WOMAN QUESTIONNAIRE
GOVERNORATE __________
PSU/SEGMENT NO. _____________
KISM/MARKAZ __________
BUILDING NO. ________________
SHIAKHA/VILLAGE __________
HOUSE NO. ___________
RURAL 2
MATERNAL MRT/ANTHROPOMETRY SUBSAMPLE
NO 2
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 ___
2 NOT AT HOME
3 POSTPONED
4 REFUSED
5 PARTLY COMPLETED
6 OTHER (SPECIFY) ___________
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
MINUTES ____
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.
DON'T KNOW MONTH 98
YEAR __
DON'T KNOW YEAR 98
104. Are you now married, widowed, or divorced?
WIDOWED 2
DIVORCED 3
105. How many times have you been married?
106. In what month and year did you first enter into a marriage contract?
DON'T KNOW MONTH 98
DON'T KNOW YEAR 98
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)?
DON'T KNOW MONTH 98
DON'T KNOW YEAR 98
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?
YES, ATTENDING CURRENTLY 2
NO, NEVER ATTENDED 3 (GO TO 112)
111. What was the highest level of to which you were admitted at school?
CIRCLE CODE FOR LEVEL.
PREPARATORY 2
SECONDARY 3
UPPER INTERMEDIATE 4
UNIVERSITY 5
MORE THAN UNIVERSITY 6 (SPECIFY) _____
111A. What was the highest grade which you successfully completed at that level? ENTER GRADE IN BOX.
PREPARATORY 2 ___ (GO TO 114)
SECONDARY 3 ___ (GO TO 114)
UPPER INTERMEDIATE 4 ___ (GO TO 114)
UNIVERSITY 5 ____ (GO TO 114)
MORE THAN UNIVERSITY 6 (SPECIFY) ___ (GO TO 114)
112. Can you read a newspaper, a magazine or a letter, for example?
NO 2 (GO TO 115)
113. Can you write a letter, for example?
NO 2
114. Do you read a newspaper or magazine at least once per week?
NO 2
115. How many hours on average do you listen to the radio each day? IF LISTENS LESS THAN ONE HOUR, ENTER '00'.
ALL OF THE TIME 96
NEVER 97
NOT SURE/DON'T KNOW 98
116. How many hours on average do you watch television each day? IF WATCHES LESS THAN ONE HOUR, ENTER '00'.
ALL OF THE TIME 96
NEVER 97
NOT SURE/DON'T KNOW 98
CHRISTIAN 2
OTHER (SPECIFY) _______3
118. Before you married your (first) husband, did you yourself ever do any work for which you were paid in cash?
NO 2 (GO TO 121)
119. When you were working then, what did you do with most of the money that you earned?
MOST FOR SELF 2
DIVIDED EQUALLY BETWEEN SELF AND FAMILY 3
OTHER (SPECIFY) ___________ 4
120. Was the money used mainly to prepare for marriage?
NO, FOR OTHER THINGS 2
121. Since you were first married, have you ever done any work for cash?
NO 2 (GO TO 125)
122. Are you now doing any work for cash?
NO 2 (GO TO 125)
123. What do you do with most of the money that you earn?
MOST FOR SELF 2
DIVIDE EQUALLY BETWEEN SELF AND FAMILY 3
OTHER (SPECIFY) ___________ 4
124. In this work, do you work on your own, for a family member, or for someone else or some other organization?
FOR A FAMILY MEMBER 2 (GO TO 127)
FOR SOMEONE ELSE/SOME OTHER ORGANIZATION 3 (GO TO 127)
125. Do you assist any family member in his/her work?
NO 2
126. Do you assist someone not in the family in his/her work?
NO 2 (GO TO 131)
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?
NONFAMILY ONLY 2
BOTH 3
129. How many hours did you work in the past week?
WORKING FOR CASH (GO TO 132)
131. If a good opportunity was available, would you like to work for cash in the future?
NO 2
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?
DISAPPROVE 2
NOT SURE/DON'T KNOW 8
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'.
ALWAYS 96 (GO TO 201)
VISITOR 97 (GO TO 135)
134. Just before you moved here, did you live in a village in a town, in Cairo or in Alexandria?
TOWN 2
CAIRO 3
ALEXANDRIA 4
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?
TOWN 2
CAIRO 3
ALEXANDRIA 4
201 Now I would like to ask about all the births you have had during your life. Have you ever had a live birth?
NO 2 (GO TO 206)
202. Do you have any sons or daughters to whom you have given birth and who are now living at home with you?
NO 2 (GO TO 204)
203. How many sons live with you? And how many daughters live with you? IF NONE, ENTER '00'.
DAUGHTERS AT HOME ___
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?
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, ENTER '00'.
DAUGHTERS ELSEWHERE ____
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?
NO 2 (GO TO 208)
207. How many boys have died? And how many girls have died? IF NONE, ENTER '00'.
GIRLS DEAD _____
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?
NO (PROBE AND CORRECT 201-209 AS NECESSARY)
NO BIRTHS (GO TO 222)
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.
213. What name was given to your (first/next) baby?
214. Is (NAME) a boy or a girl?
GIRL 2
215. In what month and year was (NAME) born?
PROBE: What is his/her birthday? OR: In what season?
NO 2 (GO TO 217)
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.
MONTHS 2 ____ (GO TO NEXT BIRTH)
YEARS 3 ____ (GO TO NEXT BIRTH)
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?
NO 2 (GO TO NEXT BIRTH)
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?
NO 2 (GO TO 226)
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?
NO 2 (GO TO 226)
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?
NO (PROBE AND CORRECT 221 TO 224 AS NECESSARY)
NO 2 (GO TO 232)
NOT SURE/DON'T KNOW 8 (GO TO 232)
227. For how many months have you been pregnant?
228. Did you see anyone for a check on this pregnancy?
NO 2 (GO TO 231)
229. Whom did you see? PROBE FOR TYPE OF PERSON AND RECORD MOST QUALIFIED.
TRAINED NURSE 2
DAYA 3
OTHER (SPECIFY) ___________ 4
230. Was it a routine (regular) checkup or did you only go because there was some medical problem?
WENT BECAUSE OF MEDICAL PROBLEM 2
OTHER (SPECIFY) ___________ 3
231. Since you have been pregnant, have you given any injection to prevent the baby from getting tetanus, that is, convulsions after birth?
