PLACE NAME__
NAME OF HEAD OF HOUSEHOLD__
CLUSTER NUMBER___
COMPOUND__
HOUSEHOLD NUMBER______
REGION__
CIRCLE__
OTHER COMMUNE 2
OTHER CITIES 3
RURAL 4
NAME AND LINE NUMBER OF THE WOMAN__
INTERVIEWER 1 (REPEAT FOR SECOND AND THIRD INTERVIEWERS)
DATE__
DAY__
MONTH__
YEAR 1996
INTERVIEWER NAME____
RESULT ____
NOT AT HOME 2
POSTPONED 3
REFUSED 4
PARTIALLY FILLED OUT 5
INCAPABLE 6
OTHER (SPECIFY)__ 7
NEXT VISIT [FOR INTERVIEWERS 1 AND 2]
DATE__
TIME__
FINAL VISIT
DAY__
MONTH__
YEAR ___
INTERVIEWER__
RESULTS ___
BAMBARA/MALINKE 02
SONRAI/DJERMA 03
PEUHL/FOULFOULDE 04
SENOUFO 05
MARIKA/SONINKE 06
DOGON 07
MINIANKA 08
TAMACHECK/BELLA 09
BOBO/DAFING 10
BOZO/SONOMO 11
OTHER 96
NO 2
FIELD EDITOR
NAME__
DATE__
OFFICE EDITOR__
KEYED BY___
SECTION 1. SOCIO-DEMOGRAPHIC CHARACTERISTICS OF RESPONDENT
MINUTES__
To begin, I would like to ask you questions about yourself and your household.
102. Until the age of 12 years, did you live the majority of the time in Bamako, in another capital, in a city, in a rural area or in another country?
IF "FOREIGNER," SPECIFY THE PLACE OF RESIDENCE.
COMMUNE/LRG. FOREIGN CITY 2
OTHER CITY/SML. FOREIGN CITY 3
RURAL 4
UNSPECIFIED OTHER COUNTRY 5
103. How long have you been living continuously in (NAME OF CURRENT CITY/VILLAGE OF RESIDENCE)?.
VISITOR 96 (GO TO 105)
104. Just before you moved here, did you live in a large city, a city or in a rural area?
COMMUNE/LRG. FOREIGN CITY 2
OTHER CITY/SML. FOREIGN CITY 3
RURAL 4
UNSPECIFIED OTHER COUNTRY 5
105. In which month and in which year were you born?
DOESN'T KNOW MONTH 98
DOESN'T KNOW YEAR 98
106. How old were you at your last birthday?
COMPARE AND CORRECT 105 AND/OR 106 IF INCONSISTENT
NO 2 (GO TO 114)
108. What is the highest level of school you attended: primary 1, primary 2, secondary or superior?
PRIMARY 2 (MIDDLE) 2
SECONDARY (HIGH SCHOOL/TECHNICAL) 3
SUPERIOR 4
109. What is the last (year/grade) that you achieved at this level?
2 ELEMENTARY 2(SECOND CYCLE)
3 SECONDARY (HIGH SCHOOL, TECHNICAL SCHOOL)
4 SUPERIOR
AGED 25 YEARS OR MORE (GO TO 113)
111. Do you currently go to school?
NO 2
112. What is the main reason why you stopped going to school?
GOT MARRIED 02
TO CARE FOR YOUNGER CHILDREN 03
FAMILY NEEDED HELP IN THE FIELD/WORK 04
COULD NOT PAY THE TUITION 05
HAD TO EARN MONEY 06
EDUCATED ENOUGH 07
FAILURE IN SCHOOL 08
NO LONGER LIKED SCHOOL 09
SCHOOL INACCESSIBLE/ TOO FAR 10
OTHER (SPECIFY) __96
DOESN'T KNOW 98
PRIMARY 2 OR MORE (GO TO 115)
114. Can you read and understand a letter or a newspaper easily, with difficulty or not at all?
WITH DIFFICULTY 2
NOT AT ALL 3 (GO TO 116)
115. Do you read a newspaper or magazine at least once a week?
NO 2
116. Do you listen to the radio at least once a week?
NO 2
117. Do you watch television at least once a week?
NO 2
CHRISTIAN 2
ANIMIST 3
OTHER (SPECIFY) __96
MALINKE 02
PEUHL 03
SARAKOLE/MARKA 04
SONRAÏ 05
DOGON 06
TAMACHEK 07
SÉNOUGO/MINIANKA 08
BOBO 09
OTHER MALIAN ETHNICITIES 10
FOREIGN 11
120. CHECK Q.4 IN THE HOUSEHOLD QUESTIONNAIRE
THE RESPONDENT IS A USUAL RESIDENT (GO TO 201)
Now I would like to ask you some questions about the place you usually live.
121. Do you live in Bamako, in another commune, in another city, in a rural area or in a foreign country?
IF "FOREIGNER," SPECIFY THE PLACE OF RESIDENCE.
IF "COMMUNE" OR "CITY" SPECIFY THE NAME
COMMUNE/LRG. FOREIGN CITY 2
OTHER CITY/SML. FOREIGN CITY 3
RURAL 4
UNSPECIFIED OTHER COUNTRY 5
122. In which region is it located?
KAYES 02
KOULIKORO 03
SIKASSO 04
SEGOU 05
MOPTI 06
GAO/KIDAL 07
TOMBOUCTOU 08
FOREIGN 09
Now I would like to ask you some questions about the household in which you usually live.
123. What is the main source of water for members of your household?
Piped into the yard/plot 12
In the yard/plot 22
Open public well 23
Covered or borehole wells 23
River/stream 32
Swamp/lake 33
Dam 34
Tanker 51
Bottled water 61 (GO TO 125)
Other (specify) _________96
124. How long does it take to go there, get water, and come back?
On site 996
125. What kind of toilet facility do the majority of the members of your household use?
Communal flush 12
Improved 22
Other_____(Specify) 96
126. Does your household have:
Electricity? (EDM or solar panel)
Radio?
Television?
Telephone?
Refrigerator or freezer?
NO 2
NO 2
NO 2
NO 2
NO 2
127. Could you describe the floor of your house?
DUNG 12
PALMS/BAMBOO 22
VINYLE OR LINO/ASPHALT 32
TILE 33
CEMENT 34
CARPET 35
128. Is there anyone in your household who owns:
NO 2
NO 2
NO 2
Now I would like to ask about all of the births you have had during your life.
201. Have you ever given birth?
NO 2 (GO TO 206)
202. Do you have any sons or daughters to whom you have given birth and who are now living with you?
NO 2 (GO TO 204)
203. How many sons live with you?
How many daughters live with you?
IF NONE, RECORD '00'
DAUGHTERS AT HOME__
204. Do you have any sons or daughters to whom you have given birth and who are alive but do not live with you?
NO 2 (GO TO 206)
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'
DAUGHTERS ELSEWHERE__
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 live at birth but did not survive?
NO 2 (GO TO 208)
207. How many sons have died?
And how many daughters have died?
IF NONE, RECORD '00'
DAUGHTERS DEAD__
208. SUM ANSWERS TO Q.203, 205, AND 207 AND RECORD THE TOTAL. IF NONE, RECORD '00'
209. CHECK 208:
Just to be sure that I have this right: You have had in TOTAL __ births during your life. Is that correct?
PROBE AND CORRECT 201-208 AS NECESSARY
NO
NONE (GO TO 226)
211. Now I would like to make a list of all your births, whether still alive or not, starting with the first one you had.
RECORD THE NAMES OF ALL THE BIRTHS IN Q.212. RECORD TWINS AND TRIPLETS ON SEPARATE LINES.
212. What name was given to your first/next baby?
213. Were any of these births twins?
MULTIPLE 2
214. Is (NAME) a boy or a girl?
GIRL 2
215. In what month and year was (NAME) born?
PROBE: What is his/her birthday?
YEAR___
NO 2 (GO TO 219)
217. IF ALIVE: How old was (NAME) at his/her last birthday?
RECORD AGE IN COMPLETED YEARS
218. IF ALIVE: Is (NAME) living with you?
NO 2 (GO TO NEXT BIRTH)
219. 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
MONTHS 2__
YEARS 3__
220. SUBTRACT THE BIRTH YEAR OF (NAME) FROM THE BIRTH YEAR OF THE PRECEDING CHILD. IS THE DIFFERENCE 4 YEARS OR MORE?
SKIP FOR FIRST BIRTH
NO 2 (GO TO NEXT BIRTH)
221. Were there any other live births between (NAME OF PREVIOUS BIRTH) and (NAME) including any children who died after birth?
