IDENTIFICATION

1. GOVERNORATE

2. DISTRICT

3. SUBDISTRICT

4. LOCALITY

5. STRATUM NUMBER

6. CENSUS BLOCK NUMBER

7. JPFHS-II CLUSTER NUMBER

8. HOUSEHOLD NUMBER

9. URBAN/RURAL

10. AMMAN/LARGE CITY/MEDIUM CITY/TOWN/COUNTRYSIDE

AMMAN ALMOST 1,000,000
MEDIUM CITY (ZARQA, RUSSAIFA, IRBID, SALT, MADABA) 50,000 - 500,000
SMALL CITY 20,000 - 49,999
TOWN 5,000 - 19,999
COUNTRYSIDE LESS THAN 5,000

11. NAME OF HOUSEHOLD HEAD

12. NAME AND LINE NUMBER OF WOMAN

INTERVIEWER VISITS

FIRST VISIT
DATE
INTERVIEWER'S NAME
RESULT

NEXT VISIT
DATE
TIME

SECOND VISIT
DATE
INTERVIEWER'S NAME
RESULT

NEXT VISIT
DATE
TIME

THIRD VISIT
DATE
INTERVIEWER'S NAME
RESULT

FINAL VISIT
DAY
MONTH
YEAR 1997
NAME
RESULT

TOTAL NUMBER OF VISITS

SUPERVISOR
NAME
DATE

FIELD EDITOR
NAME
DATE

OFFICE EDITOR

KEYED BY

SECTION 1. RESPONDENT'S BACKGROUND

101. RECORD THE TIME

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

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

104. Just before you moved here, did you live in Amman, in another city, in the countryside, or outside Jordan?

105. In what month and year were you born?

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

107. Have you ever attended school?

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

109. What is the highest level of school you attended: basic, elementary, preparatory, vocational secondary, academic secondary, intermediate diploma, the university, or higher studies?

110. CHECK 106:

111. Are you currently attending school?

112. What was the main reason you stopped attending school?

113. CHECK 108

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

115. How often do you read a newspaper or a magazine? Would you say:

116. How often do you listen to the radio? Would you say:

117. How often do you watch television? Would you say:

118. What is your religion?

119. CHECK Q. 4 IN THE HOUSEHOLD QUESTIONNAIRE

120. Now I would like to ask about the place in which you usually live. What is the name of the place in which you usually live?

Is that Amman, another city, the countryside or outside Jordan?

121. In which governorate is that located?

Now I would like to ask about the household in which you usually live.

122. What is the main source of drinking water for members of your household?

123. How long does it take to go there, get water, and come back?

124. What kind of sewage system do you have in your house?

124A. What kind of toilet facility does your household have

125. Does your household have:

126. Could you describe the main material of the floor in your home?

127. Does any member of your household own:

SECTION 2. MARRIAGE

201. PRESENCE OF OTHERS AT THIS POINT.

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

203. Does your husband have another wife (other wives) besides you?

204. How many wives does he have besides you?

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

206. CHECK 205:

(MARRIED WITH A MAN ONLY ONCE) In what month and year did you start living with your husband (consummate your marriage)?

(MARRIED WITH A MAN MORE THAN ONCE) Now we will talk about your first husband. In what month and year did you start living with him (consummate your marriage)?

207. How old were you when you started living with him (consummate your marriage)?

208. What is (was) the type of relationship between you and your (first) husband?

209. DETERMINE MONTHS MARRIED SINCE JANUARY 1992. ENTER 'X' IN COLUMN 3 OF CALENDAR FOR EACH MONTH MARRIED, AND ENTER '0' FOR EACH MONTH NOT MARRIED, SINCE JANUARY 1992.

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

FOR WOMEN NOT CURRENTLY MARRIED: PROBE FOR DATE WHEN LAST UNION STARTED AND FOR TERMINATION DATE AND, IF APPROPRIATE, FOR THE STARTING AND TERMINATION DATES OF ANY PREVIOUS UNIONS.

210. CHECK 202:

211. Does your husband live with you in this household or is he staying elsewhere?

212. WRITE THE LINE NUMBER FROM THE HOUSEHOLD QUESTIONNAIRE FOR HER HUSBAND. IF HE IS NOT LISTED IN THE HOUSEHOLD WRITE '00'.

213. In the last month were you and your husband living together all the time, or were you apart some of the time, or apart all of the time?

