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DEPARTMENT OF CENSUS AND STATISTICS OF SRI LANKA
DEMOGRAPHIC AND HEALTH SURVEY

INDIVIDUAL QUESTIONNAIRE

ZONE____
DISTRICT____
SECTOR:

URBAN
RURAL
ESTATE

WARD/GS DIV/ESTATE____
SURVEY BLOCK NUMBER____
HOUSING UNIT NUMBER____
HOUSEHOLD NUMBER____

LINE NUMBER OF ELIGIBLE WOMAN____

INTERVIEWER VISITS

FIRST VISIT
DATE____
INTERVIEWER'S NAME____
RESULT*

COMPLETED 1
NOT AT HOME 2
POSTPONED 3
REFUSED 4
PARTLY COMPLETED 5
OTHER 6

NEXT VISIT
DATE____
TIME____

SECOND VISIT
DATE____
INTERVIEWER'S NAME____
RESULT*

COMPLETED 1
NOT AT HOME 2
POSTPONED 3
REFUSED 4
PARTLY COMPLETED 5
OTHER 6

NEXT VISIT
DATE____
TIME____

FINAL VISIT
DATE____
INTERVIEWER'S NAME____
RESULT*

COMPLETED 1
NOT AT HOME 2
POSTPONED 3
REFUSED 4
PARTLY COMPLETED 5
OTHER 6

TOTAL NUMBER OF VISITS____

FIELD EDITED BY
NAME____
DATE____

OFFICE EDITED BY
NAME____
DATE____

KEYED BY
NAME____
DATE____

SECTION 1: RESPONDENT'S BACKGROUND

101) RECORD NUMBER OF PEOPLE LISTED IN THE HOUSEHOLD SCHEDULE.

NUMBER OF PEOPLE____

102) RECORD NUMBER OF CHILDREN AGE 5 AND UNDER LISTED IN THE HOUSEHOLD SCHEDULE AND WHO USUALLY LIVE IN THE HOUSEHOLD.

NUMBER OF CHILDREN AGE 5 AND UNDER____

103) RECORD THE TIME.

HOUR____
MINUTES____

104) First I would like to ask some questions about yourself and your household. For most of the time until you were 12 years old, did you live in metropolitan Colombo, another urban area, in a village, or on an estate?

COLOMBO METRO (ZONE 1) 1
OTHER URBAN 2
VILLAGE 3
ESTATE 4

105) How long have you been living continuously in the (URBAN AREA, VILLAGE, OR ESTATE)?

ALWAYS 95 (GO TO 107)
VISITOR 96 (GO TO 107)
YEARS____

106) Just before you moved here, did you live in metropolitan Colombo, another urban area, in a village, or on an estate?

COLOMBO MEETRO (ZONE 1) 1
OTHER URBAN 2
VILLAGE 3
ESTATE 4

107) In what month and year were you born?

MONTH____
DON'T KNOW 98
YEAR____
DON'T KNOW 98

108) How old were you at your last birthday? COMPARE AND CORRECT 107 AND/OR 108 IF INCONSISTENT.

AGE IN COMPLETED YEARS____

109) Have you ever attended school?

YES 1
NO 2 (GO TO 113)

110) What was the highest grade in school you completed? CIRCLE BOTH LEVEL AND GRADE.

PRIMARY 1
GRADE 00 (GO TO 112)
GRADE 01 (GO TO 112)
GRADE 02 (GO TO 112)
GRADE 03 (GO TO 112)
GRADE 04 (GO TO 112)
GRADE 05 (GO TO 112)
SECONDARY 2
GRADE 06
GRADE 07
GRADE 08
GRADE 09
HIGHER 3
GRADE 10
GRADE 11
GRADE 12
GRADE 13

111) What was the highest exam you passed?

TECHNICAL 1
G. C. E. D LEVEL 2
G. C. E. A LEVEL 3
UNIV./PROFFESIONAL 4
OTHER (SPECIFY) ____ 5
NONE 6

112) CHECK 110:

PRIMARY
SECONDARY OR HIGHER (GO TO 114)

113) Can you read a letter or newspaper easily, with difficult, or not at all?

EASILY 1
WITH DIFFICULTY 2
NOT AT ALL 3 (GO TO 115)

114) Do you read a newspaper or magazine at least once a week?

YES 1
NO 2

115) Do you usually watch television every week?

YES 1
NO 2

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

YES 1
NO 2

117) What is the major source of drinking water for members of your household?

PIPED INTO RESIDENCE 01
PIPED ONTO PREMISES 02
PUBLIC TAP 03
TUBE WELL/ABESIN. PUMP 04
PROTECTED WELL 05
UNPROTECTED WELL 06
RIVER/CANAL/TANK/SPRING WATER 07
RAINWATER 08
OTHER (SPECIFY) ____ 09

118) What is the major source of water for household use OTHER than drinking (e.g., handwashing, cooking) for members of your household?

PIPED INTO RESIDENCE 01 (GO TO 120)
PIPED ONTO PREMISES 02 (GO TO 120)
PUBLIC TAP 03
TUBE WELL/ABESIN. PUMP 04
PROTECTED WELL 05
UNPROTECTED WELL 06
RIVER/CANAL/TANK/SPRING WATER 07
RAINWATER 08
OTHER (SPECIFY) ____ 09

119) How long does it take to go there, get water, and come back?

MINUTES____
ON PREMISES 996

120) What kind of toilet facility is available for use by members of this household?

FLUSH 1
WATER SEAL 2
PIT 3
BUCKET 4
OTHER (SPECIFY) ____ 5
NONE (BUSH) 6 (GO TO 122)

121) Is this facility for the exclusive use of members of this household, or is it shared?

HOUSEHOLD MEMBERS ONLY 1
SHARED WITH OTHERS 2

122) Do you have, right now, a cake of bath soap on the premises?

YES 1
NO 2

123A) Does your house have:

Electricity?
YES 1
NO 2
A radio?
YES 1
NO 2
A refrigerator?
YES 1
NO 2
A bicycle?
YES 1
NO 2

123B) Does any member of your household own:

A bicycle?
YES 1
NO 2
A motorcycle?
YES 1
NO 2
A car?
YES 1
NO 2
A tractor?
YES 1
NO 2

124) MAIN MATERIAL OF THE FLOOR. (INTERVIEWER: RECORD OBSERVATION)

TERRAZZO FLOOR TILE 1
CEMENT 2
WOOD 3
DUNG/MUD 4
SAND 5
OTHER (SPECIFY) ____ 6

125) MAIN MATERIAL OF THE ROOF. (INTERVIEWER: RECORD OBSERVATION)

TILE 1
ASBESTOS 2
TIN 3
CADJAM/PALMAYRA/STRAW 4
WASTE MATERIALS 5
OTHER (SPECIFY) ____ 6

126) MAIN MATERIAL OF THE WALLS. (INTERVIEWER: RECORD OBSERATION)

BRICK/CEMENT/STONE/CADBOOK 1
MUD 2
WOOD 3
CADJAM/PALMAYRA 4
OTHER (SPECIFY) ____ 5

127) What religion do you belong to?

