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GHANA DEMOGRAPHIC AND HEALTH SURVEYS MAN'S QUESTIONNAIRE

GHANA STATISTICAL SERVICE

IDENTIFICATION

LOCALITY NAME _______________
NAME OF HOUSEHOLD HEAD ______________
EA NUMBER _______
HOUSEHOLD NUMBER _____
REGION ____
DISTRICT ____

URBAN/RURAL ___

URBAN 1
RURAL 2

CITY/LARGE TOWN/SMALL TOWN/VILLAGE _________

CITY 1
LARGE TOWN 2
SMALL TOWN 3
VILLAGE 4

NAME AND LINE NUMBER OF MAN ______________

INTERVIEWER VISIT 1
DATE___
INTERVIEWER'S NAME___
RESULT*____

NEXT VISIT:
DATE___
TIME___

INTERVIEWER VISIT 2
DATE___
INTERVIEWER'S NAME___
RESULT*___

NEXT VISIT:
DATE___
TIME___

INTERVIEWER VISIT 3
DATE___
INTERVIEWERS NAME___
RESULT*___

FINAL VISIT
DAY ___
MONTH___
YEAR 2003
NAME ___

RESULT___

TOTAL NO. OF VISITS___

RESULT___
*RESULT CODES:

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

LANGUAGE

LANGUAGE OF QUESTIONNAIRE: ENGLISH 1

LANGUAGE OF INTERVIEW *** ________ ___

NATIVE LANGUAGE OF RESPONDENT*** _________ ___

WAS A TRANSLATOR USED?

YES 1
NO 2

*** LANGUAGE CODES:

1 ENGLISH
2 AKAN
3 GA
4 EWE
5 NZEMA
6 DAGBANI
7 OTHER (SPECIFY) ______________________

SUPERVISOR
NAME___
DATE___

FIELD EDITOR
NAME ___
DATE___

OFFICE EDITOR __

KEYED BY __

SECTION 1. RESPONDENT'S BACKGROUND

INFORMED CONSENT

Hello. My name is and I am working with the Ghana Statistical Service. We are conducting a national survey about the health of women, men and children. We would very much appreciate your participation in this survey. I would like to ask you some questions about yourself and your family. This information will help the government to plan health services. The survey usually takes between 15 and 30 minutes to complete. Whatever information you provide will be kept strictly confidential and will not be shown to other persons.

Participation in this survey is voluntary and you can choose not to answer any individual question or all of the questions. However, we hope that you will participate in this survey since your views are important.

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

Signature of interviewer: _____________
Date: __________

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

101. RECORD THE TIME.

HOURS___
MINUTES___

102. First I would like to ask some questions about you and your household.
For most of the time until you were 12 years old, did you live in a city, in a town, or in the village?

CITY 1
TOWN 2
VILLAGE 3

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

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

104. Just before you moved here, did you live in a city, in a town, or in the village?

CITY 1
TOWN 2
VILLAGE 3

105. In the last 12 months, on how many separate occasions have you traveled away from your home community and slept away?

NUMBER OF TRIPS AWAY ___
NONE 00 (GO TO 107)

106. In the last 12 months, have you been away from your home community for more than 1 month at a time?

YES 1
NO 2

107. In what month and year were you born?

MONTH ___
DOES NOT KNOW MONTH 98
YEAR ___
DOES NOT KNOW YEAR 98

108. How old were you at your last birthday?
COMPARE AND CORRECT 107 AND/OR 108 IF INCONSISTENT.

AGE IN COMPLETED YEARS___

109. Have you ever attended school?

YES 1
NO 2 ( SKIP TO 113)

110. What is the highest level of school you attended:
primary, middle/JSS, secondary/SSS, or higher?

PRIMARY 1
MIDDLE/JSS 2
SECONDARY/SSS 3
HIGHER 4

111. What is the highest grade you completed at that level?

GRADE ___

112. CHECK 110:

PRIMARY OR MIDDLE/JSS (GO TO 113)
SECONDARY/SSS OR HIGHER (GO TO 116)

113. Now I would like you to read this sentence to me.
SHOW CARD TO RESPONDENT.

IF RESPONDENT CANNOT READ WHOLE SENTENCE, PROBE:
Can you read any part of the sentence to me?

CANNOT READ AT ALL 1
ABLE TO READ ONLY PARTS OF SENTENCE 2
ABLE TO READ WHOLE SENTENCE 3
NO CARD WITH REQUIRED LANGUAGE (SPECIFY LANGUAGE) ___ 4
BLIND/VISUALLY IMPAIRED 5

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

YES 1
NO 2

115. CHECK 113:

CODE '2,' '3' OR '4' CIRCLED (GO TO 116)
CODE '1' AND '5' CIRCLED (GO TO 117)

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

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

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

ALMOST EVERY DAY 1
AT LEAST ONCE A WEEK 2
LESS THAN ONCE A WEEK 4
NOT AT ALL 5

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

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

119. Are you currently working?

YES 1 (GO TO 122)
NO 2

120. Have you done any work in the last 12 months?

YES 1 (GO TO 122)
NO 2

121. What have you been doing for most of the time over the last 12 months?

GOING TO SCHOOL/STUDYING 1 (GO TO 129)
LOOKING FOR WORK 2 (GO TO 129)
INACTIVE 3 (GO TO 129)
COULD NOT WORK/HANDICAPPED 4 (GO TO 129)
OTHER (SPECIFY) ___ 6 (GO TO 129)

122. What is your occupation, that is, what kind of work do you mainly do?

_________ ____

123. CHECK 122:

WORKS IN AGRICULTURE (GO TO 124)
DOES NOT WORK IN AGRICULTURE (GO TO 125)

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

OWN LAND 1
FAMILY LAND 2
RENTED LAND 3
SOMEONE ELSE'S LAND 4

125. During the last 12 months, how many months did you work?

NUMBER OF MONTHS ___

126. Are you paid or do you earn in cash or kind for this work or are you not paid at all?

CASH ONLY 1
CASH AND KIND 2
IN KIND ONLY 3 (GO TO 129)
NOT PAID 4 (GO TO 129)

127. Who mainly decides how the money you earn will be used?

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

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

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

129. What is your religion?

CATHOLIC 01
ANGLICAN 02
METHODIST 03
PRESBYTERIAN 04
OTHER CHRISTIAN 05
MOSLEM 06
TRADITIONAL/SPIRITUALIST 07
NO RELIGION 08
OTHER (SPECIFY) ___ 96

130. To which ethnic group do you belong?

AKAN 01
GA/DANGME 02
EWE 03
GUAN 04
MOLE-DAGBANI 05
GRUSSI 06
GRUMA 07
HAUSA 08
OTHER (SPECIFY)____ 96

SECTION 2. REPRODUCTION AND PREFERENCES

201. Now I would like to ask about any children you have had. I am interested only in the children that are biologically yours. Have you ever fathered any children with any woman?

