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DEMOGRAPHIC AND HEALTH SURVEY
WOMAN'S QUESTIONNAIRE
REPUBLIC OF GUINEA
NATIONAL INSTITUTE OF STATISTICS

IDENTIFICATION
PLACE NAME
NAME OF HEAD OF HOUSEHOLD
CLUSTER NUMBER
HOUSEHOLD NUMBER
ADMINISTRATIVE REGION
NATURAL REGION
SANITATION DISTRICT NUMBER
LOCATION OF HOUSEHOLD

CONAKRY 1
OTHER CITY 2
RURAL 3

NAME AND LINE NUMBER OF WOMAN

INTERVIEWER VISITS
FIRST VISIT
DATE

INTERVIEWER'S NAME
RESULT___

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

FINAL VISIT
DAY
MONTH
YEAR 2018
INT. NUMBER
RESULT

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

NEXT VISIT
DATE
TIME

TOTAL NUMBER OF VISITS

LANGUAGE OF QUESTIONNAIRE: FRENCH 01

LANGUAGE OF INTERVIEW

FRENCH 01
SOUSSOU 02
PEUL 03
MALINKE 04
KISSI 05
LOMA 06
KPELE 07
OTHER (SPECIFY) ___ 08

NATIVE LANGUAGE OF RESPONDENT

FRENCH 01
SOUSSOU 02
PEUL 03
MALINKE 04
KISSI 05
LOMA 06
KPELE 07
OTHER (SPECIFY) ___ 08

TRANSLATOR USED

YES 1
NO 2

LANGUAGE OF QUESTIONNAIRE: FRENCH 01

SUPERVISOR
NAME
NUMBER

OFFICE EDITOR
NUMBER

INTRODUCTION AND CONSENT

Hello. My name is ___. I am working with the National Institute for Statistics. We are conducting a survey about health all over Guinea. The information we collect will help the government to plan health services. Your household was selected for the survey. The questions usually take about 15 to 20 minutes. All of the answers you give will be confidential and will not be shared with anyone other than members of our survey team. You don't have to be in the survey, but we hope you will agree to answer the questions since your views are important. If I ask you any question you don't want to answer, just let me know and I will go on to the next question.

In case you need more information about the survey, you may contact the person listed on this card.

Give card with contact information

Do you have any questions?
May I begin the interview?

Signature of interviewer
Date

RESPONDENT AGREES TO BE INTERVIEWED 1 (CONTINUE)
RESPONDENT DOES NOT AGREE TO BE INTERVIEWED 2 (END)

SECTION 1: RESPONDENT'S BACKGROUND

101) RECORD THE TIME

HOUR
MINUTES

102) How long have you been living continuously in (Name of current city, town or village of residence)?

IF LESS THAN ONE YEAR, RECORD 00 YEARS

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

103) Just before you moved here, did you live in a city, in a town, or in a rural area?

CITY (REGIONAL CAPITAL) 1
TOWN 2
RURAL AREA 3

104) Before you moved here, which (province/region/state) did you live in?

BOKE 01
CONAKRY 02
FARANAH 03
KANKAN 04
KINDIA 05
LABE 06
MAMOU 07
N'ZEREKORE 08
OUTSIDE OF GUINEA 96

105) In what month and year were you born?

MONTH
DON'T KNOW MONTH 98
YEAR
DON'T KNOW YEAR 9998

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

AGE IN COMPLETED YEARS

107) Have you ever attended school?

YES 1
NO 2 (GO TO 111)

108) What is the highest level of school you attended: primary, secondary 1, secondary 2, professional A, higher, or professional B?

PRIMARY 1
SECONDARY 1 (MIDDLE SCHOOL) 2
SECONDARY 2 (HIGH SCHOOL) 3
SPECIAL SECONDARY (PROFESSIONAL A) 4
HIGHER 5
SPECIAL SECONDARY (PROFESSIONAL B) 6

109) What is the highest (grade/form/year) you completed at this level?
If completed less than one year at that level, record 00

GRADE/FORM/YEAR___

PRIMARY
1 YEAR 01
2 YEAR 02
3 YEAR 03
4 YEAR 04
5 YEAR 05
6 YEAR 06


SECONDARY 1 (MIDDLE SCHOOL)
7 YEAR 01
8 YEAR 02
9 YEAR 03
10 YEAR 04


SECONDARY 1 (HIGH SCHOOL)
11 YEAR 01
12 YEAR 02
13 YEAR (FINAL) 03


SPECIAL SECONDARY (PROF. A)
PROFESSIONAL A (1 YEAR) 01
PROFESSIONAL A (2 YEAR) 02
PROFESSIONAL A (3 YEAR) 03


Higher
1 YEAR 01
2 YEAR 02
3 YEAR 03
4 YEAR 04
5 YEAR 05


SPECIAL SECONDARY (PROF. B)
PROFESSIONAL B1 (1 YEAR) 01
PROFESSIONAL B2 (2 YEAR) 02
PROFESSIONAL B3 (3 YEAR) 03


LESS THAN ONE YEAR COMPLETED 00
DON'T KNOW LEVEL OR GRADE 98

110) CHECK 108

PRIMARY (CODE 1) OR SECONDARY (CODE 2, 3, OR 4)
HIGHER (CODE 5 OR 6) (GO TO 113)

111) Now I would like you to read this sentence to me.

