Demographic and Health Surveys

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

NAME OF HOUSEHOLD HEAD _______________

NAME AND LINE NUMBER OF MAN ______

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

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

NEXT VISIT:
DATE _______
TIME ________

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

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

NEXT VISIT:
DATE _______
TIME ________

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

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

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

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

TOTAL NUMBER OF VISITS __

*RESULT CODES:

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

LANGUAGE OF QUESTIONNAIRE: ENGLISH 10

LANGUAGE USED IN INTERVIEW ** ______

KALENJIN 01
KAMBA 02
KIKUYU 03
KISII 04
LUHYA 05
LUO 06
MERU/EMBU 07
MIJIKENDA 08
KISWAHILI 09
ENGLISH 10
MASAI 11
OTHER 12

RESPONDENT'S LOCAL LANGUAGE ** ______

KALENJIN 01
KAMBA 02
KIKUYU 03
KISII 04
LUHYA 05
LUO 06
MERU/EMBU 07
MIJIKENDA 08
KISWAHILI 09
ENGLISH 10
MASAI 11
OTHER 12

TRANSLATOR USED

NOT AT ALL 1
SOMETIMES 2
ALL THE TIME 3

** LANGUAGE CODES:

KALENJIN 01
KAMBA 02
KIKUYU 03
KISII 04
LUHYA 05
LUO 06
MERU/EMBU 07
MIJIKENDA 08
KISWAHILI 09
ENGLISH 10
MASAI 11
OTHER 12

FIELD EDITED BY
NAME ______
DATE ______

OFFICE EDITED BY
NAME ______
DATE ______

KEYED BY
NAME ______ __
DATE ______

SECTION 1. RESPONDENT'S BACKGROUND

101. RECORD THE TIME

HOUR ______
MINUTES ______

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

NAIROBI/MOMBASA 1
OTHER CITY/TOWN 2
COUNTRYSIDE 3

103. How long have you been living continuously in (NAME OF 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 _____
DOES NOT KNOW MONTH 98

YEAR 19___
DOES NOT 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 111)

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/YEARS _______

110. CHECK 108:

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

111. 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 113)

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

YES 1
NO 2

113. Do you usually listen to a radio every day>

YES 1
NO 2

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

YES 1
NO 2

115. Are you currently working?

YES 1 (GO TO 117)
NO 2

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

YES 1
NO 2 (GO TO 124)

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

________________________ ___

118. CHECK 117:

WORKS IN AGRICULTURE __ (GO TO 119)
DOES NOT WORK IN AGRICULTURE __ (GO TO 120)

119. 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

120. 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

121. Do you usually work at this job throughout the year, or do you work seasonally, or only once in a while?

THROUGHOUT THE YEAR 1 (GO TO 123)
SEASONALLY/PART OF THE YEAR 2
ONCE IN A WHILE 3

122. During the last 12 months, how many months did you work at this job?

NUMBER OF MONTHS ____

123. 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

124. What is your religion?

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

125. 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

SECTION 2. REPRODUCTION

201. Now I would like to ask about your children. I am interested only in the children that are biologically yours. Have you ever had children?

YES 1
NO 2 (GO TO 206)

202. Do you have any sons or daughters 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 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 had 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. 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 ____ children during your life. Is that correct?

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

210. CHECK 208:

HAS HAD CHILDREN __ (TO 210A)
HAS NEVER HAD CHILDREN (NONE) __ (GO TO 301)

210A. In what month and year was your last child born?

MONTH ____
YEAR ____

210B. CHECK 210A, LAST CHILD:

BORN SINCE JANUARY 1995 __ (GO TO 211)
BEFORE JANUARY 1995 __ (GO TO 301)

211. When you were expecting your last born child, did you want to have the child 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 AT ALL 3

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)

METHOD 01 PILL Women can take a pill every day.

YES 1

METHOD 02 IUD Women can have a loop or coil placed inside them by a doctor or a nurse.

YES 1

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

YES 1

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

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

YES 1

METHOD 06 CONDOM Men can use a rubber sheath on their penis during sexual intercourse.

YES 1

METHOD 07 FEMALE STERILISATION Women can have an operation to avoid having any more children.

YES 1

METHOD 08 MALE STERILISATION Men can have an operation to avoid having any more children.

YES 1

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

METHOD 10 WITHDRAWAL Men can be careful and pull out before the fluids come out.

YES 1

METHOD 11 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?