[NOTE: DO NO ASK FOR LAST BIRTH]
NO 2 (GO TO NEXT BIRTH)
[Repeat lines 212-221 for each birth, use a separate sheet for more than 12 births]
222. SUBTRACT THE BIRTH YEAR OF THE LAST CHILD FROM THE YEAR OF THE INTERVIEW. IS THE DIFFERENCE 4 YEARS OR MORE?
NO 2 (GO TO 224)
223. Did you have any other live births since the birth of (NAME OF LAST BIRTH)?
NO 2
224. COMPARE 208 WITH THE NUMBER OF BIRTH RECORDED IN THE ABOVE TABLE AND MARK:
225. CHECK 215 AND RECORD THE NUMBER OF BIRTHS SINCE 1992. IF NONE, RECORD '0'
227. Are you currently pregnant?
NO 2 (GOT TO 236)
NOT SURE 8 (GO TO 236)
228. How many months pregnant are you?
229. At the moment you became pregnant, did you want to become pregnant at that time, did you want to wait until later, or did you not want to have any (more) children?
LATER 2
NOT AT ALL 3
236. When did your last menstrual period start?
WEEKS AGO 2___
MONTHS AGO 3___
YEARS AGO 4 __
BEFORE THE LAST BIRTH 995
NEVER MENSTRUATED 996
237. From one menstrual period to the next, are there certain days when a woman is more likely to become pregnant if she has sexual intercourse?
NO 2 (GO TO 239)
DOESN'T KNOW 8 (GO TO 239)
238. At what times during her menstrual cycle is a woman most likely to get pregnant?
JUST AFTER THE END OF HER PERIOD 02
HALFWAY BETWEEN 2 PERIODS 03
JUST BEFORE HER PERIOD BEGINS 04
OTHER (SPECIFY)__96
DOESN'T KNOW 98
239. Have you had pregnancies that did not end in a live birth?
NO 2 (GO TO 239)
DOESN'T KNOW 8 (GO TO 239)
240. How many pregnancies did you have that did not end in live birth?
241. Among these pregnancies how many ended with:
A provoked abortion?
A miscarriage/ spontaneous abortion?
A stillbirth?
NEITHER MISCARRIAGE NOR STILLBIRTH (GO TO 301)
243. In your opinion, what are the main causes of your miscarriages/stillbirths?
CARE NOT AVAILABLE/TOO FAR B
ILLNESS C
WITCHCRAFT D
CURSE E
VOLUNTARY ABORTION F
OTHER (SPECIFY)__X
DOESN'T KNOW Z
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 1 IF THE METHOD IS RECOGNIZED AND CODE 2 IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE 1 CIRCLED IN 301, ASK 302.
THEN FOR EACH METHOD WITH '1' AND '2' CIRCLED, ASK 303.
301. Which methods have you heard about?
302. Have you ever heard of (METHOD)?
YES DESCRIPTION 2
NO 3 (GO TO NEXT LINE)
YES DESCRIPTION 2
NO 3 (GO TO NEXT LINE)
YES DESCRIPTION 2
NO 3 (GO TO NEXT LINE)
YES DESCRIPTION 2
NO 3 (GO TO NEXT LINE)
YES DESCRIPTION 2
NO 3 (GO TO NEXT LINE)
YES DESCRIPTION 2
NO 3 (GO TO NEXT LINE)
YES DESCRIPTION 2
NO 3 (GO TO NEXT LINE)
YES DESCRIPTION 2
NO 3 (GO TO NEXT LINE)
YES DESCRIPTION 2
NO 3 (GO TO NEXT LINE)
YES DESCRIPTION 2
NO 3 (GO TO NEXT LINE)
(SPECIFY)__
NO 3
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
AT LEAST ONE "YES" (EVER USED) (GO TO 309)
305. Have you ever used anything or tried in any way to delay or avoid pregnancy?
NO 2 (GO TO 331)
307. What did you do or use?
CORRECT 303 AND 304 (AND 302 IF NECESSARY).
Now I would like to ask you about the first time that you did something or used a method to avoid getting pregnant.
309. How many living children did you have, if any?
IF NONE RECORD '00'
310. At the time you began to use family planning, was it because you wanted another child but later or because you did not want any more children?
DID NOT WANT ANY MORE CHILDREN 2
OTHER (SPECIFY)__6
WOMAN STERILIZED (GO TO 314A)
PREGNANT (GO TO 332)
313. Are you currently doing something or using any method to delay or avoid getting pregnant?
NO 2 (GO TO 331)
314. What method(s) are you using?
314A. CIRCLE "07" FOR FEMALE STERILIZATION.
IUD 02 (GO TO 326)
INJECTIONS 03 (GO TO 326)
IMPLANTS 04 (GO TO 326)
DIAPHRAGM/FOAM/JELLY 05 (GO TO 326)
CONDOM 06 (GO TO 326)
FEMALE STERILIZATION 07 (GO TO 318)
MALE STERILIZATION 08 (GO TO 318)
RHYTHM METHOD 09 (GO TO 323)
WITHDRAWAL 10 (GO TO 326)
OTHER (SPECIFY) ____96 (GO TO 326)
315. Can I see the pill box that currently you use?
IF THE PACKET IS SHOWN, RECORD THE BRAND.
316. Do you know the brand of the pill that you currently use?
RECORD THE BRAND
DOESN'T KNOW 98
317. How much does a cycle box of pills cost you?
DOESN'T KNOW 9998 (GO TO 326)
318. Where did the sterilization take place?
IF IT IS A HOSPITAL, A HEALTH CENTER OR A CLINIC, WRITE THE NAME OF THE ESTABLISHMENT. PROBE TO DETERMINE THE TYPE AND SECTOR AND CIRCLE THE APPROPRIATE CODE,
HEALTH CENTER/FREE CLINIC/CLINIC/MATERNITY 12
DOCTOR'S OFFICE 22
MUTEC (EDUCATION AND CULTURE WORKERS MUTUAL) 42
OTHER (SPECIFY) __96
DOESN'T KNOW 98
319. Do you regret having had an operation to have no more children?
NO 2 (GO TO 321)
320. Why do you regret having had the operation?
HUSBAND/PARTNER WANTS A CHILD 02
SECONDARY EFFECTS 03
CHILD DIED 04
OTHER (SPECIFY) __96
321. In which month and in which year did the sterilization occur?
YEAR__(GO TO 327)
323. How do you determine the days during your menstrual cycle when you should not have sexual intercourse?
BASED ON BODY TEMPERATURE 02
BASED ON CERVICAL MUCUS 03
BASED ON BODY TEMPERATURE AND CERVICAL MUCUS 04
NO PARTICULAR SYSTEM 05
OTHER (SPECIFY)__96
326. How many months ago did you begin to use (METHOD) continuously?
IF LESS THAN A MONTH RECORD '00'
8 YEARS OR MORE 96
327. CHECK 314: CIRCLE THE CODE OF THE METHOD:
IUD 02
INJECTIONS 03
IMPLANTS 04
DIAPHRAGM/FOAM/JELLY 05
CONDOM 06
FEMALE STERILIZATION 07 (GO TO 329A)
MALE STERILIZATION 08 (GO TO 329A)
RHYTHM METHOD 09 (GO TO 332)
WITHDRAWAL 10 (GO TO 332)
OTHER METHOD 96 (GO TO 332)
328. Where did you get (CURRENT METHOD) the last time?
IF THE SOURCE IS A HOSPITAL, A HEALTH CENTER OR A CLINIC, WRITE THE NAME OF THE ESTABLISHMENT. PROBE TO DETERMINE THE SECTOR AND CIRCLE THE APPROPRIATE CODE.
HEALTH CENTER/FREE CLINIC/CLINIC/MATERNITY 12
HEALTH CARE CLINIC 13
PRIVATE DOCTOR 22
PHARMACY 23
FIELD WORKER 24
HEALTH CARE WORKER 32
FAMILY PLANNING FIELDWORKER/DOULA/BIRTHER/HEALTH AID 33
MUTEC (EDUCATION AND CULTURE WORKERS MUTUAL) 42
HEALER/TRADITIONAL PRACTITIONER/MARABOUT (a kind of spiritual healer/witch doctor) 62
FRIEND(S)/RELATIVE(S) 63
DOESN'T KNOW 98
329. Do you know another place where you could have gotten (METHOD) the last time?
NO (GO TO 335)
329A. At the time of the sterilization, did you know of another place where you could have had the same operation?
