Data Cart

Your data extract

0 variables
0 samples
View Cart

DEMOGRAPHIC AND HEALTH SURVEY-MALAWI 2000-WOMAN'S QUESTIONNAIRE

IDENTIFICATION

VILLAGE/PLACE NAME_____

NAME OF HOUSEHOLD HEAD_____

MDHS CLUSTER NUMBER _____

HOUSEHOLD NUMBER ______

URBAN/RURAL _____

URBAN 1
RURAL 2

NAME AND LINE NUMBER OF WOMAN_____

INTERVIEWER VISITS

FIRST VISIT (REPEAT FOR SECOND AND THIRD VISITS)
DATE ___
INTERVIEWER'S NAME ___
RESULT* ____

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 ___
NAME ___
RESULT ___

TOTAL NUMBER OF VISITS ____

LANGUAGE OF QUESTIONNAIRE:

ENGLISH 3

LANGUAGE OF INTERVIEW:

CHICHEWA 1
TUMBUKA 2
OTHER (SPECIFY) ____ 3


SUPERVISOR
NAME ____
DATE ____

FIELD EDITOR
NAME ____
DATE ____

OFFICE EDITOR_____

KEYED BY____

SECTION 1. RESPONDENT'S BACKGROUND

101. RECORD THE TIME.

HOUR ___
MINUTES ___

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

CITY 1
TOWN 2
VILLAGE 3

103. How long have you been living continuously in (NAME OF CURRENT PLACE OF RESIDENCE)?
IF LESS THAN ONE YEAR, RECORD '00' YEARS.

YEARS ____
ALWAYS 95 (GO TO 105)
VISITOR 96 (GO TO 105)

104. Just before you moved here, did you live in a city, in a town, or in a village?

CITY 1
TOWN 2
VILLAGE 3

105. In what month and year were you born?

MONTH ___
DON'T KNOW MONTH 98
YEAR ___
DON'T KNOW YEAR 9998

106. How old were you at your last birthday?
COMPARE AND CORRECT 105 AND/OR 106 IF INCONSISTENT.

AGE IN COMPLETED YEARS ____

107. Have you ever attended school?

YES 1
NO 2 (GO TO 111)

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

PRIMARY 1
SECONDARY 2
HIGHER 3

109. How many years of school did you complete at that level?

YEARS ____

110. CHECK 108:

PRIMARY (GO TO 111)
SECONDARY OR HIGHER (GO TO 114)

111. Now I would like you to read this sentence to me.
SHOW CARD TO RESPONDENT.
IF RESPONDENT CANNOT READ WHOLE SENTENCE, PROBE: Can you read any part of the sentence to me?

CANNOT READ AT ALL 1
ABLE TO READ ONLY PARTS OF SENTENCE 2
ABLE TO READ WHOLE SENTENCE 3
NO CARD WITH REQUIRED LANGUAGE (SPECIFY LANGUAGE) ____ 4

112. Have you ever participated in a literacy program or any other program that involves learning to read or write (not including primary school)?

YES 1
NO 2

113. CHECK 111:

CODE '2', '3' OR '4' CIRCLED (GO TO 114)
CODE '1' CIRCLED (GO TO 115)

114. Do you read a newspaper or magazine almost every day, at least once a week, less often than that or not at all?

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

115. Do you listen to the radio almost every day, at least once a week, less often than that or not at all?

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

116. Do you watch television almost every day, at least once a week, less often than that or not at all?

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

117. What is your religion?

CATHOLIC 01
CCAP 02
ANGLICAN 03
SEVENTH DAY ADVENT./BAPTIST 04
OTHER CHRISTIAN 05
MUSLIM 06
NO RELIGION 07
OTHER (SPECIFY) _____ 96

118. What is your tribe or ethnic group?

CHEWA 01
TUMBUKA 02
LOMWE 03
TONGA 04
YAO 05
SENA 06
NKONDE 07
NGONI 08
OTHER (SPECIFY) _____ 96

119. Have you heard that when a child is born in Malawi, you can register that child with the government and receive a birth certificate?

YES 1
NO 2

SECTION 2: REPRODUCTION

201. Now I would like to ask about all the births you have had during your life. Have you ever given birth?

YES 1
NO 2 (GO TO 206)

202. Do you have any sons or daughters to whom you have given birth 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 to whom you have given birth 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 given birth to a boy or girl who was born alive but later died?
IF NO, PROBE: Any baby who cried or showed signs of life but survived only a few moments?

YES 1
NO 2 (GO TO 208)

207. How many boys have died? And how many girls have died?
IF NONE, RECORD '00'.

BOYS DEAD ___
GIRLS DEAD ___

208. SUM ANSWERS TO 203, 205, AND 207, AND ENTER TOTAL.
IF NONE, RECORD '00'.

TOTAL ____

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

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

210. CHECK 208:

ONE OR MORE BIRTHS (GO TO 211)
NO BIRTHS (GO TO 226)

211. Now I would like to record the names of all your births, whether still alive or not, starting with the first one you had.
RECORD NAMES OF ALL THE BIRTHS IN 212. RECORD TWINS AND TRIPLETS ON SEPARATE LINES.

212. What name was given to your (first/next) baby?

NAME______

213. Were any of these births twins?

SINGULAR 1
MULTIPLE 2

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

BOY 1
GIRL 2

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

MONTH ___
YEAR ___

216. Is (NAME) still alive?

YES 1
NO 2 (GO TO 220)

217. IF ALIVE: How old was (NAME) at his/her last birthday?
RECORD AGE IN COMPLETED YEARS.

AGE IN YEARS ____

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

YES 1
NO 2

219. IF ALIVE: RECORD HOUSEHOLD LINE NUMBER OF CHILD
(RECORD '00' IF CHILD NOT LISTED IN HOUSEHOLD).

LINE NUMBER ___ (GO TO NEXT BIRTH, OR IF NO MORE BIRTHS GO TO 221)

220. IF DEAD: How old was (NAME) when he/she died?
IF '1 YR', PROBE: How many months old was (NAME)?
RECORD DAYS IF LESS THAN 1 MONTH; MONTHS IF LESS THAN TWO YEARS; OR YEARS.

DAYS 1 ___
MONTHS 2 ___
YEARS 3 ___

221. Were there any other live births between (NAME OF PREVIOUS BIRTH) and (NAME)?

YES 1
NO 2

222. Have you had any live births since the birth of (NAME OF LAST BIRTH)?

YES 1
NO 2

223. COMPARE 208 WITH NUMBER OF BIRTHS IN HISTORY ABOVE AND MARK:

NUMBERS ARE SAME:
CHECK:
FOR EACH BIRTH: YEAR OF BIRTH IS RECORDED __
FOR EACH LIVING CHILD: CURRENT AGE IS RECORDED __
FOR EACH DEAD CHILD: AGE AT DEATH IS RECORDED __
FOR AGE AT DEATH 12 MONTHS OR 1 YEAR: PROBE TO DETERMINE EXACT NUMBER OF MONTHS __
NUMBERS ARE DIFFERENT (PROBE AND RECONCILE)

224. CHECK 215 AND ENTER THE NUMBER OF BIRTHS IN 1995 OR LATER.
IF NONE, RECORD '0'.

225. FOR EACH BIRTH SINCE JANUARY 1995, ENTER 'B' IN THE MONTH OF BIRTH IN THE CALENDAR. FOR EACH BIRTH, ASK THE NUMBER OF MONTHS THE PREGNANCY LASTED AND RECORD 'P' IN EACH OF THE PRECEDING MONTHS ACCORDING TO THE DURATION OF PREGNANCY.
(NOTE: THE NUMBER OF 'P's MUST BE ONE LESS THAN THE NUMBER OF MONTHS THAT THE PREGNANCY LASTED.) WRITE THE NAME OF THE CHILD TO THE LEFT OF THE 'B' CODE.

226. Are you pregnant now?

YES 1
NO 2 (GO TO 229)
UNSURE 8 (GO TO 229)

227. How many months pregnant are you?
RECORD NUMBER OF COMPLETED MONTHS.
ENTER 'P's IN THE CALENDAR, BEGINNING WITH THE MONTH OF INTERVIEW AND FOR THE TOTAL NUMBER OF COMPLETED MONTHS.

MONTHS ____

228. At the time you became pregnant 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?

THEN 1
LATER 2
NOT AT ALL 3

229. Have you ever had a pregnancy that miscarried, was aborted, or ended in a stillbirth?

YES 1
NO 2 (GO TO 236)

230. When did the last such pregnancy end?

MONTH ____
YEAR _____

231. CHECK 230:

LAST PREGNANCY ENDED IN JANUARY 1995 OR LATER (GO TO 232)
LAST PREGNANCY ENDED BEFORE JANUARY 1995 (GO TO 236)

232. How many months pregnant were you when the last such pregnancy ended?
RECORD NUMBER OF COMPLETED MONTHS.
ENTER 'T' IN THE CALENDAR IN THE MONTH THAT THE PREGNANCY TERMINATED AND 'P' FOR THE REMAINING NUMBER OF COMPLETED MONTHS.

MONTHS ___

233. Have you ever had any other pregnancies which did not result in a live birth?

YES 1
NO 2 (GO TO 236)

234. ASK THE DATE AND THE DURATION OF PREGNANCY FOR EACH EARLIER NON-LIVE BIRTH PREGNANCY BACK TO JANUARY 1995.
ENTER 'T' IN THE CALENDAR IN THE MONTH THAT EACH PREGNANCY TERMINATED AND 'P' FOR THE REMAINING NUMBER OF COMPLETED MONTHS.

234A. Did you have any pregnancies that terminated before 1995 which did not result in a live birth?

YES 1
NO 2 (GO TO 236)

235. FILL IN THE MONTH AND YEAR OF TERMINATION OF THE LAST NON-LIVE BIRTH PREGNANCY PRIOR TO JANUARY 1995.

MONTH ___
YEAR ___

236. When did your last menstrual period start?

DATE, IF GIVEN_______________
DAYS AGO 1 ___
WEEKS AGO 2 ___
MONTHS AGO 3 ___
YEARS AGO 4 ___
IN MENOPAUSE/HAS HAD HYSTERECTOMY 994
BEFORE 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 relations?

YES 1
NO 2 (GO TO 301)
DON'T KNOW 8 (GO TO 301)

238. Is this time just before her period begins, during her period, right after her period has ended, or halfway between two periods?

JUST BEFORE HER PERIOD BEGINS 1
DURING HER PERIOD 2
RIGHT AFTER HER PERIOD HAS ENDED 3
HALFWAY BETWEEN TWO PERIODS 4
OTHER (SPECIFY) ____ 6
DON'T KNOW 8

SECTION 3. CONTRACEPTION

Now I would like to talk about family planning - the various ways or methods that a couple can use to delay or avoid a pregnancy.
CIRCLE CODE 1 IN 301 FOR EACH METHOD MENTIONED SPONTANEOUSLY. THEN PROCEED DOWN COLUMN 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 EACH METHOD WITH CODE 1 CIRCLED IN 301, ASK 302.

301. Which ways or methods have you heard about?
FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK: Have you ever heard of (METHOD)?