NO 2 (GO TO 233)
NOT SURE/DON'T KNOW 8 (GO TO 233)
232. How long ago did your last menstrual period start?
WEEKS AGO 2___
MONTHS AGO 3___
YEARS AGO 4___
BEFORE LAST BIRTH 969
NEVER MENSTRUATED 979 (GO TO 234)
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?
RIGHT AFTER HER PERIOD HAS ENDED 2
IN THE MIDDLE OF THE CYCLE 3
JUST BEFORE HER PERIOD BEGINS 4
AT ANY TIME 5
OTHER (SPECIFY) ___________ 6
NOT SURE/DON'T KNOW 8
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.
YES/PROBED 2
NO 3
YES/PROBED 2
NO 3
YES/PROBED 2
NO 3
YES/PROBED 2
NO 3
YES/PROBED 2
NO 3
YES/PROBED 2
NO 3
YES/PROBED 2
NO 3
YES/PROBED 2
NO 3
YES/PROBED 2
NO 3
YES/PROBED 2
NO 3
_________________ (SPECIFY)
NO 3
(ASK 303-305 FOR EACH METHOD FOR WHICH A 1 OR 2 IS CIRCLED IN 302)
303. Have you ever used (METHOD)?
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2 (GO TO 304, METHOD 09)
NO 2
NO 2 (GO TO 304, METHOD 09)
NO 2
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)
Where would you go to obtain advice on safe period?
CODES FOR 304
02 PRIVATE VOLUNTARY FP CLINIC
03 GOVERNMENT MCH CENTER
04 GOVERNMENT HOSPITAL
05 PRIVATE DOCTOR/CLINIC
06 PHARMACY
07 HOME DELIVERED
08 OTHER (SPECIFY)
13 NOWHERE
98 NOT SURE/DON'T KNOW
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)
Where would you go to obtain advice on safe peried?
CODES FOR 305
04 HUSBAND DISAPPROVES
05 OTH RELAT DISAPPROVE
06 RELIGIOUS PROHIBITIONS
07 SIDE EFFECTS FOR WOMAN
08 SIDE EFFECTS FOR CHILD
09 METHOD PERMANENT
11 DIFFICULT TO OBTAIN
12 COSTS TOO MUCH
13 INCONVENIENT TO USE
18 OTHER (SPECIFY)
96 NO PROBLEM
98 NOT SURE/DON'T KNOW
AT LEAST ONE (EVER USED) (GO TO 309)
307. Have you ever used anything or tried in any way to delay or avoid getting pregnant?
NO 2 (GO TO 401)
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'.
NONE 00 (GO TO 311)
310. How many living sons did you have? How many living daughters did you have? IF NONE, ENTER '00'.
NUMBER OF DAUGHTERS __________
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?
DID NOT WANT ANOTHER CHILD 2
OTHER __________ 3
312. Did you talk about family planning with your husband before first using it?
NO 2
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?
MAINLY HUSBAND'S IDEA 2
JOINT IDEA 3
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:
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
315. What was the first family planning method that you and your husband ever used?
IUD 02 (GO TO 317)
INJECTIONS 03 (GO TO 317)
NORPLANT 04 (GO TO 317)
FOAM/JELLY 05 (GO TO 317)
CONDOM 06 (GO TO 317)
FEMALE STERILIZATION 07 (GO TO 317)
MALE STERILIZATION 08 (GO TO 317)
WITHDRAWAL 09 (GO TO 318)
SAFE PERIOD 10 (GO TO 318)
PROLONGED BREASTFEEDING 11 (GO TO 318)
OTHER (SPECIFY) __________ 12 (GO TO 318)
316. Who obtained the first cycle of pills that you and your husband ever used?
RESPONDENT 2
HUSBAND 3
OTHER (SPECIFY) ________ 4
317. Where did you (or your husband) obtain (FIRST METHOD USED) the first time that you ever used it?
PRIVATE VOLUNTARY FP CLINIC 02
GOVERNMENT MCH CENTER 03
GOVERNMENT HOSPITAL 04
PRIVATE DOCTOR/CLINIC 05
PHARMACY 06
OTHER (SPECIFY) __________ 08
NOT SURE/DON'T KNOW 98
318. Did you talk with your husband about which particular method to use before you began using (FIRST METHOD USED)?
NO 2
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?
MAINLY HUSBAND'S CHOICE 2
JOINT CHOICE 3
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:
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
WIDOWED/DIVORCED (GO TO 401)
PREGNANT (GO TO 401)
323. Are you currently doing something or using any method to avoid getting pregnant?
NO 2 (GO TO 401)
324. Which method are you using?
IUD 02 (GO TO 344)
INJECTIONS 03 (GO TO 352)
NORPLANT 04 (GO TO 352)
FOAM/JELLY 05 (GO TO 352)
CONDOM 06 (GO TO 352)
FEMALE STERILIZATION 07 (GO TO 352)
MALE STERILIZATION 08 (GO TO 352)
WITHDRAWAL 09 (GO TO 401)
SAFE PERIOD 10 (GO TO 401)
PROLONGED BREASTFEEDING 11 (GO TO 401)
OTHER (SPECIFY) __________ 12 (GO TO 401)
FIRST METHOD EVER USED WAS PILL (GO TO 328)
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?
RESPONDENT 2
HUSBAND 3
OTHER (SPECIFY) ___________ 4
327. Where did you (or your husband) obtain the pill the first time you ever used it?
PRIVATE VOLUNTARY FP CLINIC 02
GOVERNMENT MCH CENTER 03
GOVERNMENT HOSPITAL 04
PRIVATE DOCTOR/CLINIC 05
PHARMACY 06
OTHER (SPECIFY) __________ 08
NOT SURE/DON'T KNOW 98
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).