214. How many days was he away in the last month?

215. Did he ever come to visit you in the last month?

SECTION 3. REPRODUCTION

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

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

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

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

305. 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'.

306. Have you ever given birth to a boy or a girl who was born alive but later died?

IF NO, PROBE: Any baby who cried or showed signs of life but survived only a few hours or days?

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

308. SUM ANSWERS TO 303, 305, AND 307, AND ENTER TOTAL.
IF NONE RECORD '00'.

309. CHECK 308: Just to make sure that I have this right: you have had in TOTAL ______ births during your life. Is that correct?

310. CHECK 308:

311. Now I would like to record the names of all your births, whether still alive or not, starting with the first one you had.
RECORD NAMES OF ALL THE BIRTHS IN 312. RECORD TWINS AND TRIPLETS ON SEPARATE LINES.

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

313. Were any of these births twins?

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

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

316. Is (NAME) still alive?

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

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

319. 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 ONE MONTH; MONTHS IF LESS THAN TWO YEARS; OR YEARS.

320. FROM THE YEAR OF BIRTH OF (NAME) SUBTRACT YEAR OF PREVIOUS BIRTH. IS THE DIFFERENCE 4 OR MORE?

321. Were there any other live births between (NAME OF PREVIOUS BIRTH and NAME)?

322. FROM YEAR OF INTERVIEW SUBTRACT YEAR OF LAST BIRTH. IS THE DIFFERENCE 4 YEARS OR MORE?

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

324. COMPARE 308 WITH NUMBER OF BIRTHS IN HISTORY ABOVE AND PUT A TICK MARK:

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 OR 1 YR.: PROBE TO DETERMINE EXACT NUMBER OF MONTHS

325. CHECK 315 AND ENTER THE NUMBER OF BIRTHS SINCE JANUARY 1992. IF NONE, RECORD '0'.

326. FOR EACH BIRTH SINCE JANUARY 1992, ENTER 'B' IN THE MONTH OF BIRTH IN COLUMN 1 OF THE CALENDAR AND 'P' IN EACH OF THE 8 PRECEDING MONTHS. WRITE NAME TO THE LEFT OF THE 'B' CODE.

327. Are you pregnant now?

328. How many months pregnant are you?
RECORD NUMBER OF COMPLETED MONTHS. ENTER 'P'S IN COLUMN 1 OF CALENDAR, BEGINNING WITH THE MONTH OF INTERVIEW AND FOR TOTAL NUMBER OF COMPLETED MONTHS.

329. 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?

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

331. When did the last such pregnancy end?

332. CHECK 331:

333. How many months pregnant were you when the last pregnancy ended?

RECORD NUMBER OF COMPLETED MONTHS. ENTER 'T' IN COLUMN 1 OF CALENDAR IN THE MONTH THAT THE PREGNANCY TERMINATED AND 'P' FOR THE REMAINING NUMBER OF COMPLETED MONTHS.

334. Have you ever had any other pregnancies which did not result in a live birth?

335. ASK THE DATE AND THE DURATION OF PREGNANCY FOR EACH EARLIER PREGNANCY BACK TO JANUARY 1992.

ENTER 'T' IN COLUMN 1 OF CALENDAR IN THE MONTH THAT EACH PREGNANCY TERMINATED AND 'P' FOR THE REMAINING NUMBER OF COMPLETED MONTHS.

336. When did your last menstrual period start?

337. Between the first day of a woman's period and the first day of her next period, are there certain times when she has a greater chance of becoming pregnant than other times?

338. During which times of the monthly cycle does a woman have the greatest chance of becoming pregnant?

SECTION 4. CONTRACEPTION

Now I would like to talk about family planning - the various ways or methods that a couple can use to delay or avoid a pregnancy.
CIRCLE CODE 1 IN 401 FOR EACH METHOD MENTIONED SPONTANEOUSLY.
THEN PROCEED DOWN TO COLUMN 402, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 2 IF METHOD IS RECOGNIZED, AND CODE 3 IF NOT RECOGNIZED.
THEN, FOR EACH METHOD WITH CODE 1 OR 2 CIRCLED IN 401 OR 402, ASK 403.

401. Which ways have you heard about?
402. Have you ever heard of (METHOD)?

01) PILL: Women can take a pill every day.

02) IUD: Women can have a loop or coil placed inside them by a doctor or a nurse

03) INJECTIONS: Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.