01) FEMALE STERILIZATION: Women can have an operation to avoid having any more children.
YES 1
NO 2 (GO TO NEXT METHOD)
02) MALE STERILIZATION: Men can have an operation to avoid having any more children.
YES 1
NO 2 (GO TO NEXT METHOD)
03) PILL: Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2 (GO TO NEXT METHOD)
04) IUD: Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2 (GO TO NEXT METHOD)
05) INJECTIONS: Women can have an injection by a health provider which stops them from becoming pregnant for three months.
YES 1
NO 2 (GO TO NEXT METHOD)
06) IMPLANTS: Women can have several small rods placed in their upper arm by a doctor or nurse which can prevent pregnancy for one or more years.
YES 1
NO 2 (GO TO NEXT METHOD)
07) CONDOM: Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
08) FEMALE CONDOM: Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
09) DIAPHRAGM: Women can place a thin flexible disk in their vagina before intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
10) FOAM OR JELLY: Women can place a suppository, jelly, or cream in their vagina before intercourse.
YES 1
NO 2 (GO TO NEXT METHOD)
11) LACTATIONAL AMENORRHEA METHOD (LAM): Up to 6 months after childbirth, a woman can use a method that requires that she breastfeeds frequently, day and night, and that her menstrual period has not returned.
YES 1
NO 2 (GO TO NEXT METHOD)
12) RHYTHM, BILLINGS OR OTHER NATURAL METHODS: Every month that a woman is sexually active she can avoid pregnancy by not having sexual intercourse on the days of the month she is most likely to get pregnant.
YES 1
NO 2 (GO TO NEXT METHOD)
13) WITHDRAWAL: Men can be careful and pull out before climax.
YES 1
NO 2 (GO TO NEXT METHOD)
14) EMERGENCY CONTRACEPTION: Women can take pills up to three days after sexual intercourse to avoid becoming pregnant.
YES 1
NO 2 (GO TO NEXT METHOD)
15) Have you heard of any other ways or methods that women or men can use to avoid pregnancy? LIST UP TO TWO DIFFERENT METHODS.
SPECIFY____
YES 1
NO 2

302. Have you ever used (METHOD)?

01) FEMALE STERILIZATION: Women 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
02) MALE STERILIZATION: Men can have an operation to avoid having any more children: Have you ever had a partner who had 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) INJECTIONS: Women can have an injection by a health provider which stops them from becoming pregnant for three months.
YES 1
NO 2
06) IMPLANTS: Women can have several small rods placed in their upper arm by a doctor or nurse which can prevent pregnancy for one or more years.
YES 1
NO 2
07) CONDOM: Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
08) FEMALE CONDOM: Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
09) DIAPHRAGM: Women can place a thin flexible disk in their vagina before intercourse.
YES 1
NO 2
10) FOAM OR JELLY: Women can place a suppository, jelly, or cream in their vagina before intercourse.
YES 1
NO 2
11) LACTATIONAL AMENORRHEA METHOD (LAM): Up to 6 months after childbirth, a woman can use a method that requires that she breastfeeds frequently, day and night, and that her menstrual period has not returned.
YES 1
NO 2
12) RHYTHM, BILLINGS OR OTHER NATURAL METHODS: Every month that a woman is sexually active she can avoid pregnancy by not having sexual intercourse on the days of the month she is most likely to get pregnant.
YES 1
NO 2
13) WITHDRAWAL: Men can be careful and pull out before climax.
YES 1
NO 2
14) EMERGENCY CONTRACEPTION: Women can take pills up to three days after sexual intercourse to avoid becoming pregnant.
YES 1
NO 2
15) Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1
NO 2

303. CHECK 302:

NOT A SINGLE "YES" (NEVER USED) (GO TO 304)
AT LEAST ONE "YES" (EVER USED) (GO TO 307)

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

YES 1
NO 2 (GO TO 328)

306. What have you used or done?
CORRECT 302 AND 303 (AND 301 IF NECESSARY).

307. Now I would like to ask you about the first time that you did something or used a method to avoid getting pregnant.
How many living children did you have at that time, if any?
IF NONE, RECORD '00'.

NUMBER OF CHILDREN ___

308. CHECK 302 (01):

WOMAN NOT STERILIZED (GO TO 309)
WOMAN STERILIZED (GO TO 311A)

309. CHECK 226:

NOT PREGNANT OR UNSURE (GO TO 310)
PREGNANT (GO TO 320)

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

YES 1
NO 2 (GO TO 320)

311. Which method are you using?
311A. CIRCLE 'A' FOR FEMALE STERILIZATION.
IF MORE THAN ONE METHOD MENTIONED, FOLLOW SKIP INSTRUCTION FOR HIGHEST METHOD ON LIST.

FEMALE STERILIZATION A (GO TO 313)
MALE STERILIZATION B (GO TO 313)
PILL C (GO TO 319)
IUD D (GO TO 319)
INJECTIONS E (GO TO 319)
IMPLANTS F (GO TO 319)
CONDOM G (GO TO 319)
FEMALE CONDOM H (GO TO 319)
DIAPHRAGM I (GO TO 319)
FOAM/JELLY J (GO TO 319)
LACTATIONAL AMENORRHEA METHOD K (GO TO 319A)
PERIODIC ABSTINENCE L (GO TO 319B)
WITHDRAWAL M (GO TO 319B)
OTHER (SPECIFY) ____ X (GO TO 319B)

313. Where did the sterilization take place?

IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
IF BOTH CODE 'A' AND CODE 'B' ARE CIRCLED IN 311, ASK 313-317 ABOUT FEMALE STERILIZATION ONLY.

NAME OF PLACE_______
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
OTHER PUBLIC (SPECIFY) ____ 16
MISSION
HOSPITAL 21
HEALTH CENTER 22
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
PRIVATE DOCTOR'S OFFICE 32
OTHER PRIVATE MEDICAL (SPECIFY) _____ 36
BLM 41
OTHER (SPECIFY) _____ 96
DON'T KNOW 98

314. CHECK 311:

CODE 'A' CIRCLED: Before your sterilization operation, were you told that you would not be able to have any (more) children because of the operation?

CODE 'B' CIRCLED: Before the sterilization operation, was your husband/partner told that he would not be able to have any (more) children because of the operation?

YES 1
NO 2
DON'T KNOW 8

316. In what month and year was the sterilization performed?

MONTH ____
YEAR ____

317. CHECK 316:

STERILIZED BEFORE 1995 (GO TO 326)
STERILIZED IN 1995 OR LATER (GO TO 320)

319. Where did you obtain (CURRENT METHOD) when you started using it?
319A. Where did you learn to use the lactational amenorrhea method?

IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

NAME OF PLACE______
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14
CBDA/FIELD WORKER 15
OTHER PUBLIC (SPECIFY) ____ 16
MISSION
HOSPITAL 21
HEALTH CENTER 22
MOBILE CLINIC 23
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
PHARMACY 32
PRIVATE DOCTOR 33
MOBILE CLINIC 34
CBDA/FIELD WORKER 35
OTHER PRIVATE MEDICAL (SPECIFY) _____ 36
BLM 41
OTHER SOURCE
SHOP 51
CHURCH 52
FRIEND/RELATIVE 53
OTHER (SPECIFY) _____ 96

319B. For how many months have you been using (METHOD) continuously?
IF LESS THAN 1 MONTH RECORD '00'.

MONTHS ____
8 YEARS OR LONGER 96

320. CHECK 311/311A:
CIRCLE METHOD CODE:
IF MORE THAN ONE METHOD CODE CIRCLED IN 311/311A, CIRCLE CODE FOR HIGHEST METHOD IN LIST.

NO CODE CIRCLED 00 (GO TO 328)
FEMALE STERILIZATION 01
MALE STERILIZATION 02 (GO TO 330)
PILL 03
IUD 04
INJECTIONS 05
IMPLANTS 06
CONDOM 07 (GO TO 327)
FEMALE CONDOM 08 (GO TO 325)
DIAPHRAGM 09 (GO TO 325)
FOAM/JELLY 10 (GO TO 325)
LACTATIONAL AMENORRHEA METHOD 11 (GO TO 325)
PERIODIC ABSTINENCE 12 (GO TO 330)
WITHDRAWAL 13 (GO TO 330)
OTHER METHOD 96 (GO TO 330)

322. You obtained (CURRENT METHOD) from (SOURCE OF METHOD FROM 313 OR 319).
At that time, were you told about side effects or problems you might have with the method?

YES 1 (GO TO 323)
NO 2

322A. Were you ever told by a health or family planning worker about side effects or problems you might have with the method?

YES 1
NO 2 (GO TO 325)

323. Were you told what to do if you experienced side effects or problems?

YES 1
NO 2

325. CHECK 322:

CODE '1' CIRCLED: At that time, were you told about other methods of family planning which you could use?

CODE '1' NOT CIRCLED: When you obtained (CURRENT METHOD) from (SOURCE OF METHOD FROM 313 OR 319), were you told about other methods of family planning which you could use?

YES 1 (GO TO 326)
NO 2

325A. Were you ever told by a health or family planning worker about other methods of family planning which you could use?

YES 1
NO 2

326. CHECK 311/311A:
CIRCLE METHOD CODE:
IF MORE THAN ONE METHOD CODE CIRCLED IN 311/311A, CIRCLE CODE FOR HIGHEST METHOD IN LIST.

FEMALE STERILIZATION 01 (GO TO 330)
PILL 03
IUD 04 (GO TO 330)
INJECTIONS 05
IMPLANTS 06 (GO TO 330)
FEMALE CONDOM 08
DIAPHRAGM 09
FOAM/JELLY 10
LACTATIONAL AMENORRHEA METHOD 11 (GO TO 330)

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

IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

NAME OF PLACE______
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11 (GO TO 330)
GOVERNMENT HEALTH CENTER 12 (GO TO 330)
FAMILY PLANNING CLINIC 13 (GO TO 330)
MOBILE CLINIC 14 (GO TO 330)
CBDA/FIELD WORKER 15 (GO TO 330)
OTHER PUBLIC (SPECIFY) ____ 16 (GO TO 330)
MISSION
HOSPITAL 21 (GO TO 330)
HEALTH CENTER 22 (GO TO 330)
MOBILE CLINIC 23 (GO TO 330)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31 (GO TO 330)
PHARMACY 32 (GO TO 330)
PRIVATE DOCTOR 33 (GO TO 330)
MOBILE CLINIC 34 (GO TO 330)
CBDA/FIELD WORKER 35 (GO TO 330)
OTHER PRIVATE MEDICAL (SPECIFY) _____ 36 (GO TO 330)
BLM 41 (GO TO 330)
OTHER SOURCE
SHOP 51 (GO TO 330)
CHURCH 52 (GO TO 330)
FRIEND/RELATIVE 53 (GO TO 330)
OTHER (SPECIFY) _____ 96 (GO TO 330)

328. Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 330)

329. Where is that? Any other place?

IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
RECORD ALL MENTIONED.

NAME OF PLACE_______
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
CBDA/FIELD WORKER E
OTHER PUBLIC (SPECIFY) ____ F
MISSION
HOSPITAL G
HEALTH CENTER H
MOBILE CLINIC I
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC J
PHARMACY K
PRIVATE DOCTOR L
MOBILE CLINIC M
CBDA/FIELD WORKER N
OTHER PRIVATE MEDICAL (SPECIFY) _____ O
BLM P
OTHER SOURCE
SHOP Q
CHURCH R
FRIEND/RELATIVE S
OTHER (SPECIFY) _____ X

330. In the last 12 months, were you visited by a community-based distribution agent who talked to you about family planning?

YES 1
NO 2

331. In the last 12 months, have you visited a health facility for care for yourself (or your children)?

YES 1
NO 2 (GO TO 401)

332. Did any staff member at the health facility speak to you about family planning methods?

YES 1
NO 2

SECTION 4A. PREGNANCY, POSTNATAL CARE AND BREASTFEEDING

401. CHECK 224:

ONE OR MORE BIRTHS IN 1995 OR LATER (GO TO 402)
NO BIRTHS IN 1995 OR LATER (GO TO 486)

402. ENTER IN THE TABLE THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH IN 1995 OR LATER.
ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 2 BIRTHS, USE LAST COLUMN OF ADDITIONAL QUESTIONNAIRES).

Now I would like to ask you some questions about the health of all your children born in the last five years. (We will talk about each separately.)

403. LINE NUMBER FROM 212.

LINE NUMBER ____

404. FROM 212 AND 216.

NAME ____

ALIVE (GO TO 405)
DEAD (GO TO 405)

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?

