IDENTIFICATION

STATE _______
DISTRICT _______
TEHSIL/TALUK _______
CITY/TOWN/VILLAGE _______

MEGA CITY/LARGE CITY/SMALL CITY/LARGE TOWN/SMALL TOWN/RURAL _____

PSU NUMBER ______
HOUSEHOLD NUMBER _______
NAME AND LINE NUMBER OF WOMAN _______
ADDRESS OF HOUSEHOLD ________

IS WOMAN SELECTED FOR QUESTIONS ON HOUSEHOLD RELATIONS (SECTION 10)?

INTERVIEWER VISITS

FIRST VISIT (REPEAT FOR SECOND AND THIRD VISITS)
DATE ______
INTERVIEWER'S NAME _______
RESULT _______

NEXT VISIT
DATE ______
TIME ______

FINAL VISIT
DATE ______
MONTH ______
YEAR ______
INT. NO. ______
RESULT CODE _____

TOTAL NUMBER OF VISITS ____

NATIVE LANGUAGE OF RESPONDENT _____

SUPERVISOR
NAME ______
DATE ______

FIELD EDITOR
NAME ______
DATE ______

OFFICE EDITOR ______
KEYED BY ______

SECTION 1. RESPONDENT'S BACKGROUND

INTRODUCTION AND INFORMED CONSENT

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. Several different health-related topics will be discussed including use of health services, the quality of health care, marital and sexual relationships, and infectious diseases. This information will help the government to assess health and information needs and to better plan health services. The survey usually takes between 30 and 60 minutes to complete. Whatever information you provide will be kept strictly confidential and will not be shown to other persons.

Participation in this survey is voluntary and if you choose to participate, you may withdraw at any time. However, we hope that you will take part in this survey since your participation is important.

At this time, do you want to ask me anything about the survey?
ANSWER ANY QUESTIONS AND ADDRESS RESPONDENT'S CONCERNS.

In case you need more information about the survey, you may contact the person listed on the card that has already been given to you household.

May I begin the interview now?

SIGNATURE OF INTERVIEWER _______
DATE ________

101. RECORD THE TIME.

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

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

104. In what month and year were you born?

105. How old were you at your last birthday?
COMPARE AND CORRECT 104 AND/OR 105 IF INCONSISTENT.

106. Have you ever attended school?

107. What is the highest standard you completed?

108. CHECK 107:

109. Now I would like you to read this sentence to me.
SHOW A SENTENCE FROM THE LITERACY CARD TO THE RESPONDENT.
IF RESPONDENT CANNOT READ WHOLE SENTENCE, PROBE: Can you read any part of the sentence to me?

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

111. CHECK 109:

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

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

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

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

116. What is your religion?

117. What is your caste or tribe?

118. Do you belong to a scheduled caste, a scheduled tribe, other backward class, or none of these?

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?

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

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

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

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

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

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

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

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

210. CHECK 208:

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 BIRTHS IN 212. RECORD TWINS AND TRIPLETS ON SEPARATE LINES. IF THERE ARE MORE THAN 12 BIRTHS, USE AN ADDITIONAL QUESTIONNAIRE.

[ASK QUESTIONS 212-221 FOR ALL OF THE BIRTHS]

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

213. Were any of these births twins?

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

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

216. Is (NAME) still alive?

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

218. IF ALIVE: Is (NAME) living with you?

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

220. IF DEAD: How old was (NAME) when he/she died?
IF '1 YR', PROBE: How many months old was (NAME)?

RECORD DAYS IF LESS THAN 1 MONTH; MONTHS IF LESS THAN 2 YEARS; OR YEARS.

221. Were there any other live births between (NAME OF PREVIOUS BIRTH) and (NAME), including any children who died after birth?
[DO NOT ASK FOR MOST RECENT BIRTH]

222. Have you had any live births since the birth of (NAME OF LAST BIRTH)?
IF YES, RECORD BIRTH(S) IN TABLE.

223. Before the birth of (NAME OF FIRST BIRTH), did you have any other live births?
IF YES, RECORD BIRTH(S) IN TABLE.

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

225. CHECK 215 AND ENTER THE NUMBER OF BIRTHS IN 2000 OR LATER. IF NONE, RECORD '0'.

226. FOR EACH BIRTH SINCE JANUARY 2001, ENTER 'B' IN THE MONTH OF BIRTH IN COLUMN 1 OF THE CALENDAR. WRITE THE NAME OF THE CHILD TO THE LEFT OF THE 'B' CODE. 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 PREGNANCY. (NOTE: THE NUMBER OF P's MUST BE ONE LESS THAN THE NUMBER OF MONTHS THAT THE PREGNANCY LASTED.)

FOR EACH BIRTH ASK: At any time when you were pregnant with (NAME), did you have an ultrasound test?

RECORD 'Y' IF YES AND 'N' IF NO IN COLUMN 2 IN THE MONTH OF BIRTH.

227. Are you pregnant now?

228. How many months pregnant are you?
RECORD NUMBER OF MONTHS PREGNANT. ENTER 'P's IN COLUMN 1 OF CALENDAR, BEGINNING WITH THE MONTH OF INTERVIEW AND FOR THE REMAINING NUMBER OF MONTHS PREGNANT.

229. At any time during this pregnancy, have you had an ultrasound test?
RECORD 'Y' IF YES AND 'N' IF NO IN COLUMN 2 OF THE CALENDAR IN THE CURRENT MONTH.

230. 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?

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

232. When did the last such pregnancy end?

233. CHECK 232:

234. How many months pregnant were you when the last such pregnancy ended?
RECORD NUMBER OF MONTHS THE PREGNANCY LASTED. ENTER 'T' IN COLUMN 1 OF CALENDAR IN THE MONTH THAT THE PREGNANCY TERMINATED AND 'P' FOR THE REMAINING NUMBER OF MONTHS.

235. At any time during this pregnancy, did you have an ultrasound test?
RECORD 'Y' IF YES AND 'N' IF NO IN COLUMN 2 OF THE CALENDAR IN THE MONTH IN WHICH THE PREGNANCY WAS TERMINATED.

236. Since January 2001, have you had any other pregnancies that did not result in a live birth?

237. ASK THE DATE AND THE DURATION OF PREGNANCY FOR EACH EARLIER NON-LIVE BIRTH PREGNANCY BACK TO JANUARY 2001. ENTER 'T' IN COLUMN 1 OF CALENDAR IN THE MONTH THAT EACH PREGNANCY TERMINATED AND 'P' FOR THE REMAINING NUMBER OF MONTHS.

FOR EACH TERMINATED PREGNANCY ASK: At any time this pregnancy, did you have an ultrasound test?

RECORD 'Y' IF YES AND 'N' IF NO IN COLUMN 2 OF THE CALENDAR IN THE MONTH IN WHICH THE PREGNANCY WAS TERMINATED.