SHOW CARD TO RESPONDENT

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

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

112) CHECK 111:

CODE 2, 3, OR 4 CIRCLED
CODE 1 OR 5 CIRCLED (GO TO 114)

113) Do you read a newspaper or magazine at least once a week, less than once a week or not at all?

AT LEAST ONCE A WEEK 1
LESS THAN ONCE A WEEK 2
NOT AT ALL 3

114) Do you listen to the radio at least once a week, less than once a week or not at all?

AT LEAST ONCE A WEEK 1
LESS THAN ONCE A WEEK 2
NOT AT ALL 3

115) Do you watch television at least once a week, less than once a week, or not at all?

AT LEAST ONCE A WEEK 1
LESS THAN ONCE A WEEK 2
NOT AT ALL 3

116) Do you own a mobile telephone?

YES 1
NO 2 (GO TO 118)

117) Do you use your mobile phone for any financial transactions?

YES 1
NO 2

118) Do you have an account in a bank or other financial institution that you yourself use?

YES 1
NO 2

119) Have you ever used the internet?

YES 1
NO 2 (GO TO 122)

120) In the last 12 months, have you used the internet?

IF NECESSARY, PROBE FOR USE FROM ANY LOCATION, WITH ANY DEVICE.

YES 1
NO 2 (GO TO 122)

121) During the last one month, how often did you use the internet: 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

122) What is your religion?

MUSLIM 1
CHRISTIAN 2
ANIMIST 3
NO RELIGION 4
OTHER (SPECIFY) ___ 6

123) What is your ethnicity?

SOUSSOU 01
PEUL 02
MALINKE 03
KISSI 04
TOMA 05
GUERZE 06
OTHER ETHNICITY (SPECIFY) ___ 96
FOREIGNER 97

124) In the last 12 months, how many times have you been away from home for one or more nights?

NUMBER OF TIMES
NONE 00 (GO TO 201)

125) In the last 12 months, have you been away from home for more than one month at a time?

YES 1
NO 2

SECTION 2. REPRODUCTION

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

YES 1
NO 2 (GO TO 206)

202) Do you have any sons or daughters to whom you have given birth 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, RECORD '00'

SONS AT HOME
DAUGHTERS AT HOME

204) Do you have any sons or daughters to whom you have given birth 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, RECODE '00'

SONS ELSEWHERE
DAUGHTERS ELSEWHERE

206) Have you ever given birth to a boy or girl who was born alive but later died?
If no, PROBE: Any baby who cried, who made any movement, sound, or effort to breathe, or who showed any other signs of life even if for a very short time?

YES 1
NO 2 (GO TO 208)

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

BOYS DEAD
GIRLS DEAD

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

TOTAL BIRTHS___

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

YES
NO (PROBE AND CORRECT 201-208 AS NECESSARY)

210) CHECK 208:

ONE OR MORE BIRTHS (GO TO 211)
NO BIRTHS (GO TO 226)

211) Now I would like to record the names of all your births, whether still alive or not, starting with the first one you had. Record names of all the births in 212. Record twins and triplets on separate rows.
If there are more than 10 births, use an additional questionnaire, starting with the second row.

212) What name was given to you (first/next) baby?
RECORD NAME.

NAME__
BIRTH HISTORY NUMBER___

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

BOY 1
GIRL 2

214) Were any of these births twins?

SING 1
MULT 2

215) In what month and year was (name) born?
PROBE: What is his/her birthday?

MONTH__
YEAR___

216) Is (name) still alive?

YES 1
NO 2 (GO TO 220)

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

AGE IN YEARS___

218) IF ALIVE: Is (name) living with you?

YES 1
NO 2

219) IF ALIVE: RECORD HOUSEHOLD LINE NUMBER OF CHILD. (RECORD '00' IF CHILD NOT LISTED IN HOUSEHOLD)

HOUSEHOLD LINE NUMBER___ (GO TO 221)

220) IF DEAD: How old was (name) when he/she died?

IF 12 MONTHS OR ONE YEAR, ASK: Did (name) have his/her first birthday?
THEN ASK: Exactly how many months old was (name) when he/she died?
RECORD DAYS IF LESS THAN 1 MONTH, MONTHS IF LESS THAN TWO YEARS, OR YEARS.

DAYS__ 1
MONTHS__ 2
YEARS__ 3

221) Were there any other live births between (name of previous birth) and (name), including any children who died after birth?

YES 1 (ADD BIRTH)
NO 2 (GO TO NEXT BIRTH)

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

YES 1 (RECORD BIRTH(S) IN TABLE)
NO 2

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

NUMBERS ARE THE SAME (GO TO 224)
NUMBERES ARE DIFFERENT (PROBE AND RECONCILE)

224) CHECK 215: Enter the number of births in 2013-2018.

NUMBER OF BIRTHS__
NONE 0 (GO TO 226)

225) C
For each birth since in 2013-2018, enter B in the month of birth in the calendar. Write the name of the child to the left of the code B for each birth. Ask the number of months the pregnancy lasted and record P in each of the preceding months according to the duration of the pregnancy. (Note: The number of Ps must be one less than the number of months that the pregnancy lasted.)

226) Are you pregnant now?

YES 1
NO 2 (GO TO 230)
UNSURE 8 (GO TO 230)

227) How many months pregnant are you?
C
Record number of completed months.
Enter Ps in the calendar, beginning with the month of interview and for the total number of completed months.

