IDENTIFICATION:

FIRST AND LAST NAME OF WOMAN__
NUMBER OF QUESTIONNAIRE__

REGION__
CLUSTER__
ARRONDISSEMENT/COMMUNE__
VILLAGE CODE__
VILLAGE NEIGHBORHOOD__
NAME OF HEAD OF COMPOUND__
NAME OF HEAD OF HOUSEHOLD__
LINE NUMBER OF WOMEN IN THE HOUSEHOLD ____

INTERVIEWER VISITS:

INTERVIEWER 1(REPEAT FOR SECOND AND THIRD INTERVIEWERS)
DATE__
MONTH__
YEAR 1987
INTERVIEWER NAME____

RESULTS___

NEXT VISIT [FOR INTERVIEWERS 1 AND 2]
DATE__
TIME__
RESULTS___

FINAL VISIT
DATE ___
MONTH ___
YEAR 1987
RESULTS ___

TOTAL NUMBER OF VISITS ___

SUPERVISOR
NAME___
DATE___

FIELD EDITOR
NAME__
DATE__

OFFICE EDITOR__
KEYED BY___

SECTION 1. RESPONDENT'S BACKGROUND

100. RECORD THE NUMBER OF PEOPLE LISTED IN THE HOUSEHOLD

101. NUMBER OF CHILDREN UNDER 5 YEARS RECORDED ON THE HOUSEHOLD SURVEY AND WHO USUALLY LIVE IN THE HOUSEHOLD

102. RECORD THE TIME

To begin, I would like to ask you questions about yourself and your household.

103. How long have you been living continuously in (NAME OF VILLAGE, TOWN, CITY)?

104. For the majority of the 12 first years of your life, did you live in Bamako, in another city or in countryside?

105. Just before you moved here (or came here to visit) did you live in Bamako, in another city or in countryside?

106. In which month and in which year were you born?
IF ONLY THE YEAR IS KNOWN, PROBE TO GET THE SEASON IF NOT THE MONTH

107. How old were you at your last birthday?

IF THE BIRTH DATE AND SEASON ARE NOT KNOWN, ESTIMATE AGE ACCORDING TO AN HISTORIC EVENT OR ACCORDING TO A PERSON WHOSE AGE IS KNOWN. COMPARE AND CORRECT IF 105 AND/OR 106 ARE/IS INCONSISTENT

108. Did you go to school?

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

110. What is the last (year/grade) that you achieved at this level?

111. CHECK 109:

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

113. Do you listen to the radio at least once a week?

114. What is your religion?

115. Are you Malian?

116. What is your ethnicity?

117. Are you a member of a woman's association or a woman's cooperation?

118. What is your role in this organization?

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

120. What is the main source of water for bathing, dish/clothes-washing for the members (usual) of your household?

121. What kind of toilet facility is there in this household?

122. What kind of toilette facility do children 3 to 5 years use?

123. Does your household have:

Electricity?
Radio?
Television?
Refrigerator or freezer?

124. Is there anyone in your household who owns:

A bicycle?
A motorcycle?
A car?

125. What type of floor do the rooms where you live in your household have?

126. What type of roof does your dwelling have?

127. Do you usually have soap for hand washing in this household?

SECTION 2. REPRODUCTION

Now I would like to ask about all of the births you have had during your life.

201. Have you ever given birth to a living child?

202. Do you have any sons or daughters to whom you have given birth and who are now living with you?

203. How many sons live with you?
How many daughters live with you?
IF NONE, RECORD '00'

204. Do you have any sons or daughters to whom you have given birth and who are alive but do not live with you?

205. How many sons are alive but do not live with you?
How many daughters are alive but do not live with you?
IF NONE, RECORD '00'

206. Have you given birth to a son or daughter who was born alive but later died?
IF NO, PROBE: Any who cried and showed signs of life at birth but did not survive more than a couple hours or days?

