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NATIONAL COUNCIL FOR POPULATION AND DEVELOPMENT
CENTRAL BUREAU OF STATISTICS
KENYA DEMOGRAPHIC AND HEALTH SURVEY 2 -- MAN???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 MAN ___________

NAME AND LINE NUMBER OF WIFE ___________
NAME AND LINE NUMBER OF SECOND WIFE _______________

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 NO.OF VISITS __

RESULT___
*RESULT CODES:

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

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:

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

M101. RECORD THE TIME.

HOUR ____
MINUTES ____

M102. 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 in Nairobi or Mombasa, in another city or town or in the countryside?

NAIROBI/MOMBASA 1
OTHER CITY/TOWN 2
COUNTRYSIDE 3

M103. How long have you been living continuously in (NAME OF SUBLOCATION, TOWN OR CITY)?

YEARS _______
ALWAYS 95 (GO TO M105)
VISITOR 96 (GO TO M105)

M104. 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

M105. In what month and year were you born?

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

M106. How old were you at your last birthday?
COMPARE AND CORRECT M105 AND/OR M106 IF INCONSISTENT.

AGE IN COMPLETED YEARS _______

M107. Have you ever attended school?

YES 1
NO 2 (GO TO M111)

M108. What is the highest level of school you attended: primary, secondary, or university?

PRIMARY 1
SECONDARY 2
UNIVERSITY 3

M109. What is the highest (standard/form/year) you completed at that level?

STANDARD/FORM/YEAR _______

M109A. 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

M110. CHECK M108:

PRIMARY __ (GO TO M111)
SECONDARY OR ABOVE __ (GO TO M112)

M111. 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 M113)

M112. Do you usually read a newspaper or magazine at least once a week?

YES 1
NO 2

M113. Do you usually listen to a radio at least once a week?

YES 1
NO 2

M114. Do you usually watch television at least once a week?

YES 1
NO 2

M115. What kind of work do you mainly do?

_______________ __

M116. CHECK M115:

WORKS IN AGRICULTURE __ (GO TO M117)
DOES NOT WORK IN AGRICULTURE __ (GO TO M118)

M117. Do you work mainly on your own land or family land or do you rent land or work on someone else???s land?

HIS/FAMILY LAND 1 (GO TO M119)
RENTED LAND 2
SOMEONE ELSE???S LAND 3

M118. Do you earn a regular wage or salary?

YES 1
NO 2
DOES NOT KNOW 8

M119. What is your religion?

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

M120. 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

M121. CHECK Q.4 IN THE HOUSEHOLD QUESTIONNAIRE

THE MAN INTERVIEWED IS NOT A USUAL RESIDENT __ (GO TO M122)
THE MAN INTERVIEWED IS A USUAL RESIDENT __ (GO TO M201)

M122. 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

M123. In which district is that located?
WRITE NAME OF DISTRICT CLEARLY.

DISTRICT _____________ __

M124. 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 M126)
PUBLIC TAP 12
WELL WATER
WELL WITH PUMP 21
WELL WITHOUT PUMP 22
SURFACE WATER
LAKE 31
RIVER/STREAM 32
POND 33
RAINWATER 41 (GO TO M126)
OTHER (SPECIFY)_______ 51

M125. How long does it take to go there, get water, and come back?

MINUTES ___
ON PREMISES 996

M126. Does your household get drinking water from this same source?

YES 1 (GO TO M128)
NO 2

M127. What is the source of drinking water for members of your household?

PIPED WATER
PIPED INTO HOUSE/COMPOUND/PLOT 11 (GO TO M126)
PUBLIC TAP 12
WELL WATER
WELL WITH PUMP 21
WELL WITHOUT PUMP 22
SURFACE WATER
LAKE 31
RIVER/STREAM 32
POND 33
RAINWATER 41 (GO TO M126)
OTHER (SPECIFY)_______ 51

M128. 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 (SPECIFY) ____ 41

M129. Does your household have:

Electricity?
A radio?
A television?
A refrigerator?

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

M130. How many rooms in your household are used for sleeping?

ROOMS ___

M131. 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 (SPECIFY) ______ 41

M132. Could you describe the main material of the walls of your home?

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

M133. 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

M134. Does any member of your household own:

A bicycle?
A motorcycle?
A car?
Land?
Cattle, goats or sheep?
Cash crops?

BICYCLE
YES 1
NO 2
MOTORCYCLE
YES 1
NO 2
CAR
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. MARRIAGE

M201. Have you ever been married or lived with a woman?

