERVIEWER VISITS 2
DATE _____
TEAM _____
INTERVIEWER'S NAME _____
RESULT* ______
NEXT VISIT: DATE _____ TIME ________

INTERVIEWER VISITS 3
DATE _____
TEAM _____
INTERVIEWER'S NAME _____
RESULT* ______
NEXT VISIT: DATE _____ TIME ________

FINAL VISIT
MONTH ____ YEAR ____
TEAM _____
INTERVIEWER'S NAME _____
RESULT* ______
TOTAL NUMBER OF VISITS ___

* RESULT CODES:

FIELD EDITOR
NAME _________
DATE _________
SIGNATURE __________

OFFICE EDITOR
NAME _________
DATE _________
SIGNATURE __________

CODER
NAME _________
DATE _________
SIGNATURE __________

DATA ENTRY OPERATOR
NAME _________
DATE _________
SIGNATURE ____

SECTION 1. RESPONDENT'S BACKGROUND

101. RECORD THE TIME.

102. How old were you at your last birthday?

103. In what month and year were you born? COMPARE AND CORRECT 102 AND/OR 103 IF INCONSISTENT.

104. Are you now married, widowed, or divorced?

105. How many times have you been married?

106. In what month and year did you first enter into a marriage contract?

107. How old were you when you first entered into a marriage contract?

108. In what month and year did your first husband and you begin to live together (consummate your marriage)?

109. How old were you when your first husband and you began to live together (consummate your marriage)?

110. Have you attended school in the past or are you currently attending school?

111. What was the highest level of to which you were admitted at school?
CIRCLE CODE FOR LEVEL.

111A. What was the highest grade which you successfully completed at that level? ENTER GRADE IN BOX.

112. Can you read a newspaper, a magazine or a letter, for example?

113. Can you write a letter, for example?

114. Do you read a newspaper or magazine at least once per week?

115. How many hours on average do you listen to the radio each day? IF LISTENS LESS THAN ONE HOUR, ENTER '00'.

116. How many hours on average do you watch television each day? IF WATCHES LESS THAN ONE HOUR, ENTER '00'.

117. What is your religion?

118. Before you married your (first) husband, did you yourself ever do any work for which you were paid in cash?

119. When you were working then, what did you do with most of the money that you earned?

120. Was the money used mainly to prepare for marriage?

121. Since you were first married, have you ever done any work for cash?

122. Are you now doing any work for cash?

123. What do you do with most of the money that you earn?

124. In this work, do you work on your own, for a family member, or for someone else or some other organization?

125. Do you assist any family member in his/her work?

126. Do you assist someone not in the family in his/her work?

127. What kind of work do you mainly do? WRITE THE RESPONSE EXACTLY AS GIVEN.

128. In this work, are you in contact only with family members, or only with persons not in the family, or with both?

129. How many hours did you work in the past week?

130. CHECK 122:

131. If a good opportunity was available, would you like to work for cash in the future?

132. Would you approve or disapprove of your daughter(s) working if a good opportunity for earning cash was available?

IF ANSWER IS "HAS NO DAUGHTER", PROBE: If you had a daughter, would you approve or disapprove of her working if a good opportunity for earning cash was available?

133. How long have you been living continuously in (NAME OF MOTHER VILLAGE OR CITY IN WHICH INTERVIEW OCCURS)? IF LESS THAN ONE YEAR, ENTER
'00'.

134. Just before you moved here, did you live in a village in a town, in Cairo or in Alexandria?

135. For most of the time until you were 12 years old, did you live in village, in a town, in Cairo or in Alexandria?

SECTION 2. REPRODUCTION

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

202. Do you have any sons or daughters to whom you have given birth and who are now living at home with you?

203. How many sons live with you? And how many daughters live with you? IF NONE, ENTER '00'.

204. Do you have any sons or daughters to whom you have given birth and who are alive but do not live at home with you?

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, ENTER '00'.

206. Have you ever given birth to a boy or a girl who was born alive but later died? IF NO, PROBE: Any (other) boy or girl who cried or showed any sign of life but only survived a few hours or days?

207. How many boys have died? And how many girls have died? IF NONE, ENTER '00'.

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

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

210. CHECK 208:

211. 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 NAMES OF ALL THE BIRTHS IN 213. RECORD TWINS ON SEPARATE LINES AND MARK WITH A BRACKET. IF THERE ARE MORE THAN SEVEN BIRTHS CONTINUE RECORDING THE NAMES ON THE NEXT PAGE. THEN ASK 214 THROUGH 219 AS APPROPRIATE FOR EACH BIRTH. AFTER RECORDING THE ANSWERS TO QUESTIONS 214-219 FOR ALL THE BIRTHS THE WOMAN HAS HAD, GO TO 220.