207. How many sons have died?
And how many daughters have died?
IF NONE, RECORD '00'

208. Have you had any still born babies?

209. Among these are there any who breathed and showed signs of life after birth?

210. Among these still born babies:
How many boys showed signs of life?
How many girls showed signs of life?

211. SUM ANSWERS TO Q.203, 205, 207 AND 210 AND RECORD THE TOTAL.
IF NONE, RECORD '00'

211A. CHECK: Just to be sure that I have this right: You have had in TOTAL___ births during your life. Is that correct?

212. CHECK 211:

ONE OR MORE BIRTH:
Now I would like to make a list of all your births, whether still alive or not, starting with the first one you had.

213. What name was given to your first/next baby?
RECORD TWINS RECORD ON SEPARATE LINES AND REUNITE WITH A LINE ON THE LEFT.

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

215. Is (NAME) still alive?

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

217. IF DEAD: How old was (NAME) when he/she died?
IF '1 YEAR' PROBE: How old was (NAME) in months?

RECORD IN DAYS IF LESS THAN 1 MONTH; IN MONTHS IF LESS THAN 2 YEARS; OR
IN YEARS

218. IF ALIVE: How old is (NAME)?
RECORD AGE IN COMPLETED YEARS

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

220. CHECK THAT THE NUMBER OF RECORDED BIRTHS CORRESPONDS TO 211.

221. Have you had your period in the last 4 weeks?

222. How many days since your period started?

223. Are you pregnant?

224. How many months pregnant are you?

225. Since you became pregnant, have you ever received an injection to protect your baby from tetanus, that is to say, convulsions after birth?

226. Have you had a prenatal visit for your current pregnancy?

227. Who did you consult the first time?

PROBE AND RECORD THE CODE FOR THE MOST QUALIFIED PERSON.

228. At how many months of pregnancy did you have your first prenatal visit?

229. When did your last menstrual period start?

230. During the menstrual cycle, are there certain days when a woman is more likely to become pregnant?

231. PEOPLE PRESENT (DURING THIS FIRST PART OF THE INTERVIEW):

SECTION 3. CONTRACEPTION

Now I would like to talk to you about family planning - the various ways or methods that a couple can use to delay or avoid a pregnancy

.

CIRCLE CODE '1' ON LINE 301 FOR EACH METHOD MENTIONED SPONTANEOUSLY. THEN CONTINUE DOWN COLUMN 301 READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE '2' IF THE METHOD IS RECOGNIZED. THEN, FOR EACH METHOD WITH CODE '1' OR '2' CIRCLED IN 302, ASK 303-305.

301. Which methods have you heard about?
302. Have you ever heard of (METHOD)?

303. Have ever used (METHOD)?

304. Where can you get (METHOD)?
OR Where would you go to get advice on (METHOD)?

305. What is the major problem (if there is one) with using (METHOD)?

306. CHECK 303:

307. Have you ever used anything or tried in any way to delay or avoid pregnancy?

308. What did you do or use?
CORRECT 302-303 AND GET INFORMATION FOR 304 (AND 305 IF NECESSARY).

309. CHECK 303:

310. When you used the rhythm method the last time, how did you measure to determine the days when you should abstain?

311. How many living children did you have when you used a method to avoid becoming pregnant for the first time?
IF NONE RECORD '00'

312. CHECK 227 AND 303:

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

314. What method(s) are you using?

315. Where did you (your partner) get (advice for) (CURRENT METHOD) the last time?

315A. Where did you (or your partner) get sterilized?

316. Why don't you use one of the methods I just described to delay or space your pregnancies?

317. Do you intend to use a method or a way to avoid getting pregnant in the future?

318. Which method do you prefer to use?

319. Do you intend to use a method or a way to avoid getting pregnant in the next 12 months?

320. Where would you go to get advice or to get materials for (PREFERRED METHOD)?

321. There are women who do not want to get pregnant but do not use any methods (that I've just cited) to delay or space pregnancies. In your opinion, what are the main reasons for this?
CIRCLE ALL THE RESPONSES GIVEN.
PROBE: Other reasons?

