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NATIONAL COUNCIL FOR POPULATION AND DEVELOPMENT
CENTRAL BUREAU OF STATISTICS
KENYA DEMOGRAPHIC AND HEALTH SURVEY 3
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 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 CODES:

01 KALENJIN
02 KAMBA
03 KIKUYU
04 KISII
05 LUHYA
06 LUO
07 MERU/EMBU
08 MIJIKENDA
09 KISWAHILI
10 ENGLISH
11 MASAI
12 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 town or city, or in the countryside?

NAIROBI/MOMBASA 1
OTHER CITY/TOWN 2
COUNTRYSIDE 3

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

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 ___
DON'T KNOW MONTH 98
YEAR 19__
DON'T KNOW YEAR 9998

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

AGE IN COMPLETED YEARS ___

107. Have you ever attended school?

YES 1
NO 2 (GO to 114)

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

PRIMARY 1
SECONDARY 2
HIGHER 3

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

STANDARD/FORM/YEAR __

110. CHECK 106:

AGE 24 OR BELOW __ (GO TO 111)
AGE 25 OR ABOVE __ (GO TO 113)

111. Are you currently attending school?

YES 1 (GO TO 113)
NO 2

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

GOT PREGNANT 01
GOT MARRIED 02
TO CARE FOR YOUNGER CHILDREN 03
FAMILY NEEDED HELP ON FARM OR IN BUSINESS 04
COULD NOT PAY SCHOOL FEES 05
NEEDED TO EARN MONEY 06
COMPLETED/HAD ENOUGH SCHOOLING 07
DID NOT PASS ENTRANCE EXAMS 08
DID NOT LIKE SCHOOL 09
SCHOOL NOT ACCESSIBLE/TOO FAR 10
OTHER (SPECIFY) ______________ 96
DON'T KNOW 98

113. CHECK 108:

PRIMARY __ (GO TO 114)
SECONDARY OR HIGHER __ (GO TO 115)

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

EASILY 1
WITH DIFFICULTY 2
NOT AT ALL 3 (GO TO 116)

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

YES 1
NO 2

116. Do you usually listen to a radio every day?

YES 1
NO 2

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

YES 1
NO 2

118. What is your religion?

CATHOLIC 1
PROTESTANT/OTHER CHRISTIAN 2
MUSLIM 3
NO RELIGION 4
OTHER (SPECIFY)________ 6

119. What is your ethnic group/tribe?

KALENJIN 01
KAMBA 02
KIKUYU 03
KISII 04
LUHYA 05
LUO 06
MASAI 07
MERU/EMBU 08
MIJIKENDA/SWAHILI 09
SOMALI 10
TAITA/TAVETA 11
OTHER (SPECIFY) _______ 96

120. CHECK Q.4 IN THE QUESTIONNAIRE

THE WOMAN INTERVIEWED IS NOT A USUAL RESIDENT __ (GO TO 121)
THE WOMAN INTERVIEWED IS A USUAL RESIDENT __ (GO TO 201)

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

NAIROBI/MOMBASA 1
OTHER CITY/TOWN 2
COUNTRYSIDE 3

122. In which District is that located?

DISTRICT (PRINT DISTRICT NAME) ______________ ___

123. Now I would like to ask about the household in which you usually live.
What is the main source of drinking water for members of your household?

PIPED WATER
PIPED INTO RESIDENCE/COMPOUND/PLOT 11 (GO TO 125)
PUBLIC TAP 12
WELL WATER
WELL ON RESIDENCE/PLOT 21 (GO TO 125)
PUBLIC WELL 22
SURFACE WATER
RIVER/STREAM 31
POND/LAKE 32
RAINWATER 41 (GO TO 125)
OTHER (SPECIFY)_______ 96

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

MINUTES ___
ON PREMISES 996

125. 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 (VIP) LATRINE 22
NO FACILITY/BUSH/FIELD 31
OTHER (SPECIFY) ____ 96

126. Does your household have:

Electricity?
A radio?
A television?
A telephone?
A refrigerator?

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

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

NATURAL FLOOR
MUD/DUNG/SAND 11
RUDIMENTARY FLOOR
WOOD PLANKS 21
FINISHED FLOOR
POLISHED WOOD/VINYL/TILES 31
CEMENT 34
OTHER (SPECIFY) ______ 96

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

GRASS/THATCH 11
CORRUGATED IRON (MABATI) 21
TILES 31
OTHER SPECIFY ___________ 96

128. Does any member of your household own:

A bicycle?
A motorcycle?
A car?

BICYCLE
YES 1
NO 2
MOTORCYCLE
YES 1
NO 2
CAR
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 signs of life but survived only 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 227)

211. 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 212. RECORD TWINS AND TRIPLETS ON SEPARATE LINES.

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

(NAME) ___________

213. Were any of these births twins?.

SING 1
MULT 2

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

BOY 1
GIRL 2

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

MONTH __________
YEAR __________

216. Is (NAME) still alive?

YES 1
NO 2 (GO TO 219)

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

AGE IN YEARS __

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

YES 1 (GO TO EITHER NEXT BIRTH OR GO TO 220)
NO 2 (GO TO EITHER NEXT BIRTH OR GO TO 220)

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

DAYS 1 ____
MONTHS 2 ____
YEARS 3 ____

220. FROM YEAR OF BIRTH OF (NAME) SUBTRACT YEAR OF PREVIOUS BIRTH.
IS THE DIFFERENCE 4 OR MORE?
(THIS QUESTION STARTS FROM THE SECOND BIRTH.)

YES 1
NO 2 (GO TO NEXT BIRTH)

221. Were there any other live births between (NAME OF PREVIOUS BIRTH) and (NAME) ?
(THIS QUESTION STARTS FROM THE SECOND BIRTH.)

YES 1
NO 2

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

YES 1 (GO TO 223)
NO 2 (GO TO 224)

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

YES 1
NO 2

224. 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 DEAD CHILD: AGE AT DEATH IS RECORDED. __
FOR AGE AT DEATH 12 MONTHS OR 1 YR: PROBE TO DETERMINE EXACT NUMBER OF MONTHS. __

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

226. FOR EACH BIRTH SINCE JANUARY 1993 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.

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

YES 1
NO 2 (GO TO 230)
UNSURE 8 (GO TO 230)

228. For how many months have you been pregnant?
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.

MONTHS _______

229. At the time you became pregnant, did you want to become pregnant then, did you want to wait until later, or did you not want to have any (more) children at all?

THEN 1
LATER 2
NOT WANT MORE CHILDREN 3

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

YES 1
NO 2 (GO TO 236)

231. When did the last such pregnancy end?

MONTH _______
YEAR _______

232. CHECK 231:

LAST PREGNANCY ENDED SINCE JAN. 1993 __ (GO TO 233)
LAST PREGNANCY ENDED BEFORE JAN. 1993 __ (GO TO 236)

233. 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.

MONTHS ______

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

YES 1
NO 2 (GO TO 236)

235. ASK THE DATE AND THE DURATION OF PREGNANCY FOR EACH EARLIER PREGNANCY BACK TO JANUARY 1993.
ENTER 'T' IN COLUMN 1 OF CALENDAR IN THE MONTH THAT EACH PREGNANCY TERMINATED AND 'P' FOR THE REMAINING NUMBER OF COMPLETED MONTHS.

236. When did your last menstrual period start?
(DATE, IF GIVEN) ____________

DAYS AGO 1 __
WEEKS AGO 2 ___
MONTHS AGO 3 ___
YEARS AGO 4 ___
IN MENOPAUSE 994
BEFORE LAST PREGNANCY 995
NEVER MENSTRUATED 996

237. 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?

YES 1
NO 2 (GO TO 301)
DON'T KNOW 8 (GO TO 301)

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

DURING HER PERIOD 01
RIGHT AFTER HER PERIOD HAS ENDED 02
IN THE MIDDLE OF THE CYCLE 03
JUST BEFORE HER PERIOD BEGINS 04
OTHER (SPECIFY) _____ 96
DON'T KNOW 98

SECTION 3. 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 301 FOR EACH METHOD MENTIONED SPONTANEOUSLY.
THEN PROCEED DOWN COLUMN 302, 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 301 OR 302, ASK 303.