YES 1
NO 2 (GO TO M301)

M202. Are you now married or living with a woman, or are you widowed, divorced, or no longer living together?

MARRIED 1
LIVING TOGETHER 2
WIDOWED 3 (GO TO M205)
DIVORCED 4 (GO TO M205)
NO LONGER LIVING TOGETHER 5 (GO TO M205)

M203. How many wives do you have?

NUMBER ___

M204. Do you stay together with your wife (any of your wives?)

YES 1
NO, WITH NONE 2

M205. Have you been married or lived with a woman only once, or more than once?

ONCE 1
MORE THAN ONCE 2

M206. In what month and year did you start living with your (first) wife/partner?

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

M207. How old were you when you started living with her?

AGE ____
DOES NOT KNOW AGE 98

M208. CHECK M206 AND M207: YEAR AND AGE GIVEN?

YES __ (GO TO M209)
NO __ (GO TO M301)

M209. CHECK CONSISTENCY OF M206 AND M207:

YEAR OF BIRTH (M105) ___
PLUS +
AGE AT MARRIAGE (M207) ___
=
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 (M206)?

YES __
NO __ (PROBE AND CORRECT M206 AND M207).

SECTION 3. CONTRACEPTION

M301. 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 M302 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 M302, ASK M303-M304 BEFORE PROCEEDING TO THE NEXT METHOD.

M302. 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 arm.
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

M303. 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: Has your wife/woman 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: Have you ever had this operation?
YES 1
NO 2
METHOD 08 NORPLANT Women can have some small rods put under their skin in their arm.
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 arm.
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

M305. CHECK M303:

NOT A SINGLE ???YES??? (NEVER USED) __ (GO TO M306)
AT LEAST ONE ???YES??? (EVER USED) __ (GO TO M308)

M306. Have you or your wife or partner ever used anything or tried in any way to delay or avoid having a baby?

YES __
NO __ (GO TO M318)

M307. What have you used or done?
CORRECT M303-M305 (AND M302 IF NECESSARY).

M308. Now I would like to ask you about the time when you first did something or used a method to avoid pregnancy.
How many living children did you have at that time, if any?
IF NONE, RECORD ???00???.

NUMBER OF CHILDREN _____

M309. Are you doing something now or using any method with any partner to delay or avoid pregnancy?

YES 1
NO 2 (GO TO M316)

M310. Which method are you using?
IF USING MORE THAN ONE METHOD, CIRCLE CODE FOR METHOD THAT COMES FIRST ON THE LIST (WITH LOWEST CODE NUMBER), AND WRITE NAME OF OTHER METHOD HERE:

________
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 M315)
NATURAL FP, MUCUS, TEMPERATURE 10 (GO TO M315)
WITHDRAWAL 11 (GO TO M315)
OTHER (SPECIFY) _________ 12 (GO TO M315)

M311. CHECK M310:

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

USING ANOTHER METHOD __
Where did you (or your wife/partner) 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 HOSPITAL/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 M313)
OTHER (SPECIFY) ________ 71 (GO TO M313)
DOES NOT KNOW 98 (GO TO M313)

M312. 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

M313. CHECK M310:

SHE/HE STERILISED __ (GO TO M314)
USING ANOTHER METHOD __ (GO TO M315)

M314. In what month and year was the sterilization operation performed?

MONTH __ (GO TO M316)
YEAR __ (GO TO M316)

M315. For how many months have you been using (CURRENT METHOD) continuously?
IF LESS THAN 1 MONTH, RECORD ???00???.

MONTH ___
8 YEARS OR LONGER 96

M316. Have you used a condom in the last four weeks?

YES 1
NO 2 (GO TO M317A)

M317. How much did the condom you last used cost?

COST IN SHILLINGS __
PARTNER OBTAINED 95
FREE 96
DOES NOT KNOW 98

M317A. CHECK M309:

NOT CURRENTLY USING METHOD OR BLANK __ (GO TO M318)
USING A METHOD __ (GO TO M323)

M318. Do you intend to use a method to delay or avoid pregnancy at any time in the future?

YES 1 (GO TO M320)
NO 2
DOES NOT KNOW/NOT SURE 8 (GO TO M324)

M319. What is the main reason you do not intend to use a method?
IF HE SAYS HE IS TOO YOUNG, ASK WHAT HE WILL DO WHEN HE IS OLDER.