322. Do you think that it is acceptable that information about spacing of births be provided on radio or television?

SECTION 4. HEALTH AND BREAST FEEDING OF CHILDREN UNDER 5 YEARS

401. CHECK 216:

ONE OF MORE BIRTHS SINCE MARCH 1982. WRITE THE LINE NUMBER, THE NAME AND THE SURVIAL STATE OF EACH BIRTH SINCE MARCH 1982 IN TABLE 3 BEGINNING WITH THE LAST BIRTH.

REPEAT SECTION 4 FOR THE FOUR MOST RECENT BIRTHS SINCE MARCH 1982
NO LIVE BIRTH SINCE MARCH 1982 (GO TO SECTION 5)

402. When you were pregnant with (NAME) did you have a prenatal consultation?
IF YES: Who did you consult the first time?
PROBE AND CIRCLE THE CODE OF THE MOST QUALIFIED PERSON

403. When you were pregnant with (NAME) did you receive an injection to protect your child from tetanus?

404. Who assisted when you delivered (NAME)?
PROBE AND CIRCLE THE CODE OF THE MOST QUALIFIED PERSON.

405. Have you ever breast fed (NAME)?

406. IF ALIVE: Do you still breast feed (NAME)?
(ONLY FOR MOST RECENT BIRTH)

407. How many months did you breast feed (NAME)?

408. Has your period started again?
(ONLY FOR MOST RECENT BIRTH)

409. How long after (NAME'S) birth did you start having your period?

410. Have you begun having sexual intercourse again since the birth of (NAME)?
(ONLY FOR MOST RECENT BIRTH)

IF NO MORE BIRTHS (GO TO 412)

411. How many months after the birth of (NAME) did you have sex?
GO TO 402 FOR THE NEXT BIRTH OR GO TO 412 IF THERE ARE NO MORE BIRTHS

412. CHECK 406 FOR THE LAST BIRTH:

413. How many times did you breastfeed last night between sunset and sunrise?

414. How many times did you breastfeed your child during the day?

415. Did you feed (NAME OF LAST CHILD) any of the following liquids last night or yesterday? READ THE LIST OF CATEGORIES.

Water?
Juice?
Powdered milk?
Cow or goat milk?
Quinqueliba?
Other liquid? (SPECIFY) ____
Grain broth?
Solid food?

416. CHECK 415:

417. Did you give these liquids in a bottle?

418. When you were pregnant with (NAME OF LAST CHILD) did you want to have this child at that time, or wait until later, or not have other children at all?

419. CHECK 401:

WRITE THE NAME AND THE SURVIVAL STATE OF EACH BIRTH SINCE MARCH 1982 IN TABLE 4, BEGINNING WITH THE LAST BIRTH. THE FIRST LINE OF TABLE 4 SHOULD BE EXACTLY THE SAME AS THAT OF TABLE 3. ONLY ASK QUESTIONS OF LIVING CHILDREN.

(REPEAT FOR 4 BIRTHS)

420. Has (NAME) ever been vaccinated against illnesses?

421. Do you have a health card for (NAME)?
IF YES: May I see it?

422. THE DATES FOR EACH VACCINATION FROM THE CARD.

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

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

425. Did you or someone else do something to treat the diarrhea?

426. What was done to treat the diarrhea?
RECORD '1' FOR ALL THE TREATMENTS MENTIONED.

427. Has (NAME) had a fever in the last four weeks?

428. Did you do something to treat the fever?

429. What was done to treat the fever?
CODE '1' FOR ALL THE TREATMENTS MENTIONED.

430. Did (NAME) have difficulty breathing or rapid breathing in the last four weeks?

431. Did you or someone else do something to treat the problem?

432. What was done to treat the problem?

433. Has (NAME) had the measles?

434. Did you or someone else do something to treat the measles?

435. What was done to treat the measles?

436. Does (NAME) have one of the following handicaps?

437. Did this handicap follow:

GO TO THE NEXT BIRTH OR IF NO MORE (GO TO 438)

438. CHECK 426:

439. Have you ever heard about a product called (ORT) that you can get to treat diarrhea?

SECTION 5. MARRIAGE

501. Have you ever been or are you currently married or you live with a man?

502. Are you married, widowed, divorced or separated, do you live with or have you lived with someone?

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

504. Besides yourself, does your husband/partner have other wives or does he live with other women as if he were married?