238. Did you have any pregnancies that terminated before January 2001 that did not result in a live birth?

239. When did the last such pregnancy that terminated before January 2001 end?

240. When did your last menstrual period start?

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

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

SECTION 3A. MARRIAGE AND COHABITATION

301. What is your current marital status?

302. ENTER '0' IN COLUMN 3 OF CALENDAR IN THE MONTH OF INTERVIEW, AND IN EACH MONTH BACK TO JANUARY 2001. (GO TO 316)

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

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

305. RECORD THE HUSBAND'S NAME AND LINE NUMBER FROM THE HOUSEHOLD QUESTIONNAIRE. IF HE IS NOT LISTED IN THE HOUSEHOLD, RECORD '00'.

306. Besides yourself, does your husband have other wives?

307. How many other wives does your husband have?

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

309. In what month and year did you get married?
309A. Now I would like to ask about when you married your first husband. In what month and year was that?

310. How old were you when you (first) got married?

311. CHECK 301:

312. CHECK 308:

MARRIED ONLY ONCE:
In what month and year did you start living with your husband?

MARRIED MORE THAN ONCE:
Now I would like to ask about when you started living with your first husband. In what month and year was that?

313. How old were you when you first started living with him?

314. FOR CURRENTLY MARRIED WOMEN WHO HAVE BEEN MARRIED ONLY ONCE AND WOMEN WHO ARE MARRIED BUT GAUNA NOT PERFORMED:
DETERMINE MONTHS MARRIED OR MARRIED BUT GAUNA NOT PERFORMED SINCE JANUARY 2001. ENTER 'X' IN COLUMN 3 OF CALENDAR FOR EACH MONTH MARRIED, 'N' FOR EACH MONTH MARRIED BUT GAUNA NOT PERFORMED, AND '0' FOR EACH MONTH NOT MARRIED.

FOR CURRENTLY MARRIED WOMEN WHO HAVE BEEN MARRIED MORE THAN ONCE:
PROBE FOR DATE WHEN CURRENT MARRIAGE STARTED AND, IF APPROPRIATE,
FOR STARTING AND TERMINATION DATES OF ANY PREVIOUS MARRIAGES.

FOR WOMEN WHO ARE NOT CURRENTLY MARRIED:
PROBE FOR DATE WHEN LAST MARRIAGE STARTED, WHEN SHE WAS MARRIED BUT GAUNA WAS NOT PERFORMED, TERMINATION DATE AND, IF APPROPRIATE, FOR THE STARTING AND TERMINATION DATES OF ANY PREVIOUS MARRIAGES.

315. CHECK 301:

CHECK FOR THE PRESENCE OF OTHERS. BEFORE CONTINUING, MAKE EVERY EFFORT TO ENSURE PRIVACY.

Now I need to ask you some questions about sexual life in order to gain a better understanding of some family life issues. Let me assure you again that your answers are completely confidential and will not be told to anyone. If you do not want to answer, just let me know and I will skip to the next question.

316. Have you ever had sexual intercourse?

317. How old were you when you had sexual intercourse for the very first time?

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

CIRCLE CODE '1' IN 318 FOR EACH METHOD MENTIONED SPONTANEOUSLY.
THEN PROCEED DOWN COLUMN 318 READING THE NAME AND DESCRIPTION
OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE '1'
IF METHOD IS RECOGNIZED AND CODE '2' IF NOT RECOGNIZED. THEN
PERFORM THE CHECK AT THE BOTTOM OF THE COLUMN. IF 316 IS YES
OR NOT ASKED, ASK 320 FOR EACH METHOD WITH CODE '1' CIRCLED IN 318.

319. CHECK 316:

320. Have you ever used (METHOD)?

321. CHECK 320:

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

323. ENTER '0' IN COLUMN 1 OF CALENDAR IN EACH BLANK MONTH. (GO TO 353)

324. What have you used or done?
CORRECT 320 AND 321(AND 318 IF NECESSARY).

325. CHECK 208:

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

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

327. CHECK 320(01):

328. CHECK 227:

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

330. Which method are you using?
CIRCLE ALL MENTIONED. IF MORE THAN ONE METHOD MENTIONED, FOLLOW SKIP INSTRUCTION FOR HIGHEST METHOD ON LIST.
330A. CIRCLE 'A' FOR FEMALE STERILIZATION.

331. May I see the package of (pills/condoms) you are using?
RECORD NAME OF BRAND.

332. Do you know the brand name of the (pills/condoms) you are using?
RECORD NAME OF BRAND.

333. How many (pill cycles/condoms) did you get the last time?

334. The last time you obtained (CURRENT METHOD IN 330), how much did you pay in total, including the cost of the method and any consultation you may have had?

335. In what facility did the sterilization take place?

IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTRE, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL SECTOR, WRITE THE NAME OF THE PLACE.

336. CHECK 330/330A:

337. Before your sterilization operation, were you told that you would not be able to have any (more) children because of the operation?

338. How would you rate the care you received during and immediately after the operation: very good, all right, not so good, or bad?

339. How much did you pay in total for the sterilization, including any consultation you may have had?

340. Do you regret that you had the sterilization?

341. In what month and year was the sterilization performed?
341A. In what month and year did you start using (CURRENT METHOD) continuously? PROBE: For how long have you been using (CURRENT METHOD) now without stopping?

342. CHECK 341/341A, 215 AND 232:
ANY BIRTH OR PREGNANCY TERMINATION AFTER MONTH AND YEAR OF START OF USE OF CONTRACEPTION IN 341/341A?

343. CHECK 341/341A:

YEAR IS 2001 OR LATER:
ENTER CODE FOR METHOD USED IN MONTH OF INTERVIEW IN COLUMN 1 OF THE CALENDAR AND IN EACH MONTH BACK TO THE DATE STARTED USING. THEN (GO TO 344)

YEAR IS 2000 OR EARLIER:
ENTER CODE FOR METHOD USED IN MONTH OF INTERVIEW IN COLUMN 1 OF THE CALENDAR AND EACH MONTH BACK TO JANUARY 2001. THEN (GO TO 351)

344. I would like to ask you some questions about the times you or your husband/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 2001. USE NAMES OF CHILDREN, DATES OF BIRTH, AND PERIODS OF PREGNANCY AS REFERENCE POINTS. IN COLUMN 1, ENTER METHOD USE CODE OR '0' FOR NONUSE IN EACH BLANK MONTH.

ILLUSTRATIVE QUESTIONS:

COLUMN 1:
When was the last time you used a method? Which method was that?
When did you start using that method? How long after the birth of (NAME)?
How long did you use the method then?

IN COLUMN 4, ENTER CODES FOR DISCONTINUATION IN THE SAME ROW AS THE LAST MONTH OF USE. NUMBER OF CODES IN COLUMN 4 MUST BE SAME AS NUMBER OF INTERRUPTIONS OF METHOD USE IN COLUMN 1. ASK WHY SHE STOPPED USING THE METHOD. IF A PREGNANCY FOLLOWED, ASK WHETHER SHE BECAME PREGNANT UNINTENTIONALLY WHILE USING THE METHOD OR DELIBERATELY STOPPED TO GET PREGNANT.

