IDENTIFICATION

PLACE NAME _____
NAME OF HOUSEHOLD HEAD _____
CLUSTER NUMBER _____
HOUSEHOLD NUMBER _____
REGION CODE _____

URBAN/RURAL:

CONAKRY/CAPITAL NATURAL REGION/OTHER CITY/RURAL:

NAME OF WOMAN _____

LINE NUMBER OF WOMAN _____

INTERVIEWER VISITS

FIRST VISIT (REPEAT FOR SECOND AND THIRD VISITS)
DATE _____
INTERVIEWER'S NAME _____

RESULT _____

NEXT VISIT
DATE _____
TIME _____

FINAL VISIT
DAY _____
MONTH _____
YEAR 1999
NAME _____

RESULT _____

TOTAL NUMBER OF VISITS _____

LANGUAGE OF INTERVIEW:

INTERPRETER:

SUPERVISOR
NAME _____
DATE _____

FIELD EDITOR
NAME _____
DATE _____

OFFICE EDITOR _____

KEYED BY _____

SECTION 1. RESPONDENT'S SOCIO-DEMOGRAPHIC CHARACTERISTICS

101. RECORD THE TIME:

105. In what month and year were you born?

106. How old were you at your last birthday?
COMPARE AND CORRECT 105 AND/OR 106 IF INCONSISTENT.

106A. Do you understand French?

107. Have you ever attended school?

108. What is the highest level of school you attended: primary, secondary (1st cycle), secondary (2nd cycle), professional A, professional B, or superior?

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

110. CHECK 106:

111. Are you currently in school?

111A. How old were you when you stopped going to school?

112. What is the main reason for which you stopped attending school?

113. CHECK 108:

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

114A. Do you typically read a newspaper or magazine at least once a month?

115. Do you typically read a newspaper or magazine at least once a week?

115A. Do you typically listen to the radio?

116. Do you typically listen to the radio every day?

116A. What days of the week do you normally listen to the radio?

RECORD ALL RESPONSES GIVEN. IF THE RESPONSE IS "EVERYDAY," "IT DEPENDS," "IT DOESN'T MATTER," OR "DOESN'T KNOW", YOU ONLY NEED TO RECORD ONE CODE.

116B. What time do you normally listen to the radio?

RECORD ALL RESPONSES GIVEN. IF THE RESPONSE IS "ALL DAY", "IT DEPENDS," "IT DOESN'T MATTER," OR "DOESN'T KNOW", YOU ONLY NEED TO RECORD ONE CODE.

116C. What type of radio program do you normally listen to?
PROBE TO OBTAIN THE TYPE OF PROGRAM. RECORD ALL THE PROGRAMS.

116D. Do you usually watch television?

117. Do you usually watch television at least once a week?

117A. What days of the week do you normally watch television?

RECORD ALL RESPONSES GIVEN. IF THE RESPONSE IS "IT DEPENDS," "IT DOESN'T MATTER," OR "DOESN'T KNOW", YOU ONLY NEED TO RECORD ONE CODE.

117B. What time do you normally watch television?

RECORD ALL THE RESPONSES GIVEN. IF THE RESPONSE IS 'ALL DAY,' 'IT DEPENDS,' 'DOESN'T MATTER,' OR 'DOESN'T KNOW,' YOU ONLY HAVE TO RECORD ONE CODE.

117C. What type of television show do you normally watch?
RECORD ALL OF THE SHOWS WATCHED.

118. What is your religion?

119. What is your nationality?

120. What is your ethnicity?

121. What language do you mainly speak at home?

SECTION 2. REPRODUCTION

Now I would like to ask you about all the births you have had during your life.

201. Have you ever given birth?

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

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

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

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

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

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

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

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

210. CHECK 208:

211. Now I would like to record all your births, whether still alive or not, starting with the first one you had. RECORD NAMES OF ALL OF THE BIRTHS IN 212. RECORD TWINS AND TRIPLETS ON SEPARATE LINES.

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

213. Was (NAME) a part of a single or multiple birth?

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

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

216. Is (NAME) still alive?

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

218. IF ALIVE: Does (NAME) live with you?

219. IF DEAD: how old was (NAME) when he/she died?
IF "1 YEAR," PROBE: how many months old was (NAME)?

RECORD IN DAYS IF LESS THAN 1 MONTH; MONTHS IF LESS THAN TWO YEARS; OR YEARS.

220. FROM YEAR OF BIRTH OF (NAME) SUBTRACT YEAR OF PREVIOUS BIRTH.
IS THE DIFFERENCE 4 OR MORE?
[DO NOT ASK FOR FIRST BIRTH]

221. Were there any other live births between (NAME OF PREVIOUS BIRTH) and (NAME)?
[DO NOT ASK FOR FIRST BIRTH]

222. SUBTRACT THE YEAR OF BIRTH OF THE LAST CHILD FROM THE YEAR OF THE INTERVIEW (1999). IS THE DIFFERENCE 4 YEARS OR MORE?

223. Have you had any live births since the birth of (NAME OF LAST BIRTH)?

224. COMPARE 208 WITH NUMBER OF BIRTHS IN HISTORY ABOVE AND RECORD:

225. CHECK 215 AND ENTER THE NUMBER OF BIRTHS SINCE JANUARY 1994.
IF NONE, NOTE '0'.

227. Are you pregnant now?

228. How many months pregnant are you?
RECORD NUMBER IN COMPLETED MONTHS.

229. At the time you became pregnant did you want to become pregnant then, did you want to wait until later, or did you not want to have any more children at all?

