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GOVERNMENT OF LIBERIA

LIBERIA INSTITUTE FOR STATISTICS AND GEO-INFORMATION SERVICES

2006 LIBERIA DEMOGRAPHIC AND HEALTH SURVEY QUESTIONNAIRE FOR MEN AGED 15-49

IDENTIFICATION

NAME OF COUNTY____

NAME OF DISTRICT____

NAME OF CLAN/TOWNSHIP____

NAME OF CITY/TOWN/VILLAGE____

LDHS CLUSTER NUMBER_____

LDHS STRUCTURE NUMBER_____

HOUSEHOLD NUMBER_____

URBAN:

MONROVIA 1
OTHER URBANS 2
VILLAGE 3

NAME OF HOUSEHOLD HEAD____

NAME AND LINE NUMBER OF MAN____

INTERVIEWER VISITS

FIRST VISIT (REPEAT FOR SECOND AND THIRD VISITS)
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___

FINAL VISIT
DAY____
MONTH____
YEAR 200____
INTERVIEWER NUMBER____
RESULT*

TOTAL NUMBER OF VISITS

SUPERVISOR
NAME____
DATE____

FIELD EDITOR
NAME____
DATE____

OFFICE EDITOR____

KEYED BY____

SECTION 1. RESPONDENT'S BACKGROUND

Hello. My name is _____ and I am working with the Liberia Institute for Statistics and Geo-Information Services (LISGIS). We are conducting a National Demographic and Health Survey that asks women and men about various health issues. We would very much appreciate your participation in this survey. This information will help the government to plan health services. The survey interview usually takes about 45 minutes. The information you provide will be kept strictly confidential and will not be shown to other persons.

Participation in this survey is voluntary. If I ask you any question you don't want to answer, just let me know and I will go on to the next question; or you can stop the interview at any time. However, we hope that you will participate in this survey since your views are important.

Do you want to ask me anything about the survey? May I begin the interview now?

Signature of interviewer:________ Date: _______
RESPONDENT AGREES TO BE INTERVIEWED 1
RESPONDENT DOES NOT AGREE TO BE INTERVIEWED (END)

101) RECORD THE TIME AT START OF INTERVIEW:

HOUR____
MINUTES____

102) How long have you been living continuously in (NAME OF CITY, TOWN, VILLAGE)?
IF LESS THAN ONE YEAR, RECORD '00' YEARS.

YEARS___
ALWAYS 95 (GO TO 103A)
VISITOR 96 (GO TO 103A)

103) Just before you moved here, did you live in a city, in a town, or in a village?

CITY 1
TOWN 2
VILLAGE 3

103A) During the war, did you leave your house? IF YES: Where did you go?
CIRCLE ALL MENTIONED.

NO, DID NOT LEAVE THE HOUSE A
STAYED WITH RELATIVES OR FRIENDS INSIDE LIBERIA B
WENT TO A CAMP C
LIVED IN THE BUSH D
WENT OUTSIDE LIBERIA E
OTHER (SPECIFY) ________ X

104) In the last 12 months, how many times did you travel away from your home and slept away?

NUMBER OF TRIPS____
NONE 00 (GO TO 106)

105) In the last 12 months, have you been away from home for more than one month at a time?

YES 1
NO 2

106) In what month and year were you born?

MONTH___
DON'T KNOW MONTH 98
YEAR____
DON'T KNOW YEAR 9998

107) How old are you?
COMPARE AND CORRECT 106 AND/OR 107 IF INCONSISTENT.

AGE IN COMPLETED YEARS____

108) Have you ever been to school?

YES 1
NO 2 (GO TO 112)

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

PRIMARY 1
SECONDARY 2
HIGHER 3

110) What is the highest grade you completed at that level?

GRADE____

111) CHECK 109:

PRIMARY
SECONDARY OR HIGHER (GO TO 115)

112) Can you read this sentence to me?

SHOW SENTENCES TO RESPONDENT.

IF RESPONDENT CANNOT READ WHOLE SENTENCE, PROBE: Can you read any part of the sentence to me?

CANNOT READ AT ALL 1
CAN READ ONLY PART OF SENTENCE 2
CAN READ WHOLE SENTENCE 3
CAN READ, BUT NOT ENGLISH (SPECIFY LANGUAGE) __________ 4
BLIND/VISUALLY IMPAIRED 5

SENTENCES FOR READING (Q. 112):

1. The child is reading a book.
2. Farming is hard work.
3. Parents should care for their children.
4. The rains were heavy this year.

113) Have you ever been to any program besides primary school that teaches you to read and write?

YES 1
NO 2

114) CHECK 112:

CODE '2', '3', OR '4' CIRCLED
CODE '1' OR '5' (GO TO 116)

115) Do you read newspapers or magazines? How many times a week do you read them: almost every day, at least once a week, less than once a week or not at all?

