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NATIONAL FAMILY HEALTH SURVEY (NFHS-2)
WOMAN'S QUESTIONNAIRE
INDIA 1998-99

IDENTIFICATION

STATE ________
DISTRICT ________
TEHSIL/TALUK _________
CITY/TOWN/VILLAGE ________

URBAN/RURAL _______

URBAN 1
RURAL 2

LARGE CITY/SMALL CITY/TOWN/RURAL AREA _______

LARGE CITY 1
SMALL CITY 2
TOWN 3
RURAL AREA 4

PSU NUMBER ________
HOUSEHOLD HUMBER ________
NAME AND LINE NUMBER OF WOMAN ________
ADDRESS OF HOUSEHOLD ________

INTERVIEWER VISITS

FIRST INTERVIEW (REPEAT FOR SECOND AND THIRD INTERVIEWS)
DATE ______
INTERVIEWER'S NAME ________
RESULT _______

RESULT____

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

NEXT VISIT
DATE _______
TIME _______

FINAL VISIT
DAY _______
MONTH _______
YEAR 19______
NAME CODE _______
RESULT CODE _______

TOTAL NUMBER OF VISIT ________

NATIVE LANGUAGE OF RESPONDENT ______

01 ASSAMESE
02 BENGALI
03 ENGLISH
04 GUJARATI
05 HINDI
06 KANNADA
07 KASHMIRI
08 MALAYALAM
09 MANIPURI
10 MARATHI
11 NEPALI
12 ORIYA
13 PUNJABI
14 KONKANI
15 SINDHI
16 TAMIL
17 TELUGU
18 URDU
19 OTHER (SPECIFY) _______

SUPERVISOR
NAME _______
DATE _______

FIELD EDITOR
NAME _______
DATE _______

OFFICE EDITOR
NAME _______
DATE ______

KEYED BY
NAME ______
DATE ______

SECTION 1. RESPONDENT'S BACKGROUND

101. RECORD THE TIME

HOUR ______
MINUTES ______

Namaste. My name is _______ and I am working with (NAME OF ORGANIZATION). 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 about your health (and the health of your children). This information will help the government to plan health services. The amount of time needed will be less than one hour. Participation in this survey is voluntary. If you decide to participate, you may stop answering questions at any time. Whatever information you provide will be kept strictly confidential and will not be shown to other persons.

We hope that you will participate in this survey since your views is important. Do you want to ask me anything about the survey at this time?

SIGNATURE OF INTERVIWER ________
DATE ________

RESPONDENT AGREES TO BE INTERVIEWED 1 (GO TO 102)
RESPONDENT DOES NOT AGREE TO BE INTERVIEWED 2 (END INTERVIEW)

First I would like to ask some questions about you and your household.

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

CITY/TOWN 1
VILLAGE 2

103. How long have you been living continuously in (NAME OF CURRENT PLACE OF RESIDENCE)?

YEARS ______
SINCE BIRTH 95 (GO TO 105)
VISITOR 96 (GO TO 105)

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

CITY/TOWN 1
COUNTRYSIDE 2

105. In what month and year were you born?

MONTH ______
DOESN'T KNOW MONTH 98
YEAR ______
DOESN'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. What is your current marital status?

CURRENTLY MARRIED 1
MARRIED, GAUNA NOT PERFORMED 2 (END)
SEPARATED 3 (GO TO 110)
DESERTED 4 (GO TO 110)
DIVORCED 5 (GO TO 110)
WIDOWED 6 (GO TO 110)
NEVER MARRIED 7 (END)

108. Are you living with your husband now, or is he staying elsewhere?

LIVING WITH HUSBAND 1 (GO TO 110)
STAYING ELSEWHERE 2

109. For how long have you and your husband not been living together?
IF LESS THAN 1 YEAR, RECORD MONTHS; OTHERWISE RECORD COMPLETED YEARS.

MONTHS 1 ____
YEARS 2 ____

Now I would like to ask you some questions about your marriage.

110. Have you been married only once or more than once?

ONLY ONCE 1 (GO TO 114)
MORE THAN ONCE 2

111. How old were you at the time of your first marriage?

AGE IN COMPLETED YEARS ______

112. How old were you when you started living with your first husband?

AGE IN COMPLETED YEARS ___
GAUNA HAD NOT TAKEN PLACE 96

113. How old were you when your first marriage dissolved?

AGE IN COMPLETED YEARS ___

114. How old were you at the time of your (current) marriage?

AGE IN COMPLETED YEARS ___

115. How old were you when you started living with your (current) husband?

AGE IN COMPLETED YEARS ___
GAUNA HAD NOT TAKEN PLACE 96 (END)

116. Have you ever attended school?

YES 1
NO 2 (GO TO 119)

117. What is the highest grade you completed?

GRADE _____

118. CHECK 117:

GRADE 0-5 (GO TO 119)
GRADE 6 AND ABOVE (GO TO 120)

119. Can you read and write?

YES 1
NO 2 (GO TO 121)

120. Do you usually read a newspaper or magazine at least once a week?

YES 1
NO 2

121. Do you usually listen to a radio at least once a week?

YES 1
NO 2

122. Do you watch television at least once a week?

YES 1
NO 2

123. Do you usually go to a cinema hall or theatre to see a movie at least once a month?

YES 1
NO 2

124. How often do you yourself consume the following items: daily, weekly, occasionally, or never:

Milk or Curd?
Pulses or beans?
Green leafy vegetables?
Other vegetables?
Fruits?
Eggs?
Chicken, meat, or fish?

MILK OR CURD
DAILY 1
WEEKLY 2
OCCASIONALLY 3
NEVER 4
PULSES/BEANS
DAILY 1
WEEKLY 2
OCCASIONALLY 3
NEVER 4
GREEN LEAFY VEGETABLES
DAILY 1
WEEKLY 2
OCCASIONALLY 3
NEVER 4
OTHER VEGETABLES
DAILY 1
WEEKLY 2
OCCASIONALLY 3
NEVER 4
FRUITS
DAILY 1
WEEKLY 2
OCCASIONALLY 3
NEVER 4
EGGS
DAILY 1
WEEKLY 2
OCCASIONALLY 3
NEVER 4
CHICKEN/MEAT/FISH
DAILY 1
WEEKLY 2
OCCASIONALLY 3
NEVER 4

SECTION 2. REPRODUCTION

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

201. 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, RECORD '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 or showed signs of life but only survived a few hours or days?

YES 1
NO 2 (GO TO 208)

207. In all, 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 ______

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

YES (GO TO 210)
NO, PROBE AND CORRECT 201-208 AS NECESSARY.

210. CHECK 208:

ONE OR MORE BIRTHS (GO TO 211)
NO BIRTHS (GO TO 225)

Now I would like to record the names of all your births, whether still alive or not, starting with the first one you had.

211. RECORD NAMES OF ALL THE LIVE BIRTHS IN 212. RECORD TWINS AND TRIPLETS ON SEPARATE LINES. (IF THERE ARE MORE THAN 12 BIRTHS, USE AN ADDITIONAL QUESTIONNAIRE).

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

NAME ________

213. Were any of these births twins?

SING 1
MULT 2

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

BOY 1
GIRL 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 219)

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

218A. IF ALIVE: RECORD HOUSEHOLD LINE NUMBER OF CHILD
RECORD '00' IF CHILD NOT LISTED IN HOUSEHOLD

LINE NUMBER ______ (GO TO 220)

219. IF DEAD: How old was (NAME) when he/she died?
IF '1 YEAR', PROBE: How many months old was (NAME)?
RECORD DAYS IF LESS THAN TWO YEARS; OR YEARS.

DAYS 1 ____
MONTH 2 ____
YEARS 3 ____

220. Between (NAME OF PREVIOUS BIRTH) and (NAME OF THIS BIRTH) did you have any stillbirth, spontaneous abortion, or induced abortion?
FOR FIRST CHILD ASK: Before (NAME), did you have any stillbirth, spontaneous abotion, or induce abortion?

IF NONE, RECORD '0'. FOR SECOND TWIN, RECORD '0' IN EACH BOX WITHOUT ASKING.

NUMBER OF STILLBIRTHS ____
NUMBER OF SPON.ABORTIONS ____
NUMBER OF INDUCED ABORTIONS ____

221. After the last birth, did you have any stillbirth, spontaneous abortion, or induce abortion?
IF NONE, RECORD '0'.

NUMBER OF STILLBIRTHS ____
NUMBER OF SPON.ABORTIONS ____
NUMBER OF INDUCED ABORTIONS ____

222. CHECK 220 AND 221:
Just to make sure that I have this right: you have had in TOTAL ____STILLBIRTHS, ____ SPONTANEOUS ABORTIONS, and ___ INDUCED ABORTIONS during your life: Is that correct?

YES (GO TO 223)
NO, PROBE AND CORRECT 220-221 AS NECESSARY

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

NUMBERS ARE SAME:
CHECK:
FOR EACH BIRTH: YEAR OF BIRTH IS RECORDED.
FOR EACH LIVING CHILD: CURRENT AGE IS RECORDED.
FOR EACH DEAD CHILD: AGE AT DEATH IS RECORDED.
FOR AGE AT DEATH 12 MONTHS: PROBE TO DETERMINE EXACT NUMBER OF MONTHS.
FOR EACH CALENDAR BIRTH INTERVAL 4 OR MORE YEARS: EXPLANATION IS GIVEN.
NUMBERS ARE DIFFERENT (PROBE AND RECONCILE)

224. CHECK 215 AND ENTER THE NUMBER OF BIRTHS SINCE JANUARY 1995.
IF NONE, RECORD '0'.

NO. OF BIRTHS ______ (GO TO 229)

225. Have you ever had a stillbirth?

YES 1
NO 2 (GO TO 227)

226. How many stillbirths have you had?

NO. OF STILLBIRTHS ____

227. Have you ever had an abortion?
PROBE FOR SPONTANEOUS AND INDUCED ABORTIONS.

YES 1
NO 2 (GO TO 229)

228. Have mnay abortions have you had?
PROBE FOR NUMBER OF SPONTANEOUS AND INDUCED ABORTIONS.
IF NONE, RECORD '0'.

NO. OF SPON. ABORTIONS ____
NO. OF INDUCED ABORTIONS ____

229. CHECK 107:

CURRENTLY MARRIED (GO TO 230)
SEPARATED/DESERTED/DIVORCED/WIDOWED (GO TO 301)

230. Are you pregnant now?

YES 1
NO 2 (GO TO 233)
UNSURE 8 (GO TO 233)

231. How many months pregnant are you?

MONTHS __________

232. 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?