BUDDHIST 01
HINDU 02
MUSLIM 03
CATHOLIC 04
OTHER CHRISTIAN 05
OTHER (SPECIFY) ____ 06

128) RECORD ETHNICITY. (INTERVIEWER: RECORD OBSERVATION)

LOW COUNTRY SINHALESE 01
UP COUNTRY SINHALESE (KANDYIAN) 02
SRI LANKAN TAMIL 03
INDIAN TAMIL 04
SRI LANKAN MOOR 05
BURGHER 06
MALAY 07
OTHER (SPECIFY) ____ 08

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 son or daughter you have given birth to who is 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 ENTER ZEROS (00).

SONS AT HOME____
DAUGHTERS AT HOME____

204) Do you have any sons or daughter you have given birth to who is alive but does not live with you?

YES 1
NO 2 (GO TO 206)

205) How many sons live elsewhere? How many daughters live elsewhere? IF NONE ENTER ZEROS (00).

SONS ELSEWHERE____
DAUGHTERS ELSEWHERE____

206) Have you ever given birth to a boy or a girl who was born alive but later died? IF NO, PROBE: Any (other) boy or girl who cried or showed any signs of life but only survived 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, ENTER ZEROS (00).

BOYS DEAD____
GIRLS DEAD____

208) SUM ANSWERS TO 203, 205, 207, AND ENTER TOTAL. IF NONE ENTER ZEROS (00).

TOTAL____

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

YES
NO (PROBE AND CORRECT 201 THROUGH 209 AS NECESSARY)

210) CHECK 208:

ONE OR MORE LIVE BIRTHS
NO LIVE BIRTHS (GO TO 220)

211) Now I would like to talk to you about all of your births. It is important that you begin with your first birth and then report subsequent births in the order that they occurred. Now, please tell me the name of your first birth.

INTERVIEWER: FIRST, RECORD THE NAMES OF ALL BIRTHS THE WOMAN MENTIONS BY PROGRESSING DOWN COLUMN 212. SECOND, ASK QUESTIONS 213 THROUGH 218, AS APPROPRIATE FOR EACH BIRTH. THIRD, RECORD TWINS ON SEPARATE LINES, AND CONNECT WITH A BRACKET.

212) What is the name of your (FIRST, SECOND, etc.) birth?

NAME____

213) Is (NAME) a boy or a girl?

BOY 1
GIRL 2

214) In what month and year was (NAME) born?

MONTH____
YEAR____

215) Is (NAME) still alive?

YES 1
NO 2

216) IF DEAD: How old was (NAME) when he/she died? RECORD DAYS IF LESS THAN 1 MONTH (31 DAYS); MONTHS IF LESS THAN 2 YEARS.

DAYS____ 1 (GO TO NEXT BIRTH)
MONTHS____ 2 (GO TO NEXT BIRTH)
YEARS____ 3 (GO TO NEXT BIRTH)

217) IF ALIVE: How old was (NAME) at his/her last birthday?

AGE____

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

YES 1
NO 2

219) COMPARE 208 WITH NUMBERS OF BIRTHS IN HISTORY ABOVE AND MARK CORRECT BOX.

NUMBERS ARE SAME
FOR EACH LIVE BIRTH: YEAR OF BIRTH IS RECORDED
FOR EACH LIVE CHILD: CURRENT AGE IS RECORDED
FOR EACH DEAD CHILD: AGE AT DEATH IS RECORDED
NUMBERS ARE DIFFERENT (PROBE AND RECONCILE)

220) How long ago did your last menstrual period start?

DAYS AGO____ 1
WEEKS AGO____ 2
MONTHS AGO____ 3
YEARS AGO____ 4
BEFORE LAST BIRTH 995 (GO TO 222)
NEVER MENSTRUATED 996 (GO TO 223)
DOES NOT KNOW 998 (GO TO 223)

221) CHECK 220:

LESS THAN 1 MONTH OR 4 WEEKS (30 DAYS OR LESS) (GO TO 223 AND CIRCLE 2.)
1 MONTH OR MORE, AND LESS THAN 2 MONTHS (MORE THAN 4 WEEKS AND LESS THAN 8 WEEKS) (GO TO 223)
2 MONTHS OR MORE (MORE THAN 8 WEEKS)

222) Why did your last menstruation occur so long ago?

MENOPAUSAL 1 (GO TO 223, CIRCLE 2)
IRREGULAR DUE TO INJECTIONS 2
POSTPARTUM 3 (GO TO 223, CIRCLE 2)
PREGNANT 4 (GO TO 223, CIRCLE 1)
DOES NOT KNOW 5 (GO TO 223)
NOT UNUSUAL (GO TO 6)

223) Are you pregnant now?

YES 1
NO 2 (GO TO 228)
NOT SURE 3 (GO TO 228)

224) For how many months have you been pregnant?

MONTHS____

225) Have you had a tetanus injection since you have been pregnant?

YES 1
NO 2
DON'T KNOW 3

226) Did you see anyone for a check on this pregnancy?

YES 1
NO 2 (GO TO 228)

227) Whom did you see? PROBE FOR TYPE OF PERSON AND RECORD MOST QUALIFIED.

DOCTOR 1
GOVERNMENT NURSE/MIDWIFE 2
TRADITIONAL BIRTH ATTENDANT 3
OTHER (SPECIFY) ____ 4

228) When during her monthly cycle do you think a woman has the greatest chance of becoming pregnant? PROBE: What are the days during the month when a woman has to be careful to avoid becoming pregnant?

DURING HER PERIOD 1
RIGHT AFTER HER PERIOD HAS ENDED 2
IN THE MIDDLE OF THE CYCLE 3
JUST BEFORE HER PERIOD BEGINS 4
AT ANY TIME 5
OTHER (SPECIFY) ____ 6
DOES NOT KNOW 8

229) PRESENCE OF OTHERS AT THIS POINT:

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

SECTION 3: CONTRACEPTION

301) Now I would like to talk about a different topic. There are various ways that a couple can delay or avoid a pregnancy. Which of these methods have you heard of?

INTERVIEWER:
A) CIRCLE CODE 1 IN 302 FOR EACH METHOD MENTIONED SPONTANEOUSLY.
B) THEN PROCEED DOWN THE COLUMN, CONTINUING QUESTION 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.
C) THEN FOR EACH METHOD WITH CODE 1 OR 2 CIRCLED IN QUESTION 302, ASK QUESTION 303 THROUGH 305 BEFORE PROCEEDING TO THE NEXT METHOD.