236. When did your last menstrual cycle start?
RECORD THE DATE, IF GIVEN.

237. From one menstrual cycle to the next, are there certain days when a woman is more likely to become pregnant if she has sexual relations?

238. At what time during her menstrual cycle is a woman more likely to get pregnant?

SECTION 3. CONTRACEPTION

300. 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 302, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE '2' IF METHOD IS RECOGNIZED, AND CODE '3' IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE '1' OR '2' CIRCLED IN 301 OR 302, ASK 303.

301. Which ways methods of contraception have you heard about?
302. Have you ever heard of (METHOD)?

303. Have you ever used (METHOD)?

304. CHECK 303:

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

307. What have you used or done?
CORRECT 303 AND 304 (AND 302 IF NECESSARY).

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

309. How many living children did you have at that time, if any?
IF NONE, RECORD '00'.

310. When you first used family planning, did you want to have another child but at a later time, or did you not want to have another child at all?

311. CHECK 303:

312. CHECK 227:

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

314. Which method are you using?
314A. CIRCLE '07' FOR FEMALE STERILIZATION.

314B. Why do you use the pill over another method?

315. May I see the package of pills you are using right now?
RECORD NAME OF BRAND IF PACKAGE IS SEEN.

316. Do you know the brand name of the pills you are now using?

317. How much does one packet (cycle) of pills cost you?

317A. Why did (you or your spouse/partner) have an operation to not have any more children, rather than using another method?

318. In what facility did the sterilization take place?

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

319. Do you regret that (you or your husband) had the operation not to have any more children?

320. Why do you regret the operation?

321. In what month and year was the sterilization performed?

322A. Why do you use the rhythm/periodic abstinence rather than another method?

323. How do you determine which days of your monthly cycle to not have sexual relations?

325A. Why do you use (METHOD FROM 314) rather than another method?

326. For how many months have you been using (METHOD) continuously?
IF LESS THAN 1 MONTH, RECORD '00'.

327. CHECK 314:
CIRCLE THE CODE OF THE METHOD.

328. Where did you obtain (METHOD) the last time?

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

329. Do you know of another place where you could have obtained (METHOD) the last time?
329A. At the time of the sterilization operation, did you know of another place where you could have received the operation?

329B. People choose the place where they get family planning services for various reasons.
What was the main reason you went to (NAME OF LOCATION LISTED IN 328 OR 318) instead of some other place you know about? Other reasons?

RECORD EVERYTHING THAT IS MENTIONED. IF THE ANSWER IS 'DOESN'T KNOW' YOU ONLY NEED TO CIRCLE THE CORRESPONDING CODE.

330. INTERVIEWER:

- IF YOU ONLY CIRCLED ONE CODE FOR 329B, CIRCLE HERE THE CODE CORRESPONDING TO THE SAME ANSWER AND (GO TO 334)

- IF YOU CIRCLED SEVERAL CODES FOR 329B, ASK THE FOLLOWING QUESTION AND CIRCLE THE CODE CORRESPONDING TO THE ANSWER.

Among the reasons you gave me, what is the main reason?

331. CHECK 227:

331A. What is the main reason that you are not using a method of contraception to avoid pregnancy?

332. Do you know where you can obtain a method of family planning?

333. Where is that?

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

334. Where you visited by a family planning program worker in the last 12 months?

335. Have you visited a health facility for any reason in the last 12 months?

336. Did any staff member at the health facility speak to you about family planning methods?

337. Do you think that breastfeeding can affect a woman's chance of becoming pregnant?

338. Do you think a woman's chance of becoming pregnant is increased or decreased by breastfeeding?

339. CHECK 210:

340. Have you ever relied on breastfeeding as a method of avoiding pregnancy?

341. CHECK 227 AND 311:

342. Are you currently relying on breastfeeding to avoid getting pregnant?

SECTION 4A. PREGNANCY, POSTNATAL CARE, AND BREASTFEEDING

401. CHECK 225:

402. ENTER IN THE TABLE THE NAME, LINE NUMBER, AND SURVIVAL STATUS OF EACH BIRTH SINCE JANUARY 1994. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN THREE BIRTHS, USE ADDITIONAL QUESTIONNAIRE).

Now I would like to ask you some questions about the health of all your children born in the last five years. (We will talk about each separately).

403. SEE SECTION 2: LINE NUMBER FROM 212:

404. FROM 212 AND 216:

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

406. How much longer would you like to have waited?

407. When you were pregnant with (NAME), did you see anyone for antenatal care for this pregnancy? IF YES: Whom did you see? Anyone else?

PROBE TO OBTAIN THE TYPE OF PERSON AND RECORD ALL OF THE PERSONS SEEN.

408. How many months pregnant were you when you first received antenatal care?

409. How many times did you receive antenatal care during this pregnancy?

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

411. During this pregnancy, how many times did you get this injection?

412. Where did you give birth to (NAME)?

413. Who assisted you with the delivery of (NAME)? Anyone else?
PROBE TO OBTAIN THE TYPE OF PERSON AND RECORD ALL PERSONS ASSISTING.

