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NATIONAL COUNCIL FOR POPULATION AND DEVELOPMENT
CENTRAL BUREAU OF STATISTICS
KENYA DEMOGRAPHIC AND HEALTH SURVEY 2
WOMAN'S QUESTIONNAIRE

IDENTIFICATION

PROVINCE __________
DISTRICT __________
LOCATION/TOWN __________
SUBLOCATION/WARD __________
NASSEP CLUSTER NUMBER__
KDHS CLUSTER NUMBER__

HOUSEHOLD NUMBER

NAIROBI/MOMBASA 1, SMALL CITY 2, TOWN 3, RURAL 4

NAIROBI/MOMBASA 1
SMALL CITY 2
TOWN 3
RURAL 4

NAME OF HOUSEHOLD HEAD _______________

NAME AND LINE NUMBER OF WOMAN _________

INTERVIEWER VISIT 1
DATE _________
INTERVIEWER'S NAME __________
RESULT* __________

NEXT VISIT:
DATE _______
TIME ________

INTERVIEWER VISIT 2
DATE _________
INTERVIEWER'S NAME __________
RESULT* __________

NEXT VISIT:
DATE _______
TIME ________

INTERVIEWER VISIT 3
DATE _________
INTERVIEWER'S NAME __________
RESULT* __________

FINAL VISIT
DAY __
MONTH __
YEAR __
NAME ___
RESULT __

TOTAL NUMBER OF VISITS __

*RESULT CODES:

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

LANGUAGE OF QUESTIONNAIRE: ENGLISH 10

LANGUAGE USED IN INTERVIEW ** ______________

RESPONDENT'S LOCAL LANGUAGE ** ____________

TRANSLATOR USED

NOT AT ALL 1
SOMETIMES 2
ALL THE TIME 3

** LANGUAGE CODES:

01 KALENJIN
02 KAMBA
03 KIKUYU
04 KISII
05 LUHYA
06 LUO
07 MERU/EMBU
08 MIJIKENDA
09 KISWAHILI
10 ENGLISH
11 OTHER

FIELD EDITED BY
NAME ___________
DATE _________

OFFICE EDITED BY

NAME ___________
DATE _________

KEYED BY
NAME ___________ ___
DATE _________

SECTION 1. RESPONDENT'S BACKGROUND

101. RECORD THE TIME

HOUR _______
MINUTES _______

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 Nairobi or Mombasa, in another city or town, or in the countryside?

NAIROBI/MOMBASA 1
OTHER CITY/TOWN 2
COUNTRYSIDE 3

103. How long have you been living continuously in (NAME OF SUBLOCATION, TOWN OR CITY)?

YEARS ___
ALWAYS 95 (GO to 105)
VISITOR 96 (GO to 105)

104. Just before you moved here, did you live in Nairobi or Mombasa, in another city or town, or in the countryside?

NAIROBI/MOMBASA 1
OTHER CITY/TOWN 2
COUNTRYSIDE 3

105. In what month and year were you born?

MONTH ___
DOES NOT KNOW MONTH 98
YEAR __
DOES NOT KNOW YEAR 98

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

AGE IN COMPLETED YEARS ___

107. Have you ever attended school?

YES 1
NO 2 (GO to 111)

108. What is the highest level of school you attended:
primary, secondary, or university?

PRIMARY 1
SECONDARY 2
UNIVERSITY 3

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

STANDARD/FORM/YEAR __

109A. What is the highest certificate you obtained?

NO CERTIFICATE 00
CEE (Std. 4) 01
CPE/KPE (Std.7) 02
KAPE/KCPE (Std. 8) 03
KJSE (Form 2) 04
O LEVEL 05
KCSE 06
A LEVEL 07
ANY UNIVERSITY DEGREE 08
OTHER (SPECIFY) _______ 09

110. CHECK 108:

PRIMARY __ (GO TO 111)
SECONDARY OR ABOVE __ (GO TO 112)

111. Can you read a letter or newspaper in any language easily, with difficulty, or not at all?

EASILY 1
WITH DIFFICULTY 2
NOT AT ALL 3 (GO TO 113)

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

YES 1
NO 2

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

YES 1
NO 2

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

YES 1
NO 2

115. What is your religion?

CATHOLIC 1
PROTESTANT/OTHER CHRISTIAN 2
MUSLIM 3
NO RELIGION 4
OTHER (SPECIFY)________ 5

116. What is your ethnic group/tribe?

KALENJIN 01
KAMBA 02
KIKUYU 03
KISII 04
LUHYA 05
LUO 06
MERU/EMBU 07
MIJIKENDA/SWAHILI 08
SOMALI 09
TAITA/TAVETA 10
OTHER (SPECIFY) _______ 11

116A. Do you belong to any women's organisation or group?

YES 1
NO 2

117. CHECK 4 IN THE HOUSEHOLD QUESTIONNAIRE

THE WOMAN INTERVIEWED IS NOT A USUAL RESIDENT __ (GO TO 118)
THE WOMAN INTERVIEWED IS A USUAL RESIDENT __ (GO TO 201)

118. Now I would like to ask about the place in which you usually live.
Do you usually live in Nairobi or Mombasa, in a small city, in a town or in the countryside?

NAIROBI/MOMBASA 1
SMALL CITY 2
TOWN 3
COUNTRYSIDE 4

119. In which district is that located?
WRITE NAME OF DISTRICT CLEARLY.

DISTRICT______________ ___

120. Now I would like to ask about the household in which you usually live.
What is the source of water your household uses for handwashing and dishwashing for most of the year?

PIPED WATER
PIPED INTO HOUSE/COMPOUND/PLOT 11 (GO TO 122)
PUBLIC TAP 12
WELL WATER
WELL WITH PUMP 21
WELL WITHOUT PUMP 22
SURFACE WATER
LAKE, POND 31
RIVER/STREAM 32
RAINWATER 41 (GO to 122)
OTHER (SPECIFY)_______ 51

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

MINUTES ___
ON PREMISES 996

122. Does your household get drinking water from this same source?

YES 1 (GO TO 124)
NO 2

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

PIPED WATER
PIPED INTO HOUSE/COMPOUND/PLOT 11
PUBLIC TAP 12
WELL WATER
WELL WITH PUMP 21
WELL WITHOUT PUMP 22
SURFACE WATER
LAKE, POND 31
RIVER/STREAM 32
RAINWATER 41
OTHER (SPECIFY)_______ 51

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

FLUSH TOILET
OWN FLUSH TOILET 11
SHARED FLUSH TOILET 12
PIT TOILET/LATRINE
TRADITIONAL PIT TOILET 21
VENTILATED IMPROVED PIT TOILET 22
NO FACILITY/BUSH/FIELD 31
OTHER ____ 41

125. Does your household have:

ELECTRICITY
YES 1
NO 2
RADIO
YES 1
NO 2
TELEVISION
YES 1
NO 2
REFRIGERATOR
YES 1
NO 2

126. How many rooms in your household are used for sleeping?

ROOMS ___

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

NATURAL FLOOR
EARTH/DUNG 11
RUDIMENTARY FLOOR
WOOD PLANKS 21
FINISHED FLOOR
PARQUET OR POLISHED WOOD 31
VINYL/LINOLEUM/ASPHALT STRIPS 32
CERAMIC TILES 33
CEMENT 34
OTHER ______ 41

127A. Could you describe the main material of the walls of your home?