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

202. Do you have any sons or daughters that you have fathered who are now living with you?

YES 1
NO 2 (GO TO 204)

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

SONS AT HOME ___
DAUGHTERS AT HOME ___

204. Do you have any sons or daughters you have fathered who are alive but do not live with you?

YES 1
NO 2 (GO TO 206)

205. How many sons are alive but do not live with you? And how many daughters are alive but do not live with you?
IF NONE, WRITE '00'.

SONS ELSEWHERE ___
DAUGHTERS ELSEWHERE ___

206. Have you ever fathered a boy or girl who was born alive but later died?
IF NO, PROBE: Any baby who cried or showed signs of life but did not survive?

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

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

BOYS DEAD ___
GIRLS DEAD ___

208. (In addition to the children that you have just told me about), do you have any other sons or daughters who are biologically your children but who are not legally yours or do not have your name?
Did you have any children who died who were biologically your children but who were not legally yours or did not have your name?

IF YES, CORRECT 201-207.

YES 1
NO 2

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

TOTAL ___

210. CHECK 209:

HAS HAD MORE THAN ONE CHILD (GO TO 211)
HAS HAD ONLY ONE CHILD (GO TO 213)
HAS NOT HAD ANY CHILDREN (GO TO 301)

211. Do the children that you have fathered all have the same biological mother?

YES 1 (GO TO 213)
NO 2

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

NUMBER OF WOMEN ___

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

AGE IN YEARS ___

SECTION 3. CONTRACEPTION

Now I would like to talk about family planning - the various ways or methods that a couple can use to delay or avoid a pregnancy.

CIRCLE CODE 1 IN 301 FOR EACH METHOD MENTIONED SPONTANEOUSLY.

THEN PROCEED DOWN COLUMN 301, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY.
CIRCLE CODE 1 IF METHOD IS RECOGNISED, AND CODE 2 IF NOT RECOGNISED. THEN, FOR EACH METHOD WITH CODE 1 CIRCLED IN 301, ASK 302.

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

01) FEMALE STERILIZATION Women can have an operation to avoid having any more children.
YES 1
NO 2 (GO TO NEXT METHOD)
02) MALE STERILIZATION Men can have an operation to avoid having any more children.
YES 1
NO 2 (GO TO NEXT METHOD)
03) PILL Women can take a pill every day to stop them from becoming pregnant.
YES 1
NO 2 (GO TO NEXT METHOD)
04) IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2 (GO TO NEXT METHOD)
05) INJECTABLES Women can have an injection by a health provider which stops them from becoming pregnant for one or more months.
YES 1
NO 2 (GO TO NEXT METHOD)
06) IMPLANTS Women can have several small rods placed in their upper arm by a doctor or nurse which can prevent pregnancy for one or more years.
YES 1
NO 2 (GO TO NEXT METHOD)
07) CONDOM Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
08) FEMALE CONDOM Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
09) DIAPHRAGM Women can place a thin flexible disk in their vagina before sexual intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
10) FOAM OR JELLY Women can place a suppository, jelly, or cream in their vagina before sexual intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
11) LACTATIONAL AMENORRHEA METHOD (LAM) Up to 6 months after childbirth, a woman can use a method that requires that she breastfeeds frequently, day and night, and that her menstrual period has not returned.
YES 1
NO 2 (GO TO NEXT METHOD)
12) RHYTHM OR PERIODIC ABSTINENCE Every month that a woman is sexually active she can avoid pregnancy by not having sexual intercourse on the days of the month she is most likely to get pregnant.
YES 1
NO 2 (GO TO NEXT METHOD)
13) WITHDRAWAL Men can be careful and pull out before climax.
YES 1
NO 2 (GO TO NEXT METHOD)
14) EMERGENCY CONTRACEPTION Women can take pills up to five days after sexual intercourse to avoid becoming pregnant.
YES 1
NO 2 (GO TO NEXT METHOD)
15) Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1
(SPECIFY) _____
(SPECIFY) _____
NO 2 (GO TO 303)

302. Have you ever used (METHOD)?

02) MALE STERILIZATION Men can have an operation to avoid having any more children: Have you ever had an operation to avoid having any more children?
YES 1
NO 2
07) CONDOM Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
12) RHYTHM OR PERIODIC ABSTINENCE Every month that a woman is sexually active she can avoid pregnancy by not having sexual intercourse on the days of the month she is most likely to get pregnant.
YES 1
NO 2
DON'T KNOW 8
13) WITHDRAWAL Men can be careful and pull out before climax.
YES 1
NO 2

303. Now I would like to ask you about when a woman is most likely to get pregnant.
From one menstrual period to the next, are there certain days when a woman is more likely to become pregnant if she has sexual relations?

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

304. Is this time just before her period begins, during her period, right after her period has ended, or half way between two periods?

JUST BEFORE HER PERIOD BEGINS 1
DURING HER PERIOD 2
RIGHT AFTER HER PERIOD HAS ENDED 3
HALFWAY BETWEEN TWO PERIODS 4
OTHER (SPECIFY) ____ 6
DON'T KNOW 8

305. Do you think that a woman who is breastfeeding her baby can get pregnant?

YES 1
NO 2
DEPENDS 3
DON'T KNOW 8

306. I will now read you some statements about contraception. Please tell me if you agree or disagree with each one.

a) Contraception is women's business and a man should not have to worry about it.
AGREE 1
DISAGREE 2
DK 8
b) Women who use contraception may become promiscuous.
AGREE 1
DISAGREE 2
DK 8
c) A woman is the one who gets pregnant so she should be the one to get sterilized.
AGREE 1
DISAGREE 2
DK 8

307. CHECK 301(02) AND 302(02): KNOWLEDGE AND USE OF MALE STERILISATION

HAS HEARD OF MALE STERILIZATION BUT IS NOT STERILIZED (GO TO 308)
OTHER (GO TO 401)

308. Once you have had all the children you want, would you yourself ever consider getting sterilized?

WOULD CONSIDER 1 (GO TO 401)
WOULD NOT CONSIDER 2
UNSURE/DEPENDS 3 (GO TO 401)
WIFE ALREADY STERILIZED 4 (GO TO 401)

309. Why would you never consider getting sterilized? PROBE: Any other reasons?
RECORD ALL REASONS MENTIONED.

AGAINST RELIGION A
BAD FOR MAN'S HEALTH B
OPERATION NOT SAFE C
LESS INTRUSIVE WAYS AVAILABLE D
MAY WANT MORE CHILDREN/MAY WANT TO REPLACE CHILD WHO DIED E
LOSS OF WAGES G
LOSS OF SEXUAL FUNCTION H
LOSS OF MANLINESS I
OTHER (SPECIFY) ____ X

SECTION 4. MARRIAGE AND SEXUAL ACTIVITY

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

YES, CURRENTLY MARRIED 1
YES, LIVING WITH A WOMAN 2 (GO TO 404)
NO, NOT IN A UNION 3 (GO TO 406)

402. Do you have one wife or more than one wife?
IF ONLY ONE WIFE, ENTER '01' .
IF MORE THAN ONE, ASK: How many wives do you currently have?