415. Was (NAME) delivered by cesarean?

416. When (NAME) was born, was he/she born very large, larger than average, average, smaller than average, or very small?

417. Was (NAME) weighed at birth?

418. How much did (NAME) weigh?
RECORD THE WEIGHT WRITTEN IN THE HEALTH CARD, IF AVAILABLE.

418A. In the first month and a half after the birth of (NAME), did you see anyone to discuss your health or the baby's health?

418B. How many days after giving birth did you have this first visit?

418C. During this consultation, who examined your health or the baby's health?

418D. Where was this first consultation?

418E. During this visit, did the person you were consulting give you information or advice on family planning?

419. Has your period returned since the birth of (NAME)?
[ASK ONLY FOR MOST RECENT BIRTH]

420. Did your period return between the birth of (NAME) and your next pregnancy?
[DO NOT ASK FOR MOST RECENT BIRTH]

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

422. CHECK 227:
IS RESPONDENT PREGNANT?

423. Have you resumed sexual relations since the birth of (NAME)?
[ASK ONLY FOR MOST RECENT BIRTH]

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

425. Did you ever breastfeed (NAME)?

426. How long after birth did you first put (NAME) to the breast?
IF LESS THAN 1 HOUR, RECORD '00' HOURS. IF LESS THAN 24 HOURS, RECORD HOURS. OTHERWISE, RECORD DAYS

427. CHECK 404:
IS CHILD LIVING?
[DO NOT ASK FOR THIRD-TO-LAST BIRTH/LATER BIRTHS]

428. Are you still breastfeeding (NAME)?
[DO NOT ASK FOR THIRD-TO-LAST BIRTH/LATER BIRTHS]

429. For how many months did you breastfeed (NAME)?

430. Why did you stop breastfeeding (NAME)?

431. CHECK 431:
IS CHILD LIVING?

432. How many times did you breastfeed last night between sunset and sunrise?
IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER.
[DO NOT ASK FOR THIRD-TO-LAST BIRTH/LATER BIRTHS]

433. How many times did you breastfeed yesterday during the daylight hours?
IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER.
[DO NOT ASK FOR THIRD-TO-LAST BIRTH/LATE BIRTHS]

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

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

Plain water?
Sugar water?
Juice?
Herbal tea?
Baby formula?
Tinned or powdered milk?
Animal milk/fresh milk?
Preparation for baby?
Any other liquids?
Solid or bottled food?

[DO NOT ASK FOR THIRD-TO-LAST BIRTH/LATER BIRTHS]

439. GO BACK TO 405 IN NEXT COLUMN; OR, IF NO MORE BIRTHS, GO TO 440.

SECTION 4B. IMMUNIZATION, HEALTH, AND NUTRITION

440. ENTER IN THE TABLE THE NAME AND THE LINE NUMBER OF EACH BIRTH SINCE JANUARY 1994. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN THREE BIRTHS, USE ADDITIONAL QUESTIONNAIRE).

441. SEE SECTION 2: LINE NO. FROM 212:

442. FROM 212 AND 216:

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

444. Have you ever had a vaccination card for (NAME)?

445. (1) COPY VACCINATION DATES FOR EACH VACCINE FROM THE CARD. (2) WRITE '44' IN 'DAY' COLUMN IF CARD SHOWS THAT A VACCINATION WAS GIVEN, BUT NO DATE IS RECORDED.

446. Has (NAME) received any vaccinations that are not recorded on this card?
RECORD 'YES' ONLY IF RESPONDENT MENTIONS BCG, POLIO 0-3, DPT 1-3, MEASLES, AND/OR YELLOW FEVER.

447. Did (NAME) receive any vaccinations to prevent him/her from getting diseases?

448. Please tell me if (NAME) received any of the following vaccinations:

448A. A BCG vaccination against tuberculosis, that is, an injection in the arm or shoulder that usually causes a scar?

448B. Polio vaccine, that is, drops in the mouth?

448C. IF YES: How many times was the polio vaccine received?

448D. When was the first polio vaccine received: just after birth or later?

448E. A DPT vaccination, that is, an injection given in the thigh or buttocks, sometimes at the same time as polio drops?

448F. IF YES: How many times was the DPT vaccination received?

448G. An injection to prevent measles?

448H. An injection to prevent yellow fever?

449. Has (NAME) been ill with a fever at any time in the last 2 weeks?

450. Has (NAME) had an illness with a cough at any time in the last 2 weeks?

451. When (NAME) had an illness with a cough, did he/she breathe faster than usual with short, rapid breaths?

452. Did you seek advice or treatment for the cough?

453. Where did you seek advice or treatment? Anywhere else?
RECORD ALL SOURCES MENTIONED.

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

455. Was there blood in the stools?

456. On the worst day of the diarrhea, how many bowel movements did (NAME) have?

457. Was (NAME) given the same amount to drink as before the diarrhea, or more, or less?

458. Was (NAME) given the same amount of food to eat as before the diarrhea, or more, or less?

458A. CHECK 428:
CHILD STILL BREASTFEEDING?
[DO NOT ASK FOR THIRD-TO-LAST BIRTH/LATER BIRTHS]

458B. Was (NAME) breastfed in the same way before the diarrhea, or more or less?
[DO NOT ASK FOR THIRD-TO-LAST BIRTH/LATER BIRTHS]

459. When (NAME) had diarrhea, was he/she given any of the following to drink:

A fluid prepared from a special packet called ORS? SHOW ORS PACKET.
Homemade sugar-salt-water solution?
A bottle?
Soup?
Milk or infant formula?
Yogurt-based drink?
Water?
Any other liquids?