NATURAL WALLS
MUD/DUNG 11
RUDIMENTARY WALLS
WOOD/TIMBER 2l
FINISHED WALLS
BRICKS 31
CEMENT/STONE BLOCKS 32
OTHER ___________ 41

127B. Could you describe the main material of the roof of your home?

NATURAL ROOF
GRASS/THATCH 11
RUDIMENTARY ROOF
CORRUGATED IRON (MABATI) 21
FINISHED ROOF
TILES 31
OTHER ________ 41

128. Does any member of your household own:

BICYCLE
YES 1
NO 2
LAND
YES 1
NO 2
CATTLE, GOATS, OR SHEEP
YES 1
NO 2
CASH CROPS
YES 1
NO 2

SECTION 2. REPRODUCTION

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

YES 1
NO 2 (GO TO 206)

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

YES 1
NO 2 (GO TO 204)

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

SONS AT HOME _____
DAUGHTERS AT HOME ______

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

YES 1
NO 2 (GO TO 206)

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

SONS ELSEWHERE ____
DAUGHTERS ELSEWHERE ____

206. Sometimes it happens that children die. It may be very painful to talk about and I am sorry to ask you about painful memories, but it is important to get the right information.
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 any sign of life but only survived a few hours or days?

YES 1
NO 2 (GO TO 208)

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

BOYS DEAD ___
GIRLS DEAD ___

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

TOTAL ___

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

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

210. CHECK 208:

ONE OR MORE BIRTHS __ (GO TO 211)
NO BIRTHS __ (GO TO 223)

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

RECORD NAMES OF ALL THE BIRTHS IN 212. RECORD TWINS AND TRIPLETS ON SEPARATE LINES.

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

(NAME) ___________

213. RECORD SINGLE OR MULTIPLE BIRTH STATUS.

SING 1
MULT 2

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

BOY 1
GIRL 2

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

MONTH __________
YEAR __________

216. Is (NAME) still alive?

YES 1
NO 2 (GO TO 220)

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

AGE IN YEARS __

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

YES 1 (GO TO NEXT BIRTH)
NO 2

219. IF LESS THAN 15 YRS. OF AGE:
With whom does he/she live?
IF MORE THAN 15 YRS. OF AGE:
GO TO NEXT BIRTH.

FATHER 1
GRANDPARENTS 2
OTHER RELATIVE 3
NON-RELATIVE 4
SCHOOL 5
(GO NEXT BIRTH IF NECESSARY; IF NO MORE BIRTHS, GO TO 221)

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

RECORD DAYS IF UNDER THAN 1 MONTH, MONTHS IF UNDER 2 YEARS, OR YEARS.

DAYS 1 ____
MONTHS 2 ____
YEARS 3 ____

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

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

222. CHECK 215 AND ENTER THE NUMBER OF BIRTHS SINCE JANUARY 1988.
IF NONE, RECORD '0'. __

223. Now I would like to ask you about some current events in your life. Are you pregnant?

YES 1
NO 2 (GO TO 226)
UNSURE 8 (GO TO 226)

224. For how many months have you been pregnant?

MONTHS _______

225. 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 become pregnant at all?

THEN 1
LATER 2
NOT AT ALL 3

226. When did your last menstrual period start?

DAYS AGO 1 __
WEEKS AGO 2 ___
MONTHS AGO 3 ___
YEARS AGO 4 ___
IN MENOPAUSE 994
MENSTRUATION NOT YET RESUMED SINCE HER LAST BIRTH 995
HAS NEVER MENSTRUATED IN HER WHOLE LIFE 996

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

DURING HER PERIOD 1
RIGHT AFTER HER PERIOD HAS ENDED 2
IN THE MIDDLE OF THE CYCLE 3
JUST BEFORE HER PERIOD BEGINS 4
OTHER (SPECIFY) _____ 5
DON'T KNOW 8

SECTION 3. CONTRACEPTION

301. Now I would like to talk about family planning - the various ways or methods that a couple can use to delay or avoid a pregnancy. Which ways or methods have you heard about?

CIRCLE CODE 1 IN 302 FOR EACH METHOD MENTIONED SPONTANEOUSLY.
THEN MOVE DOWN THE COLUMN, 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 302, ASK 303-304 BEFORE PROCEEDING TO THE NEXT METHOD.

302. Have you ever heard of (METHOD)?
READ DESCRIPTION OF EACH METHOD.

METHOD 01 PILL Women can take a pill every day.
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 02 IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 03 INJECTIONS Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 04 FOAM TABLETS/JELLY/NEO-SAMPOON Women can place foam tablets, a diaphragm, sponge, jelly, or cream inside them before intercourse.
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 05 CONDOM Men can use a rubber sheath during sexual intercourse.
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 06 FEMALE STERILISATION Women can have an operation to avoid having any more children.
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 07 MALE STERILISATION Men can have an operation to avoid having any more children.
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 08 NORPLANT Women can have some small rods put under their skin in their arms.
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 09 RHYTHM, COUNTING DAYS A woman can count the days of her cycle and avoid having sexual intercourse on the days when she is more likely to become pregnant.
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 10 NATURAL FAMILY PLANNING A woman can take her temperature every day or check her vaginal mucus to tell which days to avoid having sexual intercourse.
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 11 WITHDRAWAL Men can be careful and pull out before climax
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 12 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES/SPONT 1 (SPECIFY)__
NO 3

303. Have you ever used (METHOD)?

METHOD 01 PILL Women can take a pill every day.
YES 1
NO 2
METHOD 02 IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
METHOD 03 INJECTIONS Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
YES 1
NO 2
METHOD 04 FOAM TABLETS/JELLY/NEO-SAMPOON Women can place foam tablets, a diaphragm, sponge, jelly, or cream inside them before intercourse.
YES 1
NO 2
METHOD 05 CONDOM Men can use a rubber sheath during sexual intercourse.
YES 1
NO 2
METHOD 06 FEMALE STERILISATION Women can have an operation to avoid having any more children: Have you ever had an operation to avoid having any more children?
YES 1
NO 2
METHOD 07 MALE STERILISATION Men can have an operation to avoid having any more children.
YES 1
NO 2
METHOD 08 NORPLANT Women can have some small rods put under their skin in their arms.
YES 1
NO 2
METHOD 09 RHYTHM, COUNTING DAYS A woman can count the days of her cycle and avoid having sexual intercourse on the days when she is more likely to become pregnant.
YES 1
NO 2
METHOD 10 NATURAL FAMILY PLANNING A woman can take her temperature every day or check her vaginal mucus to tell which days to avoid having sexual intercourse.
YES 1
NO 2
METHOD 11 WITHDRAWAL Men can be careful and pull out before climax.
YES 1
NO 2
METHOD 12 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1 (SPECIFY)__
NO 2

304. Do you know where a person could go to get (METHOD)?

METHOD 01 PILL Women can take a pill every day.
YES 1
NO 2
METHOD 02 IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
METHOD 03 INJECTIONS Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
YES 1
NO 2
METHOD 04 FOAM TABLETS/JELLY/NEO-SAMPOON Women can place foam tablets, a diaphragm, sponge, jelly, or cream inside them before intercourse.
YES 1
NO 2
METHOD 05 CONDOM Men can use a rubber sheath during sexual intercourse.
YES 1
NO 2
METHOD 06 FEMALE STERILISATION Women can have an operation to avoid having any more children.
YES 1
NO 2
METHOD 07 MALE STERILISATION Men can have an operation to avoid having any more children.
YES 1
NO 2
METHOD 08 NORPLANT Women can have some small rods put under their skin in their arms.
YES 1
NO 2
METHOD 09 RHYTHM, COUNTING DAYS A woman can count the days of her cycle and avoid having sexual intercourse on the days when she is more likely to become pregnant: Do you know where a person can obtain advice on how to use this method?
YES 1
NO 2
METHOD 10 NATURAL FAMILY PLANNING A woman can take her temperature every day or check her vaginal mucus to tell which days to avoid having sexual intercourse: Do you know where a person can obtain advice on how to use natural family planning?
YES 1
NO 2