NOT ABLE TO SHOW 97 (GO TO 332)
329. COUNT AND RECORD THE TOTAL NUNBER OF PILLS IN THE ENTIRE CYCLE (PACKET) REGARDLESS OF THE PILLS ALREADY TAKEN.
28 1
330. OBSERVE SEQUENCE IN WHICH PILLS TAKEN FROM CYCLE (PACKET) AND CIRCLE CORRECT CODE.
PILLS MISSING OUT OF SEQUENCE 2
NO PILLS MISSING 3
331. Why haven't you been taking the pills (in sequence)?
FOLLOWED INSTRUCTIONS ON PACKET/GIVEN BY SOURCE 02 (GO TO 333)
JUST STARTING CYCLE 03 (GO TO 333)
TAKE ONLY AS NEEDED 04 (GO TO 333)
HUSBAND AWAY/ILL 05 (GO TO 333)
OTHER (SPECIFY) ________ 06 (GO TO 333)
332. Why don't you have a cycle (packet) of pills available?
COST TOO MUCH TO BUY CYCLE 02
FORGOT TO BUY NEXT CYCLE 03
RESTING FROM PILL 04
HUSBAND AWAY/ILL 05
MISPLACED/CAN'T FIND 06
OTHER (SPECIFY) ___________ 07
333. At of any time in the past month, have you experienced any the following (READ EACH PROBLEM):
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
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?
SPOTTING/BLEEDING 02
PERIOD DID NOT COME 03
RAN OUT OF PILLS 04
FORGOT TO TAKE/MISPLACED 05
HUSBAND AWAY 06
OTHER (SPECIFY) ___________ 07
NEVER STOPPED TAKING PILL 97
335. How many days ago did you take the last pill? IF RESPONSE IS TODAY, ENTER '00' DAYS AGO.
MORE THAN 30 DAYS AGO 97
NOT SURE/DON'T KNOW 98 (TO 338)
2 DAYS AGO OR LESS (GO TO 338)
337. Why haven't you taken the pills in the last few days?
DOESN'T HAVE CYCLE 02
TAKE ONLY AS NEEDED 03
FORGOT TO TAKE 04
RESTING FROR PILL 05
HUSBAND AWAY/ILL 06
OTHER (SPECIFY) ___________ 07
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.
FIVE DAYS AFTER PERIOD BEGAN 02
DAY AFTER FINISHING 1ST PACKET 03
SEVEN DAYS AFTER FINISHING 1ST PACKET 04
OTHER (SPECIFY) ___________ 05
339. Just about everyone misses taking the pill sometime. What do you do when you forget to take one pill?
TOOK TWO PILLS THE NEXT DAY 02
USED ANOTHER METHOD 03
OTHER (SPECIFY) ___________ 04
NEVER FORGOT 97
NOT SURE/DON'T KNOW 98
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?
SOMETIMES DIFFERENT BRAND 2
OTHER (SPECIFY) ___________ 3
NOT SURE/DON'T KNOW 8
341. How many cycles (packets) of the pill do you usually get when you obtain the pill?
NOT SURE/DON'T KNOW 98
342. How much does one cycle of pills usually cost you?
NOT SURE/DON'T KNOW 998
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).
NO 2 (GO TO 351)
NO 2 (GO TO 351)
NO 2 (GO TO 351)
NO 2 (GO TO 351)
NO 2 (GO TO 351)
NO 2 (GO TO 351)
344. How can a woman know that the IUD is correctly placed without making a special trip to the clinic/doctor?
OTHER (SPECIFY) ___________ 2
NOT SURE/DON'T KNOW 8
345. Where was the IUD which you are using now inserted?
PRIVATE VOLUNTARY FP CLINIC 02
GOVERNMENT MCH CENTER 03
GOVERNMENT HOSPITAL 04
PRIVATE DOCTOR/CLINIC 05
OTHER (SPECIFY) __________ 08
NOT SURE/DON'T KNOW 98 (GO TO 348)
346. Now I would like to get some information on what you thought about the service you received at (PLACE WHERE IUD WAS INSERTED).
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
347. How much did it cost to have the IUD inserted? RECORD RESPONSE IN POUNDS, ROUNDING DOWN TO THE NEAREST POUND.
NOT SURE/DON'T KNOW 998
348. Did you get the IUD at the place where you had it inserted or did you get it somewhere else?
NO, FROM SOMEWHERE ELSE 2
349. Where did you get the IUD from?
PRIVATE VOLUNTARY FP CLINIC 02
GOVERNMENT MCH CENTER 03
GOVERNMENT HOSPITAL 04
PRIVATE DOCTOR/CLINIC 05
PHARMACY 06
OTHER (SPECIFY) __________ 08
NOT SURE/DON'T KNOW 98
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.
NOT SURE/DON'T KNOW 998 (GO TO 401)
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?
RESPONDENT 2
HUSBAND 3
OTHER (SPECIFY) ___________ 4
352. Where did you (or your husband) obtain (CURRENT METHOD) the last time?
PRIVATE VOLUNTARY FP CLINIC 02
GOVERNMENT MCH CENTER 03
GOVERNMENT HOSPITAL 04
PRIVATE DOCTOR/CLINIC 05
PHARMACY 06 (TO 401)
OTHER (SPECIFY) __________ 08 (GO TO 401)
NOT SURE/DON'T KNOW 98 (GO TO 401)
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).
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
SECTION 4. CONTRACEPTIVE USE HISTORY
PREGNANT (GO TO 422)
NEVER USED A METHOD (GO TO 421)
NOT CURRENTLY USING CONTRACEPTION (GO TO 414)
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)?
MONTH ___
DK MONTH 98
YEAR ___ (GO TO 406)
DK YEAR 98
405. How long have you been using (CURRENT METHOD) (this time) without interruption?
MONTHS __
YEARS __
406. Have you experienced any problems from using (CURRENT METHOD)?
NO 2 (GO TO 408)
407. What is the main problem you experienced?
HUSBAND DISAPPROVED 04
OTH REL DISAPPROVED 05
SIDE EFFECTS FOR RESPONDENT 07
SIDE EFFECTS FOR CHILD 08
METHOD PERMANENT 09
DIFFICULT TO OBTAIN 11
COSTS TOO MUCH 12
INCONVENIENT TO USE 13
OTHER (SPECIFY) ___________ 19
NOT SURE/DON'T KNOW 98
408. Since your last birth (you married), have you used any other method or done anything else before (CURRENT METHOD) to avoid getting pregnant?