NUMBER OF WIVES ____

403. Are there any other women with whom you live as if married?

YES 1
NO 2 (GO TO 405)

404. Are you living with one (other) woman or more than one (other) woman as if married?
IF ONE LIVE-IN PARTNER, ENTER '01'.

IF MORE THAN ONE, ASK: How many women are you living with as if you were married?

NUMBER OF LIVE-IN PARTNERS ___

405. Apart from the woman/women you have already mentioned, do you currently have any other regular or occasional sexual partners?

REGULAR PARTNER(S) ONLY 1 (GO TO 409)
OCCASIONAL PARTNER(S) ONLY 2 (GO TO 409)
REGULAR AND OCCASIONAL PARTNERS 3 (GO TO 409)
NO OTHE RPARTNER 4 (GO TO 409)

406. Do you currently have regular, occasional, or no sexual partners?

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

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

YES, USED TO BE MARRIED 1
YES, LIVED WITH A WOMAN 2 (GO TO 411)
YES, BOTH 3
NO 4 (GO TO 416)

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

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

409. WRITE THE LINE NUMBERS FROM THE HOUSEHOLD QUESTIONNAIRE FOR EACH WIFE/PARTNER REPORTED IN QUESTIONS 402 AND 404 ONLY.

IF A WIFE/PARTNER IS NOT LISTED IN THE HOUSEHOLD SCHEDULE, ENTER '00' IN THE LINE NUMBER BOXES.

THE NUMBER OF LINES FILLED IN MUST BE EQUAL TO THE NUMBER OF WIVES AND PARTNERS. (IF RESPONDENT HAS MORE THAN SEVEN WIVES/PARTNERS USE ADDITIONAL QUESTIONNAIRE(S).

CHECK 402 AND 404

IF SUM OF 402 AND 404=01:

PLEASE TELL ME THE NAME OF YOUR WIFE/PARTNER.

NAME ___________________________________________
LINE NUMBER IN HHD. QUEST
_____

WIFE 1
PARTNER 2
IF SUM OF 402 AND 404 > 01:
PLEASE TELL ME THE NAME OF EACH WIFE/PARTNER THAT YOU LIVE WITH AS IF MARRIED, STARTING WITH THE ONE YOU LIVED WITH FIRST.

NAME ________________________________________
LINE NUMBER IN HHD. QUEST
_____
WIFE 1
PARTNER 2

410. CHECK 409:

ONLY ONE WIFE/PARTNER (GO TO 411)
MORE THAN ONE WIFE/PARTNER (GO TO 412)

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

ONCE 1 (GO TO 414)
MORE THAN ONCE 2 (GO TO 413)

412. Have you ever been married to or lived as if married to any woman other than those you have just mentioned?

YES 1
NO 2 (GO TO 414)

413. In total, how many women have you been married to or lived with as if married in your whole life?

NUMBER OF WOMEN ___

414. CHECK 409 AND 411:

ONLY ONE WIFE/PARTNER AND 411=ONCE __
In what month and year did you start living with your wife/partner?

OTHER
Now we will talk about your first wife/partner.
In what month and year did you start living with her?

MONTH ___
DOES NOT KNOW MONTH 98
YEAR ___ (GO TO 416)
DOES NOT KNOW YEAR 9998

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

AGE ___

416. Now I need to ask you some questions about sexual activity in order to gain a better understanding of some family life issues.
How old were you when you first had sexual intercourse (if ever)?

NEVER 00 (GO TO 448)
AGE IN YEARS __
FIRST TIME WHEN STARTED LIVING WITH (FIRST) WIFE/PARTNER 95

416A. CHECK 108:

15-24 YEARS OLD (GO TO 416B)
25-59 YEARS OLD (GO TO 417)

416B. The first time you had sexual intercourse, was a condom used?

YES 1
NO 2

417. When was the last time you had sexual intercourse?
RECORD 'YEARS AGO' ONLY IF LAST INTERCOURSE WAS ONE OR MORE YEARS AGO. IF 12 MONTHS OR MORE, ANSWER MUST BE RECORDED IN YEARS.

DAYS AGO 1 ____
WEEKS AGO 2 ____
MONTHS AGO 3 ____
YEARS AGO 4 ____

417A. The last time you had sexual intercourse, had you or your partner been drinking alcohol?
IF YES: Who was drinking?

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

418. The last time you had sexual intercourse, was a condom used?

YES 1
NO 2 (GO TO 420)

419. What was the main reason you used a condom on that occasion?

RESPONDENT WANTED TO PREVENT STD/HIV 01
RESPONDENT WANTED TO PREVENT PREGNANCY 02 (GO TO 424)
RESPONDENT WANTED TO PREVENT BOTH STD/HIV AND PREGNANCY 03 (GO TO 424)
DID NOT TRUST PARTNER/FELT PARTNER HAD OTHER PARTNERS 04
PARTNER REQUESTED/INSISTED 05
OTHER (SPECIFY) ____ 96
DON'T KNOW 98

420. CHECK 302(02):

RESPONDENT NOT STERILIZED (GO TO 421)
RESPONDENT STERILIZED (GO TO 424)

421. The last time you had sexual intercourse, did you or your partner do something or use any method to avoid a pregnancy?