THEN 1 (GO TO 407)
LATER 2
NOT AT ALL 3 (GO TO 407)

406. How much longer would you like to have waited?

MONTHS 1 ___
YEARS 2 ___
DON'T KNOW 998

407. Did you see anyone for antenatal care for this pregnancy?
IF YES: Whom did you see? Anyone else?
PROBE FOR THE TYPE OF PERSON AND RECORD ALL PERSONS SEEN.
[FOR LAST BIRTH ONLY]

HEALTH PROFESSIONAL
DOCTOR/CLINICAL OFFICER A
NURSE/MIDWIFE B
WARD ATTENDANT C
OTHER PERSON
TRADITIONAL BIRTH ATTENDANT D
OTHER (SPECIFY) _____ X
NO ONE Y (GO TO 415)

408. How many months pregnant were you when you first received antenatal care for this pregnancy?
[FOR LAST BIRTH ONLY]

MONTHS ___
DON'T KNOW 98

409. How many times did you receive antenatal care during this pregnancy?
[FOR LAST BIRTH ONLY]

NUMBER OF TIMES ____
DON'T KNOW 98

410. CHECK 409:
NUMBER OF TIMES RECEIVED ANTENATAL CARE
[FOR LAST BIRTH ONLY]

ONCE (GO TO 412)
MORE THAN ONCE OR DON'T KNOW (GO TO 411)

411. How many months pregnant were you the last time you received antenatal care?
[FOR LAST BIRTH ONLY]

MONTHS ___
DON'T KNOW 98

412. During this pregnancy, were any of the following done at least once?
[FOR LAST BIRTH ONLY]

Were you weighed?
YES 1
NO 2
Was your height measured?
YES 1
NO 2
Was your blood pressure measured?
YES 1
NO 2
Did you give a urine sample?
YES 1
NO 2
Did you give a blood sample?
YES 1
NO 2

413. Were you told about the signs of pregnancy complications?
[FOR LAST BIRTH ONLY]

YES 1
NO 2 (GO TO 415)
DON'T KNOW 8 (GO TO 415)

414. Were you told where to go if you had these complications?
[FOR LAST BIRTH ONLY]

YES 1
NO 2
DON'T KNOW 8

415. During this pregnancy, were you given an injection in the arm to prevent the baby from getting tetanus, that is, convulsions after birth?
[FOR LAST BIRTH ONLY]

YES 1
NO 2 (GO TO 416)
DON'T KNOW 8 (GO TO 416)

415A. During this pregnancy, how many times did you get this injection?
[FOR LAST BIRTH ONLY]

TIMES ____
DON'T KNOW 8

416. During this pregnancy, were you given or did you buy any iron tablets?
SHOW TABLET.
[FOR LAST BIRTH ONLY]

YES 1
NO 2 (GO TO 418)
DON'T KNOW 8 (GO TO 418)

417. During the whole pregnancy, for how many days did you take the tablets?
IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER OF DAYS.
[FOR LAST BIRTH ONLY]

NUMBER OF DAYS ____
DON'T KNOW 998

418. During this pregnancy, did you have difficulty with your vision during the daylight?
[FOR LAST BIRTH ONLY]

YES 1
NO 2
DON'T KNOW 8

419. During this pregnancy, did you have difficulty with your vision at night?
[FOR LAST BIRTH ONLY]

YES 1
NO 2
DON'T KNOW 8

420. During this pregnancy, did you take any drugs in order to prevent you from getting malaria? Not considered here are instances where you took the drug because you had malaria.
[FOR LAST BIRTH ONLY]

YES 1
NO 2 (GO TO 422)
DON'T KNOW 8 (GO TO 422)

421. Which medicines did you take to prevent malaria?
RECORD ALL MENTIONED.
IF TYPE OF DRUG IS NOT DETERMINED, SHOW TYPICAL ANTI-MALARIAL DRUGS TO RESPONDENT.
FOR EACH DRUG CIRCLED ASK: How many times did you take the malaria medicine(s) during the pregnancy?
[FOR LAST BIRTH ONLY]

SP (NOVIDAR, FANSIDAR) A
NUMBER OF TIMES____
QUININE B____
NUMBER OF TIMES____
CHLOROQUINE C____
NUMBER OF TIMES____
AMODIAQUINE D____
NUMBER OF TIMES____
HALAFAN E____
NUMBER OF TIMES____
OTHER (SPECIFY) ____ X
NUMBER OF TIMES____

422. When (NAME) was born, was he/she very large, larger than average, average, smaller than average, or very small?

VERY LARGE 1
LARGER THAN AVERAGE 2
AVERAGE 3
SMALLER THAN AVERAGE 4
VERY SMALL 5
DON'T KNOW 8

423. Was (NAME) weighed at birth?

YES 1
NO 2 (GO TO 425)
DON'T KNOW 8 (GO TO 425)

424. How much did (NAME) weigh?
RECORD WEIGHT FROM HEALTH CARD, IF AVAILABLE.

GRAMS FROM CARD 1 ____
GRAMS FROM RECALL 2 ____
DON'T KNOW 99998

425. Who assisted with the delivery of (NAME)? Anyone else?
PROBE FOR THE TYPE OF PERSON AND RECORD ALL PERSONS ASSISTING.

HEALTH PROFESSIONAL
DOCTOR/CLINICAL OFFICER A
NURSE/MIDWIFE B
WARD ATTENDANT C
OTHER PERSON
TRADITIONAL BIRTH ATTENDANT D
RELATIVE/FRIEND E
OTHER (SPECIFY) _____ X
NO ONE Y

426. Where did you give birth to (NAME)?

HOME
YOUR HOME 11 (GO TO 428)
OTHER HOME 12 (GO TO 428)
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER 22
GOVERNMENT HEALTH POST 23
OTHER PUBLIC (SPECIFY) _____ 26
MISSION
HOSPITAL 31
HEALTH CENTER 32
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 41
OTHER PRIVATE MEDICAL (SPECIFY) _____ 46
OTHER (SPECIFY) _____ 96 (GO TO 428)

427. Was (NAME) delivered by caesarian section?

YES 1 (GO TO 432)
NO 2 (GO TO 432)

428. After (NAME) was born, did a health professional or a traditional birth attendant check on your health?

YES 1
NO 2 (GO TO 432)

429. How many days or weeks after the delivery did the first check take place?
RECORD '00' DAYS IF SAME DAY.
[FOR LAST BIRTH ONLY]

DAYS AFTER DELIVERY 1 ___
WEEKS AFTER DELIVERY 2 ___
DON'T KNOW 998

430. Who checked on your health at that time?
PROBE FOR MOST QUALIFIED PERSON.
[FOR LAST BIRTH ONLY]

HEALTH PROFESSIONAL
DOCTOR/CLINICAL OFFICER 1
NURSE/MIDWIFE 2
WARD ATTENDANT 3
OTHER PERSON
TRADITIONAL BIRTH ATTENDANT 4
OTHER (SPECIFY) ____ 6

431. Where did this first check take place?
[FOR LAST BIRTH ONLY]

HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GOVERNMENT HOSPITAL 21
GOVERNMENT HEALTH CENTER 22
GOVERNMENT HEALTH POST 23
OTHER PUBLIC (SPECIFY) _____ 26
MISSION
HOSPITAL 31
HEALTH CENTER 32
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 41
OTHER PRIVATE MEDICAL (SPECIFY) ____ 46
OTHER (SPECIFY) ____ 96

431A. At that first check, did any health worker discuss use of family planning?
[FOR LAST BIRTH ONLY]

YES 1
NO 2

432. In the first two months after delivery, did you receive a vitamin A capsule like this?
SHOW CAPSULE.
[FOR LAST BIRTH ONLY]

YES 1
NO 2

433. Has your period returned since the birth of (NAME)?
[FOR LAST BIRTH ONLY]

YES 1 (GO TO 435)
NO 2 (GO TO 436)

434. Did your period return between the birth of (NAME) and your next pregnancy?
[REPEAT QUESTION FOR ALL BIRTHS SINCE 1995 EXCEPT THE LAST BIRTH]

YES 1
NO 2 (GO TO 438)

435. For how many months after the birth of (NAME) did you not have a period?

MONTHS ____
DON'T KNOW 98

436. CHECK 226:
RESPONDENT PREGNANT?
[FOR LAST BIRTH ONLY]

NOT PREGNANT (GO TO 437)
PREGNANT OR UNSURE (GO TO 438)

437. Have you resumed sexual relations since the birth of (NAME)?
[FOR LAST BIRTH ONLY]

YES 1
NO 2 (GO TO 439)

438. For how many months after the birth of (NAME) did you not have sexual relations?

MONTHS ___
DON'T KNOW 98

439. Did you ever breastfeed (NAME)?

YES 1
NO 2 (GO TO 444)

440. How long after birth did you first put (NAME) to the breast?
IF LESS THAN 1 HOUR, RECORD '00' HOURS.
IF LESS THAN 24 HOURS, RECORD HOURS.
OTHERWISE, RECORD DAYS.

IMMEDIATELY 000
HOURS 1 ___
DAYS 2 ___

440A. Within the first three days after delivery, before your milk began flowing regularly, was (NAME) given anything to drink other than breast milk?

YES 1
NO 2 (GO TO 441)

440B. What was (NAME) given to drink before your milk began flowing regularly? Anything else?
RECORD ALL MENTIONED.

MILK (OTHER THAN BREAST MILK) A
PLAIN WATER B
SUGAR OR GLUCOSE WATER C
PHALA D
GRIPE WATER E
SALT AND SUGAR SOLUTION F
FRUIT JUICE G
INFANT FORMULA (E.G. LACTOGEN) H
TEA/INFUSIONS I
HONEY J
OTHER (SPECIFY) _____ X

441. CHECK 404:
CHILD ALIVE?

ALIVE (GO TO 442)
DEAD (GO TO 443)

442. Are you still breastfeeding (NAME)?

YES 1 (GO TO 445)
NO 2

443. For how many months did you breastfeed (NAME)?

MONTHS ___
DON'T KNOW 98

444. CHECK 404:
CHILD ALIVE?

ALIVE (GO TO 447)
DEAD (GO BACK TO 405 IN NEXT COLUMN; OR, IF NO MORE BIRTHS, GO TO 451)

445. How many times did you breastfeed last night between sunset and sunrise?
IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER.

NUMBER OF NIGHTTIME FEEDINGS ____

446. How many times did you breastfeed yesterday during the daylight hours?
IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER.

NUMBER OF DAYLIGHT FEEDINGS ___

447. Did (NAME) drink anything from a bottle with a nipple yesterday or last night?

YES 1
NO 2
DON'T KNOW 8

447A. Was sugar added to any of the foods or liquids (NAME) ate yesterday?

YES 1
NO 2

448. How many times did (NAME) eat solid, semi-solid or soft foods other than liquids yesterday during the day or at night?
IF 7 OR MORE TIMES, RECORD '7'.

NUMBER OF TIMES ___
DON'T KNOW 8

450. GO BACK TO 405 IN NEXT COLUMN; OR, IF NO MORE BIRTHS, GO TO 451.

SECTION 4B. IMMUNIZATION, HEALTH, AND NUTRITION

451. ENTER IN THE TABLE THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH IN 1995 OR LATER.
(IF THERE ARE MORE THAN 2 BIRTHS, USE LAST COLUMN OF ADDITIONAL QUESTIONNAIRES).

452. LINE NUMBER FROM 212.

LINE NUMBER ____

453. FROM 212 AND 216.

NAME ____

ALIVE (GO TO 454)
DEAD (GO TO 453 IN NEXT COLUMN; OR, IF NO MORE BIRTHS, GO TO 481)

454. Did (NAME) receive a Vitamin A dose like this during the last 6 months?
SHOW CAPSULE.

YES 1
NO 2
DON'T KNOW 8

455. Do you have a card where (NAME'S) vaccinations are written down?
IF YES: May I see it please?

YES, SEEN 1 (GO TO 457)
YES, NOT SEEN 2 (GO TO 459)
NO CARD 3

456. Did you ever have a vaccination card for (NAME)?

YES 1 (GO TO 459)
NO 2 (GO TO 459)

457. (1) COPY VACCINATION DATE FOR EACH VACCINE FROM THE CARD.
(2) WRITE '44' IN 'DAY' COLUMN IF CARD SHOWS THAT A VACCINATION WAS GIVEN, BUT NO DATE IS RECORDED.

BCG
DAY___
MONTH ___
YEAR ___
POLIO 0 (POLIO GIVEN AT BIRTH)
DAY___
MONTH ___
YEAR ___
POLIO 1
DAY___
MONTH ___
YEAR ___
POLIO 2
DAY___
MONTH ___
YEAR ___
POLIO 3
DAY___
MONTH ___
YEAR ___
DPT 1
DAY___
MONTH ___
YEAR ___
DPT 2
DAY___
MONTH ___
YEAR ___
DPT 3
DAY___
MONTH ___
YEAR ___
MEASLES
DAY___
MONTH ___
YEAR ___
VITAMIN A (MOST RECENT)
DAY___
MONTH ___
YEAR ___

458. Has (NAME) received any vaccinations that are 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, AND/OR MEASLES VACCINE(S).

YES 1 (PROBE FOR VACCINATIONS AND WRITE '66' IN THE CORRESPONDING DAY COLUMN IN 457) (GO TO 461)
NO 2 (GO TO 461)
DON'T KNOW 8 (GO TO 461)

459. Did (NAME) ever receive any vaccinations to prevent him/her from getting diseases, including vaccinations received in a national immunization day campaign?