NO 2 (GO TO 421)
409. Which was the last method you used (BEFORE CURRENT METHOD)?
IUD 02
INJECTIONS 03
NORPLANT 04
FOAM/JELLY 05
CONDOM 06
MALE STERILIZATION 08
WITHDRAWAL 09
SAFE PERIOD 10
PROLONGED BREASTFEEDING 11
OTHER (SPECIFY) ___________ 12
410. In what month and year did you start using (METHOD BEFORE CURRENT) (the last time)?
MONTH __
DK NONTH 98
YEAR __ (GO TO 412)
DK YEAR 98
411. How long after your last birth (you married) did you start using (METHOD BEFORE CURRENT) (the last time)?
YEARS __
412. For how long had you been using (METHOD BEFORE CURRENT) before you stopped using it (the last time)?
MONTH __
YEARS __
413. What was the main reason you stopped using (METHOD BEFORE CURRENT) then?
METHOD FAILED/NOT EFFECTIVE 02 (GO TO 421)
HUSBAND DISAPPROVED 04 (GO TO 421)
OTH RELATIVES DISAPPROVE 05 (GO TO 421)
RELIGIOUS PROHIBITIONS 06 (GO TO 421)
SlDE EFFECTS FOR RESP 07 (GO TO 421)
SIDE EFFECTS FOR CHILD 08 (GO TO 421)
DIFFICULT TO OBTAIN 11 (GO TO 421)
COSTS TOO MUCH 12 (GO TO 421)
INCONVENIENT TO USE 13 (GO TO 421)
DECIDED TO USE ANOTHER METHOD 14 (GO TO 421)
FATALISTIC 15 (GO TO 421)
INFREQUENT SEX 16 (GO TO 421)
OTHER (SPECIFY) ___________ 19 (GO TO 421)
NOT SURE/DON'T KNOW 98 (GO TO 421)
NO (GO TO 416)
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?
NO 2 (GO TO 421)
416. Which was the last family planning method that you used?
IUD 02
INJECTIONS 03
NORPLANT 04
FOAM/JELLY 05
CONDOM 06
MALE STERILIZATION 08
WITHDRAWAL 09
SAFE PERIOD 10
PROLONGED BREASTFEEDING 11
OTHER (SPECIFY) ___________ 12
417. In what month and year did you start using (METHOD) (last time)?
MONTH __
DK NONTH 98
YEAR __ (GO TO 419)
DK YEAR 98
418. How long after your last birth did you start using (METHOD) (the last time)?
YEARS __
419. For how long had you been using (METHOD) before you stopped using it (last time)?
MONTH __
YEAR __
420. What was the main reason you stopped using (METHOD) then?
METHOD FAILED/NOT EFFECTIVE 02
HUSBAND DISAPPROVED 04
OTH RELATIVES DISAPPROVE 05
RELIGIOUS PROHIBITIONS 06
SIDE EFFECTS FOE RESP 07
SIDE EFFECTS FOR CHILD 08
DIFFICULT TO OBTAIN 11
COSTS TOO MUCH 12
INCONVENIENT TO USE 13
DECIDED TO USE ANOTHER METHOD 14
FATALISTIC 15
INFREQUENT SEX 16
OTHER (SPECIFY) ___________ 19
NOT SURE/DON'T KNOW 98
NO BIRTH SINCE JANUARY 1983 (GO TO 501)
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
NO 2 (GO TO NEXT BIRTH)
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.
ALIVE (GO TO 426)
DEAD (GO TO 426)
NEVER USED METHOD (ASK 433 FOR EACH COLUMN)
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
NO 2 (GO TO 433)
BIRTHS
NO 2 (GO TO 433)
427. What was the last method you used then?
IUD 02
INJECTIONS 03
NORPLANT 04
FOAM/JELLY 05
CONDOM 06
MALE STERILIZATION 08
WITHDRAWAL 09
SAFE PERIOD 10
PROLONGED BREASTFEEDING 11
OTHER (SPECIFY) ___________ 12
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
NO 2 (GO TO NEXT BIRTH)
BIRTHS
ALIVE (GO TO 428)
DEAD (GO TO 428)
428. In what month and year did you start using (METHOD) then?
MONTH __
DK MONTH 98
YEAR __ (GO TO 430)
DK YEAR 98
429. How long after the birth (NAME OF PRECEDING BIRTH) did you begin to use (METHOD) then?
YEARS __
430. For how long had you been using (METHOD) MONTHS before you stopped using it then?
MONTHS __
YEARS __
431. Did you become pregnant while you were still using (LAST METHOD)?
NO 2
432. What was the main reason you stopped using (LAST METHOD)?
METHOD FAILED 02
HUSB DISAPPR 04
OTB REL DISAPPR 05
RELIGIOUS PROHIB 06
SIDE EFFECTS-RESP 07
SIDE EFFECTS-CHLD 08
DIFF TO OBTAIN 11
COSTS TOO MUCH 12
INCONVENT TO USE 13
TO USE OTH METH 14
FATALISTIC 15
INFREQUENT SEX 16
OTHER (SPECIFY) ___________ 19
DON'T KNOW 98
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?
LATER 2
NO MORE 3
(ALL GO TO 426 FOR NEXT BIRTH, OR, IF NO OTHER BIRTH, GO TO 501)
434. Did you want to have that child but at a later time, or not have another child at all?
CURRENTLY PREGNANT
NOT HAVE CHILD 2
(ALL GO TO 426 FOR NEXT BIRTH, OR, IF NO OTHER BIRTH, GO TO 501)
SECTION 5: FAMILY PLANNING AND CHILDBEARING ATTITUDES
WIDOWED/DIVORCED (GO TO 513)
PREGNANT (GO TO 506)
CURRENTLY USING CONTRACEPTION (GO TO 511)