301. Which ways or methods have you heard of? (SPONTANEOUS)
302. Have you ever heard of (METHOD)? (PROBED)

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 NORPLANT Women can have several small rods placed in their upper arm by a doctor or nurse which can prevent pregnancy for several years.
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 05 DIAPHRAGM, FOAM, JELLY Women can place a sponge, suppository, diaphragm, jelly, or cream inside themselves before intercourse.
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 06 CONDOM Men can use a rubber sheath on their penis during sexual intercourse.
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 07 FEMALE STERILISATION Women can have an operation to avoid having any more children.
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 08 MALE STERILISATION Men can have an operation to avoid having any more children.
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 09 NATURAL METHODS Every month that a woman is sexually active she can avoid having sexual intercourse on the days of the month she is most likely to get pregnant.
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 10 WITHDRAWAL Men can be careful and pull out before the fluids come out.
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 11 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1(SPECIFY) ____
NO 2

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 NORPLANT Women can have several small rods placed in their upper arm by a doctor or nurse which can prevent pregnancy for several years.
YES 1
NO 2
METHOD 05 DIAPHRAGM, FOAM, JELLY Women can place a sponge, suppository, diaphragm, jelly, or cream inside themselves before intercourse.
YES 1
NO 2
METHOD 06 CONDOM Men can use a rubber sheath on their penis during sexual intercourse.
YES 1
NO 2
METHOD 07 FEMALE STERILISATION Women can have an operation to avoid having any more children: Have you ever had an operation to avoid having children?
YES 1
NO 2
METHOD 08 MALE STERILISATION Men can have an operation to avoid having any more children: Have you ever had a partner who had an operation to avoid having children?
YES 1
NO 2
METHOD 09 NATURAL METHODS Every month that a woman is sexually active she can avoid having sexual intercourse on the days of the month she is most likely to get pregnant.
YES 1
NO 2
METHOD 10 WITHDRAWAL Men can be careful and pull out before the fluids come out.
YES 1
NO 2
METHOD 11 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1 (SPECIFY)_
NO 2

304. CHECK 303:

NOT A SINGLE 'YES' (NEVER USED) __ (GO TO 305)
AT LEAST ONE 'YES' (EVER USED) __ (GO TO 308)

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

YES 1 (GO TO 307)
NO 2

306. ENTER '0' IN COLUMN 1 OF CALENDAR IN EACH BLANK MONTH (GO TO 331)

307. What have you used or done?
CORRECT 303 AND 304 (AND 302 IF NECESSARY).

308. 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?

PILL 01
IUD 02
INJECTIONS 03
NORPLANT 04
DIAPHRAGM/FOAM/JELLY 05
CONDOM 06
FEMALE STERILIZATION 07
MALE STERILIZATION 08
NATURAL METHODS 09
WITHDRAWAL 10
OTHER (SPECIFY) _________ 96

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

NUMBER OF CHILDREN _______

311. CHECK 303:

WOMAN NOT STERILIZED __ (GO TO 312)
WOMAN STERILIZED __ (GO TO 314A)

312. CHECK 227:

NOT PREGNANT OR UNSURE __ (GO TO 313)
PREGNANT __ (GO TO 325)

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

YES 1
NO 2 (GO TO 325)

314. Which method are you using?

314A. CIRCLE '07' FOR FEMALE STERILIZATION.

PILL 01
IUD 02 (GO TO 324)
INJECTIONS 03 (GO TO 324)
NORPLANT 04 (GO TO 324)
DIAPHRAGM/FOAM/JELLY 05 (GO TO 324)
CONDOM 06 (GO TO 324)
FEMALE STERILIZATION 07 (GO TO 318)
MALE STERILIZATION 08 (GO TO 318)
NATURAL METHODS 09 (GO TO 323)
WITHDRAWAL 10 (GO TO 324)
OTHER (SPECIFY) _________ 96 (GO TO 324)

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

COST ____ (GO TO 324)
FREE 996
DON'T KNOW 998

316. Would you be willing to pay for your pills?

YES 1
NO 2 (GO TO 324)

317. How much would you be willing to pay for a package (cycle) of your pills?
Would you pay as much as 75 shillings?
IF NO: would you pay as much as 50 shillings?
IF NO: would you pay as much as 25 shillings?
IF NO: would you pay as much as 10 shillings?
IF NO: ENTER LESS THAN 10 SHILLINGS

75 SHILLINGS 1 (GO TO 324)
50 SHILLINGS 2 (GO TO 324)
25 SHILLINGS 3 (GO TO 324)
10 SHILLINGS 4 (GO TO 324)
LESS THAN 10 SHILLINGS 5 (GO TO 324)
DON'T KNOW 8 (GO TO 324)

318. Where did the sterilization take place?
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.

(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
PRIVATE DOCTOR 26
MOBILE CLINIC 31
OTHER (SPECIFY) _____ 96
DOES NOT KNOW 98

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

YES 1
NO 2 (GO TO 321)

320. Why do you regret the operation?

RESPONDENT WANTS ANOTHER CHILD 01
PARTNER WANTS ANOTHER CHILD 02
SIDE EFFECTS 03
CHILD DIED 04
OTHER (SPECIFY) __________ 96

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

MONTH ________
YEAR _______

322. CHECK 321:

STERILISED BEFORE JANUARY 1993 __
ENTER CODE FOR STERILISATION IN MONTH OF INTERVIEW IN COLUMN 1 OF THE CALENDAR AND EACH MONTH BACK TO JANUARY 1993.
THEN SKIP TO 329A.

STERILISED AFTER JANUARY 1993 __
ENTER CODE FOR STERILISATION IN MONTH OF INTERVIEW IN COLUMN 1 OF THE CALENDAR AND IN EACH MONTH BACK TO THE DATE OF THE OPERATION.
THEN SKIP TO 325.

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

BASED ON CALENDAR 01
BASED ON BODY TEMPERATURE 02
BASED ON CERVICAL MUCUS (BILLINGS METHOD) 03
BASED ON BODY TEMPERATURE AND CERVICAL MUCUS 04
NO SPECIFIC SYSTEM 05
OTHER (SPECIFY) ___________ 96

324. ENTER METHOD CODE FROM 314 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:

When did you start using continuously?
How long have you been using this method continuously?

325. 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 MOST RECENT USE, BACK TO JANUARY 1993.
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 SUCH MONTH IN COLUMN 1.

327. CHECK 314:
CIRCLE METHOD CODE:

NOT ASKED 00 (GO TO 331)
PILL 01
IUD 02
INJECTIONS 03
IMPLANTS 04
DIAPHRAGM/FOAM/JELLY 05
CONDOM 06
FEMALE STERILISATION 07 (GO TO 329A)
MALE STERILISATION 08 (GO TO 329A)
NATURAL METHODS 09 (GO TO 332)
WITHDRAWAL 10 (GO TO 332)
OTHER METHOD 96 (GO TO 332)

328. 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.

(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 41
SHOP 51
FRIENDS/RELATIVES 61
OTHER (SPECIFY) _____ 96

329. Do you know another place where you could have obtained (METHOD) the last time?
329A. At the time of the sterilization operation, did you know another place where you could have received the operation?

YES 1
NO 2 (GO TO 334)

330. 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.328 OR Q.318) instead of the other place you know about?

RECORD RESPONSE AND CIRCLE CODE. _____________
ACCESS-RELATED REASONS
CLOSER TO HOME 11 (GO TO 334)
CLOSER TO MARKET/WORK 12 (GO TO 334)
AVAILABILITY OF TRANSPORT 13 (GO TO 334)

SERVICE-RELATED REASONS
STAFF MORE COMPETENT/FRIENDLY 21 (GO TO 334)
CLEANER FACILITY 22 (GO TO 334)
OFFERS MORE PRIVACY 23 (GO TO 334)
SHORTER WAITING TIME 24 (GO TO 334)
LONGER HRS. OF OPERATION 25 (GO TO 334)
USE OTHER SERVICES AT THE FACILITY 26 (GO TO 334)
LOWER COST/CHEAPER 31 (GO TO 334)
WANTED ANONYMITY 41 (GO TO 334)
OTHER (SPECIFY) __________ 96 (GO TO 334)
DON'T KNOW 98 (GO TO 334)

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

NOT MARRIED 11
NOT INTENDING TO MARRY 12
FERTILITY-RELATED REASONS
NOT HAVING SEX 21
INFREQUENT SEX 22
MENOPAUSAL/HYSTERECTOMY 23
SUBFECUND/INFECUND 24
POSTPARTUM/BREASTFEEDING 25
WANTS (MORE) CHILDREN 26
PREGNANT 27
OPPOSITION TO USE
RESPONDENT OPPOSED 31
HUSBAND OPPOSED 32
OTHERS OPPOSED 33
RELIGIOUS PROHIBITION 34
LACK OF KNOWLEDGE
KNOWS NO METHOD 41
KNOWS NO SOURCE 42
METHOD-RELATED REASONS
HEALTH CONCERNS 51
FEAR OF SIDE EFFECTS 52
LACK OF ACCESS/TOO FAR 53
COST TOO MUCH 54
INCONVENIENT TO USE 55
INTERFERES WITH BODY'S NORMAL PROCESSES 56
OTHER (SPECIFY) ___________ 96
DON'T KNOW 98

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

YES 1
NO 2 (GO TO 334)

333. 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.

(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 41
SHOP 51
FRIENDS/RELATIVES 61
OTHER (SPECIFY) _____ 96

334. In some communities there is a person 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 335)
DON'T KNOW 8 (GO TO 335)

334a. How many times has this person visited your home in the past 6 months?

NUMBER OF VISITS ____

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

YES 1
NO 2 (GO TO 337)

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

YES 1
NO 2

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

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

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

INCREASED 1 (GO TO 401)
DECREASED 2
NOT AFFECTED 3
DON'T KNOW 8

339. CHECK 210:

ONE OR MORE BIRTHS __ (GO TO 340)
NO BIRTHS __ (GO TO 401)

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

YES 1
NO 2 (GO TO 401)

341. CHECK 227 AND 311:

NOT PREGNANT OR UNSURE AND NOT STERILIZED __ (GO TO 342)
EITHER PREGNANT OR STERILIZED __ (GO TO 401)

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

YES 1
NO 2

SECTION 4A. PREGNANCY AND BREASTFEEDING

401. CHECK 225:

ONE OR MORE BIRTHS SINCE JAN.1995 __ (GO TO 402)
NO BIRTHS SINCE JAN.1995 __ (GO TO 465)

402. ENTER THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH SINCE JANUARY 1995 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 three years. (We will talk about one child at a time.)