YES 1
NO 2 (GO TO 463)
DON'T KNOW 8 (GO TO 463)

460. Please tell me if (NAME) received any of the following vaccinations:

460A. A BCG vaccination against tuberculosis, that is, an injection in the arm or shoulder that usually causes a scar?

YES 1
NO 2
DON'T KNOW 8

460B. Polio vaccine, that is, drops in the mouth?

YES 1
NO 2 (GO TO 460E)
DON'T KNOW 8 (GO TO 460E)

460C. When was the first polio vaccine received, just after birth or later?

JUST AFTER BIRTH 1
LATER 2

460D. How many times was the polio vaccine received?

NUMBER OF TIMES ___

460E. DPT vaccination, that is, an injection given in the thigh or buttocks, sometimes at the same time as polio drops?

YES 1
NO 2 (GO TO 460G)
DON'T KNOW 8 (GO TO 460G)

460F. How many times?

NUMBER OF TIMES ___

460G. An injection to prevent measles?

YES 1
NO 2
DON'T KNOW 8

461. Were any of the vaccinations (NAME) received during the last two years given as a part of a national immunization day campaign?

YES 1
NO 2 (GO TO 463)
NO VACCINATION IN THE LAST 2 YEARS 3 (GO TO 463)
DON'T KNOW 8 (GO TO 463)

462. At which national immunization day campaigns did (NAME) receive vaccinations?
RECORD ALL MENTIONED.

MEASLES 1998 A
MEASLES 1999 B
MEASLES 2000 C
POLIO 1999 D
POLIO 2000 F

463. Has (NAME) been ill with a fever at any time in the last 2 weeks?

YES 1
NO 2 (GO TO 464)
DON'T KNOW 8 (GO TO 464)

463A. Does (NAME) have a fever now?

YES 1
NO 2
DON'T KNOW 8

463B. I would like to know what things were done in response to (NAME'S) fever.
What was done first? What was done after that?
NOTE: CIRCLE ONE CODE IN EACH COLUMN FOR FIRST FOUR ACTIONS. EACH COLUMN SHOULD HAVE ONLY ONE CODE CIRCLED.
ALL COLUMNS SHOULD CONTAIN AN ACTION.

FIRST ACTION DONE
GAVE MEDICINE FROM HOME 01
GAVE MEDICINE FROM A PHARMACIST/SHOPKEEPER (WITHOUT A PRESCRIPTION) 02
TAKEN TO A GOVERNMENT RUN HEALTH CENTER 03
TAKEN TO A MISSION HEALTH CENTER 04
TAKEN TO A PRIVATE HEALTH CENTER 05
CONSULTED TRADITIONAL HEALER 06
CONSULTED A CHW 07
GAVE TEPID SPONGING 08
GAVE HERBS AT HOME 09
OTHER 96
DID NOTHING (ELSE) 10
DON'T KNOW 98
SECOND ACTION DONE
GAVE MEDICINE FROM HOME 01
GAVE MEDICINE FROM A PHARMACIST/SHOPKEEPER (WITHOUT A PRESCRIPTION) 02
TAKEN TO A GOVERNMENT RUN HEALTH CENTER 03
TAKEN TO A MISSION HEALTH CENTER 04
TAKEN TO A PRIVATE HEALTH CENTER 05
CONSULTED TRADITIONAL HEALER 06
CONSULTED A CHW 07
GAVE TEPID SPONGING 08
GAVE HERBS AT HOME 09
OTHER 96
DID NOTHING (ELSE) 10
DON'T KNOW 98
THIRD ACTION DONE
GAVE MEDICINE FROM HOME 01
GAVE MEDICINE FROM A PHARMACIST/SHOPKEEPER (WITHOUT A PRESCRIPTION) 02
TAKEN TO A GOVERNMENT RUN HEALTH CENTER 03
TAKEN TO A MISSION HEALTH CENTER 04
TAKEN TO A PRIVATE HEALTH CENTER 05
CONSULTED TRADITIONAL HEALER 06
CONSULTED A CHW 07
GAVE TEPID SPONGING 08
GAVE HERBS AT HOME 09
OTHER 96
DID NOTHING (ELSE) 10
DON'T KNOW 98
FOURTH ACTION DONE
GAVE MEDICINE FROM HOME 01
GAVE MEDICINE FROM A PHARMACIST/SHOPKEEPER (WITHOUT A PRESCRIPTION) 02
TAKEN TO A GOVERNMENT RUN HEALTH CENTER 03
TAKEN TO A MISSION HEALTH CENTER 04
TAKEN TO A PRIVATE HEALTH CENTER 05
CONSULTED TRADITIONAL HEALER 06
CONSULTED A CHW 07
GAVE TEPID SPONGING 08
GAVE HERBS AT HOME 09
OTHER 96
DID NOTHING (ELSE) 10
DON'T KNOW 98

463C. CHECK 463B:

CODE "01" OR "02" CIRCLED IN ANY COLUMN (GO TO 463D)
CHECK "01" OR "02" NOT CIRCLED (GO TO 463E)

463D. Which medicines were given to (NAME)?
ASK TO SEE MEDICINE(S). IF NOT SEEN, SHOW MEDICINE(S) TO RESPONDENT.
FOR EACH ANTI-MALARIAL MEDICINE: How long after the fever started did (NAME) start taking the medicine?
RECORD ALL MENTIONED.

TYPE OF DRUG:

ANTI-MALARIAL
SP (FANSIDAR, NOVIDAR) A
QUININE B
CHLOROQUINE C
AMODIAQUINE D
HALAFAN E
OTHER DRUGS
ASPIRIN F
PANADOL G
OTHER (SPECIFY) _____ X
UNKNOWN Z

WHEN ANTI-MALARIAL WAS GIVEN:

SP (NOVIDAR, FANSIDAR)
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3
QUININE
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3
CHLOROQUINE
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3
AMODIAQUINE
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3
HALAFAN
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3

463E. CHECK 463B:

CODE "03" CIRCLED IN ANY COLUMN (GO TO 463F)
CODE "03" NOT CIRCLED (GO TO 463J)

463F. How long after you noticed the fever was (NAME) taken to a government-run health center?

SAME DAY 0
NEXT DAY 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3

463G. Were any drugs or prescriptions for drugs given at the government-run health center for (NAME)?

YES 1
NO 2 (GO TO 463I)
DON'T KNOW 8 (GO TO 463I)

463H. Which medicines were given to (NAME)?
ASK TO SEE MEDICINE(S). IF NOT SEEN, SHOW MEDICINE(S) TO RESPONDENT.
FOR EACH ANTI-MALARIAL MEDICINE: How long after the fever started did (NAME) start taking the medicine?
RECORD ALL MENTIONED.

TYPE OF DRUG:

ANTI-MALARIAL
SP (FANSIDAR, NOVIDAR) A
QUININE B
CHLOROQUINE C
AMODIAQUINE D
HALAFAN E
OTHER DRUGS
ASPIRIN F
PANADOL G
OTHER (SPECIFY) _____ X
UNKNOWN Z

WHEN ANTI-MALARIAL WAS GIVEN:

SP (NOVIDAR, FANSIDAR)
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3
QUININE
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3
CHLOROQUINE
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3
AMODIAQUINE
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3
HALAFAN
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3

463I. Did (NAME) receive any injection at the government-run health center?

YES 1
NO 2
DON'T KNOW 8

463J. CHECK 463B:

CODE "04" CIRCLED IN ANY COLUMN (GO TO 463K)
CODE "04" NOT CIRCLED (GO TO 463O)

.

463K. How long after you noticed the fever was (NAME) taken to a mission health center?

SAME DAY 0
NEXT DAY 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3

463L. Were any drugs or prescriptions for drugs given at the mission health center for (NAME)?

YES 1
NO 2 (GO TO 463N)
DON'T KNOW 8 (GO TO 463N)

463M. Which medicines were given to (NAME)?
ASK TO SEE MEDICINE(S). IF NOT SEEN, SHOW MEDICINE(S) TO RESPONDENT.
FOR EACH ANTI-MALARIAL MEDICINE: How long after the fever started did (NAME) start taking the medicine?
RECORD ALL MENTIONED.

TYPE OF DRUG:

ANTI-MALARIAL
SP (FANSIDAR, NOVIDAR) A
QUININE B
CHLOROQUINE C
AMODIAQUINE D
HALAFAN E
OTHER DRUGS
ASPIRIN F
PANADOL G
OTHER (SPECIFY) _____ X
UNKNOWN Z

WHEN ANTI-MALARIAL WAS GIVEN:

SP (NOVIDAR, FANSIDAR)
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3
QUININE
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3
CHLOROQUINE
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3
AMODIAQUINE
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3
HALAFAN
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3

463N. Did (NAME) receive any injection at the mission health center?

YES 1
NO 2
DON'T KNOW 8

463O. CHECK 463B:

CODE "05" CIRCLED IN ANY COLUMN (GO TO 463P)
CODE "05" NOT CIRCLED (GO TO 463T)

463P. How long after you noticed the fever was (NAME) taken to a private health center?

SAME DAY 0
NEXT DAY 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3

463Q Were any medicines or prescriptions for medicines given at the private health center for (NAME)?

YES 1
NO 2 (GO TO 463S)
DON'T KNOW 8 (GO TO 463S)

463R. Which medicines were given to (NAME)?
ASK TO SEE MEDICINE(S). IF NOT SEEN, SHOW MEDICINE(S) TO RESPONDENT.
FOR EACH ANTI-MALARIAL MEDICINE: How long after the fever started did (NAME) start taking the medicine?
RECORD ALL MENTIONED.

TYPE OF DRUG:

ANTI-MALARIAL
SP (FANSIDAR, NOVIDAR) A
QUININE B
CHLOROQUINE C
AMODIAQUINE D
HALAFAN E
OTHER DRUGS
ASPIRIN F
PANADOL G
OTHER (SPECIFY) _____ X
UNKNOWN Z

WHEN ANTI-MALARIAL WAS GIVEN:

SP (NOVIDAR, FANSIDAR)
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3
QUININE
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3
CHLOROQUINE
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3
AMODIAQUINE
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3
HALAFAN
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3

463S. Did (NAME) receive any injection during the visit to the private health center?

YES 1
NO 2
DON'T KNOW 8

463T. CHECK 463B:

CODE "07" CIRCLED IN ANY COLUMN (GO TO 463U)
CODE "07" NOT CIRCLED (GO TO 464)

463U. How long after you noticed the fever did (NAME) see the community health worker?

SAME DAY 0
NEXT DAY 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3

463V. What did the community health worker do?
RECORD ALL MENTIONED.

GAVE MEDICINE A
RECOMMENDED PURCHASE OF MEDICINE B
REFERRED TO HEALTH CENTER/DOCTOR C
OTHER (SPECIFY) _____ X

463W. CHECK 463V:

CODE "A" AND/OR CODE "B" CIRCLED (GO TO 463X)
NEITHER CODE "A" NOR CODE "B" CIRCLED (GO TO 464)

463X. Which medicines were given to (NAME) by the community health worker?
ASK TO SEE MEDICINE(S). IF NOT SEEN, SHOW MEDICINE(S) TO RESPONDENT.
FOR EACH ANTI-MALARIAL MEDICINE:
How long after the fever started did (NAME) start taking the medicine?
RECORD ALL MENTIONED.

TYPE OF DRUG:

ANTI-MALARIAL
SP (FANSIDAR, NOVIDAR) A
QUININE B
CHLOROQUINE C
AMODIAQUINE D
HALAFAN E
OTHER DRUGS
ASPIRIN F
PANADOL G
OTHER (SPECIFY) _____ X
UNKNOWN Z

WHEN ANTI-MALARIAL WAS GIVEN:

SP (NOVIDAR, FANSIDAR)
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3
QUININE
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3
CHLOROQUINE
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3
AMODIAQUINE
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3
HALAFAN
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3

464. Has (NAME) had an illness with a cough at any time in the last 2 weeks?

YES 1
NO 2 (GO TO 472)
DON'T KNOW 8 (GO TO 472)

465. When (NAME) had an illness with a cough, did he/she breathe faster than usual with short, fast breaths?

YES 1
NO 2
DON'T KNOW 8

467. Did you seek advice or treatment for the cough?

YES 1
NO 2 (GO TO 472)

468. Where did you seek advice or treatment? Anywhere else?
RECORD ALL MENTIONED.

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
GOVERNMENT HEALTH POST C
MOBILE CLINIC D
FIELD WORKER E
OTHER PUBLIC (SPECIFY) _____ F
MISSION
HOSPITAL G
HEALTH CENTER H
MOBILE CLINIC I
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC J
PHARMACY K
PRIVATE DOCTOR L
MOBILE CLINIC M
FIELD WORKER N
OTHER PRIVATE MEDICAL (SPECIFY) ____ O
OTHER SOURCE
SHOP P
TRADITIONAL PRACTITIONER Q
OTHER (SPECIFY) _____ X

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

YES 1
NO 2 (GO TO 480)
DON'T KNOW 8 (GO TO 480)

472A. Did (NAME)'s stool contain blood?