ALMOST EVERY DAY 1
AT LEAST ONCE A WEEK 2
LESS THAN ONCE A WEEK 3
NOT AT ALL 4

116) Do you listen to the radio? How many times a week do you listen: almost every day, at least once a week, less than once a week or not at all?

ALMOST EVERY DAY 1
AT LEAST ONCE A WEEK 2
LESS THAN ONCE A WEEK 3
NOT AT ALL 4

117) Do you watch TV or videos? How many times a week do you watch TV: almost every day, at least once a week, less than once a week or not at all?

ALMOST EVERY DAY 1
AT LEAST ONCE A WEEK 2
LESS THAN ONCE A WEEK 3
NOT AT ALL 4

118) What is your religion?

CHRISTIAN 1
MUSLIM 2
TRADITIONAL RELIGION 3
OTHER (SPECIFY) _________ 6

119) What dialect do you speak (besides English)?

BASSA 01
GBANDI 02
BELLE 03
DEY 04
GIO 05
GOLA 06
GREBO 07
KISSI 08
KPELLE 09
KRAHN 10
KRU 11
LORMA 12
MANDIGO 13
MANO 14
MENDE 15
VAI 16
NONE/ONLY ENGLISH 17
OTHER 96

SECTION 2. REPRODUCTION

201) Now I would like to ask about any children you have had during your life. I am interested in all of the children that are biologically yours, even if they are not legally yours or do not have your last name.

Have you ever fathered any children with any woman?

YES 1
NO 2 (GO TO 206)
DON'T KNOW 8 (GO TO 206)

202) Do you have any sons or daughters that you have fathered 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 you have fathered 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) Have you ever fathered a son or daughter who was born alive but later died?
IF NO, PROBE: Any baby who cried or showed signs of life but did not survive?

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:

HAS HAD MORE THAN ONE CHILD
HAS HAD ONLY ONE CHILD (GO TO 212)
HAS NOT HAD ANY CHILDREN (GO TO 301)

210) Did all of the children you have fathered have the same biological mother?

YES 1 (GO TO 212)
NO 2

211) In all, how many women have you fathered children with?

NUMBER OF WOMEN____

212) How old were you when your (first) child was born?

AGE IN YEARS____

213) CHECK 203 AND 205:

AT LEAST ONE LIVING CHILD
NO LIVING CHILDREN (GO TO 301)

214) How many years old is your (youngest) child?

AGE IN YEARS___

215) CHECK 214:

(YOUNGEST) CHILD IS AGE 0-3 YEARS
OTHER (GO TO 301)

216) What is the name of your (youngest) child?
WRITE NAME OF (YOUNGEST) CHILD

NAME OF (YOUNGEST) CHILD_________

217) Was (NAME) born in a hospital or health facility?

HOSPITAL/HEALTH FACILITY 1 (GO TO 219)
OTHER 2

218) What was the main reason why (NAME)'s mother did not deliver in a hospital or health facility?

COST TOO MUCH 01
FACILITY CLOSED 02
TOO FAR/NO TRANSPORTATION 03
DON'T TRUST FACILITY/POOR QUALITY SERVICE 04
NO FEMALE PROVIDER 05
NOT THE FIRST CHILD 06
CHILD'S MOTHER DID NOT THINK IT WAS NECESSARY 07
HE DID NOT THINK IT WAS NECESSARY 08
FAMILY DID NOT THINK IT WAS NECESSARY 09
OTHER (SPECIFY) 96
DON'T KNOW 98

219) When a child has a running stomach, how much should he or she be given drink: more than usual, the same amount as usual, less than usual, or should he or she not be given anything to drink at all?

MORE THAN USUAL 1
ABOUT THE SAME 2
LESS THAN USUAL 3
NOTHING TO DRINK 4
DON'T KNOW 8

SECTION 3. CONTRACEPTION

301) Now I would like to talk about family planning or birth control.

Which family planning methods have you heard about?
FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK:
Have you ever heard of (METHOD)?

CIRCLE CODE 1 IN 301 FOR EACH METHOD MENTIONED SPONTANEOUSLY. THEN PROCEED DOWN COLUMN 301, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 1 IF METHOD IS RECOGNIZED, AND CODE 2 IF NOT RECOGNIZED. THEN, FOR METHODS 02, 07, 10, AND 11, ASK 302 IF 301 HAS CODE 1 CIRCLED.

01) FEMALE STERILIZATION, TUBE TIE, TURNING THE WOMB. Women can have an operation to avoid having any more children.
YES 1
NO 2
02) MALE STERILIZATION: Men can have an operation to avoid having any more children.
YES 1
NO 2
03) PILL: Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2
04) IUD: Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
05) INJECTABLES: Women can have an injection by a health [provider in] their upper […arm] that stops them from becoming pregnant for one or more months.
YES 1
NO 2
06) IMPLANTS: Women can have several small rods placed in arm by a doctor or nurse which can prevent pregnancy for one or more years.
YES 1
NO 2
07) CONDOM, RAINCOAT: Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
08) FEMALE CONDOM: Women can put a sheath in their vagina before sexual intercourse.
YES 1
NO 2
09) RHYTHM METHOD, CALENDAR: A woman can avoid getting pregnant if she doesn't have sex on the days of the month she is most likely to get pregnant.
YES 1
NO 2
10) WITHDRAWAL: Men can be careful and pull out before climax.
YES 1
NO 2
11) EMERGENCY CONTRACEPTION: After having unprotected sex, women can take special pills at any time within five days to prevent pregnancy.
YES 1
NO 2
12) Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES (SPECIFY)_________ 1
NO 2

302) Have you ever used (METHOD)?