NO 2 (GO TO 335)
330. People choose the place where they get family planning services for different reasons
What is the main reason why you went to (NAME OF THE PLACE CITED IN 328 OR 318) rather than the place that you know?
RECORD THE RESPONSE AND CIRCLE THE CODE____
CLOSER TO THE MARKET/WORK 12 (GO TO 335)
AVAILABLE TRANSPORTATION 13 (GO TO 335)
CLEANER 22 (GO TO 335)
MORE INTIMATE 23 (GO TO 335)
LESS WAIT 24 (GO TO 335)
USES OTHER SERVICES IN THE ESTABLISHMENT 26 (GO TO 335)
WANTED TO BE ANONYMOUS 41 (GO TO 335)
OTHER (SPECIFY)__96 (GO TO 335)
DOESN'T KNOW 98 (GO TO 335)
331. What is the main reason that you do not use a method to avoid pregnancy?
INFREQUENT SEX 22
MENOPAUSE/HYSTERECTOMY 23
SUB FECUND/ STERILE 24
POST-PARTUM/ BREASTFEEDING 25
WANTS (MORE) CHILDREN 26
PREGNANT 27
HUSBAND/PARTNER OPPOSED 32
OTHER PERSONS OPPOSED 33
RELIGIOUS PROHIBITION 34
KNOWS NO SOURCE 42
FEAR OF SIDE EFFECTS 52
LACK OF ACCESS/TOO FAR 53
COSTS TOO MUCH 54
INCONVENIENT TO USE 55
INTERFERES WITH BODY'S NORMAL PROCESSES 56
DOESN'T KNOW 98
332. Do you know of a place where you can get a method of family planning?
NO 2 (GO TO 335)
IF THE SOURCE IS A HOSPITAL, A HEALTH CENTER OR A CLINIC, WRITE THE NAME OF THE ESTABLISHMENT. PROBE TO DETERMINE THE SECTOR AND CIRCLE THE APPROPRIATE CODE.
HEALTH CENTER/FREE CLINIC/CLINIC/MATERNITY 12
HEALTH CARE CLINIC 13
PRIVATE DOCTOR 22
PHARMACY 23
FIELD WORKER 24
HEALTH CARE WORKER 32
FAMILY PLANNING FIELDWORKER/DOULA/BIRTHER/HEALTH AID 33
MUTEC (EDUCATION AND CULTURE WORKERS MUTUAL) 42
HEALER/TRADITIONAL PRACTITIONER/MARABOUT (a kind of spiritual healer/witch doctor) 62
FRIEND(S)/RELATIVE(S) 63
DOESN'T KNOW 98
335. In the last 12 months have you been in a health establishment for any reason?
NO 2 (GO TO 337)
336. Did someone in this establishment talk to you about family planning?
NO 2
337. Do you think that breast feeding can influence the chances of a women becoming pregnant?
NO 2 (GO TO 401)
DOESN'T KNOW 8
338. Do you think that breast feeding increases or decreased the chance of a woman getting pregnant?
DECREASE 2
DEPENDS 3
DOESN'T KNOW 8
NO BIRTHS (GO TO 401)
340. Have you ever counted on breast feeding as a way to avoid getting pregnant?
NO 2 (GO TO 401)
PREGNANT OR STERILIZED (GO TO 401)
342. Are you currently counting on breast feeding to avoid getting pregnant?
NO 2
SECTION 4A. PREGNANCY AND BREAST FEEDING
NO BIRTHS SINCE JAN. 1992 (GO TO 487)
402. WRITE THE LINE NUMBER, NAME AND SURVIVAL STATUS OF EACH BIRTH SINCE JAN. 1992 RECODED IN THE REPRODUCTION TABLE. ASK THE QUESTIONS OF ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 2 BIRTHS, USE ADDITIONAL QUESTIONNAIRES).
Now I would like to some questions about the health of all of your children born in the last three years. (We will talk about each separately).
403. LINE NUMBER FROM LINE Q212
DEAD__
405. At the time you became pregnant with (NAME) did you want to become pregnant then, did you want to wait until later, or did you not want to have any (more) children at all?
LATER 2
NOT AT ALL 3 (GO TO 407)
406. How much time would you have liked to wait?
YEARS 2__
DOESN'T KNOW 998
407. When you were pregnant with (NAME) did you consult someone for prenatal care?
IF YES: Whom did you see? Anyone else?
PROBE TO IDENTIFY EACH TYPE OF PERSON AND RECORD ALL MENTIONED.
NURSE/MIDWIFE B
AUXILIARY MIDWIFE C
NO ONE Y (GO TO 410)
408. How many months pregnant were you when you had your first prenatal consultation?
DOESN'T KNOW 98
409. How many times did you get consultation during this pregnancy?
DOESN'T KNOW 98
410. When you were pregnant with (NAME), did you get an injection in the arm to avoid getting tetanus, that is to say to avoid having convulsions after the birth?
NO 2 (GO TO 412)
DOESN'T KNOW 8 (GO TO 412)
411. During this pregnancy, how many times did you have this injection?
DOESN'T KNOW 8
412. Where did you give birth to (NAME)?
OTHER HOME 12
HEALTH CENTER 22
MATERNITY/PMI (protection maternelle et infantile-a program created in France to give free care to expecting/recent mothers) 23
413. Who assisted you during the delivery of (NAME)? Anyone else?
PROBE TO GET THE TYPE OF PERSON. RECORD ALL THE PEOPLE CITED.
MIDEWIFE B
OBSTETRICIAN NURSE/HEALTH TECHNICIAN C
DOULA E
TRADITIONAL BIRTHER F
NO ONE Y
414. At the time of (NAME)'s birth, did you have the following problems:
- A long labor, that is to say regular contractions that lasted more than 12 hours?
- Excessive bleeding, so much so that you thought your life was in danger?
- A strong fever accompanied by foul smelling vaginal discharge?
- Convulsions not caused by fever?
NO 2
NO 2
NO 2
NO 2
415. Did you deliver (NAME) by cesarean section?
NO 2
416. When (NAME) was born was he/she very large, larger than average, average, smaller than average, or very small?
LARGER THAN AVERAGE 2
AVERAGE 3
SMALLER THAN AVERAGE 4
VERY SMALL 5
DOESN'T KNOW 8
417. Was (NAME) weighed at birth? [Repeat for last and next to last births]
NO 2 (GO TO 419)
NO 2 (GO TO 420)
418. How much did (NAME) weigh? [Repeat for last and next to last births]
RECORD THE WEIGHT FROM HEALTH CARD IF AVAILABLE.
GRAMS FROM MEMORY 2__
419. Has your period returned since the birth of (NAME)?
[Only for most recent birth]
NO 2 (GO TO 422)
420. Did your period return between the birth of (NAME) and your next pregnancy?
[Repeat this question for each birth prior to the most recent birth]
NO 2 (GO TO 424)
421. For how many months after the birth of (NAME) did you not have your period?
DOESN'T KNOW 98
422. CHECK 227: IS RESPONDENT PREGNANT?
PREGNANT OR NOT SURE (GO TO 424)
423. Have you begun to have sexual intercourse since the birth of (NAME)?
[Only for most recent birth]
NO 2 (GO TO 425)
424. For how many months after [NAME]'s birth did you not have sexual intercourse?
DOESN'T KNOW 98
425. Did you ever breastfeed [NAME]?
NO 2 (GO TO 431)
426. How long after birth did you first put [NAME] to the breast?
IF LESS THAN ONE HOUR RECORD '00' HOURS. IF LESS THAN 24 HOURS RECORD HOURS. OTHERWISE RECORD IN DAYS
HOURS 1__
DAYS 2__
426A. CHECK 426: BREAST FEEDING AFTER BIRTH
ONE HOUR OR MORE (GO TO 427)
426B. Who advised you to do this?
MIDWIFE B
OBSTETRICIAN NURSE/HEALTH TECHNICIAN C
DOULA E
TRADITIONAL BIRTH ATTENDANT F
NO ONE Y
DECEASED (GO TO 429)
428. Are you still breast feeding (NAME)?
NO 2
429. For how many months did you breast feed (NAME)?
DOESN'T KNOW 98
430. Why did you stop breast feeding (NAME)?
CHILD ILL/WEAK/DEFORMED 02
CHILD DIED 03
BREAST PROBLEMS 04
INSUFFICIENT MILK 05
MOTHER WORKING 06
BABY REFUSED 07
AGE TO WEAN 08
GOT PREGNANT 09
BEGAN USING CONTRACEPTION 10
OTHER (SPECIFY)__96
DECEASED RETURN TO 405 IN THE NEXT COLUMN OR IF NO MORE BIRTHS (GO TO 440)
432. How many times did you breastfeed last night between sunset and sunrise?
IF ANSWER IS NOT NUMERIC. PROBE FOR APPROXIMATE NUMBER.