ILLUSTRATIVE QUESTIONS:

COLUMN 4:
Why did you stop using the (METHOD)?
Did you become pregnant while using (METHOD), did you stop using to get pregnant, or did you stop for some other reason?

IF DELIBERATELY STOPPED TO BECOME PREGNANT, ASK: How many months did it take you to get pregnant after you stopped using (METHOD)? AND ENTER '0' IN EACH SUCH MONTH IN COLUMN 1.

345. CHECK 330/330A:
CIRCLE METHOD CODE: IF MORE THAN ONE METHOD CODE CIRCLED IN 330/330A, CIRCLE CODE FOR HIGHEST METHOD IN LIST.

346. You started using (CURRENT METHOD) in (DATE). At that time, were you told about side effects or problems you might have with the method?

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

348. Were you told what to do if you experienced side effects or problems?

349. CHECK 346:

CODE '1' CIRCLED
At that time, were you told about other methods of family planning that you could use?

CODE '1' CIRCLED NOT
When you obtained (CURRENT METHOD) in (DATE), were you told about other methods of family planning that you could use?

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

351. CHECK 330/330A:
CIRCLE METHOD CODE: IF MORE THAN ONE METHOD CODE CIRCLED IN 330/330A, CIRCLE CODE FOR HIGHEST METHOD IN LIST.

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

IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTRE, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL SECTOR, WRITE THE NAME OF THE PLACE.

353. Were you ever told by a health or family planning worker about any methods of family planning that you can use to avoid pregnancy?

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

355. Where is that?
Any other place?

IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTRE, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL SECTOR, WRITE THE NAME OF THE PLACE(S).
RECORD ALL PLACES MENTIONED.

SECTION 3C. CONTACTS WITH HEALTH PERSONNEL

Now I would like to talk to you about any contacts you have had recently with an ANM or Lady Health Visitor.

356. In the last three months have you met with an ANM or LHV?

357. In the last three months, how many times did you meet with (this person/these persons):

358. In the last three months, have you met with an anganwadi worker or other community health worker?

359. Who did you meet? Anyone else?
RECORD ALL MENTIONED.

360. In the last three months, how many times did you meet with (this person/these persons):

361. CHECK 356 AND 358:

362. During (this contact/all these contacts) with [PERSONS MENTIONED IN 356 AND 359] in the last three months, what were the different services provided and matters talked about? Anything else? RECORD ALL MENTIONED.

363. Who did you meet during your (most recent) contact?

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

365. When she/he explained something to you, did she/he try to make sure that you understood the information?

366. CHECK 357c AND 360c:

367. In the last three months, have you visited a health facility or camp for any reason for yourself (or for your children)?

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

IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTRE, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL SECTOR, WRITE THE NAME OF THE PLACE.

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

370. How long did you have to wait before you received the service you went for?

371. Was the person who provided the service to you responsive to your problems and needs?

372. Did she/he respect your need for privacy if you needed it?

373. Would you say that the (camp/health facility) was very clean, somewhat clean, or not clean?

SECTION 4. PREGNANCY, DELIVERY, POSTNATAL CARE AND CHILDREN'S NUTRITION

401. CHECK 225:

402. ENTER IN THE TABLE BELOW THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH IN 2001 OR LATER. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 3 BIRTHS, USE LAST 2 COLUMNS OF ADDITIONAL QUESTIONNAIRES).

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

403. LINE NUMBER FROM 212

404. FROM 212 AND 216:

405. 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 not want to have any(more) children at all?

406. How much longer would you have liked to wait?

407. Was this pregnancy registered with the ANM?
[ASK FOR LAST BIRTH ONLY]

408. Did you get a card from the ANM?
[ASK FOR LAST BIRTH ONLY]

409. Did you see anyone for antenatal care for this pregnancy?
IF YES: Whom did you see? Anyone else?
PROBE FOR THE TYPE OF PERSON AND RECORD ALL PERSONS SEEN.
[ASK FOR LAST BIRTH ONLY]

410. Where did you receive antenatal care for this pregnancy? Any other place?
[ASK FOR LAST BIRTH ONLY]

IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTRE, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL SECTOR, WRITE THE NAME OF THE PLACE(S).
RECORD ALL PLACES MENTIONED.

411. How many months pregnant were you when you first received antenatal care for this pregnancy?
[ASK FOR LAST BIRTH ONLY]

412. How many times did you receive antenatal care during this pregnancy?
[ASK FOR LAST BIRTH ONLY]

413. As part of your antenatal care during this pregnancy, were any of the following done at least once?
[ASK FOR LAST BIRTH ONLY]

a. Were you weighed?
b. Was your blood pressure measured?
c. Did you give a urine sample?
d. Did you give a blood sample?
e. Was your abdomen checked?
f. Were you told your expected delivery date?
g. Were you advised to deliver in a hospital or health facility?
h. Were you advised about proper nutrition during pregnancy?

414. During (any of) your antenatal care visit(s), were you told about the following signs of pregnancy complications?
[ASK FOR LAST BIRTH ONLY]

a. Vaginal bleeding?
b. Convulsions?
c. Prolonged labour?

415. Were you told where to go if you had any pregnancy complications?
[ASK FOR LAST BIRTH ONLY]

416. Was (NAME'S) father present during (any of) your antenatal visits?
[ASK FOR LAST BIRTH ONLY]

417. During this pregnancy, were you given an injection to prevent you and the baby from getting tetanus?
[ASK FOR LAST BIRTH ONLY]

418. During this pregnancy, how many times did you get a tetanus injection?
[ASK FOR LAST BIRTH ONLY]

419. CHECK 418:
[ASK FOR LAST BIRTH ONLY]

420. At any time before this pregnancy, did you receive any tetanus injections?
[ASK FOR LAST BIRTH ONLY]

421. How many years ago did you receive the last tetanus injection before this pregnancy?
[ASK FOR LAST BIRTH ONLY]

422. During this pregnancy, were you given or did you buy any iron folic acid tablets or syrup? SHOW TABLETS/SYRUP.
[ASK FOR LAST BIRTH ONLY]

423. During the whole pregnancy, for how many days did you take the tablets or syrup?
IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER OF DAYS.
[ASK FOR LAST BIRTH ONLY]