MONTHS___

228) When you got pregnant, did you want to get pregnant at that time?

YES 1 (GO TO 230)
NO 2

229) CHECK 208: Total number of births

ONE OR MORE

a) Did you want to have a baby later on or did you not want any more children?

LATER 1
NO MORE/NONE 2

NONE

b) Did you want to have a baby later on or did you not want any children?

LATER 1
NO MORE/NONE 2

230) Have you ever had a pregnancy that miscarried, was aborted, or ended in a stillbirth?

YES 1 (GO TO 230)
NO 2 (GO TO 239)

231) When did the last such pregnancy end?

MONTH__
YEAR__

232) CHECK 231:

LAST PREGNANCY ENDED IN 2013-2018 OR LATER (GO TO 234)
LAST PREGNANCY ENDED IN 2012 OR EARLIER (GO TO 239)
LINE NUMBER___

233) In what month and year did the preceding such pregnancy end?

MONTH__
YEAR__

234) How many months pregnant were you when that pregnancy ended?

NUMBER OF MONTHS

235) Since January 2013, have you had any other pregnancies that did not result in a live birth?

YES 1 (GO TO NEXT LINE)
NO 2 (GO TO 236)

236) For each pregnancy that did not end in a live birth in 2013-2018 or later, enter T in the calendar in the month that the pregnancy terminated and P for the remaining number of completed months of pregnancy.

If there are more than four pregnancies that did not end in a live birth, use an additional questionnaire starting on the second line.

237) Did you have any miscarriages, abortions or stillbirths that ended before 2013?

YES 1
NO 2 (GO TO 239)

238) When did the last such pregnancy that terminated before 2013 end?

MONTH__
YEAR__

239) When did you last menstrual period start?
(DATE, IF GIVEN)

DAYS AGO 1
WEEKS AGO 3
MONTHS AGO 2
YEARS AGO 4
IN MENOPAUSE/HAS HAD HYSTERECTOMY 994
BEFORE LAST BIRTH 995
NEVER MENSTRUATED 996

240) From one menstrual period to the next, are there certain days when a woman is more likely to become pregnant?

YES 1
NO 2 (GO TO 242)
DON'T KNOW 8 (GO TO 242)

241) Is this time just before her period begins, during her period, right after her period has ended, or halfway 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

242) After the birth of a child, can a woman become pregnant before her menstrual period has returned?

YES 1
NO 2
DON'T KNOW 8

SECTION 3. CONTRACPTION

301) Now I would like to talk about family planning-the various ways or methods that a couple can use to delay or avoid a pregnancy.
Have you ever heard of (method)?

01) Female Sterilization
PROBE: Women can have an operation to avoid having any more children

YES 1
NO 2

02) Male Sterilization
PROBE: Men can have an operation to avoid having any more children

YES 1
NO 2

03) IUD
PROBE: Women can have a loop or coil placed inside them by a doctor or a nurse/midwife which can prevent pregnancy for one or more months.

YES 1
NO 2

04) Injectables
PROBE: Women can have an injection by a heath provider that stops them from becoming pregnant for one or more months.

YES 1
NO 2

05) Implants
PROBE: Women can have one or more 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

06) Pill
PROBE: Women can take a pill every day to avoid becoming pregnant

YES 1
NO 2

07) Condom
PROBE: Men can put a rubber sheath on their penis before sexual intercourse.

YES 1
NO 2

08) Female condom
PROBE: Women can place a sheath in their vagina before sexual intercourse.

YES 1
NO 2

09) Emergency contraception
PROBE: As an emergency measure, within three days after they have unprotected sexual intercourse, women can take special pills to prevent pregnancy.

YES 1
NO 2

10) Standard Days Method
PROBE: A women uses a string of colored beads to know the days she can get pregnant. On the days she can get pregnant, she uses a condom or does not have sexual intercourse.

YES 1
NO 2

11) Locational amenorrhea method (LAM)
PROBE: Up to six months after giving birth, before the menstrual period has returned, women use a method which requires her to breastfeed frequently day and night.

YES 1
NO 2

12) Rhythm Method
PROBE: To avoid pregnancy, women do not have sexual intercourse on the days of the month they think they can get pregnant.

YES 1
NO 2

13) Withdrawal
PROBE: Men can be careful and pull out before climax.

YES 1
NO 2

14) Have you heard of any other ways or methods that women or men can use to avoid pregnancy?

YES, MODERN METHOD (SPECIFY) A
YES, TRADITIONAL METHOD (SPECIFY) B
NO Y

302) CHECK 226:

NOT PREGNANT OR UNSURE (GO TO 303)
PREGNANT (GO TO 312)

303) Are you or your partner currently doing something or using any method to delay or avoid getting pregnant?

YES 1
NO 2 (GO TO 312)

304) Which method are you using?

CIRCLE ALL MENTIONED
IF MORE THAN ONE METHOD MENTIONED, FOLLOW SKIP INSTRUCTION FOR HIGHEST METHOD IN LIST.