02) MALE STERILIZATION: 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
07) CONDOM, RAINCOAT: Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
09) RHYTHM METHOD, CALENDAR: A woman can avoid getting pregnant if she doesn't have sex on the days of the month she is most likely to get pregnant.
YES 1
NO 2
10) WITHDRAWAL: Men can be careful and pull out before climax.
YES 1
NO 2

303) In the last few months, have you:

Heard about family planning on the radio?
YES 1
NO 2
Heard about family planning on the television?
YES 1
NO 2
Read about family planning in a newspaper or magazine?
YES 1
NO 2

304) In the last few months, have you discussed family planning with a health worker or health professional?

YES 1
NO 2

306) When do you think a woman can get pregnant: just before her period begins, during her period, just after her period ends, or halfway between two periods?

JUST BEFORE HER PERIOD BEGINS 1
DURING HER PERIOD 2
JUST AFTER HER PERIOD ENDS 3
HALFWAY BETWEEN TWO PERIODS 4
ANY TIME 5
OTHER (SPECIFY) 6
DON'T KNOW 8

307) Do you think that a woman who is giving titi to her baby can get pregnant?

YES 1
NO 2
DEPENDS 3
DON'T KNOW 8

308) Please tell me if you agree or disagree.

a) Contraception is women's business and a man should not have to worry about it.
AGREE 1
DISAGREE 2
DON'T KNOW 8
b) Women who use contraception may become promiscuous.
AGREE 1
DISAGREE 2
DON'T KNOW 8

309) CHECK 301 (07): KNOWS MALE CONDOM

YES
NO (GO TO 401)

310) Do you know of a place where a person can get condoms?

YES 1
NO 2 (GO TO 401)

311) Where is that? Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

NAME OF PLACE(S)_____
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
GOVERNMENT HEALTH CLINIC C
NACP D
OTHER PUBLIC (SPECIFY) ________ E
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC F
PHARMACY G
PRIVATE DOCTOR H
FAMILY PLANNING ASSN. LIBERIA
MOBILE CLINIC J
OTHER PRIVATE MEDICAL (SPECIFY) _______ K
OTHER SOURCE
SHOP L
CHURCH M
FRIEND/RELATIVE N
OTHER (SPECIFY) __________ X

312) If you wanted to, could you get yourself a condom?

YES 1
NO 2

SECTION 4. MARRIAGE AND SEXUAL ACTIVITY

401) Are you currently married or living together with a woman as if married?

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

402) Have you ever been married or lived together with a woman as if married?

YES, FORMERLY MARRIED 1
YES, LIVED WITH A WOMAN 2
NO 3 (GO TO 413)

403) What is your marital status now: are you widowed, divorced, or separated?

WIDOWED 1 (GO TO 410)
DIVORCED 2 (GO TO 410)
SEPARATED 3 (GO TO 410)

404) Is your wife/partner living with you now or is she staying elsewhere?

LIVING WITH HIM 1
STAYING ELSEWHERE 2

405) Do you have more than one wife or woman you live with as if married?

YES 1
NO 2 (GO TO 407)

406) Altogether, how many wives do you have or other partners do you live with as if married?

TOTAL NUMBER OF WIVES AND LIVE-IN PARTNERS____

407) CHECK 405:

ONE WIFE/PARTNER: Please tell me the name of your wife (the woman you are living with as if married).

MORE THAN ONE WIFE/PARTNER: Please tell me the name of each of your current wives (and/or of each woman you are living with as if married).

RECORD THE NAME AND THE LINE NUMBER FROM THE HOUSEHOLD QUESTIONNAIRE FOR EACH WIFE AND LIVE-IN PARTNER.

IF WOMAN IS NOT LISTED IN THE HOUSEHOLD, RECORD '00'.

ASK 408 FOR EACH PERSON.

NAME____
LINE NUMBER___

408) How old was (NAME) on her last birthday?

AGE___

409) CHECK 407:

ONE WIFE/PARTNER
MORE THAN ONE WIFE/PARTNER (GO TO 411A)

410) Have you been married or lived with a woman only once or more than once?

ONLY ONCE 1
MORE THAN ONCE 2 (GO TO 411A)

411) In what month and year did you start living with your wife (partner)?
411A) Now I would like to ask a question about your first wife/partner. In what month and year did you start living with your first wife/partner?