424. During this pregnancy, did you take any drug to get rid of worms in your intestines?
[ASK FOR LAST BIRTH ONLY]

425. During this pregnancy, did you have difficulty with your vision during daylight?
[ASK FOR LAST BIRTH ONLY]

426. During this pregnancy, did you suffer from night blindness [USE LOCAL TERM]?
[ASK FOR LAST BIRTH ONLY]

427. During this pregnancy, did you have convulsions not from fever?
[ASK FOR LAST BIRTH ONLY]

428. During this pregnancy, did you have swelling of the legs, body or face?
[ASK FOR LAST BIRTH ONLY]

429. During this pregnancy, did you feel excessive fatigue?
[ASK FOR LAST BIRTH ONLY]

430. During this pregnancy, did you have any vaginal bleeding?
[ASK FOR LAST BIRTH ONLY]

431. Did you receive any supplementary nutrition from the anganwadi centre during this pregnancy?
[ASK FOR LAST BIRTH ONLY]

432. During this pregnancy, were you always able to get the supplementary nutrition from the anganwadi centre when you wanted it?
[ASK FOR LAST BIRTH ONLY]

433. During the last three months of this pregnancy, did you meet with an ANM, Lady Health Visitor, anganwadi worker, or other community health worker?
IF YES: Where did you meet this/these person(s)?
[ASK FOR LAST BIRTH ONLY]

434. During any of these meetings in the last three months of this pregnancy, did you receive advice on the following at least once?
[ASK FOR LAST BIRTH ONLY]

a. Breastfeeding?
b. Keeping the baby warm?
c. The need for cleanliness at the time of delivery?
d. Family planning or delaying your next child?

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

436. Was (NAME) weighed at birth?

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

438. 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.

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

IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTRE, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL SECTOR, WRITE THE NAME OF THE PLACE.

440. How long after (NAME) was delivered did you stay there?
IF LESS THAN ONE DAY, RECORD HOURS.
IF LESS THAN ONE WEEK, RECORD DAYS.

441. Was (NAME) delivered by caesarean section?

442. Before you were discharged (FROM PLACE IN 439) after (NAME) was born, did any health personnel check on your health?

443. How long after delivery did the first check take place?
IF LESS THAN ONE DAY, RECORD HOURS.
IF LESS THAN ONE WEEK, RECORD DAYS.
[ASK FOR LAST BIRTH ONLY]

444. Who checked on your health at that time?
PROBE FOR MOST QUALIFIED PERSON.
[ASK FOR LAST BIRTH ONLY]

445. In the two months after you were discharged, did any health personnel, anganwadi worker, or traditional birth attendant [dai] check on your health?

446. Why didn't you deliver in a health facility?
PROBE: Any other reason?
RECORD ALL MENTIONED.
[ASK FOR LAST BIRTH ONLY]

447. At the time of delivery of (NAME) were the following done?
[ASK FOR LAST BIRTH ONLY]

a. Was a disposable delivery kit used?
b. Was the baby immediately wiped dry and then wrapped without being bathed?
c. Was a clean blade used to cut the cord?

448. In the two months after (NAME) was born, did any health personnel, anganwadi worker, or a traditional birth attendant check on your health?

449. How many hours, days or weeks after delivery did the first check take place?
IF LESS THAN ONE DAY, RECORD HOURS.
IF LESS THAN ONE WEEK, RECORD DAYS.
[ASK FOR LAST BIRTH ONLY]

450. Who checked on your health at that time?
PROBE FOR MOST QUALIFIED PERSON.
[ASK FOR LAST BIRTH ONLY]

451. Where did this first check take place?
[ASK FOR LAST BIRTH ONLY]

IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTRE, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL SECTOR, WRITE THE NAME OF THE PLACE.

452. CHECK 445:
[ASK FOR LAST BIRTH ONLY]

453. Was the health of (NAME) also checked at this time?
[ASK FOR LAST BIRTH ONLY]

454. Was this the first time the health of (NAME) was checked?
[ASK FOR LAST BIRTH ONLY]

455. In the two months after (NAME) was born, did any health personnel or a traditional birth attendant check on his/her health?
[ASK FOR LAST BIRTH ONLY]

456. How many hours, days or weeks after the birth of (NAME) did the first check take place?
IF LESS THAN ONE DAY, RECORD HOURS.
IF LESS THAN ONE WEEK, RECORD DAYS.
[ASK FOR LAST BIRTH ONLY]

457. Who checked on (NAME)'s health at that time?
PROBE FOR MOST QUALIFIED PERSON.
[ASK FOR LAST BIRTH ONLY]

458. Where did this first check of (NAME) take place?
[ASK FOR LAST BIRTH ONLY]

IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTRE, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL SECTOR, WRITE THE NAME OF THE PLACE.

459. In the first two months after delivery, did you have:
[ASK FOR LAST BIRTH ONLY]

460. Has your menstrual period returned since the birth of (NAME)?
[ASK FOR LAST BIRTH ONLY]

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

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

463. CHECK 227:
IS RESPONDENT PREGNANT?
[ASK FOR LAST BIRTH ONLY]

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

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

466. Did you ever breastfeed (NAME)?

467. How long after birth did you first put (NAME) to the breast?
[ASK FOR LAST BIRTH ONLY]

IF LESS THAN HALF AN HOUR, CIRCLE '000'.
IF LESS THAN 24 HOURS, RECORD HOURS.
OTHERWISE, RECORD DAYS.

468. In the first three days after delivery, was (NAME) given anything to drink other than breast milk?
[ASK FOR LAST BIRTH ONLY]

469. What was (NAME) given to drink? Anything else?
RECORD ALL LIQUIDS MENTIONED.
[ASK FOR LAST BIRTH ONLY]

470. CHECK 404:
IS CHILD LIVING?

471. Are you still breastfeeding (NAME)?

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

473. CHECK 404:
IS CHILD LIVING?

474. How many times did you breastfeed last night between sunset and sunrise?
IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER.
[ASK FOR LAST BIRTH ONLY]

475. How many times did you breastfeed yesterday during the daylight hours?
IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER.
[ASK FOR LAST BIRTH ONLY]

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

477. GO BACK TO 405 IN NEXT COLUMN OR THE NEXT-TO-LAST COLUMN OF NEW QUESTIONNAIRE; OR, IF NO MORE BIRTHS, GO TO 478.

478. CHECK 215 AND 218:

479. Now I would like to ask you about liquids (NAME FROM 478) drank yesterday during the day or at night. Did (NAME FROM 478) drink:

a. Plain water?
b. Commercially produced infant formula?
c. Any other milk such as tinned, powdered, or fresh animal milk?
d. Fruit juice?
e. Tea or coffee?
f. Any other liquids?

480. Now I would like to ask you about the food (NAME FROM 478) ate yesterday during the day or at night, either separately or combined with other foods. Did (NAME FROM 478) eat:

a. Any porridge or gruel?
b. Any commercially fortified baby food such as Cerelac or Farex?
c. Any bread, roti, chapati, rice, noodles, biscuits, idli, or any other foods made from grains?
d. Any pumpkin, carrots, or sweet potatoes that are yellow or orange inside?
e. Any white potatoes, white yams, cassava, or any other foods made from roots?
f. Any dark green, leafy vegetables?
g. Any ripe mangoes, papayas, cantaloupe, or jackfruit?
h. Any other fruits or vegetables?
i. Any liver, kidney, heart or other organ meats?
j. Any chicken, duck or other birds?
k. Any other meat?
l. Any eggs?
m. Any fresh or dried fish or shellfish?
n. Any foods made from beans, peas, or lentils?
o. Any nuts?
p. Any cheese, yogurt or other milk products?
q. Any food made with oil, fat, ghee or butter?
r. Any other solid or semi-solid food?