YES 1
NO 2

473. Now I would like to know how much (NAME) was offered to drink during the diarrhea. Was he/she offered less than usual to drink, about the same amount, or more than usual to drink?
IF LESS, PROBE: Was he/she offered much less than usual to drink or somewhat less?

MUCH LESS 1
SOMEWHAT LESS 2
ABOUT THE SAME 3
MORE 4
NOTHING TO DRINK 5
DON'T KNOW 8

474. When (NAME) had diarrhea, was he/she offered less than usual to eat, about the same amount, more than usual, or nothing to eat?
IF LESS, PROBE: Was he/she offered much less than usual to eat or somewhat less?

MUCH LESS 1
SOMEWHAT LESS 2
ABOUT THE SAME 3
MORE 4
STOPPED FOOD 5
NEVER GAVE FOOD 6
DON'T KNOW 8

475. Was he/she given a drink made from a special packet called ORS?

YES 1
NO 2
DON'T KNOW 8

476. Was anything (else) given to treat the diarrhea?

YES 1
NO 2 (GO TO 478)
DON'T KNOW 8 (GO TO 478)

477. What was given to treat the diarrhea? Anything else?
RECORD ALL MENTIONED.

PILL OR SYRUP A
INJECTION B
(I.V.) INTRAVENOUS C
HOME REMEDIES/HERBAL MEDICINES D
OTHER (SPECIFY) ____ X

478. Did you seek advice or treatment for the diarrhea?

YES 1
NO 2 (GO TO 480)

479. Where did you seek advice or treatment? Anywhere else?
RECORD ALL MENTIONED.

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
GOVERNMENT HEALTH POST C
MOBILE CLINIC D
FIELD WORKER E
OTHER PUBLIC (SPECIFY) _____ F
MISSION
HOSPITAL G
HEALTH CENTER H
MOBILE CLINIC I
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC J
PHARMACY K
PRIVATE DOCTOR L
MOBILE CLINIC M
FIELD WORKER N
OTHER PRIVATE MEDICAL (SPECIFY) ____ O
OTHER SOURCE
SHOP P
TRADITIONAL PRACTITIONER Q
OTHER (SPECIFY) _____ X

480. Do you have any mosquito nets in your house?

YES 1
NO 2 (GO TO 480G)

480A. Does (NAME) usually sleep under a mosquito net?

YES 1
NO 2

480B. Did (NAME) sleep under a mosquito net last night?

YES 1
NO 2 (GO TO 480G)
DON'T KNOW 8 (GO TO 480G)

480C. Where was the mosquito net (NAME) slept under bought or obtained?

SHOP 1
VENDOR 2
NGO OR OTHER ORGANIZATION 3
OTHER (SPECIFY) ____ 6
DON'T KNOW 8

480D. How long ago was the mosquito net bought or obtained?
WRITE THE ANSWER IN MONTHS (LESS THAN 1 MONTH = 00)
IF MORE THAN 7 YEARS, RECORD '95'.

MONTHS ___
DON'T KNOW 98

480E. Since you got the mosquito net was it ever soaked or dipped in an insecticide to repel mosquitoes or bugs?

YES 1
NO 2 (GO TO 480G)
DON'T KNOW 8 (GO TO 480G)

480F. How long ago was the mosquito net last soaked or dipped?
WRITE THE ANSWER IN MONTHS (LESS THAN 1 MONTH = 00)

MONTHS ___
DON'T KNOW 98

480G. GO BACK TO 451 IN NEXT COLUMN, OR, IF NO MORE CHILDREN, GO TO 481.

481. CHECK 453, ALL COLUMNS:
NUMBER OF LIVING CHILDREN BORN IN 1995 OR LATER

ONE OR MORE (GO TO 482)
NONE (GO TO 486)

482. The last time you fed your child(ren), did you wash your hands immediately before feeding (him/her/them)?

YES 1
NO 2
NEVER FED CHILD(REN) 3

483. The last time you had to clean (your child/one of your children) after he/she defecated, did you wash your hands immediately afterwards?

YES 1
NO 2
NEVER CLEANED CHILD(REN) 3

484. What is usually done to dispose of your (youngest) child's stools when he/she does not use any toilet facility?

ALWAYS USE TOILET/LATRINE 01
THROW IN THE TOILET/LATRINE 02
THROW OUTSIDE THE DWELLING 03
THROW OUTSIDE THE YARD 04
BURY IN THE YARD 05
RINSE AWAY 06
NOT DISPOSED OF 07
OTHER (SPECIFY) _____ 96

485. CHECK 475, ALL COLUMNS:

NO CHILD RECEIVED FLUID FROM ORS PACKET (GO TO 486)
ANY CHILD RECEIVED FLUID FROM ORS PACKET (GO TO 487)

486. Have you ever heard of a special product called ORS you can get for the treatment of diarrhea?

YES 1
NO 2

487. CHECK 218:

HAS ONE OR MORE CHILDREN LIVING WITH HER (GO TO 488)
HAS NO CHILDREN LIVING WITH HER (GO TO 489)

488. When (your child/one of your children) is seriously ill, can you decide by yourself whether or not the child should be taken for medical treatment?
IF SAYS NO CHILD EVER SERIOUSLY ILL, ASK:
If (your child/one of your children) became seriously ill, could you decide by yourself whether the child should be taken for medical treatment?

YES 1
NO 2
DEPENDS 3

489. Now I would like to ask you some questions about medical care for you yourself.
Many different factors can prevent women from getting medical advice or treatment for themselves. When you are sick and want to get medical advice or treatment, is each of the following a big problem or not?

Knowing where to go.
BIG PROBLEM 1
NOT A BIG PROBLEM 2
Getting permission to go.
BIG PROBLEM 1
NOT A BIG PROBLEM 2
Getting money needed for treatment.
BIG PROBLEM 1
NOT A BIG PROBLEM 2
The time required to cover distance to facility.
BIG PROBLEM 1
NOT A BIG PROBLEM 2
The availability of means of transport.
BIG PROBLEM 1
NOT A BIG PROBLEM 2
The cost of transport.
BIG PROBLEM 1
NOT A BIG PROBLEM 2
Not wanting to go alone.
BIG PROBLEM 1
NOT A BIG PROBLEM 2
Concern that there may not be a female health provider.
BIG PROBLEM 1
NOT A BIG PROBLEM 2

489A. CHECK 215 AND 218:

HAS AT LEAST ONE CHILD BORN IN 1997 OR LATER AND LIVING WITH HER (RECORD NAME OF YOUNGEST CHILD LIVING WITH HER (AND CONTINUE TO 489B)

NAME_______


DOES NOT HAVE ANY CHILDREN BORN IN 1997 OR LATER AND LIVING WITH HER (GO TO 491)

489B. Now I would like to ask you about liquids (NAME FROM Q. 489A) drank over the last seven days, including yesterday.
How many days during the last seven days did (NAME FROM Q. 489A) drink each of the following?
FOR EACH ITEM GIVEN AT LEAST ONCE IN LAST SEVEN DAYS, BEFORE PROCEEDING TO THE NEXT ITEM, ASK:
In total, how many times yesterday during the day or at night did (NAME FROM Q. 489A) drink (ITEM)?
IF 7 OR MORE TIMES, RECORD '7'.
IF DON'T KNOW, RECORD '8'.

a. Plain water?
(LAST 7 DAYS) NUMBER OF DAYS _____
(YESTERDAY/LAST NIGHT) NUMBER OF TIMES _____
b. Commercially produced infant formula? (e.g. Lactogen)
(LAST 7 DAYS) NUMBER OF DAYS _____
(YESTERDAY/LAST NIGHT) NUMBER OF TIMES _____
c. Any other milk such as tinned, powdered, or fresh animal milk?
(LAST 7 DAYS) NUMBER OF DAYS _____
(YESTERDAY/LAST NIGHT) NUMBER OF TIMES _____
d. Fruit juice?
(LAST 7 DAYS) NUMBER OF DAYS _____
(YESTERDAY/LAST NIGHT) NUMBER OF TIMES _____
e. Thobwa?
(LAST 7 DAYS) NUMBER OF DAYS _____
(YESTERDAY/LAST NIGHT) NUMBER OF TIMES _____
Any other liquids such as tea, coffee, carbonated drinks, "freezes," or soup broth?
(LAST 7 DAYS) NUMBER OF DAYS _____
(YESTERDAY/LAST NIGHT) NUMBER OF TIMES _____

Now I would like to ask you about the types of foods (NAME FROM Q. 489A) ate over the last seven days, including yesterday.
How many days during the last seven days did (NAME FROM Q. 489A) eat each of the following foods either separately or combined with other food?
FOR EACH ITEM GIVEN AT LEAST ONCE IN LAST SEVEN DAYS, BEFORE PROCEEDING TO THE NEXT ITEM, ASK:
In total, how many times yesterday during the day or at night did (NAME FROM Q. 489A) eat (ITEM)?
IF 7 OR MORE TIMES, RECORD '7'.
IF DON'T KNOW, RECORD '8'.

g. Any food, such as bread or nsima, made from grains [e.g., millet, sorghum, maize, rice, wheat, or other local grains]?
(LAST 7 DAYS) NUMBER OF DAYS _____
(YESTERDAY/LAST NIGHT) NUMBER OF TIMES _____
h. Plain porridge?
(LAST 7 DAYS) NUMBER OF DAYS _____
(YESTERDAY/LAST NIGHT) NUMBER OF TIMES _____
i. Porridge enriched with foods such as legumes, vegetables, fruits, ground nut flour, fish, or meat?
(LAST 7 DAYS) NUMBER OF DAYS _____
(YESTERDAY/LAST NIGHT) NUMBER OF TIMES _____
j. Pumpkin, yellow squash, carrots, or yellow sweet potatoes?
(LAST 7 DAYS) NUMBER OF DAYS _____
(YESTERDAY/LAST NIGHT) NUMBER OF TIMES _____
k. Any other food made from roots or tubers [e.g., white potatoes, cassava, or other local roots/tubers]?
(LAST 7 DAYS) NUMBER OF DAYS _____
(YESTERDAY/LAST NIGHT) NUMBER OF TIMES _____
l. Any green leafy vegetables?
(LAST 7 DAYS) NUMBER OF DAYS _____
(YESTERDAY/LAST NIGHT) NUMBER OF TIMES _____
m. Mango or papaya?
(LAST 7 DAYS) NUMBER OF DAYS _____
(YESTERDAY/LAST NIGHT) NUMBER OF TIMES _____
n. Any other fruits and vegetables [e.g., oranges, bananas, guava, green beans, avocados, tomatoes]?
(LAST 7 DAYS) NUMBER OF DAYS _____
(YESTERDAY/LAST NIGHT) NUMBER OF TIMES _____
o. Meat, poultry, fish, termites, or eggs?
(LAST 7 DAYS) NUMBER OF DAYS _____
(YESTERDAY/LAST NIGHT) NUMBER OF TIMES _____
p. Any food made from legumes [e.g., peas, beans, cowpeas, pulses, or groundnuts]?
(LAST 7 DAYS) NUMBER OF DAYS _____
(YESTERDAY/LAST NIGHT) NUMBER OF TIMES _____
q. Cheese or yoghurt?
(LAST 7 DAYS) NUMBER OF DAYS _____
(YESTERDAY/LAST NIGHT) NUMBER OF TIMES _____
r. Any food made with oil, fat, margarine, or butter?
(LAST 7 DAYS) NUMBER OF DAYS _____
(YESTERDAY/LAST NIGHT) NUMBER OF TIMES _____

491. The last time you prepared a meal for your family, before starting did you wash your hands?

YES 1
NO 2
NEVER PREPARED MEAL 3

492. Do you currently smoke cigarettes or tobacco?
IF YES: What type of tobacco do you smoke?
RECORD ALL MENTIONED.

YES, CIGARETTES A
YES, PIPE B
YES, OTHER TOBACCO C
NO Y

492A. CHECK 492:

CODE 'A' CIRCLED (GO TO 493)
CODE 'A' NOT CIRCLED (GO TO 493A)

493. In the last 24 hours, how many cigarettes did you smoke?

CIGARETTES ___

493A. Have you ever drank an alcohol-containing beverage?