04) IMPLANTS: Women can have several small rods placed in their upper arm by a doctor or nurse which can prevent pregnancy for several years.

05) DIAPHRAGM, FOAM, JELLY: Women can place a sponge, suppository, diaphragm, jelly, or cream inside themselves before intercourse.

06) CONDOM: Men can put a rubber sheath on their penis during sexual intercourse.

07) FEMALE STERILIZATION: Women can have an operation to avoid having any more children.

08) MALE STERILIZATION: Men can have an operation to avoid having any more children.

09) RHYTHM, PERIODIC ABSTINENCE: Every month that a woman is sexually active she can avoid having sexual intercourse on the days of the month that she is most likely to get pregnant.

10) WITHDRAWAL: Men can be careful and pull out before climax.

11) PROLONGED BREASTFEEDING: Women can breastfeed for longer period to avoid getting pregnant.

12. Have you heard of any other methods that women or men can use to avoid pregnancy?

403. Have you ever used (METHOD)?

01) PILL: Women can take a pill every day.

02) IUD: Women can have a loop or coil placed inside them by a doctor or a nurse

03) INJECTIONS: Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.

04) IMPLANTS: Women can have several small rods placed in their upper arm by a doctor or nurse which can prevent pregnancy for several years.

05) DIAPHRAGM, FOAM, JELLY: Women can place a sponge, suppository, diaphragm, jelly, or cream inside themselves before intercourse.

06) CONDOM: Men can put a rubber sheath on their penis during sexual intercourse.

07) FEMALE STERILIZATION: Have you ever had an operation to avoid having any more children?

08) MALE STERILIZATION: Have you ever had a husband who had an operation to avoid having children?

09) RHYTHM, PERIODIC ABSTINENCE: Every month that a woman is sexually active she can avoid having sexual intercourse on the days of the month that she is most likely to get pregnant.

10) WITHDRAWAL: Men can be careful and pull out before climax.

11) PROLONGED BREASTFEEDING: Women can breastfeed for longer period to avoid getting pregnant.

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

404. CHECK 403:

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

406. ENTER "0" IN COLUMN 1 OF CALENDAR IN EACH BLANK MONTH. (GO TO 433)

407. What have you used or done?

CORRECT 403 AND 404 (AND 402 IF NECESSARY).

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

What was the first method you ever used?

409. How many living children did you have at the time, if any?

IF NONE, RECORD '00'.

410. CHECK 403:

411. CHECK 327

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

413. Which method are you using?
413A. CIRCLE '07' FOR FEMALE STERILIZATION.

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

415. Do you know the brand name of the pills you are now using? RECORD NAME OF BRAND.

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

416A. IUD: How much did the insertion of IUD cost you, including transportation, pap smear and IUD device?

416B. INJECTIONS: How much did this injection cost you, including transportation and medical check up?

416C. IMPLANTS: How much did the implants cost you, including transportation and medical checkup?

416D. CONDOM: How much did a package of three cost you, including transportation?

CODING A-D:

416E. FEMALE STERILIZATION: How much did the operation cost you including transportation and medical check up?

417. Where did the sterilization take place? IF SOURCE IS HOSPITAL, HEATH CENTER, OR CLINIC, WRITE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

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

419. Why do you regret the operation?

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

421. CHECK 420:

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

423. ENTER METHOD CODE FROM 413 IN CURRENT MONTH IN COLUMN 1 OF CALENDAR. THEN DETERMINE WHEN SHE STARTED USING METHOD THIS TIME. ENTER METHOD CODE IN EACH MONTH OF USE.
ILLUSTRATIVE QUESTIONS:

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

USE CALENDAR TO PROBE FOR EARLIER PERIODS OF USE AND NONUSE, STARTING WITH THE MOST RECENT USE, BACK TO JANUARY 1992. USE NAMES OF CHILDREN, DATES OF BIRTH, AND PERIODS OF PREGNANCY AS REFERENCE POINTS.

IN COLUMN 1, ENTER CODE IN EACH MONTH OF METHOD USE OR '0' FOR NONUSE.
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 2, ENTER CODES FOR DISCONTINUATION NEXT TO LAST MONTH OF USE.
NUMBER OF CODES IN COL. 2 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 2:
Why did you stop using the (METHOD)?
Did you become pregnant while using (METHOD), or did you stop 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 OF SUCH MONTH IN COLUMN 1

425. CHECK 413:

CIRCLE METHOD CODE:

426A. Did you talk to your husband about (CURRENT METHOD) before starting to use it?