403. LINE NUMBER FROM Q212

LINE NUMBER _____

404. FROM Q212 AND Q216

NAME _______
LIVING __ DEAD __

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

THEN 1 (GO TO 407)
LATER 2
NO MORE 3 (GO TO 407)

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

MONTHS 1 __
YEARS 2 __
DON'T KNOW 998

407. 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.

HEALTH PROFESSIONAL
DOCTOR A
NURSE/MIDWIFE B
BIRTH ATTENDANT
TRAINED C
UNTRAINED D
OTHER (SPECIFY) ________ X
NO ONE Y (GO TO 410)

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

MONTHS _____
DON'T KNOW 98

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

NO. OF TIMES _____
DON'T KNOW 98

410. 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 412)
DON'T KNOW 8 (GO TO 412)

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

TIMES __
DON'T KNOW 8

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

HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVT. HOSPITAL 21
GOVT. HEALTH CENTER 22
GOVT. MATERNITY CLINIC 23
OTHER PUBLIC (SPECIFY) _____ 26
PRIVATE MEDICAL SECTOR
MISSION HOSP/CLINIC 31
OTHER PVT. HOSP/CLNC 32
OTHER (SPECIFY) ________ 96

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

LAST BIRTH
HEALTH PROFESSIONAL
DOCTOR A
NURSE/MIDWIFE B
BIRTH ATTENDENT
TRAINED D
UNTRAINED E
RELATIVE/FRIEND F
OTHER (SPECIFY) _____________ X
NO ONE Y

413A. Did you pay for delivery services?
IF YES: How much in total did you pay for all services connected to the delivery of (NAME)?

SHILLINGS ______
NO COST 99994

414. Around the time of the birth of (NAME), did you have any of the following problems:
Long labor, that is, did your regular contractions last more than 12 hours?
Excessive bleeding that was so much that you feared it was life threatening?
A high fever with bad smelling vaginal discharge?
Convulsions not caused by fever?

LABOR MORE THAN 12 HOURS
YES 1
NO 2
EXCESSIVE BLEEDING
YES 1
NO 2
FEVER/BAD SMELLING VAG. DISCHARGE
YES 1
NO 2
CONVULSIONS
YES 1
NO 2

415. Was (NAME) delivered by caesarian section?

YES 1
NO 2

416. When (NAME) was born, was he/she:

very large,
larger than average,
average,
smaller than average,
or very small?

VERY LARGE 1
LARGER THAN AVERAGE 2
AVERAGE 3
SMALLER THAN AVERAGE 4
VERY SMALL 5
DON'T KNOW 8

417. Was (NAME) weighed at birth?

YES 1
NO 2 (GO TO 419)

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

GRAMS FROM CARD 1 ______
GRAMS FROM RECALL 2 ________
DON'T KNOW 99998

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

YES 1 (GO TO 421)
NO 2 (GO TO 422)

420. 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 424)

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

MONTHS ______
DON'T KNOW 98

422. CHECK 227:
RESPONDENT PREGNANT?

NOT PREGNANT __ (GO TO 423)
PREGNANT OR UNSURE __ (GO TO 424)

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

YES 1
NO 2 (GO TO 425)

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

MONTHS ___________
DON'T KNOW 98

425. Did you ever breastfeed (NAME)?

YES 1
NO 2 (GO TO 431)

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.

IMMEDIATELY 000
HOURS 1 ______
DAYS 2 ______

427. CHECK 404:
CHILD ALIVE?

ALIVE __ (GO TO 428)
DEAD __ (GO TO 429)

428. Are you still breastfeeding (NAME)?

YES 1 (GO TO 432)
NO 2

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

MONTHS _________
DON'T KNOW 98

430. Why did you stop breastfeeding (NAME)?

MOTHER ILL/WEAK 01
CHILD ILL/WEAK 02
CHILD DIED 03
NIPPLE/BREAST PROBLEM 04
NOT ENOUGH MILK 05
MOTHER WORKING 06
CHILD REFUSED 07
WEANING AGE/AGE TO STOP 08
BECAME PREGNANT 09
STARTED USING CONTRACEPTION 10
OTHER (SPECIFY) _______ 96

431. CHECK 404:
CHILD ALIVE?

ALIVE __ (GO TO 434)
DEAD __ (GO BACK TO 405 IN NEXT COLUMN OR, IF NO MORE BIRTHS, GO TO 440)

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

NUMBER OF NIGHTTIME FEEDINGS ______

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

NUMBER OF DAYLIGHT FEEDINGS _________

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

YES 1
NO 2
DON'T KNOW 8

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

Plain water?
Sugar water?
Juice?
Herbal tea?
Baby formula?
Tinned or powdered milk?
Fresh milk?
Any other liquids?
Any fruits or vegetables?
Any food made from wheat, maize, or rice such as porridge, bread or pasta?
Any food made from cassava or plaintain?
Eggs, fish, or poultry?
Meat?
Any other solid or semi-solid foods?

PLAIN WATER
YES 1
NO 2
DK 8
SUGAR WATER
YES 1
NO 2
DK 8
JUICE
YES 1
NO 2
DK 8
HERBAL TEA
YES 1
NO 2
DK 8
BABY FORMULA
YES 1
NO 2
DK 8
TINNED/POWDR'D MILK
YES 1
NO 2
DK 8
FRESH MILK
YES 1
NO 2
DK 8
OTHER LIQUIDS
YES 1
NO 2
DK 8
FRUITS/VEGETABLES
YES 1
NO 2
DK 8
FOOD MADE FROM GRAIN
YES 1
NO 2
DK 8
FOOD MADE FROM CASSAVA/PLAINTAIN
YES 1
NO 2
DK 8
EGGS/FISH/POULTRY
YES 1
NO 2
DK 8
MEAT
YES 1
NO 2
DK 8
OTHER SOLID/SEMI-SOLID FOODS
YES 1
NO 2
DK 8

436. CHECK 435:
FOOD OR LIQUID GIVEN YESTERDAY?

'YES' TO ONE OR MORE __ (GO TO 437)
'NO/DK' TO ALL __ (GO TO 439)

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

NUMBER OF TIMES ___
DON'T KNOW 8

439. GO BACK TO 405 IN NEXT COLUMN; OR, IF NO MORE BIRTHS, GO TO 440.

SECTION 4B. IMMUNIZATION AND HEALTH

440. ENTER LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH SINCE JANUARY 1995 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).

441. LINE NUMBER FROM Q212

LINE NUMBER ____

442. FROM Q212 AND Q216

NAME ______
ALIVE __ (GO TO 443)
DEAD __ (GO TO 442 IN NEXT COLUMN OR, IF NO MORE BIRTHS, GO TO 465)

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

YES, SEEN 1 (GO TO 445)
YES, NOT SEEN 2 (GO TO 447)
NO CARD 3

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

YES 1 (GO TO 447)
NO 2 (GO TO 447)

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

BCG
Polio 0 (at birth)
Polio 1
Polio 2
Polio 3
DPT 1
DPT 2
DPT 3
Measles

BCG
DAY __
MONTH __
YEAR __
P0
DAY __
MONTH __
YEAR __
P1
DAY __
MONTH __
YEAR __
P2
DAY __
MONTH __
YEAR __
P3
DAY __
MONTH __
YEAR __
D1
DAY __
MONTH __
YEAR __
D2
DAY __
MONTH __
YEAR __

D3
DAY __
MONTH __
YEAR __
MEA
DAY __
MONTH __
YEAR __

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

YES 1 (PROBE FOR VACCINATIONS AND WRITE '66' IN THE CORRESPONDING DAY COLUMN IN 445) (GO TO 449)
NO 2 (GO TO 449)
DON'T KNOW 8 (GO TO 449)

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

YES 1
NO 2 (GO TO 449)
DON'T KNOW 8 (GO TO 449)

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

448A. A BCG vaccination against tuberculosis, that is, an injection in the left arm that caused a scar?

YES 1
NO 2
DON'T KNOW 8

448B. Polio vaccine, that is, drops in the mouth?

YES 1
NO 2 (GO TO 448E)
DON'T KNOW 8 (GO TO 448E)

448C. How many times?

NUMBER OF TIMES __

448D. When was the first polio vaccine given, just after birth or later?

JUST AFTER BIRTH 1
LATER 2

448E. DPT vaccination, that is, an injection usually given at the same time as polio drops?

YES 1
NO 2 (GO TO 448G)
DON'T KNOW 8 (GO TO 448G)

448F. How many times?

NUMBER OF TIMES __

448G. An injection to prevent measles?

YES 1
NO 2
DON'T KNOW 8

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

YES 1
NO 2 (GO TO 450)
DON'T KNOW 8 (GO TO 450)

449a. Did you seek advice or treatment for the fever?

YES 1
NO 2 (GO TO 450)

449b. Where did you seek advice or treatment?
Anywhere else?
RECORD ALL MENTIONED.

PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
GOVT. DISPENSARY C
PRIVATE MEDICAL SECTOR
MISSION HOSP/CLINIC D
OTHER PVT. HOSP/CLINIC E
PHARMACY F
PRIVATE DOCTOR G
MOBILE CLINIC H
COMM. HEALTH WORKER I
OTHER SOURCE
SHOP J
HERBALIST/TRAD. PRACT. K
RELATIVE/FRIEND L
OTHER (SPECIFY) ______ X

449c. Were any medicines given to (NAME) to treat the fever?