THEN 1 (GO TO 301)
LATER 2 (GO TO 301)
NO MORE 3 (GO TO 301)

233. When did your last menstrual period start?

DATE, IF GIVEN ______
DAYS AGO 1 ____
WEEKS AGO 2 ____
MONTHS AGO 3 ____
YEARS AGO 4 ____
IN MENOPAUSE/HYSTERECTOMY 993
BEFORE LAST BIRTH 994
NEVER MENSTRUATED 995

SECTION 3A. QUALITY OF CARE

301. During the last 12 months, has a health or family planning worker visited you at home?

YES 1
NO 2 (GO TO 308)

302. How many times did a worker visit you in the last 12 months?

NUMBER OF TIMES ____

303. During these visits, what were the different matters talked about?
Anything else?
RECORD ALL MENTIONED.

FAMILY PLANNING A
BREASTFEEDING B
SUPPLEMENTARY FEEDING C
IMMUNIZATION D
NUTRITION E
DISEASE PREVENTION F
TREATMENT OF HEALTH PROBLEM G
ANTENATAL CARE H
DELIVERY CARE I
POSTPARTUM CARE J
CHILD CARE K
SANITATION/CLEANLINESS L
ORAL REHYDRATION M
OTHER (SPECIFY) _________ X

304. When was the last time a health or family planning worker visited you at home?
IF LESS THAN ONE MONTH, RECORD '00' MONTHS.

MONTHS AGO _______

305. Who visited you at that time?

PUBLIC SECTOR WORKER
GOVT. DOCTOR 11
PUBLIC HEALTH NURSE 12
ANM/LHV 13
MALE MPW/SUPERVISOR 14
ANGANWADI WORKER 15
VILLAGE HEALTH GUIDE 16
OTHER PUBLIC SECTOR HEALTH WORKER 17
NGO DOCTOR 21
NGO WORKER 22
PRIVATE SECTOR WORKER
PRIVATE DOCTOR 31
PRIVATE NURSE 32
COMPOUNDER 33
TRADITIONAL HEALER 34
DAI (TBA) 35
OTHER PRIVATE SECTOR HEALTH WORKER 36
OTHER (SPECIFY) ________ 96

305A. What type of services did you receive during this visit?
Any other service?
RECORD ALL MENTIONED.

PILL SUPPLY A
CONDOM SUPPLY B
FOLLOW-UP FOR STERILIZATION C
FOLLOW-UP FOR IUD INSERTION D
FAMILY PLANNING ADVICE E
OTHER FAMILY PLANNING SERVICE F
IMMUNIZATION G
ANTENATAL CARE H
DELIVERY CARE I
POSTPARTUM CARE J
DISEASE PREVENTION K
MEDICAL TREATMENT FOR SELF L
TREATMENT FOR SICK CHILD M
TREATMENT FOR OTHER PERSON N
OTHER (SPECIFY) ________ X

306. Did she/he spend enough time with you?

YES 1
NO 2

307. Did she/he talk to you nicely, somewhat nicely, or not nicely?

NICELY 1
SOMEWHAT NICELY 2
NOT NICELY 3

308. Have you visited a health facility or camp for any reason for yourself (or your children) in the last 12 months?

YES 1
NO 2 (GO TO 317)

309. During these visits in the last 12 months, what were the different matters talked about? Anything else?
RECORD ALL MENTIONED.

FAMILY PLANNING A
BREASTFEEDING B
SUPPLEMENTARY FEEDING C
IMMUNIZATION D
NUTRITION E
DISEASE PREVENTION F
TREATMENT OF HEALTH PROBLEM G
ANTENATAL CARE H
DELIVERY CARE I
POSTPARTUM CARE J
CHILD CARE K
SANITATION/CLEANLINESS L
ORAL REHYDRATION M
OTHER (SPECIFY) ________ X

310. What type of health facility did you visit most recently for yourself (or your children)?

PUBLIC MEDICAL SECTOR
GOVT./MUNICIPAL HOSPITAL 11
GOVT. DISPENSARY 12
UHC/UHP/UFWC 13
CHC/RURAL HOSPITAL/PHC 14
SUB-CENTRE 15
GOVT. MOBILE CLINIC 16
CAMP 17
OTHER PUBLIC SECTOR HEALTH FACILITY 18
NGO/TRUST HOSPITAL/CLINIC 21
PRIVATE MEDICAL SECTOR
PVT. HOSPITAL/CLINIC 31
PVT. MOBILE CLINIC 32
PHARMACY/DRUGSTORE 33
OTHER PRIVATE SECTOR HEALTH FACILITY 34
OTHER (SPECIFY) _______ 96

311. What service did you go for?
Any other service?
RECORD ALL MENTIONED.

PILL SUPPLY A
CONDOM SUPPLY B
IUD/LOOP INSERTION C
STERILIZATION OPERATION D
FOLLOW-UP FOR STERILIZATION E
FOLLOW-UP FOR IUD INSERTION F
FAMILY PLANNING ADVICE G
OTHER FAMILY PLANNING SERVICE H
IMMUNIZATION I
ANTENATAL CARE J
DELIVERY CARE K
POSTPARTUM CARE L
DISEASE PREVENTION M
MEDICAL TREATMENT FOR SELF N
TREATMENT FOR SICK CHILD O
TREATMENT FOR OTHER PERSON P
OTHER (SPECIFY) ________ X

311A. Did you receive the service that you went for?

YES 1
NO 2

312. CHECK 311A:

RECEIVED SERVICE:
How long did you have to wait before being served?

DID NOT RECEIVE SERVICE
How long did you have to wait before you learned that the service you went for would not be available?

MINUTES 1 ____
HOURS 2 ____
NO WAIT AT ALL 995
OTHER (SPECIFY) ________ 996

313. During this visit did the staff spend enough time with you?

YES 1
NO 2

314. Did the staff talk to you nicely, somewhat nicely, or not nicely?

NICELY 1
SOMEWHAT NICELY 2
NOT NICELY 3

315. Did the staff respect your need for privacy?

YES 1
NO 2
SAYS PRIVACY NOT NEEDED 3

316. Would you say the health facility was very clean, somewhat clean, or not clean?

VERY CLEAN 1
SOMEWHAT CLEAN 2
NOT CLEAN 3

Now I would like to ask about all the contacts you have had with health or family planning workers at home or anywhere else in the last 12 months or ever before.

317. During any of these contacts, which methods of delaying or avoiding pregnancy were discussed, if any?
PROBE: Any other methods discussed?
RECORD ALL MENTIONED.

PILL A
CONDOM/NIRODH B
IUD/LOOP C
FEMALE STERILIZATION D
MALE STERILIZATION E
RHYTHM/SAFE PERIOD F
WITHDRAWAL G
OTHER (SPECIFY) _______ X
NONE/NEVER DISCUSSED Y

SECTION 3B. 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

318. For each method I mention, please tell me if you have ever heard of the method and whether you have ever used the method at any time in your life?

01. PILL Women can take a pill daily or weekly.
HAS USED 1
HAS HEARD, BUT HAS NOT USED 2
HAS NOT HEARD 3
02. CONDOM OR NIRODH Men can use a rubber sheath during sexual intercourse.
HAS USED 1
HAS HEARD, BUT HAS NOT USED 2
HAS NOT HEARD 3
03. IUD OR LOOP Women can have a loop or coil placed inside them by a doctor or a nurse.
HAS USED 1
HAS HEARD, BUT HAS NOT USED 2
HAS NOT HEARD 3
04. FEMALE STERILIZATION Women can have an operation to avoid having any more children. Have you ever heard of female sterilization? IF YES: Have you ever had an operation to avoid having any more children?
HAS USED 1
HAS HEARD, BUT HAS NOT USED 2
HAS NOT HEARD 3
05. MALE STERILIZATION Men can have an operation to avoid having any more children. Have you ever heard of male sterilization? IF YES: Has your husband ever had an operation to avoid having any more children?
HAS USED 1
HAS HEARD, BUT HAS NOT USED 2
HAS NOT HEARD 3
06. RHYTHM OR SAFE PERIOD METHOD Couples can avoid having sexual intercourse on certain days of the month when the woman is more likely to become pregnant.
HAS USED 1
HAS HEARD, BUT HAS NOT USED 2
HAS NOT HEARD 3
07. WITHDRAWAL Men can be careful and pull out before climax.
HAS USED 1
HAS HEARD, BUT HAS NOT USED 2
HAS NOT HEARD 3
08. Have you ever heard of any other ways or methods that women or men can use to delay or avoid pregnancy? IF YES: Have you ever used this method?
LIST UP TO TWO METHODS.
METHOD (SPECIFY) ______
HAS USED 1
HAS HEARD, BUT HAS NOT USED 2
HAS NOT HEARD 3

319. CHECK 318:

NOT A SINGLE CODE '1' (NEVER USED) (GO TO 320)
AT LEAST ONE CODE '1' (EVER USED) (GO TO 322)

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

YES 1
NO 2 (GO TO 356)

321. What have you used or done?
CORRECT 318 AND 319.

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

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

NUMBER OF CHILDREN _______

323. CHECK 107:

CURRENTLY MARRIED (GO TO 324)
SEPARATED/DESERTED/DIVORCED/WIDOWED (GO TO 364)

324. CHECK 230:

NOT PREGNANT OR UNSURE (GO TO 325)
PREGNANT (GO TO 358)

325. CHECK 318:

NEITHER STERILIZED (GO TO 326)
HE OR SHE STERILIZED (GO TO 327A)

326. Are you or your husband currently doing something or using any method to delay or avoid getting pregnant?

YES 1
NO 2 (GO TO 355)

327. Which method are you using?
327A. CIRCLE '04' FOR FEMALE STERILIZATION.
CIRCLE '05' FOR MALE STERILIZATION.

PILL 01
CONDOM/NIRODH 02
IUD/LOOP 03 (GO TO 336)
FEMALE STERILIZATION 04 (GO TO 339)
MALE STERILIZATION 05 (GO TO 339)
RHYTHM/SAFE PERIOD 06 (GO TO 350)
WITHDRAWAL 07 (GO TO 350)
OTHER (SPECIFY) ________ 96 (GO TO 350)

328. For how many months have you been using pills/condoms continuously?
IF LESS THAN 1 MONTH, RECORD '00'.

MONTHS _____
8 YEARS OR LONGER 96

329. Where did you obtain the pills/condoms the last time?

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

NAME OF HOSPITAL OR CLINIC________
PUBLIC MEDICAL SECTOR
GOVT./MUNICIPAL HOSPITAL 11 (GO TO 331)
GOVT. DISPENSARY 12 (GO TO 331)
UHC/UHP/UFWC 13 (GO TO 331)
CHC/RURAL HOSPITAL/PHC 14 (GO TO 331)
SUB-CENTRE 15 (GO TO 331)
GOVT. MOBILE CLINIC 16 (GO TO 331)
GOVT. PARAMEDIC 17 (GO TO 331)
CAMP 18 (GO TO 331)
OTHER PUBLIC SECTOR HEALTH FACILITY 19 (GO TO 331)
NGO OR TRUST HOSPITAL/CLINIC 21 (GO TO 331)
NGO WORKER 22 (GO TO 331)
PRIVATE MEDICAL SECTOR
PVT. HOSPITAL/CLINIC 31 (GO TO 331)
PVT. DOCTOR 32 (GO TO 331)
PVT. MOBILE CLINIC 33 (GO TO 331)
PVT. PARAMEDIC 34 (GO TO 331)
VAIDYA/HAKIM/HOMEOPATH 35 (GO TO 331)
TRADITIONAL HEALER 36 (GO TO 331)
PHARMACY/DRUGSTORE 37 (GO TO 331)
DAI (TBA) 38 (GO TO 331)
OTHER PRIVATE SECTOR HEALTH FACILITY 39 (GO TO 331)
OTHER SOURCE
SHOP 41 (GO TO 331)
HUSBAND 42
FRIEND/OTHER RELATIVE 43
OTHER (SPECIFY) ________ 96 (GO TO 331)