460. Was anything else given to (NAME) to treat the diarrhea?

461. What was given to treat the diarrhea? Anything else?
RECORD ALL MENTIONED.

462. Did you seek advice or for a treatment for the diarrhea?

463. Where did you seek advice or treatment? Anywhere else?
RECORD ALL MENTIONED.

464. GO BACK TO 442 IN THE NEXT COLUMN; OR, IF NO MORE BIRTHS, GO TO 465.

465. When a child has diarrhea, should he/she be given less to drink than usual to drink, the same amount, or more than usual?

466. When a child has diarrhea, should he/she be given less to eat than usual, about the same amount, or more than usual?

467. When a child is sick with diarrhea, what signs of illness would tell you that he or she should be taken to a health facility or health worker? Any other symptom?
RECORD ALL MENTIONED.

467A. In your opinion, what causes diarrhea in children 5 years or younger?
RECORD ALL RESPONSES MENTIONED.

467B. What is the main cause of diarrhea in children 5 years or younger?
RECORD ONLY ONE RESPONSE.

467C. What are the consequences of diarrhea for children 5 years or younger?
RECORD ALL RESPONSES MENTIONED.

467D. Are most cases of diarrhea not very serious, serious, or very serious?

468. When a child is sick with a cough, what signs of illness would tell you that he or she should be taken to a health facility or health worker? Any other symptom?
RECORD ALL MENTIONED.

469. CHECK 459, ALL COLUMNS:

470. Have you ever heard of a special product called ORS that you can get for the treatment of diarrhea?

471. Have you ever used this product?

472. Where did you get ORS last time?

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

473. Do you currently have an ORS packet in your home?

474. Could I see the ORS packet you have?
IF THE PACKET IS SHOWN, CIRCLE THE CORRESPONDING NUMBER.

475. Do you know the brand name of the ORS packet that you have now?
RECORD THE NAME OF THE BRAND.

476. How much did the packet of ORS cost?

476A. What was your information source on the type of ORS you used?

476B. Who advised or decided to give this ORS?

477. CHECK 459, ALL THE COLUMNS:

478. Have you heard of a solution of salt, sugar, and water that you prepare at home and that you give to children to treat diarrhea?

479. Have you already prepared this solution?

SECTION 5. MARRIAGE AND SEXUAL ACTIVITY

501. Are you currently married or living with a man?

502. Have you ever been married or lived with a man?

505. What is your current marital status: are you a widow, divorced, or separated?

507. Is your husband/partner living with you now or is he staying elsewhere?

507A. RECORD THE LINE NUMBER OF HER HUSBAND ACCORDING TO THE HOUSEHOLD QUESTIONNAIRE. IF HE IS NOT A PART OF THE HOUSEHOLD, RECORD '00'.

508. Does your husband/partner have any other wives, besides yourself?

509. How many other wives does he have?

510. Are you the first, second?wife?

511. Have you been married or have you lived with a man only once or more than once?

511A. How much time passed between the end of your second to last union and the beginning of your last union (your current union)? IF LESS THAN ONE YEAR, RECORD '00'.

512. CHECK 511:

MARRIED/LIVED WITH MAN ONLY ONCE: In what month and year did you start living with your husband/partner?

MARRIED/LIVED WITH MAN MORE THAN ONCE: Now we will talk about your first husband/partner. In what month and year did you start living with him?

513. How old were you when you started living with him?

514A. CHECK 502:

Now I need to ask you some questions about sexual activity in order to gain a better understanding of some family planning issues.

515. When was the last time you had sexual intercourse with (your husband/the man with whom you live)?

IF "NEVER HAD RELATIONS", GO BACK TO 501 AND CIRCLE CODE '3' (MARRIAGE NOT CONSUMMATED) AND FOLLOW THE NEW INSTRUCTIONS STARTING WITH 501.

515A. CHECK 301 AND 302:

KNOWS WHAT CONDOMS ARE: The last time you had sex with (your husband/the man with whom you live), was a condom used?

DOES NOT KNOW WHAT CONDOMS ARE: Some men use a condom, which means they put a rubber sheath on their penis during sexual intercourse. The last time you had sex with (your husband/the man with whom you live), was a condom used?

515AA. During this last sexual relation, who suggested using the condom?

515B. Have you had sexual relations with someone other than (your husband/the man with whom you live) in the last 12 months?

515C. When was the last time you had sexual relations with someone other than (your husband/the man with whom you live)

515CA. The last time you had sexual relations with someone other than your husband/the man with whom you live, was it with a regular partner, an acquaintance, for money, or someone else?

515D. Was a condom used on this occasion?

515DA. During this last sexual relation, who suggested using the condom?

515E. During the last 12 months, how many different people other than (your husband/the man with whom you live) did you have sexual relations with?

Now I would like to ask you some questions about sexual activity in order to gain a better understanding of some family planning issues.

515F. When was the last time you had sexual intercourse (if ever)?

515FA. The last time you had sexual relations, was it a regular partner, an acquaintance, for money, or someone else?