FEMALE STERILIZATION A (GO TO 307)
MALE STERILIZATION B (GO TO 307)
IUD C (GO TO 309)
INJECTABLES D (GO TO 309)
IMPLANTS E (GO TO 309)
PILL F
CONDOM G (GO TO 306)
FEMALE CONDOM H (GO TO 309)
EMERGENCY CONTRACEPTION I (GO TO 309)
STANDARD DAYS METHOD J (GO TO 309)
LACTATIONAL AMEN. METHOD K (GO TO 309)
RHYTHM METHOD L (GO TO 309)
WITHDRAWAL M (GO TO 309)
OTHER MODERN METHOD X (GO TO 309)
OTHER TRADITIONAL METHOD Y (GO TO 309)

305) What is the brand name of the pills you are using?
IF DON'T KNOW BRAND, ASK TO SEE THE PACKAGE.

PLANYL 01 (GO TO 309)
MINIDRIIL 02 (GO TO 309)
ADEPAL 03 (GO TO 309)
TRIELLA 04 (GO TO 309)
STEDRIL 05 (GO TO 309)
MICROVAL 06 (GO TO 309)
ORETTE 07 (GO TO 309)
NORLEVO 08 (GO TO 309)
MICROLUTTE 09 (GO TO 309)
MICROGINON 10 (GO TO 309)
LOFEMENAL 11 (GO TO 309)
OTHER (SPECIFY) 96 (GO TO 309)
DON'T KNOW 98 (GO TO 309)

306) What is the brand name of the condoms you are using?
IF DON'T KNOW THE BRAND, ASK TO SEE THE PACKAGE.

PRUDENCE PLUS 01 (GO TO 309)
CONDOM IPPF 02 (GO TO 309)
DUREX 03 (GO TO 309)
SULTAN 04 (GO TO 309)
SUPERMANIX 05 (GO TO 309)
INOTEX 06 (GO TO 309)
FEMIDON 07 (GO TO 309)
MANIX EXTRA 08 (GO TO 309)
MANIX NOUVEAU 09 (GO TO 309)
MANIX CONTACT 10 (GO TO 309)
MANIX PLEASURE 11 (GO TO 309)
KAMASUTURA 12 (GO TO 309)
FAGARU 13 (GO TO 309)
TTK 14 (GO TO 309)
ANYTIME 15 (GO TO 309)
CASANOVA 16 (GO TO 309)
PROTECTOR 17 (GO TO 309)
OTHER (SPECIFY) 96 (GO TO 309)
DON'T KNOW 98 (GO TO 309)

307) In what facility did the sterilization take place?
PROBE to identify the type of source.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE

(NAME OF PLACE ___)

PUBLIC SECTOR
PUBLIC HOSPITAL 11
HEALTH CENTER 12
COMMUNAL MEDICAL CENTER 13
OTHER PUBLIC SECTOR (SPECIFY) 16


PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PRIVATE DOCTOR'S OFFICE 22
PRIVATE HEALTH CLINIC 23
FAMILY PLANNING CLINIC 24
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) 26


OTHER (SPECIFY) 96
DON'T KNOW 98

308) In what month and year was the sterilization performed?

MONTH__ (GO TO 310)
YEAR__ (GO TO 310)

309) Since what month and year did you start using (Current method) without stopping?

PROBE: For how long have you been using (Current method first mentioned) now without stopping?

MONTH__
YEAR__

310) CHECK 308 and 309, 215, and 231:
Any birth or pregnancy termination after month and year of start of use of contraception in 308 or 309?

NO
YES (Go back to 308 and 309, PROBE and record month and year at start of continuous use of current method (must be after last birth or pregnancy termination))

311) CHECK 308 AND 309:

YEAR IS 2013-2018
Enter code for method used in month of interview in the calendar and in each month back to the date started using.
Then continue.

YEAR IS 2011 OR EARLIER
Enter code for method used in month of interview in the calendar and each month back to January 2013
Then (GO TO 324)

312) I would like to ask you some questions about the times you or your partner may have used a method to avoid getting pregnant during the last few years.

Use calendar to probe for earlier periods of use and nonuse, starting with most recent use, back to January 2013. Use names of children, dates of birth, and periods of pregnancy as reference points.

COLUMN 1
COLUMN 2
COLUMN 3

312a) Month and year of start of internal of use or non-use.

MONTH__
YEAR__

312b) Between (event) in (Month/year) and (event) in (month/year), did you or your partner use any method of contraception?

YES 1
NO 2 (GO TO 312i)

312c) Which method was that?

METHOD CODE___

312d) How many months after (event) in (month/year) did you start to use (method)?
Record 95 if respondent gives the date of starting to use the method.

IMMEDIATELY 00 (GO TO 312f)
MONTHS (GO TO 312f)
DATE GIVEN 95

312e) Record the month and year respondent started using method

MONTH__
YEAR__

312f) For how many months did you use (method)?
RECORD 95 IF RESPONDENT GIVES THE DATE OF TERMINATION OF USE

MONTHS (GO TO 312h)
DATE GIVEN 95

312g) Record month and year respondent stopped using method

MONTH__
YEAR__

312h) Why did you stop using (method)?

REASON STOPPED___

312i) Go back to 312a in next column; or, if no more gaps, go to 313.

313) Check the calendar for use of any contraceptive method in any month.

NO METHOD USED
ANY METHOD USED (GO TO 315)

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

YES 1 (GO TO 326)
NO 2 (GO TO 326)

315) CHECK 304:
CIRCLE METHOD CODE.
IF MORE THAN ONE METHOD CODE CIRCLED IN 304, CIRCLE CODE FOR HIGHEST METHOD IN LIST.