330. Do you know where this person obtained the pills/condoms the last time?

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

NAME OF HOSPITAL OR CLINIC________
PUBLIC MEDICAL SECTOR
GOVT./MUNICIPAL HOSPITAL 11
GOVT. DISPENSARY 12
UHC/UHP/UFWC 13
CHC/RURAL HOSPITAL/PHC 14
SUB-CENTRE 15
GOVT. MOBILE CLINIC 16
GOVT. PARAMEDIC 17
CAMP 18
OTHER PUBLIC SECTOR HEALTH FACILITY 19
NGO OR TRUST HOSPITAL/CLINIC 21
NGO WORKER 22
PRIVATE MEDICAL SECTOR
PVT. HOSPITAL/CLINIC 31
PVT. DOCTOR 32
PVT. MOBILE CLINIC 33
PVT. PARAMEDIC 34
VAIDYA/HAKIM/HOMEOPATH 35
TRADITIONAL HEALER 36
PHARMACY/DRUGSTORE 37
DAI (TBA) 38
OTHER PRIVATE SECTOR HEALTH FACILITY 39
OTHER SOURCE
SHOP 41
OTHER (SPECIFY) ________ 96
DOESN'T KNOW 98

331. May I see the packet of pills/condoms you are using now?
IF PACKET SEEN, RECORD BRAND NAME.

PACKET SEEN 1 (GO TO 333)
BRAND NAME _______ (GO TO 333)
PACKET NOT SEEN 2

332. Do you know the brand name of the pills/condoms you are using now?

BRAND NAME _______
DOESN'T KNOW 998

333. How much does one packet of pills/condoms cost you?

COST Rs: _____
FREE 995 (GO TO 335)
DOESN'T KNOW 998 (GO TO 335)

334. For that cost how many condoms/pill cycles do you get?

NUMBER _____

335. Have you been able to get the supply of pills/condoms whenever you need them?

YES 1 (GO TO 344)
NO 2 (GO TO 344)

336. For how many months have you been using the IUD/LOOP continuously?
IF LESS THAN 1 MONTH, RECORD '00'.

MONTHS ____
8 YEARS OR LONGER 96

337. Who inserted the IUD/LOOP?

GOVERNMENT DOCTOR 01
GOVERNMENT NURSE/PARAMEDIC 02
NGO DOCTOR 03
NGO NURSE/PARAMEDIC 04
PRIVATE DOCTOR 05
PRIVATE NURSE/PARAMEDIC 06
OTHER (SPECIFY) ________ 96

338. Where did you go to get the IUD/LOOP inserted?

NAME OF PLACE IF HOSPITAL OR CLINIC ________
PUBLIC MEDICAL SECTOR
GOVT./MUNICIPAL HOSPITAL 11
GOVT. DISPENSARY 12
UHC/UHP/UFWC 13
CHC/RURAL HOSPITAL/PHC 14
SUB-CENTRE 15
GOVT. MOBILE CLINIC 16
CAMP 17
OTHER PUBLIC SECTOR HEALTH FACILITY 18
NGO OR TRUST HOSPITAL/CLINIC 21
PRIVATE MEDICAL SECTOR
PVT. HOSPITAL/CLINIC 31
PVT. DOCTOR 32
PVT. MOBILE CLINIC 33
OTHER PRIVATE SECTOR HEALTH FACILITY 34
OTHER (SPECIFY) ________ 96

338A. How much did the IUD/LOOP insertion cost you?
IF NO CHARGE, RECORD `0000'.

COST Rs: _____ (GO TO 342)
DOESN'T KNOW 9998 (GO TO 342)

339. In what month and year was your/your husband's sterilization operation performed?

MONTH _____
YEAR ____

340. Where did you/your husband get sterilized?

NAME OF PLACE IF HOSPITAL OR CLINIC ________
PUBLIC MEDICAL SECTOR
GOVT./MUNICIPAL HOSPITAL 11
UHC/UHP/UFWC 12
CHC/RURAL HOSPITAL/PHC 13
GOVT. MOBILE CLINIC 14
CAMP 15
OTHER PUBLIC SECTOR HEALTH FACILITY 16
NGO OR TRUST HOSPITAL/CLINIC 21
PRIVATE MEDICAL SECTOR
PVT. HOSPITAL/CLINIC 31
PVT. DOCTOR 32
PVT. MOBILE CLINIC 33
OTHER PRIVATE SECTOR HEALTH FACILITY 34
OTHER (SPECIFY) ________ 96

341. How much did the operation cost you?
IF NO CHARGE, RECORD '0000'.

COST Rs: _____
DOESN'T KNOW 9998

342. How would you rate the care you/your husband received during or immediately after the operation/IUD insertion: very good, all right, not so good, or bad?

VERY GOOD 1
ALL RIGHT 2
NOT SO GOOD 3
BAD 4

343. What improvements would you suggest in the care you/your husband received during or immediately after the operation/IUD insertion? Anything else?
RECORD ALL MENTIONED.

MORE CLEANLINESS A
MORE PRIVACY B
BETTER CARE BY THE DOCTOR C
BETTER CARE BY THE OTHER STAFF D
SHORTER WAITING TIME E
LOWER COST F
OTHER (SPECIFY) _______X
NONE Y

344. Who mainly motivated you to use (CURRENT METHOD)?

GOVT. DOCTOR 01
PUBLIC HEALTH NURSE 2
ANM/LHV 03
MALE MPW/SUPERVISOR 04
ANGANWADI WORKER 05
OTHER GOVT. HEALTH WORKER 06
NGO WORKER 07
PRIVATE DOCTOR 08
PRIVATE PARAMEDIC 09
DAI (TBA) 10
TEACHER 11
RELIGIOUS LEADER 12
POLITICAL LEADER 13
HUSBAND 14
MOTHER/MOTHER-IN-LAW 15
OTHER RELATIVE/FRIEND 16
NO ONE/SELF 17 (GO TO 347)
OTHER (SPECIFY) _______ 96

345. Did he/she tell you about any other methods that you might use?

YES 1
NO 2 (GO TO 347)

346. Which other methods were you told about?
RECORD ALL MENTIONED.

PILL A
CONDOM/NIRODH B
IUD/LOOP C
FEMALE STERILIZATION D
MALE STERILIZATION E
RHYTHM/SAFE PERIOD F
WITHDRAWAL G
OTHER (SPECIFY) _______ X

347. At the time when you accepted the (CURRENT METHOD) did any health or family planning worker tell you about side effects or other problems you might have using the (CURRENT METHOD)?

YES 1
NO 2

348. Were you told what to do in case you experienced problems with the method?

YES 1
NO 2

349. Did you receive any follow-up, either at home or in a health facility, after you accepted the (CURRENT METHOD)?
PROBE FOR TYPE OF VISIT.

AT HOME ONLY 1 (GO TO 351)
IN A FACILITY ONLY 2 (GO TO 351)
BOTH 3 (GO TO 351)
NEITHER 4 (GO TO 351)

350. For how long have you been using this method continuously?
IF LESS THAN 1 MONTH, RECORD '00'.

MONTHS ______
8 YEARS OR LONGER 96

351. Have you had any problems related to the use of (CURRENT METHOD)?

YES 1
NO 2 (GO TO 362)

352. What problems have you had related to the use of (CURRENT METHOD)?
PROBE: Any other problems?
RECORD ALL MENTIONED.

WEIGHT GAIN A
WEIGHT LOSS B
TOO MUCH BLEEDING C
HYPERTENSION D
HEADACHE/BODYACHE/BACKACHE E
NAUSEA/VOMITING F
NO MENSTRUATION G
WEAKNESS/TIREDNESS H
DIZZINESS I
FEVER J
CRAMPS K
SPOTTING L
INCONVENIENT TO USE M
ABDOMINAL PAIN N
WHITE DISCHARGE O
IRREGULAR PERIODS P
BREAST TENDERNESS Q
ALLERGY R
EXPULSION S
REDUCED SEXUAL SATISFACTION T
OTHER (SPECIFY) ________ X

353. When you first started having these problems, did you talk to anyone about these problems?

YES 1
NO 2 (GO TO 362)

354. Who did you talk to about these problems?
Any other person?
RECORD ALL PERSONS TALKED TO.

GOVT. DOCTOR A (GO TO 362)
PUBLIC HEALTH NURSE B (GO TO 362)
ANM/LHV C (GO TO 362)
ANGANWADI WORKER D (GO TO 362)
OTHER GOVT. HEALTH WORKER E (GO TO 362)
NGO DOCTOR F (GO TO 362)
NGO WORKER G (GO TO 362)
PRIVATE DOCTOR H (GO TO 362)
PRIVATE PARAMEDIC I (GO TO 362)
COMPOUNDER/PHARMACIST J (GO TO 362)
TRADITIONAL HEALER K (GO TO 362)
HUSBAND L (GO TO 362)
FRIEND/OTHER RELATIVE M (GO TO 362)
OTHER (SPECIFY) ________ X (GO TO 362)

355. What is the main reason you stopped using family planning?

METHOD FAILED/GOT PREGNANT 01 (GO TO 358)
LACK OF SEXUAL SATISFACTION 02 (GO TO 358)
CREATED MENSTRUAL PROBLEM 03 (GO TO 358)
CREATED HEALTH PROBLEM 04 (GO TO 358)
INCONVENIENT TO USE 05 (GO TO 358)
HARD TO GET METHOD 06 (GO TO 358)
PUT ON WEIGHT 07 (GO TO 358)
DID NOT LIKE THE METHOD 08 (GO TO 358)
WANTED TO HAVE A CHILD 09 (GO TO 358)
WANTED TO REPLACE DEAD CHILD 10 (GO TO 358)
LACK OF PRIVACY FOR USE 11 (GO TO 358)
HUSBAND AWAY 12 (GO TO 358)
COST TOO MUCH 13 (GO TO 358)
OTHER (SPECIFY) ________ 96 (GO TO 358)

356. CHECK 107:

CURRENTLY MARRIED (GO TO 356A)
SEPARATED/DESERTED/DIVORCED/WIDOWED (GO TO 364)

356A. CHECK 230:

NOT PREGNANT (GO TO 357)
PREGNANT (GO TO 358)