MONTH____
DON'T KNOW MONTH 98
YEAR___ (GO TO 413)
DON'T KNOW YEAR 9998

412) How old were you when you first started living with her?

AGE____

413) CHECK FOR THE PRESENCE OF OTHERS. BEFORE CONTINUING, MAKE EVERY EFFORT TO ENSURE PRIVACY.

414) Now I would like to ask you some questions about woman business in order to gain a better understanding of some important life issues.

How old were you when you did woman business for the first time?

NEVER HAD SEXUAL INTERCOURSE 00
AGE IN YEARS___ (GO TO 417)
FIRST TIME WHEN STARTED LIVING WITH (FIRST) WIFE/PARTNER 95 (GO TO 417)

415) CHECK 107:

AGE 15-24
AGE 25-49 (GO TO 501)

416) Do you plan to wait until you get married to do woman business?

YES 1 (GO TO 501)
NO 2 (GO TO 501)
DON'T KNOW/UNSURE 8 (GO TO 501)

417) CHECK 107:

AGE 15-24
AGE 24-49 (GO TO 419)

418) The first time you did woman business, did you use a condom?

YES 1
NO 2
DON'T KNOW/DON'T REMEMBER 8

419) When was the last time you did woman business?

IF LESS THAN 12 MONTHS, ANSWER MUST BE RECORDED IN DAYS, WEEKS OR MONTHS. IF 12 MONTHS (ONE YEAR) OR MORE, ANSWER MUST BE RECORDED IN YEARS.

DAYS AGO 1____
WEEKS AGO 2____
MONTHS 3____
YEARS 4____ (GO TO 435)

420) Now I would like to ask you some questions about your recent sexual activity. Let me assure you again that your answers are completely confidential and will not be told to anyone. If I ask any question that you don't want to answer, just let me know and we will go to the next question. (GO TO 422)

421) When was the last time you did woman business with this person?
[EXCLUDE LAST SEXUAL PARTNER]

DAYS 1____
WEEKS 2____
MONTHS 3____

422) The last time you did woman business (with this second/third person), did you use a condom?

YES 1
NO 2 (GO TO 424)

423) Did you use a condom every time you did woman business with this person in the last 12 months?

YES 1
NO 2

424) What was your relationship to this (second/third) person with whom you did woman business?

IF GIRLFRIEND: Were you living together as if married?
IF YES, CIRCLE '02'. IF NO, CIRCLE '03'.

WIFE 1 (GO TO 426)
LIVE-IN PARTNER 2 (GO TO 426)
GIRLFRIEND NOT LIVING WITH RESPONDENT 3
CASUAL ACQUAINTANCE 4
PROSTITUTE 5
OTHER (SPECIFY) 6

425) How long (have you done/did you do) woman business with her?
IF ONLY HAD SEXUAL RELATIONS WITH THIS PERSON ONCE, RECORD '01' DAYS.

DAYS 1____
MONTHS 2____
YEARS 3____

426) The last time you did woman business with this (second/third) person, did you or this person drink alcohol?

YES 1
NO 2 (GO TO 428)

427) Were you or your partner drunk at that time?
IF YES: Who was drunk?

RESPONDENT ONLY 1
PARTNER ONLY 2
RESPONDENT AND PARTNER BOTH 3
NEITHER 4

428) Apart from [this person/these two people], did you do woman business with any other person in the last 12 months?
[EXCLUDE THIRD TO LAST PARTNER]

YES 1 (GO BACK TO 421 IN NEXT COLUMN)
NO 2 (GO TO 430)

429) In the last 12 months, how many women have you done woman business with?
PROBE TO GET AN ESTIMATE.
[ASK ONLY FOR THIRD TO LAST SEXUAL PARTNER]

IF MORE THAN 96, WRITE '96'.

NUMBER OF PARTNERS LAST 12 MONTHS____
DON'T KNOW 98

430) CHECK 424 (ALL COLUMNS):

AT LEAST ONE PARTNER IS PROSTITUTE
NO PARTNERS ARE PROSTITUTES (GO TO 432)

431) CHECK 424 AND 422 (ALL COLUMNS):

CONDOM USED WITH EVERY PROSTITUTE (GO TO 434)
OTHER (GO TO 435)

432) In the last 12 months, did you pay anyone in exchange for doing woman business?

YES 1
NO 2 (GO TO 435)

433) The last time you paid someone in exchange for doing woman business, did you use a condom?

YES 1
NO 2 (GO TO 435)

434) Did you use a condom every time you paid someone in exchange for doing woman business in the last 12 months?

YES 1
NO 2
DON'T KNOW 8

435) In your whole life, how many woman have you done woman business with?
PROBE TO GET AN ESTIMATE.

IF MORE THAN 96, WRITE '96'.

NUMBER OF PARTNERS IN LIFETIME____
DON'T KNOW 98

436) CHECK 422, MOST RECENT PARTNER (FIRST COLUMN):

CONDOM USED
NO CONDOM USED (GO TO 442)

439) How many condoms did you get the last time?