481. CHECK 480:

482. How many times did (NAME) eat solid, semisolid, or soft foods other than liquids yesterday during the day or at night?
IF 7 OR MORE TIMES, RECORD '7'.

SECTION 5. IMMUNIZATION, HEALTH, AND WOMEN'S NUTRITION

501. ENTER IN THE TABLE THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH IN 2001 OR LATER. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 3 BIRTHS, USE LAST 2 COLUMNS OF ADDITIONAL QUESTIONNAIRES).

502. LINE NUMBER FROM 212:

503. FROM 212 AND 216:

504. Has (NAME) ever received a vitamin A dose (like this/any of these)?
SHOW COMMON AMPULES/SYRUPS/CAPSULES

505. How many times has (NAME) received a vitamin A dose?
IF 7 OR MORE TIMES, RECORD '7'

506. How many months ago did (NAME) take the last dose?

507. Is (NAME) currently taking iron pills or iron syrup (like this/any of these)?
SHOW COMMON CAPSULES/SYRUPS.

508. Has (NAME) taken any drug to get rid of intestinal worms in the past 6 months?

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

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

511. (1) COPY VACCINATION DATE 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. (3) IF ONLY PART OF DATE IS SHOWN ON CARD, RECORD '98' OR '9998' FOR 'DOESN'T KNOW' IN THE COLUMN FOR WHICH INFORMATION IS NOT GIVEN.

512. CHECK 511:

513. Has (NAME) received any vaccinations that are not recorded on this card, including vaccinations received in a Pulse Polio campaign?
RECORD 'YES' ONLY IF RESPONDENT MENTIONS BCG, POLIO 0-3, DPT 1-3, AND/OR MEASLES VACCINES.

514. Did (NAME) ever receive any vaccinations to prevent him/her from getting diseases, including vaccinations received in a Pulse Polio campaign?

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

515A. A BCG vaccination against tuberculosis, that is, an injection in the arm or shoulder that usually causes a scar?

515B. Polio vaccine, that is, drops in the mouth, including vaccine received in a Pulse Polio campaign?

515C. Was the first polio vaccine received in the first two weeks after birth or later?

515D. How many times was the polio vaccine received?
IF MORE THAN 7, RECORD '7'.

515E. A DPT vaccination, that is, an injection given in the thigh or buttocks, sometimes at the same time as polio drops?

515F. How many times was a DPT vaccination received?

515G. An injection to prevent measles?

516. CHECK 511 AND 514:
ANY VACCINATIONS RECEIVED?

517. Where did (NAME) receive most of his/her vaccinations?
IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTRE, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL SECTOR, WRITE THE NAME OF THE PLACE.

518. Has (NAME) had diarrhoea in the last 2 weeks?

519. How long ago did the diarrhoea start?
IF LESS THAN ONE WEEK, RECORD NUMBER OF DAYS AGO; OTHERWISE RECORD WEEKS AGO.

520. Was there any blood in the stools?

521. Now I would like to know how much (NAME) was given to drink during the diarrhoea. Was he/she given less than usual to drink, about the same amount, or more than usual to drink?
IF LESS, PROBE: Was he/she given much less than usual to drink or somewhat less?

522. When (NAME) had diarrhoea, was he/she given less than usual to eat, about the same amount, more than usual, or nothing to eat?
IF LESS, PROBE: Was he/she given much less than usual to eat or somewhat less?

523. Did you seek advice or treatment for the diarrhoea from any source?

524. Where did you seek advice or treatment?
Anywhere else?

IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTRE, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL SECTOR, WRITE THE NAME OF THE PLACE(S) RECORD ALL SOURCES MENTIONED.

525. CHECK 524:

526. Where did you first seek advice or treatment?
USE LETTER CODE FROM 524.

527. How many days after the diarrhoea began did you first seek advice or treatment for (NAME)? IF THE SAME DAY, RECORD '00'.

528. Does (NAME) still have diarrhoea?

529. Was he/she given any of the following to drink at any time since he/she started having the diarrhoea:

a. A fluid made from a special packet called [LOCAL NAME FOR ORS PACKET]?
b. Gruel made from rice [OR OTHER LOCAL GRAIN]?

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

531. What (else) was given to treat the diarrhoea?
Anything else?
RECORD ALL TREATMENTS GIVEN.

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

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

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

535. When (NAME) had this illness, did he/she have a problem in the chest or a blocked or runny nose?

536. CHECK 532:
HAD FEVER?

537. How long ago did the (fever/cough) start?
IF LESS THAN ONE WEEK, RECORD NUMBER OF DAYS AGO; OTHERWISE RECORD WEEKS AGO.

538. Now I would like to know how much (NAME) was given to drink during the illness with a (fever/cough). Was he/she given less than usual to drink, about the same amount, or more than usual to drink?
IF LESS, PROBE: Was he/she given much less than usual to drink or somewhat less?

539. When (NAME) had a (fever/cough), was he/she given less than usual to eat, about the same amount, more than usual, or nothing to eat?
IF LESS, PROBE: Was he/she given much less than usual to eat or somewhat less?

540. Did you seek advice or treatment for the illness from any source?

541. Where did you seek advice or treatment?
Anywhere else?

IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTRE, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL SECTOR, WRITE THE NAME OF THE PLACE(S). RECORD ALL SOURCES MENTIONED.

542. CHECK 541:

543. Where did you first seek advice or treatment?
USE LETTER CODE FROM 541.

544. How many days after the illness began did you first seek advice or treatment for (NAME)?
IF THE SAME DAY, RECORD '00'.

545. Is (NAME) still sick with a (fever/ cough)?

546. At any time during the illness, did (NAME) take any drugs for the illness?

547. What drugs did (NAME) take?
Any other drugs?
RECORD ALL MENTIONED.

548. CHECK 547:
ANY CODE A-G CIRCLED?

549. Did you already have (NAME OF DRUG FROM 547) at home when the child became ill? IF YES, CIRCLE CODE FOR THAT DRUG. ASK SEPARATELY FOR EACH

550. CHECK 547:
ANY CODE A-F CIRCLED?

551. How long after the fever started, did (NAME) first take (DRUG(S) FROM 547 A-F)?

552. GO TO 503 IN NEXT COLUMN OR THE NEXT-TO-LAST COLUMN OF NEW QUESTIONNAIRE; OR, IF NO MORE BIRTHS, (GO TO 553).

553. CHECK 215 AND 218, ALL ROWS:
NUMBER OF CHILDREN BORN IN 2001 OR LATER LIVING WITH THE RESPONDENT?

554. The last time (NAME OF YOUNGEST CHILD) passed stools, what was done to dispose of the stools?

555. CHECK 529(a), ALL COLUMNS:

556. Have you ever heard of a special product called [LOCAL NAME FOR ORS PACKET] you can get for the treatment of diarrhoea?
IF SHE HAS NEVER HEARD OF ORS, SHOW GOVERNMENT AND COMMERCIAL ORS PACKETS AND ASK: Have you ever seen a packet like one of these before?