504. If you became pregnant in the next few weeks, would you feel happy, unhappy, or would it not matter very much?
UNHAPPY 2
WOULD NOT MATTER 3
505. What is the main reason that you are not using a method to avoid pregnancy?
HUSBAND DISAPPROVES 04
OTHER REL DISAPPROVE 05
RELIGIOUS PROHIBITIONS 06
SIDE EFFECTS FOR RESP 07
SIDE EFFECTS FOR CHILD 08
LACK OF KNOWLEDGE 10
DIFFICULT TO OBTAIN METH(S) 11
COST TOO MUCH 12
INCONVENIENT TO USE 13
FATALISTIC 15
INFREQUENT SEX 16
POSTPARTUM/BREASTFEEDING 17
MENOPAUSAL/SUBFECUND 18
OTHER (SPECIFY) ___________ 19
NOT SURE/DON'T KNOW 98
506. Do you intend to use a method to avoid pregnancy at any time in the future?
NO 2 (GO TO 510)
NOT SURE/DON'T KNOW 8 (GO TO 510)
507. Which method would you prefer to use?
IUD 02
INJECTIONS 03
NORPLANT 04
FOAM/JELLY 05
CONDOM 06
MALE STERILIZATION 08
WITHDRAWAL 09
SAFE PERIOD 10
PROLONGED BREASTFEEDING 11
OTHER (SPECIFY) ___________ 12
NOT SURE/DON'T KNOW 98
508. When do you plan to begin using (METHOD)?
WITHIN NEXT 2-3 YEARS 2
AFTER THREE YEARS OR MORE 3
NOT SURE/DON'T KNOW 8
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?
NO 2 (TO 512)
511. How often have you talked with your husband about family planning in the last twelve months?
ONCE 2
TWO TO THREE TIMES 3
FOUR TIMES OR MORE 4
512. In your opinion, in general, does your husband approve or disapprove of couples using a method to avoid pregnancy?
CONDITIONALLY APPROVES 2
DISAPPROVES 3
NOT SURE/DON'T KNOW 8
513. In general, do you approve or disapprove of a couple using a method to avoid pregnancy?
CONDITIONALLY APPROVE 2
DISAPPROVE 3 (TO 515)
NOT SURE/DON'T KNOW 8 (TO 515)
514. In your opinion, how many children should a woman have before her husband and she begin to use family planning?
SHOULD NOT USE 96
NOT SURE/DON'T KNOW 98
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?
SOMETIMES ACCEPTABLE 2
NOT ACCEPTABLE 3
NOT SURE/DON'T KNOW 8
516. In the last month, have you heard a show or message about family planning on the radio?
NO 2 (TO 518)
517. How many times did you hear a family planning show or message on the radio during the past month?
TWO OR THREE TIMES 2
MORE THAN THREE TIMES 3
518. In the last month, have you seen a show or message about family planning on the television?
NO 2 (GO TO 524)
519. How many times did you see a family planning show or message on television during the past month?
TWO OR THREE TIMES 2
MORE THAN THREE TIMES 3
520. What was the last show or message about family planning which you saw on television?
WAHID FAMILY 02
OM EL-HANA FAMILY 03
FARAHAT FAMILY 04
AZIZA AND HER MOTHER 05
PHYSICIAN AND THE AMBULANCE 06
SAHA AND HER DAUGHTER 07
SANA AND BRIDE AND BRIDEGROOM 08
SANA AND EARLY PREGNANCIES 09
SANA AND LATE PREGNANCIES 10
SANA AND THE PILL 11
SANA AND OTHER METHODS (IUD, FOAM AND TABLETS) 12
SANA AND MEDICAL ADVICE 13
OTHER (SPECIFY) ___________ 14
NOT SURE/DON'T KHOW 98 (GO TO 524)
521. What did you particularly like about this show or message?
ADVICE ABOUT WAITING TO MARRY UNTIL GIRL IS OLDER 02
ADVICE ABOUT USING PILL 03
ADVICE ABOUT EFFICIENT METHODS 04
ADVICE ABOUT FINANCIAL BENEFITS OF SMALL FAMILIES 05
OTHER ADVICE (SPECIFY) _________ 06
PROMOTED UNDERSTANDING OF FP 10
SHOW UNDERSTOOD BY ILLITERATE 11
LIKED ACTORS/ACTRESSES 12
SHOW INTERESTING/FUNNY 13
OTHER (SPECIFY) ___________ 14
LIKED EVERYTHING 96
DISLIKED EVERYTHING 97
NOT SURE/DON'T KNOW 98
522. What did you particularly dislike about this show or message?
MOTHER'S INTERFERENCE IN DAUGHTER'S BUSINESS 02
MOTHER'S ARGUMENT THAT MANY CHILDREN MEAN WEALTH 03
SHOW BIASED AGAINST LARGE FAMILIES 04
FORCED TO WATCH SHOW CONTRARY TO OWN OPINIONS/VALUES 05
ACTRESS'S ROLE REQUIRES HER TO ALWAYS DEMAND AGREEMENT WITH HER VIEWPOINT 06
DISLIKED ACTORS/ACTRESSES 07
OTHER (SPECIFY) ___________ 08
DISLIKED EVERYTHING 96
LIKED EVERYTHING 97
NOT SURE/DON'T KNOW 98
523. Do you agree with all of the information which got from the show or message? IF NO: With what don't you agree?
DISAGREE THAT LACK OF FINANCIAL RESOURCES IS GOOD REASON FOR HAVING FEWER CHILDREN 02
OTHER (SPECIFY) ___________ 03
DISAGREES WITH EVERYTHING 96
AGREES WITH EVERYTHING 97
NOT SURE/DON'T KNOW 98
524. On what (other) topics related to family planning would you like more information to be provided?
MORE INFORMATION ABOUT IUD 02
MORE INFORMATION ABOUT OTHER METHODS (SPECIFY) __________ 03 MORE INFORMATION ABOUT BENEFITS OF FAMILY PLANNING (SPECIFY)__________ 04
OTHER (SPECIFY) ___________ 05
NOT SURE/DON'T KNOW 98
WIDOWED/DIVORCED (GO TO 536)
PREGNANT (GO TO 528)
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?
NO MORE 2 (GO TO 529)
SAYS SHE CAN'T GET PREGNANT 3 (GO TO 536)
UNDECIDED/DON'T KNOW 8 (GO TO 530)
528. After the child you are expecting, would you like to have another child or would you prefer not to have any (more) children?