NO CODE CIRCLED 00 (GO TO 326)
FEMALE STERILIZATION 01 (GO TO 319)
MALE STERILIZATION 02 (GO TO 327)
IUD 03
INJECTABLES 04
IMPLANTS 05
PILL 06
CONDOM 07
FEMALE CONDOM 08
EMERGENCY CONTRACEPTION 09
STANDARD DAY METHOD 10
LACTATIONAL AMEN. METHOD 11 (GO TO 323)
RHYTHM METHOD 12 (GO TO 323)
WITHDRAWAL 13 (GO TO 323)
OTHER MODERN METHOD 95
OTHER TRADITIONAL METHOD 96

316) You first started using (current method) in (date from 309). Where did you get it at that time?

PROBE TO IDENTITY THE TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE___)

PUBLIC SECTOR
NATIONAL HOSPITAL 11
REGIONAL HOSPITAL 12
PREFECTURAL HOSPITAL/COMMUNAL MEDICAL CENTER 13
HEALTH CENTER 14
HEALTH POST 15
OTHER PUBLIC SECTOR (SPECIFY) 16


PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY 22
PRIVATE DOCTOR 23
PRIVATE HEALTH CLINIC 24
FAMILY PLANNING CLINIC/GUINEAN ASSOCIATION FOR FAMILY WELL-BEING 25


OTHER PRIVATE MEDICAL (SPECIFY) 26

OTHER SOURCE
SHOP 31
RELIGIOUS INSTITUTE 32
FRIENDS/PARENTS 33
COMMUNITY FIELDWORKER 34


OTHER (SPECIFY) 96

317) CHECK 304:
CIRCLE METHOD CODE:
IF MORE THAN ONE METHOD CODE CIRCLED IN 304, CIRCLE CODE FOR HIGHEST METHOD IN LIST.

IUD 03
INJECTABLES 04
IMPLANTS 05
PILL 06
CONDOM 07 (GO TO 323)
FEMALE CONDOM 08 (GO TO 322)
EMERGENCY CONTRACEPTION 09 (GO TO 322)
STANDARD DAY METHOD 10 (GO TO 322)
OTHER MODERN METHOD 95 (GO TO 322)
OTHER TRADITIONAL METHOD 96 (GO TO 323)

318) At that time, where you told about side effects or problems you might have with the method?

YES 1 (GO TO 321)
NO 2 (GO TO 320)

319) When you got sterilized, were you told about side effects or problems you might have with the method?

YES 1 (GO TO 321)
NO 2

320) Were you ever told by a health or family planning worker about side effects or problems you might have with the method?

YES 1
NO 2 (GO TO 322)

321) Were you told what to do if you experienced side effects or problems?

YES 1
NO 2

322) CHECK 318 AND 319:

ANY YES
At that time, were you told about other methods of family planning that you could use?

OTHER
When you obtained (Current method from 315) from (Source of method from 307 or 316), were you told about other methods of family planning that you could use?

YES 1 (GO TO 324)
NO 2

323) Were you ever told by a health or family planning worker about other methods of family planning that you could use?

YES 1
NO 2

324) CHECK 304:
Circle method code.
If more than one method code circled in 304, circle code for highest method in list.

FEMALE STERILIZATION 01 (GO TO 327)
MALE STERILIZATION 02 (GO TO 327)
IUD 03
INJECTABLES 04
IMPLANTS 05
PILL 06
CONDOM 07
FEMALE CONDOM 08
EMERGENCY CONTRACEPTION 09
STANDARD DAYS METHOD 10
LACTATIONAL AMEN. METHOD 11 (GO TO 327)
RHYTHM METHOD 12 (GO TO 327)
WITHDRAWAL 13 (GO TO 327)
OTHER MODERN METHOD 95
OTHER TRADITIONAL METHOD 96 (GO TO 327)

325) Where did you obtain (current method) the last time?
PROBE to identity the type of source.
If unable to determine if public or private sector, write the name of the place.

(NAME OF PLACE___)

PUBLIC SECTOR
NATIONAL HOSPITAL 11
REGIONAL HOSPITAL 12
PREFECTURAL HOSPITAL/COMMUNAL MEDICAL CENTER 13
HEALTH CENTER 14
HEALTH POST/CENTER 15
OTHER PUBLIC SECTOR (SPECIFY) 16


PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY 22
PRIVATE DOCTOR 23
PRIVATE HEALTH CLINIC 24
FAMILY PLANNING CLINIC/GUINEAN ASSOCIATION FOR FAMILY WELL-BEING 25

OTHER PRIVATE MEDICAL (SPECIFY) 26


OTHER SOURCE
SHOP 31
RELIGIOUS INSTITUTE 32
FRIENDS/PARENTS 33
COMMUNITY FIELDWORKER 34


OTHER (SPECIFY) 96

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

YES 1
NO 2

327) In the last 12 months, were you visited by a fieldworker?

YES 1
NO 2 (GO TO 329)

328) Did the fieldworker talk to you about family planning?

YES 1
NO 2

329) CHECK 202: Living children

YES
a) In the last 12 months, have you visited a health facility for care for yourself or your children?

NO
b) In the last 12 months, have you visited a health facility for yourself?