NUMBER OF CONDOMS____
DON'T KNOW 998

440) The last time you obtained condoms, how much did you pay in total, including the cost of the condom(s) and any consultation you may have had?

COST___
FREE 995
DON'T KNOW 998

441) From where did you obtain the condom the last time?

PROBE TO IDENTIFY TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF PLACE.

NAME OF PLACE____
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
GOVERNMENT HEALTH CLINIC 13
NACP 14
OTHER PUBLIC (SPECIFY) __________ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY 22
PRIVATE 23
FAMILY PLANNING ASSN. LIBERIA 24
MOBILE CLINIC 25
OTHER PRIVATE MEDICAL (SPECIFY) __________ 26
OTHER SOURCE
SHOP 31
CHURCH 32
FRIEND/RELATIVE 33
OTHER (SPECIFY) _________ 96

442) CHECK 302 (02): RESPONDENT EVER STERILIZED

NO
YES (GO TO 501)

443) The last time you did woman business did you or your partner use any family planning method (other than a condom)?

YES 1
NO 2 (GO TO 501)
DON'T KNOW 8 (GO TO 501)

444) What method did you or your partner use?

PROBE: Did you or your partner use any other method to prevent pregnancy?
RECORD ALL MENTIONED.

FEMALE STERILIZATION A
PILL B
IUD C
INJECTABLES D
IMPLANTS E
RHYTHM METHOD I
WITHDRAWAL J
OTHER (SPECIFY) _________ X

SECTION 5. FERTILITY PREFERENCES

501) CHECK 407:

ONE OR MORE WIVES/PARTNERS
QUESTION NOT ASKED (GO TO 508)

502) CHECK 302:

MAN NOT STERILIZED
MAN STERILIZED (GO TO 508)

503) (Is your wife (partner)/Are any of your wives (partners)) currently pregnant?

YES 1
NO 2
DON'T KNOW 8

504) CHECK 503:

NO WIFE/PARTNER PREGNANT OR DON'T KNOW: 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?

WIFE (WIVES)/PARTNER(S) PREGNANT: Now I have some questions about the future. After the child(ren) you and your (wife(wives)/partner(s)) 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 508)
COUPLE INFECUND 3 (GO TO 508)
WIFE (WIVES)/PARTNER(S) STERILIZED 4 (GO TO 508)
UNDECIDED/DON'T KNOW 8 (GO TO 508)

506) CHECK 503:

WIFE/PARTNER NOT PREGNANT OR DON'T KNOW: How long would you like to wait from now before the birth of (a/another) child?

WIFE/PARTNER PREGNANT: After the birth of 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
COUPLE INFECUND 994
OTHER (SPECIFY) _________ 996
DON'T KNOW 998

508) CHECK 203 AND 205:

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?

NONE 00 (GO TO 601)
NUMBER___
OTHER (SPECIFY) ___________ 96 (GO TO 601)

509) How many of these children would you like to be boys, how many would you like to be girls and for how many would the sex not matter?

NUMBER OF BOYS____
OTHER (SPECIFY) 96
NUMBER OF GIRLS____
OTHER (SPECIFY) 96
NUMBER OF EITHER SEX____
OTHER (SPECIFY) 96

SECTION 6. EMPLOYMENT AND GENDER ROLES

601) Have you done any work in the last seven days?

YES 1 (GO TO 604)
NO 2

602) Although you did not work in the last seven days, do you have any job or business from which you were absent for leave, illness, vacation, or any other such reason?

YES 1 (GO TO 604)
NO 2

603) Have you done any work in the last 12 months?

YES 1
NO 2 (GO TO 613)

604) What is your occupation, that is, what kind of work do you mainly do?

OCCUPATION__________

605) CHECK 604:

WORKS IN AGRICULTURE
DOES NOT WORK IN AGRICULTURE (GO TO 607)

606) Do you work mainly on your own land or on family land, or do you work on land that you rent from someone else, or do you work on someone else's land?

OWN LAND 1
FAMILY LAND 2
RENTED LAND 3
SOMEONE ELSE'S LAND 4
COMMUNAL LAND 5

607) 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

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

THROUGHOUT THE YEAR 1
SEASONALLY/PART OF THE YEAR 2
ONCE IN A WHILE 3

609) Are you paid in cash or kind for this work or are you not paid at all?

CASH ONLY 1
CASH AND KIND 2
IN KIND ONLY 3
NOT PAID 4

610) CHECK 407:

ONE OR MORE WIVES/PARTNERS
QUESTION NOT ASKED (GO TO 613)

611) CHECK 609:

CODE 1 OR 2 CIRCLED
OTHER (GO TO 613)

612) Who decides how the money you earn will be used: mainly you, mainly your (wife (wives)/partner(s)), or you and your (wife (wives)/partner(s)) jointly?