357. What is the main reason you are not using a method of contraception to delay or avoid pregnancy?

HUSBAND AWAY 11
FERTILITY-RELATED REASONS
NOT HAVING SEX 21
INFREQUENT SEX 22
MENOPAUSAL/HAD HYSTERECTOMY 23 (GO TO 362)
SUBFECUND/INFECUND 24
POSTPARTUM/BREASTFEEDING 25
WANTS MORE CHILDREN 26
OPPOSITION TO USE
OPPOSED TO FAMILY PLANNING 31
HUSBAND OPPOSED 32
OTHER PEOPLE OPPOSED 33
AGAINST RELIGION 34
LACK OF KNOWLEDGE
KNOWS NO METHOD 41
KNOWS NO SOURCE 42
METHOD-RELATED REASONS
HEALTH CONCERNS 51
WORRY ABOUT SIDE EFFECTS 52
HARD TO GET METHOD 53
COSTS TOO MUCH 54
INCONVENIENT 55
AFRAID OF STERILIZATION 56
DON'T LIKE EXISTING METHODS 57
OTHER(SPECIFY) ________96
DOESN'T KNOW 98

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

YES 1 (GO TO 360)
NO 2
DOESN'T KNOW 8

359. Do you think you will use a method to delay or avoid pregnancy at any time in the future?

YES 1
NO 2 (GO TO 361)
DOESN'T KNOW 8 (GO TO 361)

360. Which method would you prefer to use?

PILL 01 (GO TO 362)
CONDOM/NIRODH 02 (GO TO 362)
IUD/LOOP 03 (GO TO 362)
FEMALE STERILIZATION 04 (GO TO 362)
MALE STERILIZATION 05 (GO TO 362)
RHYTHM/SAFE PERIOD 06 (GO TO 362)
WITHDRAWAL 07 (GO TO 362)
OTHER (SPECIFY) ________ 96 (GO TO 362)
DOESN'T KNOW/UNSURE 98 (GO TO 362)

361. What is the main reason that you think you will not use a family planning method at any time in the future?

FERTILITY-RELATED REASONS
NOT HAVING SEX 11
INFREQUENT SEX 12
MENOPAUSAL/HAD HYSTERECTOMY 13
SUBFECUND/INFECUND 14
WANTS AS MANY CHILDREN AS POSSIBLE 15
OPPOSITION TO USE
OPPOSED TO FAMILY PLANNING 21
HUSBAND OPPOSED 22
OTHER PEOPLE OPPOSED 23
AGAINST RELIGION 24
LACK OF KNOWLEDGE
KNOWS NO METHOD 31
KNOWS NO SOURCE 32
METHOD-RELATED REASONS
HEALTH CONCERNS 41
WORRY ABOUT SIDE EFFECTS 42
HARD TO GET METHOD 43
COSTS TOO MUCH 44
INCONVENIENT 45
AFRAID OF STERILIZATION 46
DOESN'T LIKE EXISTING METHODS 47
OTHER(SPECIFY) _______96
DOESN'T KNOW 98

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

YES 1
NO 2 (GO TO 364)

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

HUSBAND A
MOTHER B
SISTER(S) C
DAUGHTER D
MOTHER-IN-LAW E
SISTER-IN-LAW F
FRIEND/NEIGHBOUR G
OTHER (SPECIFY) ______ X

364. In the last few months, have you heard or seen any message about family planning:

on radio?
on television?
in a cinema or film show?
in a newspaper or magazine?
on a wall painting or hoarding?
in a drama, folk dance, or street play?

RADIO
YES 1
NO 2
TELEVISION
YES 1
NO 2
CINEMA/FILM SHOW
YES 1
NO 2
NEWSPAPER/MAGAZINE
YES 1
NO 2
WALL PAINTING/HOARDING
YES 1
NO 2
DRAMA/FOLK DANCE/STREET
YES 1
NO 2
PLAY
YES 1
NO 2

SECTION 4A. ANTENATAL, NATAL, AND POSTNATAL CARE

401. CHECK 224:

ONE OR MORE BIRTH SINCE JAN. 1995 (GO TO 402)
NO BIRTHS SINCE JAN. 1995 (GO TO 486)

402. ENTER THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF LAST TWO BIRTHS SINCE JANUARY 1995 IN THE TABLE. ASK THE QUESTIONS ABOUT THESE TWO BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 2 BIRTHS, RECORD ONLY LAST TWO BIRTHS.)

Now I would like to ask you some questions about the health of your children born since January 1995. (We will talk about one child at a time.)

LINE NUMBER FROM QUESTION 212:

LINE NO. ______

FROM QUESTIONS 212 AND 216:

NAME _______
ALIVE (GO TO 403)
DEAD (GO TO 403)

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

THEN 1 (GO TO 405)
LATER 2
NO MORE 3 (GO TO 405)

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

MONTHS 1 ___
YEARS 2 ___
DOESN'T KNOW 998

405. When you were pregnant with (NAME), did you go for an antenatal check-up?

YES 1
NO 2 (GO TO 407)

406. Whom did you see?
Anyone?
RECORD ALL PERSONS SEEN.

HEALTH PROFESSIONAL
DOCTOR A
ANM/NURSE/MIDWIFE/LHV B
OTHER HEALTH PROFESSIONAL C
TRADITIONAL BIRTH ATTENDANT (DAI) D
OTHER (SPECIFY) ________ X

407. When you were pregnant with (NAME), did any health worker visit you at home for an antenatal check-up?

YES 1
NO 2

408. CHECK 405 AND 407:

YES IN EITHER (GO TO 409)
NO IN BOTH (GO TO 413)

409. How many months pregnant were you when you first received an antenatal check-up?

MONTHS ____

410. How many times did you receive antenatal check-ups during this pregnancy?

NO. OF TIMES ____

411. Did you have the following performed at least once during any of your antenatal check-ups for this pregnancy:

Weight measured?
Height measured?
Blood pressure checked?
Blood?
Urine?
Abdomen examined?
Internal exam?
X-ray?
Sonogram or ultrasound?
Amniocentesis?

WEIGHT
YES 1
NO 2
HEIGHT
YES 1
NO 2
BLOOD PRESSURE
YES 1
NO 2
BLOOD TEST
YES 1
NO 2
URINE TEST
YES 1
NO 2
ABDOMEN EXAMINED
YES 1
NO 2
INTERNAL EXAM
YES 1
NO 2
X-RAY
YES 1
NO 2
SONOGRAM/ULTRASOUND
YES 1
NO 2
AMNIOCENTESIS
YES 1
NO 2

412. Did you receive advice on any of the following during at least one of your antenatal check-ups for this pregnancy:

Diet?
Danger signs of pregnancy?
Delivery care?
Newborn care?
Family planning?

DIET
YES 1
NO 2
DANGER SIGNS
YES 1
NO 2
DELIVERY CARE
YES 1
NO 2
NEWBORN CARE
YES 1
NO 2
FAMILY PLANNING
YES 1 (GO TO 414)
NO 2 (GO TO 414)

413. What is the main reason you did not receive an antenatal check-up?

NOT NECESSARY 01
NOT CUSTOMARY 02
COST TOO MUCH 03
TOO FAR/NO TRANSPORT 04
POOR QUALITY SERVICE 05
NO TIME TO GO 06
FAMILY DID NOT ALLOW 07
LACK OF KNOWLEDGE 08
NO HEALTH WORKER VISITED 09
OTHER (SPECIFY) ________ 96

414. When you were pregnant with (NAME), did you experience any of the following problems at any time:

Night blindness? (USE LOCAL TERM)
Blurred vision?
Convulsions not from fever?
Swelling of the legs, body, or face?
Excessive fatigue?
Anemia?
Any vaginal bleeding?

NIGHT BLINDNESS
YES 1
NO 2
BLURRED VISION
YES 1
NO 2
CONVULSIONS
YES 1
NO 2
SWELLING
YES 1
NO 2
EXCESSIVE FATIGUE
YES 1
NO 2
ANEMIA
YES 1
NO 2
VAGINAL BLEEDING
YES 1
NO 2

415. When you were pregnant with (NAME), were you given any iron folic tablets or syrup?

YES 1
NO 2 (GO TO 418)

416. Did you receive enough iron folic tablets or syrup to last about three months or longer?

YES 1
NO 2
DOESN'T KNOW 8

417. Did you consume all the iron folic tablets or syrup you were given ?

YES 1
NO 2

418. When you were pregnant with (NAME), were you given an injection in the arm to prevent you and the baby from getting tetanus (USE LOCAL TERM FOR TETANUS)?

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

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

TIMES ____
DOESN'T KNOW 8

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

HOME
YOUR HOME 11
PARENTS' HOME 12
OTHER HOME 13
PUBLIC MEDICAL SECTOR
GOVT./MUNICIPAL HOSPITAL 21 (GO TO 422)
GOVT. DISPENSARY 22 (GO TO 422)
UHC/UHP/UFWC 23 (GO TO 422)
CHC/RURAL HOSPITAL/PHC 24 (GO TO 422)
SUB-CENTRE 25 (GO TO 422)
OTHER PUBLIC SECTOR HEALTH FACILITY 26 (GO TO 422)
NGO/TRUST HOSPITAL/CLINIC 31 (GO TO 422)
PRIVATE MEDICAL SECTOR
PVT. HOSPITAL/CLINIC/MATERNITY HOME 41 (GO TO 422)
OTHER PRIVATE SECTOR HEALTH FACILITY 42 (GO TO 422)
OTHER (SPECIFY) ________ 96 (GO TO 422)

421. What is the main reason you did not go to a health facility for delivery?

NOT NECESSARY 01
NOT CUSTOMARY 02
COST TOO MUCH 03
TOO FAR/NO TRANSPORT 04
POOR QUALITY SERVICE 05
NO TIME TO GO 06
FAMILY DID NOT ALLOW 07
BETTER CARE AT HOME 08
LACK OF KNOWLEDGE 09
OTHER (SPECIFY) ______ 96

422. Who assisted with the delivery of (NAME)? Anyone else?
PROBE FOR THE TYPE OF PERSON AND RECORD ALL PERSONS ASSISTING.

HEALTH PERSONNEL
DOCTOR A
ANM/NURSE/MIDWIFE/LHV B
OTHER HEALTH PROFESSIONAL C
OTHER PERSON
DAI (TBA) D
FRIEND/RELATIVE E
OTHER (SPECIFY) ________ X
NO ONE Y

423. CHECK 422:

ANY CODE A, B. OR C (GO TO 425)
NO CODE A, B, OR C (GO TO 424)

424. What is the main reason you did not receive an antenatal check-up?

NOT NECESSARY 01 (GO TO 426)
NOT CUSTOMARY 02 (GO TO 426)
COST TOO MUCH 03 (GO TO 426)
TOO FAR/NO TRANSPORT 04 (GO TO 426)
PROFESSIONAL NOT AVAILABLE 05 (GO TO 426)
NO CONFIDENCE IN AVAILABLE PROFFESIONAL 06 (GO TO 426)
NO TIME TO GET HELP 07 (GO TO 426)
FAMILY DID NOT ALLOW 08 (GO TO 426)
OTHER (SPECIFY) _______ 96 (GO TO 426)

425. Was (NAME) delivered by caesarian section?

YES 1
NO 2

426. When (NAME) was born, was he/she: large, average, small, or very small?

LARGE 1
AVERAGE 2
SMALL 3
VERY SMALL 4

427. Was (NAME) weighted at birth?

YES 1
NO 2 (GO TO 429)

428. How much did (NAME) weigh?

GRAMS _____
DOESN'T KNOW 9998

Now I would like to ask you about the 2-month period after the delivery of (NAME).