305. CHECK 303:

NOT A SINGLE 'YES' (NEVER USED) (GO TO 306)
AT LEAST ONE 'YES' (EVER USED) (GO TO 307A)

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

YES 1
NO 2 (GO TO 324)

307. What have you used or done?
CORRECT 303-305 (AND 302 IF NECESSARY).

307A. CHECK 303:

EVER USED NATURAL FAMILY PLANNING (GO TO 307B)
NEVER USED NATURAL FAMILY PLANNING (GO TO 308)

307B. The last time you used natural family planning, how did you determine on which days to avoid having sexual intercourse?

TOOK BODY TEMPERATURE 1
CHECKED CERVICAL MUCUS 2
BODY TEMPERATURE AND MUCUS 3
COUNTING DAYS 4
OTHER (SPECIFY) ____ 5

308. Now I would like to ask you about the time when you first did something or used a method to avoid getting pregnant.
How many living children did you have at that time, if any?
IF NONE, RECORD '00'.

NUMBER OF CHILDREN _____

309. CHECK 223:

NOT PREGNANT OR UNSURE (GO TO 310)
PREGNANT (GO TO 324)

310. CHECK 303:

WOMAN NOT STERILISED (GO TO 311)
WOMAN STERILISED (GO TO 312A)

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

YES 1
NO 2 (GO TO 324)

312. Which method are you using?
312A. CIRCLE '06' FOR FEMALE STERILISATION.

PILL 01
IUD 02 (GO TO 318)
INJECTIONS 03 (GO TO 318)
FOAM TABLETS/JELLY/DIAPHRAGM 04 (GO TO 318)
CONDOM 05 (GO TO 318)
FEMALE STERILISATION 06 (GO TO 318)
MALE STERILISATION 07 (GO TO 318)
NORPLANT 08 (GO TO 318)
RHYTHM, COUNTING DAYS 09 (GO TO 323)
NATURAL FP, MUCUS, TEMPERATURE 10 (GO TO 323)
WITHDRAWAL 11 (GO TO 323)
OTHER (SPECIFY) _________ 12 (GO TO 323)

313. At the time you first started using the pill, did you have a physical checkup by a doctor or nurse?
PROBE: Did you have your blood pressure checked or an internal examination?

YES 1
NO 2
DOES NOT KNOW 8

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

SHILLINGS ____
FREE 996
DOES NOT KNOW 998

318. CHECK 312:

SHE/HE STERILISED __
Where did the sterilization take place?

USING ANOTHER METHOD __
Where did you obtain (METHOD) the last time?

(NAME OF PLACE) __________
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTRE 12
GOVERNMENT DISPENSARY 13
MEDICAL PRIVATE SECTOR
MISSION, CHURCH HOSP./CLINIC 21
FPAK HEALTH CENTRE/CLINIC 22
OTHER NON-GOVERNMENTAL SERVICE 23
PRIVATE HOSPITAL OR CLINIC 24
PHARMACY 25
PRIVATE DOCTOR 26
MOBILE CLINIC 31
COMMUNITY-BASED DISTRIBUTOR/COMMUNITY HEALTH WORKER 41
SHOP 51
FRIENDS/RELATIVES 61 (GO TO 321)
OTHER (SPECIFY) ________ 71 (GO TO 321)
DOES NOT KNOW 98 (GO TO 321)

319. How long does it take to travel from your home to this place?
IF LESS THAN 2 HOURS, RECORD MINUTES.
OTHERWISE, RECORD HOURS.

MINUTES 1___
HOURS 2 __
DOES NOT KNOW 9998

320. Do you walk or use some means of transportation to get there?

WALK 1
USE TRANSPORT 2
DOES NOT KNOW 8

321. CHECK 312:

SHE/HE STERILISED __ (GO TO 322)
USING ANOTHER METHOD __ (GO TO 323)

322. In what month and year was the sterilization operation performed?

MONTH __ (GO TO 333A)
YEAR __ (GO TO 333A)

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

MONTHS ___ (GO TO 329)
8 YEARS OR LONGER 96 (GO TO 329)

324. Do you intend to use a method to delay or avoid pregnancy at any time in the future?

YES 1 (GO TO 326)
NO 2
DOES NOT KNOW/NOT SURE 8 (GO TO 330)

325. What is the main reason you do not intend to use a method?

IF SHE SAYS SHE IS TOO YOUNG, ASK WHAT SHE WILL DO WHEN SHE IS OLDER.
IF SHE SAYS SHE IS BREASTFEEDING OR HER PERIOD HAS NOT YET RETURNED, ASK WHAT SHE WILL DO WHEN SHE STOPS BREASTFEEDING OR HER PERIODS RESUME.

IF ANSWERS TO THESE PROBES REQUIRE CHANGING 324, DO SO.

WANTS CHILDREN 01 (GO TO 330)
LACK OF KNOWLEDGE 02 (GO TO 330)
HUSBAND OPPOSED TO USING 03 (GO TO 330)
COST TOO MUCH 04 (GO TO 330)
SIDE EFFECTS 05 (GO TO 330)
FEARS IT WILL MAKE HER STERILE 06 (GO TO 330)
OTHER HEALTH CONCERNS 07 (GO TO 330)
HARD TO GET METHODS 08 (GO TO 330)
RELIGION 09 (GO TO 330)
OPPOSED TO FAMILY PLANNING 10 (GO TO 330)
FATALISTIC 11 (GO TO 330)
OTHER PEOPLE OPPOSED 12 (GO TO 330)
INFREQUENT SEX 13 (GO TO 330)
DIFFICULT TO GET PREGNANT 14 (GO TO 330)
MENOPAUSAL/HAD HYSTERECTOMY 15 (TO 330)
INCONVENIENT 16 (GO TO 330)
OTHER (SPECIFY) ______ 17 SKIP (TO 330)
DOES NOT KNOW 98 (GO TO 330)

326. Do you intend to use a method within the next 12 months?

YES 1
NO 2
DOES NOT KNOW 8

327. When you use a method, which method would you prefer to use?

PILL 01
IUD 02
INJECTIONS 03
FOAM TABLETS/JELLY/DIAPHRAGM 04
CONDOM 05
FEMALE STERILISATION 06
MALE STERILISATION 07
NORPLANT 08
RHYTHM, COUNTING DAYS 09 (GO TO 330)
NATURAL FP, MUCUS, TEMPERATURE 10 (GO TO 330)
WITHDRAWAL 11 (GO TO 330)
OTHER (SPECIFY) _________ 12 (GO TO 330)
UNSURE 98 (GO TO 330)