212. LINE NO. (01-14)

213. What name was given to your (first/next) baby?

214. Is (NAME) a boy or a girl?

215. In what month and year was (NAME) born?
PROBE: What is his/her birthday? OR: In what season?

216. Is (NAME) still alive?

217. IF DEAD: How old was (NAME) when he/she died? RECORD DAYS IF LESS THAN ONE MONTH, MONTHS IF LESS THAN TWO YEARS, OR YEARS.

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

219. IF ALIVE: Is he/she living with you?

220. COMPARE 208 WITH NUMBER OF BIRTHS IN HISTORY ABOVE AND MARK:
NUMBERS ARE DIFFERENT: ____ (PROBE AND RECONCILE)
NUMBERS ARE SAME ____

CHECK:
FOR EACH LIVE BIRTH: YEAR OF BIRTH IS RECORDED ___
FOR EACH LIVE CHILD: CURRENT AGE IS RECORDED ___
FOR EACH DEAD CHILD: AGE AT DEATH IS RECORDED ___

221. In addition to the pregnancies which ended in live births, have you had any other pregnancy which ended in a miscarriage, still birth or an abortion?
PROBE: Any pregnancy which lasted only a few weeks or months?

222. Have you had any pregnancy which ended in a miscarriage, still birth or abortion? PROBE: Any other pregnancy which lasted only a few weeks or months?

223. How many pregnancies ended in still births? IF NONE, ENTER '00'.

224. How many pregnancies ended in miscarriages and abortions? IF NONE, ENTER '00'.

225. SUM 223 AND 224 AND ENTER TOTAL BELOW:
Just to be sure that I have this right you had TOTAL _____ pregnancies which ended in miscarriages, still births or abortions. Is that correct?

226. Are you pregnant now?

227. For how many months have you been pregnant?

228. Did you see anyone for a check on this pregnancy?

229. Whom did you see? PROBE FOR TYPE OF PERSON AND RECORD MOST QUALIFIED.

230. Was it a routine (regular) checkup or did you only go because there was some medical problem?

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

232. How long ago did your last menstrual period start?

233. At what age did you have your first menstrual period?

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

SECTION 3. CONTRACEPTION

301. Now I would like to talk about a different topic. There are various ways or methods that a couple can use to delay or avoid a pregnancy. Which of these 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 DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 2 IF METHOD IS RECOGNIZED, AND CODE 3 IF IT IS NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE 1 OR 2 CIRCLED IN 302, ASK 303-305 BEFORE GOING ON TO THE NEXT METHOD.

302. Have you ever heard of (METHOD)? READ DESCRIPTION.

(ASK 303-305 FOR EACH METHOD FOR WHICH A 1 OR 2 IS CIRCLED IN 302)

303. Have you ever used (METHOD)?

304. Where would you go to obtain (METHOD) if you wanted to use it? (WRITE THE RESPONSE AS GIVEN AND THEN ENTER THE CODE FROM BELOW)

CODES FOR 304

305 In your opinion, what is the main problem, if any, with using (METHOD)? (WRITE THE RESPONSE AS GIVEN AND THEN ENTER THE CODE FROM BELOW)

CODES FOR 305

306. CHECK 303:

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

308. What have you used or done? (SPECIFY) _______

CHECK AND CORRECT 302-303 AND OBTAIN INFORMATION FOR 304 TO 306 AS NECESSARY.

309. How many living children, if any, did you have when you first did something or used a method to avoid getting pregnant? IF NONE, CIRCLE CODE '00'.

310. How many living sons did you have? How many living daughters did you have? IF NONE, ENTER '00'.

311. When you first began to use family planning, did you want to have another child but at a later time or did you want no more children at all?

312. Did you talk about family planning with your husband before first using it?

313. Would you say that the use of family planning for the first time was mainly your idea, mainly your husband's idea, or a joint idea?

314. Before you decided to use family planning for the first time, did you talk about whether you should use family planning with any of the following persons:

315. What was the first family planning method that you and your husband ever used?

316. Who obtained the first cycle of pills that you and your husband ever used?

317. Where did you (or your husband) obtain (FIRST METHOD USED) the first time that you ever used it?

318. Did you talk with your husband about which particular method to use before you began using (FIRST METHOD USED)?

319. Would you say that the choice to use (FIRST METHOD USED) the first time was mainly your choice, mainly your husband's choice or a joint choice?