429. During that period, did a doctor or other health professional check your health or the health of your baby?

YES 1
NO 2 (GO TO 433)

430. How soon after the birth of (NAME) did you first get a check-up?

DAYS 1 ____
WEEKS 2 ____

431. Where did you get the check-up?

HOME VISIT 11
PUBLIC MEDICAL SECTOR
GOVT./MUNICIPAL HOSPITAL 21
GOVT.DISPENSARY 22
UHC/UHP/UFWC 23
CHC/RURAL HOSPITAL/PHC 24
SUB-CENTER 25
OTHER PUBLIC SECTOR HEALTH FACILITY 26
NGO OR TRUST HOSPITAL/CLINIC 31
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/MATERNITY HOME 41
OTHER PRIVATE SECTOR HEALTH FACILITY 42
OTHER (SPECIFY) _______ 96

432. Did any of the following happen when you had the check-up:

Was your abdomen examined?
Did you receive advice on family planning?
Did you receive advice on breastfeeding?
Did you receive advice on baby care?

ABDOMEN EXAMINED
YES 1
NO 2
FAMILY PLANNING
YES 1
NO 2
BREASTFEEDING
YES 1
NO 2
BABY CARE
YES 1
NO 2

433. At any time during the two months after the delivery of (NAME), did you have any of the following: Massive vaginal bleeding? Very high fever?

VAGINAL BLEEDING
YES 1
NO 2
VERY HIGH FEVER
YES 1
NO 2

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

YES 1 (GO TO 436)
NO 2 (GO TO 437)

435. Did your period return between the birth of (NAME) and your next pregnancy?
[ASK FOR SECOND-TO-LAST BIRTH ONLY]

YES 1
NO 2 (GO TO 439)

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

MONTHS ____
DOESN'T KNOW 98

437. CHECK 230:
RESPONDENT PREGNANT?
[ASK FOR MOST RECENT BIRTH ONLY]

NOT PREGNANT OR QUESTION 230 NOT ASKED (GO TO 438)
PREGNANT OR UNSURE (GO TO 439)

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

YES 1
NO 2 (GO TO 440)

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

MONTHS ____
DOESN'T KNOW 98

440. Did you ever breastfeed (NAME)?

YES 1 (GO TO 442)
NO 2

441. Why did you not breastfeed (NAME)?

MOTHER ILL/WEAK 01 (GO TO 448)
CHILD ILL/WEAK 02 (GO TO 448)
CHILD DIED 03 (GO TO 448)
NIPPLE/BREAST PROBLEM 04 (GO TO 448)
INSUFFICIENT MILK 05 (GO TO 448)
MOTHER WORKING 06 (GO TO 448)
CHILD REFUSED 07 (GO TO 448)
OTHER (SPECIFY) ________ 96 (GO TO 448)

442. 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.

IMMEDIATELY 000
HOURS 1 ____
DAYS 2 ____

443. Did you squeeze out the milk from the breast before you first put (NAME) to the breast?

YES 1
NO 2

444. CHECK 216:
CHILD ALIVE?

ALIVE (GO TO 445)
DEAD (GO TO 446)

445. Are you still breastfeeding (NAME)?

YES 1 (GO TO 449)
NO 2

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

MONTHS _____
UNTIL DIED 96 (GO TO 452)

447. Why did you stop breastfeeding (NAME)?

MOTHER ILL/WEAK 01
CHILD ILL/WEAK 02
CHILD DIED 03
NIPPLE/BREAST PROBLEM 04
INSUFFICIENT MILK 05
MOTHER WORKING 06
CHILD REFUSED 07
WEANING AGE 08
BECAME PREGNANT 09
STARTED USING CONTRACEPTION 10
OTHER (SPECIFY) ______ 96

448. CHECK 216:
CHILD ALIVE?

ALIVE (GO TO 449)
DEAD (GO TO 452)

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

YES 1
NO 2
DOESN'T KNOW 8

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

Plain water?
Powdered milk?
Any other milk (other than breast milk)?
Any other liquid?
Green, leafy vegetables?
Fruits?
Any other solid or mushy food?

PLAIN WATER
YES 1
NO 2
DOESN'T KNOW 8
POWDERED MILK
YES 1
NO 2
DOESN'T KNOW 8
OTHER MILK
YES 1
NO 2
DOESN'T KNOW 8
ANY OTHER LIQUIDS
YES 1
NO 2
DOESN'T KNOW 8
GREEN/LEAFY VEGETABLES
YES 1
NO 2
DOESN'T KNOW 8
FRUITS
YES 1
NO 2
DOESN'T KNOW 8
SOLID/MUSHY FOOD
YES 1
NO 2
DOESN'T KNOW 8

451. How often during the last seven days was (NAME) given any of the following:

Plain water?
Powdered milk?
Any other milk (other than breast milk)?
Any other liquid?
Green, leafy vegetables?
Fruits?
Any other solid or mushy food?

PLAIN WATER
1 EVERY DAY
2 SOME DAYS
3 NOT AT ALL
8 DOESN'T KNOW
POWDERED MILK
1 EVERY DAY
2 SOME DAYS
3 NOT AT ALL
8 DOESN'T KNOW
OTHER MILK
1 EVERY DAY
2 SOME DAYS
3 NOT AT ALL
8 DOESN'T KNOW
ANY OTHER LIQUIDS
1 EVERY DAY
2 SOME DAYS
3 NOT AT ALL
8 DOESN'T KNOW
GREEN/LEAFY VEGETABLES
1 EVERY DAY
2 SOME DAYS
3 NOT AT ALL
8 DOESN'T KNOW
FRUITS
1 EVERY DAY
2 SOME DAYS
3 NOT AT ALL
8 DOESN'T KNOW
SOLID/MUSHY FOOD
1 EVERY DAY
2 SOME DAYS
3 NOT AT ALL
8 DOESN'T KNOW

452. FOR THE MOST RECENT BIRTH: GO BACK TO 403 IN NEXT COLUMN; OR, IF NO MORE BIRTHS, GO TO 453 FOR THE SECOND-TO-LAST BIRTH: GO TO 453

SECTION 4B. IMMUNIZATION AND HEALTH

453. ENTER THE LINE NUMBER AND NAME OF LAST TWO BIRTHS SINCE JANUARY 1995 IN THE TABLE. ASK THE QUESTIONS ABOUT THESE TWO BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 2 BIRTHS, RECORD ONLY LAST TWO BIRTHS.)

LINE NUMBER FROM QUESTION 212:

LINE NO. _______

FROM QUESTIONS 212 AND 216:

NAME ________
ALIVE (GO TO 454)
DEAD (GO TO NEXT COLUMN/BIRTH OR, IF NO MORE BIRTHS, GO TO 481)

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

YES, SEEN 1 (GO TO 456)
YES, NOT SEEN 2 (GO TO 458)
NO CARD 3

455. Did you ever have a vaccination card for (NAME)?

YES 1 (GO TO 458)
NO 2 (GO TO 458)

456. (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.

BCG
DAY _____
MONTH _____
YEAR ____
POLIO 0
DAY _____
MONTH _____
YEAR ____
DPT 1
DAY _____
MONTH _____
YEAR ____
DPT 2
DAY _____
MONTH _____
YEAR ____
DPT 3
DAY _____
MONTH _____
YEAR ____
POLIO 1
DAY _____
MONTH _____
YEAR ____
POLIO 2
DAY _____
MONTH _____
YEAR ____
POLIO 3
DAY _____
MONTH _____
YEAR ____
MEASLES
DAY _____
MONTH _____
YEAR ____

457. 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, AND/OR MEASLES VACCINE(S).

YES 1 (PROBE FOR VACCINATIONS AND WRITE '66' IN THE CORRESPONDING DAY COLUMN IN 456) (GO TO 460)
NO 2 (GO TO 460)
DOESN'T KNOW 8 (GO TO 460)

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

YES 1
NO 2 (GO TO 462)
DOESN'T KNOW 8 (GO TO 462)

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

459A. A BCG vaccination against tuberculosis, that is, an injection in the arm or shoulder that usually causes a scar?

YES 1
NO 2
DOESN'T KNOW 8

459B. A DPT vaccination against diphtheria, whooping cough, and tetanus given as an injection?

YES 1
NO 2 (GO TO 459D)
DOESN'T KNOW 8 (GO TO 459D)

459C. How many times?

NUMBER OF TIMES ______

459D. Polio vaccine, that is, drops in the mouth?

YES 1
NO 2 (GO TO 459G)
DOESN'T KNOW 8 (GO TO 459G)

459E. How many times?

NUMBER OF TIMES ______

459F. When was the first polio vaccine given just after birth or later?

JUST AFTER BIRTH 1
LATER 2

459G. An injection against measles?

YES 1 (GO TO 461)
NO 2 (GO TO 461)
DOESN'T KNOW 8 (GO TO 461)

460. CHECK 456:
ANY VACCINATIONS RECEIVED?

YES 1 (GO TO 461)
NO 2 (GO TO 462)

461. Where did (NAME) receive most of his/her vaccinations?

PUBLIC MEDICAL SECTOR
GOVT./MUNICIPAL HOSPITAL 11
GOVT. DISPENSARY 12
UHC/UHP/UFWC 13
CHC/RUR. HOSP/PHC 14
SUB-CENTRE 15
GOVT. MOBILE CLINIC 16
CAMP 17
PULSE POLIO LOCATION 18
OTHER PUBLIC SECTOR HEALTH FACILITY 19
NGO/TRUST HOSP./CLINIC 21
PRIVATE MEDICAL SECTOR
PVT. HOSPITAL/CLINIC 31
PVT. DOCTOR 32
PVT. MOBILE CLINIC 33
VAIDYA/HAKIM/HOMEOPATH 34
PHARMACY/DRUGSTORE 35
OTHER PRIVATE SECTOR HEALTH FACILITY 36
OTHER (SPECIFY) _______ 96

462. Was a dose of vitamin A liquid or capsule ever given to (NAME) to protect him/her from night blindness (USE LOCAL TERM)?