YES 1
(SPECIFY) ____
(SPECIFY) ____

302. Have you ever heard of (METHOD)? (PROBED)

METHOD 01 PILL Women can take a pill every day.

YES 2
NO 3

METHOD 02 IUD Women can have a loop or coil placed inside them by a doctor or a nurse.

YES 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 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 2
NO 3

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

YES 2
NO 3

METHOD 06 CONDOM Men can use a rubber sheath on their penis during sexual intercourse.

YES 2
NO 3

METHOD 07 FEMALE STERILISATION Women can have an operation to avoid having any more children.

YES 2
NO 3

METHOD 08 MALE STERILISATION Men can have an operation to avoid having any more children.

YES 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 2
NO 3

METHOD 10 WITHDRAWAL Men can be careful and pull out before the fluids come out.

YES 2
NO 3

METHOD 11 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?

NO 3

303. Have you ever used (METHOD)?

METHOD 01 PILL Women can take a pill every day.

YES 1
NO 2

METHOD 02 IUD Women can have a loop or coil placed inside them by a doctor or a nurse.

YES 1
NO 2

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

YES 1
NO 2

METHOD 04 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 a partner who 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 an operation to avoid having any more 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
NO 2

304. CHECK 303:

NOT A SINGLE 'YES' (NEVER USED) __ (GO TO 305)
AT LEAST ONE 'YES' (EVER USED) __ (GO TO 307)

305. Have you or any of your partners ever used anything or tried in any way to delay or avoid pregnancy?

YES 1
NO 2 (GO TO 309)

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

307. Are you or your partner doing something or using a method to delay or avoid a pregnancy?

YES 1
NO 2 (GO TO 309)

308. Which method are you using?

PILL 01 (GO TO 401)
IUD 02 (GO TO 401)
INJECTIONS 03 (GO TO 401)
IMPLANTS 04 (GO TO 401)
DIAPHRAGM/FOAM/JELLY 05 (GO TO 401)
CONDOM 06 (GO TO 401)
FEMALE STERILISATION 07 (GO TO 401)
MALE STERILISATION 08 (GO TO 401)
NATURAL METHODS 09 (GO TO 401)
WITHDRAWAL 10 (GO TO 401)
OTHER (SPECIFY) ____________ 96 (GO TO 401)

309. 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
WIFE MENOPAUSAL/HYSTERECTOMY 23
WIFE SUBFECUND/INFECUND 24
POSTPARTUM/BREASTFEEDING 25
WANTS (MORE) CHILDREN 26
WIFE PREGNANT 27

OPPOSITION TO USE

RESPONDENT OPPOSED 31
WIFE/PARTNER 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

UP TO THE WOMAN TO USE 61
OTHER (SPECIFY) ___________ 96
DOES NOT KNOW 98

SECTION 4. MARRIAGE

401. Are you currently married or living with a woman?

YES, CURRENTLY MARRIED 1
YES, LIVING WITH A WOMAN 2 (GO TO 402A)
NO, NOT IN UNION 3 (GO TO 404)

402. How many wives do you have?
402A. How many women are you living with as if you are married?

NUMBER OF WIVES ____

403. WRITE THE LINE NUMBERS FROM THE HOUSEHOLD QUESTIONNAIRE FOR HIS WIFE/WIVES.
IF A WIFE DOES NOT LIVE IN THE HOUSEHOLD, WRITE '00'.
THE NUMBER OF BOXES FILLED MUST EQUAL THE NUMBER OF WIVES.

___ (GO TO 407)

404. 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

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

YES, FORMERLY MARRIED 1
YES, LIVED WITH A WOMAN 2 (GO TO 407)
NO 3 (GO TO 410F)

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

WIDOWED 1
DIVORCED 2
SEPARATED 3

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

ONCE 1
MORE THAN ONCE 2

408. CHECK 407:

MARRIED/LIVED WITH A WOMAN ONLY ONCE __
In what month and year did you start living with your wife/woman?

MARRIED/LIVED WITH A WOMAN MORE THAN ONCE __
Now we will talk about your first wife/woman you lived with. In what month and year did you start living with her?

MONTH __
DOES NOT KNOW MONTH 98
YEAR 19__ (GO TO 409A)
DOES NOT KNOW YEAR 9998

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

AGE _________

409A. CHECK 401:

CURRENTLY MARRIED OR LIVING WITH A WOMAN __ (GO TO 410)
NOT IN UNION __ (GO TO 410F)

410. 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 with (your wife/the woman you are living with)?