320. Before you decided to adopt (FIRST METHOD USED) for the first time, did you seek advice about which particular method to use from any of the following persons:

321. CHECK 104:

322. CHECK 226:

323. Are you currently doing something or using any method to avoid getting pregnant?

324. Which method are you using?

325. CHECK 315:

326. Now I would like to ask some questions about the first time you ever used the pill. Who obtained the first cycle of pills that you used then--you or your husband?

327. Where did you (or your husband) obtain the pill the first time you ever used it?

328. Now I would like to ask some questions about the brand of pill that you are using now. Please show me the cycle (packet) of pills that you actually are using now. RECORD NAME OF BRAND EXACTLY AS SHOWN ON CYCLE (PACKET).

329. COUNT AND RECORD THE TOTAL NUNBER OF PILLS IN THE ENTIRE CYCLE (PACKET) REGARDLESS OF THE PILLS ALREADY TAKEN.

330. OBSERVE SEQUENCE IN WHICH PILLS TAKEN FROM CYCLE (PACKET) AND CIRCLE CORRECT CODE.

331. Why haven't you been taking the pills (in sequence)?

332. Why don't you have a cycle (packet) of pills available?

333. At of any time in the past month, have you experienced any the following (READ EACH PROBLEM):

334. At any time in the past month, did you fail to take a pill for even one day because of the problems that you mentioned or for any other reason?
IF YES: What was the main reason you stopped taking the pill?

335. How many days ago did you take the last pill? IF RESPONSE IS TODAY, ENTER '00' DAYS AGO.

336. CHECK 335:

337. Why haven't you taken the pills in the last few days?

338. After you finished your last pill cycle (packet), when did (will) you start the next cycle (packet)?
WRITE RESPONSE EXACTLY AS GIVEN BELOW AND THEN CIRCLE THE APPROPRIATE CODE.

339. Just about everyone misses taking the pill sometime. What do you do when you forget to take one pill?

340. During the past twelve months whenever you obtained the pill, have you always gotten the same brand or have you sometimes obtained another brand?

341. How many cycles (packets) of the pill do you usually get when you obtain the pill?

342. How much does one cycle of pills usually cost you?

343. Would you buy a cycle of pills if it cost:
(IF YES, CONTINUE WITH NEXT AMOUNT. IF NO, GO TO 351 FOR AMOUNT 'MORE THAN 2 POUNDS', GO TO 351 IF YES OR NO).

344. How can a woman know that the IUD is correctly placed without making a special trip to the clinic/doctor?

345. Where was the IUD which you are using now inserted?

346. Now I would like to get some information on what you thought about the service you received at (PLACE WHERE IUD WAS INSERTED).

347. How much did it cost to have the IUD inserted? RECORD RESPONSE IN POUNDS, ROUNDING DOWN TO THE NEAREST POUND.

348. Did you get the IUD at the place where you had it inserted or did you get it somewhere else?

349. Where did you get the IUD from?

350. How much did it cost to get the IUD at (PLACE WHERE IUD WAS BOUGHT)?
RECORD RESPONSE IN POUNDS, ROUNDING DOWN TO THE NEAREST POUND.

351. Now 1 would like to ask some questions about the last cycle (packet) of the pill which you bought. Who obtained the pill the last time?

352. Where did you (or your husband) obtain (CURRENT METHOD) the last time?

353. Now I would like to get some information on what you thought about the service you received at (PLACE WHERE CURRENT METHOD WAS OBTAINED).

SECTION 4. CONTRACEPTIVE USE HISTORY

401. CHECK 226:

402. CHECK 306:

403. CHECK 323 AND 324:

404. Now I would like to ask you some questions about the length of time that you have been using your (CURRENT METHOD) without interruption.
In what month and year did you begin the most recent period of continuous use of (CURRENT METHOD)?

405. How long have you been using (CURRENT METHOD) (this time) without interruption?

406. Have you experienced any problems from using (CURRENT METHOD)?

407. What is the main problem you experienced?

408. Since your last birth (you married), have you used any other method or done anything else before (CURRENT METHOD) to avoid getting pregnant?

409. Which was the last method you used (BEFORE CURRENT METHOD)?

410. In what month and year did you start using (METHOD BEFORE CURRENT) (the last time)?

411. How long after your last birth (you married) did you start using (METHOD BEFORE CURRENT) (the last time)?

412. For how long had you been using (METHOD BEFORE CURRENT) before you stopped using it (the last time)?

413. What was the main reason you stopped using (METHOD BEFORE CURRENT) then?

414. CHECK 208: ANY BIRTHS?

415. Now I would like to ask questions about the last time that you used a family planning method. Since your last birth have you done anything or used any method to avoid getting pregnant?