515G. CHECK 301 AND 302:

KNOWS WHAT CONDOMS ARE: The last time you had sex, was a condom used?

DOES NOT KNOW WHAT CONDOMS ARE: Some men used a condom, which means they put a rubber sheath on their penis during sexual intercourse. The last time you had sex, was a condom used?

515GA. During this last sexual relation, who suggested using the condom?

515H. CHECK 515F:

515I. In total, with how many different people have you had sex in the last 12 months?

517. Do you know of a place where you can get condoms?

518. Where is that?

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.

518A. CHECK 515A, 515D AND 515G:

518B. Where did you get the condom last time?

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

518C. Do you know the brand name of the condoms that you used last time?
RECORD NAME OF BRAND.

518D. The last time you bought condoms, how many did you buy?
DETERMINE THE NUMBER AND RECORD. RECORD '90' FOR 90 OR MORE.

518E. How much did you pay?

519. How old were you when you first had sexual intercourse?

SECTION 6. FERTILITY PREFERENCES

601. CHECK 314:

602. CHECK 227:

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

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?

603. CHECK 227:

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

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

604. CHECK 227:

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

606. CHECK 313:
USING A METHOD?

607. Do you think you will use a method to delay or avoid pregnancy within the next 12 months?

608. Do you think you will use a method any time in the future?

609. Which method would you prefer to use?

610. What is the main reason that you think you will never use a method?

611. Would you use a method if you were married?

612. CHECK 216:

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.

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

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

615. Is it acceptable or not acceptable to you for information on family planning to be provided:

On the radio?
On the television?

616. In the last few months have you heard about family planning:

On the radio?
On the television?
In a newspaper in magazine?
Poster?
From leaflets or brochures?
On an advertising sign?
During a community meeting?

616A. What is your main source of information on family planning?

618. In the last few months, have you discussed the practice of family planning with anyone?

619. With whom? Anyone else?
RECORD ALL PERSONS MENTIONED.

620. CHECK 501:

Spouses/partner do not always agree on everything. Now I want to ask you about your husband's/partner's views on family planning.

621. Do you think your husband/partner approves or disapproves of couples using a contraceptive method to avoid pregnancy?

622. How often have you talked to your husband/partner about family planning in the last twelve months?

622A. Who usually starts the discussion on family planning: you, your husband/partner, or both?

622B. CHECK 313:
USES A METHOD?

622C. Before beginning to use (CURRENT METHOD), did you discuss which method you would use with your husband/partner?

622D. After having started (CURRENT METHOD), did you discuss this method with your husband/partner?

622E. CHECK 314:
CIRCLE CODE OF METHOD.

622F. Did your husband/partner encourage you or discourage you from using (CURRENT METHOD)?

623. Do you think your husband/partner wants the same number of children that you want, or does he want more or fewer than you want?

624. According to you, who should make the decision to use a contraceptive method, the man or the woman?

625. According to you, who generally makes the decision to use a contraceptive method, the man or the woman?

626. Do you think your mother (guardian) approves or disapproves of couples using a method to avoid or delay pregnancy?

IF THE MOTHER (GUARDIAN) IS DEAD, ASK: If your mother (guardian) were alive, do you think she would approve or disapprove of couples using a method to avoid or delay pregnancy?

627. Do you think your father (guardian) approves or disapproves of couples using a method to avoid or delay pregnancy?

IF THE FATHER (GUARDIAN) IS DEAD, ASK: If your father (guardian) were alive, do you think he would approve or disapprove of couples using a method to avoid or delay pregnancy?

628. Do you think that the use of contraceptives goes against or does not go against your religion?

629. Do you think that it is better to have small family or a large family to improve the quality of life?

630. Have you tried to encourage or persuade a friend or relative to use family planning?

SECTION 7. CHILDREN'S EDUCATION

701. CHECK 216 AND 217:

702. What mode of transportation do the children of this community most often use to get to the closest primary school?

703. How long does it take you to get the closest primary school using the most commonly used mode of transportation?

704. What is the ideal average number of years that a girl should be in school?

705. What is the ideal average number of years that a boy should be in school?

706. RECORD THE LINE NUMBER OF EACH LIVING CHILDREN BETWEEN THE AGES OF 6 AND 15. START WITH THE YOUNGEST CHILD. ASK THE QUESTIONS ABOUT ALL THESE CHILDREN. IF THERE ARE MORE THAN 3 CHILDREN, USE AN ADDITIONAL QUESTIONNAIRE.

Now I would like to ask you some questions about the education of your children between the ages of 6 and 15. We will talk about one child at a time.

707. COPY: LINE NUMBER FROM 212:

708. COPY: LINE NUMBER FROM HOUSEHOLD QUESTIONNAIRE:
IF THE CHILD ISN'T IN THE HOUSEHOLD, RECORD '00'.

709. CHECK 212 AND 218:

710. Does (NAME) live in a boarding school, with his/her father, with another relative/s, with an unrelated person, or with someone else?

711. Did (NAME) ever attend school?

712. What were the main reasons for which (NAME) didn't go to school? Other reasons?
RECORD ALL REASONS MENTIONED. IF ANSWER IS "DOESN'T KNOW," YOU MUST CIRCLE THAT CODE.