DAYS AGO 1 __
WEEKS AGO 2 __
MONTHS AGO 3 __
YEARS AGO 4 __

410A. CHECK 301 AND 302:

KNOWS CONDOM __
The last time you had sex with (your wife/the woman you are living with), did you use a condom?

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 wife/the woman you are living with) did you use a condom?

YES 1
NO 2
DOES NOT KNOW/NOT SURE 8

410B. Have you had sex with anyone other than (your wife/the woman you are living with) in the last 12 months?

YES 1
NO 2 (GO TO 413)

410C. When was the last time you had sexual intercourse with someone other than (your wife/the woman you are living with)?

DAYS AGO 1 __
WEEKS AGO 2 __
MONTHS AGO 3 __
YEARS AGO 4 __

410D. Did you use a condom that time?

YES 1
NO 2
DOES NOT KNOW/NOT SURE 8

410E. In the last 12 months, how many different persons other than (your wife/the woman you are living with) have you had sex with?

NUMBER OF PERSONS _____ (GO TO 410J)
DOES NOT KNOW 98 (GO TO 410J)

410F. 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 509)
DAYS AGO 1 __
WEEKS AGO 2 __
MONTHS AGO 3 __
YEARS AGO 4 __

410G. CHECK 301 AND 302:

KNOWS CONDOM __
The last time you had sex, did you use a condom?

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, did you use a condom?

YES 1
NO 2
DOES NOT KNOW 8

410H. CHECK 410F:

LESS THAN 12 MONTHS SINCE LAST SEX __ (GO TO 410I)
12 MONTHS OR LONGER SINCE LAST SEX __ (GO TO 410J)

410I. In the last 12 months, how many different persons have you had sex with?

NUMBER OF PERSONS ____
DOES NOT KNOW 98

410J. CHECK 401:

CURRENTLY MARRIED OR LIVING WITH A WOMAN __
The last time you had sex, was it with your (wife/the woman you live with), a regular partner, an acquaintance, someone you paid for sex, or someone else?

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

WIFE/WOMAN LIVES WITH 1
REGULAR PARTNER 2
ACQUAINTANCE 3
SOMEONE HE PAID FOR SEX 4
SOMEONE ELSE 5

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

YES 1
NO 2 (GO TO 415)

414. 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

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

YES 1
NO 2

415a. Would you be willing to pay for condoms?

YES 1
NO 2 (GO TO 416)

415b. 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

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

AGE ____
FIRST TIME WHEN MARRIED 96

SECTION 5. FERTILITY PREFERENCES

501. CHECK 401:

NOT IN UNION __ (GO TO 502)
CURRENTLY MARRIED OR LIVING WITH A WOMAN __ (GO TO 503)

502. CHECK 404:

REGULAR SEXUAL PARTNER __ (GO TO 503)
OCCASIONAL SEXUAL PARTNER __ (GO TO 503)
NO SEXUAL PARTNER __ (GO TO 505A)

503. Is your wife (or one of your wives)/partner pregnant now?

YES 1
NO 2 (GO TO 505A)
UNSURE 8 (GO TO 505A)

504. When she became pregnant, did you want her to become pregnant then, did you want her to wait until later, or did you not want this pregnancy at all?

THEN 1 (GO TO 505B)
LATER 2 (GO TO 505B)
NOT AT ALL 3 (GO TO 505B)

505. CHECK 503:

A) WIFE/PARTNER NOT PREGNANT OR UNSURE OR NO WIFE/PARTNER __
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?

B) WIFE/PARTNER PREGNANT __
Now I have some questions about the future. After the child your wife/partner is expecting, would you like to have another child or would you prefer not to have any more children?

HAVE (A/ANOTHER) CHILD 1
NO MORE/NONE 2 (GO TO 507)
SAYS WIFE CAN'T GET PREGNANT 3 (GO TO 507)
SAYS HE CAN'T HAVE ONE ANY MORE 4 (GO TO 507)
UNDECIDED/DOES NOT KNOW 8 (GO TO 507)

506. CHECK 503:

WIFE/PARTNER NOT PREGNANT OR UNSURE OR NO WIFE/PARTNER __
How long would you like to wait from now before the birth of (a/another) child?

WIFE/PARTNER PREGNANT __
After the child your wife/partner is expecting, how long would you like to wait before the birth of another child?