416. Which was the last family planning method that you used?

417. In what month and year did you start using (METHOD) (last time)?

418. How long after your last birth did you start using (METHOD) (the last time)?

419. For how long had you been using (METHOD) before you stopped using it (last time)?

420. What was the main reason you stopped using (METHOD) then?

421. CHECK 215:

422. FILL IN INFORMATION IN 423 TO 425. THEN USING THE INFORMATION ENTERED IN 423 AND 424 COMPLETE THE TABLE ON THE TOP OF THE NEXT PAGE. ASK 426-434 AS APPROPRIATE FOR THE INTERVAL BEFORE A CURRENT PREGNANCY (IF THE RESPONDENT IS PREGNANT) EACH BIRTH INTERVAL (PERIOD BETWEEN SUCCESSIVE BIRTHS).

423. CHECK 226 FOR PREGNANCY STATUS.

CURRENTLY PREGNANT

424. CHECK 215 FOR BIRTHS OCCURRING SINCE JANUARY 1983. IF THE WOMAN HAD ONE OR MORE BIRTHS SINCE JANUARY 1983, CHECK 212, 213 AND 216.
BEGINNING WITH THE LAST BIRTH, RECORD THE LINE NUMBER, NAME AND STATUS OF ALL BIRTHS AT THE TOP OF THE APPROPRIATE COLUMNS BELOW. RECORD THE NAMES OF TWINS IN THE SAME COLUMN AND TREAT AS ONE BIRTH.

425. CHECK 306:

426. Now I would like some more information to get about your use of family planning during the last five years.

FOR INTERVAL BEFORE A CURRENT PREGNANCY, ASK:
Before you became pregnant (but after you had NAME OF LAST BIRTH), did you do anything or use any method, even for a short time, to avoid getting pregnant?

FOR EACH BIRTH INTERVAL ASK:
In the interval before you gave birth to NAME (but after you had NAME OF PRECEDING BIRTH), did you do anything, or use any method, even for a short time, to avoid getting pregnant?

CURRENTLY PREGNANT

BIRTHS

427. What was the last method you used then?

THE HEADINGS AT THE TOP OF THE TABLE BELOW SHOULD BE THE SAME AS THOSE IN THE TABLE ON THE PRECEDING PAGE. WHEN RECORDING RESPONSES, BE SURE THAT YOU ENTER THE ANSWERS IN THE CORRECT COLUMN.

LINE NUMBER FROM 212

CURRENTLY PREGNANT

BIRTHS

428. In what month and year did you start using (METHOD) then?

429. How long after the birth (NAME OF PRECEDING BIRTH) did you begin to use (METHOD) then?

430. For how long had you been using (METHOD) MONTHS before you stopped using it then?

431. Did you become pregnant while you were still using (LAST METHOD)?

432. What was the main reason you stopped using (LAST METHOD)?

433. At the time you became pregnant (with NAME), did you want to have that child then, did you want to wait until later, or did you want no (more) children at all?

434. Did you want to have that child but at a later time, or not have another child at all?

CURRENTLY PREGNANT

SECTION 5: FAMILY PLANNING AND CHILDBEARING ATTITUDES

501. CHECK 104:

502. CHECK 226:

503. CHECK 323 AND 324:

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

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

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

507. Which method would you prefer to use?

508. When do you plan to begin using (METHOD)?

509. How many additional children would you like to have before using (METHOD)? IF NONE, WRITE '00'.

510. Have you ever talked about family planning with your husband?

511. How often have you talked with your husband about family planning in the last twelve months?

512. In your opinion, in general, does your husband approve or disapprove of couples using a method to avoid pregnancy?

513. In general, do you approve or disapprove of a couple using a method to avoid pregnancy?

514. In your opinion, how many children should a woman have before her husband and she begin to use family planning?

515. If a couple has had the number of children that they want, do you think that it is acceptable for the woman to have an operation to prevent her from becoming pregnant again if her husband agrees?

516. In the last month, have you heard a show or message about family planning on the radio?

517. How many times did you hear a family planning show or message on the radio during the past month?

518. In the last month, have you seen a show or message about family planning on the television?

519. How many times did you see a family planning show or message on television during the past month?

520. What was the last show or message about family planning which you saw on television?

521. What did you particularly like about this show or message?

522. What did you particularly dislike about this show or message?

523. Do you agree with all of the information which got from the show or message? IF NO: With what don't you agree?

524. On what (other) topics related to family planning would you like more information to be provided?

525. CHECK 104:

526. CHECK 226:

527. Now I have some questions about the future. Would you like to have a (another) child or would you prefer not to have any (more) children?