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

PILL: Women can take a pill every day.
YES SPONTANEOUSLY 1 (GO TO 303)
YES PROBED 2 (GO TO 303)
NO 3
IUD: Women can have a loop or coil placed inside them by a doctor or a nurse.
YES SPONTANEOUSLY 1 (GO TO 303)
YES PROBED 2 (GO TO 303)
NO 3
INJECTIONS: Women can have an injection oby a doctor or nurse which stops them from becomming pregnant for several months.
YES SPONTANEOUSLY 1 (GO TO 303)
YES PROBED 2 (GO TO 303)
NO 3
DIAPHRAGM, FOAM, JELLY: Women can place a sponge or suppository or diaphragm or jelly or cream inside them immediately before intercourse
YES SPONTANEOUSLY 1 (GO TO 303)
YES PROBED 2 (GO TO 303)
NO 3
CONDOM: Men can use a rubber sheath during sexual intercourse.
YES SPONTANEOUSLY 1 (GO TO 303)
YES PROBED 2 (GO TO 303)
NO 3
FEMALE STERILIZATION: Women can have an operation to avoid having any more children.
YES SPONTANEOUSLY 1 (GO TO 303)
YES PROBED 2 (GO TO 303)
NO 3
MALE STERILIZATION: Men can have an operation to avoid having any mroe children.
YES SPONTANEOUSLY 1 (GO TO 303)
YES PROBED 2 (GO TO 303)
NO 3
SAFE PERIOD: Couples can avoid having sexual intercourse on certain days of each month when the women is more likely to get pregnant
YES SPONTANEOUSLY 1 (GO TO 303)
YES PROBED 2 (GO TO 303)
NO 3
WITHDRAWAL: Men can be careful and pull out before climax.
YES SPONTANEOUSLY 1 (GO TO 303)
YES PROBED 2 (GO TO 303)
NO 3
NORPLANT: Women can have a tube inserted into their arms and avoid pregnancy for many years.
YES SPONTANEOUSLY 1 (GO TO 303)
YES PROBED 2 (GO TO 303)
NO 3
ANY OTHER METHODS? Have you heard of any other ways or methods taht women or men can use to avoid pregnancy? (SPECIFY)
YES 1 (GO TO 303)
NO 3

303. Have you ever used (METHOD)?

YES 1
NO 2

304. Where would you go to obtain (METHOD) if you wanted to use it?

GOVERNMENT HOSPITAL/MCH CENTER 1
PRIVATE DOCTOR/PRIVATE NURSING HOME 2
NON-GOVERNMENT CLINIC 3
MOBILE CLINIC 4
GOVERNMENT PUBLIC HEALTH MIDWIFE/NURSE 5
OTHER FIELD WORKERS 6
AYURVEDIC DOCTOR 7
FRIEND/RELATIVE 8
PHARMACY/SHOP 9
OTHER (SPECIFY ABOVE) ____10
NOWHERE 11
DOES NOT KNOW 98

305. What would you say is the main problem, if any, in getting or using (METHOD)?

NOT EFFECTIVE 2
HUSBAND DISAPPROVES 3
HEALTH CONCERNS 4
ACCESS/AVAILABILITY 5
COSTS TOO MUCH 6
INCONVENIENT TO USE 7
OTHER (SPECIFY ABOVE) ____ 10
NONE 11
DOES NOT KNOW 98

306) CHECK 303: EVER USED A METHOD?

NO, NEVER USED
YES, EVER USED

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

YES 1
NO 2 (GO TO 315)

308) What have you used or done? CORRECT 302 AND 303 AND OBTAIN INFORMATION FOR 304 TO 306 AS NECESSARY.

309) CHECK 303:

EVER USED SAFE PERIOD
NEVER USED SAFE PERIOD (GO TO 311)

310) The last time you used the safe period, how did you determine on which days you had to abstain?

BASED ON CALENDAR 1
BASED ON BODY TEMPERATURE 2
BASED ON CERVICAL MUCUS (BILLINGS METHOD) 3
BASED ON BODY TEMPERATURE AND MUCUS 4
OTHER (SPECIFY) ____ 5

311) How many living children, if any, did you already have when you first did something to avoid getting pregnant? IF NONE ENTER ZEROS (00).

NUMBER OF CHILDREN____

312) CHECK 223:

NOT PREGNANT/NOT SURE
PREGNANT (GO TO 324)

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

YES 1 (GO TO 319)
NO 2

314) Have you done something or used a method in the past month to avoid getting pregnant?

YES 1 (GO TO 319)
NO 2

315) Some women abstain from sexual relations completely for more than one or two months for the following reasons: 1: To avoid pregnancy. 2: Because the eldest child is of marriage age. 3: Because the husband is away. 4: A women has just had a baby or is breastfeeding. 5: Illness. 6: Religious reasons. Have you ever abstained for any of these reasons?

YES 1
NO 2 (GO TO 323)

316) Are you currently abstaining for any of these reasons?

YES 1
NO 2 (GO TO 323)

317) Which reason?

AVOID PREGNANCY 1 (GO TO 319)
ELDEST CHILD OF MARRIAGE AGE 2 (GO TO 319)
HUSBAND AWAY 3 (GO TO 323)
POSTPARTUM/BREAST FEEDING 4 (GO TO 323)
ILLNESS 5 (GO TO 323)
RELIGIOUS REASONS 6 (GO TO 323)
OTHER (SPECIFY) ____ 7 (GO TO 323)

319) Which method are you using?

PILL 1 (GO TO 320)
IUD 2 (GO TO 327)
INJECTIONS 3 (GO TO 327)
DIAPHRAGM/FOAM/JELLY 4 (GO TO 327)
CONDOM 5 (GO TO 327)
FEMALE STERILIZATION 6 (GO TO 322)
MALE STERILIZATION 7 (GO TO 322)
SAFE PERIOD 8 (GO TO 323)
WITHDRAWAL 9 (GO TO 323)
NORPLANT 10 (GO TO 327)
OTHER (SPECIFY) ____ 11 (GO TO 323)
PROLONGED ABSTINENCE 12 (GO TO 323)

320) Please show me the package of pills you are now using. (RECORD NAME OF BRAND.)

NITNURI 1
EUGYNON 2
MICROGYNON 3
OVULEN 4
OVRAL 5
TRIQUILAR 6
TRINORDIOL 7
NORDETTE 8
OTHER (SPECIFY) ____ 9
NOT ABLE TO SHOW 98

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

COST____ (GO TO 327)
FREE 9996 (GO TO 327)
DON'T KNOW 9998 (GO TO 327)

322) In what month and year did you (he) have the operation?

MONTH____ (GO TO 327A)
YEAR____ (GO TO 327A)

323) CHECK 306:

NEVER USED
EVER USED (GO TO 324)

323A) CHECK 317:

317 IS 1 OR 2
317 IS 3 THROUGH 7 OR NOTHING CIRCLED (GO TO 347)

324) Have you obtained a method to avoid pregnancy in the last twelve months from a hospital, a clinic, a doctor, or a fieldworker?

YES 1
NO 2 (GO TO 326)

325) Which method did you obtain?

PILL 1 (GO TO 327)
IUD 2 (GO TO 327)
INJECTIONS 3 (GO TO 327)
DIAPHRAGM/FOAM/JELLY 4 (GO TO 327)
CONDOM 5 (GO TO 327)
MALE STERILIZATION 7 (GO TO 327)
SAFE PERIOD 8 (GO TO 327)
NORPLANT 10 (GO TO 327)
OTHER (SPECIFY) ____ 11 (GO TO 327)

326) Have you obtained instructions for using the safe period in the last twelve months from a hospital, clinic, a doctor, or a fieldworker?

YES 1
NO 2 (GO TO 329)

327) Where did you obtain (METHOD) the last time?