RESPONDENT 1
WIFE (WIVES)/PARTNER(S) 2
RESPONDENT AND WIFE (WIVES)/PARTNER(S) JOINTLY 3
OTHER (SPECIFY) ________ 6

613) In a couple, who do you think should have the greater say in each of the following decisions: the husband, the wife or both equally:

a) making large household purchases?
HUSBAND 1
WIFE 2
BOTH EQUALLY 3
DON'T KNOW/DEPENDS 8
b) making small daily household purchases?
HUSBAND 1
WIFE 2
BOTH EQUALLY 3
DON'T KNOW/DEPENDS 8
c) deciding when to visit the wife's family or relatives?
HUSBAND 1
WIFE 2
BOTH EQUALLY 3
DON'T KNOW/DEPENDS 8
d) deciding what to do with the money she earns for her work?
HUSBAND 1
WIFE 2
BOTH EQUALLY 3
DON'T KNOW/DEPENDS 8
e) deciding how many children to have?
HUSBAND 1
WIFE 2
BOTH EQUALLY 3
DON'T KNOW/DEPENDS 8

614) I will now read you some statements about pregnancy. Please tell me if you agree or disagree with them.

a) Childbearing is a woman's concern and there is no need for the father to get involved.
AGREE 1
DISAGREE 2
DON'T KNOW 8
b) It is crucial for the mother's and child's health that a woman have assistance from a doctor or nurse at delivery.
AGREE 1
DISAGREE 2
DON'T KNOW 8

615) Sometimes a husband is annoyed or angered by things that his wife does. In your opinion, is a husband justified in hitting or beating his wife in the following situations:

If she goes out without telling him?
YES 1
NO 2
DON'T KNOW 8
If she neglects the children?
YES 1
NO 2
DON'T KNOW 8
If she argues with him?
YES 1
NO 2
DON'T KNOW 8
If she refuses to do men business with him?
YES 1
NO 2
DON'T KNOW 8
If she burns the food?
YES 1
NO 2
DON'T KNOW 8

616) Do you think that if a woman refuses to do men business with her husband when he wants her to, he has the right to...

a) Get angry and reprimand her?
YES 1
NO 2
DON'T KNOW/DEPENDS 8
b) Refuse to give her money or other means of support?
YES 1
NO 2
DON'T KNOW/DEPENDS 8
c) Use force and do woman business with her even if she doesn't want to?
YES 1
NO 2
DON'T KNOW/DEPENDS 8
d) Go ahead and have sex with another woman?
YES 1
NO 2
DON'T KNOW/DEPENDS 8

SECTION 7. HIV/AIDS

701) Now I would like to talk about something else. Have you ever heard of an illness called AIDS?

YES 1
NO 2 (GO TO 733)

702) Can people reduce their chances of getting the AIDS virus by having just one uninfected sex partner who has no other sex partners?

YES 1
NO 2
DON'T KNOW 8

703) Can people get the AIDS virus from mosquito bites?

YES 1
NO 2
DON'T KNOW 8

704) Can people reduce their chance of getting the AIDS virus by using a condom every time they do woman business?

YES 1
NO 2
DON'T KNOW 8

705) Can people get the AIDS virus by sharing food with a person who has AIDS?

YES 1
NO 2
DON'T KNOW 8

706) Can people reduce their chances of getting the AIDS virus by not doing woman business at all?

YES 1
NO 2
DON'T KNOW 8

707) Can people get the AIDS virus because of witchcraft or other supernatural means?

YES 1
NO 2
DON'T KNOW 8

708) Is it possible for a healthy-looking person to have the AIDS virus?

YES 1
NO 2
DON'T KNOW 8

709) Can the virus that causes AIDS be transmitted from a mother to her baby:

During pregnancy?
YES 1
NO 2
DON'T KNOW 8
During delivery?
YES 1
NO 2
DON'T KNOW
By breastfeeding?
YES 1
NO 2
DON'T KNOW 8

710) CHECK 709:

AT LEAST ONE 'YES'
OTHER (GO TO 712)

711) Are there any special drugs that a doctor or a nurse can give to a woman infected with the AIDS virus to reduce the risk of transmission to the baby?

YES 1
NO 2
DON'T KNOW 8

712) Have you heard about antiretroviral drugs that people infected with the AIDS virus can get from a doctor or nurse to help them live longer?

YES 1
NO 2
DON'T KNOW 8

712A) CHECK FOR PRESENCE OF OTHERS. BEFORE CONTINUING, MAKE EVERY EFFORT TO ENSURE PRIVACY.

713) I don't want to know the results, but have you ever gone for an AIDS test?

YES 1
NO 2 (GO TO 718)

714) When was the last time you were tested?

LESS THAN 12 MONTHS AGO 1
12-23 MONTHS AGO 2
2 OR MONTHS AGO 3

715) The last time you had the test, did you ask for the test, was if offered to you and you accepted, or was it required?