328. Where can you get (METHOD MENTIONED IN 327)?

(NAME OF PLACE) __________
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11 (GO TO 332)
GOVERNMENT HEALTH CENTRE 12 (GO TO 332)
GOVERNMENT DISPENSARY 13 (GO TO 332)
MEDICAL PRIVATE SECTOR
MISSION, CHURCH HOSP./CLINIC 21 (GO TO 332)
FPAK HEALTH CENTRE/CLINIC 22 (GO TO 332)
OTHER NON-GOVERNMENTAL SERVICE 23(GO TO 332)
PRIVATE HOSPITAL OR CLINIC 24 (GO TO 332)
PHARMACY 25 (GO TO 332)
PRIVATE DOCTOR 26 (GO TO 332)
MOBILE CLINIC 31 (GO TO 332)
COMMUNITY-BASED DISTRIBUTOR/COMMUNITY HEALTH WORKER 41 (GO TO 332)
SHOP 51 (GO TO 332)
FRIENDS/RELATIVES 61 (GO TO 333A)
OTHER (SPECIFY) ________ 71 (GO TO 333A)
DOES NOT KNOW 98 (GO TO 333A)

329. CHECK 312:

USING RHYTHM, COUNTING DAYS, WITHDRAWAL OR OTHER TRADITIONAL METHOD ___ (GO TO 330)
USING A MODERN METHOD __ (GO TO 333A)

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

YES 1
NO 2 (GO TO 333A)

331. Where is that?

(NAME OF PLACE) __________
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTRE 12
GOVERNMENT DISPENSARY 13
MEDICAL PRIVATE SECTOR
MISSION, CHURCH HOSP./CLINIC 21
FPAK HEALTH CENTRE/CLINIC 22
OTHER NON-GOVERNMENTAL SERVICE 23
PRIVATE HOSPITAL OR CLINIC 24
PHARMACY 25
PRIVATE DOCTOR 26
MOBILE CLINIC 31
COMMUNITY-BASED DISTRIBUTOR/COMMUNITY HEALTH WORKER 41
SHOP 51
FRIENDS/RELATIVES 61 (GO TO 333A)
OTHER (SPECIFY) ________ 71 (GO TO 333A)

332. How long does it take to travel from your home to this place?
IF LESS THAN 2 HOURS, RECORD MINUTES.
OTHERWISE, RECORD HOURS.

MINUTES 1___
HOURS 2 __
DK 9998

333. Do you walk or use some means of transportation to get there?

WALK 1
USE TRANSPORT 2
DOES NOT KNOW 8

333A. How did you first hear about family planning?

RADIO 01
TELEVISION 02
NEWSPAPERS 03
POSTERS 04
HUSBAND 05
FRIENDS/RELATIVES 06
HEALTH WORKER/CLINIC 07
COMMUNITY BASED DISTRIBUTOR/COMMUNITY HEALTH WORKER 08
OTHER (SPECIFY) ______ 09
CAN'T REMEMBER/DOES NOT KNOW 98

333B. From which place or person did you get the most information?

RADIO 01
TELEVISION 02
NEWSPAPERS 03
POSTERS 04
HUSBAND 05
FRIENDS/RELATIVES 06
HEALTH WORKER/CLINIC 07
COMMUNITY BASED DISTRIBUTOR/COMMUNITY HEALTH WORKER 08
OTHER (SPECIFY) ______ 09
CAN'T REMEMBER/DOES NOT KNOW 98

334. In the last 6 months, have you heard a radio program about family planning?

YES 1
NO 2 (GO TO 335)
DOES NOT KNOW 8 (GO TO 335)

334A. Which program have you heard?
Any others?
DO NOT READ CODES TO RESPONDENT.
CIRCLE ALL MENTIONED.

MWENDA POLE A
PANGA UZAZI B
MAISHA YA JAMI I YAKO C
JIFUNZE NA UENDELEA D
MAISHA BORA E
AFYA YAKO F
DAKTARI AKUSHAURI G
KUELEWANA NI KUZUNGUMZA H
OTHER (SPECIFY) _____ I
DOES NOT KNOW/CANNOT REMEMBER J

335. Do you think that information about family planning should be available to young people?

YES 1
NO 2
OTHER (SPECIFY) ________ 3
DOES NOT KNOW 8

335A. Do you think that family planning services should be available to young people?

YES 1
NO 2
OTHER (SPECIFY) ________ 3
DOES NOT KNOW 8

336. In some communities there is a woman or man who is trained to talk to families in that area about family planning. Sometimes they visit each house and talk about family planning and give out supplies. Other times they have supplies in their houses. Is there any woman or man like that in your area?

YES 1
NO 2 (GO TO 401)
DON'T KNOW 8 (GO TO 401)

337. How many times has this person visited your home in the last six months?

TIMES ____

SECTION 4A. PREGNANCY AND BREASTFEEDING

401. CHECK 222:

ONE OR MORE BIRTHS SINCE JAN.1988 __ (GO TO 402)
NO BIRTHS SINCE JAN.1988 __ (GO TO 501)

402. ENTER THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH SINCE JANUARY 1988 IN THE TABLE. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 3 BIRTHS, USE ADDITIONAL FORMS).

Now I would like to ask you some more questions about the health of all your children born in the past 5 years. We will talk about one child at a time.

LINE NUMBER FROM 212

LINE NUMBER _____

FROM 212 AND 216

NAME _______
ALIVE
DEAD

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

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

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

MONTHS 1 __
YEARS 2 __
DOES NOT KNOW 998

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

HEALTH PROFESSIONAL
DOCTOR A
NURSE/MIDWIFE B
OTHER PERSON
TRAINED TRADITIONAL BIRTH ATTENDANT C
UNTRAINED TRADITIONAL BIRTH ATTENDANT D
OTHER (SPECIFY) ________ E
NO ONE F (GO TO 409)

406. Were you given an antenatal card for this pregnancy?

YES 1
NO 2
DOES NOT KNOW 8

407. How many months pregnant were you when you first saw someone for an antenatal check on this pregnancy?

MONTHS _____
DOES NOT KNOW 98

408. How many antenatal visits did you have during this pregnancy?

NO. OF VISITS _____
DOES NOT KNOW 98

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

YES 1
NO 2 (GO TO 411)
DOES NOT KNOW 8 (GO TO 411)

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

TIMES __
DOES NOT KNOW 8

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

HER HOME, OTHER HOME 11
GOVERNMENT HOSPITAL/HLTH CENT./MATERNITY 21
PRIVATE SECTOR
MISSION HOSP/CLINIC 31
PRIVATE HOSP./CLINIC 32
OTHER (SPECIFY) ________ 41

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

HEALTH PROFESSIONAL
DOCTOR A
NURSE/MIDWIFE B
OTHER PERSON
TRAINED TRADITIONAL BIRTH ATTENDANT C
UNTRAINED TRADITIONAL BIRTH ATTENDANT D
RELATIVE/FRIEND E
OTHER (SPECIFY) ________ F
NO ONE G

413. Was (NAME) born on time or prematurely?

ON TIME 1
PREMATURELY 2
DOES NOT KNOW 8

414. Was (NAME) delivered by caesarian section?

YES 1
NO 2

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

VERY LARGE 1
LARGE 2
AVERAGE 3
SMALL 4
VERY SMALL 5
DOES NOT KNOW 8

416. Was (NAME) weighed at birth?

YES 1
NO 2 (GO TO 418)

417. How much did (NAME) weigh?

KILOGRAMS __.__
DOES NOT KNOW 98

418. Has your period returned since the birth of (NAME)?
[Most recent birth within the last five years]

YES 1 (GO TO 420)
NO 2 (GO TO 421)