GOVERNMENT HOSPITAL/MCH CENTER 1
PRIVATE DOCTOR/PRIVATE NRSG HOME 2
NON-GOVERNMENT CLINIC 3
MOBILE CLINIC 4
GOVERNMENT PUBLIC HEALTH MIDWIFE/NURSE 5
OTHER FIELD WORKERS 6
AYURVEDIC DOCTOR 7
FRIEND/RELATIVE 8 (GO TO 329)
PHARMACY/SHOP 9 (GO TO 329)
OTHER (SPECIFY) ____ 10 (GO TO 329)
DON'T KNOW 98 (GO TO 329)

327A) Where did the sterilization take place?

GOVERNMENT HOSPITAL/MCH CENTER 1
PRIVATE DOCTOR/PRIVATE NRSG HOME 2
NON-GOVERNMENT CLINIC 3
MOBILE CLINIC 4
GOVERNMENT PUBLIC HEALTH MIDWIFE/NURSE 5
OTHER FIELD WORKERS 6
AYURVEDIC DOCTOR 7
FRIEND/RELATIVE 8 (GO TO 329)
PHARMACY/SHOP 9 (GO TO 329)
OTHER (SPECIFY) ____ 10 (GO TO 329)
DON'T KNOW 98 (GO TO 329)

328) Was there anything you disliked about the service you received there? IF YES: What?

WAIT TOO LONG 1
STAFF DISCOURTEOUS 2
SERVICES EXPENSIVE 3
NOT ABLE TO GET DESIRED SERVICES/METHOD 4
OTHER (SPECIFY) ____ 5
NO COMPLAINTS 6

329) CHECK 223:

NOT PREGNANT OR NOT SURE
PREGNANT (GO TO 347)

330) CHECK 319:

HE/SHE STERILIZED (GO TO 332)
CURRENTLY USING ANOTHER METHOD
NOT CURRENTLY USING (GO TO 341)

331) For how long have you been using (CURRENT METHOD) continuously?

MONTHS____
YEARS____
SINCE LAST BIRTH 96

332) Have you experienced any problem from using (CURRENT METHOD)?

YES 1
NO 2 (GO TO 334)

333) What is the main problem you experienced?

METHOD FAILED 2
HUSBAND DISAPPROVED 3
HEALTH CONCERNS 4
ACCESS/AVAILABILITY 5
COSTS TOO MUCH 6
INCONVENIENT TO USE 7
OTHER (SPECIFY) ____ 10
DON'T KNOW 98

334) At any time during the same month, do you regularly use any other method than (CURRENT METHOD)?

YES 1
NO 2 (GO TO 336)

335) Which method is that? CHECK 302 THROUGH 333 AND CORRECT AS NECESSARY

PILL 1
IUD 2
INJECTIONS 3
DIAPHRAGM/FOAM/JELLY 4
CONDOM 5
SAFE PERIOD 8
WITHDRAWAL 9
NORPLANT 10
OTHER (SPECIFY) ____ 11

336) Have you ever used any other method before (CURRENT METHOD) (since your last birth) to avoid getting pregnant?

YES 1
NO 2 (GO TO 350)

337) Which method did you use before (CURRENT METHOD)?

PILL 1
IUD 2
INJECTIONS 3
DIAPHRAGM/FOAM/JELLY 4
CONDOM 5
MALE STERILIZATION 7
SAFE PERIOD 8
WITHDRAWAL 9
NORPLANT 10
OTHER (SPECIFY) ____ 11

338) In what month and year did you start using (METHOD BEFORE CURRENT) (the last time)?

MONTH____
YEAR____

339) For how long had you been using (METHOD BEFORE CURRENT) before you stopped using it (last time)?

MONTHS____
YEARS____
DON'T KNOW 98

340) What was the main reason you stopped using (METHOD BEFORE CURRENT) then?

METHOD FAILED 2 (GO TO 350)
HUSBAND DISAPPROVED 3 (GO TO 350)
HEALTH CONCERNS 4 (GO TO 350)
ACCESS/AVAILABILITY 5 (GO TO 350)
COST TOO MUCH 6 (GO TO 350)
INCONVENIENT TO USE 7 (GO TO 350)
INFEQUENT SEX 8 (GO TO 350)
TO USE PERMANENT METHOD 9 (GO TO 350)
OTHER (SPECIFY) ____ 10
DON'T KNOW 98 (GO TO 350)

341) CHECK 208: ANY BIRTHS?

YES
NO (GO TO 343)

342) Since your last birth have you used any method to avoid getting pregnant?

YES 1
NO 2 (GO TO 347)

343) Which was the last method you used?

PILL 1
IUD 2
INJECTIONS 3
DIAPHRAGM/FOAM/JELLY 4
CONDOM 5
MALE STERILIZATION 7
SAFE PERIOD 8
WITHDRAWAL 9
NORPLANT 10
OTHER (SPECIFY) ____ 11
DON'T KNOW 98

344) In what month and year did you start using that method (the last time)?

MONTH____
YEAR____

345) For how long had you been using (LAST METHOD) before you stopped using it (last time)?

MONTHS____
YEARS____

346) What was the main reason you stopped using (LAST METHOD) then?

TO BECOME PREGNANT 1
METHOD FAILED 2
HUSBAND DISAPPROVED 3
HEALTH CONCERNS 4
ACCESS/AVAILABILITY 5
COST TOO MUCH 6
INCONVENIENT TO USE 7
INFREQUENT SEX 8
OTHER (SPECIFY) ____ 9
DON'T KNOW 98

347) Do you intend to use a method to avoid pregnancy at any time in the future?

YES 1
NO 2 (GO TO 350)
DON'T KNOW 8 (GO TO 350)

348) Which method would you prefer to use?

PILL 1
IUD 2
INJECTIONS 3
DIAPHRAGM/FOAM/JELLY 4
CONDOM 5
FEMALE STERILIZATION 6
MALE STERILIZATION 7
SAFE PERIOD 8
WITHDRAWAL 9
NORPLANT 10
OTHER (SPECIFY) ____ 11
NOT SURE 12

349) Do you intend to use (PREFERRED METHOD) in the next 12 months?

YES 1
NO 2
DON'T KNOW 8

350) In the last month, have you heard or seen a message about family planning on the radio or on tv?

YES 1
NO 2 (GO TO 352)

351) Did you hear it once or more than once?

ONCE 1
MORE THAN ONCE 2

352) Do you think that it is acceptable or not acceptable for family planning information to be provided on radio? On television?

RADIO
ACCEPTABLE 1
NOT ACCEPTABLE 2
DON'T KNOW 8
TV
ACCEPTABLE 1
NOT ACCEPTABLE 2
DON'T KNOW 8

353) When do you listen to the radio?

MORNING 1
AFTERNOON 2
EVENING 3

354) What progress do you listen to? (CIRCLE ALL MENTIONED.)

NEWS OR BEHIND NEWS 1
QUIZ, DISCUSSIONS, DOCUMENTARIES 1
PLAYS, SOAPS, MUSIC 1
OTHER (SPECIFY) ____ 1

355) CHECK 223:

NOT PREGNANT OR UNSURE
PREGNANT (GO TO 356)

355A) CHECK 214:

HAD BIRTH SINCE JANUARY 1982
NO BIRTH SINCE JANUARY 1982 (GO TO 501)

356) Now I would like to get some more information about (your pregnancy and) the children you had in the last five years.