YES 1
NO 2 (GO TO 423)
UNSURE/DON'T KNOW 8 (GO TO 424)

422. What method was used?
IF MORE THAN ONE METHOD USED, RECORD THE HIGHEST METHOD ON THE LIST.

FEMALE STERILIZATION 01 (GO TO 424)
PILL 03 (GO TO 424)
IUD 04 (GO TO 424)
INJECTABLES 05 (GO TO 424)
IMPLANTS 06 (GO TO 424)
MALE CONDOM 07 (GO TO 424)
FEMALE CONDOM 08 (GO TO 424)
DIAPHRAGM 09 (GO TO 424)
FOAM/JELLY 10 (GO TO 424)
LACTATIONAL AMEN. METHOD 11 (GO TO 424)
PERIODIC ABSTINENCE 12 (GO TO 424)
WITHDRAWAL 13 (GO TO 424)
OTHER METHOD 96 (GO TO 424)

423. What is the main reason a method was not used?

CASUAL PARTNER, DOESN'T CARE 11
CONTRACEPTION IS WOMEN'S BUSINESS 12
WOMAN IS MENOPAUSAL/HAD HYSTERECTOMY 23
COUPLE INFERTILE/SUB-FERTILE 24
WOMAN WAS PREGNANT 25
WOMAN WAS AMENORRHEIC 26
WOMAN WAS BREASTFEEDING 27
WANTED (MORE) CHILDREN 28
RESPONDENT OPPOSED 31
WOMAN OPPOSED 32
OTHERS OPPOSED 33
RELIGIOUS PROHIBITION 34
KNOWS NO METHOD 41
KNOWS NO SOURCE 42
HEALTH CONCERNS 51
FEAR OF SIDE EFFECTS 52
LACK OF ACCESS/TOO FAR 53
COST TOO MUCH 54
INCONVENIENT TO USE 55
INTERFEERES WITH BODY'S NORMAL PROCESSES 56
OTHER (SPECIFY) ____ 96
DOES NOT KNOW 98

424. What is your relationship to the person with whom you last had sex?

IF WOMAN IS 'GIRLFRIEND' OR 'FIANCE', ASK:
Was your girlfriend/fianc? living with you when you last had sex?
IF YES, RECORD '01'.
IF NO, RECORD '02'.

WIFE/LIVE-IN PARTNER 01 (GO TO 426)
WOMAN IS GIRLFRIEND/FIANCEE 02
OTHER FRIEND 03
CASUAL ACQUAINTANCE 04
RELATIVE 05
PROSTITUTE 06
OTHER (SPECIFY) ____ 96

425. For how long have you had a sexual relationship with this person?
IF ONLY HAD SEX WITH THIS PERSON ONCE, WRITE '01' DAYS

DAYS 1 ___
WEEKS 2 ____
MONTHS 3 ___
YEARS 4 ____

426. Have you had sex with any other person in the last 12 months?

YES 1
NO 2 (GO TO 445)

427. The last time you had sexual intercourse with another person, was a condom used?

YES 1
NO 2 (GO TO 429)

428. What is the main reason you used a condom on that occasion?

RESPONDENT WANTED TO PREVENT STD/HIV 01
RESPONDENT WANTED TO PREVENT PREGNANCY 02 (GO TO 433)
RESPONDENT WANTED TO PREVENT BOTH STD/HIV AND PREGNANCY 03 (GO TO 433)
DID NOT TRUST PARTNER/FELT PARTNER HAD OTHER PARTNERS 04
PARTNER REQUESTED/INSISTED 05
OTHER (SPECIFY) ____ 96
DON'T KNOW 98

429. CHECK 302(02):

RESPONDENT NOT STERILIZED (GO TO 430)
RESPONDENT STERILIZED (GO TO 433)

430. The last time you had sexual intercourse with this person, did you or that person do something or use any method to avoid a pregnancy?

YES 1
NO 2 (GO TO 432)
UNSURE/DON'T KNOW 8 (GO TO 433)

431. What method was used?
IF MORE THAN ONE METHOD USED, CIRCLE THE HIGHEST METHOD ON THE LIST.

FEMALE STERILIZATION 01 (GO TO 433)
PILL 03 (GO TO 433)
IUD 04 (GO TO 433)
INJECTABLES 05 (GO TO 433)
IMPLANTS 06 (GO TO 433)
MALE CONDOM 07 (GO TO 433)
DIAPHRAGM 09 (GO TO 433)
FOAM/JELLY 10 (GO TO 433)
LACTATIONAL AMEN. METHOD 11 (GO TO 433)
PERIODIC ABSTINENCE 12 (GO TO 433)
WITHDRAWAL 13 (GO TO 433)
OTHER METHOD 96 (GO TO 433)

432. What is the main reason a method was not used?

CASUAL PARTNER, DOESN'T CARE 11
CONTRACEPTION IS WOMEN'S BUSINESS 12
WOMAN IS MENOPAUSAL/HAD HYSTERECTOMY 23
COUPLE INFERTILE/SUB-FERTILE 24
WOMAN WAS PREGNANT 25
WOMAN WAS AMENORRHEIC 26
WOMAN WAS BREASTFEEDING 27
WANTED (MORE) CHILDREN 28
RESPONDENT OPPOSED 31
WOMAN OPPOSED 32
OTHERS OPPOSED 33
RELIGIOUS PROHIBITION 34
KNOWS NO METHOD 41
KNOWS NO SOURCE 42
HEALTH CONCERNS 51
FEAR OF SIDE EFFECTS 52
LACK OF ACCESS/TOO FAR 53
COST TOO MUCH 54
INCONVENIENT TO USE 55
INTERFEERES WITH BODY'S NORMAL PROCESSES 56
OTHER (SPECIFY) ____ 96
DOES NOT KNOW 98

433. What is your relationship to this other person?
IF WOMAN IS 'GIRLFRIEND' OR 'FIANCE', ASK:

Was your girlfriend/fianc? living with you when you last had sex?
IF YES, RECORD '01'.
IF NO, RECORD '02'.

WIFE/LIVE-IN PARTNER 01 (GO TO 435)
WOMAN IS GIRLFRIEND/FIANCEE 02
OTHER FRIEND 03
CASUAL ACQUAINTANCE 04
RELATIVE 05
PROSTITUTE 06
OTHER (SPECIFY) ____ 96

434. For how long have you had a sexual relationship with this person?
IF ONLY HAD SEX WITH THIS PERSON ONCE, WRITE '01' DAYS

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

435. Other than these two people, have you had sex with any other person in the last 12 months?

YES 1
NO 2 (GO TO 445)

436. The last time you had sexual intercourse with this third person, was a condom used?

YES 1
NO 2 (GO TO 438)

437. What is the main reason you used a condom on that occasion?

RESPONDENT WANTED TO PREVENT STD/HIV 01
RESPONDENT WANTED TO PREVENT PREGNANCY 02 (GO TO 442)
RESPONDENT WANTED TO PREVENT BOTH STD/HIV AND PREGNANCY 03 (GO TO 442)
DID NOT TRUST PARTNER/FELT PARTNER HAD OTHER PARTNERS 04
PARTNER REQUESTED/INSISTED 05
OTHER (SPECIFY) ____ 96
DON'T KNOW 98

438. CHECK 302(02):

RESPONDENT NOT STERILIZED (GO TO 439)
RESPONDENT STERILIZED (GO TO 442)

439. The last time you had sexual intercourse with this third person, did you or that person do something or use any method to avoid a pregnancy?