YES 1
NO 2 (GO TO 464)
DOESN'T KNOW 8 (GO TO 464)

463. How many months ago did (NAME) receive the last dose of Vitamin A?

MONTHS AGO _____

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

YES 1
NO 2
DOESN'T KNOW 8

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

YES 1
NO 2 (GO TO 469)
DOESN'T KNOW 8 (GO TO 469)

466. When (NAME) was ill with a cough, did he/she breathe faster than usual with short, rapid breaths?

YES 1
NO 2
DOESN'T KNOW 8

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

YES 1
NO 2 (GO TO 469)

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

PUBLIC MEDICAL SECTOR
GOVT./MUNICIPAL HOSPITAL A
GOVT. DISPENSARY B
UHC/UHP/UFWC C
CHC/RURAL HOSPITAL/PHC D
SUB-CENTRE E
GOVT. MOBILE CLINIC F
GOVT. PARAMEDIC G
CAMP H
OTHER PUBLIC SECTOR HEALTH FACILITY I
NGO/TRUST HOSP./CLINIC J
NGO WORKER K
PRIVATE MEDICAL SECTOR
PVT. HOSPITAL/ CLINIC L
PVT. DOCTOR M
PVT. MOBILE CLINIC N
PVT. PARAMEDIC O
VAIDYA/HAKIM/HOMEOPATH P
TRADITIONAL HEALER Q
PHARMACY/DRUGSTORE R
OTHER PRIVATE HEALTH FACILITY S
OTHER SOURCE
SHOP T
FRIEND/RELATIVE U
OTHER (SPECIFY) ________ X

469. Has (NAME) had diarrhoea in the last two weeks?

YES 1
NO 2 (GO TO 480)
DOESN'T KNOW 8 (GO TO 480)

470. Was there any blood in the stools?

YES 1
NO 2

471. (Including breast milk) Was he/she given the same amount to drink as before the diarrhoea, or more, or less?

SAME 1
MORE 2
LESS 3
DOESN'T KNOW 8

472. Was he/she given the same amount of food as before the diarrhoea, or more, or less?

SAME 1
MORE 2
LESS 3
STOPPED COMPLETELY 4
DOESN'T KNOW 8

473. Did you seek advice or treatment for the diarrhoea?

YES 1
NO 2 (GO TO 475)

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

PUBLIC MEDICAL SECTOR
GOVT./MUNICIPALHOSPITAL A
GOVT. DISPENSARY B
UHC/UHP/UFWC C
CHC/RURAL HOSPITAL/PHC D
SUB-CENTRE E
GOVT. MOBILE CLINIC F
GOVT. PARAMEDIC G
CAMP H
OTHER PUBLIC SECTOR HEALTH FACILITY I
NGO/TRUST HOSP./CLINIC J
NGO WORKER K
PRIVATE MEDICAL SECTOR
PVT. HOSPITAL/ CLINIC L
PVT. DOCTOR M
PVT. MOBILE CLINIC N
PVT. PARAMEDIC O
VAIDYA/HAKIM/HOMEOPATH P
TRADITIONAL HEALER Q
PHARMACY/DRUGSTORE R
OTHER PRIVATE HEALTH FACILITY S
OTHER SOURCE
SHOP T
FRIEND/RELATIVE U
OTHER (SPECIFY) ________ X

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

A fluid made from a special packet called [LOCAL NAME]?
Gruel made from rice [OR OTHER LOCAL GRAIN, TUBER, OR PLANTAIN]?

FLUID FROM ORS PACKET
YES 1
NO 2
DOESN'T KNOW 8
GRUEL
YES 1
NO 2
DOESN'T KNOW 8

476. CHECK 475:
FLUID FROM ORS PACKET GIVEN?

YES (GO TO 477)
NO OR DOESN'T KNOW (GO TO 478)

477. Where did you obtain the ORS packet?

PUB. MED. SECTOR
GOVT./MUNICIPALHOSPITAL 11
GOVT. DISPENSARY 12
UHC/UHP/UFWC 13
CHC/RURAL HOSPITAL/PHC 14
SUB-CENTRE 15
GOVT. MOBILE CLINIC 16
GOVT. PARAMEDIC 17
OTHER PUBLIC SECTOR HEALTH FACILITY 18
NGO/TRUST HOSP./CLINIC 21
NGO WORKER 22
PRIVATE MEDICAL SECTOR
PVT. HOSPITAL/ CLINIC 31
PVT. DOCTOR 32
PVT. MOBILE CLINIC 33
VAIDYA/HAKIM/HOMEOPATH 34
PVT. PARAMEDIC 35
PHARMACY/DRUGSTORE 36
DAI(TBA) 37
OTHER PRIVATE SECTOR HEALTH FACILITY 38
OTHER SOURCE
SHOP 41
HUSBAND 42
FRIEND/OTHER RELATIVE 43
OTHER (SPECIFY) _______ 96

478. Was anything (else) given to treat the diarrhoea?

YES 1
NO 2 (GO TO 480)
DOESN'T KNOW 8 (GO TO 480)

479. What was given to treat the diarrhoea?
Anything else?
RECORD ALL MENTIONED.

PILL OR SYRUP A
INJECTION B
INTRAVENOUS (I.V./DRIP/BOTTLE) C
HOMEMADE SUGAR-SALT-WATER SOLUTION D
HOME REMEDY/HERBAL MEDICINE E
OTHER (SPECIFY) ______ X

480. FOR THE LAST BIRTH, GO BACK TO 454 IN NEXT COLUMN; OR, IF NO MORE BIRTHS, GO TO 481. FOR THE NEXT-TO-LAST BIRTH, GO TO 481.

481. CHECK 475 ALL COLUMNS:

ORS FLUID FROM PACKET GIVEN TO ANY CHILD (GO TO 483)

ORS FLUID FROM PACKET NOT GIVEN TO ANY CHILD OR 475 NOT ASKED (GO TO 482)

482. Have you ever heard of a special product called (LOCAL TERM FOR ORS) you can get for the treatment of diarrhoea?
IF SHE NEVER HEARD OF ORS, SHOW GOVERNMENT AND COMMERCIAL ORS PACKETS AND ASK: Have you ever seen a packet like one of these before?

YES, WITHOUT SHOWING PACKETS 1
YES, AFTER SHOWING PACKETS 2
NO 3

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

LESS TO DRINK 1
ABOUT SAME AMOUNT TO DRINK 2
MORE TO DRINK 3
DOESN'T KNOW 8

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

REPEATED WATERY STOOLS A
ANY WATERY STOOLS B
REPEATED VOMITING C
ANY VOMITING D
BLOOD IN STOOLS E
FEVER F
MARKED THIRST G
NOT EATING/NOT DRINKING WELL H
GETTING SICKER/VERY SICK I
NOT GETTING BETTER J
OTHER (SPECIFY) _______ X
DOESN'T KNOW Z

485. 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 signs?
RECORD ALL MENTIONED.

RAPID BREATHING A
DIFFICULT BREATHING B
NOISY BREATHING C
FEVER D
UNABLE TO DRINK E
NOT EATING/NOT DRINKING WELL F
GETTING SICKER/VERY SICK G
NOT GETTING BETTER H
OTHER (SPECIFY) _______ X
DOESN'T KNOW Z

Now I would like to ask you about some health symptoms you yourself may have.

486. During the past three months, have you had any of the following problems with your vaginal discharge:

Any itching or irritation in vaginal area with the discharge?
A bad odour along with the discharge?
Severe lower abdominal pain with the discharge, not related with menstruation?
A fever along with the discharge?
Any other problem with the discharge?

ITCHING/IRRITATION
YES 1
NO 2
BAD ODOUR
YES 1
NO 2
ABDOMINAL PAIN
YES 1
NO 2
FEVER
YES 1
NO 2
OTHER PROBLEM
YES 1
NO 2

487. During the past three months have you had a problem with pain or burning while urinating, or have you had more frequent or difficult urination?

YES 1
NO 2

488. CHECK 107:

CURRENTLY MARRIED (GO TO 489)
SEPARATED/DESERTED/DIVORCED/WIDOWED (GO TO 491)

489. Another problem some women have is feeling pain in their abdomen or vagina during intercourse. Do you often experience this kind of pain?

YES 1
NO 2

490. Do you ever see blood after having sex, at times when you are not menstruating?

YES 1
NO 2

491. CHECK 486, 487, 489 AND 490:

YES TO ANY (GO TO 492)
OTHER (GO TO 501)

492. Have you seen anyone for advice or treatment to help you with (this problem/these problems)?
IF YES, ASK: Whom did you see? Anyone else?
RECORD ALL PERSONS SEEN.

PUBLIC MEDICAL SECTOR
GOVT. DOCTOR A
PUBLIC HEALTH NURSE B
ANM/LHV C
MALE MPW/SUPERVISOR D
ANGANWADI WORKER E
VILLAGE HEALTH GUIDE F
OTHER PUBLIC SECTOR HEALTH WORKER G
NGO WORKER H
PRIVATE MEDICAL SECTOR
PRIVATE DOCTOR I
PRIVATE NURSE J
COMPOUNDER/PHARMACIST K
VAID/HAKIM/HOMEOPATH L
DAI(TBA) M
TRADITIONAL HEALER N
OTHER PRIVATE SECTOR HEALTH WORKER O
OTHER (SPECIFY) _______ X
NO, NOBODY SEEN Y

SECTION 5A. FERTILITY PREFERENCES

501. CHECK 107:

CURRENTLY MARRIED (GO TO 502)
SEPARATED/DESERTED/DIVORCED/WIDOWED (GO TO 507)

502. CHECK 327/327A:

NEITHER STERILIZED (GO TO 503)
HE OR SHE STERILIZED (GO TO 507)

503. CHECK 230:

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?

PREGNANT:
Now I have some questions about the future. After the child you are expecting, 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 506)
SAYS SHE CAN'T GET PREGNANT 3 (GO TO 507)
UP TO GOD 4 (GO TO 506)
UNDECIDED/DOESN'T KNOW 8 (GO TO 506)

504. Would you prefer your next child to be a boy or a girl or doesn't it matter?

BOY 1
GIRL 2
DOESN'T MATTER 3
UP TO GOD 4

505. CHECK 230:

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

PREGNANT
How long would you like to wait after the birth of the child you are expecting before the birth of another child?

MONTHS 1 _____
YEARS 2 _____
SOON/NOW 993
SAYS SHE CAN'T GET PREGNANT 994 (GO TO 507)
OTHER (SPECIFY) _______ 996
DOESN'T KNOW 998

506. CHECK 230:

NOT PREGNANT OR UNSURE
Do you think your husband would like to have (a/another) child or do you think he would prefer not have any (more) children?

PREGNANT
After the child you are expecting, do you think your husband would like to have another child or do you think he would prefer not have any more children?

HAVE A (ANOTHER) CHILD 1
NO MORE/NONE 2
UP TO GOD 3
UNDECIDED 4
DOESN'T KNOW 8

507. CHECK 216:

HAS LIVING CHILD(REN)
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 to have in exactly the number of children to have in your whole life, how many would that be?

RECORD SINGLE NUMBER OR OTHER ANSWER.

NUMBER _____
OTHER ANSWER (SPECIFY) _______96 (GO TO 509)

508. 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?