426B. Did your husband encourage or discourage your use of (CURRENT METHOD) before starting to use it?

426C. Did you talk to your husband about (CURRENT METHOD) after starting to use it?

426D. Did your husband encourage or discourage your use of (CURRENT METHOD) after starting to use it?

427. CHECK 413:

CIRCLE METHOD CODE:

428. Where did you obtain (METHOD) the last time? IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

429. Do you know another place where you could have obtained (METHOD) the last time?

429A. At the time of the sterilization operation, did you know another place where you could have received the operation?

430. People select the place where they get family planning services for various reasons.
What was the main reason you went to (NAME OF PLACE IN Q. 430 OR Q. 417) instead of some other place you know about?

RECORD RESPONSE AND CIRCLE CODE _________________

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

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

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

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

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

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

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

438. For how many months?

439. CHECK 310:

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

441. CHECK 327 AND 410:

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

SECTION 5A. PREGNANCY AND BREASTFEEDING

501. CHECK 325:

502. ENTER THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH SINCE JANUARY 1992 IN THE TABLE. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS BEGIN WITH THE LAST BIRTH.
(IF THERE ARE MORE THAN 2 BIRTHS, USE ADDITIONAL QUESTIONNAIRES).

Now I would like to ask you some more questions about the health of all your children born in the past five years. (We will talk about one child at a time.)

503. LINE NUMBER FROM Q312

504. FROM Q312 AND Q316.

505. 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?

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

507. When you were pregnant with (NAME), did you see anyone for antenatal care for this pregnancy?
IF YES: Whom did you see? Anyone else?
PROBE FOR THE TYPE OF PERSON AND RECORD ALL PERSONS SEEN.

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

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

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

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

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

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

514. Up to 42 days after the birth of (NAME), did you have any of the following problems:

515. Was (NAME) delivered by caesarian section?

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

517. Was (NAME) weighed at birth?

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

519. (ONLY LAST CHILD) Has your period returned since the birth of (NAME)?

520. (NOT LAST CHILD) Did your period return between the birth of (NAME) and your next pregnancy?

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

522. CHECK 327: RESPONDANT PREGNANT?

523. Have you resumed sexual relations since the birth of (NAME)?

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

525. Did you ever breastfeed (NAME)?

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

527. CHECK 504: CHILD ALIVE?

528. Are you still breastfeeding (NAME)?

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

530. Why did you stop breastfeeding (NAME)?

531. CHECK 504: CHILD ALIVE?

532. How many times did you breastfeed last night between sunset and sunrise? IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER.

533. How many times did you breastfeed yesterday during the daylight hours? IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER.

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

535. At any time yesterday or last night was (NAME) given any of the following?

536. CHECK 535: FOOD OR LIQUID GIVEN YESTERDAY?

537. (Aside from breastfeeding,) how many times did (NAME) eat yesterday, including both meals and snacks? IF MORE THAN 7 TIMES, RECORD '7'.

538. On how man days during the last seven days was (NAME) given any of the following:
RECORD THE NUMBER OF DAYS.

539. GO BACK TO 505 IN NEXT COUMN; OR, IF NO MORE BIRTHS, GO TO 540.

540. ENTER LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH SINCE JANUARY 1992 IN THE TABLE. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH.
(IF THERE ARE MORE THAN 2 BIRTHS USE ADDITIONAL QUESTIONNAIRES)

541. LINE NUMBER FROM Q312.

542. FROM Q312 AND Q316

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

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

545. (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.

546. Has (NAME) received any vaccinations that are not recorded on this card? RECORD 'YES' ONLY IF RESPONDENT MENTIONS BCG, POLIO 1-5, DPT 1-3, AND/OR MEASLES VACCINE(S).

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

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

548A. A BCG vaccination against tuberculosis, that is, an injection in the left arm or shoulder that caused a scar?

548B. Polio vaccine, that is, drops in the mouth?

548C. How many times?

548D. When was the first polio vaccine given, just after birth or later?

548E. DPT vaccination, that is, an injection usually given at the same time as polio drops?

548F. How many times?

548G. An injection to prevent measles?

549a. Has (NAME) been ill with a fever at any time in the last 2 weeks?

549b. Has (NAME) been ill with measles?