YES 1
NO 2 (GO TO 493F)

493B. Have you ever gotten "drunk" from drinking an alcohol-containing beverage?

YES 1
NO 2

493C. In the last 3 months, on how many days did you drink an alcohol-containing beverage?

NUMBER OF DAYS ___
NONE/NEVER 97 (GO TO 493F)

493D. CHECK 493B:

YES (GO TO 493E)
NO (GO TO 493F)

493E. In the last 3 months, on how many occasions did you get "drunk"?

NUMBER OF TIMES ____
NONE/NEVER 97

493F. Have you had any kind of injection in the last 3 months?

YES 1
NO 2 (GO TO 494F)

493G. How many times did you have an injection in the last 3 months?

NUMBER OF INJECTIONS ____
EVERY DAY 96

493H. The last time you had an injection, who was the person who gave you the injection?

HEALTH PROFESSIONAL 1
PHARMACIST 2
TRADITIONAL HEALER 3
FRIEND/RELATIVE 4
SELF 5
OTHER (SPECIFY) _____ 6

494F. CHECK 226:

CURRENTLY PREGNANT (GO TO 494G)
NOT PREGNANT OR UNSURE (GO TO 494K)

494G. Did you have a fever at any time in the last two weeks?

YES 1
NO 2 (GO TO 494K)

494H. Did you take any medicine for the fever?

YES 1
NO 2 (GO TO 494K)

494I. Which medicines did you take?
ASK TO SEE MEDICINE(S). IF NOT SEEN, SHOW MEDICINE(S) TO RESPONDENT.
FOR EACH ANTI-MALARIAL MEDICINE:
How long after the fever started did you start taking the medicine?
RECORD ALL MENTIONED.

ANTI-MALARIAL
SP (FANSIDAR, NOVIDAR) A
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE DAYS OR MORE AFTER THE FEVER 3
QUININE B
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE DAYS OR MORE AFTER THE FEVER 3
CHLOROQUINE C
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE DAYS OR MORE AFTER THE FEVER 3
AMODIAQUINE D
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE DAYS OR MORE AFTER THE FEVER 3
HALAFAN E
SAME DAY 0
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE DAYS OR MORE AFTER THE FEVER 3
OTHER DRUGS
ASPIRIN F
PANADOL G
OTHER (SPECIFY) _____ X
UNKNOWN Z

494J. How many times did you take this medicine(s)?

NUMBER OF TIMES ___

494K. Did you sleep under a mosquito net last night?

YES 1
NO 2 (GO TO 501)

494L. Where was the mosquito net you slept under bought or obtained?

SHOP 1
NGO OR OTHER ORGANIZATION 2
OTHER (SPECIFY) _____ 6
DON'T KNOW 8

494M. How long ago was the mosquito net bought or obtained?
WRITE THE ANSWER IN MONTHS (LESS THAN 1 MONTH = 00)
IF MORE THAN 84 MONTHS, WRITE 95.

NUMBER OF MONTHS ____
DON'T KNOW 8

494N. Since you got the mosquito net, was it ever soaked or dipped in an insecticide to repel mosquitoes or bugs?

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

494O. How long ago was the mosquito net last soaked or dipped?
WRITE THE ANSWER IN MONTHS (LESS THAN 1 MONTH = 00)
IF MORE THAN 84 MONTHS, WRITE 95.

MONTHS ____
DON'T KNOW 98

SECTION 5. MARRIAGE AND SEXUAL ACTIVITY

501. Are you currently married or living with a man?

YES, CURRENTLY MARRIED 1 (GO TO 505)
YES, LIVING WITH A MAN 2 (GO TO 505)
NO, NOT IN UNION 3

502. Have you ever been married or lived with a man?

YES, FORMERLY MARRIED 1
YES, LIVED WITH A MAN 2 (GO TO 510)
NO 3 (GO TO 514)

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

WIDOWED 1 (GO TO 510)
DIVORCED 2 (GO TO 510)
SEPARATED 3 (GO TO 510)

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

LIVING WITH HER 1
STAYING ELSEWHERE 2

506. RECORD THE HUSBAND'S/PARTNER'S NAME AND LINE NUMBER FROM THE HOUSEHOLD QUESTIONNAIRE. IF HE IS NOT LISTED IN THE HOUSEHOLD, RECORD '00'.

NAME ____
LINE NUMBER ___

507. Does your husband/partner have any other wives besides yourself?

YES 1
NO 2 (GO TO 510)

508. How many other wives does he have?

NUMBER ___
DON'T KNOW 98

510. Have you been married or lived with a man only once, or more than once?

ONCE 1
MORE THAN ONCE 2

511. CHECK 510:

MARRIED/LIVED WITH A MAN ONLY ONCE: In what month and year did you start living with your husband/partner?

MARRIED/LIVED WITH A MAN MORE THAN ONCE: Now we will talk about your first husband/partner. In what month and year did you start living with him?

MONTH ___
DON'T KNOW MONTH 98
YEAR ___ (GO TO 514)
DON'T KNOW YEAR 9998

512. How old were you when you started living with him?

AGE ___

514. Now I need to ask you some questions about sexual activity in order to gain a better understanding of some family life issues.
How old were you when you first had sexual intercourse (if ever)?

NEVER 00 (GO TO 524)
AGE IN YEARS ___
FIRST TIME WHEN STARTED LIVING WITH (FIRST) HUSBAND/PARTNER 96

515. When was the last time you had sexual intercourse?
RECORD 'YEARS AGO' ONLY IF LAST INTERCOURSE WAS ONE OR MORE YEARS AGO

DAYS AGO 1 ___
WEEKS AGO 2 ___
MONTHS AGO 3 ___
YEARS AGO 4 ___ (GO TO 524)

516. The last time you had sexual intercourse, was a condom used?

YES 1
NO 2 (GO TO 517)

516A. What was the main reason you used a condom on that occasion?

OWN CONCERN TO PREVENT STD/HIV 1
OWN CONCERN TO PREVENT PREGNANCY 2
OWN CONCERN TO PREVENT BOTH STD/HIV AND PREGNANCY 3
DID NOT TRUST PARTNER/FEELS PARTNER HAS OTHER PARTNERS 4
PARTNER INSISTED 5
DON'T KNOW 6
OTHER (SPECIFY) ____ 7

517. What is your relationship to the man with whom you last had sex?
IF "BOYFRIEND" OR "FIANCE", ASK: Was your boyfriend/fianc? living with you when you last had sex?
IF 'YES' RECORD '1'
IF 'NO' RECORD '2'

HUSBAND/COHABITING PARTNER 01 (GO TO 519)
BOYFRIEND/FIANCE 02
OTHER FRIEND 03
CASUAL ACQUAINTANCE 04
RELATIVE 05
COMMERCIAL SEX CUSTOMER 06
OTHER (SPECIFY) ____ 96

518. For how long have you had sexual relations with this man?

DAYS 1 ___
WEEKS 2 ___
MONTHS 3 ___
YEARS 4 ___

519. Have you had sex with any other man in the last 12 months?

YES 1
NO 2 (GO TO 524)

520. The last time you had sexual intercourse with this other man, was a condom used?

YES 1
NO 2 (GO TO 521)

520A. What was the main reason you used a condom on that occasion?

OWN CONCERN TO PREVENT STD/HIV 1
OWN CONCERN TO PREVENT PREGNANCY 2
OWN CONCERN TO PREVENT BOTH STD/HIV AND PREGNANCY 3
DID NOT TRUST PARTNER/FEELS PARTNER HAS OTHER PARTNERS 4
PARTNER INSISTED 5
DON'T KNOW 6
OTHER (SPECIFY) _____ 7

521. What is your relationship to this man?
IF "BOYFRIEND" OR "FIANCE", ASK: Was your boyfriend/fianc? living with you when you last had sex?
IF 'YES' RECORD '1'
IF 'NO' RECORD '2'

HUSBAND/COHABITING PARTNER 01 (GO TO 522A)
BOYFRIEND/FIANCE 02
OTHER FRIEND 03
CASUAL ACQUAINTANCE 04
RELATIVE 05
COMMERCIAL SEX CUSTOMER 06
OTHER (SPECIFY) _____ 96

522. For how long have you had sexual relations with this man?

DAYS 1 ___
WEEKS 2 ___
MONTHS 3 ___
YEARS 4 ___

522A. Other than these two men, have you had sex with anyone else in the last 12 months?

YES 1
NO 2 (GO TO 523)

522B. The last time you had sexual intercourse with this other man, was a condom used?

YES 1
NO 2 (GO TO 522D)

522C. What was the main reason you used a condom on that occasion?

OWN CONCERN TO PREVENT STD/HIV 1
OWN CONCERN TO PREVENT PREGNANCY 2
OWN CONCERN TO PREVENT BOTH STD/HIV AND PREGNANCY 3
DID NOT TRUST PARTNER/FEELS PARTNER HAS OTHER PARTNERS 4
PARTNER INSISTED 5
DON'T KNOW 6
OTHER (SPECIFY) _____ 7

522D. What is your relationship to this man?
IF "BOYFRIEND" OR "FIANCE", ASK: Was your boyfriend/fianc? living with you when you last had sex?
IF 'YES' RECORD '1'
IF 'NO' RECORD '2'

HUSBAND/COHABITING PARTNER 01 (GO TO 523)
BOYFRIEND/FIANCE 02
OTHER FRIEND 03
CASUAL ACQUAINTANCE 04
RELATIVE 05
COMMERCIAL SEX CUSTOMER 06
OTHER (SPECIFY) _____ 96

522E. For how long have you had a sexual relationship with this man?

DAYS 1 ___
WEEKS 2 ___
MONTHS 3 ___
YEARS 4 ___

523. Altogether, with how many different men have you had sex in the last 12 months?

NUMBER OF PARTNERS ___

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

YES 1
NO 2 (GO TO 527)

525. Where is that?
RECORD FIRST RESPONSE ONLY.

IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

NAME OF PLACE______
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14
FIELD WORKER 15
OTHER PUBLIC (SPECIFY) _____ 16
MISSION
HOSPITAL 21
HEALTH CENTER 22
MOBILE CLINIC 23
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
PHARMACY 32
PRIVATE DOCTOR 33
MOBILE CLINIC 34
FIELD WORKER 35
OTHER PRIVATE MEDICAL (SPECIFY) ____ 36
BLM 41
OTHER SOURCE
SHOP 51
CHURCH 52
FRIEND/RELATIVE 53
OTHER (SPECIFY) _____ 96

526. If you wanted to, could you yourself get a condom?

YES 1
NO 2
DON'T KNOW/UNSURE 8

527. Do you know of a place where one can get female condoms?

YES 1
NO 2 (GO TO 530)

528. Where is that?
RECORD FIRST RESPONSE ONLY.

IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

NAME OF PLACE________
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14
FIELD WORKER 15
OTHER PUBLIC (SPECIFY) _____ 16
MISSION
HOSPITAL 21
HEALTH CENTER 22
MOBILE CLINIC 23
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
PHARMACY 32
PRIVATE DOCTOR 33
MOBILE CLINIC 34
FIELD WORKER 35
OTHER PRIVATE MEDICAL (SPECIFY) ____ 36
BLM 41
OTHER SOURCE
SHOP 51
CHURCH 52
FRIEND/RELATIVE 53
OTHER (SPECIFY) _____ 96

529. If you wanted to, could you yourself get a female condom?

YES 1
NO 2
DON'T KNOW/UNSURE 8

530. Have you heard of a condom called "Chishango"?

YES 1
NO 2
DON'T KNOW/UNSURE 8

SECTION 6. FERTILITY PREFERENCES

601. CHECK 311/311A:

NEITHER STERILIZED (GO TO 602)
HE OR SHE STERILIZED (GO TO 614)

602. CHECK 226:

NOT PREGNANT OR UNSURE: 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?