YES 1
NO 2 (GO TO 441)
UNSURE/DON'T KNOW 8 (GO TO 442)

440. What method was used?
IF MORE THAN ONE METHOD USED, CIRCLE THE HIGHEST METHOD ON THE LIST.

FEMALE STERILIZATION 01
PILL 03
IUD 04
INJECTABLES 05
IMPLANTS 06
MALE CONDOM 07
FEMALE CONDOM 08
DIAPHRAGM 09
FOAM/JELLY 10
LACTATIONAL AMEN. METHOD 11
PERIODIC ABSTINENCE 12
WITHDRAWAL 13
OTHER METHOD 96

441. What is the main reason a method was not used?

CASUAL PARTNER, DOESN'T CARE 11
CONTRACEPTION IS WOMEN'S BUSINESS 12
WOMAN IS MENOPAUSAL/HAD HYSTERECTOMY 23
COUPLE INFERTILE/SUB-FERTILE 24
WOMAN WAS PREGNANT 25
WOMAN WAS AMENORRHEIC 26
WOMAN WAS BREASTFEEDING 27
WANTED (MORE) CHILDREN 28
RESPONDENT OPPOSED 31
WOMAN OPPOSED 32
OTHERS OPPOSED 33
RELIGIOUS PROHIBITION 34
KNOWS NO METHOD 41
KNOWS NO SOURCE 42
HEALTH CONCERNS 51
FEAR OF SIDE EFFECTS 52
LACK OF ACCESS/TOO FAR 53
COST TOO MUCH 54
INCONVENIENT TO USE 55
INTERFERES WITH BODY'S NORMAL PROCESSES 56
OTHER (SPECIFY) ____ 96
DOES NOT KNOW 98

442. What is your relationship to this other person?

IF WOMAN IS 'GIRLFRIEND' OR 'FIANCE', ASK:
Was your girlfriend/fianc? living with you when you last had sex?
IF YES, RECORD '01'.
IF NO, RECORD '02'.

WIFE/LIVE-IN PARTNER 01 (GO TO 444)
WOMAN IS GIRLFRIEND/FIANCEE 02
OTHER FIREND 03
CASUAL ACQUAINTANCE 04
RELATIVE 05
PROSTITUTE 06
OTHER (SPECIFY) ____ 96

443. For how long have you had a sexual relationship with this person?
IF ONLY HAD SEX WITH THIS PERSON ONCE, WRITE '01' DAYS

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

444. In total, with how many different people have you had sex in the last 12 months?

NUMBER OF PARTNERS ___

445. Have you ever paid for sex?

YES 1
NO 2 (GO TO 448)

446. How long ago was the last time you paid for sex?

DAYS AGO 1 ___
WEEKS AGO 2 ___
MONTHS AGO 3 ___
YEARS AGO 4 ___

447. The last time that you paid for sex, was a condom used?

YES 1
NO 2

448. Do you know of a place where a person can get male condoms?

YES 1
NO 2 (GO TO 450A)

449. Where is that? Any other place? RECORD ALL SOURCES MENTIONED.

IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE.

PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

(NAME OF PLACE) ____________

.

PUBLIC SECTOR
GOVT. HOSPITAL/POLYCLINIC A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY)____ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PRIVATE DOCTOR H
PHARMACY/CHEMIST/DRUG STORE I
MOBILE CLINIC J
FIELDWORKER K
FP/PPAG CLINIC L
MATERNITY HOME M
OTHER PRIVATE MEDICAL (SPECIFY)____ N
OTHER SOURCE
SHOP O
CHURCH P
FRIENDS/RELATIVES Q
OTHER (SPECIFY) ____ X

450. If you wanted to, could you yourself get a male condom?

YES 1
NO 2
DOES NOT KNOW/UNSURE 8

450A. Do you know of a place where a person can get female condoms?

YES 1
NO 2 (GO TO 451)

450B. Where is that? Any other place? RECORD ALL SOURCES MENTIONED.
IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE.
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

(NAME OF PLACE) ____________
PUBLIC SECTOR
GOVT. HOSPITAL/POLYCLINIC A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY)____ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PRIVATE DOCTOR H
PHARMACY/CHEMIST/DRUG STORE I
MOBILE CLINIC J
FIELDWORKER K
FP/PPAG CLINIC L
MATERNITY HOME M
OTHER PRIVATE MEDICAL (SPECIFY)____ N
OTHER SOURCE

SHOP O
CHURCH P
FRIENDS/RELATIVES Q
OTHER (SPECIFY) ____ X

450C. If you wanted to, could you yourself get a female condom?

YES 1
NO 2
DON'T KNOW/UNSURE 8

451. CHECK 302(07), 416B(1), 418(1), 427(1), 436(1), AND 447(1): EVER USED A CONDOM?

AT LEAST ONE 'YES' HAS USED CONDOM (GO TO 452)
NO 'YES' NEVER USED CONDOM (GO TO 460)

452. How old were you when you used a condom for the first time?

AGE AT FIRST USE ___
DOES NOT REMEMBER 98

453. Why did you use a condom that first time?
PROBE: Any other reason?
RECORD ALL REASONS MENTIONED.

WANTED TO PREVENT STD/HIV A
WANTED TO PREVENT PREGNANCY B
WANTED TO PREVENT BOTH STD/HIV AND PREGNANCY C
DID NOT TRUST PARTNER/THOUGHT PARTNER HAD OTHER PARTNERS D
PARTNER REQUESTED/INSISTED E
DON'T KNOW Z
OTHER (SPECIFY) ____ X

454. Have you ever experienced any problems with using condoms?
IF YES: What problems have you experienced?
PROBE: Any other problems?
CIRCLE ALL PROBLEMS MENTIONED.