557. Now I would like to ask you some questions about medical care for you yourself. Many different factors can prevent women from getting medical advice or treatment for themselves.
When you are sick and want to get medical advice or treatment, is each of the following a big problem, a small problem, or no problem?

a. Getting permission to go?
b. Getting money needed for treatment?
c. The distance to the health facility?
d. Having to take transport?
e. Finding someone to go with you?
f. Concern that there may not be a female health provider?
g. Concern that there may not be any health provider?
h. Concern that there may be no drugs available?

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

Now I would like to ask you some questions about any injections you have had in the last 12 months.

559. Have you had an injection for any reason in the last 12 months?
IF YES: How many injections have you had?

IF NUMBER OF INJECTIONS IS GREATER THAN 90, OR DAILY FOR 3 MONTHS OR MORE, RECORD '90'. IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE.

560. CHECK 559:

ONE INJECTION:
Was this injection administered by a doctor, a nurse, a pharmacist, a dentist, or any other health worker? IF YES, RECORD '01'.

MORE THAN ONE INJECTION:
Among these injections, how many were administered by a doctor, a nurse, a pharmacist, a dentist, or any other health worker?

IF NUMBER OF INJECTIONS IS GREATER THAN 90, OR DAILY FOR 3 MONTHS OR MORE, RECORD '90'. IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE.

561. The last time you had an injection given to you by a health worker, where did you go to get the injection?

IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTRE, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL SECTOR, WRITE THE NAME OF THE PLACE.

562. Did the person who gave you that injection take the syringe and needle from a new, unopened package?

563. As far as you know, was the needle sterilized?

564. Have you ever had a blood transfusion?

565. Do you currently smoke cigarettes or bidis?

566. In the last 24 hours, how many cigarettes or bidis did you smoke?

567. Do you currently smoke or use tobacco in any other form?

568. In what other form do you currently smoke or use tobacco?
Any other form?
RECORD ALL MENTIONED.

569. Do you drink alcohol?

570. How often do you drink alcohol: almost every day, about once a week or less often?

571. Have you ever heard of an illness called tuberculosis or TB?

572. How does tuberculosis spread from one person to another?
PROBE: Any other ways?
RECORD ALL MENTIONED.

573. Can tuberculosis be cured?

574. If a member of your family got tuberculosis, would you want it to remain a secret from the neighbors or not?

575. Do you currently have:

a. Diabetes?
b. Asthma?
c. Goiter or any other thyroid disorder?

576. CHECK 215:
ANY LIVE BIRTH IN 2000 OR LATER?

SECTION 5A. UTILIZATION OF ICDS SERVICES

577. ENTER IN THE TABLE THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH IN 2000 OR LATER. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 5 BIRTHS, USE ADDITIONAL QUESTIONNAIRES).

578. LINE NUMBER FROM 212:

579. FROM 212 AND 216:

580. During the last 12 months, has (NAME) received any benefits from the anganwadi or ICDS centre?
IF NO, PROBE: Any benefits such as supplementary food, growth monitoring, immunizations, health check-ups or education?

581. In the last 12 months, how often has (NAME) received food from the anganwadi/ICDS centre?
IF CHILD RECEIVES TAKE HOME RATIONS FOR DAILY CONSUMPTION WEEKLY OR MONTHLY CODE '1'.

582. In the last 12 months, how often has (NAME) had a health check-up from the anganwadi/ICDS centre?

583. In the last 12 months, has (NAME) received any immunizations through the anganwadi/ICDS centre?

584. In the last 12 months, how often did (NAME) go to the anganwadi/ICDS centre for early childhood care or for preschool: regularly, occasionally, or not at all?

585. In the last 12 months, how often has (NAME's) weight been measured by the anganwadi/ICDS centre?

586. After (NAME) was weighed, did you ever receive counselling from the anganwadi/ICDS worker or ANM?

587. When you were pregnant with (NAME), did you receive any benefits from the anganwadi/ICDS centre?

588. Did you receive any of the following benefits:

a. Supplementary food?
b. Health check-ups?
c. Health and nutrition education?

589. When you were breastfeeding (NAME) did you receive any benefits from the anganwadi/ICDS centre?

590. Did you receive any of the following benefits:

a. Supplementary food?
b. Health check-ups?
c. Health and nutrition education?

591. GO TO 579 IN NEXT COLUMN OR IN FIRST COLUMN OF ADDITIONAL QUESTIONNIARE; OR IF NO MORE BIRTHS, GO TO 601.

SECTION 6. SEXUAL LIFE

601. CHECK 316 AND 317:

READ TO RESPONDENTS
Now I need to ask you some more questions about relationships and sexual life. Once again, let me assure you that your answers are completely confidential. If we should come to any question that you don't want to answer, just let me know and I will skip to the next question.

602. CHECK 105:

603. How old was the person you first had sexual intercourse with?

604. Would you say this person was ten or more years older than you?

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

606. When was the last time you had sexual intercourse?
IF LESS THAN 12 MONTHS, ANSWER MUST BE RECORDED IN DAYS, WEEKS, OR MONTHS AGO. IF 12 MONTHS OR MORE, ANSWER MUST BE RECORDED IN YEARS AGO.

[ASK QUESTIONS 607-615 FOR THE LAST AND SECOND-TO-LAST BUSINESS PARTNERS]

607. When was the last time you had sexual intercourse with this other person?
[ASK FOR SECOND-TO LAST SEXUAL PARTNER ONLY]

608. The last time you had sexual intercourse (with this other person), was a condom used?

609. Did you use a condom every time you had sexual intercourse with this person in the last 12 months?

610. What was this person's relationship to you?

611. For how long (have you had/did you have) a sexual relationship with this person?
IF ONLY HAD SEXUAL RELATIONS WITH THIS PERSON ONCE, RECORD '01' DAYS.

612. CHECK 105:

613. How old is this person?

614. Would you say this person is ten or more years older than you?

615. Apart from this person, have you had sexual intercourse with any other person in the last 12 months?
[ASK FOR SECOND-TO LAST SEXUAL PARTNER ONLY]

616. In total, with how many different people have you had sexual intercourse in the last 12 months?
IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE.

617. In total, with how many different people have you had sexual intercourse in your lifetime? IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE.