NO MORE 2
UNDECIDED/DON'T KNOW 8 (GO TO 530)
529. Would you say that you definitely do not want to have (more) children, or are you not sure?
NOT SURE 2 (GO TO 533)
530. Are you more inclined toward having a (another) child or toward not having a (another) child?
NOT HAVE ANOTHER 2 (GO TO 533)
UNDECIDED/DON'T KNOW 8 (GO TO 533)
531. Would you say that you definitely want a (another) child, or are you not sure?
NOT SURE 2
532. How long would you like to wait from now before the birth of a (another) child?
MONTHS 1 __
YEARS 2 __
NOT SURE/DON'T KNOW 989
PREGNANT (GO TO 535)
534. In your opinion, would your husband like to have a (another) child or would he prefer not to have any (more) children?
NO MORE 2 (GO TO 536)
UNDECIDED/DON'T KNOW 8 (GO TO 536)
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?
NO MORE 2
UNDECIDED/DON'T KNOW 8
HAS LIVING CHILDREN (GO TO 538)
537. If you could choose exactly the number of children to have in your whole life, how many would that be?
OTHER ANSWER (SPECIFY) _________ 96 (GO TO 540)
NOT SURE/DON'T KNOW 98 (GO TO 540)
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?
OTHER ANSWER (SPECIFY) _________ 96 (GO TO 540)
NOT SURE/DON'T KNOW 98 (GO TO 540)
539. How many boys would that be? And how many girls would that be? IF NONE, ENTER '00'.
GIRLS _______
OTHER ANSWER (SPECIFY) _________ 96
NOT SURE/DON'T KNOW 98
WIDOWED/DIVORCED (GO TO 544)
541. Have you ever talked to your husband about the exact number of children that he would have liked?
NO 2
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?
OTHER ANSWER (SPECIFY) _________ 96 (GO TO 544)
NOT SURE/DON'T KNOW 98 (GO TO 544)
543. How many boys would that be? And how many girls would that be? IF NONE, ENTER '00'.
GIRLS _______
OTHER ANSWER (SPECIFY) _________ 96
NOT SURE/DON'T KNOW 98
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?
OTHER ANSWER (SPECIFY) _________ 96 (GO TO 546)
NOT SURE/DON'T KNOW 98 (GO TO 546)
545. How many boys? And how many girls? IF NONE, ENTER '00'.
GIRLS _______
OTHER ANSWER (SPECIFY) _________ 96
NOT SURE/DON'T KNOW 98
546. In your opinion, what is the most suitable age for a girl to marry?
OTHER ANSWER (SPECIFY) ________ 96
NOT SURE/DON'T KNOW 98
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?
YES, ATTENDING CURRENTLY 2
NO, NEVER ATTENDED 3 (GO TO 603)
NOT SURE/DON'T KNOW 8 (GO TO 603)
602. What was the highest level to which he was admitted at school? CIRCLE CODE FOR LEVEL.
PRIMARY 1
PREPARATORY 2 (GO TO 605)
SECONDARY 3 (GO TO 605)
UPPER INTERMEDIATE 4 (GO TO 605)
UNIVERSITY 5 (GO TO 605)
MORE THAN UNIVERSITY 6 (GO TO 605)
DON'T KNOW LEVEL 88
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?
NO 2 (GO TO 605)
NOT SURE/DON'T KNOW 8 (GO TO 605)
604. Can (could) he write letter, for example?
NO 2
NOT SURE/DON'T KNOW 8
605. What kind of work does (did) your husband mainly do? WRITE THE RESPONSE EXACTLY AS GIVEN.
WORKS (WORKED) IN AGRICULTURE (GO TO 608)
607. Does (did) he earn a regular wage or salary?
NO 2
NOT SURE/DON'T KNOW 8
608. Does (did) your husband work mainly on his or family land, or on someone else's land?
SOMEONE ELSE'S LAND 2
609. Does (did) he work mainly for money or does (did) he work for a share of the crops?
A SHARE OF THE CROPS 2
610. Is (was) your husband your first cousin or other blood relative or isn't he related to you at all?
YES, OTHER RELATIVE 2
NO, NOT A RELATIVE 3
611. Now I would like to ask some questions about your parents and the parents of your (first) husband.
NO 2
DK 3
NO 2
DK 3
NO 2
DK 3
NO 2
DK 3
ALL PARENTS ALIVE: (GO TO 614)
613. Was (MENTION PARENTS NOT ALIVE NOW OR DK) alive at the time you began living together with your (first) husband?
NO 2
DK 3
NO 2
DK 3
NO 2
DK 3
NO 2
DK 3
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?
LIVED IN SOMEONE ELSE'S HOME FOR AT LEAST SIX MONTHS 2 (GO TO 616)
LIVED IN SOMEONE ELSE'S HOME FOR LESS THAN 6 MONTHS 3 (GO TO 618)
615. At the time of your (first) marriage, did anyone else live with you and your husband for at least six months?
NO 2 (GO TO 618)
616. Were you living together with any of the following persons for at least six months after you (first) married:
NO 2
NO 2
NO 2
NO 2
NO 2
617. For about how many years did you live together at that time?
UP TO THE PRESENT 96
618. In how many different places have you lived for six months or more since you were first married including this place?
WIDOWED/DIVORCED (GO TO 630)
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?
SPEAK UP 2
NOT SURE/ DON'T KNOW 8
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?
LISTENS AND ACCEPTS HER OPINION 2
NOT SURE/DON'T KNOW 3
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?