433. Yesterday, how many times did you breastfeed during the day?
IF ANSWER IS NOT NUMERIC. PROBE FOR APPROXIMATE NUMBER.
433A. Did (NAME) drink anything in a bottle since his/her birth?
NO 2 (GO TO 435)
DOESN'T KNOW 8 (GO TO 435)
434. Did (NAME) drink something from a bottle yesterday or last night?
NO 2
DOESN'T KNOW 8
435. Did (NAME) get, at any time yesterday or last night, one of the following things?
NO 2
DOESN'T KNOW 8
NO 2
DOESN'T KNOW 8
NO 2
DOESN'T KNOW 8
NO 2
DOESN'T KNOW 8
NO 2
DOESN'T KNOW 8
NO 2
DOESN'T KNOW 8
NO 2
DOESN'T KNOW 8
NO 2
DOESN'T KNOW 8
NO 2
DOESN'T KNOW 8
NO 2
DOESN'T KNOW 8
NO 2
DOESN'T KNOW 8
NO 2
DOESN'T KNOW 8
NO 2
DOESN'T KNOW 8
436. CHECK 435: FOOD OR LIQUID YESTERDAY?
"NO/DOESN'T KNOW" TO ALL (GO TO 438)
437. (Besides mother's milk) how many times did (NAME) eat yesterday, including meals and snacks?
IF 7 TIMES OR MORE, RECORD '7'
DOESN'T KNOW 8
438. How many of the last 7 days did (NAME) get one of the following liquids/foods?
IF DOESN'T KNOW RECORD '8'
DOESN'T KNOW 8
DOESN'T KNOW 8
DOESN'T KNOW 8
DOESN'T KNOW 8
DOESN'T KNOW 8
DOESN'T KNOW 8
DOESN'T KNOW 8
DOESN'T KNOW 8
439. RETURN TO 405 IN THE FOLLOWING COLUMN OR, IF NO MORE BIRTHS (GO TO 440)
SECTION 4B. VACCINATION AND HEALTH
440. RECORD THE LINE NUMBER, NAME AND SURVIVAL STATUS OF EACH BIRTH SINCE JAN. 1992 IN THE REPRODUCTION TABLE. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 2 BIRTHS, USE THE LAST COLUMN OF ADDITIONAL QUESTIONNAIRES).
DEAD (GO TO 442)
443. Do you have a card where (NAME)'s vaccinations are written down?
IF YES: May I see it?
YES, NOT SEEN 2 (GO TO 447)
NO CARD 3
444. Did you ever have a vaccination card for (NAME)?
NO 1 (GO TO 447)
445. (1) COPY THE DATES FOR EACH VACCINATION FROM THE CARD.
(2) WRITE '44' IN 'DAY' COLUMN IF THE CARD SHOWS THAT A VACCINATION WAS GIVEN BUT NO DATE IS RECORDED.
MONTH__
YEAR__
MONTH__
YEAR__
MONTH__
YEAR__
MONTH__
YEAR__
MONTH__
YEAR__
MONTH__
YEAR__
MONTH__
YEAR__
MONTH__
YEAR__
MONTH__
YEAR__
MONTH__
YEAR__
MONTH__
YEAR__
MONTH__
YEAR__
446. Has (NAME) received any immunizations not recorded on this card, including vaccinations received in a national immunization day campaign?
RECORD 'YES' ONLY IF RESPONDENT MENTIONS BCG, POLIO 0-3, DPT 1-3, MEASLES, AND/OR YELLOW FEVER VACCINES.
NO 2 (GO TO 448I)
DOESN'T KNOW 8 (GO TO 448I)
447. Did (NAME) ever receive any vaccinates to prevent him/her from getting diseases, including vaccinations received in a national immunization campaign?
NO 2 (GO TO 448J)
DOESN'T KNOW 8 (GO TO 448J)
448. Tell me, please, if (NAME) received one of the following vaccinations:
448A. A BCG vaccination against tuberculosis, that is, an injection in the arm or shoulder that usually causes a scar?
NO 2
DOESN'T KNOW 8
448B. Polio vaccine, that is, drops in the mouth?
NO 2 (GO TO 448E)
DOESN'T KNOW 8 (GO TO 448E)
448C. How many times?
448D. Was the first vaccine for polio received right after birth or later?
LATER 2
448E. A DPT vaccination, that is, an injection given in the thigh or buttocks, generally at the same time as the polio drops?
NO 2 (GO TO 448G)
DOESN'T KNOW (GO TO 448G)
448F. How many times?
448G. An injection against the measles?
NO 2
DOESN'T KNOW 8
448H. An injection against yellow fever?
NO 2
DOESN'T KNOW 8
448I. CHECK 445: AT LEAST ONE DOSE OF VITAMIN A RECORDED ON THE CARD.
NO (GO TO 448J)
448J. Did (NAME) get a capsule like this one?
SHOW THE VITAMIN A CAPSULE.
NO 2 (GO TO 449)
DOESN'T KNOW 8 (GO TO 449)
449. Has (NAME) suffered from a fever, at any moment, during the past two weeks?
NO 2
DOESN'T KNOW 8
450. Has (NAME) suffered from a cough, at any moment, during the past two weeks?
NO 2 (GO TO 454)
DOESN'T KNOW 8 (GO TO 454)
451. When (NAME) had a cough, did he/she breathe faster than usual with short, rapid breaths?
NO 2
DOESN'T KNOW 8
452. Did you seek advice or treatment for the fever/cough?
NO 2 (GO TO 454)
453. Where did you seek advice or treatment? Where else?
RECORD EVERYTHING MENTIONED.
GOVERNMENT HEALTH CENTER/MATERNITY/GOVERNMENT PMI B
HEALTH AGENT C
PRIVATE DOCTOR E
PHARMACY F
FIELD WORKER G
DOULA/BIRTHER/HEALTH AID I
MUTEC (EDUCATION AND CULTURE WORKERS MUTUAL) K
HEALER/TRADITIONAL PRACTITIONER/MARABOUT (a kind of spiritual healer/witch doctor) M
FRIEND(S)/RELATIVE(S) N
454. Has (NAME) had diarrhea during the past two weeks?
NO 2 (GO TO 464)
DOESN'T KNOW 8 (GO TO 464)
455. Was there blood in his/her stool?
No 2
DOESN'T KNOW 8
456. The worst day of the diarrhea, how many stools did she/he have?
DOESN'T KNOW 98
457. Did you give him/her less or more to drink than before the diarrhea?
MORE 2
LESS 3
DOESN'T KNOW 8
458. When (NAME) had diarrhea did you give him/her less to eat than before the diarrhea, about the same amount, more than usual or nothing to eat?
MORE 2
LESS 3
DOESN'T KNOW 8
459. Did you give (NAME) a liquid prepared from a special packet called keneyadji?
NO 2
DOESN'T KNOW 8
460. Was something (else) given to (NAME) treat diarrhea?
NO 2 (GO TO 462)
DOESN'T KNOW 8 (GO TO 462)
461. What was given to treat the diarrhea? Anything else?
RECORD EVERYTHING MENTIONED.
PILL OR SYRUP B
INJECTION C
(I.V.) INTRAVENOUS D
HOMEMADE REMEDIES/MEDICINAL PLANTS E
OTHER (SPECIFY) __X
462. Did you seek advice or treatment for the diarrhea?
NO 2 (GO TO 464)
463. Where did you seek advice or treatment for the diarrhea? Anywhere else?
RECORD EVERYTHING MENTIONED
GOVERNMENT HEALTH CENTER/MATERNITY/GOVERNMENT PMI C
HEALTH AGENT C
PRIVATE DOCTOR E
PHARMACY F
FIELD WORKER G
DOULA/BIRTH ATTENDANT/HEALTH AID I
MUTEC (EDUCATION AND CULTURE WORKERS MUTUAL) K
HEALER/TRADITIONAL PRACTITIONER/MARABOUT (a kind of spiritual healer/witch doctor) M
FRIEND(S)/RELATIVE(S) N
464. RETURN TO 442 IN THE NEXT COLUMN, IF NO MORE BIRTHS (GO TO 465).
465. When a child has diarrhea, should he/she be given less to drink than usual, the same amount, or more liquids than usual?