YES 1
NO 2 (GO TO 401)

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

YES 1
NO 2

SECTION 4. PREGNANCY AND POSTNATAL CARE

401) CHECK 224:

ONE OR MORE BIRTHS 2013-2018
NO BIRTHS IN 2013-2018 (GO TO 648)

402) CHECK 215: Record the birth history number in 403 and the survival state from 404 for each birth in 2013-2018. Ask the questions about all these births. Begin with the last birth. (If there are more than 2 births, use last column of additional questionnaire(s)).

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

403) Birth history number from 212 in birth history

BIRTH HISTORY NUMBER___

404) From 212 and 216

NAME__
LIVING
DEAD

405) When you got pregnant with (NAME), did you want to become pregnant at that time?

YES 1 (GO TO 408)
NO 2

406) CHECK 208:

ONLY ONE BIRTH
a) Did you want to have a baby later on, or did you not want any children?

MORE THAN ONE BIRTH
b) Did you want to have a baby later on, or did you not want any more children?

LATER 1
NO MORE 2 (GO TO 408/426)

407) How much longer did you want to wait?

MONTHS 1
YEARS 2
DON'T KNOW 998

408) Did you see anyone for antenatal care for this pregnancy?

YES 1
NO 2 (GO TO 414)

409) Whom did you see?
Anyone else?
PROBE TO IDENTIFY EACH TYPE OF PERSON AND RECORD ALL MENTIONED.

HEATH PROFESSIONAL
DOCTOR A
NURSE/MIDWIFE B
TECHNICAL HEALTH WORKER C


OTHER PERSON
TRADITIONAL BIRTH ATTENDANT D
COMMUNITY/VILLAGE HEALTH WORKER E


OTHER (SPECIFY) X

410) Where did you receive this antenatal care for this pregnancy?
Anywhere else?
PROBE TO IDENTITY THE TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE(S))

HOME
HER HOME A
OTHER HOME B


PUBLIC SECTOR
NATIONAL HOSPITAL C
REGIONAL HOSPITAL D
PREFECTURAL HOSPITAL/COMMUNAL MEDICAL CENTER E
HEALTH CENTER F
HEALTH POST G
OTHER PUBLIC SECTOR (SPECIFY) H


PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC I
FAMILY PLANNING CLINIC/GUINEAN ASSOCIATION FOR FAMILY WELL-BEING J
PRIVATE MIDWIFE'S OFFICE K
OTHER PRIVATE MEDICAL (SPECIFY) L


OTHER (SPECIFY) X

411) How many months pregnant were you when you first received antenatal care for this pregnancy?

MONTHS__
DON'T KNOW 98

412) How many times did you receive antenatal care during this pregnancy?

MONTHS__
DON'T KNOW 98

413) As part of your antenatal care during this pregnancy, were any of the following done at least once?

Was your blood pressure measured?

YES 1
NO 2

Did you give a urine sample?

YES 1
NO 2

Did you give a blood sample?

YES 1
NO 2

414) During this pregnancy, were you given an injection in the arm to prevent the baby from getting tetanus, that is, convulsions after birth?

YES 1
NO 2 (GO TO 417)
DON'T KNOW 8 (GO TO 417)

415) During this pregnancy, how many times did you get this injection?

TIMES__
DON'T KNOW 98

416) CHECK 415: Tetanus injections

2 OR MORE TIMES (GO TO 420)
DON'T KNOW

417) At any time before this pregnancy, did you receive any tetanus injections?

YES 1
NO 2 (GO TO 420)
DON'T KNOW 8 (GO TO 420)

418) Before this pregnancy, how many times did you receive a tetanus injection?
IF 7 OR MORE TIMES, RECORD 7

TIMES
DON'T KNOW 8

419) CHECK 418:

ONLY ONCE
a) How many years ago did you receive this tetanus injection?

YEARS AGO___

MORE THAN ONCE
b) How many years ago did you last receive this tetanus injection?

YEARS AGO___

420) During this pregnancy, were you given or did you buy iron tablets or iron syrup?
Show tables/syrup

YES 1
NO 2 (GO TO 422)
DON'T KNOW (GO TO 422)

421) During the whole pregnancy, for how many days did you take the tables or syrup?
IF ANSWER NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER OF DAYS.

DAYS__
DON'T KNOW 998

422) During this pregnancy, did you take any drug for intestinal worms?

YES 1
NO 2
DON'T KNOW 8

423) During this pregnancy, did you take FP/Fansidar to keep you from getting malaria?

YES 1 (GO TO 423C)
NO 2
DON'T KNOW 8

423a) I would like to ask you if you took any drugs during this pregnancy to prevent malaria. During this pregnancy, did you take any drugs to prevent malaria?

YES 1
NO 2 (GO TO 425a1)
DON'T KNOW 8 (GO TO 425a1)

423b) What medications did you take to prevent malaria?
RECORD ALL MENTIONED. IF THE NAMES OF THE DRUGS ARE UNKNOWN, SHOW SAMPLE BOXES ORE PHOTOS OF THE DRUGS.

SP/FANSIDAR A
CHLOROQUINE B
OTHER (SPECIFY) X
TRADITIONAL MEDICINE Y
DON'T KNOW Z

423c) CHECK 423 AND 423b

Code 1 circled in Q 423 (GO TO 424a)
Code 2 or 8 circled in Q 423 and code A circled in Q423b (GO TO 424b)
Code 2 or 8 circled in Q 423 and code A not circled in Q 423b (GO TO 425a1)

424)
a) How many times did you take SP/Fansidar during this pregnancy?