INTERVIEWER: FIRST, MARK PREGNANCY STATUS, AND FROM PAGE 10 RECORD NAMES OF BIRTHS SINCE 1982. SECOND, MARK APPROPRIATE BOX IN 357, AND ASK THE APPROPRIATE QUESTIONS FOR EACH COLUMN FOR WHICH THE HEADING IS FILLED OUT.

357) CHECK 306:

EVER USED A METHOD (ASK 358 THROUGH 365 FOR EACH COLUMN)
NEVER USED A METHOD (ASK 364 FOR EACH COLUMN)

358) Before you became pregnant (with NAME) and after the birth of (NAME) did you do anything to avoid getting pregnant, even for a short time?

YES 1
NO 2 (GO TO 364)

359) Which was the last method you used then? (CODES BELOW)

PILL 1
IUD 2
INJECTION 3
DIAPHRAGM/FOAM/JELLY 4
CONDOM 5
MALE STERILIZATION 7
SAFE PERIOD 8
WITHDRAWAL 9
NORPLANT 10
OTHER (SPECIFY) ____ 11

360) Any method before that? (RECORD CODE) (IF NONE, ENTER 00)

PILL 1
IUD 2
INJECTION 3
DIAPHRAGM/FOAM/JELLY 4
CONDOM 5
MALE STERILIZATION 7
SAFE PERIOD 8
WITHDRAWAL 9
NORPLANT 10
OTHER (SPECIFY) ____ 11

361) For how long had you used (LAST METHOD) that time?

MONTHS____
YEARS____

362) Did you become pregnant while you were still using (LAST METHOD)?

YES 1 (GO TO 365)
NO 2

363) What was the main reason you stopped using (LAST METHOD)? IF RESPONSE IS ΓÇ£TO GET PREGNANTΓÇ¥ CIRCLE 1 AND GO TO NEXT COLUMN. IF NOT, SEE CODES BELOW.

TO GET PREGNANT 1 (GO TO NEXT COLUMN)
NOT EFFECTIVE 2
HUSBAND DISAPPROVED 3
HEALTH CONCERNS 4
ACCESS/AVAILABILITY 5
COST TOO MUCH 6
INCONVINIENT TO USE 7
INFREQUENT SEX 8
OTHER (SPECIFY) ____ 10
DON'T KNOW 98

364) At the time you became pregnant (with NAME) did you want to have that child then, to wait until later, or to have no (more) children at all?

THEN 1 (GO TO NEXT COLUMN)
LATER 2 (GO TO NEXT COLUMN)
NO MORE 3 (GO TO NEXT COLUMN)

365) Did you want to have that child, but at a later time, or not have another child at all?

HAVE CHILD LATER 1 (GO TO NEXT COLUMN)
NOT HAVE CHILD 2 (GO TO NEXT COLUMN)

SECTION 4: HEALTH OF CHILDREN

401) CHECK 214:

HAD BIRTH SINCE JANUARY 1982
NO BIRTH SINCE JANUARY 1982 (GO TO 501)

402) FROM QUESTION 212 ON PAGE 10, RECORD THE NAMES AND LINE NUMBERS OF ALL BIRTHS SINCE JANUARY 1982 IN THE FOLLOWING TABLE. FOR EACH BIRTH, CHECK IF ALIVE OR DEAD, AND MARK THE APPROPRIATE BOX.

LAST BIRTH NAME____
LAST BIRTH LINE NUMBER____
ALIVE
DEAD

403) Did you receive a tetanus injection when you were pregnant with (NAME)?

YES, 1 DOSE 1
YES, 2 DOSES 2
NO 3
DOES NOT KNOW 4

404) Did you receive a tetanus injection when you were pregnant with (NAME)?

YES 1
NO 2

405) Did you visit a doctor or a clinic for a check on this pregnancy?

YES 1
NO 2

406) In what type of place was (NAME) born?

GOVERNMENT HOSPITAL/MATERNITY HOME 1
PRIVATE NURSING HOME 2
AT HOME 3
OTHER (SPECIFY) ____ 4

407) Who assisted with the delivery of (NAME)? PROVE AND RECORD MOST QUALIFIED PERSON.

DOCTOR 1
GOVERNMENT NURSE/MIDWIFE 2
TRADITIONAL BIRTH ATTENDANT 3
RELATIVE/NEIGHBOR 4
OTHER (SPECIFY) ____ 5
NO ONE 6

408) Did you ever feed (NAME) at the breast?

YES 1
NO 2 (GO TO 414)

409) How many days after birth did you begin feeding (NAME) at the breast?

SAME DAY 1
NEXT DAY 2
TWO DAYS AFTER 3
THREE OR MORE DAYS 4

410) Was the colostrum (the first milk produced) given to (NAME) or was it thrown away?

FED TO BABY 1 (GO TO 412)
THROWN AWAY 2

411) Why did you throw it away?

MILK BAD FOR BABY 1
MILK YELLOW 2
BABY REFUSED 3
HABIT 4

412) Are you still breastfeeding (NAME)? IF DEAD, CIRCLE ΓÇÿ3'.

YES 1 (GO TO 415)
NO 2
CHILD DEAD 3

413) At what age did you totally stop breastfeeding (NAME)?

MONTHS____
AT DEATH 96 (GO TO 415)

414) What is the main reason you (never breastfed/stopped breastfeeding)(NAME)?

NO MILK 1
INSUFFICIENT MILK 2
NIPPLE INJURED 3
MOTHER ILL 4
MOTHER BUSY 5
OTHER MILK/FOOD BTR FOR BABY 6
BABY ILL 7
BABY REFUSED 8
OTHER (SPECIFY) ____ 9
BECAME PREGNANT 10
BABY DIED RIGHT AFTER BIRTH 11 (GO TO 420)

415) At what age did you begin to give the following foods to (NAME)? READ OUT CATEGORIES. Powdered milk: half cream, powdered milk: full cream, cow/goat milk, cungee, eggs, mashed potatoes/cereal, fruit/juice/soup
00 IF GIVEN IN FIRST MOTH
96 IF NEVER GIVEN
98 IF DON'T KNOW

HALF CREAM
MONTHS____
FULL CREAM
MONTHS____
COW MILK
MONTHS____
CUNGEE
MONTHS____
EGGS
MONTHS____
POTATOES
MONTHS____
FRUIT
MONTHS____

416) At what age did you start at least one food on a daily basis?

MONTHS____

417) CHECK 416:

6 MONTHS OR LESS (GO TO 419)
7 MONTHS OR MORE

418) Why did you wait so long to begin daily supplemental feeding of (NAME)?

REASON____

419) When you began daily supplemental feeding of (NAME), did you continue full breastfeeding, did you reduce; or did you stop completely?

CONTINUED FULL 1
REDUCED 2
STOPPED 3
NEVER BREASTFED 4

420) How many months after the birth of (NAME) did your period return?

MONTHS____
NOT RETURNED 96

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

YES (OR PREGNANT) 1
NO 2 (GO TO NEXT COLUMN) 2

422) How many months after the birth of (NAME) did you not have sexual relations?