ABOUT THE SAME AMOUNT 2
MORE LIQUIDS 3
DOESN'T KNOW 8
466. When a child has diarrhea, should he/she be given less to eat than usual, the same amount, or more than usual?
ABOUT THE SAME AMOUNT 2
MORE TO EAT 3
DOESN'T KNOW 8
466A. When a child has diarrhea and is breast fed, should he/she be given less breast milk than usual, the same amount, or more than usual?
ABOUT THE SAME AMOUNT 2
MORE TO EAT 3
DOESN'T KNOW 8
467. When a child has diarrhea, what are the symptoms that indicate that he/she should be taken to a health establishment or to health care workers?
RECORD ALL MENTIONED.
LIQUID STOOLS B
REPEATED VOMITING C
VOMITING D
BLOOD IN THE STOOLS E
FEVER F
CONSIDERABLE THIRST G
DOESN'T EAT/DOESN'T DRINK ENOUGH H
BECOMES MORE/VERY SICK I
DOESN'T GET BETTER J
OTHER (SPECIFY)__X
DOESN'T KNOW Z
468. When a child suffers from a cough, what are the symptoms that indicated that he/she should be taken to a health establishment or to health care workers?
RECORD EVERYTHING MENTIONED.
DIFFICULTY BREATHING B
LOUD BREATHING C
FEVER D
INCAPABLE OF DRINKING E
DOES NOT EAT OR DRINK WELL F
BECOMES MORE/VERY ILL G
DOESN'T GET BETTER H
OTHER (SPECIFY) _____ X
DOESN'T KNOW Z
469. CHECK 459 ALL OF THE COLUMNS
A CHILD RECEIVED KENEYADJI (GO TO 501)
470. Have you ever heard of a special product called KENEYADJI, that you can get to treat diarrhea?
NO 2
501. OTHER PEOPLE PRESENT AT THIS TIME.
NO 2
NO 2
NO 2
NO 2
502. Are you currently married or do you live with a man?
YES, LIVING WITH A MAN 2 (GO TO 507)
FIRST UNION NOT CONSUMMATED 3 (GO TO 515)
NO, NOT IN UNION 4
503. Do you currently have a regular sexual partner, an occasional sexual partner, or no sexual partner at all?
OCCASIONAL SEXUAL PARTNER 2
NO SEXUAL PARTNER 3
504. Have you ever been married or lived with a man?
YES, HAS LIVED WITH A MAN 2
NO 3 (GO TO 515)
506. What is your current marital status: are you widowed, divorced or separated?
DIVORCED 2 (GO TO 511)
SEPARATED 3 (GO TO 511)
507. Is your husband/partner living with you now or is he staying elsewhere?
LIVES ELSEWHERE 2
507A. RECORD THE HUSBAND'S/PARTNER'S LINE NUMBER FROM THE HOUSEHOLD QUESTIONNAIRE. IF HE IS NOT LISTED IN THE HOUSEHOLD, RECORD '00'
508. Besides yourself, does your husband/partner have other wives or does he live with other women as if he were married?
NO 2 (GO TO 511)
509. How many wives or partners does your husband currently have?
DOESN'T KNOW 98 (GO TO 511)
510. Are you the first, second...wife?
511. Have you been married or lived with a man only once or more than once?
MORE THAN ONCE 2
MARRIED/HAS LIVED WITH 1 MAN ONLY ONCE.
In which month and in which year did you begin to live with your husband/partner and in which month and in which year did you consummate your union?
MARRIED/HAS LIVED WITH 1 MAN MORE THAN ONCE
I would like to ask about when you started living with your first husband/partner. In what month and year was that and in which month in which year did you consummate your union?
Live with Husband:
DOESN'T KNOW MONTH 98
DOESN'T KNOW YEAR 9998
Consummated union:
DOESN'T KNOW MONTH 98
DOESN'T KNOW YEAR 9998
513. How old were you when you began living with him that is to say in which month in which year did you consummate your union?
Now I would like to ask you some questions about sexual activity in order to gain a better understanding of family planning problems.
515. How long has it been since you last had sexual intercourse (if you already had it)?
NUMBER OF DAYS 1__
NUMBER OF WEEKS 2__
NUMBER OF MONTHS 3__
NUMBER OF YEARS 4__
BEFORE THE LAST BIRTH 996
KNOWS ABOUT CONDOMS
Did you use a condom last time you had sexual intercourse?
DOES NOT KNOW ABOUT CONDOMS
Certain men use a condom that is to say that they put a rubber sheath on their penis during sexual intercourse. Did you use a condom last time you had sexual intercourse?
NO 2
DOESN'T KNOW 8
517. Do you know a place where you can get condoms?
NO 2 (GO TO 519)
IF IT IS HOSPITAL, HEALTH CENTER OR A CLINIC, CIRCLE THE NAME OF THE PLACE. PROBE TO DETERMINE THE TYPE OF SERVICE AND CIRCLE THE APPROPRIATE CODE.
HEALTH CENTER/FREE CLINIC/CLINIC/MATERNITY 12
HEALTH AGENT 13
PRIVATE DOCTOR 22
PHARMACY 23
FIELD WORKER 24
HEALTH CARE WORKER 32
FAMILY PLANNING FIELDWORKER/DOULA/BIRTHER/HEALTH AID 33
MUTEC (EDUCATION AND CULTURE WORKERS MUTUAL) 42
HEALER/TRADITIONAL PRACTITIONER/MARABOUT (a kind of spiritual healer/witch doctor) 62
FRIEND(S)/RELATIVE(S) 63
DOESN'T KNOW 98
519. How old were you the first time you had sexual intercourse?
FIRST TIME AT MARRIAGE 96
SECTION 5B. FEMALE CIRCUMCISION
NO 2 (GO TO 555)
552. What type of circumcision did you undergo Did you have a clitoridectomy, an excision, or an infibulation?
EXCISION 02
INFIBULATION 03
OTHER(SPECIFY)__96
553. How old were you when you underwent this practice?
DOESN'T KNOW 98
554. Who performed your circumcision?
NURSE/MIDWIFE 02
TRADITIONAL MIDWIFE 03
TRADITIONAL CIRCUMCISER 04
OTHER (SPECIFY)__96
DOESN'T KNOW 98
NO LIVING DAUGHTER (GO TO 560)
556. Has (NAME OF OLDEST DAUGHTER) been circumcised?
NO 2 (GO TO 559A)
NOT YET 8 (GO TO 559A)
557. How old was she at the time of the circumcision?
DOESN'T KNOW 98
558. Who performed the circumcision?
NURSE/MIDWIFE 02
TRADITIONAL MIDWIFE 03
TRADITIONAL CIRCUMCISER 04
OTHER (SPECIFY)__96
DOESN'T KNOW 98
559. Did anyone object to (NAME OF OLDEST DAUGHTER'S) circumcision? Anyone else?
RECORD ALL THE PEOPLE MENTIONED.
RESPONDENT'S HUSBAND B (GO TO 560)
RESPONDENT'S MOTHER C (GO TO 560)
RESPONDENT'S MOTHER IN LAW D (GO TO 560)
OTHER RELATIVE OF RESPONDENT E (GO TO 560)
OTHER RELATIVE OF HUSBAND F (GO TO 560)
OTHER (SPECIFY)__X (GO TO 560)
NO ONE Y (GO TO 560)
559A. Do you intend to circumcise her?
NO 2
DOESN'T KNOW 8
560. Do you think female circumcision should still be practiced or should it be stopped?
STOPPED 2 (GO TO 563)
DOESN'T KNOW 8 (GO TO 600)
561. In your opinion, what type of female circumcision should still be practiced: clitoridectomy, excision or infibulations?
EXCISION 02
INFIBULATION 03
OTHER (SPECIFY)__96
562. Why do you think female circumcision should still be practiced? What other reason?
RECORD ALL MENTIONED.
