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REPUBLIC OF NIGER
DEMOGRAPHIC AND HEALTH SURVEY
HUSBAND'S INDIVIDUAL QUESTIONNAIRE
1992

IDENTIFICATION

DEPARTMENT___
DISTRICT ___
MUNICIPALITY/ADMINISTRATIVE DISTRICT/CITY CENTER ___

VILLAGE/QUARTER:

NIAMEY 1
AGADEZ, MARADI, TAHOUA, ZINDER 2
OTHER CITY 3
RURAL 4

NAME OF HUSBAND ___

LINE NUMBER OF ELIGIBLE MAN ___

STRATUS NUMBER ___
CLUSTER NUMBER ___
STRUCTURE NUMBER ___
RESIDENCE NUMBER ___
CENSUS ZONE NUMBER ___

LINE NUMBER OF HUSBAND ___

INTERVIEWER VISITS:

INTERVIEWER:
(REPEAT FOR SECOND AND THIRD INTERVIEWERS)
DATE__
DAY__
MONTH__
YEAR__
INTERVIEWER NAME___
RESULTS___

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

FINAL VISIT:
DAY__
MONTH__
YEAR 19__
INTERVIEWER__
RESULT__

RESULT CODES:

COMPLETED 1
NOT AT HOME 2
POSTPONED 3
REFUSED 4
PARTIALLY FILLED OUT 5
OTHER (SPECIFY): ___ 6

TOTAL NUMBER OF VISITS ___

FRENCH QUESTIONNAIRE: 1

INTERVIEW LANGUAGE:

FRENCH 1
HAOUSSA 2
DJERMA 3
OTHERS 4

INTERPRETER??:

YES 1
NO 2

FIELD EDITED BY:
NAME ___
DATE ___

OFFICE EDITED BY:
NAME ___
DATE ___

KEYED BY:
NAME ___
DATE ___

SECTION 1. RESPONDENT BACKGROUND

101) RECORD TIME

HOUR: ___
MINUTES: ___

102) In what month and year were you born?

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

103) How old were you at your last birthday?

COMPARE AND CORRECT IF 102 AND 103 ARE INCOMPATIBLE.

AGE IN COMPLETED YEARS: ___

104) Did you go to school?

YES 1
NO 2 (GO TO 107)

105) What is the highest level of education that you attended: primary, first cycle of secondary, second cycle of secondary, or higher?

PRIMARY 1
SECONDARY, FIRST CYCLE 2
SECONDARY, SECOND CYCLE 3
HIGHER 4
DON'T KNOW 8

106) What is the highest (class, year) you completed with success at that level?

CLASS: ___
CLASSES FOR PRIMARY LEVEL
INTRODUCTORY COURSE 1
PREPARATORY COURSE 2
ELEMENTARY COURSE 1 3
ELEMENTARY COURSE 2 4
MID-LEVEL COURSE 1 5
MID-LEVEL COURSE 2 6
CLASSES FOR SECONDARY, FIRST CYCLE LEVEL
6TH 1
5TH 2
4TH 3
3RD 4
DON'T KNOW 8
CLASSES FOR SECONDARY, SECOND CYCLE LEVEL
2ND 1
1ST 2
FINAL YEAR 3
DON'T KNOW 8
CLASSES FOR HIGHER LEVEL
FIRST YEAR 1
SECOND YEAR 2
THIRD YEAR 3
FOURTH YEAR AND HIGHER 4
DON'T KNOW 8

107) What is your main occupation?

_____

108) What is your religion?

MUSLIM 1
CHRISTIAN 2
ANIMIST 3
OTHER (SPECIFY): ___ 4

109) What is your nationality?

NIGERIAN 01
TOGOLESE 02 (GO TO 111)
BENINESE 03(GO TO 111)
MALIAN 04 (GO TO 111)
BURKINABE 05 (GO TO 111)
OTHER AFRICAN 06 (GO TO 111)
OTHER (SPECIFY): ___ 07 (GO TO 111)

110) What is your ethnicity?

ARABE 01
DJERMA 02
GOURMANTH 03
HAUSSA 04
KAMOURI 05
MOSSI 06
PEULH 07
TOUAREG BELLA 08
TOUBOU 09
OTHER (SPECIFY): ___ 10

111) Now I'd like to ask you some questions about marriage:
How many spouses/wives do you currently have?

NUMBER: ___

112) Do you intend to take another or other spouses/wives in the future?

YES 1
NO 2

113) In what month and year did you get married or start to live together with a woman for the first time?

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

114) How old were you when you got married or started to live together with a woman for the first time?