713. How old was (NAME) when he/she went to primary school for the first time?
RECORD IN COMPLETED YEARS.

714. CHECK 713:

715. Why did he/she not go to school when he/she was 7 years old?

716. What is the highest level (NAME) completed?

717. What is the highest (grade/form/year) (NAME) completed?

718. Is (NAME) currently attending primary school?

719. Did (NAME) attend school at any time during the current school year?

720. What grade did (NAME) attend during the current school year?

721. Did (NAME) attend school at any time during the previous school year (1997-1998)?

722. What grade did (NAME) attend during the previous 1997-1998 school year?

723. Did (NAME) repeat one of his or her classes?

724. How many time did (NAME) repeat his or her classes?

725. CHECK 718:

726. How old was (NAME) when he or she stopped attending school?
RECORD IN COMPLETED YEARS.

727. What are the main reasons for which he or she stopped going to school?
RECORD ALL RESPONSES MENTIONED. IF THE RESPONSE IS "DOESN'T KNOW," YOU MUST CIRCLE THAT CODE.

728. CHECK 709:

729. How many days was the school open during the last 2 weeks?
IF NONE, RECORD '00'.

730. How many days did (NAME) attend school in the last 2 weeks?
IF NONE, RECORD '00'.

731. CHECK 729 AND 730:

732. What are the main reasons for which (NAME) missed school during the last 2 weeks?

733. Does (NAME) attend a public school, a secular private school, or a religious private school?

734. How much did you pay each month in tuition to send (NAME) to school?

735. Are there other fees for (NAME)'s education?

Uniform and other school clothes per year?
Borrow or buy books per year?
Pens, notebooks, and other supplies per year?
Fees for meals and transportation per day?
Money for private lessons per month?
Extra money for teachers per month?
All other expenses on average per year?

IF NO EXPENSES ON SPECIFICS, RECORD '00000' GF.

736. GO BACK TO 707 FOR THE NEXT CHILD; OR, IF THERE ARE NO MORE CHILDREN BETWEEN 6 AND 15 YEARS OLD, GO TO 737.

737. What is the most difficult expense that you must make at the primary school level?

738. CHECK 501:

739. Who in your family makes the final decisions about the following subjects: you, your husband, both of you, or someone else?

If the children need to go to school?
Age at which the children must go to school for the first time?
How much money should be spent on education?
When the children should stop going to school?

740. Are school books readily available for purchase in your community?

741. Have you or anyone in your family contributed to any of the following regarding primary education?

A. Money for the school or for the construction of lodging for teachers or upkeep, or for other project?
B. Manual labor to support or maintain the school buildings or grounds?
C. Land for school use?
D. Other reasons?

742. Who paid for and built the school in your community/the school your child goes to?

743. Did you or someone in your family contribute in cash or in kind to support one of the teachers at a primary school in your community?

744. What type of contribution or support?

745. Who pays the teachers' salaries of the primary school in your community/the school your children attend?

746. Does the primary school in your community have an association for the parents and friends of the school?

747. Do you know a member of the association for your primary school in your community?

748. Can you name an activity that the association has already done or is in the process of doing to help the primary school in your community?

SECTION 8. HIV/AIDS AND OTHER SEXUALLY TRANSMITTED INFECTIONS

801A. Have you ever heard of illnesses that you can get from having sex?

801B. What illnesses have you heard of?
RECORD ALL RESPONSES.

801C. CHECK 515 AND 515F:

801D. Over the last 12 months, have you had any of these illnesses?

801E. Which illnesses did you have?
RECORD ALL RESPONSES.

801F. The last time that you had (ILLNESS FROM 801E) did you seek advice or treatment?

801G. Where did you seek advice or treatment?
Any other place?
RECORD ALL MENTIONED.

801H. When you had the (ILLNESS(ES) OF 801E), did you tell your sexual partner(s)?

801I. When you had the (ILLNESS(ES) OF 801E) did you do something to avoid infecting your sexual partner(s)?

801J. What did you do?
RECORD ALL MENTIONED.

801K. CHECK 801B:

801L. Have you ever heard of an illness called AIDS?

802. From which sources of information have you learned about AIDS? Any other sources? RECORD ALL MENTIONED.

802A. If you wanted more information on AIDS, where (from whom) would you like to get this information?

802B. How can you get AIDS? Any other way?
RECORD ALL MENTIONED.

803. Is there anything a person can do to avoid getting AIDS or the virus that causes AIDS?

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

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

808. Do you think that persons with AIDS almost never die from the disease, sometimes die, or almost always die from the disease?

808A. Can AIDS be cured?

808B. Can AIDS be transmitted from a mother to a child?

808C. Do you know someone personally who has AIDS or someone who died of AIDS?

809. Do you think your chances of getting AIDS are small, moderate, great, or no risk at all?

809B. Why do you think that you (have no risk/have small risk) for getting AIDS? Any other reason? RECORD ALL MENTIONED.

809C. Why do you think you have (moderate/great) risk of getting AIDS? Any other reason? RECORD ALL MENTIONED.

811A. Since you have heard of AIDS, have you changed your behavior to avoid getting AIDS?
IF YES: What have you done? Anything else? RECORD ALL MENTIONED.

811B. Has your knowledge of AIDS influenced or changed your decisions about having sex or sexual behavior?
IF YES: What did you do?
IF YES: In what way?

RECORD ALL MENTIONED.