MONTHS____ (GO BACK TO PAGE 24 ASK 403 NEXT BIRTH)

423) FROM PAGE 10, RECORD THE NAMES OF ALL BIRTHS SINCE JANUARY 1982 IN THE FOLLOWING TABLE. FOR EACH BIRTH, CHECK IF ALIVE OR DEAD, AND MARK THE APPROPRIATE BOX.
ASK QUESTIONS 424 HROUGH 434 FOR ALL SURVIVING BIRTHS

LAST BIRTH (NAME) ____
ALIVE
DEAD (GO TO NEXT TO LAST BIRTH)

424) Do you have a clinic card, a child growth card or any other document showing what immunizations (NAME) was given?

YES, CARD SEEN 1
YES, NOT SEEN 2 (GO TO 426)
NO CARD 3 (GO TO 426)

425) RECORD THE DATES OF INJECTIONS FROM THE CARD. CIRCLE ΓÇ£1ΓÇ¥ IF NOT GIVEN.

BCG
NOT GIVEN 1 (GO TO 430)
YEAR____ (GO TO 430)
MONTH____ (GO TO 430)
DAY____ (GO TO 430)
TRIPLE 1
NOT GIVEN 1 (GO TO 430)
YEAR____ (GO TO 430)
MONTH____ (GO TO 430)
DAY____ (GO TO 430)
POLIO 1
NOT GIVEN 1 (GO TO 430)
YEAR____ (GO TO 430)
MONTH____ (GO TO 430)
DAY____ (GO TO 430)
TRIPLE 2
NOT GIVEN 1 (GO TO 430)
YEAR____ (GO TO 430)
MONTH____ (GO TO 430)
DAY____ (GO TO 430)
POLIO 2
NOT GIVEN 1 (GO TO 430)
YEAR____ (GO TO 430)
MONTH____ (GO TO 430)
DAY____ (GO TO 430)
TRIPLE 3
NOT GIVEN 1 (GO TO 430)
YEAR____ (GO TO 430)
MONTH____ (GO TO 430)
DAY____ (GO TO 430)
POLIO 3
NOT GIVEN 1 (GO TO 430)
YEAR____ (GO TO 430)
MONTH____ (GO TO 430)
DAY____ (GO TO 430)
MEASLES
NOT GIVEN 1 (GO TO 430)
YEAR____ (GO TO 430)
MONTH____ (GO TO 430)
DAY____ (GO TO 430)

426) Has (NAME) ever had an immunization to prevent him/her from getting diseases?

YES 1
NO 2 (GO TO 430)
DON'T KNOW 8 (GO TO 430)

427) Please tell me if (NAME) has had any of the following injections:

BCG
YES 1
NO 2
TRIPLE 1
YES 1
NO 2
POLIO 1
YES 1
NO 2
TRIPLE 2
YES 1
NO 2
POLIO 2
YES 1
NO 2
TRIPLE 3
YES 1
NO 2
POLIO 3
YES 1
NO 2
MEASLES
YES 1
NO 2

428) At what age was (NAME) given the last of these immunizations?

MONTHS____

429) Was (NAME) given a measles vaccine?

YES 1
NO 2

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

YES 1 (GO TO 432)
NO 2

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

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

432) Did you take (NAME) to a government hospital or clinic, to a Western doctor, or to an Ayurvetic doctor to treat the diarrhea (the last time)? IF YES: Where did you take him/her?

YES, GOVERNMENT HOSPITAL/CLINIC 1
YES, WESTERN DOCTOR 2
YES, AYURVETIC DOCTOR 3
NO, NOT TAKEN 9

433) Was (NAME) given any packet of Jeevanee or UNICEF salts to treat the diarrhea (the last time)?

YES 1
NO 2
DON'T KNOW 8

434) Was there anything (else) you or somebody did to treat the diarrhea? IF YES: What was done? CIRCLE CODE 1 FOR ALL MENTIONED

HOME SUGAR/SALT/ WATER SOLUTION 1 (GO TO NEXT COLUMN)
TABLETS/INJECTIONS, SYRUPS 1 (GO TO NEXT COLUMN)
INCREASE FLUIDS 1 (GO TO NEXT COLUMN)
INCREASE FOODS 1 (GO TO NEXT COLUMN)
GIVE CUNJEE 1 (GO TO NEXT COLUMN)
DECREASE FLUIDS 1 (GO TO NEXT COLUMN)
DECREASE FOODS 1 (GO TO NEXT COLUMN)
OTHER (SPECIFY) ____ 1 (GO TO NEXT COLUMN)
NOTHING 1 (GO TO NEXT COLUMN)

435) CHECK 433: ΓÇ£1ΓÇ¥ MARKED FOR ANY BIRTH? IF 433 IS EMPTY, MARK ΓÇ£NOΓÇ¥.

NO
YES (GO TO 439)

436) Have you ever heard of JEEVANEE or UNICEF Salts which you can give to a child with diarrhea?

JEEVANEE 1 (GO TO 438)
UNICEF 2 (GO TO 438)
BOTH 3 (GO TO 438)
NEITHER 4

437) INTERVIEWER: SHOW JEEVANEE AND UNICEF PACKETS. ASK: Have you ever seen either or both packets before?

JEEVANEE 1
UNICEF 2
BOTH 3
NEITHER 4 (GO TO 446)

438) Have you ever given either JEEVANEE or UNICEF Salts to any of your children?

YES 1
NO 2 (GO TO 446)

439) Where did you obtain the packet (the last time)?

GOVERNMETN HOSPITAL/CLINIC 1
MOH OFFICE 2
PHARMACY 3
PRIVATE DOCTOR4
OTHER (SPECIFY) ____ 5

440) How much did one packet cost? IF FREE, ENTER RS.00.00.

COST IN Rs.____
DON'T KNOW 9998

441) I now have some questions about how to prepare Jeevanee.

442) Please describe the type of water used to mix Jeevanee.

PLAIN WATER 1
BOILED AND COOLED 2
OTHER/DON'T KNOW 3

443) Describe how the powder is mixed.

1 PACKET IN 1 LITER OF WATER 1
OTHER/DON'T KNOW 2 (GO TO 445)

444) How do you measure the water?

1 LITER VESSEL 1
2.5 BOTTLES SODA WATER 2
1 1/3 BOTTLES ARRACK 3
5 TEA CUPS 4
OTHER/DON'T KNOW 5

445) How long can you keep the solution once it has been mixed?

24 HOURS OR LESS 1
OTHER/DON'T KNOW 2

446) CHECK 412 FOR LAST BIRTH:

LAST CHILD STILL BREASTFED
ALL OTHERS (GO TO 501)

447) How many times did you breastfeed (NAME OF LAST BIRTH) last night, between sundown and sunrise?

NUMBER OF TIMES____
CHILD SLEEPS AT BREAST 96

448) How many times did you breastfeed (NAME OF LAST BIRTH ) yesterday during the daylight hours?