TOO EXPENSIVE A
EMBARRASSING TO BUY/OBTAIN B
DIFFICULT TO DISPOSE OF C
DIFFICULT TO PUT ON/TAKE OFF D
SPOILS THE MOOD E
DIMINISHES PLEASURE F
WIFE PARTNER OBJECTS/DOES NOT LIKE G
WIFE/PARTNER GOT PREGNANT H
INCONVENIENT TO USE/MESSY I
CONDOM BROKE J
OTHER (SPECIFY ) ____ X
NO PROBLEM Y

455. What brand of condom do you usually use?
ASK TO SEE CONDOM PACKET IF BRAND NOT KNOWN.

PROTECTOR 1
ROUGH RIDER 2
CHAMPION 3
PANTHER 4
NO BRAND 5
OTHER (SPECIFY) ____ 6
DON'T KNOW BRAND 8

456. Where do you usually get condoms?

IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE.

PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
(NAME OF PLACE) ____________

PUBLIC SECTOR
GOVT. HOSPITAL/POLYCLINIC A
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
FIELDWORKER E
OTHER PUBLIC (SPECIFY)____ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PRIVATE DOCTOR H
PHARMACY/CHEMIST/DRUG STORE I
MOBILE CLINIC J
FIELDWORKER K
FP/PPAG CLINIC L
MATERNITY HOME M
OTHER PRIVATE MEDICAL (SPECIFY)____ N
OTHER SOURCE
SHOP O
CHURCH P
FRIENDS/RELATIVES Q
OTHER (SPECIFY) ____ X

457. How much do you usually pay for condoms? .

PER PACKET ____
FREE 99996 (GO TO 460)
DON'T KNOW 99998 (GO TO 460)

458. How many condoms are in each packet?

NUMBER PER PACKET ___

459. Do you think that at this price condoms are inexpensive, just affordable, or too expensive?

INEXPENSIVE 1
JUST AFFORDABLE 2
TOO EXPENSIVE 3

460. I will now read you some statements about condom use.
Please tell me if you agree or disagree with each.

a) Condoms diminish a man's sexual pleasure.

AGREE 1
DISAGREE 2
DK 8

b) It's okay to re-use a condom if you wash it.

AGREE 1
DISAGREE 2
DK 8

c) Condoms protect against disease.

AGREE 1
DISAGREE 2
DK 8

d) Buying condoms is embarrassing.

AGREE 1
DISAGREE 2
DK 8

e) A woman has no right to tell a man to use a condom.

AGREE 1
DISAGREE 2
DK 8

f) Condoms contain HIV.

AGREE 1
DISAGREE 2
DK 8

SECTION 5. FERTILITY PREFERENCES

501. CHECK 401:

CURRENTLY MARRIED OR LIVING TOGETHER (GO TO 502)
NOT MARRIED (GO TO 505)

502. Is your wife/partner currently pregnant?
IF MORE THAN ONE WIFE/PARTNER, ASK: Are any of your wives/partners currently pregnant?

YES 1
NO 2
NOT SURE 3

503. CHECK 502:

WIFE NOT PREGNANT OR UNSURE __
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?

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

HAVE (A/ANOTHER) CHILD 1
NO MORE/NONE 2 (GO TO 505)
WIFE CANNOT GET PREGNANT 3 (GO TO 505)
UNDECIDED/DON'T KNOW 8 (GO TO 505)

504. CHECK 502:

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

WIFE PREGNANT __
After the birth of the child you are expecting now, how long would you like to wait before the birth of another child?

MONTHS 1 ___
YEARS 2 ___
SOON/NOW 993
WIFE CANNOT GET PREGNANT 994
AFTER MARRIAGE 995
OTHER (SPECIFY) ___ 996
DOES NOT KNOW 998

505. CHECK 203 AND 205:

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

NO LIVING CHILDREN __
If you could choose exactly the number of children to have in your whole life, how many would that be?

PROBE FOR A NUMERIC RESPONSE.

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

506. How many of these children would you like to be boys,
how many would you like to be girls and for how many would the sex not matter?

NUMBER:
BOYS ___
GIRLS ___
EITHER ___
OTHER (SPECIFY) ___ 96

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

APPROVE 1
DISAPPROVE 2
DON'T KNOW/UNSURE 3

508. In the last few months have you heard or seen messages about family planning:

On the radio?
On the television?
In a newspaper or magazine?
In a poster?
In leaflets or brochures?
From a health worker?
At a community or social club meeting?

RADIO
YES 1
NO 2
TELEVISION
YES 1
NO 2
NEWSPAPER OR MAGAZINE
YES 1
NO 2
POSTER
YES 1
NO 2
LEAFLETS OR BROCHURES
YES 1
NO 2
HEALTH WORKER
YES 1
NO 2
MEETING
YES 1
NO 2

509. Have you heard the following messages about family planning:

Life Choices: It's your life. It's your choice?
Make the choice that is best for you?
Contraceptives are safe and effective?
Obra ni wora bo?

LIFE CHOICES: ITS YOUR LIFE ITS YOUR CHOICE
YES 1
NO 2
MAKE THE CHOICE THAT IS BEST FOR YOU
YES 1
NO 2
CONTRACEPTIVES ARE SAFE AND EFFECTIVE
YES 1
NO 2
OBRA NI WORA BO
YES 1
NO 2

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

YES 1
NO 2 (GO TO 512)

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

WIFE(VES)/PARTNER A
MOTHER B
FATHER C
SISTER(S) D
BROTHER(S) E
DAUGHTER(S) F
SON(S) G
FATHER(S)-IN-LAW H
FRIENDS/NEIGHBOURS I
OTHER (SPECIFY) ____ X

512. In the last few months, have you discussed family planning with a health worker or health professional?

YES 1
NO 2

SECTION 6. HEALTH ISSUES

601. Now I would like to ask you some questions about health. When a child has diarrhea, should he or she be given less to drink than usual, about the same amount, or more to drink than usual?

LESS 1
ABOUT THE SAME 2
MORE 3
DOES NOT KNOW 8

602. Have you ever heard of a special product called ORS for the treatment of diarrhea?

YES 1
NO 2

603. Now please tell me about yourself. Do you smoke cigarettes or use tobacco?
IF YES: What type of tobacco do you smoke?
CIRCLE ALL TYPES MENTIONED.

YES, CIGARETTES A
YES, PIPE B
YES, OTHER TOBACCO C
NO Y

604. CHECK 603:

CODE 'A' CIRCLED (GO TO 605)
CODE 'A' NOT CIRCLED (GO TO 701)

605. In the last 24 hours, how many cigarettes did you smoke?

CIGARETTES ___

SECTION 7. AIDS AND OTHER SEXUALLY-TRANSMITTED DISEASES

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

YES 1
NO 2 (GO TO 724)

702. Can people reduce their chances of getting the AIDS virus by having just one sex partner who is not infected and who has no other partners?