YES 1
NO 2 (GO TO 450)

449d. Which medicines were given to (NAME)?
Any other?
RECORD ALL MENTIONED.

ANTIPYRETICS (ASPRO, CALPOL, BRUFEN, ETC.) A
CHLOROQUINE (MALAROQUINE, ETC.) B
SULFA COMBINATIONS (FANCIDAR, METAKELFIN, ETC.) C
HALOFANTRINE (HANFAN) D
AMODIAQUINE (CAMOQUINE) E
COTRIMOXAZOLE (BACTRIM, SEPTRIN, ETC.) F
ARTIMISININ (ARTENAM, ARTOMOTHOR, ETC.) G
HERBAL/TRADITIONAL REMEDIES H
OTHER ANTIBIOTICS (SPECIFY) ________ I
OTHER (SPECIFY) ________ X

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

YES 1
NO 2 (GO TO 454)
DON'T KNOW 8 (GO TO 454)

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

YES 1
NO 2
DON'T KNOW 8

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

YES 1
NO 2 (GO TO 454)

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

PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
GOVT. DISPENSARY C
PRIVATE MEDICAL SECTOR
MISSION HOSP/CLINIC D
OTHER PVT. HOSP/CLINIC E
PHARMACY F
PRIVATE DOCTOR G
MOBILE CLINIC H
COMM. HEALTH WORKER I
OTHER SOURCE
SHOP J
HERBALIST/TRAD. PRACT. K
RELATIVE/FRIEND L
OTHER (SPECIFY) ______ X

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

YES 1
NO 2 (GO TO 463A)
DON'T KNOW 8 (GO TO 463A)

455. Was there any blood in the stools?

YES 1
NO 2
DON'T KNOW 8

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

NUMBER OF BOWEL MOVEMENTS __
DON'T KNOW 98

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

SAME 1
MORE 2
LESS 3
DON'T KNOW 8

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

SAME 1
MORE 2
LESS 3
DON'T KNOW 8

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

A fluid made from a special packet called ORALITE or ORS?
Thin watery porridge made from maize, rice or wheat? (Ugi)
Soup?
Home-made sugar-salt-water solution?
Milk or infant formula?
Yoghurt-based drink?
Water?
Any other liquids?

FLUID FROM ORS PKT
YES 1
NO 2
DK 8
THIN WATERY GRUEL
YES 1
NO 2
DK 8
SOUP
YES 1
NO 2
DK 8
SUG.-SALT-WAT. SOL
YES 1
NO 2
DK 8
MILK/INFANT FORMULA
YES 1
NO 2
DK 8
YOGHURT-BASED DR
YES 1
NO 2
DK 8
WATER
YES 1
NO 2
DK 8
OTHER LIQUID
YES 1
NO 2
DK 8

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

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

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

PILL OR SYRUP A
INJECTION B
(I.V.) INTRAVENOUS C
HOME REMEDIES/HERBAL MEDICINES D
OTHER (SPECIFY) ____ X

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

YES 1
NO 2 (GO TO 463A)

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

PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
GOVT. DISPENSARY C
PRIVATE MEDICAL SECTOR
MISSION HOSP/CLINIC D
OTHER PVT. HOSP/CLINIC E
PHARMACY F
PRIVATE DOCTOR G
MOBILE CLINIC H
COMM. HEALTH WORKER I
OTHER SOURCE
SHOP J
HERBALIST/TRAD. PRACT. K
RELATIVE/FRIEND L
OTHER (SPECIFY) ______ X

463A. CHECK 449:
FEVER IN LAST TWO WEEKS?

'YES' FEVER __ (GO TO 463B)
'NO' FEVER __ (GO TO 464)

463B. You said that (NAME) had a fever in the last two weeks. Could you please tell me whether, at the time of that fever, (NAME) experienced any other symptoms or diseases?
IF YES, Which symptoms or diseases did (NAME) experience?
Any others?
RECORD ALL MENTIONED.

COUGH A
DIARRHEA B
'MALARIA' C
CONVULSIONS/FITS D
LOSS OF WEIGHT E
RASH F
ANEMIA G
VOMITING H
DIFFICULT BREATHING I
UNCONCIOUS J
UNABLE TO DRINK K
STIFF NECK L
OTHER (SPECIFY) ___________ X
NO OTHER SYMPTOMS Y

464. GO BACK TO 442 IN NEXT COLUMN; OR, IF NO MORE BIRTHS, GO TO 465.

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

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

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

LESS TO EAT 1
ABOUT SAME AMOUNT TO EAT 2
MORE TO EAT 3
DON'T KNOW 8

467. 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.

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

468. 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.

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

468a. When a child is sick with a fever, what signs of illness would tell you that he or she should be taken to a health facility or health worker?
RECORD ALL MENTIONED.

FEVER INCREASING/VERY HIGH A
FEVER RECURRENT B
DIFFICULT BREATHING C
NOISY BREATHING D
CONVULSIONS E
SHIVERING F
UNABLE TO DRINK G
NOT EATING/NOT DRINKING WELL H
NOT GETTING BETTER I
OTHER (SPECIFY) ____________ X
DON'T KNOW Z

469. CHECK 459, ALL COLUMNS:

NO CHILD RECEIVED ORS __ (GO TO 470)
ANY CHILD RECEIVED ORS __ (GO TO 501)

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

YES 1
NO 2

SECTION 5. MARRIAGE

501. PRESENCE OF OTHERS AT THIS POINT.

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

502. Are you currently married or living with a man?

YES, CURRENTLY MARRIED 1 (GO TO 507)
YES, LIVING WITH A MAN 2 (GO TO 507)
NO, NOT IN UNION 3

503. Do you currently have a regular sexual partner, an occasional sexual partner, or no sexual partner at all?

REGULAR SEXUAL PARTNER 1
OCCASIONAL SEXUAL PARTNER 2
NO SEXUAL PARTNER 3

504. Have you ever been married or lived with a man?

YES, FORMERLY MARRIED 1 (GO TO 506)
YES, LIVED WITH A MAN 2 (GO TO 511 )
NO 3

505. ENTER '0' IN COLUMN 3 OF CALENDAR IN THE MONTH OF INTERVIEW, AND IN EACH MONTH BACK TO JANUARY 1993. (GO TO 515F)

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

WIDOWED 1 (GO TO 511)
DIVORCED 2 (GO TO 511)
SEPARATED 3 (GO TO 511)

507. Is your husband/partner living with you now or is he staying elsewhere?

LIVES WITH HER 1
STAYING ELSEWHERE 2

507A. WRITE THE LINE NUMBER FROM THE HOUSEHOLD QUESTIONNAIRE FOR HER HUSBAND. IF HE IS NOT LISTED IN THE HOUSEHOLD, WRITE '00'. ___

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

YES 1
NO 2 (GO TO 511)

509. How many other wives does he have?

NUMBER ___
DON'T KNOW 98

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

ONCE 1
MORE THAN ONCE 2

512. CHECK 511:

MARRIED/LIVED WITH A MAN ONLY ONCE __
(In what month and year did you start living with your husband/partner?)

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

MONTH ___
DON'T KNOW MONTH 98
YEAR ___ (GO TO 514)
DON'T KNOW YEAR 9998

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

AGE ____

514. DETERMINE MONTHS MARRIED OR IN UNION SINCE JANUARY 1993. ENTER 'X' IN COLUMN 3 OF CALENDAR FOR EACH MONTH MARRIED OR IN UNION, AND ENTER '0' FOR EACH MONTH NOT MARRIED/NOT IN UNION, SINCE JANUARY 1993.

FOR WOMEN WITH MORE THAN ONE UNION: PROBE FOR DATE WHEN CURRENT UNION STARTED AND, IF APPROPRIATE, FOR STARTING AND TERMINATION DATES OF ANY PREVIOUS UNIONS.

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

514A. CHECK 502:

CURRENTLY MARRIED OR LIVING WITH A MAN __ (GO TO 515)
NOT IN UNION __ (GO TO 515F)

515. Now I need to ask you some questions about sexual activity in order to gain a better understanding of some family planning issues.
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

515A. CHECK 301 AND 302:

KNOWS CONDOM __
The last time you had sex with (your husband/the man you are living with), was a condom used?

DOES NOT KNOW CONDOM __
Some men use a condom, which means that they use a rubber sheath on their penis during sexual intercourse. The last time you had sex with (your husband/the man you are living with), was a condom used?

YES 1
NO 2
DOES NOT KNOW 8

515B. Have you had sex with anyone other than (your husband/the man you are living with) in the last 12 months?

YES 1
NO 2 (GO TO 517)

515C. When was the last time you had sexual intercourse with someone other than (your husband/the man you are living with)?

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

515D. Was a condom used that time?

YES 1
NO 2
DOES NOT KNOW 8

515E. In the last 12 months, how many different persons other than (your husband/the man you are living with) have you had sex with?

NUMBER OF PERSONS ___ (GO TO 515J)
DOES NOT KNOW 98 (GO TO 515J)

515F. Now I need to ask you some questions about sexual activity in order to gain a better understanding of some family planning issues.
When was the last time you had sexual intercourse (if ever)?