NUMBER OF TIMES____
AS OFTEN AS WANTED 96

449) At any time yesterday or last night, was (NAME OF LAST BIRTH) given any of the following? READ OUT CODING CATEGORIES

PLAIN WATER?
YES 1
NO 2
JUICE?
YES 1
NO 2
POWDERED MILK
YES 1
NO 2
COW OR GOAT MILK
YES 1
NO 2
ANY OTHER LIQUID
YES 1
NO 2
SOLID OR MUSHY FOOD
YES 1
NO 2

450) CHECK 449:

NO FOOD OR LIQUIDS GIVEN (ALL ΓÇ£2ΓÇ¥S CIRCLED) (GO TO 452)
WAS GIVEN FOOD OR LIQUIDS (AT LEAST ONE ΓÇ£1ΓÇ¥ CIRCLED)

451) Were any of these given in a bottle with a nipple?

YES 1
NO 2

452) CHECK 430 AND 431 FOR LAST BIRTH:

NO DIARRHEA IN LAST 2 WEEKS (GO TO 501)
HAD DIARRHEA IN LAST 2 WEEKS

453) When (NAME) had diarrhea recently, did you continue (full) breastfeeding, did you reduce, or did you stop completely?

CONTINUED FULL 1 (GO TO 501)
REDUCED 2
STOPPED COMPLETELY 3

454) Why did you (reduce/stop)?

REASON____

SECTION 5: MARRIAGE

501) Are you currently married, or are you widowed, divorced, or separated?

MARRIED 1
WIDOWED 2 (GO TO 502)
DIVORCED 3 (GO TO 502)
SEPARATED 4 (GO TO 502)

501A) Are you and your husband currently living together?

YES 1
NO 2

502) Have you been married once, or more than once?

ONCE 1
MORE THAN ONCE 2

503) In what month and year did you start living with your (first) husband as husband and wife?

MONTH____
DON'T KNOW 98
YEAR____ (GO TO 505)
DON'T KNOW 98

504) How old were you when you started living with him?

AGE____

505) Where did you live before you began living with your husband: in metropolitan Colombo, another urban area, in a village, or on an estate?

COLOMBO METRO (ZONE 1) 1
OTHER URBAN 2
VILLAGE 3
ESTATE 4

506) Did your (first) husband live in the same place before marriage, or in a different urban area, village, or estate?

SAME URBAN AREA/VILLAGE/ESTATE 1 (GO TO 508)
DIFFERENT URBAN AREA 2
DIFFERENT VILLAGE 3
DIFFERENT ESTATE 4

507) How many miles was his place from yours?

MILES____

508) Are your mother and father still alive?

WOMAN'S MOTHER
YES 1
NO 2
DON'T KNOW 8
WOMAN'S FATHER
YES 1
NO 2
DON'T KNOW 8

509) Are your first husband's parents still alive?

HUSBAND'S MOTHER
YES 1
NO 2
DON'T KNOW 8
HUSBAND'S FATHER
YES 1
NO 2
DON'T KNOW 8

510) CHECK 508 AND 509:

AT LEAST ONE PARENT NOT LIVING (NOT ALL 1'S CIRCLED)
ALL PARENTS LIVING (ALL 1'S CIRCLED) (GO TO 514)

511) FOR EACH ΓÇ£1ΓÇ¥ CIRCLED IN 508 AND 509, CIRCLE A ΓÇ£1ΓÇ¥ FOR THE CORRESPONDING PARENT IN 512. THEN ASK 512 FOR THOSE PARENTS NOT HAVING A ΓÇ£1ΓÇ¥ CIRCLED.

512) Was (MENTION PARENTS NOT ALIVE NOW) alive at the time you began living with your (first) husband?

WOMAN'S MOTHER
YES 1
NO 2
DON'T KNOW 8
WOMAN'S FATHER
YES 1
NO 2
DON'T KNOW 8
HUSBAND'S MOTHER
YES 1
NO 2
DON'T KNOW 8
HUSBAND'S FATHER
YES 1
NO 2
DON'T KNOW 8

513) CHECK 512:

SOME PARENT ALIVE AT MARRIAGE
NO PARENT ALIVE AT MARRIAGE (GO TO 517)

514) At the time you began living with your (first) husband, did you and he live with any of these parents for at least 6 months?

YES 1
NO 2 (GO TO 516)

515) For about how many years did you live with your parents at this time?

YEARS____
UP TO THE PRESENT 96 (GO TO 517)

516) Are you now living either with your parents or with your husband's parents?

YES 1
NO 2

517) CHECK 501:

CURRENTLY MARRIED
OTHER (GO TO 601)

518) Have you had sexual intercourse in the last four weeks?

YES 1
NO 2 (GO TO 520)

519) How many times?

TIMES_____

520) When was the last time you had sexual intercourse?

DAYS AGO____ 1
WEEKS AGO____ 2
MONTHS AGO____ 3
YEARS AGO____ 4
BEFORE LAST BIRTH 995 (GO TO 525)

521) CHECK 223:

NOT PREGNANT/NOT SURE
PREGNANT (GO TO 525)

522) CHECK 315:

NOT USING CONTRACEPTION
CURRENTLY USING (GO TO 525)

523) If you became pregnant in the next few weeks, would you feel happy, unhappy, or would it not matter very much?

HAPPY (GO TO 525)
UNHAPPY 2
WOULD NOT MATTER 3

524) What is the main reason that you are not using a method to avoid pregnancy?

LACK OF KNOWLEDGE OR LACK OF SOURCE 1
OPPOSED TO FAMILY PLANNING 2
HUSBAND DISAPPROVES 3
OTHER PEOPLE DISAPPROVE 4
INFREQUENT SEX 5
POSTPARTUM/BREASTFEEDING 6
MENOPAUSAL/SUBFECUND 7
HEALTH CONCERNS 8
ACCESS/AVAILABILITY 9
COSTS TOO MUCH 10
RELIGION 11
INCONVENIENT TO USE 12
OTHER (SPECIFY) ____ 13
DON'T KNOW 98

525) PRESENCE OF OTHERS AT THIS POINT:

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

SECTION 6: FERTILITY PREFERENCES

601) CHECK 319:

WOMAN STERILIZED (GO TO 609)
HUSBAND STERILIZED (GO TO 610)
OTHER

602) CHECK 501:

CURRENTLY MARRIED
OTHER (GO TO 612)

603) Now I have some questions about the future. CHECK 223:

NOT PREGNANT/NOT SURE: Would you like to have a (another) child or would you prefer not to have any (any more) children?
HAVE A/ANOTHER CHILD 1 (GO TO 606)
NO (MORE) CHILDREN 2
UNDECIDED OR DON'T KNOW 8 (GO TO 605)
PREGNANT: After the child you are expecting, would you like to have another child or would you prefer not to have any more children?
HAVE A/ANOTHER CHILD 1 (GO TO 606)
NO (MORE) CHILDREN 2
UNDECIDED OR DON'T KNOW 8 (GO TO 605)

604) Would you say that you definitely do not want to have (more) children, or are you not sure?

DEFINITELY NO MORE 1 (GO TO 612)
NOT SURE (GO TO 612)

605) Are you more inclined toward having a (another) child, or toward not having a (another) child?

HAVE ANOTHER 1 (GO TO 607)
NOT HAVE ANOTHER 2 (GO TO 612)
NOT SURE 8 (GO TO 612)

606) Would you say that you definitely want a (another) child, or are you not sure?

DEFINITELY MORE 1
NOT SURE 2

607) How long would you like to wait from now before the birth of a (another) child?