CUSTOM AND TRADITION B (GO TO 560)
RELIGIOUS NECESSITY C (GO TO 560)
BETTER HYGIENE D (GO TO 560)
BETTER CHANCE FOR MARRIAGE E (GO TO 560)
MORE SEXUAL PLEASURE FOR THE HUSBAND F (GO TO 560)
PRESERVATION OF VIRGINITY/PREVENT SEXUAL INTERCOURSE BEFORE MARRIAGE G (GO TO 560)
OTHER (SPECIFY)__X (GO TO 560)
DOESN'T KNOW Y (GO TO 560)
563. Why do you think female circumcision should be stopped? Any other reason?
RECORD ALL MENTIONED
AGAINST RELIGION B
MEDICAL COMPLICATIONS C
OWN PAINFUL EXPERIENCE D
AGAINST THE DIGNITY OF THE WOMAN E
PREVENTS SEXUAL PLEASURE F
OTHER (SPECIFY)__X
DOESN'T KNOW Y
SECTION 6. FERTILITY PREFERENCES
NEVER HAD SEX (GO TO 608)
HE OR SHE STERILIZED (GO TO 612)
NOT PREGNANT OR NOT SURE
Now I have a few questions about the future.
Would you like to have (a/another) child, or would you prefer not to have (other) children at all?
PREGNANT
Now I have a few questions about the future.
After the child that you are expecting, would you like to have (a/another) child, or would you prefer not to have (other) children at all?
NO MORE/NONE 2 (GO TO 606)
SAYS SHE CAN NOT GET PREGNANT 3 (GO TO 606)
NOT SURE/DOESN'T KNOW (GO TO 604)
NOT PREGNANT OR NOT SURE.
How long would you like to wait from now before the birth of (a/another) child?
PREGNANT
After the birth of the child you are expecting, how long would you like to wait from now before the birth of (a/another) child?
YEARS 2__
SAYS SHE CAN NOT GET PREGNANT 994 (GO TO 606)
AFTER MARRIAGE 995
OTHER(SPECIFY)__996
DOESN'T KNOW 998
PREGNANT (GO TO 607)
605. If you were to get pregnant in the next weeks, would you be happy, not happy or not care?
NOT HAPPY 2
NOT CARE 3
606. CHECK 310: USES A CONTRACEPTIVE METHOD?
DOES NOT CURRENTLY USE (GO TO 607)
CURRENTLY USES (GO TO 612)
607. Do you think that you will use a method to delay or avoid pregnancy during the next 12 months?
NO 2
DOESN'T KNOW 8
608. Do you think that in the future you will use a method to delay or avoid a pregnancy?
NO 2 (GO TO 610)
DOESN'T KNOW (GO TO 610)
609. Which method would you prefer to use?
IUD 02 (GO TO 612)
INJECTIONS 03 (GO TO 612)
IMPLANTS 04 (GO TO 612)
DIAPHRAGM/FOAM/JELLY 05 (GO TO 612)
CONDOM 06 (GO TO 612)
FEMALE STERILIZATION 07 (GO TO 612)
MALE STERILIZATION 08 (GO TO 612)
RHYTHM METHOD 09 (GO TO 612)
WITHDRAWAL 10 (GO TO 612)
OTHER (SPECIFY)__96 (GO TO 612)
NOT SURE 98 (GO TO 612)
610. What is the main reason why you think you will never use a contraceptive method?
MENOPAUSE/HYSTERECTOMY 23 (GO TO 612)
NOT FECUND/STERILE 24 (GO TO 612)
WANTS CHILDREN 26 (GO TO 612)
HUSBAND/PARTNER OPPOSED 32 (GO TO 612)
OTHER PERSONS OPPOSED 33 (GO TO 612)
RELIGIOUS PROHIBITION 34 (GO TO 612)
KNOWS NO SOURCE 42 (GO TO 612)
FEAR OF SIDE EFFECTS 52 (GO TO 612)
LACK OF ACCESS/TOO FAR 53 (GO TO 612)
COSTS TOO MUCH 54 (GO TO 612)
INCONVENIENT TO USE 55 (GO TO 612)
INTERFERES WITH BODY'S NORMAL PROCESSES 56 (GO TO 612)
DOESN'T KNOW 98 (GO TO 612)
611. Would you use a contraceptive method if you were married?
NO 2
DOESN'T KNOW 8
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?
PROBE FOR A NUMERIC RESPONSE.
NO LIVING CHILDREN
If you could choose exactly the number of children to have in your whole life, how many would that be?
PROBE FOR A NUMERIC RESPONSE.
OTHER(SPECIFY)__96 (GO TO 614)
IF '00' (GO TO 614)
613. How many of these children would you like to be boys, how many would you like to be girls and for how many would the sex not matter?
614. Would you say that you approve or disapprove of couples that use a method to avoid getting pregnant?
DISAPPROVE 2
NO OPINION 3
615. In your opinion, is it ok or not ok to talk about family planning:
On the radio?
On the television?
NOT OK 2
NOT OK 2
616. During the last few months, have you heard about family planning:
On the radio?
On the television?
In newspapers or magazines?
On a poster?
On a flier or brochure?
NO 2
NO 2
NO 2
NO 2
NO 2
618. During the past few months, have you discussed the practice of family planning with your friends, neighbors, or relatives?
NO 2 (GO TO 620)
619. With whom did you discuss this? Anyone else?
RECORD EVERYTHING MENTIONED.
MOTHER B
FATHER C
SISTER(S) D
BROTHER(S) E
DAUGHTER(S) F
STEP MOTHER(S)/MOTHER(S) IN LAW G
COUSIN(S) H
FRIEND(S)/NEIGHBOR(S) I
OTHER(SPECIFY)__X
YES, LIVES WITH A MAN (GO TO 621)
NO, NOT IN A UNION (GO TO 624)
Spouses/partners do not always agree about everything. Now I would like to ask you about your partner/husband's opinions about family planning.
621. Do you think that your partner/husband approves or disapproves of using methods to avoid pregnancy?
DISAPPROVES 2
DOESN'T KNOW 8
622. How many times during the past year did you speak with your partner/husband about family planning?
ONCE OR TWICE 2
MORE OFTEN 3
623. Does your husband want the same number of children that you want, or does he want more of fewer than you want?
MORE CHILDREN 2
FEWER CHILDREN 3
DOESN'T KNOW 8
NEVER HAD SEX (GO TO 701)
625. Sometimes a woman gets pregnant at a time when she does not want to. Have you ever gotten pregnant when you did not wish to?
NO 2 (GO TO 637)
626. At what time did this happen to you?
RECORD THE MONTH AND YEAR
YEAR ____
627. When this happened, what did you do?
TRIED BUT FAILED TO END THE PREGNANY 02
HAD A MISCARRIAGE 03 (GO TO 630)
NOTHING/CONTINUED THE PREGNANCY 04 (GO TO 637)
OTHER (SPECIFY)__ 96
628. Could you tell me what you did?
Was another thing tried?
FOLLOW THE SHIP INSTRUCTIONS FOR 'H' AND 'I' ONLY IF NOTHING ELSE WAS TRIED.
PILLS B
MASSAGES/PRESSURE ON THE ABDOMEN C
OBJECT IN THE UTERUS D
INJECTION E
ASPIRATION F
DILATION AND SCRAPING G
PRAYERS/ GOD'S WILL H (GO TO 630)
HARD/EXHAUSTING WORK I (GO TO 630)
OTHER (SPECIFY)__X
DOESN'T KNOW Z
629. Could you tell me who helped you?
Anyone else?
MIDWIFE B
DOULA C
TRADITIONAL BIRTH ATTENDANT D
NURSE E
HEALTH AID F
PHARMACIST G
TRADITIONAL HEALER H
HUSBAND/PARTNER J
RELATIVES K
FRIENDS L
OTHER (SPECIFY)__X
ANYONE Y
630. Could you tell me where you sought aid for this?
HEALTH CENTER/FREE CLINIC/CLINIC/MATERNITY 12
PRIVATE DOCTOR 22
PHARMACY 23
MUTEC (EDUCATION AND CULTURE WORKERS MUTUAL) 42
OWN HOUSE 62
OTHER HOUSE 63
OTHER (SPECIFY)__96
631. Sometimes women can have health problems after that. Did you have health problems after that?
NO 2 (GO TO 637)
632. What health problems did you have?
CONSIDERABLE VAGINAL BLEEDING 02
OTHER (SPECIFY)__96
633. Did you seek care because of these problems?
NO 2 (GO TO 637)
HEALTH CENTER/FREE CLINIC/CLINIC/MATERNITY 12
PRIVATE DOCTOR 22
PHARMACY 23
MUTEC (EDUCATION AND CULTURE WORKERS MUTUAL) 42
OWN HOUSE 62
OTHER HOUSE 63
NO 2 (GO TO 637)
636. How many nights did you spend at the hospital?
IF NO NIGHTS, RECORD '00'
637. PEOPLE PRESENT AT THIS TIME.
NO 2
NO 2
NO 2
NO 2
SECTION 7. HUSBAND'S BACKGROUND AND WOMAN'S PROFESSIONAL ACTIVITY
HAS BEEN MARRIED/HAS LIVED WITH A MAN (GO TO 702)
NOT IN UNION/FIRST MARRIAGE NOT CONSUMMATED (GO TO 709)
702. How old was your husband at his last birthday?
703. Did your (last) husband attend school?
NO 2 (GO TO 706)
704. What was the highest level of school that he achieved: primary 1 (first cycle), primary 2 (second cycle), secondary (high school or technical) or superior?