NEVER 000 (GO TO 608)
DAYS AGO 1 __
WEEKS AGO 2 __
MONTHS AGO 3 __
YEARS AGO 4 __
BEFORE LAST BIRTH 996

515G. CHECK 301 AND 302:

KNOWS CONDOM __
The last time you had sex, was a condom used?

DOES NOT KNOW CONDOM __
Some men use a condom, which means that they use a rubber sheath on their penis during sexual intercourse. The last time you had sex, was a condom used?

YES 1
NO 2
DOES NOT KNOW 8

515H. CHECK 515F:

LESS THAN 12 MONTHS SINCE LAST SEX __ (GO TO 515I)
12 MONTHS OR LONGER SINCE LAST SEX __ (GO TO 515J)

515I. In the last 12 months, how many different persons have you had sex with?

NUMBER OF PERSONS ___
DOES NOT KNOW 98

515J. CHECK 501:

CURRENTLY MARRIED OR LIVING WITH A MAN __
The last time you had sex, was it with your (husband/man you live with), a regular partner, a casual acquaintance, or someone else?

NOT CURRENTLY MARRIED AND NOT LIVING WITH A MAN __
The last time you had sex, was it with a regular partner, a casual acquaintance, or someone else?

HUSBAND/MAN LIVES WITH 1
REGULAR PARTNER 2
ACQUAINTANCE 3
SOMEONE ELSE 4

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

YES 1
NO 2 (GO TO 519)

518. 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.

(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 41
SHOP 51
FRIENDS/RELATIVES 61
OTHER (SPECIFY) _____ 96

519. Have you ever heard of a condom called 'Trust'?

YES 1
NO 2

519a. Would you be willing to pay for condoms?

YES 1
NO 2 (GO TO 520)

519b. How much would you be willing to pay for a package of 3 condoms?
Would you pay as much as 50 shillings?
IF NO: would you pay as much as 25 shillings?
IF NO: would you pay as much as 10 shillings?
IF NO: would you pay as much as 5 shillings?
IF NO: ENTER LESS THAN 5 SHILLINGS

50 SHILLINGS 1
25 SHILLINGS 2
10 SHILLINGS 3
5 SHILLINGS 4
LESS THAN 5 SHILLINGS 5
DON'T KNOW 8

520. How old were you when you first had sexual intercourse?

AGE ____
FIRST TIME WHEN MARRIED 96

SECTION 6. FERTILITY PREFERENCES

601. CHECK 314:

NEITHER STERILIZED __ (GO TO 602)
HE OR SHE STERILIZED __ (GO TO 612)

602. CHECK 227:

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?

HAVE (A/ANOTHER) CHILD 1
NO MORE/NONE 2 (GO TO 606)
SAYS SHE CAN'T GET PREGNANT 3 (GO TO 606)
UNDECIDED/DON'T KNOW 8 (GO TO 604)

603. CHECK 227:

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

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

MONTHS 1 ___
YEARS 2 ___
SOON/NOW 993 (GO TO 606)
SAYS SHE CAN'T GET PREGNANT 994 (GO TO 606)
AFTER MARRIAGE 995
OTHER (SPECIFY) _____ 996
DON'T KNOW 998

604. CHECK 227:

NOT PREGNANT OR UNSURE __ (GO TO 605)
PREGNANT __ (GO TO 607)

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

HAPPY 1
UNHAPPY 2
WOULD NOT MATTER 3

606. CHECK 313:
USING A METHOD?

NOT ASKED __ (GO TO 607)
NOT CURRENTLY USING __ (GO TO 607)
CURRENTLY USING __ (GO TO 612)

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

YES 1 (GO TO 609)
NO 2
DON'T KNOW 8

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

YES 1
NO 2 (GO TO 610)
DON'T KNOW 8 (GO TO 610)

609. Which method would you prefer to use?

PILL 01 (GO TO 612)
IUD 02 (GO TO 612)
INJECTIONS 03 (GO TO 612)
IMPLANTS 04 (GO TO 612)
DIAPHRAGM/FOAM/JELLY 05 (GO TO 612)
CONDOM 06 (GO TO 612)
FEMALE STERILIZATION 07 (GO TO 612)
MALE STERILIZATION 08 (GO TO 612)
PERIODIC ABSTINENCE 09 (GO TO 612)
WITHDRAWAL 10 (GO TO 612)
OTHER (SPECIFY) ____________ 96 (GO TO 612)
UNSURE 98 (GO TO 612)

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

NOT MARRIED 11
NOT INTENDING TO MARRY 12
FERTILITY-RELATED REASONS
INFREQUENT SEX 22 (GO TO 612)
MENOPAUSAL/HYSTERECTOMY 23 (GO TO 612)
SUBFECUND/INFECUND 24 (GO TO 612)
WANTS (MORE) CHILDREN 26 (GO TO 612)
OPPOSITION TO USE
RESPONDENT OPPOSED 31 (GO TO 612)
HUSBAND OPPOSED 32 (GO TO 612)
OTHERS OPPOSED 33 (GO TO 612)
RELIGIOUS PROHIBITION 34 (GO TO 612)
LACK OF KNOWLEDGE
KNOWS NO METHOD 41 (GO TO 612)
KNOWS NO SOURCE 42 (GO TO 612)
METHOD-RELATED REASONS
HEALTH CONCERNS 51 (GO TO 612)
FEAR OF SIDE EFFECTS 52 (GO TO 612)
LACK OF ACCESS/TOO FAR 53 (GO TO 612)
COST TOO MUCH 54 (GO TO 612)
INCONVENIENT TO USE 55 (GO TO 612)
INTERFERES WITH BODY'S NORMAL PROCESSES 56 (GO TO 612)
OTHER (SPECIFY) ___________ 96 (GO TO 612)
DON'T KNOW 98 (GO TO 612)

611. Would you ever use a method if you were married?

YES 1
NO 2
DON'T KNOW 8

612. CHECK 216:

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

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

PROBE FOR A NUMERIC RESPONSE.

NUMBER ____
OTHER (SPECIFY) ____ 96 (GO TO 614)

613. 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?

NUMBER
BOYS ______
GIRLS ______
EITHER ______
OTHER (SPECIFY) ______ 999996

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

APPROVE 1
DISAPPROVE 2
NO OPINION 3

615. Is it acceptable or not acceptable to you for information on family planning to be provided: On the radio?
On the television?

RADIO
ACCEPTABLE 1
NOT ACCEPTABLE 2
DK 8
TELEVISION
ACCEPTABLE 1
NOT ACCEPTABLE 2
DK 8

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

On the radio?
On the television?
In a newspaper or magazine?
From a billboard?
At a live drama?
At a community event?

RADIO
YES 1
NO 2
TELEVISION
YES 1
NO 2
NEWSPAPER OR MAGAZINE
YES 1
NO 2
BILLBOARD
YES 1
NO 2
LIVE DRAMA
YES 1
NO 2
COMMUNITY EVENT
YES 1
NO 2

616a. CHECK 616: FAMILY PLANNING ON RADIO?

YES __ (GO TO 616b)
NO __ (GO TO 616c)

616b. Which programs have you heard?
Any others?
DO NOT READ CODES TO RESPONDENT.
CIRCLE ALL MENTIONED.

UGUA POLE A
MTU NI AFYA B
DAKTARI WA RADIO C
KINGA YASHINDA TIBA D
TEMBEA NA MAJIRA E
USIPOZIBA UFA UTAJENGA UKUTA F
HEALTH WATCH G
HEALTH IS LIFE H
MAN AND MEDICINE I
AQUAFRESH HEALTH J
OTHER (SPECIFY) ____________ X
DOES NOT KNOW/CANNOT REMEMBER Z

616c. Do you think that information about family planning should be available for persons under 18 years of age?

YES 1
NO 2
DOES NOT KNOW 8

616d. Do you think that family planning services should be available for persons under 18 years of age?

YES 1
NO 2
DOES NOT KNOW 8

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

YES 1
NO 2 (GO TO 620)

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

HUSBAND/PARTNER A
MOTHER B
FATHER C
SISTER(S) D
BROTHER(S) E
DAUGHTER F
MOTHER-IN-LAW G
FRIENDS/NEIGHBORS H
OTHER (SPECIFY) ___________ X

620. CHECK 502:

YES, CURRENTLY MARRIED __ (GO TO 621)
YES, LIVING WITH A MAN __ (GO TO 621)
NO, NOT IN UNION __ (GO TO 701)

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

APPROVES 1
DISAPPROVES 2
DON'T KNOW 8

622. 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

623. 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
DON'T KNOW 8

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

701. CHECK 502 AND 504:

CURRENTLY MARRIED/LIVING WITH A MAN __ (GO TO 702)
FORMERLY MARRIED/LIVED WITH A MAN __ (GO TO 703)
NEVER MARRIED AND NEVER IN UNION __ (GO TO 709)

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

AGE _______

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

YES 1
NO 2 (GO TO 706)

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

PRIMARY 1
SECONDARY 2
HIGHER 3
DON'T KNOW 8 (GO TO 706)

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

STANDARD/FORM/YEARS ____
DON'T KNOW 98


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

_______________________ ___

707. CHECK 706:

WORKS (WORKED) IN AGRICULTURE __ (GO TO 708)
DOES (DID) NOT WORK IN AGRICULTURE __ (GO TO 709)

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?