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

619. Where is that? Any other place?

IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTRE, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL SECTOR, WRITE THE NAME OF THE PLACE(S). RECORD ALL SOURCES MENTIONED.

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

SECTION 7. FERTILITY PREFERENCES

701. CHECK 301:

702. CHECK 330/330A:

703. CHECK 227:

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

704. CHECK 227:

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

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

705. CHECK 227:

706. CHECK 329:
USING A CONTRACEPTIVE METHOD?

707. CHECK 704:

708. CHECK 703:

WANTS TO HAVE A/ANOTHER CHILD:
You have said that you do not want (a/another) child soon, but you are not using any method to avoid pregnancy. Can you tell me why you are not using a method? PROBE: Any other reason?

WANTS NO MORE/NONE
You have said that you do not want any (more) children, but you are not using any method to avoid pregnancy. Can you tell me why you are not using a method? PROBE: Any other reason?

RECORD ALL REASONS MENTIONED.

709. CHECK 329:
USING A CONTRACEPTIVE METHOD?

710. Do you think you will use a contraceptive method to delay or avoid pregnancy in the next 12 months?

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

712. Which contraceptive method would you prefer to use?

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

714. CHECK 216:

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

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

PROBE FOR A NUMERIC RESPONSE.

715. 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?

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

a. On the radio?
b. On the television?
c. In a newspaper or magazine?
d. On a wall painting or hoarding?

717. CHECK 301:

718. CHECK 330/330A:

719. Does your husband know that you are using a method of family planning?

720. Would you say that using contraception is mainly your decision, mainly your husband's decision, or did you both decide together?

721. CHECK 330/330A:

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

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

a. She knows her husband has a sexually transmitted disease.
b. She knows her husband has sex with other women.
c. She is tired or not in the mood.

SECTION 8. HUSBAND'S BACKGROUND AND WOMAN'S WORK

801. CHECK 301:

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

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

804. What was the highest standard he completed?

805. CHECK 801:

CURRENTLY MARRIED OR MARRIED, GAUNA NOT PERFORMED:
What is your husband's occupation? That is, what kind of work does he mainly do?

OTHER:
What was your (last) husband's occupation? That is, what kind of work did he mainly do?

806. Aside from your own housework, have you done any work in the last seven days?

807. 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.
In the last seven days, have you done any of these things or any other work?

808. Although you did not work in the last seven days, do you have any job or business from which you were absent for leave, illness, vacation, maternity leave or any other such reason?

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

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

811. CHECK 810:

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

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

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

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

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

817. CHECK 301:

818. CHECK 816:

819. Who decides how the money you earn will be used: mainly you, mainly your husband, or you and your husband jointly?

820. Would you say that the money that you earn is more than what your husband earns, less than what he earns, or about the same?

821. Who decides how your husband's earnings will be used: mainly you, mainly your husband, or you and your husband jointly?

822. Who usually makes the following decisions: mainly you, mainly your husband, you and your husband jointly, or someone else?

a. Decisions about health care for yourself?
b. Decisions about making major household purchases?
c. Decisions about making purchases for daily household needs?
d. Decisions about visits to your family or relatives?

823. Do you have any money of your own that you alone can decide how to use?

824 Are you usually allowed to go to the following places alone, only with someone else, or not at all?

a. To the market?
b. To the health facility?
c. To places outside this (village/community)?

825. Do you have a bank or savings account that you yourself use?

826. Do you know of any programmes in this area that give loans to women to start or expand a business of their own?

827. Have you yourself ever taken a loan, in cash or in kind, from any of these programmes, to start or expand a business?

828. PRESENCE OF OTHERS AT THIS POINT (PRESENT AND LISTENING, PRESENT BUT NOT LISTENING, OR NOT PRESENT)

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

a. If she goes out without telling him?
b. If she neglects the house or the children?
c. If she argues with him?
d. If she refuses to have sex with him?
e. If she doesn't cook food properly?
f. If he suspects her of being unfaithful?
g. If she shows disrespect for in-laws?

SECTION 9. HIV/AIDS AND OTHER SEXUALLY TRANSMITTED INFECTIONS

Now I would like to talk about something else.

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

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

903. In your opinion, can people reduce their chances of getting HIV/AIDS by having just one uninfected sex partner who has no other sex partners?

904. In your opinion, can people get HIV/AIDS from mosquito bites?

905. In your opinion, can people reduce their chances of getting HIV/AIDS by using a condom every time they have sex?

906. In your opinion, can people get HIV/AIDS by sharing food with a person who has AIDS?

907. In your opinion, can people get HIV/AIDS by hugging someone who has AIDS?

908. In your opinion, can people reduce their chance of getting HIV/AIDS by abstaining from sexual intercourse?

909. Is there anything else a person can do to avoid or reduce the chances of getting HIV/AIDS?

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

911. Is it possible for a healthy-looking person to have HIV/AIDS?

912. Can HIV/AIDS be transmitted from a mother to her baby?

913. Are there any special medications that a doctor or a nurse can give to a woman infected with HIV/AIDS to reduce the risk of transmitting HIV/AIDS to the baby?

914. Have you heard about special antiretroviral drugs (USE LOCAL NAME(S)) that people infected with HIV/AIDS can get from a doctor or a nurse to help them live longer?

915. I don't want to know the results, but have you ever been tested to see if you have HIV/AIDS?

916. When was the last time you were tested?

917. The last time you had the test, did you yourself ask for the test, was it offered to you and you accepted, was it required, or was it done without your consent?

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

919. Where was the test done?

IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTRE, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL SECTOR, WRITE THE NAME OF THE PLACE.

920. Do you know of a place where people can go to get tested for HIV/AIDS?

921. Where is that? Any other place?

IF UNABLE TO DETERMINE IF A HOSPITAL, HEALTH CENTRE, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL SECTOR, WRITE THE NAME OF THE PLACE.
RECORD ALL PLACES MENTIONED.

922. Would you buy fresh vegetables from a shopkeeper or vendor if you knew that this person had HIV/AIDS?

923. If a member of your family got infected with HIV/AIDS, would you want it to remain a secret or not?

924. If a relative of yours became sick with the HIV/AIDS, would you be willing to care for her or him in your own household?

925. In your opinion, if a female teacher has HIV/AIDS but is not sick, should she be allowed to continue teaching in the school?

926. In your opinion, if a male teacher has HIV/AIDS but is not sick, should he be allowed to continue teaching in the school?

927. CHECK 901:

HEARD ABOUT HIV/AIDS:
Apart from AIDS, have you heard about other infections that can be transmitted through sexual contact?

NOT HEARD ABOUT HIV/AIDS:
Have you heard about infections that can be transmitted through sexual contact?

928. CHECK 316 AND 317:

929. CHECK 927:
HEARD ABOUT OTHER SEXUALLY TRANSMITTED INFECTIONS?

Now I would like to ask you some questions about your health in the last 12 months.