549c. How old was (NAME) when s/he had measles?

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

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

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

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

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

555. Was there any blood in the stools?

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

557. Was he/she given the same amount to drink as before the diarrhea, or more, or less?

557A. CHECK 528: LAST CHILD STILL BREASTFED?

557B. During (NAME)'s diarrhea, did you change the frequency of breastfeeding?

557C. Did you increase the number of feeds, or reduce them, or did you stop completely?

558. Was he/she given the same amount of food to eat as before the diarrhea, or more, or less?

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

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

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

562. Did you seek advice for treatment for the diarrhea?

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

564. GO BACK TO 542 IN NEXT COLUMN; OR, IF NO MORE BIRTHS, GO TO 565.

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

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

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

568. 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? RECORD ALL MENTIONED.

569. CHECK 559, ALL COLUMNS:

570. Have you ever heard of a special product called Aquacell or Paralait you can get for the treatment of diarrhea?

SECTION 6. FERTILITY PREFERENCES

601. CHECK 413:

602. CHECK 327:

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 now, would you like to have another child or would you prefer not to have any more children?

603. CHECK 327:

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

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

604. CHECK 327:

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

606. CHECK 412: USING A METHOD?

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

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

609. Which method would you prefer to use? (AFTER ALL RESPONSES, GO TO 611)

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

611. CHECK 316:

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 life, how many would that be?

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

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

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

615. In the last six months have you heard about family planning:

616. From what sources do you receive information about family planning? (CIRCLE ALL RESPONSES MENTIONED) (PROBE: Any others?)

617. CHECK 613:

617A. Where or from whom would you prefer to get information about family planning? (CIRCLE ONLY ONE ANSWER)

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

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

619A. Have you tried to encourage or persuade anyone to use family planning?

620. CHECK 202:

621. Spouses do not always agree on everything. Now I want to ask you about your husband's views on family planning. Do you think that your husband approves or disapproves of couples using a method to avoid pregnancy?

621A. In your opinion, who should make the decision whether to use a family planning method, your husband, you, or you and your husband?

621B. In your family, who does make the decision whether to use a family planning method, your husband, you or you and your husband?

622. How often have you talked to your husband about family planning in the past year?

622A. Who usually starts the discussion about family planning, you or your husband?

622B. Do you approve or disapprove of these statements:

A. RELIGION: According to my religion family planning is permitted.

B. MOTHER'S HEALTH: Using family planning methods helps a mother regain her strength before having her next baby.

C. ECONOMICS: Having a small family will improve one's standard of living.

D. RELATIONSHIP TO PARTNERS: The use of family planning will bring the relationship of a couple closer.

E. CHILDREN'S HEALTH: Spacing out births protects the health of children.

622C. Do you think that the following people would approve or disapprove of you using a family planning method? (READ LIST)

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

SECTION 7. HUSBAND'S BACKGROUND

701. CHECK 202:

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

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

704. What was the highest level of school he attended: basic, elementary, preparatory, vocational secondary, academic secondary, intermediate diploma, the university or higher studies?

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

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

707. CHECK 706:

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

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

710. As you know, some women can 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?

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

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

713. CHECK 712

714. Do you work mainly on you own land or on family land, or do you rent land, or work on someone else's land?

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

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

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

718. (In the months you worked,) How many days a week did you usually work?

719. During the last 12 months, approximately how many days did you work?

720. Do you earn cash for your work? PROBE: Do you make money for working?

721. How much do you usually earn for this work? PROBE: Is this by the day, by the week, or by the month?

722. CHECK 202:

YES, CURRENTLY MARRIED: Who mainly decides how the money will be used: you, your husband, you and your husband jointly, or someone else?

NO, NOT MARRIED: Who mainly decides how the money you earn will be used: you, someone else, or you and someone else jointly?