528. After the child you are expecting, would you like to have another child or would you prefer not to have any (more) children?

529. Would you say that you definitely do not want to have (more) children, or are you not sure?

530. Are you more inclined toward having a (another) child or toward not having a (another) child?

531. Would you say that you definitely want a (another) child, or are you not sure?

532. How long would you like to wait from now before the birth of a (another) child?

533. CHECK 226:

534. In your opinion, would your husband like to have a (another) child or would he prefer not to have any (more) children?

535. In your opinion, in addition to the child you are expecting, would your husband like to have a (another) child or would he prefer not to have any (more) children?

536. CHECK 202 AND 204:

537. If you could choose exactly the number of children to have in your whole life, how many would that be?

538. 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?

539. How many boys would that be? And how many girls would that be? IF NONE, ENTER '00'.

540. CHECK 104:

541. Have you ever talked to your husband about the exact number of children that he would have liked?

542. If your husband could choose exactly the number of children to have in his life (without regard to the number of children that you may already have), how many do you think that would be?

543. How many boys would that be? And how many girls would that be? IF NONE, ENTER '00'.

544. In your opinion, how many children should your daughter have (regardless of the number that she may already have)?
IF RESPONSE IS 'HAS NO DAUGHTER', ASK: If you were to have a daughter, in your opinion, how many children should she have?

545. How many boys? And how many girls? IF NONE, ENTER '00'.

546. In your opinion, what is the most suitable age for a girl to marry?

SECTION 6. HUSBAND'S AND PARENTS' STATUSES

601. Now I have some questions about your (most recent) husband. Has your husband attended school in the past or is he currently attending school?

602. What was the highest level to which he was admitted at school? CIRCLE CODE FOR LEVEL.

602A. What was the highest grade which he completed at that level? ENTER GRADE IN BOX.

603. Can he read a newspaper or a letter, for example?

604. Can (could) he write letter, for example?

605. What kind of work does (did) your husband mainly do? WRITE THE RESPONSE EXACTLY AS GIVEN.

606. CHECK 605:

607. Does (did) he earn a regular wage or salary?

608. Does (did) your husband work mainly on his or family land, or on someone else's land?

609. Does (did) he work mainly for money or does (did) he work for a share of the crops?

610. Is (was) your husband your first cousin or other blood relative or isn't he related to you at all?

611. Now I would like to ask some questions about your parents and the parents of your (first) husband.

612. CHECK 611:

613. Was (MENTION PARENTS NOT ALIVE NOW OR DK) alive at the time you began living together with your (first) husband?

614. At the time you first married, did you and your first husband have your own home, or did you begin by living in someone else's home for at least six months?

615. At the time of your (first) marriage, did anyone else live with you and your husband for at least six months?

616. Were you living together with any of the following persons for at least six months after you (first) married:

617. For about how many years did you live together at that time?

618. In how many different places have you lived for six months or more since you were first married including this place?

619. CHECK 104:

620. Now I would like to talk with you about a different topic. In general if a wife disagrees with her husband should she keep quiet or speak up?

621. Do you think a wife respects a husband more if he insists she accept his opinion in everything or if he listens to and accepts her opinions?

622. In your home, does your point of view carry the same weight as your husband's, less weight than his point of view or isn't it taken into account at all?

623. Who should have the last word on the following---the husband, the wife, both, or someone else?

624. Do you go out with your husband to purchase major household items/clothing?

625. How often do you go out with him?

626. Does your husband allow you to go out alone or with your children to buy household items?

627. Do you go out with your husband to visit relatives or friends?

628. How often do you go out with him?

629. Does your husband allow you to go out alone or with your children to visit relatives or friends?

630. How often do you visit with relatives, either in your or in their homes?

631. Some say a woman's place is at home and she should not work. Do you agree or disagree?

SECTION 7. MATERNAL HEALTH AND BREASTFEEDING

701. CHECK 215:

ONE OR MORE BIRTHS SINCE JANUARY 1983: (GO TO 702)
NO BIRTHS SINCE JANUARY 1983: (GO TO 848)

702. CHECK 212, 213 AND 216 AND ENTER THE NAME, LINE NUMBER, AND SURVIVAL STATUS OF EACH BIRTH SINCE JANUARY 1983 AT THE TOP OF THE TABLE BELOW, BEGINNING WITH THE LAST BIRTH. RECORD NAMES OF TWINS IN SEPARATE COLUMNS. COPY THE SAME INFORMATION AT THE TOP OF THE TABLES ON THE FOLLOWING THREE PAGES. THEN ASK QUESTIONS 703-712 AS APPROPRIATE FOR BIRTH SINCE 1983 REGARDLESS OF THE SURVIVAL STATUS. COMPLETE ALL QUESTIONS FOR ONE BIRTH BEFORE GOING ON TO THE NEXT BIRTH.