930. During the last 12 months, have you had a disease which you got through sexual contact?

931. Sometimes women experience a bad smelling abnormal genital discharge. During the last 12 months, have you had a bad smelling abnormal genital discharge?

932. Sometimes women have a genital sore or ulcer. During the last 12 months, have you had a genital sore or ulcer?

933. CHECK 930, 931, AND 932:

934. The last time you had (PROBLEM FROM 930/931/932), did you seek any kind of advice or treatment?

935. Who did you see?
Anyone else?
RECORD ALL PERSONS SEEN.

Now I would like to ask your opinion about family life education for children.

936. For each of the following, please tell me whether or not it should be taught in school, and if yes, at what age the topic should first be taught.

936A. First we will talk about boys. Should boys be taught in school about_____ ?

936B. At what age should boys first be taught this topic in school?

936C. Now let us talk about girls. Should girls be taught in school about_____ ?

936D. At what age should girls first be taught this topic in school?

SECTION 10. HOUSEHOLD RELATIONS

1000. CHECK FRONT COVER:
WOMAN SELECTED FOR THIS SECTION?

1001. CHECK FOR PRESENCE OF OTHERS:
DO NOT CONTINUE UNTIL EFFECTIVE PRIVACY IS ENSURED.

READ TO THE RESPONDENT
Now I would like to ask you questions about some other important aspects of a woman's life. I know that some of these questions are very personal. However, your answers are crucial for helping to understand the condition of women in India. Let me assure you that your answers are completely confidential and will not be told to anyone and no one else will know that you were asked these questions.

1002. CHECK 301 AND 308:

First, I am going to ask you about some situations which happen to some women.

1003. Please tell me if these apply to your relationship with your (last) husband.

a. He (is/was) jealous or angry if you (talk/talked) to other men.
b. He frequently (accuses/accused) you of being unfaithful.
c. He (does/did) not permit you to meet your female friends.
d. He (tries/tried) to limit your contact with your family.
e. He (insists/insisted) on knowing where you (are/were) at all times.
f. He (does/did) not trust you with any money.

Now if you will permit me, I need to ask some more questions about your relationship with your (last) husband.

1004A. (Does/did) your (last) husband ever:

CHECK 301: ASK ONLY IF RESPONDENT IS NOT A WIDOW:

1004B. How often did this happen during the last 12 months: often, only sometimes, or not at all?

1005A. (Does/did) your (last) husband ever do any of the following things to you:

CHECK 301: ASK ONLY IF RESPONDENT IS NOT A WIDOW:

1005B. How often did this happen during the last 12 months: often, only sometimes, or not at all?

1006. CHECK 1005A (a-i):

1007. How long after you first got married to your (last) husband did (this/any of these things) first happen?
IF LESS THAN ONE YEAR, RECORD '00'.

1008. Did the following ever happen as a result of what your (last) husband did to you at any time:

a. You had cuts, bruises or aches?
b. You had severe burns?
c. You had eye injuries, sprains, dislocations, or minor burns?
d. You had deep wounds, broken bones, broken teeth, or any other serious injury?

1009. Have you ever hit, slapped, kicked, or done anything else to physically hurt your (last) husband at times when he was not already beating or physically hurting you?

1010. CHECK 301:

1011. In the last 12 months, how often have you done this to your husband: often, only sometimes, or not at all?

1012. Does (did) your husband drink alcohol?

1013. How often does (did) he get drunk: often, only sometimes, or never?

1014. CHECK 301:

NEVER MARRIED OR MARRIED, GAUNA NOT PERFORMED
From the time you were 15 years old has anyone ever hit, slapped, kicked, or done anything else to hurt you physically?

EVER MARRIED
From the time you were 15 years old has anyone other than your (current/last) husband hit, slapped, kicked, or done anything else to hurt you physically?

1015. Who has hurt you in this way?
Anyone else?
RECORD ALL MENTIONED.

1016. In the last 12 months, how often have you been hit, slapped, kicked, or physically hurt by this/these person(s): often, only sometimes, or not at all?

1017. At any time in your life, as a child or as an adult, has anyone ever forced you in any way to have sexual intercourse or perform any other sexual acts?

1018. How old were you the first time you were forced to have sexual intercourse or perform any other sexual acts?

1019. Who was the person who was forcing you at that time?

1020. CHECK 301:

NEVER MARRIED OR MARRIED, GAUNA NOT PERFORMED
In the last 12 months has anyone forced you to have sexual intercourse or perform any other sexual acts against your will?

EVER MARRIED
In the last 12 months, has anyone other than your (current/last) husband forced you to have sexual intercourse or perform any other sexual acts against your will?

1021. CHECK 1005A (a-i), 1014, AND 1017:

1022. Thinking about what you yourself have experienced among the different things we have been talking about, have you ever tried to seek help to stop the person(s) from doing this to you again?

1023. From whom have you sought help to stop this?
Anyone else?
RECORD ALL MENTIONED.

1024. Have you ever told anyone else about this?

1025. As far as you know, did your father ever beat your mother?

THANK THE RESPONDENT FOR HER COOPERATION AND REASSURE HER ABOUT THE CONFIDENTIALITY OF HER ANSWERS. FILL OUT THE QUESTIONS BELOW WITH REFERENCE TO THE HOUSEHOLD RELATIONS MODULE ONLY.

1026. DID YOU HAVE TO INTERRUPT THIS SECTION OF THE INTERVIEW BECAUSE SOME ADULT WAS TRYING TO LISTEN, OR CAME INTO THE ROOM, OR INTERFERED IN ANY OTHER WAY?

1027. INTERVIEWER'S COMMENTS / EXPLANATION FOR NOT COMPLETING THE DOMESTIC VIOLENCE MODULE_______

1028. RECORD THE TIME.

INTERVIEWER'S OBSERVATIONS

TO BE FILLED IN AFTER COMPLETING INTERVIEW.

COMMENTS ABOUT RESPONDENT ______

COMMENTS ON SPECIFIC QUESTIONS ______

ANY OTHER COMMENTS ______

SUPERVISOR'S OBSERVATIONS ______
NAME OF SUPERVISOR_______
DATE_______

EDITOR'S OBSERVATIONS______
NAME OF EDITOR______
DATE_______

INSTRUCTIONS:

ONLY ONE CODE SHOULD APPEAR IN ANY BOX. FOR COLUMNS 1 AND 3, ALL MONTHS SHOULD BE FILLED IN. INFORMATION TO BE CODED FOR EACH COLUMN

[ASK COLUMNS 1-4 FOR ALL TWELVE MONTHS FROM 2001 THROUGH 2006]

COL. 1: BIRTHS, PREGNANCIES, CONTRACEPTIVE USE?

COL.2: ULTRASOUND CONDUCTED DURING PREGNANCY?

COL. 3: MARRIAGE

COL. 4: DISCONTINUATION OF CONTRACEPTIVE USE?