419. Did your period return between the birth of (NAME) and your next pregnancy?
[Repeat questions for all children born in the last 5 years, excluding the most recent birth]

YES 1
NO 2 (GO TO 423)

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

MONTHS ______
DOES NOT KNOW 98

421. CHECK 223:
RESPONDENT PREGNANT?
[Most recent birth within the last five years]

NOT PREGNANT __ (GO TO 422)
PREGNANT OR UNSURE __ (GO TO 423)

422. Have you resumed sexual relations since the birth of (NAME)?
[Most recent birth within the last five years]

YES 1
NO 2 (GO TO 424)

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

MONTHS ___________
DOES NOT KNOW 98

424. Did you ever breastfeed (NAME)?

YES 1 (GO TO 426)
NO 2

425. Why did you not breastfeed (NAME)?

MOTHER ILL/WEAK 01 (GO TO 435)
CHILD ILL/WEAK 02 (GO TO 435)
CHILD DIED 03 (GO TO 435)
NIPPLE/BREAST PROBLEM 04 (GO TO 435)
INSUFFICIENT MILK 05 (GO TO 435)
MOTHER WORKING 06 (GO TO 435)
CHILD REFUSED 07 (GO TO 435)
OTHER (SPECIFY) _________ 08 (GO TO 435)

426. How long after birth did you first put (NAME) to the breast?
IF LESS THAN 1 HOUR, RECORD '00' HOURS.
IF LESS THAN 24 HOURS, RECORD HOURS.
OTHERWISE, RECORD DAYS.
[Most recent birth within the last five years]

IMMEDIATELY 000
HOURS 1 ______
DAYS 2 ______

427. CHECK 216: CHILD ALIVE?
[Most recent birth within the last five years]

ALIVE __ (GO TO 428)
DEAD __ (GO TO 433)

428. Are you still breastfeeding (NAME)?
[Most recent birth within the last five years]

YES 1
NO 2 (GO TO 433)

429. How many times did you breastfeed last night between sunset and sunrise?
IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER.
[Most recent birth within the last five years]

NUMBER OF NIGHTTIME FEEDINGS ______

430. How many times did you breastfeed yesterday during the daylight hours?
IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER.
[Most recent birth within the last five years]

NUMBER OF DAYLIGHT FEEDINGS _________

431. At any time yesterday or last night was (NAME) given any of the following:
[Most recent birth within the last five years]

PLAIN WATER
YES 1
NO 2
SUGAR WATER
YES 1
NO 2
JUICE
YES 1
NO 2
BABY FORMULA
YES 1
NO 2
FRESH MILK
YES 1
NO 2
TINNED/POWDERED MILK
YES 1
NO 2
OTHER LIQUIDS
YES 1
NO 2
PORRIDGE, UJI
YES 1
NO 2
SOLID/MUSHY FOOD
YES 1
NO 2

432. CHECK 431:
FOOD OR LIQUID GIVEN YESTERDAY?
[Most recent birth within the last five years]

'YES' TO ONE OR MORE __ (GO TO 437)
'NO' TO ALL __ (GO TO 436)

433. For how many months did you breastfeed (NAME)?
[Most recent birth within the last five years]

MONTHS _________
UNTIL DIED 96 (GO TO 436)

434. Why did you stop breastfeeding (NAME)?
[Most recent birth within the last five years]

MOTHER ILL/WEAK 01
CHILD ILL/WEAK 02
CHILD DIED 03
NIPPLE/BREAST PROBLEM 04
INSUFFICIENT MILK 05
MOTHER WORKING 06
CHILD REFUSED 07
WEANING AGE 08
BECAME PREGNANT 09
STARTED USING CONTRACEPTION 10
OTHER (SPECIFY) _______ 11

435. CHECK 216: CHILD ALIVE?
[Most recent birth within the last five years]

ALIVE __ (GO TO 437)
DEAD __ (GO TO 436)

436. Was (NAME) ever given water or anything else to drink or eat (other than breastmilk)?
[Most recent birth within the last five years]

YES 1
NO 2 (GO TO 440)

437. How many months old was (NAME) when you started giving the following on a regular basis?:

IF LESS THAN 1 MONTH, WRITE '00'.

Formula or milk other than breastmilk?
AGE IN MONTHS __
NOT GIVEN 96
Plain water?
AGE IN MONTHS __
NOT GIVEN 96
Other liquids?
AGE IN MONTHS __
NOT GIVEN 96
Porridge or uji?
AGE IN MONTHS __
NOT GIVEN 96
Any solid or mushy food?
AGE IN MONTHS __
NOT GIVEN 96

438. CHECK 216: CHILD ALIVE?
[Most recent birth within the last five years]

ALIVE __ (GO TO 439)
DEAD __ (GO TO 440)

439. Did (NAME) drink anything from a bottle with a nipple yesterday or last night?
[Most recent birth within the last five years]

YES 1
NO 2
DOES NOT KNOW 8

440. GO BACK TO 403 FOR NEXT BIRTH; OR, IF NO MORE BIRTHS, GO TO FIRST COLUMN OF 441.

SECTION 4B. IMMUNISATION AND HEALTH

441. ENTER THE LINE NUMBER AND NAME OF EACH BIRTH SINCE JANUARY 1988 IN THE TABLE. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS, BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 3 BIRTHS, USE ADDITIONAL FORMS).

LINE NUMBER FROM 212

NAME ________ __
ALIVE __ (GO TO 442)
DEAD __ (GO TO 442)

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

YES, SEEN 1 (GO TO 444)
YES, NOT SEEN 2 (GO TO 446)
NO CARD 3

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

YES 1 (GO TO 446)
NO 2 (GO TO 446)

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

TUBERCULOSIS (BCG)
DAY ___
MONTH ____
YEAR ____
DPT 1st DOSE (D1)
DAY ___
MONTH ____
YEAR ____
DPT 2nd DOSE (D2)
DAY ___
MONTH ____
YEAR ____
DPT 3rd DOSE (D3)
DAY ___
MONTH ____
YEAR ____
POLIO-BIRTH DOSE (P0)
DAY ___
MONTH ____
YEAR ____
POLIO-1st DOSE (P1)
DAY ___
MONTH ____
YEAR ____
POLIO-2nd DOSE (P2)
DAY ___
MONTH ____
YEAR ____
POLIO-3rd DOSE (P3)
DAY ___
MONTH ____
YEAR ____
MEASLES (MEA)
DAY ___
MONTH ____
YEAR ____

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

YES 1 (PROBE FOR VACCINATIONS AND WRITE '66' IN THE CORRESPONDING DAY COLUMN IN 444) (GO TO 448)
NO 2 (GO TO 448)
DK 8 (GO TO 448)

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

YES 1
NO 2 (GO TO 448)
DOES NOT KNOW 8 (GO TO 448)

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

A BCG vaccination against tuberculosis, that is, an injection in the left forearm that made a scar?
YES 1
NO 2
DOES NOT KNOW 8
Polio vaccine, that is, drops in the mouth?
YES 1 (If YES, how many times _____ )
NO 2
DOES NOT KNOW 8
An injection against measles, that is, in the top part of the right arm?
YES 1
NO 2
DOES NOT KNOW 8

448. CHECK 216: CHILD ALIVE?

ALIVE __ (GO TO 450)
DEAD __ (GO TO 449)

449. GO BACK TO 442 FOR NEXT BIRTH; OR, IF NO MORE BIRTHS, SKIP TO 480.

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

YES 1
NO 2
DOES NOT KNOW 8

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

YES 1
NO 2 (GO TO 455)
DOES NOT KNOW 8 (GO TO 455)

452. Has (NAME) been ill with a cough in the last 24 hours?

YES 1
NO 2
DOES NOT KNOW 8

453. For how many days (has the cough lasted/did the cough last)? IF LESS THAN 1 DAY, RECORD '00'.

DAYS ____

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

YES 1
NO 2
DOES NOT KNOW 8

455. CHECK 450 AND 451:
FEVER OR COUGH?

LAST BIRTH
'YES' IN EITHER 450 OR 451 __ (GO TO 456)
OTHER __ (GO TO 460)

456. Was anything given to treat the fever/cough?

YES 1
NO 2 (GO TO 458)
DOES NOT KNOW 8 (GO TO 458)

457. What was given to treat the fever/cough? Anything else?

RECORD ALL MENTIONED.