811C. Some people use condoms during sex to avoid getting AIDS or other sexually transmitted illnesses. Have you ever heard of condoms?

811D. CHECK 515 AND 515F:

811E. We may have already discussed this. Have you ever used a condom during sexual relations to avoid getting AIDS or transmitting illnesses, like AIDS?

811EA. Do you use a condom from time to time, often, or with each sexual encounter?

811F. CHECK 515 AND 515F:

811G. Have you given or received money, gifts, or favors in exchange for sexual relations in the last 12 months?

SECTION 9. MATERNAL MORTALITY

Now I would like to ask you some questions about your brothers and sisters, that is, all of the children born to your natural mother, including those who are living with you, those living elsewhere and those who have died.

901. How many children did your mother give birth to, including you?

902. CHECK 901:

903. How many of these births did your mother have before you were born?

904. What was the name given to your oldest (next oldest) brother or sister?

905. Is (NAME) male or female?

906. Is (NAME) still alive?

907. How old is (NAME)?

908. What year did he/she die in?

909. How many years ago did (NAME) die?

910. How old was (NAME) when he/she died?

911. Was (NAME) pregnant when she died?

912. Did (NAME) die during childbirth?

913. Did (NAME) die within two months after the end of a pregnancy or childbirth?

914. Did (NAME) die due to complications of pregnancy or childbirth?

915. How many live born children did (NAME) give birth to during her lifetime (before this pregnancy)?

[IF NO OTHER BROTHERS OR SISTERS, GO TO 1001]

SECTION 10. TRADITIONAL PRACTICES

1001. Have you ever heard of female circumcision?

1002. In parts of Guinea and in other countries, there is a practice in which a girl may have part of her genitals cut. Have you ever heard of this practice?

1003. Have you yourself ever had this type of practice

1004. How old were you when this occurred?

1005. What do you call the type of practice you underwent?
PROBE TO DETERMINE THE EXACT NAME OF THE TYPE OF PRACTICE.

1006. Who cut (or nicked) your genitals?

1007. Did they totally close or almost close the opening of the cut part?

1008. When you had your first period or when you got married, did someone have to make an incision to open the vaginal area?

1009. CHECK 214 AND 216:

1010. Have any of your daughters had her genitals cut?
IF YES: How many?

1011. To which of your daughters did this happen most recently?
CHECK 212 AND RECORD THE LINE NUMBER OF THE DAUGHTER.

1012. How old was (NAME OF DAUGHTER FROM 1011) when she was circumcised?

1013. What do you call the type of practice that (NAME OF DAUGHTER FROM 1011) underwent? PROBE TO DETERMINE THE EXACT NAME OF THE TYPE OF PRACTICE.

1014. Who cut (or nicked) her genitals?

1015. Did they totally close or almost close the opening of the cut part?

1016. At the time that the genitals were cut or afterwards, did (NAME OF THE DAUGHTER FROM 1011) have any of the following problems:

Excessive bleeding?
An infection/or a fever?
Difficulty in passing urine or urine retention?
Swelling?
Wound that did not heal properly?

1017. Do you intend to have this genital cutting done on your daughter in the future?

1018. What advantages are there for girls if they undergo this genital cutting?
RECORD ALL MENTIONED.

1019. What disadvantages are there for girls if they undergo this genital cutting?
RECORD ALL MENTIONED.

1020. Would you say that this practice is a way to prevent a girl from having sex before marriage or does it have no effect on premarital sex?

1021. Do you think that this practice increases the chances of marriage for a girl or has no effect?

1022. Do you believe this practice is accepted by your religion?

1023. Do you think that this practice should be continued, or should it be discontinued?

SECTION 11. MALARIA, MOSQUITOES, AND MOSQUITO NETS

1101. Have you ever heard of malaria?

1102. What are the symptoms of malaria?
RECORD ALL RESPONSES MENTIONED.

1103. What people are the most affected by this illness in your village?
RECORD ALL RESPONSES MENTIONED. IF THE ANSWER IS "EVERYONE" OR "DOESN'T KNOW", YOU ONLY HAVE TO CIRCLE ONE CODE.

1104. How do you catch malaria?
RECORD ALL RESPONSES MENTIONED.

1105. Have you ever heard or seen educational messages on malaria?

1106. How did you get these messages?
RECORD ALL RESPONSES MENTIONED.

1107. What was in these messages?
RECORD ALL RESPONSES MENTIONED.

1108. Do you think that you can die from malaria?

1109. Do you know someone who died of malaria?

1110. Are there ways to avoid malaria?

1111. How can you avoid malaria?
RECORD ALL RESPONSES MENTIONED.

1112. Have you ever had malaria?

1113. The last time you had malaria, did you get treatment?

1114. Where did you get this treatment?
RECORD ALL RESPONSES MENTIONED.

1115. Do you do something to avoid malaria?

1116. What do you do to avoid malaria?
RECORD ALL RESPONSES MENTIONED.

1117. When during the day (24 hours) do mosquitoes annoy you the most?

1118. During which season do mosquitoes annoy you the most?

1119. How do the mosquitoes annoy you?
RECORD ALL RESPONSES MENTIONED.

1120. How do you protect yourself against mosquitoes?
RECORD ALL RESPONSES MENTIONED.

1123. Why do you not protect yourself from mosquitoes?
RECORD ALL RESPONSES MENTIONED.

1123A. CHECK 1116 AND 1121:

1124. Do you know what a mosquito net is?

1125. What is a mosquito net used for?

1126. Do you use a mosquito net?

1127. Why do you not use a mosquito net?
RECORD ALL RESPONSES MENTIONED.

1128. How many mosquito nets does your household have?

1129. Is there a mosquito net on each bed in your household?

1130. Why do some beds/mattresses not have mosquito nets?
RECORD ALL RESPONSES MENTIONED.

1131. Which people in the household used a mosquito net last night?
RECORD ALL RESPONSES MENTIONED.

1132. CHECK 1126

1132A. Did you sleep under a mosquito net last night?