PRIMARY 2 (SECOND CYCLE) 2
SECONDARY (HIGH SCHOOL/TECH) 3
SUPERIOR 4
DOESN'T KNOW 8 (GO TO 706)
705. What was the last year that he achieved at this level?
DOESN'T KNOW 98
2 ELEMENTARY 2(SECOND CYCLE)
3 SECONDARY (HIGH SCHOOL, TECHNICAL SCHOOL)
4 SUPERIOR
706. What is(was) the primary occupation of your husband/partner, that is to say what kind of work did/does he do?
STUDENT/ DOES/DID NOT WORK IN AGRICULTURE (GO TO 709)
708. 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?
FAMILY LAND 2
RENTED LAND 3
SOMEONE ELSE'S LAND 4
709. Aside from your housework, do you currently work?
NO 2
710. As you know, some women take up jobs for which they are paid in cash or in kind. Others sell things, have a small business or work on the family farm or in a family business.
Do you currently do something like this or any other work?
NO 2
711. Did you do any type of work during the past 12 months?
NO 2 (GO TO 801A)
712. What is your occupation, that is, what kind of work do you mainly do?
DOES NOT WORK IN AGRICULTURE (GO TO 715)
714. Do you work mainly on your own land or on family land, or did you work on land that you rent from someone else, or do you work on someone else's land?
FAMILY LAND 2
RENTED LAND 3
SOMEONE ELSE'S LAND 4
715. Do you do this work for a member of your family, for someone else, or are you self-employed?
FOR SOMEONE ELSE 2
SELF-EMPLOYED 3
716. Do you usually work throughout the year, seasonally or only once in a while?
SEASONALLY/PART OF THE YEAR 2
ONCE IN A WHILE 3 (GO TO 719)
717. During the past 12 months, how many months did you work?
718. (During the months you worked) how many days a week did you usually work?
719. During the past 12 months, how many days did you work?
720. Do you get paid for this work?
PROBE: do you get money for this work?
NO 2 (GO TO 723)
721. How much per month do you usually get for this work?
PROBE: Is this per hour, day, week, or per month?
P/DAY 2__
P/WEEK 3__
P/MONTH 4__
P/YEAR 5__
OTHER (SPECIFY)__99999996
YES, CURRENTLY MARRIED
Who mainly decides how the money you earn will be used? You, your husband/partner, you and your husband/partner, or someone else?
NO, NOT IN A UNION
Who mainly decides how the money you earn will be used? You, you and someone else, or someone else?
HUSBAND/PARTNER 2
RESPONDENT AND HUSBAND/PARTNER TOGETHER 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE TOGETHER 5
723. Do you usually work at home or outside the home?
OUTSIDE 2
724. CHECK 217 AND 218: DOES SHE HAVE CHILDREN LESS THAN 5 YEARS OLD LIVING WITH HER?
NO 2 (GO TO 801A)
725. Who mainly takes care of (NAME OF THE YOUNGEST CHILD AT HOME) while you work?
HUSBAND/ PARTNER 02
CHILD-OLDEST GIRL 03
CHILD-OLDEST BOY 04
OTHER RELATIVES 05
NEIGHBOR 06
FRIEND(S) 07
SERVANT/HIRED PERSON 08
CHILD GOES TO SCHOOL 09
KINDERGARTEN/DAY CARE 10
HAS NOT WORKED SINCE LAST BIRTH 95
OTHER (SPECIFY) __96
SECTION 8. AIDS AND OTHER SEXUALLY TRANSMISSED DISEASES
801A. Have you ever heard of an illness that can be transmitted sexually?
NO 2 (GO TO 801K)
801B. Which illnesses do you know of?
RECORD ALL MENTIONED
GONORRHEA B
AIDS C
CONDYLOMA/TUMOR D
OTHER (SPECIFY)__X
DOESN'T KNOW Z
HAS NOT HAD SEX (GO TO 801K)
801D. During the last 12 months, did you have one of these illnesses?
NO 2 (GO TO 801K)
DOESN'T KNOW 8 (GO TO 801K)
801E. Which illness did you have?
RECORD ALL MENTIONED
GONORRHEA B
AIDS C
CONDYLOMA/TUMOR D
OTHER (SPECIFY)__X
DOESN'T KNOW Z
801F. The last time you had (ILLNESS FROM 801E) did you seek advice or treatment?
NO 2 (GO TO 801H)
801G. Where did you seek advice or treatment?
HEALTH CENTER/MATERNITY/GOVERNMENT PMI B
HEALTH AGENT C
PRIVATE DOCTOR E
PHARMACY F
FIELD WORKER G
HEALTH CARE WORKER I
FAMILY PLANNING FIELDWORKER/DOULA/BIRTHER/HEALTH AID J
MUTEC (EDUCATION AND CULTURE WORKERS MUTUAL) L
HEALER/TRADITIONAL PRACTITIONER/MARABOUT (a kind of spiritual healer/witch doctor) O
FRIEND(S)/RELATIVE(S) P
DOESN'T KNOW Z
801H. When you had (ILLNESS FROM 801E), did you tell your partner?
NO 2
801I. When you had (ILLNESS FROM 801E), did you do something to avoid infecting your partner?
NO 2 (GO TO 801K)
PARTNER ALREADY INFECTED 3 (GO TO 801K)
801J. What did you do?
RECORD EVERYTHING MENTIONED,
USED CONDOMS B
TOOK MEDICINE C
OTHER (SPECIFY)__X
CITED "AIDS" (GO TO 802)
801L. Have you ever heard of a disease called AIDS?
NO 2 (GO TO 811C)
802. From which source of information did you learn the most about AIDS? Any other source?
RECORD EVERYTHING MENTIONED.
TV B
NEWSPAPERS/MAGAZINES C
BROCHURES/FLIERS D
CENTER/HEALTH CARE WORKERS E
MOSQUE/ CHURCH F
SCHOOL/PROFESSOR G
NEIGHBORHOOD MEETINGS H
POPULAR THEATER I
FRIEND(S)/RELATIVES J
WORK PLACE K
OTHER (SPECIFY)__X
802B. How can one get AIDS? Any other way?
RECORD EVERYTHING CITED.
NOT USING CONDOMS C
SEX WITH MULTIPLE PARTNERS E
SEX WITH PROSTITUTES G
SEX WITH HOMOSEXUALS H
BLOOD TRANSFUSIONS I
INJECTIONS J
FROM MOTHER TO BABY K
KISSING L
MOSQUITO BITES M
LIVING WITH SOMEONE WITH AIDS N
BLADES/RAZORS/SCISSORS/DIRTY CUTTING INSTRUMENTS P
OTHER(SPECIFY)__X
DOESN'T KNOW Z
803. Is there anything a person can do to avoid getting AIDS or the virus that causes AIDS?
NO 2 (GO TO 807)
DOESN'T KNOW 8 (GO TO 807)
804. What can a person do? Anything else?
RECORD EVERYTHING CITED.
USE CONDOMS C
LIMIT TO ONE PARTNER D
STAY LOYAL F
AVOID SEX WITH PROSTITUTES G
AVOID SEX WITH HOMOSEXUALS H
AVOID BLOOD TRANSFUSIONS I
AVOID INJECTIONS J
AVOID SHARING THE SAME BLADES/RAZORS K
AVOID KISSING L
AVOID MOSQUITO BITES M
AVOID LIVING WITH SOMEONE WITH AIDS N
SEEK PROTECTION FROM A TRADITIONAL HEALER O
AVOID BLADES/RAZORS/SCISSORS/DIRTY CUTTING INSTRUMENTS P
OTHER(SPECIFY)__X
DOESN'T KNOW Z
807. Is it possible that a person who appears to be healthy, in fact, has AIDS virus?
NO 2
DOESN'T KNOW 8
808. Do you think someone with AIDS almost never dies of this illness, sometimes dies of it, or always dies of it?
SOMETIMES 2
ALMOST ALWAYS 3
808A. Can someone be cured of AIDS?