505. How many wives or partners does your husband currently have?
(6=6 AND MORE)

506. What is your rank: Are you the first, second, third...wife?

507. At the beginning of this marriage or union did your husband/partner have other wives besides yourself?

IF THERE WERE NO OTHER WIVES, RECORD '0'. IF 6 OR MORE, RECORD '6'.

508. Is this/was this your first marriage (union)?

509. In which month and in which year did you begin to live with your husband/partner?

510. How old were you when you began living with him?

511. Did you already have a boyfriend?

512. How old were you when you had sexual intercourse for the first time?

513. How long has it been since you last had sexual intercourse (if you already had it)?

514. CHECK 223 AND 313:

515. Would you be upset if you found out that you were pregnant in the coming weeks?

516. PRESENCE OF OTHER PEOPLE:

SECTION 6. FERTILITY PREFERENCES

601. CHECK 502:

Now I would like to ask you questions about the future.

602. CHECK 223:

NOT PREGNANT OR NOT SURE: Would you like to have (a/another) child,?

PREGNANT: After the child that you are expecting, would you like to have (a/another) child?

603. How long would you like to wait from now before the birth of (a/another) child (outside of the current pregnancy)?

604. In your opinion what is the best interval between two births?

605. After a birth, how long should a couple wait before having sexual intercourse again?

606. In your opinion should a mother wait until she is no longer breastfeeding to have sexual intercourse again?

607. Would you say that your husband approves or disapproves of couples that use a method to delay or space pregnancies?

608. How many times during the past 12 months did you speak with your partner/husband about
methods to delay or space pregnancies?

609. Would you say that you approve or disapprove of couples that use a method to avoid to delay or space pregnancies?

610. CHECK 211:

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

HAS 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?

611. 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?

612. In your opinion, what are the advantages of having many children? (CITE 3)

613. What are the disadvantages of having many children? (CITE 3)

614. In your opinion, how many children are considered as a lot for a woman?

615. Which do you prefer, many children or fewer children?

SECTION 7. HUSBAND'S BACKGROUND AND WOMAN'S PROFESSIONAL ACTIVITY

701. CHECK 501 AND 502:

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

703. What was the highest level of school that he achieved?

704. What was the last year that he achieved at this level?

705. CHECK 703:

706. Can he read a letter or a newspaper in any language?

707. What kind of work did/does he mainly do?

708. CHECK 707:

709. Does/did he receive a regular weekly or monthly salary?

710. Does your husband/partner work mainly on his own land or on family land, or does he work on land that he rents from someone else, or does he work on someone else's land?

711. Does or did he work mainly to be paid in money or in kind?

712. Before marriage (living regularly with a partner), did you work regularly to earn money other than working in a family field or business?

713. Did you give most of the money you earned to your family or did you keep most of it for yourself?

714. (Since you started living with a partner), have you worked regularly to earn money other than working in a family field or business?

715. Have you ever worked regularly to earn money other than working in a family field or business?

716. Did you give most of the money you earned to your family or did you keep most of it for yourself?

717. Outside of working the field or in a family business, do you work to make money?

718. RECORD THE TIME:

SECTION 8. WEIGHT AND HEIGHT

801. CHECK TABLE 1:

FOR EACH LIVING CHILD BORN SINCE MARCH 1984 (THAT IS TO SAY 3 TO 36 MONTHS OLD) RECORD THE LINE NUMBER, THE BIRTH DATE, THE WEIGHT AND THE HEIGHT.

OBSERVATIONS____

INTERVIEWER'S OBSERVATIONS

RESPONDENT COMMENTS ____

SPECIFIC QUESTIONS ____

OTHER ASPECTS ____

INTERVIEWER
NAME____
DATE____

SUPERVISOR'S OBSERVATIONS_____
NAME____
DATE____

OFFICE EDITOR'S OBSERVATIONS ____
NAME ____
DATE____

KEYED BY____
DATE____