MONTHS 1 __
YEARS 2 __
SOON/NOW 993
SAYS WIFE CAN'T GET PREGNANT 994
AFTER MARRIAGE 995
OTHER (SPECIFY) ___________ 996
DOES NOT KNOW 998

507. CHECK 308: USING A METHOD?

NOT ASKED __ (GO TO 508)
NOT CURRENTLY USING __ (GO TO 508)
CURRENTLY USING __ (GO TO 512)

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

YES 1 (GO TO 510)
NO 2
DOES NOT KNOW 8

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

YES 1
NO 2 (GO TO 511)
DOES NOT KNOW 8 (GO TO 511)

510. Which method would you prefer to use?

PILL 01 (GO TO 512)
IUD 02 (GO TO 512)
INJECTIONS 03 (GO TO 512)
IMPLANTS 04 (GO TO 512)
DIAPHRAGM/FOAM/JELLY 05 (GO TO 512)
CONDOM 06 (GO TO 512)
FEMALE STERILISATION 07 (GO TO 512)
MALE STERILISATION 08 (GO TO 512)
NATURAL METHODS 09 (GO TO 512)
WITHDRAWAL 10 (GO TO 512)
OTHER (SPECIFY) _____________ 96 (GO TO 512)
UNSURE 98 (GO TO 512)

511. 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
WIFE MENOPAUSAL/HYSTERECTOMY 23
WIFE SUBFECUND/INFECUND 24
WANTS MORE CHILDREN 26

OPPOSITION TO USE

RESPONDENT OPPOSED 31
WIFE 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

UP TO THE WOMAN TO USE 61
OTHER (SPECIFY) ___________ 96
DOES NOT KNOW 98

512. CHECK 202 AND 204:

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 514)

513. 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

514. Would you say that you approve or disapprove of couples using a method to avoid pregnancy?

APPROVES 1
DISAPPROVES 2
NO OPINION 3

515. 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
DO NOT KNOW 8

TELEVISION

ACCEPTABLE 1
NOT ACCEPTABLE 2
DO NOT KNOW 8

516. 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

516a. CHECK 516: FAMILY PLANNING ON RADIO?

YES __ (GO TO 516b)
NO __ (GO TO 516c)

516b. 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

516c. 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

516d. 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

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

YES 1
NO 2 (GO TO 520)

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

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

520. CHECK 401:

CURRENTLY MARRIED __ (GO TO 521)
LIVING WITH A WOMAN __ (GO TO 521)
NOT IN UNION __ (GO TO 601A)

521. Spouses do not always agree on everything. Now I want to ask you about your wife's/the woman you live withs views on family planning.
Do you think that your wife/the woman you live with approves or disapproves of couples using a method to avoid pregnancy?

APPROVES 1
DISAPPROVES 2
DOES NOT KNOW 8

522. How often have you talked to your wife/the woman you live with about family planning in the past year?

NEVER 1
ONCE OR TWICE 2
MORE OFTEN 3

523. Do you think your wife/the woman you live with 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
DON'T KNOW 8

SECTION 6. AIDS AND OTHER SEXUALLY TRANSMITTED DISEASES

601A. Have you heard about diseases that can be transmitted through sex?

YES 1
NO 2 (GO TO 601F)

601B. Which diseases do you know?
RECORD ALL RESPONSES.

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

601C. CHECK 410 AND 410F:

HAS HAD SEXUAL INTERCOURSE __ (GO TO 601D)
HAS NEVER HAD SEXUAL INTERCOURSE __ (GO TO 601F)

601D. During the last twelve months, did you have any of these diseases?

YES 1
NO 2 (GO TO 601F)
DOES NOT KNOW 8 (GO TO 601F)

601E. Which of the diseases did you have?
RECORD ALL RESPONSES.

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

601F. During the last twelve months, did you have a discharge from your penis?

YES 1
NO 2
DOES NOT KNOW 8

601G. During the last twelve months, did you have a sore or ulcer on your penis?

YES 1
NO 2
DOES NOT KNOW 8

601H. CHECK 601E, 601F AND 601G

HAD ONE OR MORE DISEASES __ (GO TO 601I)
NONE OF THE DISEASES __ (GO TO 601N)

601I. The last time you had (DISEASE FROM 601E/DISCHARGE/SORE) did you seek advice or treatment?

YES 1
NO 2 (GO TO 601JA)

601J. 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

601JA. CHECK 410 AND 410F:

HAS HAD SEXUAL INTERCOURSE __ (GO TO 601K)
HAS NEVER HAD SEXUAL INTERCOURSE __ (GO TO 601N)

601K. When you had (DISEASE FROM FROM 601E/DISCHARGE/SORE) did you inform your partner(s)?