MONTHS____ 1 (GO TO 612)
YEARS____ 2 (GO TO 612)
DON'T KNOW 998

608) How old would your youngest child be? IF NO LIVING CHILDREN, CIRCLE ΓÇÿ96'.

YEARS____ (GO TO 612)
NO LIVING CHILDREN 96 (GO TO 612)
DON'T KNOW 98 (GO TO 612)

609) Was your last child born by caesarean section?

YES 1
NO 2

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

YES 1
NO 2 (GO TO 612)

611) Would you like to have another child or would you prefer not to have any more children?

HAVE ANOTHER 1
NO MORE 2
DON'T KNOW 8

612) CHECK 202 AND 204 AND MARK CORRECT BOX. RECORD SINGLE NUMBER, RANGE OR OTHER ANSWER.

HAS NO LIVING CHILDREN: If you could choose exactly the number of children to have in your whole life, how many would that be?
NUMBER____
RANGE BETWEEN____ AND____
OTHER ANSWER (SPECIFY) ____
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?
NUMBER____
RANGE BETWEEN____ AND____
OTHER ANSWER (SPECIFY) ____

SECTION 7: HUSBAND'S BACKGROUND AND WORK

701) Now I have some questions about your (most recent) husband, his background, and his work.

702) Did your husband ever attend school?

YES 1
NO 2 (GO TO 706)

703) What was the highest grade in school he completed? CIRCLE BOTH LEVEL AND GRADE.

PRIMARY 1
00 (GO TO 705)
01 (GO TO 705)
02 (GO TO 705)
03 (GO TO 705)
04 (GO TO 705)
05 (GO TO 705)
SECONDARY 2
06
07
08
09
HIGHER 3
10
11
12
13
DON'T KNOW 998 (GO TO 706)

704) What was the highest exam he passed?

TECHNICAL 1
G.C.E. O LEVEL 2
G.C.E. A LEVEL 3
UNIVERSITY/PROFESSIONAL 4
OTHER (SPECIFY) ____ 5
NONE 6

705) CHECK 703:

PRIMARY
SECONDARY OR HIGHER (GO TO 707)

706) Can (could) he read a letter or newspaper easily, with difficulty, or not at all?

EASILY 1
WITH DIFFICULTY 2
NOT AT ALL 3

707) What kind of work does (did) your husband mainly do?

FARMING 1 (GO TO 709)
FISHING/HUNTING 2
ESTATE WORKER 3
UNSKILLED LABORER/OWN ACCOUNT 4
UNSKILLED LABORER/PRIVATE/GOVERNMENT EMPLOYEE 5
SKILLED LABORER/PRIVATE/GOVERNMENT EMPLOYEE 6
SKILLED LABORER/PRIVATE/GOVERNMENT EMPLOYEE 7
PETIT TRADER/HAWKER 8
COTTAGE INDUSTRY 9
DOMESTIC WORKER 10
TEACHER: PRIMARY/SECONDARY 11
TEACHER: UNIVERSITY/OTHER 12
NURSE/HEALTH WORKER 13
TECHNICAL/MANAGERIAL/PROFESSIONAL 14
OTHER (SPECIFY) ____ 15
DOES NOT KNOW 98

708) Does (did) he earn a regular wage or salary?

YES 1 (GO TO 711)
NO 2 (GO TO 711)
DOES NOT KNOW 8 (GO TO 711)

709) Does (did) your husband work mainly on his or his family's or on someone else's land?

HIS/FAMILY LAND 1
SOMEONE ELSE'S LAND 2 (GO TO 710)

709A) Does (did) he hire others to work the land or his?

YES 1 (GO TO 711)
NO 2 (GO TO 711)

710) Does (did) he work mainly for money or does (did) he work for a share of the crops?

MONEY 1
SHARE OF CROPS 2

711) Now I have some questions about your work.

712) Before you married your (first) husband, did you ever work regularly to earn money, other than on a farm or in a business run by your family?

YES 1
NO 2 (GO TO 714)

713) When you were earning money then, did you turn most of it over to your family or did you keep most of it for yourself?

TURNED OVER TO FAMILY 1
KEPT FOR SELF 2

714) Since you were first married, have you ever worked regularly to earn money other than on a farm or in a business run by your family?

YES 1
NO 2 (GO TO 716)

715) Are you now working to earn money, other than on a farm or in a business run by your family?

YES 1 (GO TO 717)
NO 2

716) Are you now working to earn money on a farm or in a business run by your family?

YES 1
NO 2 (GO TO 801)

717) What kind of work do you mainly do?

FARMING 1 (GO TO 709)
FISHING/HUNTING 2
ESTATE WORKER 3
UNSKILLED LABORER/OWN ACCOUNT 4
UNSKILLED LABORER/PRIVATE/GOVERNMENT EMPLOYEE 5
SKILLED LABORER/PRIVATE/GOVERNMENT EMPLOYEE 6
SKILLED LABORER/PRIVATE/GOVERNMENT EMPLOYEE 7
PETIT TRADER/HAWKER 8
COTTAGE INDUSTRY 9
DOMESTIC WORKER 10
TEACHER: PRIMARY/SECONDARY 11
TEACHER: UNIVERSITY/OTHER 12
NURSE/HEALTH WORKER 13
TECHNICAL/MANAGERIAL/PROFESSIONAL 14
OTHER (SPECIFY) ____ 15
DOES NOT KNOW 98

SECTION 8: SOCIOECONOMIC INDICATORS

801) Has your household experienced any food shortages in the past 6 months?

YES 1
NO 2 (GO TO 803)

802) Has your household experienced any food shortages in the past 2 weeks?

YES 1
NO 2

803) INTERVIEWER: DO MEMBERS OF THE HOUSEHOLD APPEAR WEALTHY ENOUGH TO OWN A CHANGE OF CLOTHES?

YES 1
NO 2

804) RECORD THE TIME.

HOUR____
MINUTES____

SECTION 9: LENGTH AND WEIGHT

INTERVIEWER: FROM PAGE 10, RECORD NAMES AND LINE NUMBERS OF ALL LIVING CHILDREN BORN SINCE JANUARY 1, 1984. START WITH THE YOUNGEST CHILD. RECORD DATE OF BIRTH IN 901 AND CHECK AGE IN 902. THEN GO TO TEAR-OFF SHEET.

901) DATE OF BIRTH

MONTH____
YEAR____

902) CHECK AGE: 3 TO 36 MONTHS?

YES
NO (GO TO NEXT YOUNGEST LIVING CHILD

903) LENGTH (IN CENTIMETERS)

LENGTH____

904) WEIGHT (IN KILOGRAMS)

WEIGHT____

905) STATE REASON IF UNABLE TO RECORD

REASON____

906) NAME OF MEASURER____
NAME OF ASSISTANT____

INTERVIEWER'S OBSERVATIONS

(To be filled in after completing interview.)

Person Interviewed____

Specific Questions____

Other Aspects____

Name of Interviewer____

Date____

SUPERVISOR'S OBSERVATIONS.

Name of Supervisor____

Date____

EDITOR'S OBSERVATIONS.

Name of Field Editor____

Date____

Name of Keyer____

Date____