PREGNANT: Now I have some questions about the future. After the child you 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 604)
SAYS SHE CAN'T GET PREGNANT 3 (GO TO 614)
UNDECIDED/DON'T KNOW AND PREGNANT 4 (GO TO 610)
UNDECIDED/DON'T KNOW AND NOT PREGNANT OR UNSURE 5 (GO TO 608)

603. CHECK 226:

NOT PREGNANT OR UNSURE: 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 now, how long would you like to wait before the birth of another child?

MONTHS 1 ___
YEARS 2 ___
SOON/NOW 993 (GO TO 609)
SAYS SHE CAN'T GET PREGNANT 994 (GO TO 614)
AFTER MARRIAGE 995 (GO TO 609)
OTHER (SPECIFY) ____ 996 (GO TO 609)
DON'T KNOW 998 (GO TO 609)

604. CHECK 226:

NOT PREGNANT OR UNSURE (GO TO 605)
PREGNANT (GO TO 610)

605. CHECK 310:
USING A METHOD?

NOT ASKED (GO TO 606)
NOT CURRENTLY USING (GO TO 606)
CURRENTLY USING (GO TO 608)

606. CHECK 603:

NOT ASKED (GO TO 607)
24 OR MORE MONTHS OR 02 OR MORE YEARS (GO TO 607)
00-23 MONTHS OR 00-01 YEAR (GO TO 610)

607. CHECK 602:

WANTS TO HAVE A/ANOTHER CHILD: You have said that you do not want (a/another) child soon, but you are not using any method to avoid pregnancy. Can you tell me why? Any other reason?

WANTS NO MORE/NONE: You have said that you do not want any (more) children, but you are not using any method to avoid pregnancy. Can you tell me why? Any other reason?

RECORD ALL MENTIONED.

NOT MARRIED A
FERTILITY-RELATED REASONS
NOT HAVING SEX B
INFREQUENT SEX C
MENOPAUSAL/HYSTERECTOMY D
SUBFECUND/INFECUND E
POSTPARTUM AMENORRHEIC F
BREASTFEEDING G
FATALISTIC H
OPPOSITION TO USE
RESPONDENT OPPOSED I
HUSBAND/PARTNER OPPOSED J
OTHERS OPPOSED K
RELIGIOUS PROHIBITION L
LACK OF KNOWLEDGE
KNOWS NO METHOD M
KNOWS NO SOURCE N
METHOD-RELATED REASONS
HEALTH CONCERNS O
FEAR OF SIDE EFFECTS P
LACK OF ACCESS/TOO FAR Q
COST TOO MUCH R
INCONVENIENT TO USE S
INTERFERES WITH BODY'S NORMAL PROCESSES T
OTHER (SPECIFY) _____ X
DON'T KNOW Z

608. In the next few weeks, if you discovered that you were pregnant, would that be a big problem, a small problem, or no problem for you?

BIG PROBLEM 1
SMALL PROBLEM 2
NO PROBLEM 3
SAYS SHE CAN'T GET PREGNANT/NOT HAVING SEX 4

609. CHECK 310:
USING A METHOD?

NOT ASKED (GO TO 610)
NO, NOT CURRENTLY USING (GO TO 610)
YES, CURRENTLY USING (GO TO 614)

610. Do you think you will use a method to delay or avoid pregnancy at any time in the future?

YES 1
NO 2 (GO TO 612)
DON'T KNOW 8 (GO TO 612)

611. Which method would you prefer to use?

FEMALE STERILIZATION 01 (GO TO 614)
MALE STERILIZATION 02 (GO TO 614)
PILL 03 (GO TO 614)
IUD 04 (GO TO 614)
INJECTIONS 05 (GO TO 614)
IMPLANTS 06 (GO TO 614)
CONDOM 07 (GO TO 614)
FEMALE CONDOM 08 (GO TO 614)
DIAPHRAGM 09 (GO TO 614)
FOAM/JELLY 10 (GO TO 614)
LACTATIONAL AMENORRHEA METHOD 11 (GO TO 614)
PERIODIC ABSTINENCE 12 (GO TO 614)
WITHDRAWAL 13 (GO TO 614)
OTHER (SPECIFY) ____ 96 (GO TO 614)
UNSURE 98 (GO TO 614)

612. What is the main reason that you think you will not use a method at any time in the future?

NOT MARRIED 11
FERTILITY-RELATED REASONS
INFREQUENT SEX 22 (GO TO 614)
MENOPAUSAL/HYSTERECTOMY 23 (GO TO 614)
SUBFECUND/INFECUND 24 (GO TO 614)
WANTS AS MANY CHILDREN AS POSSIBLE 26 (GO TO 614)
OPPOSITION TO USE
RESPONDENT OPPOSED 31 (GO TO 614)
HUSBAND/PARTNER OPPOSED 32 (GO TO 614)
OTHERS OPPOSED 33 (GO TO 614)
RELIGIOUS PROHIBITION 34 (GO TO 614)
LACK OF KNOWLEDGE
KNOWS NO METHOD 41 (GO TO 614)
KNOWS NO SOURCE 42 (GO TO 614)
METHOD-RELATED REASONS
HEALTH CONCERNS 51 (GO TO 614)
FEAR OF SIDE EFFECTS 52 (GO TO 614)
LACK OF ACCESS/TOO FAR 53 (GO TO 614)
COST TOO MUCH 54 (GO TO 614)
INCONVENIENT TO USE 55 (GO TO 614)
INTERFERES WITH BODY'S NORMAL PROCESSES 56 (GO TO 614)
OTHER (SPECIFY) _____ 96 (GO TO 614)
DON'T KNOW 98 (GO TO 614)

613. Would you ever use a method if you were married?

YES 1
NO 2
DON'T KNOW 8

614. CHECK 216:

HAS LIVING CHILDREN: If you could go back to the time you did not have any children and could choose exactly the number of children to have in your whole life, how many would that be?

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

PROBE FOR A NUMERIC RESPONSE.

NUMBER ___
OTHER (SPECIFY) 96 (GO TO 616)

615. 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

616. Would you say that you approve or disapprove of couples using a method to avoid getting pregnant?

APPROVE 1
DISAPPROVE 2
DON'T KNOW/UNSURE 3

617. In the last few months have you seen or heard about family planning:

On the radio?
YES 1
NO 2
On the television?
YES 1
NO 2
In a newspaper or magazine?
YES 1
NO 2
On a poster?
YES 1
NO 2
On clothing (i.e. cap, chitenji, t-shirt)
YES 1
NO 2
In a drama?
YES 1
NO 2

618. In the last few months, have you listened to any of the following program series about family planning or health on the radio?

Uchembere Wabwino?
YES 1
NO 2
Phukusi la Moyo?
YES 1
NO 2
Pa Mtondo?
YES 1
NO 2
Women's Talking Point?
YES 1
NO 2
Window Through Health?
YES 1
NO 2
Umoyo M'Malawi?
YES 1
NO 2
Tinkanena?
YES 1
NO 2
Radio Doctor?
YES 1
NO 2
Chitukuku M'Malawi?
YES 1
NO 2
Women's Forum?
YES 1
NO 2
Tichitenji?
YES 1
NO 2
Kulera?
YES 1
NO 2

619. In the last few months, have you discussed the practice of family planning with your friends, neighbors, or relatives?

YES 1
NO 2 (GO TO 621)

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

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

621. CHECK 501:

YES, CURRENTLY MARRIED (GO TO 621A)
YES, LIVING WITH A MAN (GO TO 621A)
NO, NOT IN UNION (GO TO 624A)

621A. CHECK 311/311A:

ANY CODE CIRCLED (GO TO 621B)
NO CODE CIRCLED (GO TO 622)

621B. You have told me that you are currently using contraception. Would you say that using contraception is mainly your decision, mainly your husband's/partner's decision or did you both decide together?

MAINLY RESPONDENT 1
MAINLY HUSBAND/PARTNER 2
JOINT DECISION 3
OTHER (SPECIFY) ____ 6

622. Now I want to ask you about your husband's/partner's views on family planning.
Do you think that your husband/partner approves or disapproves of couples using a method to avoid pregnancy?

APPROVES 1
DISAPPROVES 2
DON'T KNOW 8

623. How often have you talked to your husband/partner about family planning in the past year?

NEVER 1
ONCE OR TWICE 2
MORE OFTEN 3

623A. CHECK 311/311A:

NEITHER STERILIZED (GO TO 624)
HE OR SHE STERILIZED (GO TO 624A)

624. Do you think your husband/partner wants the same number of children that you want, or does he want more or fewer than you want?

SAME NUMBER 1
MORE CHILDREN 2
FEWER CHILDREN 3
DON'T KNOW 8

624A. CHECK 501 AND 502:

EVER IN UNION CODE '3' NOT CIRCLED IN 501 OR 502 (GO TO 625)
NEVER IN UNION CODE '3' CIRCLED IN 501 AND 502 (GO TO 701)

625. Husbands and wives do not always agree on everything. Please tell me if you think a wife is justified in refusing to have sex with her husband when:

She knows her husband has a sexually transmitted disease?
YES 1
NO 2
DON'T KNOW 8
She knows her husband has sex with other women?
YES 1
NO 2
DON'T KNOW 8
She has recently given birth?
YES 1
NO 2
DON'T KNOW 8
She is tired or not in the mood?
YES 1
NO 2
DON'T KNOW 8

SECTION 7. HUSBAND'S BACKGROUND AND WOMAN'S WORK

701. CHECK 501 AND 502:

CURRENTLY MARRIED/LIVING WITH A MAN (GO TO 702)
FORMERLY MARRIED/LIVED WITH A MAN (GO TO 703)
NEVER MARRIED AND NEVER LIVED WITH A MAN (GO TO 707)

702. How old was your husband/partner on his last birthday?

AGE IN COMPLETED YEARS ___

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

YES 1
NO 2 (GO TO 706)

704. What was the highest level of school he attended: primary, secondary, or higher?

PRIMARY 1
SECONDARY 2
HIGHER 3
DON'T KNOW 8 (GO TO 706)

705. How many years of school did he complete at that level?

YEARS ___
DON'T KNOW 98

706. CHECK 701:

CURRENTLY MARRIED/LIVING WITH A MAN: What is your husband's/partner's occupation? That is, what kind of work does he mainly do?

FORMERLY MARRIED/LIVED WITH A MAN: What was your (last) husband's/ partner's occupation? That is, what kind of work did he mainly do?

OCCUPATION____

707. Aside from your own housework, are you currently working?

YES 1 (GO TO 710)
NO 2

708. As you know, some women take up jobs for which they are paid in cash or kind. Others sell things, have a small business or work on the family farm or in the family business.
Are you currently doing any of these things or any other work?

YES 1 (GO TO 710)
NO 2

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

YES 1
NO 2 (GO TO 719)

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

OCCUPATION______

711. CHECK 710:

WORKS IN FARMING (GO TO 712)
DOES NOT WORK IN FARMING (GO TO 713)

712. 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

713. 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

713A. Do you usually work at home or away from home?

HOME 1
AWAY 2

714. 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

715. Are you paid or do you earn 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 (GO TO 719)
NOT PAID 4 (GO TO 719)

716. Who mainly decides how the money you earn will be used?

RESPONDENT 1
HUSBAND/PARTNER 2
RESPONDENT AND HUSBAND/PARTNER JOINTLY 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE JOINTLY 5

717. On average, how much of your household's expenditures do your earnings pay for: almost none, less than half, about half, more than half, or all?