YES 1
NO 2

601L. When you had (DISEASE FROM FROM 601E/DISCHARGE/SORE) did you do something not to infect your partner(s)?

YES 1
NO 2 (GO TO 601N)
PARNTER ALREADY INFECTED 3 (GO TO 601N)

601M. What did you do?
RECORD ALL MENTIONED.

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

601N. CHECK 601B

DID NOT MENTION 'AIDS' __ (GO TO 601O)
MENTIONED 'AIDS' __ (GO TO 602)

601O. Have you ever heard of an illness called AIDS?

YES 1
NO 2 (GO TO 611C)

602. 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

602B. 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

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

YES 1
NO 2 (GO TO 607)
DOES NOT KNOW 8 (GO TO 607)

604. 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

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

YES 1
NO 2
DOES NOT KNOW 8

608. 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

608A. Can AIDS be cured?

YES 1
NO 2
DOES NOT KNOW 8

608B. Can AIDS be transmitted from mother to child?

YES 1
NO 2
DOES NOT KNOW 8

608C. Do you personally know someone who has AIDS or has died of AIDS?

YES 1
NO 2
DOES NOT KNOW 8

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

SMALL 1
MODERATE 2 (GO TO 609C)
GREAT 3 (GO TO 609C)
NO RISK AT ALL 4
HAS AIDS 5 (GO TO 611A)

609B. 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 611A)
USE CONDOMS C (GO TO 611A)
HAVE ONLY ONE SEX PARTNER D (GO TO 611A)
LIMITED NUMBER OF SEX PARTNERS E (GO TO 611A)
AVOID SEX WITH PROSTITUTES F (GO TO 611A)
SPOUSE HAS NO OTHER PARTNER G (GO TO 611A)
NO HOMOSEXUAL CONTACT H (GO TO 611A)
NO BLOOD TRANSFUSIONS I (GO TO 611A)
NO INJECTIONS J (GO TO 611A)
OTHER (SPECIFY) ___________________X (GO TO 611A)

609C. 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
SEX WITH PROSTITUTES F
SPOUSE HAS OTHER PARTNER(S) G
HOMOSEXUAL CONTACT H
HAD BLOOD TRANSFUSION I
HAD INJECTIONS J
OTHER (SPECIFY) ___________________X

611A. 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 611C)
STOPPED ALL SEX B (GO TO 611C)
STARTED USING CONDOMS C (GO TO 611C)
RESTRICTED SEX TO ONE PARTNER D (GO TO 611C)
REDUCED NUMBER OF PARTNERS E (GO TO 611C)
AVOID SEX WITH PROSTITUTES F (GO TO 611C)
ASK SPOUSE TO BE FAITHFUL G (GO TO 611C)
NO MORE HOMOSEXUAL CONTACTS H (GO TO 611C)
STOPPED INJECTIONS J
OTHER (SPECIFY) ___________ W
OTHER (SPECIFY) ___________ X
NO BEHAVIOR CHANGE Y

611B. 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
AVOID SEX WITH PROSTITUTES F
NO MORE HOMOSEXUAL CONTACTS H
OTHER (SPECIFY) __________ X
NO CHANGE IN SEXUAL BEHAVIOR Y
DOES NOT KNOW Z

611C. 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 611F)

611D. CHECK 410 AND 410F:

HAS HAD SEXUAL INTERCOURSE __ (GO TO 611E)
HAS NEVER HAD SEXUAL INTERCOURSE __ (GO TO 613)

611E. 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 611G)
NO 2 (GO TO 611G)

611F. CHECK 410 AND 410F:

HAS HAD SEXUAL INTERCOURSE __ (GO TO 611G)
HAS NEVER HAD SEXUAL INTERCOURSE __ (GO TO 612)

611G. 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

612. CHECK 601B and 601O

KNOWS 'AIDS' __ (GO TO 613)
DOES NOT KNOW 'AIDS' __ (GO TO 616)

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

YES 1 (GO TO 613D)
NO 2
DOES NOT KNOW/NOT SURE 8

613A. Would you like to be tested for the AIDS virus?

YES 1
NO 2
DOES NOT KNOW/NOT SURE 8

613B. Do you know a place where you could go to get an AIDS test?

YES 1
NO 2 (GO TO 614)
DOES NOT KNOW/NOT SURE 8 (GO TO 614)

613C. Where could you go?
613D. 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

614. 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

615. 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 8

616. RECORD THE TIME

HOUR ____
MINUTES ____

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: _____________