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

724. CHECK 316: IS A CHILD LIVING AT HOME WHO IS AGE 5 OR LESS?

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

726. Have you lived in only one community or in more than one community since January 1992?

727. IN COLUMN 4 OF CALENDAR, ENTER THE APPROPRIATE CODE FOR CURRENT COMMUNITY, ('1' AMMAN, '2' ANOTHER CITY, '3' COUNTRYSIDE/VILLAGE, '4' OUTSIDE JORDAN). ALL PRECEDING MONTHS BACK TO JANUARY 1992. THEN SKIP TO 801

728. In what month and year did you move to (NAME OF COMMUNITY OF INTERVIEW)?

IN COLUMN 4 OF CALENDAR, ENTER 'X' IN THE MONTH AND YEAR OF THE MOVE. IN SUBSEQUENT MONTHS ENTER THE APPROPRIATE CODE FOR TYPE OF COMMUNITY, ('1' AMMAN, '2' ANOTHER CITY '3' COUNTRYSIDE/VILLAGE, '4' OUTSIDE JORDAN). CONTINUE PROBING FOR PREVIOUS COMMUNITIES, AND RECORD MOVES AND TYPES OF COMMUNITIES ACCORDINGLY.

ILLUSTRATIVE QUESTIONS:

Where did you live before...?
In what month and year did you arrive there?
Is that place in Amman, a medium city, a small city, a town, or in the countryside?

SECTION 8. AIDS

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

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

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

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

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

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

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

SECTION 9. MATERNAL MORTALITY

901. Now I would like to ask you some questions about your brothers and sisters, that is, all of the children who were born to your natural mother, including those who are living with you, those living elsewhere, and those who have died. How many children did your mother give birth to, including yourself?

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

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

904. Is (NAME) male or female?

905. Is (NAME) still alive?

906. How old is (NAME)?

907. In what year did (NAME) die?

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

(IF MALE OR DIED BEFORE 15 YEARS GO BACK TO NEXT OLDEST SIBLING)

909. Had (NAME) ever been married?

910. Was (NAME) pregnant when she died?

911. Did (NAME) die during childbirth?

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

913. Did (NAME) die due to complications of pregnancy or delivery?

914. How many children had (NAME) given birth to (before that pregnancy)?

915. RECORD THE TIME.

SECTION 10. HEIGHT AND WEIGHT

1001. CHECK 315:

IN 1002 (COLUMNS 2 AND 3) RECORD THE LINE NUMBER FOR EACH CHILD BORN SINCE JANUARY 1991 AND STILL ALIVE. IN 1003 AND 1004 RECORD THE NAME AND BIRTH DATE FOR THE RESPONDANT AND FOR ALL LIVING CHILDREN BORN SINCE JANUARY 1992. IN 1006 AND 1008 RECORD HEIGHT AND WEIGHT OF THE RESPONDENT AND THE LIVING CHILDREN. (NOTE: ALL RESPONDENTS WITH ONE OR MORE BIRTHS SINCE JANUARY 1992 SHOULD BE WEIGHED AND MEASURED EVEN IF ALL OF THE CHILDREN HAVE DIED. IF THERE ARE MORE THAN 2 LIVING CHILDREN BORN SINCE JANUARY 1992, USE ADDITIONAL QUESTIONNAIRES).

1002. LINE NO. FROM Q. 312

1003. NAME (FROM Q. 312 FOR CHILDREN)

1004. DATE OF BIRTH (FROM Q. 315, AND ASK FOR DAY OF BIRTH)

1005. BCG SCAR ON TOP LEFT SHOULDER

1006. HEIGHT (in centimeters)

1007. WAS LENGTH/HEIGHT OF CHILD MEASURED LYING DOWN OR STANDING UP?

1008. WEIGHT (in kilograms)

1009. DATE WEIGHED AND MEASURED

1010. RESULT

1011. NAME OF MEASURER_____________ NAME OF ASSISTANT______________

INTERVIEWER OBSERVATIONS

COMMENTS ABOUT RESPONDENT:
_________________________________________

COMMENTS ON SPECIFIC QUESTIONS:
_________________________________________

ANY OTHER COMMENTS:
_________________________________________

SUPERVISOR'S OBSERVATIONS
_________________________________________

NAME OF SUPERVISOR: ___________________
DATE: ____________

EDITOR'S OBSERVATIONS
__________________________________________

NAME OF EDITOR: ___________________
DATE: ____________

CALENDAR

INSTRUCTIONS:

ONLY ONE CODE SHOULD APPEAR IN ANY BOX.

FOR COLUMNS 1,3 AND 4, ALL MONTHS SHOULD BE FILLED IN.

INFORMATION TO BE CODED FOR EACH COLUMN

COL. 1: BIRTHS, PREGNANCIES, CONTRACEPTIVE USE

COL. 2: Discontinuation of Contraceptive Use

COL. 3: Marriage

COL. 4: Moves and Types of Communities