NO 2
DOESN'T KNOW 8
808B. Can AIDS be transmitted from mother to child?
NO 2
DOESN'T KNOW 8
808C. Do you personally know anyone who has the AIDS virus or who died of AIDS?
NO 2
DOESN'T KNOW 8
809. Do you think your chances of getting AIDS are small, moderate, great, or no risk at all?
MODERATE 2 (GO TO 809C)
GREAT 3 (GO TO 809C)
NO RISK AT ALL 4
HAS AIDS 5 (GO TO 811A)
809B. Why do you think you (HAVE NO RISK/SMALL RISK) of getting AIDS?
Any other reason?
RECORD ALL MENTIONED.
USES CONDOMS C (GO TO 811A)
ONLY HAS ONE SEXUAL PARTNER D (GO TO 811A)
LIMITED NUMBER OF SEXUAL PARTNERS E (GO TO 811A)
PARTNER DOESN'T HAVE OTHER PARTNERS F (GO TO 811A)
DOESN'T HAVE HOMOSEXUAL SEX H (GO TO 811A)
NO BLOOD TRANSFUSIONS I (GO TO 811A)
NO INJECTIONS J (GO TO 811A)
AVOIDS DIRTY BLADES, SCISSORS, KNIVES, CUTTING INSTRUMENTS P (GO TO 811A)
OTHER (SPECIFY)__ X (GO TO 811A)
809C. Why do you think you (HAVE AVERAGE RISK/LARGE RISK) of getting AIDS?
Any other reason?
RECORD ALL MENTIONED.
MORE THAN ONE SEXUAL PARTNER D
MANY SEXUAL PARTNERS E
PARTNER HAS OTHER PARTNERS F
HOMOSEXUAL SEX H
BLOOD TRANSFUSIONS I
INJECTIONS J
AVOIDS [sic.] DIRTY BLADES, SCISSORS, KNIVES, CUTTING INSTRUMENTS P OTHER (SPECIFY)__ X
811A. Since you have heard of AIDS, have you changed your behavior to avoid getting AIDS?
IF YES, What have you done?
RECORD EVERYTHING MENTIONED.
STOPPED HAVING SEXUAL INTERCOURSE B (GO TO 811C)
BEGAN USING CONDOMS C (GO TO 811C)
LIMITED TO 1 SEXUAL PARTNER D (GO TO 811C)
REDUCED THE NUMBER OF PARTNERS E (GO TO 811C)
ASKED SPOUSE TO BE FAITHFUL F (GO TO 811C)
STOPPED HAVING HOMOSEXUAL SEX H (GO TO 811C)
STOPPED GETTING INJECTIONS J
AVOIDED BLADES, SCISSORS, KNIVES, AND/OR SHARP, CONTAMINATED INSTRUMENTS P
OTHER (SPECIFY)__X
NO CHANGE IN BEHAVIOR Y
811B. Has the fact of you being familiar with AIDS influenced or changed your decisions regarding having sex or your sexual behavior?
IF YES: In what ways?
RECORD EVERYTHING MENTIONED.
STOPPED HAVING SEXUAL INTERCOURSE B
BEGAN USING CONDOMS C
LIMITED TO ONE SEXUAL PARTNER D
REDUCED THE NUMBER OF PARTNERS E
STOPPED HAVING HOMOSEXUAL SEX H
OTHER (SPECIFY) ____ X
NO CHANGE IN SEXUAL BEHAVIOR Y
811C. Some people use condoms during sexual intercourse to avoid getting AIDS or other sexually transmitted illnesses. Have you ever heard of this?
NO 2 (GO TO 811F)
HAS NEVER HAD SEXUAL INTERCOURSE (GO TO 901)
811E. It is possible that we've already spoken about this. Have you ever used a condom during sexual intercourse to avoid getting or transmitting AIDS or other sexually transmitted diseases?
NO 2
811F. During the past 12 months, have you given money or gifts in exchange for sexual intercourse?
NO 2
Now I would like to ask you some questions about your brothers and sisters, that is to say about all of the children born to your biological mother, including those who live with you, those who live elsewhere and those who died.
901. To how many children, including yourself, did your mother give birth?
ONLY ONE BIRTH (GO TO 916)
903. How many births did your mother have before your own birth?
[REPEAT QUESTIONS 904 -915A FOR ALL BIRTHS]
904. What name was given to your oldest brother or sister (or the next)?
905. Is (NAME) male or female?
FEMALE 2
NO 2 (GO TO 908)
DOESN'T KNOW 8 (GO TO NEXT BIRTH)
907. How old is (NAME)?
If male or female sibling is less than 12 years old, GO TO THE NEXT BIRTH.
If sister is age 12 or older, GO TO 915.
908. In which year did (NAME) die?
DOESN'T KNOW 98
909. How many years has (NAME) been deceased?
910. How old was (NAME) when he/she died?
IF MAN, OR IF WOMAN DECEASED BEFORE THE AGE OF 12 YEARS GO TO NEXT BIRTH.
911. Was (NAME) pregnant when she died?
NO 2
912. Did (NAME) die during childbirth?
NO 2
913. Did (NAME) die in the two months following a pregnancy or birth?
NO 2
914. Was death due to pregnancy or delivery complications?
NO 2
915. To how many children did (NAME) give birth during her life (before this pregnancy)?
915A. Among [NAME's] children, how many are dead?
[IF NO MORE BROTHERS OR SISTERS, GO TO 916.]
Minutes___
NO BIRTHS SINCE JAN. 1992 (GO TO END)
IN 1002 (COLUMNS 2-4) RECORD THE LINE NUMBER OF EACH CHILD BORN SINCE JAN. 1992 AND STILL ALIVE. IN 1003 AND 1004, RECORD THE NAME AND BIRTH DATE OF THE RESPONDENT AND ALL OF HER LIVING CHILDREN BORN SINCE 1992. IN 1006 AND 1008 RECORD THE WEIGHT AND HEIGHT OF THE RESPONDANT AND THE LIVING CHILDREN. (NOTE: ALL OF THE RESPONDENTS WHO GAVE BIRTH SINCE JAN. 1992 MUST BE WEIGHED AND MEASURED EVEN IF ALL THEIR CHILDREN ARE DEAD. IF THERE ARE MORE THAN 2 CHILDREN BORN SINCE JAN. 1992 AND STILL ALIVE, USE A SUPPLEMENTARY QUESTIONNAIRE.
1002. LINE NUMBER ACCORDING TO Q. 212
[LAST BIRTH AND SECOND TO LAST BIRTH]
1003. NAME ACCORDING TO Q212 FOR CHILDREN
[RESPONDENT, LAST BIRTH AND SECOND TO LAST BIRTH]
1004. BIRTH DATE ACCORDING TO Q.215, AND ASK THE BIRTH DAY.
[LAST BIRTH AND SECOND TO LAST BIRTH]
MONTH__
YEAR__
1005. BCG SCAR ON THE SIDE OF LEFT ARM.
[LAST BIRTH AND SECOND TO LAST BIRTH]
NO SCAR 2
1006. HEIGHT (in centimeters)
[RESPONDENT, LAST BIRTH AND SECOND TO LAST BIRTH]
1007. WAS THE CHILD MEASURED LYING DOWN OR STANDING UP?
[LAST BIRTH AND SECOND TO LAST BIRTH]
STANDING 2
1008. WEIGHT (IN KILOGRAMS)
[RESPONDENT, LAST BIRTH AND SECOND TO LAST BIRTH]
1009. DATE OF MEASUREMENT AND WEIGHING
MONTH ___
YEAR ___
RESPONDENT
ABSENTE 3
REFUSED 4
OTHER (SPECIFY)__6
LAST BIRTH AND SECOND TO LAST BIRTH
CHILD ILL 2
CHILD ABSENT 3
CHILD REFUSED 4
MOTHER REFUSED 5
OTHER (SPECIFY)__6
1011. NAME OF PERSON WHO TOOK THE MEASUREMENTS___
ASSISTANT'S NAME___
FILL OUT AFTER HAVING ENDED THE INTERVIEW
COMMENTS ABOUT THE RESPONDENT ______
COMMENTS ON PARTICULAR QUESTIONS ______
OTHER COMMENTS ______
SUPERVISOR'S OBSERVATIONS ______
NAME_____
DATE_____
FIELD EDITOR'S OBSERVATIONS ______
NAME_____
DATE_____