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

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

YES 1 (GO TO 712)
NO 2

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

YES 1 (GO TO 712)
NO 2

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

YES 1
NO 2 (GO TO 726)

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

_____________ __

713. CHECK 712:

WORKS IN AGRICULTURE __ (GO TO 714)
DOES NOT WORK IN AGRICULTURE __ (GO TO 715)

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

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

715. Do you do this 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

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

THROUGHOUT THE YEAR 1 (GO TO 718)
SEASONALLY/PART OF THE YEAR 2
ONCE IN A WHILE 3 (GO TO 719)

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

NUMBER OF MONTHS ____

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

NUMBER OF DAYS ____ (GO TO 720)

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

NUMBER OF DAYS ____

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

YES 1
NO 2 (GO TO 723)


721. How much do you earn for this work per month?
Is it less than 1,000 shillings?
1,000-5,000 shillings?
5,000-10,000 shillings?
or more than 10,000 shillings?

LESS THAN 1,000 1
1,000-5,000 2
5,000-10,000 3
MORE THAN 10,000 4


722. CHECK 502:

YES, CURRENTLY MARRIED/YES, LIVING WITH A MAN:
Who mainly decides how the money you earn will be used: you, your husband/partner, you and your husband/partner jointly, or someone else?

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

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

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

HOME 1
AWAY 2

724. CHECK 217 AND 218: IS A CHILD LIVING AT HOME WHO IS AGE 5 OR LESS?

YES __ (GO TO 725)
NO __ (GO TO 726)

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

RESPONDENT 01
HUSBAND/PARTNER 02
OLDER FEMALE CHILD 03
OLDER MALE CHILD 04
OTHER RELATIVES 05
NEIGHBORS 06
FRIENDS 07
SERVANTS/HIRED HELP 08
CHILD IS IN SCHOOL 09
INSTITUTIONAL CHILDCARE 10
HAS NOT WORKED SINCE LAST BIRTH 95
OTHER (SPECIFY) ______________ 96

726. Have you lived in only one community or in more than one community since January 1993?

ONE COMMUNITY 1
MORE THAN ONE COMMUNITY 2 (GO TO 728)

727. IN COLUMN 4 OF CALENDAR, ENTER THE APPROPRIATE CODE FOR CURRENT COMMUNITY, ('1' CITY, '2' TOWN, '3' COUNTRYSIDE).
BEGIN IN THE MONTH OF INTERVIEW AND CONTINUE WITH ALL PRECEDING MONTHS BACK TO JAN. 1993. THEN SKIP TO 801A.

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' CITY, '2' TOWN, '3' COUNTRYSIDE).
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 a city, a town, or in the countryside?

SECTION 8. AIDS AND OTHER SEXUALLY TRANSMITTED DISEASES

801A. Have you heard about diseases that can be transmitted through sex?

YES 1
NO 2 (GO TO 801L)

801B. Which diseases do you know?
RECORD ALL RESPONSES.

SYPHILIS A
GONORRHEA B
HIV/AIDS C
GENITAL WARTS D
UGONGWA ZINAA E
OTHER (SPECIFY) _______________ W
OTHER (SPECIFY) _______________ X
DOES NOT KNOW Z

801C. CHECK 515 AND 515F:

HAS HAD SEXUAL INTERCOURSE __ (GO TO 801D)
HAS NEVER HAD SEXUAL INTERCOURSE __ (GO TO 801K)

801D. During the last twelve months, did you have any of these diseases?

YES 1
NO 2 (GO TO 801K)
DOES NOT KNOW 8 (GO TO 801K)

801E. Which of the diseases did you have?
RECORD ALL RESPONSES.

SYPHILIS A
GONORRHEA B
HIV/AIDS C
GENITAL WARTS D
UGONGWA ZINAA E
OTHER (SPECIFY) _______________ W
OTHER (SPECIFY) _______________ X
DOES NOT KNOW Z

801F. The last time you had (DISEASE(S) FROM 801E) did you seek advice or treatment?

YES 1
NO 2 (GO TO 801H)

801G. Where did you seek advice or treatment?
Any other place or person?
RECORD ALL MENTIONED.

PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
GOVT. DISPENSARY C
PRIVATE MEDICAL SECTOR
MISSION HOSP/CLINIC D
OTHER PVT. HOSP/CLINIC E
PHARMACY F
PRIVATE DOCTOR G
MOBILE CLINIC H
COMMUNITY BASED DISTRIBUTOR I
COMM. HEALTH WORKER J
OTHER SOURCE
SHOP K
HERBALIST/TRAD. PRACT. L
RELATIVE/FRIEND M
OTHER (SPECIFY) ______ X
DOES NOT KNOW Z

801H. When you had (DISEASE(S) FROM 801E) did you inform your partner(s)?

YES 1
NO 2

801I. When you had (DISEASE(S) FROM 801E) did you do something not to infect your partner(s)?

YES 1
NO 2 (GO TO 801K)
PARTNER ALREADY INFECTED 3 (GO TO 801K)

801J. What did you do?
RECORD ALL MENTIONED.

NO SEXUAL INTERCOURSE A
USED CONDOMS B
TOOK MEDICINES C
OTHER (SPECIFY) ___________ X

801K. CHECK 801B

DID NOT MENTION 'AIDS' __ (GO TO 801L)
MENTIONED 'AIDS' __ (GO TO 802)

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

YES 1
NO 2 (GO TO 811C)

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

RADIO A
TV B
NEWSPAPERS/MAGAZINES C
PAMPLETS/POSTERS D
HEALTH WORKERS E
MOSQUES/CHURCHES F
SCHOOLS/TEACHERS G
COMMUNITY MEETINGS H
FRIENDS/RELATIVES I
WORK PLACE J
DRAMA/PERFORMANCE K
OTHER (SPECIFY) ___________X

802B. How can a person get AIDS?
Any other ways?
RECORD ALL MENTIONED.

SEXUAL INTERCOURSE A
SEXUAL INTERCOURSE WITH MULTIPLE PARTNERS B
SEX WITH PROSTITUTES C
NOT USING CONDOM D
HOMOSEXUAL CONTACT E
MOTHER TO CHILD F
BLOOD TRANSFUSION G
SHARING RAZORS BLADES H
INJECTIONS I
KISSING J
MOSQUITO BITES K
OTHER (SPECIFY) ___________ W
OTHER (SPECIFY) ___________ X
DOES NOT KNOW Z

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

YES 1
NO 2 (GO TO 807)
DOES NOT KNOW 8 (GO TO 807)

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

ABSTAIN FROM SEX B
USE CONDOMS C
AVOID MULTIPLE SEX PARTNERS D
AVOID SEX WITH PROSTITUTES E
AVOID SEX WITH HOMOSEXUALS F
BE FAITHFUL TO PARTNER G
AVOID BLOOD TRANSFUSIONS H
AVOID INJECTIONS I
AVOID KISSING J
AVOID MOSQUITO BITES K
SEEK PROTECTION FROM TRADITIONAL HEALER L
OTHER (SPECIFY) ___________ W
OTHER (SPECIFY) ___________ X
DOES NOT KNOW Z

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

YES 1
NO 2
DOES NOT KNOW 8

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

ALMOST NEVER 1
SOMETIMES 2
ALMOST ALWAYS 3
DOES NOT KNOW 8

808A. Can AIDS be cured?

YES 1
NO 2
DOES NOT KNOW 8

808B. Can AIDS be transmitted from mother to child?

YES 1
NO 2
DOES NOT KNOW 8

808C. Do you personally know someone who has AIDS or has died of AIDS?

YES 1
NO 2
DOES NOT KNOW 8

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

SMALL 1
MODERATE 2 (GO TO 809C)
GREAT 3 (GO TO 809C)
NO RISK AT ALL 4
HAS AIDS 5 (GO TO 811A)

809B. Why do you think that you have (NO RISK/A SMALL CHANCE) of getting AIDS?
Any other reasons?
RECORD ALL MENTIONED.

ABSTAIN FROM SEX B (GO TO 811A)
USE CONDOMS C (GO TO 811A)
HAVE ONLY ONE SEX PARTNER D (GO TO 811A)
LIMITED NUMBER OF SEX PARTNERS E (GO TO 811A)
SPOUSE HAS NO OTHER PARTNER G (GO TO 811A)
NO HOMOSEXUAL CONTACT H (GO TO 811A)
NO BLOOD TRANSFUSIONS I (GO TO 811A)
NO INJECTIONS J (GO TO 811A)
OTHER (SPECIFY) ___________________X (GO TO 811A)

809C. Why do you think that you have a (MODERATE/GREAT) chance of getting AIDS?
Any other reasons?
RECORD ALL MENTIONED.