YES 1
NO 2
DON'T KNOW 8

703. Can a person get the AIDS virus from mosquito bites?

YES 1
NO 2
DON'T KNOW 8

704. Can people reduce their chances of getting the AIDS virus by using a condom every time they have sex?

YES 1
NO 2
DON'T KNOW 8

705. Can people get the AIDS virus by sharing food with a person who has AIDS?

YES 1
NO 2
DON'T KNOW 8

706. Can people reduce their chances of getting the AIDS virus by not having sex at all?

YES 1
NO 2
DON'T KNOW 8

706A. Can people get the AIDS virus because of witchcraft or other supernatural means?

YES 1
NO 2
DON'T KNOW 8

707. Is there anything (else) a person can do to avoid getting AIDS or the virus that causes AIDS?

YES 1
NO 2 (GO TO 709)
DON'T KNOW 8 (GO TO 709)

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

ABSTAIN FROM SEX A
USE CONDOMS B
LIMIT SEX TO ONE PARTNER/STAY FAITHFUL TO ONE PARTNER C
LIMIT NUMBER OF SEXUAL PARTNERS D
AVOID SEX WITH PROSTITUTES E
AVOID SEX WITH PERSONS WHO HAVE MANY PARTNERS F
AVOID SEX WITH HOMOSEXUALS G
AVOID SEX WITH PERSONS WHO INJECT DRUGS INTRAVENOUSLY H
AVOID BLOOD TRANSFUSIONS I
AVOID INJECTIONS J
AVOID SHARING RAZORS/BLADES K
AVOID KISSING L
AVOID MOSQUITO BITES M
SEEK PROTECTION FROM TRADITIONAL PRACTITIONER N
OTHER (SPECIFY) ____ W
OTHER (SPECIFY) ____ X

709. Is it possible for a healthy-looking person to have the AIDS virus?

YES 1
NO 2
DON'T KNOW 8

710. Do you know someone personally who has the virus that causes AIDS or someone who died of AIDS?

YES 1
NO 2
DON'T KNOW 8

711. Can the virus that causes AIDS be transmitted from a mother to a child?

YES 1
NO 2 (GO TO 713)
DON'T KNOW 8 (GO TO 713)

712. Can the virus that causes AIDS be transmitted from a mother to a child:

During pregnancy?
During delivery?
By breastfeeding?

DURING PREGNANCY
YES 1
NO 2
DK 8
DURING DELIVERY
YES 1
NO 2
DK 8
BY BREASTFEEDING
YES 1
NO 2
DK 8

712A. Are there any special drugs that a pregnant woman infected with the AIDS virus can take to reduce the risk of transmission to the baby during pregnancy?

YES 1
NO 2
DON'T KNOW 8

713. CHECK 401:

YES, CURRENTLY MARRIED/LIVING WITH A WOMAN (GO TO 714)
NO, NOT MARRIED OR LIVING WITH A WOMAN (GO TO 715)

714. Have you ever talked about ways to prevent getting the virus that causes AIDS with (your wife/woman you are living with)?
IF MORE THAN ONE WIFE/PARTNER, ASK ABOUT ANY OF HIS WIVES/PARTNERS.

YES 1
NO 2
DON'T KNOW 8

715. In your opinion, is it acceptable or unacceptable for AIDS to be discussed:

on the radio?
on the TV?
in newspapers?

ON THE RADIO
ACCEPTABLE 1
NOT ACCEPTABLE 2
ON THE TV
ACCEPTABLE 1
NOT ACCEPTABLE 2
IN NEWSPAPERS
ACCEPTABLE 1
NOT ACCEPTABLE 2

715A. Have you heard or seen any messages about HIV/AIDS?

YES 1
NO 2
DON'T KNOW 8

715B. Have you heard or seen the slogan 'Reach Out, Show Compassion?'

YES 1
NO 2
DON'T KNOW 8

715C. Have you heard or seen the slogan 'Stop AIDS, Love Life?'

YES 1
NO 2
DON'T KNOW 8

715D.CHECK 715B AND 715C:

YES, CIRCLED FOR EITHER OR BOTH (GO TO 715E)
NO, DON'T KNOW CIRCLED (GO TO 715F)

715E. Did you hear or see this slogan:
On the TV?
In a music video?
On the radio?
In a newspaper or magazine?
In a poster?
On a car sticker?
In leaflets or brochures?
On a tee-shirt or a cap?
From a mobile 'ISD' van?
During a community event?
At a road show?

TV
YES 1
NO 2
MUSIC VIDEO
YES 1
NO 2
RADIO
YES 1
NO 2
NEWSPAPER/MAGAZINE
YES 1
NO 2
POSTER
YES 1
NO 2
CAR STICKER
YES 1
NO 2
LEAFLETS/BROCHURES
YES 1
NO 2
T-SHIRT/CAP
YES 1
NO 2
ISD VAN
YES 1
NO 2
COMMUNITY EVENT
YES 1
NO 2
ROAD SHOW
YES 1
NO 2

715F. Have you seen a television show called 'Things we do for love' that features the characters Pusher, B.B. and Marcia?

YES 1
NO 2
DON'T KNOW 8

715G. Would you buy fresh vegetables from a vendor who has the AIDS virus?

YES 1
NO 2
DON'T KNOW 8

716. If a member of your family got infected with the virus that causes AIDS,
would you want it to remain a secret or not?

YES 1
NO 2
DON'T KNOW 8

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

YES 1
NO 2
DON'T KNOW 8

718. If a female teacher has the AIDS virus, should she be allowed to continue teaching in school?

YES 1
NO 2
DON'T KNOW 8

719. Should children aged 12-14 be taught about using a condom to avoid AIDS?

YES 1
NO 2
DON'T KNOW 8

720. I don't want to know the results, but have you ever been tested for the AIDS virus?

YES 1
NO 2 (GO TO 721)

720A. When was the last time you were tested?

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

720B. The last time you had the test, did you yourself ask for the test, was it offered to you and you accepted, or was it required?

ASKED FOR THE TEST 1
OFFERED AND ACCEPTED 2
REQUIRED 3

720C. I don't want to know the results, but did you get the results of the test?