WANTS CHILDREN 01 (GO TO M324)
LACK OF KNOWLEDGE 02 (GO TO M324)
HUSBAND OPPOSED TO USING 03 (GO TO M324)
COST TOO MUCH 04 (GO TO M324)
SIDE EFFECTS 05
FEARS IT WILL MAKE HER STERILE 06 (GO TO M324)
OTHER HEALTH CONCERNS 07 (GO TO M324)
HARD TO GET METHODS 08 (GO TO M324)
RELIGION 09 (GO TO M324)
OPPOSED TO FAMILY PLANNING 10
FATALISTIC 11 (GO TO M324)
OTHER PEOPLE OPPOSED 12 (GO TO M324)
INFREQUENT SEX 13 (GO TO M324)
DIFFICULT TO GET PREGNANT 14 (GO TO M324)
MENOPAUSAL/HAD HYSTERECTOMY 15 (GO TO M324)
INCONVENIENT 16 (GO TO M324)
OTHER (SPECIFY) ______ 17 (GO TO M324)
DOES NOT KNOW 98 (GO TO M324)

M320. Do you intend to use a method within the next 12 months?

YES 1
NO 2
DOES NOT KNOW 8

M321. 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 M324)
NATURAL FP, MUCUS, TEMPERATURE 10 (GO TO M324)
WITHDRAWAL 11 (GO TO M324)
OTHER (SPECIFY) _________ 12 (GO TO M324)
UNSURE 98 (GO TO M324)

M322. Where can you get (METHOD MENTIONED IN M321)?

(NAME OF PLACE) __________
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11 (GO TO M326)
GOVERNMENT HEALTH CENTRE 12 (GO TO M326)
GOVERNMENT DISPENSARY 13 (GO TO M326)
MEDICAL PRIVATE SECTOR
MISSION, CHURCH HOSPITAL/CLINIC 21 (GO TO M326)
FPAK HEALTH CENTRE/CLINIC 22 (GO TO M326)
OTHER NON-GOVERNMENTAL SERVICE 23 (GO TO M326)
PRIVATE HOSPITAL OR CLINIC 24 (GO TO M326)
PHARMACY 25 (GO TO M326)
PRIVATE DOCTOR 26 (GO TO M326)
MOBILE CLINIC 31 (GO TO M326)
COMMUNITY-BASED DISTRIBUTOR/COMMUNITY HEALTH WORKER 41 (GO TO M326)
SHOP 51 (GO TO M326)
FRIENDS/RELATIVES 61 (GO TO M327)
OTHER (SPECIFY) ________ 71 (GO TO M327)
DOES NOT KNOW 98 (GO TO M327)

M323. CHECK M310:

USING RHYTHM, COUNTING DAYS, WITHDRAWAL OR OTHER TRADITIONAL METHOD __ (GO TO M324)
USING A MODERN METHOD __ (GO TO M327)

M324. Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO M327)

M325. Where is that?

(NAME OF PLACE) __________
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTRE 12
GOVERNMENT DISPENSARY 13
MEDICAL PRIVATE SECTOR
MISSION, CHURCH HOSPITAL/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 M327)
OTHER (SPECIFY) ________ 71 (GO TO M327)

M326. 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

M327. How did you first hear about family planning?

RADIO 01
TELEVISION 02
NEWSPAPERS 03
POSTERS 04
WIFE 05
FRIENDS/RELATIVES 06
HEALTH WORKER/CLINIC 07
CBD/CHW 08
BARAZAS 09
OTHER (SPECIFY) ______ 10
CAN???T REMEMBER/DOES NOT KNOW 98

M328. From which place or person did you get the most information?

RADIO 01
TELEVISION 02
NEWSPAPERS 03
POSTERS 04
WIFE 05
FRIENDS/RELATIVES 06
HEALTH WORKER/CLINIC 07
CBD/CHW 08
BARAZAS 09
OTHER (SPECIFY) ______ 10
CAN???T REMEMBER/DOES NOT KNOW 98

M329. In the last 6 months, have you heard a radio program about family planning?

YES 1
NO 2 (GO TO M331)
DOES NOT KNOW 8 (GO TO M331)

M330. 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

M331. 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

M332. 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 M335)
DOESN???T KNOW 8 (GO TO M335)

M334. How many times has this person visited your home in the last six months?

TIMES ____

M335. 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
DOES NOT KNOW 8

SECTION 4. SEXUAL ACTIVITY AND AIDS

M401. CHECK M201:

NEVER MARRIED OR LIVED TOGETHER WITH A WOMAN __ (GO TO M402)
EVER MARRIED OR LIVED WITH A WOMAN __ (GO TO M403)

M402. Have you ever had sexual intercourse?