1133. Why didn't you sleep under a mosquito net last night?
RECORD ALL RESPONSES MENTIONED.

1134. How long have you had a mosquito net?

1135. Why type of mosquito net do you use in your household?
RECORD ALL RESPONSES MENTIONED.

1136. How did you get your mosquito net(s)?
RECORD ALL RESPONSES MENTIONED.

1137. Did you get the mosquito net yourself?

1138. What type of mosquito net was the last one you got?

1139. Why did you prefer this type of mosquito net?
RECORD ALL RESPONSES MENTIONED.

1140. Where did you get it?

1141. How many did you buy?

1142. What did you think of the price?

1143. Have you ever heard of mosquito nets soaked in insecticide?

1144. Do you know why these mosquito nets are soaked in insecticide?

1145. What are the reasons?
RECORD ALL REASONS MENTIONED.

1146. What shape of mosquito net do you prefer?

1147. Are there any colors that aren't acceptable?

1148. Which ones?
RECORD ALL RESPONSES MENTIONED.

1149. Do you prefer the plain mosquito net or the mosquito net treated with insecticide?

1150. At what price would you buy a treated mosquito net?

SECTION 12. PROFESSIONAL ACTIVITY

1201. CHECK 501 AND 502:

1202. How old was your husband/partner on his last birthday?

1203. Did your (last) husband/partner ever attend school?

1204. What was the highest level of school he attended: primary, secondary (1st cycle), secondary (2nd cycle), or higher?

1205. What was the highest (grade/form/year) he completed at that level?

1206. What is/was your (last) husband's occupation, that is, what kind of work does/did he mainly do?

1209. Aside from your own housework, are you currently working?

1210. As you know, some women take up jobs for which they are paid in cash or kind. Others sell things, have a small business or work on the family farm or in the family business. Are you currently doing any of these things or any other work?

1211. Have you done any work in the last 12 months?

1212. What is your occupation, that is, what kind of work do you mainly do?

1213. CHECK 1212:

1214. 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?

1215. Do you do this work for a member of your family, for someone else, or are you self-employed?

1216. Do you usually work throughout the year, or do you work seasonally, or only once in a while?

1217. END OF INTERVIEW:
RECORD THE TIME.

SECTION 13. HEIGHT AND WEIGHT

1301. CHECK 215 AND 217:

IN 1303, RECORD THE NAME OF THE RESPONDENT.
IN 1306 AND 1308, RECORD THE HEIGHT AND WEIGHT OF THE RESPONDENT.

IN 1302, 1303, AND 1304 (COLUMNS 2-4), RECORD THE LINE NUMBER, NAME, AND DATE OF BIRTH OF EACH CHILD BORN SINCE JANUARY 1994 AND STILL LIVING, STARTING WITH THE YOUNGEST.

IN 1306 AND 1308, RECORD THE HEIGHT AND WEIGHT OF LIVING CHILDREN.

[ASK QUESTIONS 1302-1310 FOR RESPONDENT AND YOUNGEST THREE CHILDREN]

1302. LINE NO. FROM 212 FROM SECTION 2:
[DO NOT ASK RESPONDENT; ASK ONLY FOR CHILDREN]

1303. NAME (FROM 212):

1304. DATE OF BIRTH (FROM 215, AND ASK FOR DAY OF BIRTH):
[DO NOT ASK RESPONDENT; ASK ONLY FOR CHILDREN]

1305. BCG SCAR ON TOP OF LEFT SHOULDER:
[DO NOT ASK RESPONDENT; ASK ONLY FOR CHILDREN]

1306. HEIGHT (IN CENTIMETERS):

1307. WAS LENGTH/HEIGHT OF CHILD MEASURED LYING DOWN OR STANDING UP? [DO NOT ASK RESPONDENT; ASK ONLY FOR CHILDREN]

1308. WEIGHT (IN KILOGRAMS):

1309. DATE WEIGHED AND MEASURED:

1310. RESULT:

1311. NAME OF MEASURER _____

MEASURER CODE ____

NAME OF ASSISTANT ____

ASSISTANT CODE ____

IF ASSISTANT IS A TEAM MEMBER, RECORD HIS/HER CODE, OTHERWISE USE THE FOLLOWING CODES:

INTERVIEWER'S OBSERVATIONS

TO BE FILLED OUT AFTER COMPLETING INTERVIEW.

COMMENTS ABOUT RESPONDENT _____

COMMENTS ON SPECIFIC QUESTIONS _____

ANY OTHER COMMENTS _____

SUPERVISOR'S OBSERVATIONS _____
NAME _____
DATE _____

EDITOR'S OBSERVATIONS _____
NAME _____
DATE _____