DO NOT USE CONDOMS C
MORE THAN ONE SEX PARTNER D
MANY SEX PARTNERS E
SPOUSE HAS OTHER PARTNER(S) G
HOMOSEXUAL CONTACT H
HAD BLOOD TRANSFUSION I
HAD INJECTIONS J
OTHER (SPECIFY) ___________________X

811A. Since you heard of AIDS, have you changed your behavior to prevent getting AIDS?
IF YES, what did you do?
Anything else?
RECORD ALL MENTIONED

DIDN'T START SEX A (GO TO 811C)
STOPPED ALL SEX B (GO TO 811C)
STARTED USING CONDOMS C (GO TO 811C)
RESTRICTED SEX TO ONE PARTNER D (GO TO 811C)
REDUCED NUMBER OF PARTNERS E (GO TO 811C)
ASK SPOUSE TO BE FAITHFUL G (GO TO 811C)
NO MORE HOMOSEXUAL CONTACTS H (GO TO 811C)
STOPPED INJECTIONS J
OTHER (SPECIFY) ___________ W
OTHER (SPECIFY) ___________ X
NO BEHAVIOR CHANGE Y

811B. Has your knowledge of AIDS influenced or changed your decisions about having sex or your sexual behavior?
IF YES, In what way?
RECORD ALL MENTIONED

DIDN'T START SEX A
STOPPED ALL SEX B
STARTED USING CONDOMS C
RESTRICTED SEX TO ONE PARTNER D
REDUCED NUMBER OF PARTNERS E
NO MORE HOMOSEXUAL CONTACTS H
OTHER (SPECIFY) __________ X
NO CHANGE IN SEXUAL BEHAVIOR Y
DOES NOT KNOW Z

811C. Some people use a condom during sexual intercourse to avoid getting AIDS or other sexually transmitted diseases? Have you ever heard of this?

YES 1
NO 2 (GO TO 811F)

811D. CHECK 515 AND 515F:

HAS HAD SEXUAL INTERCOURSE __ (GO TO 811E)
HAS NEVER HAD SEXUAL INTERCOURSE __ (GO TO 812)

811E. We may already have talked about this. Have you ever used a condom during sex to avoid getting or transmitting diseases, such as AIDS?

YES 1 (GO TO 811G)
NO 2 (GO TO 811G)

811F. CHECK 515 AND 515F:

HAS HAD SEXUAL INTERCOURSE __ (GO TO 811G)
HAS NEVER HAD SEXUAL INTERCOURSE __ (GO TO 812)

811G. Have you given or received money, gifts or favours in return for sex at any time in the last 12 months?

YES 1
NO 2

812. CHECK 801B and 801L

KNOWS 'AIDS' __ (GO TO 813)
DOES NOT KNOW 'AIDS' __ (GO TO 901)

813. Have you ever been tested to see if you have the AIDS virus?

YES 1 (GO TO 813D)
NO 2
DOES NOT KNOW/NOT SURE 8

813A. Would you like to be tested for the AIDS virus?

YES 1
NO 2
DOES NOT KNOW/NOT SURE 8

813B. Do you know a place where you could go to get an AIDS test?

YES 1
NO 2 (GO TO 814)
DOES NOT KNOW/NOT SURE 8 (GO TO 814)

813C. Where could you go?
813D. Where did you go?

PUBLIC SECTOR
GOVT. HOSPITAL A
GOVT. HEALTH CENTER B
GOVT. DISPENSARY C
PRIVATE MEDICAL SECTOR
MISSION HOSP/CLINIC D
OTHER PVT. HOSP/CLINIC E
PHARMACY F
PRIVATE DOCTOR G
MOBILE CLINIC H
COMMUNITY BASED DISTRIBUTOR I
COMM. HEALTH WORKER J
OTHER SOURCE
SHOP K
HERBALIST/TRAD. PRACT. L
RELATIVE/FRIEND M
OTHER (SPECIFY) ______ X
DOES NOT KNOW Z

814. What do you suggest is the most important thing the government should do for people who have AIDS?

PROVIDE MEDICAL TREATMENT 1
HELP RELATIVES PROVIDE CARE 2
ISOLATE/QUARANTINE/JAIL PEOPLE 3
NOT BE INVOLVED 4
OTHER (SPECIFY) _____________ 6

815. If a member of your family is suffering from AIDS would you be willing to care for him or her at home?

YES 1
NO 2
DEPENDS 3
NOT SURE/DO NOT KNOW 9

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 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 you?

NUMBER OF BIRTHS TO NATURAL MOTHER ______

902. CHECK 901:

TWO OR MORE BIRTHS __ (GO TO 903)
ONLY ONE BIRTH (RESPONDENT ONLY) __ (GO TO 916)

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

NUMBER OF PRECEDING BIRTHS ____

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

__________

905. Is (NAME) male or female?

MALE 1
FEMALE 2

906. Is (NAME) still alive?

YES 1
NO 2 (GO TO 909)
DK 8 (GO TO NEXT BROTHER OR SISTER)

907. How old is (NAME)?

__________ (GO TO NEXT BROTHER OR SISTER)

909. How many years ago did (NAME) die?

__________

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

__________

IF MALE OR DIED BEFORE 12 YEARS OF AGE GO TO NEXT BROTHER OR SISTER

911. Was (NAME) pregnant when she died?

YES 1 (GO TO 914)
NO 2

912. Did (NAME) die during childbirth?

YES 1 (GO TO 914)
NO 2

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

YES 1
NO 2

914. Where did the death of (NAME) take place?

HOME 1
ON WAY TO HOSP/CLIN 2
HOSP/CLIN 3
ELSE 4

915. How many children did (NAME) give birth to during her lifetime?

__________ (GO TO NEXT BROTHER OR SISTER)

916. IF NO MORE BROTHERS OR SISTERS, GO TO NEXT SECTION.

SECTION 10. FEMALE CIRCUMCISION

1001. In many communities, girls are introduced to womanhood by participating in some ceremonies and undergoing specific procedures. Now, I want to discuss with you the circumcision of girls. In this community, is female circumcision practiced?

YES 1
NO 2

1002. Are you circumcised?

YES 1
NO 2 (GO TO 1004)

1003. How old were you when you were circumcised?

AGE IN COMPLETED YEARS ___
DOES NOT KNOW 98

1004. CHECK 214 AND 217:

HAS AT LEAST ONE LIVING DAUGHTER __ (GO TO 1005)
HAS NO LIVING DAUGHTER __ (GO TO 1012)

1005. Is (NAME OF ELDEST DAUGHTER) circumcised?

YES 1 (GO TO 1007)
NO 2

1006. Do you plan to have (NAME OF ELDEST DAUGHTER) circumcised?

YES 1 (GO TO 1012)
NO 2 (GO TO 1012)

1007. How old was she when she was circumcised?

AGE IN COMPLETED YEARS ____
DOES NOT KNOW 98

1008. Who performed the circumcision?

DOCTOR 01
TRAINED NURSE/MIDWIFE 02
TRADITIONAL MIDWIFE 03
TRADITIONAL CIRCUMCISER 04
OTHER (SPECIFY) ____________ 96
DOES NOT KNOW 98

1009. Where was the circumcision performed?

OWN HOME 01
ANOTHER'S HOME 02
HOME OF CIRCUMCISION PRACTITIONER 03
OTHER (SPECIFY) ____________ 96
DOES NOT KNOW 98

1009a. Which instruments were used to perform the circumcision?

OWN BLADE/RAZOR 01
SHARED BLADE/RAZOR 02
SCALPEL 03
KNIFE 04
OTHER (SPECIFY) ____________ 96
DOES NOT KNOW 98

1010. During the circumcision of (NAME OF ELDEST DAUGHTER), which parts of the body were removed?
RECORD PARTS AS REPORTED ON LINES PROVIDED.
LEAVE THE BOX BLANK.

1._______________________ __
2._______________________
3._______________________
DOES NOT KNOW 8

1011. Before (NAME OF ELDEST DAUGHTER) circumcised, was she informed about the details of the circumcision procedures?

YES 1
NO 2

1012. Do you think female circumcision should be continued, or should it be discontinued?

CONTINUED 1
DISCONTINUED 2 (GO TO 1014)
DOES NOT KNOW 8 (GO TO 1015)

1013. Why do you think female circumcision should be continued?
Any other reasons?
RECORD ALL REASONS MENTIONED.

GOOD TRADITION A (GO TO 1015)
CUSTOM AND TRADITION B (GO TO 1015)
RELIGIOUS DEMAND C (GO TO 1015)
CLEANLINESS D (GO TO 1015)
BETTER MARRIAGE PROSPECTS E (GO TO 1015)
BETTER MARRIAGE LIFE F (GO TO 1015)
GREATER PLEASURE OF HUSBAND G (GO TO 1015)
PRESERVATION OF VIRGINITY H (GO TO 1015)
PREVENTION OF IMMORALITY I (GO TO 1015)
OTHER (SPECIFY) ____________X (GO TO 1015)
DOES NOT KNOW Z (GO TO 1015)

1014. Why do you think female circumcision should be discontinued?
Any other reasons?
RECORD ALL REASONS MENTIONED.

BAD TRADITION A
AGAINST RELIGION B
MEDICAL COMPLICATIONS C
PAINFUL PERSONAL EXPERIENCE D
AGAINST DIGNITY OF WOMEN E
PREVENTS SEXUAL SATISFACTION F
FALSE STATUS/LIMITS EDUCATION G
OTHER (SPECIFY) ____________X
DOES NOT KNOW Z

1015. In the last 12 months, have you discussed the practice of female circumcision with anyone?
IF YES: with whom?
RECORD ALL PERSONS MENTIONED.