ALMOST NONE 1
LESS THAN HALF 2
ABOUT HALF 3
MORE THAN HALF 4
ALL 5
NONE, HER INCOME IS ALL SAVED 6

719. Who in your family usually has the final say on the following decisions:

Your own health care?
RESPONDENT 1
HUSBAND/PARTNER 2
RESPONDENT AND HUSBAND/PARTNER JOINTLY 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE JOINTLY 5
DECISION NOT MADE/NOT APPLICABLE 6
Making large household purchases?
RESPONDENT 1
HUSBAND/PARTNER 2
RESPONDENT AND HUSBAND/PARTNER JOINTLY 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE JOINTLY 5
DECISION NOT MADE/NOT APPLICABLE 6
Making household purchases for daily needs?
RESPONDENT 1
HUSBAND/PARTNER 2
RESPONDENT AND HUSBAND/PARTNER JOINTLY 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE JOINTLY 5
DECISION NOT MADE/NOT APPLICABLE 6
Visits to family or relatives?
RESPONDENT 1
HUSBAND/PARTNER 2
RESPONDENT AND HUSBAND/PARTNER JOINTLY 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE JOINTLY 5
DECISION NOT MADE/NOT APPLICABLE 6
What food should be cooked each day?
RESPONDENT 1
HUSBAND/PARTNER 2
RESPONDENT AND HUSBAND/PARTNER JOINTLY 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE JOINTLY 5
DECISION NOT MADE/NOT APPLICABLE 6
The number of children you should bear?
RESPONDENT 1
HUSBAND/PARTNER 2
RESPONDENT AND HUSBAND/PARTNER JOINTLY 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE JOINTLY 5
DECISION NOT MADE/NOT APPLICABLE 6

720. PRESENCE OF OTHERS AT THIS POINT (PRESENT AND LISTENING, PRESENT BUT NOT LISTENING OR NOT PRESENT)

CHILDREN UNDER 10
PRESENT AND LISTENING 1
PRESENT BUT NOT LISTENING 2
NOT PRESENT 3
HUSBAND
PRESENT AND LISTENING 1
PRESENT BUT NOT LISTENING 2
NOT PRESENT 3
OTHER MALES
PRESENT AND LISTENING 1
PRESENT BUT NOT LISTENING 2
NOT PRESENT 3
OTHER FEMALES
PRESENT AND LISTENING 1
PRESENT BUT NOT LISTENING 2
NOT PRESENT 3

721. Sometimes a husband is annoyed or angered by things which 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 have sex with him?
YES 1
NO 2
DON'T KNOW 8
If she burns the food?
YES 1
NO 2
DON'T KNOW 8

SECTION 8: AIDS AND OTHER SEXUALLY TRANSMITTED DISEASES

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

YES 1
NO 2 (GO TO 818)

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

YES 1
NO 2 (GO TO 809)
DON'T KNOW 8 (GO TO 809)

803. What can a person do? Anything else?
RECORD ALL MENTIONED.

ABSTAIN FROM SEX A
USE CONDOMS B
LIMIT SEX TO ONE PARTNER/STAY FAITHFUL TO ONE PARTNER C
LIMIT NUMBER OF SEXUAL PARTNERS D
AVOID SEX WITH PROSTITUTES E
AVOID SEX WITH PERSONS WHO HAVE MANY PARTNERS F
AVOID SEX WITH HOMOSEXUALS G
AVOID SEX WITH PERSONS WHO INJECT DRUGS INTRAVENOUSLY H
AVOID BLOOD TRANSFUSIONS I
AVOID INJECTIONS J
AVOID KISSING K
AVOID MOSQUITO BITES L
SEEK PROTECTION FROM TRADITIONAL HEALER M
AVOID SHARING RAZORS, BLADES N
OTHER (SPECIFY) ____ W
OTHER (SPECIFY) ____ X
DON'T KNOW Z

804. Can people protect themselves from getting the AIDS virus by having just one uninfected sex partner who has no other partners?

YES 1
NO 2
DON'T KNOW 8

805. Can a person get the AIDS virus from mosquito bites?

YES 1
NO 2
DON'T KNOW 8

806. Can people protect themselves from getting the AIDS virus by using a condom every time they have sex?

YES 1
NO 2
DON'T KNOW 8

807. Can a person get the AIDS virus from sharing food with a person who has AIDS?

YES 1
NO 2
DON'T KNOW 8

808. Can people protect themselves from getting the AIDS virus by not having sex at all?

YES 1
NO 2
DON'T KNOW 8

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

YES 1
NO 2
DON'T KNOW 8

811. Do you know someone personally who has the virus that causes AIDS or someone who died from AIDS?

YES 1
NO 2

812. Can the virus that causes AIDS be transmitted from a mother to a child?

YES 1
NO 2 (GO TO 814)
DON'T KNOW 8 (GO TO 814)

813. Can the virus that causes AIDS be transmitted from a mother to a child:

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

814. CHECK 501:

YES, CURRENTLY MARRIED/LIVING WITH A MAN (GO TO 815)
NO, NOT IN UNION (GO TO 815A)

815. Have you ever talked about ways to prevent getting the virus that causes AIDS with (your husband/the man you are living with)?

YES 1
NO 2

815A. In your opinion, is it acceptable or unacceptable for AIDS to be discussed:

On the radio?
ACCEPTABLE 1
NOT ACCEPTABLE 2
On the TV?
ACCEPTABLE 1
NOT ACCEPTABLE 2
In newspapers?
ACCEPTABLE 1
NOT ACCEPTABLE 2

816. If a person learns that he/she is infected with the virus that causes AIDS, should the person be allowed to keep this fact private or should this information be available to the community?

CAN BE KEPT PRIVATE 1
AVAILABLE TO COMMUNITY 2
DON'T KNOW/NOT SURE 8

817. If a relative of yours 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

817A. Should persons with the AIDS virus who work with other persons such as in a shop, office, or farm be allowed to continue their work or not?

CAN CONTINUE WORK 1
SHOULD NOT CONTINUE WORK 2
DON'T KNOW/NOT SURE/DEPENDS 8

817B. Should children aged 12-14 be taught about using a condom to avoid AIDS?

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

817BX. Do you think that condoms are safe to use?

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

817BY. Do you think that men and women who intend to marry should be tested for the AIDS virus before marriage?

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

817C. Have you ever been tested to see if you have the AIDS virus?

YES 1 (GO TO 817FX)
NO 2

817D. Would you want to be tested for the AIDS virus?

YES 1
NO 2
DON'T KNOW/UNSURE 8

817E. Do you know a place where you could go to get an AIDS test?

YES 1
NO 2 (GO TO 818)

817F. Where can you go for the test?
817FX. Where did you go for the test?

IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

NAME OF PLACE____
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14
OTHER PUBLIC (SPECIFY) _____ 16
MISSION
HOSPITAL 21
HEALTH CENTER 22
MOBILE CLINIC 23
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 31
PRIVATE DOCTOR 32
MOBILE CLINIC 33
OTHER PRIVATE MEDICAL (SPECIFY) ____ 36
BLM 41
MACRO 51
OTHER (SPECIFY) _____ 96

818. Apart from AIDS, have you heard about other infections that can be transmitted through sexual contact?

YES 1
NO 2 (GO TO 820C)

820A. CHECK 514:

HAS HAD SEXUAL INTERCOURSE (GO TO 820B)
HAS NOT HAD SEXUAL INTERCOURSE (GO TO 901)

820B. 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 sexually-transmitted disease?

YES 1
NO 2
DON'T KNOW 8

820C. Sometimes, women experience an abnormal genital discharge. During the last 12 months, have you had an abnormal genital discharge?

YES 1
NO 2
DON'T KNOW 8

820D. Sometimes, women experience a genital sore or ulcer. During the last 12 months, have you had a genital sore or ulcer?

YES 1
NO 2
DON'T KNOW 8

820E. CHECK 820B, 820C, 820D:

HAS HAD AN INFECTION (GO TO 820F)
HAS NOT HAD AN INFECTION (GO TO 901)

820F. The last time you had (INFECTION FROM 820B/820C/820D), did you seek any kind of advice or treatment?

YES 1
NO 2 (GO TO 820H)

820G. The last time you had (INFECTION FROM 820B/820C/820D) did you do any of the following? Did you....

Go to a clinic, hospital, or private doctor?
YES 1
NO 2
Consult a traditional healer?
YES 1
NO 2
Seek advice or buy medicines in a shop or pharmacy?
YES 1
NO 2
Ask for advice from friends or relatives?
YES 1
NO 2

820H. When you had (INFECTION FROM 820B/820C/820D), did you inform the persons with whom you were having sex?

YES 1
NO 2
SOME/NOT ALL 3

820I. When you had (INFECTION FROM 820B/820C/820D) did you do something to avoid infecting your sexual partner(s)?

YES 1
NO 2 (GO TO 901)
PARTNER ALREADY INFECTED 3 (GO TO 901)

820J. What did you do to avoid infecting your partner(s)? Did you....

Stop having sex?
YES 1
NO 2
Use a condom when having sex?
YES 1
NO 2
Use medicine?
YES 1
NO 2

SECTION 9. MATERNAL MORTALITY

901. Now I would like to ask you some questions about your brothers and sisters, that is, all of the children born to your natural mother, including those who are living with you, those living elsewhere and those who have died.
How many children did your mother give birth to, including you?

NUMBER OF BIRTHS TO NATURAL MOTHER ___

902. CHECK 901:

TWO OR MORE BIRTHS (GO TO 903)
ONLY ONE BIRTH (RESPONDENT ONLY) (GO TO 916)

903. How many of these births did your mother have before you were born?

NUMBER OF PRECEDING BIRTHS ___

904. Please tell me the names of all your brothers and sisters starting with the oldest.

NAME______

905. Is (NAME) male or female?

MALE 1
FEMALE 2

906. Is (NAME) still alive?

YES 1
NO 2 (GO TO 908)
DON'T KNOW 8 (GO TO NEXT SIBLING)

907. How old is (NAME)?

AGE_____ (GO TO NEXT SIBLING)

908. In what year did (NAME) die?

YEAR_____ (GO TO 910)
DON'T KNOW 9998

909. How many years ago did (NAME) die?

YEARS_____

910. How old was (NAME) when he/she died?

AGE_____ (IF (1) MALE OR (2) FEMALE AND DIED BEFORE 12 YEARS OF AGE GO TO NEXT SIBLING)

911. Was (NAME) pregnant when she died?

YES 1 (GO TO 915)
NO 2

912. Did (NAME) die during childbirth?

YES 1 (GO TO 915)
NO 2

913. Did (NAME) die within two months after the end of a pregnancy or childbirth?

YES 1
NO 2

915. How many children did (NAME) give birth to during her lifetime?

NUMBER OF CHILDREN_____ (GO TO NEXT SIBLING)


IF NO MORE BROTHERS OR SISTERS, GO TO 916

916. RECORD THE TIME.

HOURS ____
MINUTES ____

INTERVIEWER'S OBSERVATIONS

TO BE FILLED IN AFTER COMPLETING INTERVIEW

COMMENTS ABOUT RESPONDENT:_____________________________

COMMENTS ON SPECIFIC QUESTIONS:_____________________________

ANY OTHER COMMENTS:_____________________________

SIGNATURE OF THE INTERVIEWER: ______________
DATE: ______________

SUPERVISOR'S OBSERVATIONS:____________________________

NAME OF THE SUPERVISOR: _____________________
DATE: ______________

EDITOR'S OBSERVATIONS:____________________________

NAME OF EDITOR: _______________________________
DATE: ______________

INSTRUCTIONS:
ONLY ONE CODE SHOULD APPEAR IN ANY BOX.

BIRTHS AND PREGNANCIES

B BIRTHS
P PREGNANCIES
T TERMINATIONS
2000
12 DEC 01___
11 NOV 02___
10 OCT 03___
09 SEP 04___
08 AUG 05___
07 JUL 06___
06 JUN 07___
05 MAY 08___
04 APR 09___
03 MAR 10___
02 FEB 11___
01 JAN 12___
1999
12 DEC 13___
11 NOV 14___
10 OCT 15___
09 SEP 16___
08 AUG 17___
07 JUL 18___
06 JUN 19___
05 MAY 20___
04 APR 21___
03 MAR 22___
02 FEB 23___
01 JAN 24___
1998
12 DEC 25___
11 NOV 26___
10 OCT 27___
09 SEP 28___
08 AUG 29___
07 JUL 30___
06 JUN 31___
05 MAY 32___
04 APR 33___
03 MAR 34___
02 FEB 35___
01 JAN 36___
1997
12 DEC 37___
11 NOV 38___
10 OCT 39___
09 SEP 40___
08 AUG 41___
07 JUL 42___
06 JUN 43___
05 MAY 44___
04 APR 45___
03 MAR 46___
02 FEB 47___
01 JAN 48___
1996
12 DEC 49___
11 NOV 50___
10 OCT 51___
09 SEP 52___
08 AUG 53___
07 JUL 54___
06 JUN 55___
05 MAY 56___
04 APR 57___
03 MAR 58___
02 FEB 59___
01 JAN 60___
1995
12 DEC 61___
11 NOV 62___
10 OCT 63___
09 SEP 64___
08 AUG 65___
07 JUL 66___
06 JUN 67___
05 MAY 68___
04 APR 69___
03 MAR 70___
02 FEB 71___
01 JAN 72___