LINE NUMBER FROM 212

NAME FROM 213 SURVIVAL STATUS FROM 216

703. When you were pregnant with (NAME), did you see anyone for a check on the pregnancy?

704. Whom did you see? PROBE FOR TYPE OF PERSON AND RECORD MOST QUALIFIED.

705. Did you regularly have checkups during that pregnancy or did you only have the checkup(s) because there was some medical problem?

706. When you were pregnant with (NAME) were you given any injection to prevent the baby from getting tetanus, that is, convulsions after birth?

707. Where did you give birth to this child?

708. Who assisted with the delivery of (NAME)? PROBE FOR THE TYPE OF PERSON AND RECORD THE MOST QUALIFIED.

709. Has your menstrual period resumed since the birth of (NAME)?
[Most recent birth within the last five years]

710. How many months after the birth of (NAME) did your period return?

711. Have you resumed sexual relations since the birth of (NAME)?
[Most recent birth within the last five years]

712. How many months after the birth of (NAME) did you resume sexual relations?

713. THE HEADINGS IN THIS TABLE SHOULD BE EXACTLY THE SAME AS THOSE IN 702. ASK QUESTIONS 714-733 AS APPROPRIATE FOR ALL BIRTHS. COMPLETE ALL QUESTIONS FOR ONE BIRTH BEFORE GOING ON TO THE NEXT BIRTH. WHEN RECORDING THE RESPONSES TO QUESTIONS FOR A BIRTH, CHECK TO BE SURE THAT YOU ARE ENTERING THE ANSWERS IN THE APPROPRIATE COLUMN.

714. Now I would like to ask some questions about breastfeeding. Did you ever feed (NAME) at the breast?

715. Why did you never breastfeed (NAME)?

716. CHECK 715:

717. Are you still breastfeeding (NAME)? IF DEAD, CIRCLE '2'.
[Most recent birth within the last five years]

718. How many times did you breastfeed (NAME) last night between sundown and sunrise?
[Most recent birth within the last five years]

719. How many times did you breastfeed (NAME) yesterday during daylight hours?
[Most recent birth within the last five years]

720. How many months did you breastfeed (NAME)?

721. Why did you stop breastfeeding (NAME)?

722. CHECK SURVIVAL STATUS. RECORDED IN HEADING AT THE TOP OF THIS TABLE.

723. Now I would like to ask some questions about the foods or liquids you are giving (gave) your child.
How many months after (NAME'S birth did you give him/her milk other than breastmilk? IF LESS THAN 1 MONTHS, ENTER '00'.

724. Is (NAME) receiving any of the following types of milk regularly:
[Most recent and next-to-last birth within the last five years]

725. How many months after (NAME)'s birth did you first give him/her other liquids? IF LESS THAN 1 MONTH, ENTER '00'.

726. Is (NAME) receiving any of the following liquids regularly:
[Most recent and next-to-last birth within the last five years]

727. CHECK 723 TO 726:

728. Are any of the milks or other liquids your child drinks given in a bottle with a nipple?
[Repeat for the most recent birth and next to last birth]

729. How many months after (NAME'S) birth did you first give him/her solid or semi-solid food?

730. How many months after (NAME)'s birth did you first give him/her milk other than breastmilk? IF LESS THAN 1 MONTH, ENTER '00'.

731. How many months after (NAME)'s birth did you first give him/her other liquids? IF LESS THAN 1 MONTH, ENTER '00'.

732. CHECK 730 and 711:

733. How many months after (NAME'S) birth did you first give him/her solid or semi-solid food?

SECTION 8. CHILD HEALTH AND CAUSE OF DEATH

801. CHECK 215:

ONE OR MORE LIVE BIRTHS SINCE JANUARY 1983
NO LIVE BIRTHS SINCE JANUARY 1983 (GO TO 848)

CHECK 212, 213 AND 216 AND ENTER THE NAME, LINE NUMBER, AND SURVIVAL STATUS OF EACH BIRTH SINCE JANUARY 1983 AT THE TOP OF THE TABLE BELOW, BEGINNING WITH THE LAST BIRTH. RECORD NAMES OF TWINS IN SEPARATE COLUMNS.
COPY THE SAME INFORMATION AT THE TOP OF THE TABLES ON THE FOLLOWIHG THREE PAGES. YOU SHOULD RECORD THE NAMES OF DEAD AS WELL AS LIVING CHILDREN EVEN THOUGH QUESTIONS 803-821 WILL BE ASKED ONLY FOR LIVING CHILDREN.
AFTER THE TABLE HEADINGS ARE COMPLETE, ASK QUESTIONS 802-821 FOR EACH LIVING CHILD. COMPLETE ALL QUESTIONS FOR ONE LIVING CHILD BEFONE GOING ON TO THE NEXT CHILD. REMEMBER TO SKIP QUESTIONS 803-821 FOR DEAD CHILDREN.
AFTER ASKING QUESTIONS 802-812 FOR ALL LIVING CHILDREN, GO ON TO QUESTION 822.