NO ONE A
RESPONDENT'S HUSBAND B
RESPONDENT'S MOTHER C
RESPONDENT'S MOTHER-IN-LAW D
OTHER RELATIVE OF RESPONDENT E
OTHER RELATIVE OF HUSBAND F
OTHER (SPECIFY) ___________ X

1016. RECORD THE TIME

HOUR ___
MINUTES ___

SECTION 11. HEIGHT AND WEIGHT

1101. CHECK 215:

ONE OR MORE BIRTHS SINCE JAN. 1993 __ (GO TO 1102)
NO BIRTHS SINCE JAN. 1993 __ (END)


IN 1102 (COLUMNS 2 AND 3) RECORD THE LINE NUMBER FOR EACH CHILD BORN SINCE JANUARY 1993 AND STILL ALIVE.
IN 1103 AND 1104 RECORD THE NAME AND BIRTH DATE FOR THE RESPONDENT AND FOR ALL LIVING CHILDREN BORN SINCE JANUARY 1993.
IN 1106 AND 1108 RECORD HEIGHT AND WEIGHT OF THE RESPONDENT AND THE LIVING CHILDREN.
(NOTE: ALL RESPONDENTS WITH ONE OR MORE BIRTHS SINCE JANUARY 1993 SHOULD BE WEIGHED AND MEASURED EVEN IF ALL OF THE CHILDREN HAVE DIED.
IF THERE ARE MORE THAN 2 LIVING CHILDREN BORN SINCE JANUARY 1993, USE ADDITIONAL QUESTIONNAIRES).

1102. LINE NO. FROM Q.212
[Only children born since 1993]

LINE NO.__

1103. NAME FROM Q.212 FOR CHILDREN

(NAME) ______________

1104. DATE OF BIRTH FROM Q.215, AND ASK FOR DAY OF BIRTH
[Only children born since 1993]

DAY __
MONTH __
YEAR __

1105. BCG SCAR ON LEFT FOREARM
[Only children born since 1993]

SCAR SEEN 1
NO SCAR 2

1106. HEIGHT (in centimeters)

_____._

1107. WAS LENGTH/HEIGHT OF CHILD MEASURED LYING DOWN OR STANDING UP?
[Only children born since 1993]

LYING 1
STANDING 2

1108. WEIGHT (in kilograms)

_____._

1109. DATE WEIGHED AND MEASURED

DAY __
MONTH __
YEAR __

1110. RESULT

RESPONDENT
MEASURED 1
NOT PRESENT 3
REFUSED 4
OTHER (SPECIFY) ________6
CHILDREN BORN SINCE 1993
CHILD MEASURED 1
CHILD SICK 2
CHILD NOT PRESENT 3
CHILD REFUSED 4
MOTHER REFUSED 5
OTHER (SPECIFY) ________ 6

1111.
NAME OF MEASURER: ________
NAME OF ASSISTANT: _________

INTERVIEWERS OBSERVATIONS

To be filled in after completing interview

Comments about Respondent:
______________________________

Comments on Specific Questions:
_______________________________

Any Other Comments:
________________________
SUPERVISOR'S OBSERVATIONS
_________________________
Name of Supervisor: ___________________________
Date: _____________

EDITOR'S OBSERVATIONS
_________________________
Name of Editor: _______________________________
Date: _____________

INSTRUCTIONS:

ONLY ONE CODE SHOULD APPEAR IN ANY BOX.
FOR COLUMNS 1, 3, AND 4, ALL MONTHS SHOULD BE FILLED IN.

INFORMATION TO BE CODED FOR EACH COLUMN

COL.1: Births, Pregnancies, Contraceptive Use

B BIRTHS
P PREGNANCIES
T TERMINATIONS

0 NO METHOD
1 PILL
2 IUD
3 INJECTIONS
4 IMPLANTS
5 DIAPHRAGM/FOAM/JELLY
6 CONDOM
7 FEMALE STERILISATION
8 MALE STERILISATION
9 NATURAL METHODS
A WITHDRAWAL
X OTHER (SPECIFY) ________________

COL.2: Discontinuation of Contraceptive Use

0 INFREQUENT SEX/HUSBAND AWAY
1 BECAME PREGNANT WHILE USING
2 WANTED TO BECOME PREGNANT
3 HUSBAND DISAPPROVED
4 WANTED MORE EFFECTIVE METHOD
5 HEALTH CONCERNS
6 SIDE EFFECTS
7 LACK OF ACCESS/TOO FAR
8 COST TOO MUCH
9 INCONVENIENT TO USE
F FATALISTIC
A DIFFICULT TO GET PREGNANT/MENOPAUSE
D MARITAL DISSOLUTION/SEPARATION
X OTHER (SPECIFY) ____________________
Z DON'T KNOW

COL.3: Marriage/Union

X IN UNION (MARRIED OR LIVING TOGETHER)
0 NOT IN UNION

COL.4: Moves and Types of Communities

X CHANGE OF COMMUNITY
1 CITY
2 TOWN
3 COUNTRYSIDE

1998 1 2 3 4
12 DEC 01 _____ _____ _____ ______ 01 DEC
11 NOV 02 _____ _____ _____ ______ 02 NOV
10 OCT 03 _____ _____ _____ ______ 03 OCT
09 SEP 04 _____ _____ _____ ______ 04 SEP
08 AUG 05 _____ _____ _____ ______ 05 AUG
07 JUL 06 _____ _____ _____ ______ 06 JUL
06 JUN 07 _____ _____ _____ ______ 07 JUN
05 MAY 08 _____ _____ _____ ______ 08 MAY
04 APR 09 _____ _____ _____ ______ 09 APR
03 MAR 10 _____ _____ _____ ______ 10 MAR
02 FEB 11 _____ _____ _____ ______ 11 FEB
01 JAN 12 _____ _____ _____ ______ 12 JAN

1997 1 2 3 4
12 DEC 13 _____ _____ _____ ______ 13 DEC
11 NOV 14 _____ _____ _____ ______ 14 NOV
10 OCT 15 _____ _____ _____ ______ 15 OCT
09 SEP 16 _____ _____ _____ ______ 16 SEP
08 AUG 17 _____ _____ _____ ______ 17 AUG
07 JUL 18 _____ _____ _____ ______ 18 JUL
06 JUN 19 _____ _____ _____ ______ 19 JUN
05 MAY 20 _____ _____ _____ ______ 20 MAY
04 APR 21 _____ _____ _____ ______ 21 APR
03 MAR 22 _____ _____ _____ ______ 22 MAR
02 FEB 23 _____ _____ _____ ______ 23 FEB
01 JAN 24 _____ _____ _____ ______ 24 JAN

1996 1 2 3 4
12 DEC 25 _____ _____ _____ ______ 25 DEC
11 NOV 26 _____ _____ _____ ______ 26 NOV
10 OCT 27 _____ _____ _____ ______ 27 OCT
09 SEP 28 _____ _____ _____ ______ 28 SEP
08 AUG 29 _____ _____ _____ ______ 29 AUG
07 JUL 30 _____ _____ _____ ______ 30 JUL
06 JUN 31 _____ _____ _____ ______ 31 JUN
05 MAY 32 _____ _____ _____ ______ 32 MAY
04 APR 33 _____ _____ _____ ______ 33 APR
03 MAR 34 _____ _____ _____ ______ 34 MAR
02 FEB 35 _____ _____ _____ ______ 35 FEB
01 JAN 36 _____ _____ _____ ______ 36 JAN

1995 1 2 3 4
12 DEC 37 _____ _____ _____ ______ 37 DEC
11 NOV 38 _____ _____ _____ ______ 38 NOV
10 OCT 39 _____ _____ _____ ______ 39 OCT
09 SEP 40 _____ _____ _____ ______ 40 SEP
08 AUG 41 _____ _____ _____ ______ 41 AUG
07 JUL 42 _____ _____ _____ ______ 42 JUL
06 JUN 43 _____ _____ _____ ______ 43 JUN
05 MAY 44 _____ _____ _____ ______ 44 MAY
04 APR 45 _____ _____ _____ ______ 45 APR
03 MAR 46 _____ _____ _____ ______ 46 MAR
02 FEB 47 _____ _____ _____ ______ 47 FEB
01 JAN 48 _____ _____ _____ ______ 48 JAN

1994 1 2 3 4
12 DEC 49 _____ _____ _____ ______ 48 DEC
11 NOV 50 _____ _____ _____ ______ 50 NOV
10 OCT 51 _____ _____ _____ ______ 51 OCT
09 SEP 52 _____ _____ _____ ______ 52 SEP
08 AUG 53 _____ _____ _____ ______ 53 AUG
07 JUL 54 _____ _____ _____ ______ 54 JUL
06 JUN 55 _____ _____ _____ ______ 55 JUN
05 MAY 56 _____ _____ _____ ______ 56 MAY
04 APR 57 _____ _____ _____ ______ 57 APR
03 MAR 58 _____ _____ _____ ______ 58 MAR
02 FEB 59 _____ _____ _____ ______ 59 FEB
01 JAN 60 _____ _____ _____ ______ 60 JAN

1993 1 2 3 4
12 DEC 61 _____ _____ _____ ______ 61 DEC
11 NOV 62 _____ _____ _____ ______ 62 NOV
10 OCT 63 _____ _____ _____ ______ 63 OCT
09 SEP 64 _____ _____ _____ ______ 64 SEP
08 AUG 65 _____ _____ _____ ______ 65 AUG
07 JUL 66 _____ _____ _____ ______ 66 JUL
06 JUN 67 _____ _____ _____ ______ 67 JUN
05 MAY 68 _____ _____ _____ ______ 68 MAY
04 APR 69 _____ _____ _____ ______ 69 APR
03 MAR 70 _____ _____ _____ ______ 70 MAR
02 FEB 71 _____ _____ _____ ______ 71 FEB
01 JAN 72 _____ _____ _____ ______ 72 JAN