INJECTION A
ANTIBIOTIC PILL, SYRUP. B
ANTIMALARIAL PILL OR SYRUP C
COUGH SYRUP D
OTHER PILL OR SYRUP E
HOME REMEDY/HERBAL MEDICINE F
OTHER (SPECIFY) _______ G

458. Did you seek advice or treatment for the fever/cough?

YES 1
NO 2 (GO TO 460)

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

RECORD ALL MENTIONED.

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVT. HEALTH CENTRE B
GOVT. DISPENSARY C
MEDICAL PRIVATE SECTOR
MISSION, CHURCH HOSPITAL OR CLINIC D
OTHER NON-GOVT. SERVICE E
PVT. HOSPITAL/CLINIC F
PHARMACY G
PRIVATE DOCTOR H
MOBILE CLINIC I
COMMUNITY HEALTH WORKER J
OTHER PRIVATE SECTOR
SHOP K
HERBALIST L
RELATIVE/FRIEND M
OTHER (SPECIFY) ______ N

460. Has (NAME) had diarrhea in the last 2 weeks?

YES 1 (GO TO 462)
NO 2
DOES NOT KNOW 8

461. GO BACK TO 442 FOR NEXT BIRTH OR, IF NO MORE BIRTHS, GO TO 480

462. Has (NAME) had diarrhea in the last 24 hours?

YES 1
NO 2
DOES NOT KNOW 8

463. For how many days (has the diarrhea lasted/did the diarrhea last)?

DAYS ____

463A. How many stools did (NAME) have on the worst day of the diarrhea?

NUMBER OF STOOLS __

464. Was there any blood in the stools?

YES 1
NO 2
DOES NOT KNOW 8

465. CHECK 424/428: LAST CHILD STILL BREASTFED?
[Only for most recent birth]

YES __ (GO TO 466)
NO __ (GO TO 468)

466. During (NAME)'s diarrhea, did you change the frequency of breastfeeding?
[Only for most recent birth]

YES
NO (GO TO 468)

467. Did you increase the number of breastfeeds, reduce them or did you stop completely?
[Only for most recent birth]

INCREASED 1
REDUCED 2
STOPPED COMPLETELY 3

468. (Aside from breastmilk) Was he/she given the same amount to drink as before the diarrhea, or more, or less?

SAME 1
MORE 2
LESS 3
DOES NOT KNOW 8

469. Was anything given to treat the diarrhea?

YES 1
NO 2 (GO TO 471)
DOES NOT KNOW 8 (GO TO 471)

470. What was given to treat the diarrhea? Anything else?

RECORD ALL MENTIONED.

FLUID FROM ORS PACKET A
ANTIBIOTIC PILL, SYRUP B
OTHER PILL OR SYRUP C
INJECTION D
I.V. (INTRAVENOUS) E
HOME REMEDY OR HERBS F
OTHER (SPECIFY) _______ G

471. Did you seek advice or treatment for the diarrhea?

YES 1
NO 2 (GO TO 473)

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

RECORD ALL MENTIONED.

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVT. HEALTH CENTRE B
GOVT. DISPENSARY C
MEDICAL PRIVATE SECTOR
MISSION, CHURCH HOSPITAL OR CLINIC D
OTHER NON-GOVT. SERVICE E
PVT. HOSPITAL/CLINIC F
PHARMACY G
PRIVATE DOCTOR H
MOBILE CLINIC I
COMMUNITY HEALTH WORKER J
OTHER PRIVATE SECTOR
SHOP K
HERBALIST L
RELATIVE/FRIEND M
OTHER (SPECIFY) ______ N

473. CHECK 470: ORS FLUID FROM PACKET MENTIONED?

NO, ORS FLUID NOT MENTIONED __ (GO TO 474)
YES, ORS FLUID MENTIONED __ (GO TO 475)

474. Was (NAME) given water mixed with Oralite or ORS sachet when he/she had the diarrhea?

YES 1
NO 2 (GO TO 479)
DOES NOT KNOW 8 (GO TO 479)

475. For how many days was (NAME) given the Oralite/ORS?

IF LESS THAN 1 DAY, WRITE 00.

DAYS _____
DOES NOT KNOW 98

479. GO BACK TO 442 FOR NEXT BIRTH; OR, IF NO MORE BIRTHS, GO TO 480.

480. CHECK 470 AND 474 (ALL COLUMNS):

ORS FLUID FROM SACHET GIVEN TO ANY CHILD __ (GO TO 484)
ORS FLUID FROM SACHET NOT GIVEN TO ANY CHILD OR 470 AND 474 NOT ASKED __ (GO TO 481)

481. Have you ever heard of a special product called ORS or Oralite you can get for the treatment of diarrhea?

YES 1 (GO TO 483)
NO 2

482. Have you ever seen a sachet like this before?
SHOW SACHETS.

YES 1
NO 2 (GO TO 501)

483. Have you ever prepared a solution with one of these sachets to treat diarrhea in yourself or someone else?

SHOW SACHETS.

YES 1
NO 2 (GO TO 486)

484. The last time you prepared Oralite (ORS), did you prepare the whole sachet at once or only part of the sachet?

WHOLE SACHET AT ONCE 1
PART OF SACHET 2 (GO TO 486)

485. What container did you use to measure the water the last time you made Oralite (ORS)?

SMALL KIMBO (1/2 KG) 01
LARGE KIMBO (1 KG) 02
BEER BOTTLE (TUSKER) 03
BEER BOTTLE (PREMIUM) 04
TREETOP BOTTLE (750 ML) 05
SODA BOTTLE (250 ML) 06
TEACUP 07
GLASS 08
OTHER (SPECIFY) _____ 09

485A. How many of these containers did you mix with the contents of the ORS sachet?

NUMBER OF CONTAINERS ___

486. Where can you get Oralite/ORS sachets?
PROBE: Anywhere else?

RECORD ALL PLACES MENTIONED.

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTRE B
GOVERNMENT DISPENSARY C
MEDICAL PRIVATE SECTOR
MISSION, CHURCH HOSPITAL OR CLINIC D
OTHER NON-GOVERNMENTAL SERVICE E
PRIVATE HOSPITAL/CLINIC F
PHARMACY G
PRIVATE DOCTOR H
MOBILE CLINIC I
COMMUNITY HEALTH WORKER J
OTHER PRIVATE SECTOR
SHOP K
HERBALIST L
RELATIVE/FRIEND M
OTHER (SPECIFY) ______ N

SECTION 5. MARRIAGE

501. Now we come to matters of marriage. Have you ever been married or lived with a man?

YES 1
NO 2 (GO TO 512)

502. Are you now married or living with a man, or are you now widowed, divorced, or no longer living together?

MARRIED 1
LIVING TOGETHER 2
WIDOWED 3 (GO TO 507)
DIVORCED 4 (GO TO 507)
NO LONGER LIVING TOGETHER 5 (GO TO 507)

503. Does your husband/partner usually live with you or does he usually stay somewhere else?

LIVES WITH HER 1 (GO TO 504)
STAYS SOMEWHERE ELSE 2

503A. Where does he usually stay?