YES 1 (SKIP TO 723A)
NO 2 (SKIP TO 723A)

721. Would you want to be tested for the AIDS virus?

YES 1
NO 2
DON'T KNOW 8

722. Do you know a place where you could go to get an AIDS test?

YES 1
NO 2 (GO TO 724)

723. Where can you go for the test?
723A. Where did you go for the test?

IF SOURCE IS HOSPITAL, HEALTH CENTRE, OR CLINIC, WRITE THE NAME OF THE PLACE.
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

NAME OF PLACE ____________
PUBLIC SECTOR
GOVT. HOSPITAL/POLYCLINIC 11
GOVT. HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14
FIELDWORKER 15
OTHER PUBLIC (SPECIFY)____ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PRIVATE DOCTOR 22
PHARMACY/CHEMIST/DRUG STORE 23
MOBILE CLINIC 24
FIELDWORKER 25
FP/PPAG CLINIC 26
MATERNITY HOME 27
OTHER PRIVATE MEDICAL (SPECIFY)____ 28
OTHER SOURCE

SHOP 31
CHURCH 32
FRIENDS/RELATIVES 33
OTHER (SPECIFY) ____ 96

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

YES 1
NO 2 (GO TO 727)

725. If a man has a sexually transmitted disease, what symptoms might he have? Any others?
CIRCLE ALL MENTIONED.

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

726. If a woman has a sexually transmitted disease, what symptoms might she have? Any others?
CIRCLE ALL MENTIONED.

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

727. CHECK 416:

HAS HAD SEXUAL INTERCOURSE (GO TO 727A)
HAS NOT HAD SEXUAL INTERCOURSE (GO TO 737)

727A. CHECK 724:

KNOWS STI (GO TO 728)
DOES NOT KNOW STI (GO TO 729)

728. Now I would like to ask you some questions about your health in the last 12 months.
During the last 12 months, have you had a sexually-transmitted disease?

YES 1
NO 2
DON'T KNOW 8

729. Sometimes, men experience an abnormal discharge from their penis. During the last 12 months, have you had an abnormal discharge from your penis?

YES 1
NO 2
DON'T KNOW 8

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

YES 1
NO 2
DON'T KNOW 8

731. CHECK 728/729/730:

HAS HAD AN INFECTION (GO TO 732)
HAS NOT HAD AN INFECTION OR DOES NOT KNOW (GO TO 737)

732. The last time you had (PROBLEM(S) FROM 728/729/730), did you seek any kind of advice or treatment?

YES 1
NO 2 (GO TO 734)

733. The last time you had (PROBLEM(S) FROM 728/729/730), did you do any of the following? Did you:
Go to a clinic, hospital or private doctor?
Consult a traditional healer?
Seek advice or buy medicines in a shop or pharmacy?
Ask for advice from friends or relatives?

CLINIC/HOSPITAL
YES 1
NO 2
TRADITIONAL HEALER
YES 1
NO 2
SHOP/PHARMACY
YES 1
NO 2
FRIENDS/RELATIVES
YES 1
NO 2

734. When you had (PROBLEM(S) FROM 728/729/730), did you inform the person(s) with whom you were having sex?

YES 1
NO 2
SOME/NOT AT ALL 3
DID NOT HAVE A PARTNER 4 (GO TO 737)

735. When you had (PROBLEM(S) FROM 728/729/730), did you do anything to avoid infecting your sexual partner(s)?

YES 1
NO 2 (GO TO 737)
PARTNER ALREADY INFECTED 3 (GO TO 737)

736. What did you do to avoid infecting your partner(s)? Did you:

Use medicine?
Stop having sex?
Use a condom when having sex?

USE MEDICINE
YES 1
NO 2
STOP SEX
YES 1
NO 2
USE CONDOM
YES 1
NO 2

737. In many communities, boys are also circumcised. In your community, is male circumcision practiced?

YES 1
NO 2

738. Are you circumcised?

YES 1
NO 2

SECTION 8. ATTITUDES TOWARD WOMEN

801. Who in your family usually has the final say on the following decisions:

YOUR OWN HEALTH CARE?
RESPONDENT 1
HUSBAND/PARTNER 2
RESPONDENT AND PARTNER JOINTLY 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE JOINTLY 5
DECISION NOT MADE/NOT APPLICABLE 6
MAKING LARGE HOUSEHOLD PURCHASES?
RESPONDENT 1
HUSBAND/PARTNER 2
RESPONDENT AND PARTNER JOINTLY 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE JOINTLY 5
DECISION NOT MADE/NOT APPLICABLE 6
MAKING HOUSEHOLD PURCHASES FOR DAILY NEEDS?
RESPONDENT 1
HUSBAND/PARTNER 2
RESPONDENT AND PARTNER JOINTLY 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE JOINTLY 5
DECISION NOT MADE/NOT APPLICABLE 6
VISITS TO FAMLY OR RELATIVES?
RESPONDENT 1
HUSBAND/PARTNER 2
RESPONDENT AND PARTNER JOINTLY 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE JOINTLY 5
DECISION NOT MADE/NOT APPLICABLE 6
WHAT FOOD SHOULD BE COOKED EACH DAY?
RESPONDENT 1
HUSBAND/PARTNER 2
RESPONDENT AND PARTNER JOINTLY 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE JOINTLY 5
DECISION NOT MADE/NOT APPLICABLE 6

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

If she goes out without telling him?
If she neglects the children?
If she argues with him?
If she refuses to have sex with him?
If she burns the food?

GOES OUT
YES 1
NO 2
DK 8
NEGL. CHILDREN
YES 1
NO 2
DK 8
ARGUES
YES 1
NO 2
DK 8
REFUSES SEX
YES 1
NO 2
DK 8
BURNS FOOD
YES 1
NO 2
DK 8

803. When a wife knows her husband has a sexually transmitted disease, is she justified in asking her husband to use a condom?

YES 1
NO 2
DOES NOT KNOW 8

804. Husbands and wives do not always agree on everything. Please tell me if you think a wife is justified in refusing to have sex with her husband when:

She knows her husband has a sexually transmitted disease?
She knows her husband has sex with women other than his wives?
She has recently given birth?
She is tired or not in the mood?

HAS STD
YES 1
NO 2
DK 8
OTHER WOMEN
YES 1
NO 2
DK 8
RECENT BIRTH
YES 1
NO 2
DK 8
TIRED/MOOD
YES 1
NO 2
DK 8

805. Do you think that if a woman refuses to have sex with her husband when he wants her to, he has the right to:

Get angry and reprimand her?
Refuse to give her money or other means of financial support?
Use force and have sex with her even if she does not want to?
Go and have sex with another woman

REPRIMAND
YES 1
NO 2
DK 8
REFUSE MONEY
YES 1
NO 2
DK 8
USE FORCE
YES 1
NO 2
DK 8
SEX WITH ANOTHER
YES 1
NO 2
DK 8

806. RECORD THE TIME.

HOUR ____
MINUTES ____

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: ____________________