BOYS _____
GIRLS _____
EITHER _____
OTHER (SPECIFY)________999996

509. In your opinion, how much education should be given to girls these days?

NO EDUCATION 01
LESS THAN PRIMARY 02
PRIMARY 03
MIDDLE 04
HIGH SCHOOL 05
HIGHER SECONDARY 06
GRADUATE AND ABOVE 07
PROFESSIONAL DEGREE 08
AS MUCH AS SHE DESIRES 09
DEPENDS 10
DOESN'T KNOW 98

510. In your opinion, how much education should be given to boys these days?

NO EDUCATION 01
LESS THAN PRIMARY 02
PRIMARY 03
MIDDLE 04
HIGH SCHOOL 05
HIGHER SECONDARY 06
GRADUATE AND ABOVE 07
PROFESSIONAL DEGREE 08
AS MUCH AS HE DESIRES 09
DEPENDS 10
DOESN'T KNOW 98

SECTION 5B. STATUS OF WOMAN

511. Who makes the following decisions in your household:

What items to cook?
Obtaining health care for yourself?
Purchasing jewellery or other major household items?
Your going and staying with parents or siblings?

ITEMS TO COOK
1 RESPONDENT
2 HUSBAND
3 JOINTLY WITH HUSBAND
4 OTHERS IN HOUSEHOLD
5 JOINTLY WITH OTHERS IN HOUSEHOLD
OBTAINING HEALTH CARE FOR SELF
1 RESPONDENT
2 HUSBAND
3 JOINTLY WITH HUSBAND
4 OTHERS IN HOUSEHOLD
5 JOINTLY WITH OTHERS IN HOUSEHOLD
PURCHASING JEWELLERY/OTHER HOUSEHOLD ITEMS
1 RESPONDENT
2 HUSBAND
3 JOINTLY WITH HUSBAND
4 OTHERS IN HOUSEHOLD
5 JOINTLY WITH OTHERS IN HOUSEHOLD
GOING/STAYING WITH PARENTS/SIBLINGS
1 RESPONDENT
2 HUSBAND
3 JOINTLY WITH HUSBAND
4 OTHERS IN HOUSEHOLD
5 JOINTLY WITH OTHERS IN HOUSEHOLD

512. Do you need permission to: go to the market? To visit relatives or friends?

GO TO THE MARKET
YES 1
NO 2
NOT ALLOWED TO GO 3
VISIT RELATIVES/FRIENDS
YES 1
NO 2
NOT ALLOWED TO GO 3

513. Are you allowed to have some money set aside that you can use as you wish?

YES 1
NO 2

514. Sometimes a wife can do things that bother her husband. Please tell me if you think that a husband is justified in beating his wife in each of the following situations:

If he suspects her of being unfaithful?
If her natal family does not give expected money, jewellery, or other items?
If she shows disrespect for in-laws?
If she goes out without telling him?
If she neglects the house or children?
If she doesn't cook food properly?

UNFAITHFUL
YES 1
NO 2
DOESN'T KNOW 8
MONEY/JEWELLERY/OTHER ITEMS
YES 1
NO 2
DOESN'T KNOW 8
DISRESPECT
YES 1
NO 2
DOESN'T KNOW 8
GOING WITHOUT TELLING
YES 1
NO 2
DOESN'T KNOW 8
NEGLECT
YES 1
NO 2
DOESN'T KNOW 8
NOT COOK PROPERLY
YES 1
NO 2
DOESN'T KNOW 8

515. Since you completed 15 years of age, have you been beaten or mistreated physically by any person?

YES 1
NO 2 (GO TO 601)

516. Who has beaten you or mistreated you physically?
Anyone else?
RECORD ALL PERSONS MENTIONED.

MOTHER A
FATHER B
STEP MOTHER C
STEP FATHER D
SON E
DAUGHTER F
BROTHER/SISTER G
BOYFRIEND H
HUSBAND I
EX-HUSBAND J
SON-IN-LAW K
DAUGHTER-IN-LAW L
MOTHER-IN-LAW M
FATHER-IN-LAW N
BROTHER-IN-LAW O
SISTER-IN-LAW P
OTHER RELATIVE Q
FRIEND/ACQUAINTANCE R
TEACHER S
EMPLOYER T
STRANGER U
OTHER (SPECIFY) ______ X

517. How often have you been beaten or mistreated physically in the last 12 months: once, a few times, many times, or not at all?

ONCE 1
A FEW TIMES 2
MANY TIMES 3
NOT BEATEN 4

SECTION 6. HUSBAND'S BACKGROUND AND WOMAN'S WORK

601. CHECK 107:

CURRENTLY MARRIED (GO TO 602)
SEPARATED/DESERTED/DIVORCED/WIDOWED (GO TO 603)

602. How old was your husband on his last birthday?

AGE IN COMPLETED YEARS ______

603. Did your (last) husband ever attend school?

YES 1
NO 2 (GO TO 606)

604. What is the highest grade he completed?

GRADE _____

605. CHECK 604:

GRADE 0-5 (GO TO 606)
GRADE 6 AND ABOVE (GO TO 607)

606. (Can/Could) he read and write?

YES 1
NO 2

607. What kind of work (does/did) your (last) husband mainly do?

______

608. CHECK 607:

WORKS (WORKED) ON FARM (GO TO 609)
DOES (DID) NOT WORK ON FARM (GO TO 610)

609. (Does/did) your husband work mainly on his own land or family land, or (does/did) he rent land, or (does/did) he work on someone else's land?

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

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

YES 1 (GO TO 613)
NO 2

611. 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?

YES 1 (GO TO 613)
NO 2

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

YES 1
NO 2 (GO TO 701)

613. What is your occupation, that is, what kind of work do/did you mainly do?

_______

614. Do you do this work for your family's farm or business, for someone else, or are you self-employed?

FAMILY FARM/BUSINESS 1
SOMEONE ELSE 2
SELF-EMPLOYED 3

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

THROUGHOUT THE YEAR 1
SEASONALLY/PART OF THE YEAR 2
ONCE IN A WHILE 3

616. Are you paid in cash or kind for this work, or are you not paid at all?

CASH ONLY 1
CASH AND KIND 2
KIND ONLY 3 (GO TO 619)
NOT PAID 4 (GO TO 619)

617. Generally, how much do your earnings contribute to the total family earnings: 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

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

RESPONDENT DECIDES 1
HUSBAND DECIDES 2
JOINTLY WITH HUSBAND 3
SOMEONE ELSE DECIDES 4
JOINTLY WITH SOMEONE ELSE 5

619. Do you usually work at home or away from home?

HOME 1 (GO TO 701)
AWAY 2

620. CHECK 215/218:
HAS CHILD BEEN BORN SINCE JAN. 1995 AND LIVING AT HOME?

YES (GO TO 621)
NO (GO TO 701)

621. While you are working, do you usually have (NAME OF YOUNGEST CHILD AT HOME) with you, sometimes have him/her with you, or never have him/her with you?

USUALLY 1 (GO TO 701)
SOMETIMES 2
NEVER 3

622. Who usually takes care of (NAME OF YOUNGEST CHILD AT HOME) while you are working?

HUSBAND 01
OLDER BOYS 02
OLDER GIRLS 03
OTHER RELATIVES 04
NEIGHBOURS 05
FRIENDS 06
SERVANTS/HIRED HELP 07
CHILD IS IN SCHOOL 08
INSTITUTIONAL CHILDCARE 09
OTHER (SPECIFY) _______96

SECTION 7. AIDS

701. Have you ever heard of an illness called AIDS?

YES 1
NO 2 (GO TO 705)

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

RADIO A
TELEVISION B
CINEMA C
NEWSPAPERS/MAGAZINES D
POSTERS/HOARDINGS E
EXHIBITION/MELA F
HEALTH WORKERS G
ADULT EDUCATION PROGRAMME H
RELIGIOUS LEADERS I
POLITICAL LEADERS J
SCHOOLS/TEACHERS K
COMMUNITY MEETINGS L
FRIENDS/RELATIVES M
WORK PLACE N
OTHER (SPECIFY) ______X

703. Is there anything a person can do to avoid getting AIDS?

YES 1
NO 2 (GO TO 705)
DOESN'T KNOW 8 (GO TO 705)

704. What can a person do?
Any other ways?
RECORD ALL MENTIONED.

ABSTAIN FROM SEX A
USE CONDOMS B
HAVE ONLY ONE SEX PARTNER C
AVOID SEX WITH COMMERCIAL SEX WORKERS D
AVOID SEX WITH HOMOSEXUALS E
AVOID BLOOD TRANSFUSIONS F
AVOID INJECTIONS/USE CLEAN NEEDLES G
AVOID I.V. DRUG USE H
AVOID KISSING I
AVOID HUGGING J
AVOID HAND SHAKING K
AVOID SHARING CLOTHES L
AVOID SHARING UTENSILS M
AVOID SHARING SHAVING KITS/RAZORS N
AVOID STEPPING ON URINE/STOOL O
AVOID MOSQUITO BITES P
OTHER (SPECIFY)________X
DOESN'T KNOW Z

705. RECORD THE TIME

HOUR ____
MINUTES _____

706. PRESENCE OF OTHERS DURING MOST OF THE INTERVIEW TIME.

CHILDREN UNDER 10
YES 1
NO 2
HUSBAND
YES 1
NO 2
MOTHER-IN-LAW
YES 1
NO 2
OTHER MALES
YES 1
NO 2
OTHER FEMALES
YES 1
NO 2

HEALTH INVESTIGATOR VISITS

FIRST VISIT (REPEAT FOR SECOND AND THIRD VISIT)
DATE _____
INVESTIGATOR'S NAME _____
RESULT _____

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

NEXT VISIT
DATE ______
TIME _____

FINAL VISIT
DAY ____
MONTH ____
YEAR 19__
NAME CODE ____
RESULT CODE ____

TOTAL NUMBER OF VISITS ____

SECTION 8: HEIGHT AND WEIGHT

INTERVIEWER: IN 801 (COLUMNS 23) RECORD THE LINE NUMBER FOR EACH CHILD BORN SINCE JANUARY 1995 AND STILL ALIVE. IN 802 AND 803 RECORD THE NAME OF THE RESPONDENT AND ALL HER LIVING CHILDREN BORN SINCE JANUARY 1995, AND THE DATE OF BIRTH OF THE CHILDREN. IN 804 AND 806 RECORD THE HEIGHT AND WEIGHT OF THE RESPONDENT AND LIVING CHILDREN.
(NOTE: IF THERE ARE MORE THAN 2 LIVING CHILDREN BORN SINCE JANUARY 1995, CHECK BOX AND USE ADDITIONAL QUESTIONNAIRE)

[REPEAT QUESTIONS 801-809 FOR RESPONDENT, LAST BIRTH, AND NEXT-TO-LAST BIRTH]

801. LINE NUMBER FROM QUESTION 212
[DO NOT ASK FOR MOST RECENT BIRTH]

LINE NO. ______

802. NAME FROM QUESTION 212 FOR CHILDREN

NAME ________

803. DATE OF BIRTH
[DO NOT ASK FOR MOST RECENT BIRTH]

FROM QUESTION 215 FOR CHILDREN, COPY MONTH AND YEAR OF BIRTH AND ASK FOR DAY OF BIRTH

DAY_____
MONTH_____
YEAR_____

804. HEIGHT (IN CENTIMETERS)

CM _____

805. WAS HEIGHT/LENGTH OF CHILD MEASURED LYING DOWN OR STANDING UP?
[DO NOT ASK FOR MOST RECENT BIRTH]

LYING 1
STANDING 2

806. WEIGHT (IN KILOGRAMS)

KM _____

807. DATE WEIGHED AND MEASURED

DAY _____
MONTH _____
YEAR _____

808. RESULT

RESPONDENT
COMPLETED 1
NOT PRESENT 2
REFUSED 3
OTHER (SPECIFY) ______ 6
LAST BIRTH AND NEXT-TO-LAST BIRTH
COMPLETED 1
CHILD SICK 2
CHILD NOT PRESENT 3
CHILD DID NOT ALLOW 4
MOTHER REFUSED 5
OTHER (SPECIFY) ______ 6

809. NAME OF MEASURER _______
NAME OF ASSISTANT_______

SECTION 9. ANAEMIA

901. As a part of this survey, we are studying anaemia among women and children. We request your cooperation in this regard. This will assist the Government of India to develop programs to prevent and treat anaemia.