LINE NUMBER FROM 212

NAME FROM 213

SURVIVAL STATUS FROM 216

802. Now I would like to ask some questions about any illnesses your child has had recently. Has (NAME) had diarrhea in the last seven days?

803. Has (NAME) had diarrhea since the start of the fasting month this year? IF YES: In what month did (NAME) have his/her most recent episode of diarrhea? SPECIFY CALENDAR MONTH.

804. I would like some information about (NAME)'s last episode of diarrhea. How many days ago did the diarrhea start? IF LESS THAN 24 HOURS, CIRCLE '00'.

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

806. For how many days did (NAME) have diarrhea during the most recent episode? IF LESS THAN 24 HOURS ENTER '00'.

807. In your opinion was (is) the most recent episode of diarrhea (NAME) had mild or severe?

808. Were (are) the stools watery or just soft?

809. Was (is) there blood in the stools?

810. Did (NAME) also experience vomiting?

811. Did (NAME) also experience dehydration?

812. During the most recent episode of diarrhea, did (NAME) show any of these other symptoms:

813. There are many kinds of things parents do to treat children with diarrhea. During the most recent episode, was (NAME) given:

814. During the most recent episode of diarrhea (NAME) had, did you stop, decrease, continue without change, or increase:

815. Was the opinion of any of the following sought during the episode:

816. CHECK 815:

817. Did the doctor you consulted prescribe any of the following even if you did not use it in treating the diarrhea:

818. CHECK 813:

819. How many days after the most recent episode of diarrhea began, did you start to give (NAME) mahloul el-gaffaf? IF LESS THAN 24 HOURS, ENTER '00'.

820. On the first day you gave the mahloul el-gaffaf, how many packets did you give (NAME)? IF LESS THAN ONE, ENTER '00'.

821. For how many days did you continue to give the mahloul el-gaffaf to (NAME)? IF LESS THAN 24 HOURS, ENTER '00'.

822. Have you heard about mahloul el-gaffaf?

823. Do you know how to prepare the mahloul el-gaffaf?

824 Do you have any packets of mahloul el-gaffaf in the house? IF YES: May I see one?

825. THE HEADINGS IN THIS TABLE SHOULD BE EXACTLY THE SAME AS THOSE IN 802. COPY THE SAME INFORMATION AT THE TOP OF THE FOLLOWING PAGE.

AFTER THE TABLE HEADINGS ARE COMPLETE. ASK QUESTIONS 826-836 FOR EACH LIVING CHILD. COMPLETE ALL QUESTIONS FOR ONE LIVING CHILD BEFORE GOING ON TO THE NEXT CHILD. REMEMBER TO SKIP QUESTIONS 826-836 FOR DEAD CHILDREN.
AFTER ASKING QUESTIONS 826-836 FOR ALL LIVING CHILDREN, GO ON TO QUESTION 837.

LINE NUMBER FROM 212

NAME FROM 213
SURVIVAL STATUS FROM 216

826. Did (NAME) have a cough at any time during the past month?

827. For how many days did the (NAME) have the cough the last time? IF LESS THAN 24 HOURS, ENTER '00'.

828. Did (NAME) also experience difficulty breathing when he/she had the cough?

829. When (NAME) had the cough did you ask anyone's opinion on how to treat it?

830. Did you seek the opinion of any of the following:

831. Did (NAME) ever have the measles?

832. Has (NAME) ever been given drops in the mouth for protecting against illness and not for curing?

833. How many times has (NAME) been given these drops?

834. Has (NAME) ever been given injection for protecting against illness and not for curing?

835. Do you have a birth certificate for (NAME)? IF YES: May I see it, please?

836. RECORD DATES OF IMMUNIZATIONS FROM BIRTH CARD. CIRCLE '1' IF THERE IS NO RECORD THE IMMUNIZATION WAS GIVEN. CIRCLE '2' IF IMMUNIZATION GIVEN BUT NO DATE IS RECORDED.