ASKED FOR THE TEST 1
OFFERED AND ACCEPTED 2
REQUIRED 3

716) I don't want to know the results, but did you get the results of the test?

YES 1
NO 2

717) Where was the test done?

PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER, VCT CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

NAME OF PLACE____
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11 (GO TO 720)
GOVERNMENT HEALTH CENTER 12 (GO TO 720)
GOVERNMENT HEALTH CLINIC 13 (GO TO 720)
STAND-ALONE VCT CENTER 14 (GO TO 720)
NACP 15 (GO TO 720)
OTHER PUBLIC (SPECIFY) _________ 16 (GO TO 720)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21 (GO TO 720)
PRIVATE DOCTOR 22 (GO TO 720)
STAND-ALONE VCT CENTER 23 (GO TO 720)
PHARMACY 24 (GO TO 720)
FAMILY PLANNING ASSN. LIBERIA 25 (GO TO 720)
MOBILE CLINIC 26 (GO TO 720)
OTHER PRIVATE MEDICAL (SPECIFY) _________ 27 (GO TO 720)
OTHER SOURCE
SHOP 31 (GO TO 720)
OTHER (SPECIFY) _________ 96 (GO TO 720)

718) Do you know of a place where people can go to get tested for the AIDS virus?

YES 1
NO 2 (GO TO 720)

719) Where is that? Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S).

IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER, VCT CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

NAME OF PLACE____
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
GOVERNMENT HEALTH CLINIC C
STAND-ALONE VCT CENTER D
NACP E
OTHER PUBLIC (SPECIFY) _________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PRIVATE DOCTOR H
STAND-ALONE VCT CENTER I
PHARMACY J
FAMILY PLANNING ASSN. LIBERIA K
MOBILE CLINIC L
OTHER PRIVATE MEDICAL (SPECIFY) _________ M
OTHER SOURCE
SHOP N
OTHER (SPECIFY) __________ X

720) Would you buy fresh vegetables from a shopkeeper or vendor if you knew that this person had the AIDS virus?

YES 1
NO 2
DON'T KNOW 8

721) If a member of your family got infected with the AIDS virus, would you want it to remain a secret or not?

YES, REMAIN A SECRET 1
NO 2
DON'T KNOW/NOT SURE/DEPENDS 8

722) If a member of your family became sick with AIDS, would you be willing to care for her or him in your own household?

YES 1
NO 2
DON'T KNOW/NOT SURE/DEPENDS 8

723) In your opinion, if a female teacher has the AIDS virus but is not sick, should she be allowed to continue teaching in the school?

SHOULD BE ALLOWED 1
SHOULD NOT BE ALLOWED 2
DON'T KNOW/NOTSURE/DEPENDS 8

731) Should children age 12-14 be taught about using a condom to avoid getting AIDS?

YES 1
NO 2
DON'T KNOW/NOT SURE/DEPENDS 8

732) Should children age 12-14 be taught to wait until they get married to do woman business in order to avoid getting AIDS?

YES 1
NO 2
DON'T KNOW/NOT SURE/DEPENDS 8

733) CHECK 701:

HEARD ABOUT AIDS: Apart from AIDS, have you heard about other infections that can be transmitted through woman business?

NOT HEARD ABOUT AIDS: Have you heard about infections that can be transmitted through woman business?

YES 1
NO 2

734) CHECK 414:

HAS HAD SEXUAL INTERCOURSE
HAS NOT HAD SEXUAL INTERCOURSE (GO TO 742)

735) CHECK 733:
HEARD ABOUT OTHER SEXUALLY TRANSMITTED INFECTIONS?

YES
NO (GO TO 737)

736) Now I would like to ask you some questions about your health in the last 12 months. During the last 12 months, have you had a disease which you got from doing woman business?

YES 1
NO 2
DON'T KNOW 8

737) Sometimes men experience an abnormal discharge from their penis. During the last 12 months, have you had an abnormal discharge from your penis?

YES 1
NO 2
DON'T KNOW 8

738) Sometimes men have a sore or ulcer near their penis. During the last 12 months, have you had a sore or ulcer near your penis?

YES 1
NO 2
DON'T KNOW 8

739) CHECK 736, 737, AND 738:

HAS HAD AN INFECTION (ANY 'YES')
HAS NOT HAD AN INFECTION OR DOES NOT KNOW (GO TO 742)

740) The last time you had (PROBLEM FROM 736/737/738), did you see any kind of advice or treatment?

YES 1
NO 2 (GO TO 742)

741) Where did you go? Any other place?

PROBE TO IDENTIFY EACH TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE(S).

IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER, VCT CENTER, OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

NAME OF PLACE(S)______
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
GOVERNMENT HEALTH CLINIC C
STAND-ALONE VCT CENTER D
OTHER PUBLIC (SPECIFY) _______ E
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC F
PRIVATE DOCTOR G
STAND-ALONE VCT CENTER H
PHARMACY I
FAMILY PLANNING ASSN. LIBERIA J
MOBILE CLINIC K
OTHER PRIVATE MEDICAL (SPECIFY) _______ L
OTHER SOURCE
SHOP M
OTHER (SPECIFY) ________ X

742) Husbands and wives do not always agree in everything. If a wife knows her husband has a disease that she can get from doing men business, is she justified in refusing to do men business with him?