Anaemia is a serious health problem in India, which results from poor nutrition. However, if a person is found to have anaemia, the person can be given iron folic tablets to cure the disease.

[We are also doing research on lead poisoning among children and we request your cooperation in this regard. This will assist the Government of India to develop programs to prevent and treat lead poisoning. The benefit to you is that you will learn whether your child has a high lead exposure that needs to be addressed. If children are exposed to too much lead from the environment around them, it can harm their intelligence, growth and hearing and can contribute to anaemia. However, it is possible to take steps to decrease the amount of lead that a child is exposed to. Children with severe lead poisoning can get medical treatment.]

If you decide to be tested for anaemia, we will request that you give a drop of blood from your finger for the test. (Also, if you have a child under 3 years old, please allow me to take a (few) drop(s) of blood from him/her for anaemia [and lead] testing). We will use disposable sterile instruments that are clean and completely safe. Your child will feel a slight pinch when the blood is drawn. There is essentially no risk to your child from this procedure. The blood will be analyzed with new equipment provided by the United Nations. The result(s) of the test(s) will be given to you right after the blood is taken. The results of the tests will be kept confidential and will not be shown to other persons. Are there any questions about the blood testing that you would like to ask me now?

May I ask you now to give your consent to have the test(s) done. If you decide not to have the test(s), it is your right, and we will respect your decision. Now please tell me whether you agree to have the test(s) (and allow me to test your child).

AFTER EXPLAINING THE ABOVE, I HAVE FOUND THAT (NAME OF RESPONDENT) AGREED TO GIVE A (FEW) DROP(S) OF BLOOD FOR HERSELF [AND FOR HER CHILD (REN) NAMED (NAME OF CHILD(REN))]

SIGNATURE OF INTERVIEWER ________
DATE ________

RESPONDENT AGREES TO TESTING OF HERSELF AND/OR HER CHILD(REN) 1
RESPONDENT DOES NOT AGREE TO TESTING 2 (GO TO 914)

SIGNATURE OF WITNESS ________
DATE ________

(STATEMENTS ABOUT IN SQUARE BRACKETS WERE ADDED ONLY FOR USE IN DELHI AND MUMBAI)

902. RESPONDENT'S HAEMOGLOBIN LEVEL (G/DL)

G/DL ______

903. RESULT

MEASURED 1
REFUSED 2
OTHER (SPECIFY) _______6

904. CHECK 215/216:

ONE OR MORE LIVING CHILDREN BORN SINCE JANUARY 1995 (GO TO 905)
NO LIVING CHILDREN BORN SINCE JANUARY 1995 (GO TO 910)

[IN 905 RECORD THE LINE NUMBER FOR EACH CHILD BORN SINCE JANUARY 1995 AND STILL ALIVE. IN 906 RECORD THE NAMES OF THE LIVING CHILDREN. IN 907 RECORD THE HAEMOGLOBIN LEVEL IN THE BLOOD OF THE LIVING CHILDREN.
(NOTE:IF THERE ARE MORE THAN 2 LIVING CHILDREN BORN SINCE JANUARY 1995, CHECK BOX AND USE ADDITIONAL QUESTIONNAIRE)]

905. LINE NUMBER FROM QUESTION 212

LINE NO. ______

906. NAME FROM QUESTION 212

NAME_______

907. HAEMOGLOBIN LEVEL IN THE BLOOD (G/DL)

G/DL ______

DELHI AND MAHARASHTRA ONLY:

907A. CHECK SAMPLE:
IS PSU IN LEAD TESTING SAMPLE?

YES 1
NO 2 (GO TO 908)

907B. LEAD LEVEL IN THE BLOOD (?g/dL)

?g/dL ______

908. RESULT

MEASURED 1
CHILD SICK 2
CHILD NOT PRESENT 3
CHILD DID NOT ALLOW 4
MOTHER REFUSED 5
OTHER (SPECIFY) _______ 6

909. NAME OF MEASURER ________

910. CHECK 902 AND 907:

NO VALUES BELOW 7 G/DL, GIVE MOTHER RESULT OF HAEMOGLOBIN MEASUREMENT (GO TO 913A)

ANY VALUE BELOW 7 G/DL FOR MOTHER AND/OR CHILD(REN), GIVE MOTHER RESULT OF HAEMOGLOBIN MEASUREMENT (GO TO 911)

911. CHECK COLUMN (5) OF HOUSEHOLD SCHEDULE:

RESPONDENT IS USUAL RESIDENT (GO TO 912)
RESPONDENT IS VISITOR (END INTERVIEW)

912. We detected a low level of haemoglobin in your (your child's) blood. This indicates you (your child) have developed severe anaemia, which is a serious health problem. We would like to inform the doctor at _______ about your (your child's) condition. This will assist you to obtain appropriate treatment of your (your child's) condition.

Do you agree that the information about the level of haemoglobin in your (your child's) blood may be given to the doctor.

AFTER EXPLAINING THE ABOVE, I HAVE FOUND THAT (NAME OF RESPONDENT)
AGREED FOR REFERRAL FOR HERSELF [AND FOR HER CHILD(REN), (NAME OF CHILD(REN))]

SIGNATURE OF INTERVIEWER ________
DATE ________

RESPONDENT AGREES TO REFERRAL FOR HERSELF AND/OR HER CHILD(REN) 1 (GO TO 913)
RESPONDENT DOES NOT AGREE FOR REFERRAL 2 (GO TO 913A)

913. RECORD NAMES OF WOMAN AND CHILD (REN) WITH HAEMOGLOBIN LEVEL LESS THAN 7 G/DL ON REFERRAL FORM.

DELHI AND MAHARASHTRA ONLY:

913A. CHECK 907B:

907B BLANK IN EVERY COLUMN (GO TO 914)
NO VALUES OF 45 ?g/dL OR ABOVE, GIVE MOTHER RESULT OF LEAD MEASUREMENT (GO TO 914)

ANY VALUE OF 45 ?g/dL OR ABOVE, GIVE MOTHER RESULT OF LEAD MEASUREMENT (GO TO 913B)

913B. We detected a high level of lead in your child's blood. This indicates your child has developed lead poisoning, which is a serious health problem. We would like to inform the doctor at________ about your child's condition. This will assist you to obtain appropriate treatment of your child's condition.

Do you agree that the information about the level of lead in your child's blood may be given to the doctor?

AFTER EXPLAINING THE ABOVE, I HAVE FOUND THAT (NAME OF RESPONDENT)
AGREED FOR REFERRAL FOR HER CHILD(REN), (NAME OF CHILD(REN)).

SIGNATURE OF INVESTIGATOR________
DATE ________

RESPONDENT AGREES TO REFERRAL FOR HER CHILD(REN) 1 (GO TO 914)
RESPONDENT DOES NOT AGREE TO REFERRAL 2 (GO TO 914)

SIGNATURE OF WITNESS _______
DATE ________

DELHI, MAHARASHTRA, AND TAMIL NADU ONLY:

914. Would you mind if we come again for a similar study at some future date after a year or so?

AGREES TO REVISIT 1
DOES NOT AGREE TO REVISIT 2

INTERVIEWER'S OBSERVATIONS
(TO BE FILLED OUT AFTER COMPLETING INTERVIEW)

COMMENTS ABOUT RESPONDENT _______
COMMENTS ON SPECIFIC QUESTIONS _______
ANY OTHER COMMENTS ______

SUPERVISOR'S OBSERVATIONS/COMMENTS _______
NAME OF SUPERVISOR _______
DATE ______

EDITOR'S OBSERVATIONS/COMMENTS _______
NAME OF EDITOR _______
DATE ______

RESULTS OF HAEMOGLOBIN MEASUREMENT IN THE BLOOD

DATE _______

HAEMOGLOBIN LEVEL IN THE BLOOD (G/DL):

WOMAN
NAME________
G/DL ________
CHILD
NAME________
G/DL ________
CHILD
NAME________
G/DL ________

WHO CLASSIFICATION OF ANAEMIA:

- NORMAL LEVEL: HB LEVEL ABOVE 11 G/DL
- MILD ANAEMIA: HB (10-10.9 G/DL)
- MODERATE ANAEMIA: HB (7-9.9 G/DL)
- SEVERE ANAEMIA HB (LESS THAN 7 G/DL)

WOMAN: You have
NORMAL LEVEL
MILD ANAEMIA
MODERATE ANAEMIA
SEVERE ANAEMIA
CHILD: Your child has
NORMAL LEVEL
MILD ANAEMIA
MODERATE ANAEMIA
SEVERE ANAEMIA
CHILD: Your child has
NORMAL LEVEL
MILD ANAEMIA
MODERATE ANAEMIA
SEVERE ANAEMIA

In case of severe anaemia (Hb less than 7 G/DL), we recommend that you immediately contact your doctor.

DELHI AND MAHARASHTRA ONLY: RESULTS OF LEAD MEASUREMENT IN THE BLOOD

DATE _______

LEAD LEVEL IN THE BLOOD (?g/dL):

CHILD
NAME________
?g/dL ________
CHILD
NAME________
?g/dL ________

CLASSIFICATION OF LEAD LEVELS:
(BASED ON CLASSIFICATION SYSTEM OF CENTRE FOR DISEASE CONTROL AND PREVENTION OF THE UNITED STATES)

- CLASS I: PB LEVEL BELOW 10 ?g/DL
- CLASS II: PB LEVEL 10-19 ?g/DL
- CLASS III: PB LEVEL 20-44 ?g/DL
- CLASS IV: PB LEVEL 45-65 ?g/DL
- CLASS V: PB LEVEL ABOVE 65 ?g/DL

CHILD: Your child has
CLASS I
CLASS II
CLASS III
CLASS IV
CLASS V
CHILD: Your child has
CLASS I
CLASS II
CLASS III
CLASS IV
CLASS V

CLASS I indicates no exposure to lead or exposure below the level of concern.

CLASS II and CLASS III indicate some exposure to lead has occurred. Families should attempt to minimize exposure to lead.

CLASS IV and CLASS V indicate children should be referred to a clinician for confirmation of blood lead level, medical evaluation and treatment.

In case of severe lead poisoning (Pb above 65 ?g/DL, CLASS V), we recommend that you contact your doctor for immediate treatment.