PROBE BY SHOWING THE SAMPLE BOTTLES OF SP/FANSIDAR OR PHOTOS.

NUMBER OF TIMES___

b) How many times did you take the SP/Fansidar that you showed during this pregnancy?

PROBE BY SHOWING THE SAMPLE BOTTLES OF SP/FANSIDAR OR PHOTOS.

NUMBER OF TIMES___

425) a) Did you get the SP/Fansidar during any antenatal care visit, during another visit to a health facility or from another source?

PROBE BY SHOWING THE SAMPLE BOTTLES OF SP/FANSIDAR OR PHOTOS.

IF MORE THAN ONE SOURCE, RECORD THE HIGHEST SOURCE ON THE LIST.

ANTENATAL VISIT 1
ANOTHER FACILITY VISIT 2
OTHER SOURCE 6

b) Did you get the SP/Fansidar that you showed me during any antenatal care visit, during another visit to a health facility or from another source?

PROBE BY SHOWING THE SAMPLE BOTTLES OF SP/FANSIDAR OR PHOTOS.

IF MORE THAN ONE SOURCE, RECORD THE HIGHEST SOURCE ON THE LIST.

ANTENATAL VISIT 1
ANOTHER FACILITY VISIT 2
OTHER SOURCE 6

425a1) CHECK 408:

RECEIVED ANTENATAL CARE
DIDN'T RECEIVE ANTENATAL CARE (GO TO 425b)

425a2) Do you have a health/antenatal visit card or booklet from the time you were pregnant with (name from pregnancy from 408)?
ASK TO SEE THE CARD OR BOOKLET

YES, SEEN 1
YES, NOT SEEN 2 (GO TO 425b)
NO CARD OR BOOKLET 3 (GO TO 425b)

425a3) CHECK THE CARD OR BOOKLET AND RECORD THE NUMBER OF SP/FANSIDAR DOSES:

NUMBER OF DOSES__
NO DOSES__

425b) CHECK 424:

NUMBER OF DOSES IS 1 OR MORE
Q424 NOT ASKED OR NUMBER OF DOSES EQUAL TO 0 (GO TO 426)

425b1) How many tablets did they give you the first time you received SP/Fansidar?

NUMBER OF TABLETS IN THE DOSE ___

425b2) Did you get the SP/Fansidar tablets during any antenatal care visit, during another visit to a health facility or from another source?

IF MORE THAN ONE SOURCE, RECORD THE HIGHEST SOURCE ON THE LIST

ANTENATAL VISIT 1
OTHER FACILITY VISIT 2 (GO TO 425b5)
OTHER SOURCE 3 (GO TO 425b5)

425b3) Did you take the SP/Fansidar tablets in front of the health care agent during the antenatal visits?

YES 1 (GO TO 425b5)
NO 2

425b4) Where did you take them, at home, elsewhere, or not at all?

AT HOME 1
ELSEWHERE 2
NOT TAKEN AT ALL 3

425b5) The first time you took SP/Fansidar that you received, how many months pregnant were you?

NUMBER OF MONTHS PREGNANT AT FIRST DOSE

425c) CHECK 424:

NUMBER OF DOSES EQUAL TO 2 OR MORE (GO TO 425C1)
NUMBER OF DOSES EQUAL TO 1 (GO TO 426)

425c1) The second time you took the SP/Fansidar you received, how many tablets were you given?

NUMBER OF TABLETS IN THE DOSE

425c2) Did you get the SP/Fansidar tablets during any antenatal care visit, during another visit to a health facility or from another source?

IF MORE THAN ONE SOURCE, RECORD THE HIGHEST SOURCE ON THE LIST

ANTENATAL VISIT 1
OTHER FACILITY VISIT 2 (GO TO 425c5)
OTHER SOURCE 3 (GO TO 425c5)

425c3) Did you take the SP/Fansidar tablets in front of the health care agent during the antenatal visits?

YES 1 (GO TO 425c5)
NO 2

425c4) Where did you take them, at home, elsewhere, or not at all?

AT HOME 1
ELSEWHERE 2
NOT TAKEN AT ALL 3

425c5) The second time you took SP/Fansidar that you received, how many months pregnant were you?

NUMBER OF MONTHS PREGNANT AT SECOND DOSE___

425d) CHECK 424:

NUMBER OF DOSES EQUALS 3 OR MORE (GO TO 425D1)
NUMBER OF DOSES EQUALS 2 (GO TO 426)

425d1) The third time you took the SP/Fansidar you received, how many tablets were you given?

NUMBER OF TABLETS IN THE DOSE

425d2) Did you get the SP/Fansidar tablets during any antenatal care visit, during another visit to a health facility or from another source?

IF MORE THAN ONE SOURCE, RECORD THE HIGHEST SOURCE ON THE LIST

ANTENATAL VISIT 1
OTHER FACILITY VISIT 2 (GO TO 425D5)
OTHER SOURCE 3 (GO TO 425D5)

425d3) Did you take the SP/Fansidar tablets in front of the health care agent during the antenatal visits?

YES 1 (GO TO 425d5)
NO 2

425d4) Where did you take them, at home, elsewhere, or not at all?

AT HOME 1
ELSEWHERE 2
NOT TAKEN AT ALL 3

425d5) The third time you took SP/Fansidar that you received, how many months pregnant were you?