WITHIN SAME DISTRICT 1
NAIROBI 2
MOMBASA 3
OUTSIDE DISTRICT 4
DOES NOT KNOW 8

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

YES 1
NO 2 (GO TO 507)

505. How many other wives/partners does he have?

NUMBER ___
DOES NOT KNOW 98

507. Have you been married or lived with a man only once, or more than once?

ONCE 1
MORE THAN ONCE 2

508. In what month and year did you start living with your (first) husband/partner?

MONTH ___
DOES NOT KNOW MONTH 98
YEAR ____
DOES NOT KNOW YEAR 98

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

AGE ____
DOES NOT KNOW AGE 98

510. CHECK 508 AND 509: YEAR AND AGE GIVEN?

YES __ (GO TO 511)
NO __ (GO TO 513)

511. CHECK CONSISTENCY OF 508 AND 509:

YEAR OF BIRTH (105) ___
PLUS +
AGE AT MARRIAGE (509) ___ equals
CALCULATED YEAR OF MARRIAGE ___

IF NECESSARY, CALCULATE YEAR OF BIRTH
CURRENT YEAR 93
MINUS -
CURRENT AGE (106) ___ =
CALCULATED YEAR OF BIRTH ___

IS THE CALCULATED YEAR OF MARRIAGE WITHIN ONE YEAR OF THE REPORTED YEAR OF MARRIAGE (508)?

YES __ (GO TO 513)
NO __ (PROBE AND CORRECT 508 AND 509)

512. IF NEVER MARRIED OR LIVED WITH A MAN: Have you ever had sexual intercourse?

YES 1
NO 2 (GO TO 520)

513. Now we need some details about your sexual activity in order to get a better understanding of family planning and fertility. How old were you when you first had sexual intercourse?

AGE __
FIRST TIME WHEN MARRIED 96

514. In the last four weeks, on how many days did you have sexual intercourse?

IF NONE, WRITE '00'.

DAYS ___

516. How many different men have you had sexual intercourse within the last 6 months?

IF 00, SKIP TO 518.

NUMBER OF MEN ___

517. Did you use a condom with any of these men?

YES 1
NO 2

518. How many different men have you had sexual intercourse with in your whole life?

NUMBER OF MEN ___

519. When was the last time you had sexual intercourse?

DAYS AGO 1 __
WEEKS AGO 2 __
MONTHS AGO 3 __
YEARS AGO 4 __
BEFORE LAST BIRTH 996

520. Now I have a few questions about a very important topic. Have you heard of a disease called AIDS?

YES 1
NO 2 (GO TO 531)

521. From which sources of information or persons have you heard about AIDS in the last month? Any others?

CIRCLE ALL MENTIONED.

RADIO A
TV B
NEWSPAPERS C
HEALTH WORKERS D
PRIESTS/PREACHERS/KADNIS E
HUSBAND F
FRIENDS/RELATIVES G
SCHOOLS H
BOOKLETS/PAMPHLETS/POSTERS I
BARAZAS J
OTHER (SPECIFY) _____ K
NONE L

522. How is AIDS transmitted? Any other ways?

DO NOT READ CODES. CIRCLE ALL MENTIONED.

SEXUAL INTERCOURSE A
SHAVING/RAZORS B
INJECTIONS C
CIRCUMCISION, TATTOOS D
MOTHER TO CHILD E
TRANSFUSION OF INFECTED BLOOD F
OTHER (SPECIFY) _____ G
DOES NOT KNOW H

523. Do you think that you can get AIDS from:

HANDSHAKING
YES 1
NO 2
DK 8
KISSING
YES 1
NO 2
DK 8
SHARING CLOTHES
YES 1
NO 2
DK 8
SHARING EATING UTENSILS
YES 1
NO 2
DK 8
TOUCHING SOMEONE WHO DIED
YES 1
NO 2
DK 8
MOSQUITO/FLEA/BEDBUG BITES
YES 1
NO 2
DK 8

524. Is it possible for a healthy looking person to be infected with the AIDS virus?

YES 1
NO 2
DOES NOT KNOW 8

525. Is it possible for a woman who has the AIDS virus to give birth to a child with the AIDS virus?

YES 1
NO 2
DOES NOT KNOW 8

526. Can people protect themselves from getting AIDS or is there nothing that people can do?

CAN PROTECT THEMSELVES 1
NOTHING THEY CAN DO 2 (GO TO 528)
DOES NOT KNOW 8 (GO TO 528)

527. How can people protect themselves from getting AIDS? Any other ways?

DO NOT READ CODES TO RESPONDENT.
CIRCLE ALL MENTIONED.

DO NOT HAVE SEX AT ALL A
LIMIT NUMBER OF SEXUAL PARTNERS B
USE CONDOMS DURING SEX C
STERILIZE SYRINGES/NEEDLES D
AVOID PROSTITUTES E
OTHER (SPECIFY) _______ F

528. Do you know anyone who has AIDS or anyone who has died from AIDS?

YES 1
NO 2

529. Do you think that you yourself can catch AIDS?

YES 1
NO 2 (GO TO 531)
DOES NOT KNOW 8 (GO TO 531)

530. How do you think you might catch AIDS?

FROM HUSBAND/PARTNER 1
FROM NEEDLES/INJECTIONS 2
FROM BLOOD TRANSFUSIONS 3
OTHER (SPECIFY) _____ 4
NOT SURE/DOES NOT KNOW 8

531. PRESENCE OF OTHERS AT THIS POINT.

CHILDREN UNDER 10
YES 1
NO 2
HUSBAND
YES 1
NO 2
OTHER MALES
YES 1
NO 2
OTHER FEMALES
YES 1
NO 2

SECTION 6. FERTILITY PREFERENCES

601. CHECK 312:

NEITHER STERILISED __ (GO TO 602)
HE OR SHE STERILISED __ (GO TO 607)

602. CHECK 502:

CURRENTLY MARRIED OR LIVING TOGETHER __ (GO TO 603)
NOT MARRIED/NOT LIVING TOGETHER __ (GO TO 614)

603. CHECK 223:

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

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

HAVE A (ANOTHER) CHILD 1
NO MORE/NONE 2 (GO TO 610)
SAYS SHE CAN'T GET PREGNANT 3 (GO TO 610)
UNDECIDED, DOES NOT KNOW 8 (GO TO 610)

604. CHECK 223:

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

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

MONTHS 1 ___ (GO TO 610)
YEARS 2 ___ (GO TO 610)
SOON/NOW 994 (GO TO 610)
SAYS SHE CAN'T GET PREGNANT 995 (GO TO 610)
OTHER (SPECIFY) _____ 996
DOES NOT KNOW 998

605. CHECK 216 AND 223:
HAS LIVING CHILD(REN) OR PREGNANT?

YES __ (GO TO 606)
NO __ (GO TO 610)

606. CHECK 223:

NOT PREGNANT OR UNSURE __
How old would you like your youngest child to be when your next child is born?