YES 1
NO 2
DON'T KNOW 8

743) If a wife knows her husband has a disease that she can get from doing men business, is she justified in asking that they use a condom when they have sex?

YES 1
NO 2
DON'T KNOW 8

744) Is a wife justified in refusing to do men business with her husband when she is tired or not in the mood?

YES 1
NO 2
DON'T KNOW 8

745) Is a wife justified in refusing to do men business with her husband when she knows her husband has sex with other women?

YES 1
NO 2
DON'T KNOW 8

SECTION 8. OTHER HEALTH ISSUES

801) Have you ever heard of an illness called tuberculosis or TB?

YES 1
NO 2 (GO TO 805)

802) How does tuberculosis spread from one person to another?
PROBE: Any other ways?

RECORD ALL MENTIONED.

THROUGH THE AIR WHEN COUGHING OR SNEEZING A
BY SHARING UTENSILS B
BY TOUCHING A PERSON WITH TB C
THROUGH FOOD D
THROUGH SEXUAL CONTACT E
THROUGH MOSQUITO BITES F
OTHER (SPECIFY) __________ X
DON'T KNOW Z

803) Can tuberculosis be cured?

YES 1
NO 2
DON'T KNOW 8

804) If a member of your family got tuberculosis, would you want it to remain a secret or not?

YES, REMAIN A SECRET 1
NO 2
DON'T KNOW/NOT SURE/DEPENDS 8

805) Some men are circumcised. Are you circumcised?

YES 1
NO 2
DON'T KNOW 8

806) Have you had an injection for any reason in the last 12 months?
IF YES: How many injections have you had?

IF NUMBER OF INJECTIONS IS GREATER THAN 90, OR DAILY FOR 3 MONTHS OR MORE, RECORD '90'.

IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE.

NUMBER OF INJECTIONS____
NONE 00 (GO TO 810)

807) Among these injections, how many were administered by a doctor, a nurse, a pharmacist, a dentist, or any other health worker?

IF NUMBER OF INJECTIONS IS GREATER THAN 90, OR DAILY FOR 3 MONTHS OR MORE, RECORD '90'.

IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE.

NUMBER OF INJECTIONS____
NONE 00 (GO TO 810)

808) The last time you had an injection give to you by a health worker, where did you go to get the injection?

PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

IF UNABLE TO DETERMINE IF HOSPITAL, HEALTH CENTER OR CLINIC IS PUBLIC OR PRIVATE MEDICAL, WRITE THE NAME OF THE PLACE.

NAME OF PLACE____
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
GOVERNMENT HEALTH CLINIC 13
OTHER PUBLIC (SPECIFY) ________ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/DOCTOR 21
DENTAL CLINIC/OFFICE 22
PHARMACY 23
OFFICE OR HOME OF NURSE/HEALTH WORKER 24
MOBILE CLINIC 25
OTHER PRIVATE MEDICAL (SPECIFY) ________ 26
OTHER PLACE
AT HOME 31
OTHER (SPECIFY) ________ 96

809) Did the person who gave you that injection take the syringe and needle from a new, unopened package?

YES 1
NO 2
DON'T KNOW 8

810) Do you currently smoke cigarettes?

YES 1
NO 2 (GO TO 812)

811) In the last 24 hours, how many cigarettes did you smoke?

CIGARETTES____

812) Do you currently smoke or use any other type of tobacco?

YES 1
NO 2 (GO TO 814)

813) What (other) type of tobacco do you currently smoke or use?
RECORD ALL MENTIONED.

PIPE A
CHEWING TOBACCO B
SNUFF C
OTHER (SPECIFY) _________ X

814) CHECK 107:

AGE 15-24
AGE 25-49 (GO TO 820)

815) Are you currently attending school?

YES 1
NO 2 (GO TO 817)

816) Who is helping to pay for most of your school expenses?

RESPONDENT HIMSELF 01
PARENTS 02
RELATIVES 03
ON SCHOLARSHIP 04
WIFE/PARTNER 05
GIRLFRIEND/LOVER 06
OTHER (SPECIFY) _________ 96

817) Do you drink liquor?

YES 1
NO 2

820) RECORD THE TIME.

HOUR____
MINUTES____

INTERVIEWER'S OBSERVATIONS

TO BE FILLED OUT AFTER COMPLETING INTERVIEW.

COMMENTS ABOUT RESPONDENT_____
COMMENTS ON SPECIFIC QUESTIONS_____
ANY OTHER COMMENTS_____

SUPERVISOR'S OBSERVATIONS_____
NAME____
DATE____

EDITOR'S OBSERVATIONS_____
NAME ____
DATE____