NUMBER OF MONTHS PREGNANT AT THIRD DOSE__

425e) CHECK 424:

NUMBER OF DOSES EQUALS 4 OR MORE
NUMBER OF DOSES EQUALS 3 (GO TO 426)

425e1) The fourth time you took the SP/Fansidar you received, how many tablets were you given?

NUMBER OF TABLETS IN THE DOSE___

425e2) Did you get the SP/Fansidar tablets during any antenatal care visit, during another visit to a health facility or from another source?

IF MORE THAN ONE SOURCE, RECORD THE HIGHEST SOURCE ON THE LIST

ANTENATAL VISIT 1
OTHER FACILITY VISIT 2 (GO TO 425E5)
OTHER SOURCE 3 (GO TO 425E5)

425e3) Did you take the SP/Fansidar tablets in front of the health care agent during the antenatal visits?

YES 1 (GO TO 425e5)
NO 2

425e4) Where did you take them, at home, elsewhere, or not at all?

AT HOME 1
ELSEWHERE 2
NOT TAKEN AT ALL 3

425e5) The fourth time you took SP/Fansidar that you received, how many months pregnant were you?

NUMBER OF MONTHS PREGNANT AT FOURTH DOSE___

425f) CHECK 424:

NUMBER OF DOSES EQUALS 5 OR MORE
NUMBER OF DOSES EQUALS 4 (GO TO 426)

425f1) The fifth time you took the SP/Fansidar you received, how many tablets were you given?

NUMBER OF TABLETS IN THE DOSE___

425f2) Did you get the SP/Fansidar tablets during any antenatal care visit, during another visit to a health facility or from another source?

IF MORE THAN ONE SOURCE, RECORD THE HIGHEST SOURCE ON THE LIST

ANTENATAL VISIT 1
OTHER FACILITY VISIT 2 (GO TO 425F5)
OTHER SOURCE 3 (GO TO 425F5)

425f3) Did you take the SP/Fansidar tablets in front of the health care agent during the antenatal visits?

YES 1 (GO TO 425f5)
NO 2

425f4) Where did you take them, at home, elsewhere, or not at all?

AT HOME 1
ELSEWHERE 2
NOT TAKEN AT ALL 3

425f5) The fifth time you took SP/Fansidar that you received, how many months pregnant were you?

NUMBER OF MONTHS PREGNANT AT FIFTH DOSE___

425g) CHECK 424:

NUMBER OF DOSES EQUALS 6 OR MORE
NUMBER OF DOSES EQUALS 5 (GO TO 426)

425g1) The sixth time you took the SP/Fansidar you received, how many tablets were you given?

NUMBER OF TABLETS IN THE DOSE

425g2) Did you get the SP/Fansidar tablets during any antenatal care visit, during another visit to a health facility or from another source?

IF MORE THAN ONE SOURCE, RECORD THE HIGHEST SOURCE ON THE LIST

ANTENATAL VISIT 1
OTHER FACILITY VISIT 2 (GO TO 425G5)
OTHER SOURCE 3 (GO TO 425G5)

425g3) Did you take the SP/Fansidar tablets in front of the health care agent during the antenatal visits?

YES 1 (GO TO 425g5)
NO 2

425g4) Where did you take them, at home, elsewhere, or not at all?

AT HOME 1
ELSEWHERE 2
NOT TAKEN AT ALL 3

425g5) The sixth time you took SP/Fansidar that you received, how many months pregnant were you?

NUMBER OF MONTHS PREGNANT AT SIXTH DOSE___

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

VERY LARGE 1
LARGER THAN AVERAGE 2
AVERAGE 3
SMALLER THAN AVERAGE 4
VERY SMALL 5
DON'T KNOW 8

427) Was (NAME) weighed at birth?

YES 1
NO 2 (GO TO 429)
DON'T KNOW 8 (GO TO 429)

428) How much did (NAME) weigh?
RECORD WEIGHT IN KILOGRAMS FROM HEALTH CARD, IF AVAILABLE

GRAMS FROM CARD 1
GRAMS FROM RECALL 2
DON'T KNOW 99998

429) Who assisted with the delivery of (NAME)?
Anyone else?

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

If respondent says no one assisted, PROBE to determine whether any adults were present at the delivery.

HEATH PROFESSIONAL

DOCTOR A
NURSE/MIDWIFE B
TECHNICAL HEALTH WORKER C


OTHER PERSON

TRADITIONAL BIRTH ATTENDANT D
COMMUNITY/VILLAGE FIELDWORKER E
RELATIVE/FRIEND G


OTHER (SPECIFY) X

430) Where did you give birth to (name)?
PROBE TO IDENTITY THE TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.


(NAME OF PLACE(S))____

HOME

HER HOME 11 (GO TO 434
OTHER HOME 12 (GO TO 434


PUBLIC SECTOR

NATIONAL HOSPITAL 21
REGIONAL HOSPITAL 22
PREFECTURAL HOSPITAL/COMMUNAL HEALTH CENTER 23
HEALTH CENTER 24
HEALTH POST 25
OTHER PUBLIC SECTOR (SPECIFY) 26


PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC 31
FAMILY PLANNING CLINIC/GUINEAN ASSOCIATION FOR FAMILY WELL-BEING 32
PRIVATE MIDWIFE'S CLINIC 33
OTHER PRIVATE MEDICAL (SPECIFY) 36


OTHER (SPECIFY) 96 (GO TO 434)