PREGNANT __
How old would you like the child you are expecting to be when your next child is born?

AGE OF CHILD YEARS ____ (GO TO 610)
DOES NOT KNOW 98 (GO TO 610)

607. Would you recommend to a friend or relative in your circumstances to have an operation not to have any more children?

YES 1 (GO TO 610)
NO 2

608. Why not?

_______________

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

APPROVES 1
DISAPPROVES 2
DOES NOT KNOW 8

610A. Have you ever talked to your husband/partner about household finances and economic matters such as the costs of children?

YES 1
NO 2

611. Have you ever talked to your husband/partner about family planning?

YES 1
NO 2 (GO TO 612)

611A. How often have you talked to your husband/partner about family planning in the past year?

NEVER 1
ONCE OR TWICE 2
MORE OFTEN 3

612. Have you and your husband/partner ever discussed the number of children you would like to have?

YES 1
NO 2

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

SAME NUMBER 1
MORE CHILDREN 2
FEWER CHILDREN 3
DOES NOT KNOW 8

614. How long should a couple wait before starting sexual intercourse after the birth of a baby?

MONTHS 1 __
YEARS 2 __
OTHER (SPECIFY) ________ 996

615. Should a mother wait until she has completely stopped breastfeeding before starting to have sexual relations again, or doesn't it matter?

WAIT 1
DOESN'T MATTER 2

616. In general, do you approve or disapprove of couples using a method to avoid getting pregnant?

APPROVE 1
DISAPPROVE 2

617. CHECK 216:

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

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

RECORD SINGLE NUMBER OR OTHER ANSWER.

NUMBER ______
OTHER ANSWER (SPECIFY) ____________96 (GO TO 618)

617A. How many boys? How many girls?

NUMBER OF BOYS _______
NUMBER OF GIRLS _______
OTHER (SPECIFY) _________ 96

618. What do you think is the best number of months or years between the birth of one child and the birth of the next child?

MONTHS 1 __
YEARS 2 __
OTHER (SPECIFY) ______ 996

SECTION 7. HUSBAND'S BACKGROUND AND WOMAN'S WORK

701. CHECK 501:

EVER MARRIED OR LIVED TOGETHER __ (ASK QUESTIONS ABOUT CURRENT OR MOST RECENT HUSBAND/PARTNER)
NEVER MARRIED/NEVER LIVED TOGETHER __ (GO TO 708)

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

YES 1
NO 2 (GO TO 704B)

703. What was the highest level of school he attended: primary, secondary, or university?

PRIMARY 1
SECONDARY 2
UNIVERSITY 3
DOES NOT KNOW 8 (GO TO 704B)

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

STANDARD/FORM/YEAR ____
DOES NOT KNOW 98

704A. CHECK 703:

PRIMARY __ (GO TO 704B)
SECONDARY OR ABOVE __ (GO TO 705)

704B. Can (Could) he read a letter or newspaper in any language easily, with difficulty, or not at all?

EASILY 1
WITH DIFFICULTY 2
NOT AT ALL 3
DOES NOT KNOW 8

705. What kind of work does (did) your (last) husband/partner mainly do?
LEAVE BOXES BLANK.

____________________

706. CHECK 705:

WORKS (WORKED) IN AGRICULTURE __ (GO TO 707)
DOES (DID) NOT WORK IN AGRICULTURE __ (GO TO 708)

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

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

707A. (Does/did) he earn a regular wage or salary?

YES 1
NO 2
DOES NOT KNOW 8

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

YES 1 (GO TO 710)
NO 2

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

YES 1
NO 2 (GO TO 717)

710. What is your occupation, that is, what kind of work do you do?
LEAVE BOXES BLANK.

____________________

711. In your current work, do you work for a member of your family, for someone else, or are you self-employed?

FOR FAMILY MEMBER 1
FOR SOMEONE ELSE 2
SELF-EMPLOYED 3

712. Do you earn cash for this work?

PROBE: Do you make money for working?

YES 1
NO 2

713. Do you do this work at home or away from home?

HOME 1
AWAY 2

714. CHECK 215/216/218:
HAS CHILD BORN SINCE JAN. 1988 AND LIVING AT HOME?

YES 1 __ (GO TO 715)
NO 2 __ (GO TO 717)

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

USUALLY 1 (GO TO 717)
SOMETIMES 2
NEVER 3

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

HUSBAND/PARTNER 01
OLDER CHILD(REN) 02
OTHER RELATIVES 03
NEIGHBORS 04
FRIENDS 05
SERVANTS/HIRED HELP 06
CHILD IS IN SCHOOL 07
INSTITUTIONAL CHILDCARE 08
OTHER (SPECIFY) ________ 09

717. RECORD THE TIME

HOUR __
MINUTES __

SECTION 8. HEIGHT AND WEIGHT

801. CHECK 222:

ONE OR MORE BIRTHS SINCE JAN. 1988 __ (GO TO 802)
NO BIRTHS SINCE JAN. 1988 __ (END)

INTERVIEWER:
IN 802 (COLUMNS 2-4) RECORD THE LINE NUMBER FOR EACH CHILD BORN SINCE JANUARY 1988 AND STILL ALIVE.
IN 803 AND 804 RECORD THE NAME AND BIRTH DATE FOR THE RESPONDENT AND FOR ALL LIVING CHILDREN BORN SINCE JANUARY 1988. IN 806 AND 808 RECORD HEIGHT AND WEIGHT OF THE RESPONDENT AND THE LIVING CHILDREN.
(NOTE: ALL RESPONDENTS WITH ONE OR MORE BIRTHS SINCE JANUARY 1988 SHOULD BE WEIGHED AND MEASURED EVEN IF ALL OF THE CHILDREN HAVE DIED. IF THERE ARE MORE THAN 3 LIVING CHILDREN BORN SINCE JANUARY 1988, USE ADDITIONAL FORMS)

802. LINE NO. FROM 212
[Only children born since 1988]

___

803. NAME FROM 212 FOR CHILDREN
[Respondent and only children born since 1988]

(NAME) ___________

804. DATE OF BIRTH
FROM l05 FOR RESPONDENT
FROM 215 FOR CHILDREN, AND ASK FOR DAY OF BIRTH
[Respondent and only children born since 1988]

MONTH ___
YEAR ___

805. BCG SCAR ON LOWER LEFT ARM
[Only children born since 1988]

SCAR SEEN 1
NO SCAR 2

806. HEIGHT (in centimeters)
[Respondent and only children born since 1988]

____.__

807. WAS HEIGHT/LENGTH OF CHILD MEASURED LYING DOWN OR STANDING UP?
[Only children born since 1988]

LYING 1
STANDING 2

808. WEIGHT (in kilograms)
[Respondent and only children born since 1988]

____.__

809. MID-UPPER ARM CIRCUMFERENCE (in millimeters)
[Respondent and only children born since 1988]

____

810. DATE WEIGHED AND MEASURED
[Respondent and only children born since 1988]

DAY ___
MONTH ___
YEAR __

811. RESULT
[Respondent and only children born since 1988]

MEASURED 1
NOT PRESENT 3
REFUSED 4
OTHER (SPECIFY) _______ 6

812. NAME OF MEASURER: __________
NAME OF ASSISTANT: _________

** Adapt question locally after determining the most common injection site (usually the left arm or shoulder).

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
_________________________________