YES 1
NO 2 (GO TO M410)

M403. 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

M404. In the last four weeks, on how many days did you have sexual intercourse?
IF NONE, WRITE ???00???.

DAYS ____________

M406. How many different women have you had sexual intercourse within the last 6 months?
IF 00, SKIP TO M408.

NUMBER OF WOMEN _____

M407. Did you use a condom with any of these women?

YES 1
NO 2

M408. How many different women have you had sexual intercourse with in your whole life?

NUMBER OF WOMEN ________

M409. 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

M410. 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 M421)

M411. 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/KADHIS E
WIFE F
FRIENDS/RELATIVES G
SCHOOLS H
BOOKLETS/PAMPHLETS/POSTERS I
BARAZAS J
OTHER (SPECIFY) ___________ K
HOME L

M412. 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

M413. Do you think that you can get AIDS from:

shaking hands with someone who has AIDS?
kissing someone who has AIDS?
wearing the clothes of someone who has AIDS?
sharing eating utensils with someone who has AIDS?
touching someone who has died from AIDS?
mosquito, flea or bedbug bites?

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

M414. Is it possible for a healthy looking person to be infected with the AIDS virus?

YES 1
NO 2
DOES NOT KNOW 8

M415. 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

M416. 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 M418)
DOES NOT KNOW 8 (GO TO M418)

M417. How can people protect themselves from getting AIDS?
DO NOT READ CODES TO RESPONDENT.
Any other ways?
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

M418. Do you know anyone who has AIDS or anyone who has died from AIDS?

YES 1
NO 2

M419. Do you think that you yourself can catch AIDS?

YES 1
NO 2 (GO TO M421)
DOES NOT KNOW 8 (GO TO M421)

M420. How do you think you might catch AIDS?

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

M421. In the last 12 months, have you noticed any discharge from your penis?

YES 1
NO 2
NOT SURE/DOES NOT KNOW 8

M422. PRESENCE OF OTHERS AT THIS POINT.

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


SECTION 5. FERTILITY PREFERENCES

M501. How many sons do you have who are your own?
IF NONE, WRITE ???00???.

NUMBER OF SONS _____

M502. How many daughters do you have who are your own?
IF NONE, WRITE ???00???.

NUMBER OF DAUGHTERS _____

M503. CHECK M310:

NEITHER STERILISED __ (GO TO M504)
HE OR SHE STERILISED __ (GO TO M507)

M504. CHECK M202:

CURRENTLY MARRIED OR LIVING TOGETHER __ (GO TO M505)
NOT MARRIED/NOT LIVING TOGETHER __ (GO TO M515)

M505. Now I have some questions about the future.
Would you like to have another (a) child or would you prefer not to have any (more) children?

HAVE A (ANOTHER) CHILD 1
NO MORE/NONE 2 (GO TO M509)
SAYS SHE CAN???T GET PREGNANT 3 (GO TO M509)
UNDECIDED, DOES NOT KNOW 8 (GO TO M509)

M506. How long would you like to wait before the birth of another (a) child?

MONTHS 1 ___ (GO TO M509)
YEARS 2 ___ (GO TO M509)
SOON/NOW 994 (GO TO M509)
SAYS WIFE CAN???T GET PREGNANT 995 (GO TO M509)
OTHER (SPECIFY) _____ 996 (GO TO M509)
DOES NOT KNOW 998 (GO TO M509)

M507. 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 M509)
NO 2

M508. Why not?

_______________ ___

M509. Do you think that your wife/partner approves or disapproves of couples using a method to avoid pregnancy?

APPROVES 1
DISAPPROVES 2
DOES NOT KNOW 8

M510. Have you ever talked to your wife/partner about household finances and economic matters such as the costs of children?

YES 1
NO 2

M511. Have you ever talked to your wife/partner about family planning?

YES 1
NO 2 (GO TO M513)

M512. How often have you talked to your wife/partner about family planning in the past year?

NEVER 1
ONCE OR TWICE 2
MORE OFTEN 3

M513. Have you and your wife/partner ever discussed the number of children you would like to have?

YES 1
NO 2

M514. Do you think your wife/partner wants the same number of children that you want, or does she want more or fewer than you want?

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

M515. How long should a couple wait before starting sexual intercourse after the birth of a baby?

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

M516. 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

M517. In general, do you approve or disapprove of couples using a method to avoid getting pregnant?

APPROVE 1
DISAPPROVE 2

M518. CHECK M501 AND M502:

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 M520)

M519. How many boys? How many girls?

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

M520. 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

M521. RECORD THE TIME

HOUR ___
MINUTES ____

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____________________________