LESS WEIGHT THAN HUSBAND 2
NOT TAKEN INTO ACCOUNT AT ALL 3
OTHER (SPECIFY) ____ 4
623. Who should have the last word on the following---the husband, the wife, both, or someone else?
WIFE 2
BOTH 3
OTHER 4
WIFE 2
BOTH 3
OTHER 4
WIFE 2
BOTH 3
OTHER 4
WIFE 2
BOTH 3
OTHER 4
WIFE 2
BOTH 3
OTHER 4
WIFE 2
BOTH 3
OTHER 4
WIFE 2
BOTH 3
OTHER 4
624. Do you go out with your husband to purchase major household items/clothing?
NO 2 (GO TO 626)
625. How often do you go out with him?
ONCE PER MONTH 2
ONCE EVERY TWO MONTHS 3
ONCE VERY SIX MONTHS 4
SELDOM 5
626. Does your husband allow you to go out alone or with your children to buy household items?
YES WITH CHILDREN 2
NOT ALLOWED 3
OTHER (SPECIFY) ___ 4
627. Do you go out with your husband to visit relatives or friends?
NO 2 (GO TO 629)
628. How often do you go out with him?
ONCE PER MONTH 2
ONCE EVERY TWO MONTHS 3
ONCE VERY SIX MONTHS 4
SELDOM 5
629. Does your husband allow you to go out alone or with your children to visit relatives or friends?
YES WITH CHILDREN 2
NOT ALLOWED 3
OTHER ____ 4
630. How often do you visit with relatives, either in your or in their homes?
WEEKLY 2
BIWEEKLY 3
MONTHLY 4
LESS THAN ONCE PER MONTH 5
631. Some say a woman's place is at home and she should not work. Do you agree or disagree?
DISAGREE 2
NOT SURE/DON'T KNOW 8
SECTION 7. MATERNAL HEALTH AND BREASTFEEDING
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
ALIVE (GO TO 703)
DEAD (GO TO 703)
703. When you were pregnant with (NAME), did you see anyone for a check on the pregnancy?
NO 2 (GO TO 706)
704. Whom did you see? PROBE FOR TYPE OF PERSON AND RECORD MOST QUALIFIED.
TRAINED NURSE/MIDWIFE 2
DAYA 3
OTHER (SPECIFY) ___________ 4
705. Did you regularly have checkups during that pregnancy or did you only have the checkup(s) because there was some medical problem?
CHECKUP FOR MEDICAL PROBLEM 2
OTHER (SPECIFY) ___________ 3
706. When you were pregnant with (NAME) were you given any injection to prevent the baby from getting tetanus, that is, convulsions after birth?
NO 2
NOT SURE/DK 8
707. Where did you give birth to this child?
AT ANOTHER HOUSE 2
HOSPITAL/CLINIC 3
OTHER (SPECIFY) ___ 4
708. Who assisted with the delivery of (NAME)? PROBE FOR THE TYPE OF PERSON AND RECORD THE MOST QUALIFIED.
TRAINED NURSE/MIDWIFE 2
DAYA 3
RELATIVE 4
OTHER (SPECIFY) ___ 5
NO ONE 6
709. Has your menstrual period resumed since the birth of (NAME)?
[Most recent birth within the last five years]
NO 2 (GO TO 711)
710. How many months after the birth of (NAME) did your period return?
NOT RETURNED 96
711. Have you resumed sexual relations since the birth of (NAME)?
[Most recent birth within the last five years]
NO 2 (GO TO 703 FOR NEXT BIRTH, OR, IF NO OTHER BIRTH, GO TO 713)
712. How many months after the birth of (NAME) did you resume sexual relations?
40 DAYS 96
(ALL GO TO 703 FOR NEXT BIRTH, OR, IF NO OTHER BIRTH, ALL GO TO 713)
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.
ALIVE (GO TO 714)
DEAD (GO TO 714)
714. Now I would like to ask some questions about breastfeeding. Did you ever feed (NAME) at the breast?
NO 2
715. Why did you never breastfeed (NAME)?
CHILD DIED 03
CHILD REFUSED 04
MOTHER SICK 05
NO/INSFFCNT MILK 06
USING PILL 08
PREFFERRED BOTTLE 09
OTHER (SPECIFY) ____ 10
OTHER 2 (GO TO 722)
717. Are you still breastfeeding (NAME)? IF DEAD, CIRCLE '2'.
[Most recent birth within the last five years]
NO (OR DEAD) 2 (GO TO 720)
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)?
UNTIL DEATH 96 (GO TO 730)
721. Why did you stop breastfeeding (NAME)?
CHILD SICK 02
CHILD DIED 03
CHILD REFUSED 04
MOTHER SICK 05
NO/INSFFCNT MILK 06
PREGNANT 07
USING PILL 08
PREFERRED BOTTLE 09
OTHER (SPECIFY) ____ 10
722. CHECK SURVIVAL STATUS. RECORDED IN HEADING AT THE TOP OF THIS TABLE.
CHILD DIED 2 (GO TO 730)
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'.
NOT YET GIVEN 96 (GO TO 725)
724. Is (NAME) receiving any of the following types of milk regularly:
[Most recent and next-to-last birth within the last five years]
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
725. How many months after (NAME)'s birth did you first give him/her other liquids? IF LESS THAN 1 MONTH, ENTER '00'.
NOT YET GIVEN 96 (GO TO 727)
726. Is (NAME) receiving any of the following liquids regularly:
[Most recent and next-to-last birth within the last five years]
NO 2
NO 2
NO 2
NO 2
NO 2
NEITHER MILK NOR OTHER LIQUIDS GIVEN (ALL GO TO 714 FOR NEXT BIRTH, OR, IF NO OTHER BIRTH, GO TO 801)
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]
NO 2
NOT SURE/DK 8
729. How many months after (NAME'S) birth did you first give him/her solid or semi-solid food?
NOT YET GIVEN 96
(ALL GO TO 714 FOR NEXT BIRTH, OR, IF NO OTHER BIRTH, GO TO 801)
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'.
CHILD DIED BEFORE GIVEN 97
731. How many months after (NAME)'s birth did you first give him/her other liquids? IF LESS THAN 1 MONTH, ENTER '00'.
CHILD DIED BEFORE GIVEN 97
NEITHER MILK NOR OTHER LIQUIDS GIVEN (ALL GO TO 714 FOR NEXT BIRTH, OR, IF NO OTHER BIRTH, GO TO 801)
733. How many months after (NAME'S) birth did you first give him/her solid or semi-solid food?
CHILD DIED BEFORE GIVEN 97
(ALL GO TO 714 FOR NEXT BIRTH, OR, IF NO OTHER BIRTH, GO TO 801)
SECTION 8. CHILD HEALTH AND CAUSE OF DEATH
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
ALIVE (GO TO 802)
DEAD (GO TO NEXT BIRTH)
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?
NO 2
NOT SURE/DK 8
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.