(GO TO 825 FOR NEXT BIRTH, OR, IF NO OTHER BIRTH, GO TO 837)

837. THE HEADINGS IN THIS TABLE SHOULD BE EXACTLY THE SAME AS THOSE IN 802. COPY THE SAME INFORMATION AT THE TOP OF THE FOLLOWING PAGE. NOTE THAT, UNLIKE QUESTIONS 802-821 AND 826-836, QUESTIONS 838-847 ARE TO BE ASKED ABOUT DEAD NOT LIVING CHILDREN.
COMPLETE ALL QUESTIONS FOR ONE DEAD CHILD BEFORE GOING OR TO THE NEXT CHILD. REMEMBER TO SKIP QUESTIONS 838-847 FOR LIVING CHILDREN. AFTER ASKING QUESTIONS 838-847 FOR ALL DEAD CHILDREN, GO ON TO QUESTION 848.

LINE NUMBER FROM 212

NAME FROM 213
SURVIVAL STATUS FROM 216

838. Now I would like to ask a few questions about (NAME OF DEAD CHILD). Did he/she die in the last 12 months?

839. Did (NAME OF DEAD CHILD) have diarrhea during the seven days before his/her death?

840. Did (NAME) have watery stools?

841. In the seven days before his/her death, did (NAME) have cough?

842. In the seven days before his/her death, did (NAME) have difficulty breathing?

843. In the seven days before his/her death, did (NAME) have any of the following:

844. During the period of illness before his/her death, was (NAME) examined by a doctor?

845. CHECK 217:

846. Before his/her death, did (NAME) have convulsions?

847. Was (NAME) nursing normally until he/she became ill?

OBSERVATIONS

THANK THE RESPONDENT FOR HER PARTICIPATION IN THE SURVEY. FILL IN THE APPROPRIATE RESPONSES IN QUESTIONS 848-853. BE SURE TO REVIEW THE QUESTIONNAIRE FOR COMPLETENESS BEFORE LEAVING THE HOUSEHOLD.

848. RECORD THE TIME.

849. DEGREE OF COOPERATION.

850. INTERVIEWED RESPONDENT ALONE OR WITH OTHERS PRESENT PART OR ALL OF THE INTERVIEW.

851. MARK WHETHER ANY OF THE FOLLOWING WERE PRESENT DURING THE INTERVIEW.

852. DID ANY OF THE PERSONS PRESENT INTERFERE WITH THE INTERVIEW?

853. INTERVIEWER'S COMMENTS:

____________________________________

854. FIELD EDITOR'S COMMENTS:

____________________________________

855. SUPERVISOR'S COMMENTS:

____________________________________

856. OFFICE EDITOR'S COMMENTS:

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SECTION 9. WEIGHT AND LENGTH

INTERVIEWER: IN 901-904, RECORD THE LINE NUMBERS, NAMES, SEX AND BIRTH DATES OF LIVING CHILDREN BONN SINCE JANUARY 1. 1985, STARTING WITH THE YOUNGEST CHILD. CHECK AGE IN 906-906 AND IDENTIFY CHILDREN 0-36 MONTHS OF AGE, RECORD LENGTH AND WEIGHT IN 907 AND 908. MEASURE ONE CHILD COMPLETELY (BOTH LENGTH AND WEIGHT) BEFORE GOING ON TO THE NEXT CHILD.

901. LINE NO. FROM 212

902. NAME FROM 213

903. SEX FROM 214

904. DATE OF BIRTH FROM 215

905. CHECK AGE AND MARK RESPONSE IN 906. IF FULL BIRTH DATE IS NOT AVAILABLE AND THE CHILD IS THREE YEARS OLD OR LESS ACCORDING TO QUESTION 218, THEN MARK 'YES' IN 906.

906. CHECK AGE: 0-36 MONTHS?

907. LENGTH (in cms)

908. WEIGHT (in kgs)

908A. CLOTHED WHEN WEIGHED

909. STATE REASON UNABLE TO RECORD

910. NAME OF MEASURER: _________ __
NAME OF ASSISTANT: ___________

OBSERVATIONS
THANK THE RESPONDENT FOR HER CHILD(REN)'S PARTICIPATION. FILL IN THE APPROPRIATE RESPONSES IN QUESTIONS 911-912. BE SURE TO REVIEW THE QUESTIONS 901-910 FOR COMPLETENESS BEFORE LEAVING THE HOUSEHOLD.

911. DEGREE OF COOPERATION.

912. MEASURER'S COMMENTS:

____________________________________

913. FIELD EDITOR'S COMMENTS:

____________________________________

914. SUPERVISOR'S COMMENTS:

____________________________________

915. OFFICE EDITOR'S COMMENTS:

____________________________________