NO 2 (GO TO 802 FOR NEXT BIRTH, OR, IF NO OTHER BIRTH, GO TO 822)
NOT SURE/DK 8 (GO TO 802 FOR NEXT BIRTH, OR, IF NO OTHER BIRTH, GO TO 822)
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'.
LESS THAN 24 HOURS 00 (GO TO 807)
805. Has (NAME) had diarrhea in the last 24 hours?
NO 2
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?
SEVERE 2
NOT SURE/DK 8
808. Were (are) the stools watery or just soft?
JUST SOFT 2
NOT SURE/DK 8
809. Was (is) there blood in the stools?
NO 2
NOT SURE/DK 8
810. Did (NAME) also experience vomiting?
NO 2
NOT SURE/DK 8
811. Did (NAME) also experience dehydration?
NO 2
NOT SURE/DK 8
812. During the most recent episode of diarrhea, did (NAME) show any of these other symptoms:
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
813. There are many kinds of things parents do to treat children with diarrhea. During the most recent episode, was (NAME) given:
NO 2
NO 2
NO 2
814. During the most recent episode of diarrhea (NAME) had, did you stop, decrease, continue without change, or increase:
DECREASED 2
INCREASED 3
NO CHANGE 4
NOT GIVEN 5
DECREASED 2
INCREASED 3
NO CHANGE 4
NOT GIVEN 5
DECREASED 2
INCREASED 3
NO CHANGE 4
NOT GIVEN 5
DECREASED 2
INCREASED 3
NO CHANGE 4
NOT GIVEN 5
815. Was the opinion of any of the following sought during the episode:
NO 2
NO 2
NO 2
NO 2
NO 2
DID NOT CONSULT GOVT HLTH SRV/PR DOCTOR (GO TO 818)
817. Did the doctor you consulted prescribe any of the following even if you did not use it in treating the diarrhea:
NO 2
NO 2
NO 2
DID NOT GIVE MAHLOUL EL-GAFFAF (GO TO 802 FOR NEXT BIRTH, OR, IF NO OTHER BIRTH, GO TO 822)
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'.
(GO TO 802 FOR NEXT BIRTH, OR, IF NO OTHER BIRTH, GO TO 822)
822. Have you heard about mahloul el-gaffaf?
NO 2 (GO TO 825)
823. Do you know how to prepare the mahloul el-gaffaf?
NO 2
824 Do you have any packets of mahloul el-gaffaf in the house? IF YES: May I see one?
YES, NOT SHOWN 2
NO 3
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
ALIVE____ (GO TO 826)
DEAD____(GO TO NEXT BIRTH)
826. Did (NAME) have a cough at any time during the past month?
NO 2 (GO TO 831)
NOT SURE/DK 8 (GO TO 831)
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?
NO 2
NOT SURE/DK 8
829. When (NAME) had the cough did you ask anyone's opinion on how to treat it?
NO 2 (GO TO 831)
NOT SURE/DK 8 (GO TO 831)
830. Did you seek the opinion of any of the following:
NO 2
NO 2
NO 2
NO 2
NO 2
831. Did (NAME) ever have the measles?
NO 2
832. Has (NAME) ever been given drops in the mouth for protecting against illness and not for curing?
NO 2 (GO TO 834)
NOT SURE/DK 8 (GO TO 834)
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?
NO 2
NOT SURE/DK 8
835. Do you have a birth certificate for (NAME)? IF YES: May I see it, please?
YES, NOT SEEN 2 (GO TO 825 FOR NEXT BIRTH, OR, IF NO OTHER BIRTH, GO TO 837)
NO CARD 3 (GO TO 825 FOR NEXT BIRTH, OR, IF NO OTHER BIRTH, GO TO 837)
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.
NO DATE 2
DA__
MO__
YR__
NO DATE 2
DA__
MO__
YR__
NO DATE 2
DA__
MO__
YR__
NO DATE 2
DA__
MO__
YR__
NO DATE 2
DA__
MO__
YR__
NO DATE 2
DA__
MO__
YR__
NO DATE 2
DA__
MO__
YR__
NO DATE 2
DA__
MO__
YR__
(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
ALIVE__ (GO TO NEXT-TO-LAST BIRTH)
DEAD__(GO TO 838)
838. Now I would like to ask a few questions about (NAME OF DEAD CHILD). Did he/she die in the last 12 months?
NO 2
839. Did (NAME OF DEAD CHILD) have diarrhea during the seven days before his/her death?
NO 2 (GO TO 841)
840. Did (NAME) have watery stools?
NO 2
841. In the seven days before his/her death, did (NAME) have cough?
NO 2
842. In the seven days before his/her death, did (NAME) have difficulty breathing?
NO 2
843. In the seven days before his/her death, did (NAME) have any of the following:
NO 2
NO 2 (SPECIFY) ____
NO 2
844. During the period of illness before his/her death, was (NAME) examined by a doctor?
NO 2
CHILD OLDER THAN ONE MONTH AT DEATH (GO TO 838 FOR NEXT BIRTH, OR, IF NO OTHER BIRTH, GO TO 848)
846. Before his/her death, did (NAME) have convulsions?
NO 2
847. Was (NAME) nursing normally until he/she became ill?
NO 2
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.
MINUTES___
FAIR 2
GOOD 3
VERY GOOD 4
850. INTERVIEWED RESPONDENT ALONE OR WITH OTHERS PRESENT PART OR ALL OF THE INTERVIEW.
OTHERS PRESENT DURING PART OF THE INTERVIEW 2
OTHERS PRESENT DURING ALL OF THE INTERVIEW 3
851. MARK WHETHER ANY OF THE FOLLOWING WERE PRESENT DURING THE INTERVIEW.
NO 2
NO 2
NO 2
NO 2
852. DID ANY OF THE PERSONS PRESENT INTERFERE WITH THE INTERVIEW?
NO 2
____________________________________
____________________________________
____________________________________
856. OFFICE EDITOR'S COMMENTS:
____________________________________
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.
GIRL 2
YEAR__
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.
NO__ (GO TO NEXT CHILD)
NO__ (SPECIFY)
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.
FAIR 2
GOOD 3
VERY GOOD 4
____________________________________
____________________________________
____________________________________
915. OFFICE EDITOR'S COMMENTS:
____________________________________