AGE IN COMPLETED YEARS: ___
DON'T KNOW AGE 98

SECTION 2: CONTRACEPTION

201) Now I would like to talk to you about family planning - the different ways or methods that a couple can use to delay or avoid a pregnancy. Which ways or methods have you heard about?

CIRCLE CODE 1 IN 202 FOR EACH METHOD MENTIONED SPONTANEOUSLY.

THEN PROCEED DOWN THE COLUMN, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY.

CIRCLE CODE 2 IF METHOD IS RECOGNISED, AND CODE 3 IF NOT RECOGNIZED.
THEN FOR EACH METHOD WITH CODE 1 OR 2 CIRCLED IN 202, ASK QUESTIONS 203 BEFORE PROCEEDING TO THE NEXT METHOD.

202) Have you ever heard of (METHOD)?

READ DESCRIPTION OF EACH METHOD

01. PILL: Women can take a pill every day.
YES/SPONTANEOUS 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
02. IUD: Some women have a "sterilet" that a doctor or nurse places in their uterus.
YES/SPONTANEOUS 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
03. INJECTIONS: Women can receive an injection by a doctor or nurse to avoid becoming pregnant for several months.
YES/SPONTANEOUS 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
04. DIAPHRAGM/FOAM/GEL: Women can put a sponge, suppository, diaphragm, jelly, or cream inside them before intercourse.
YES/SPONTANEOUS 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
05. CONDOM: Men can wear a condom during sexual intercourse.
YES/SPONTANEOUS 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
06. FEMALE STERILIZATION: Women can undergo an operation in order to avoid having any more children.
YES/SPONTANEOUS 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
07. MALE STERILIZATION: Men can undergo an operation in order to avoid having any more children.
YES/SPONTANEOUS 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
08. RHYTHM, PERIODIC ABSTINENCE: Couples can avoid having sexual intercourse on certain days of the month when the woman is more likely to become pregnant.
YES/SPONTANEOUS 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
09. WITHDRAWAL: Certain men are careful and pull out before ejaculation.
YES/SPONTANEOUS 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
10. GRIS-GRIS: Women can use an amulet to avoid becoming pregnant.
YES/SPONTANEOUS 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
11. OTHER METHODS: Have you heard of other ways or methods that women or men can use to avoid pregnancy?
YES/SPONTANEOUS (SPECIFY): ___ 1
NO 3 (GO QUESTION 305)

203) Have you ever used (METHOD)?

01. PILL: Have you ever had a wife/partner who used this method?
YES 1
NO 2
02. IUD: Have you ever had a wife/partner who used this method?
YES 1
NO 2
03. INJECTIONS: Have you ever had a wife/partner who used this method?
YES 1
NO 2
04. DIAPHRAGM/FOAM/GEL: Have you ever had a wife/partner who used this method?
YES 1
NO 2
05. CONDOM
YES 1
NO 2
06. FEMALE STERILIZATION: Have you ever had a wife/partner that had an operation to avoid having any more children?
YES 1
NO 2
07. MALE STERILIZATION: Have you ever had an operation to avoid having any more children?
YES 1
NO 2
08. RHYTHM, PERIODIC ABSTINENCE
YES 1
NO 2
09. WITHDRAWAL
YES 1
NO 2
10. GRIS-GRIS: Have you ever had a wife/partner who used this method?
YES 1
NO 2
11. OTHER METHODS
YES 1
NO 2

204) CHECK 203:

NOT A SINGLE "YES" (NEVER USED): ___
AT LEAST ONE "YES" (EVER USED): ___ (GO TO 207)

205) Have you or your wife/wives ever used or tried any way to delay or avoid getting pregnant?

YES: ___
NO: ___ (GO TO 209)

206) What have you done or used?

CORRECT 203-204 (AND 202 IF NECESSARY).

207) Are you or your wife/wives currently doing anything or using a method to avoid getting pregnant?

YES 1
NO 2 (GO TO 209)

208) What method are you currently using?

PILL 01 (GO TO 212)
IUD 02 (GO TO 212)
INJECTIONS 03 (GO TO 212)
DIAPHRAGM/FOAM/GEL 04 (GO TO 212)
CONDOM 05 (GO TO 212)
FEMALE STERILIZATION 06 (GO TO 212)
MALE STERILIZATION 07(GO TO 212)
PERIODIC ABSTINENCE 08 (GO TO 212)
WITHDRAWAL 09 (GO TO 212)
GRIS-GRIS 10 (GO TO 212)
OTHER (SPECIFY): ___ 11 (GO TO 212)

209) Do you intend to use a method to avoid getting pregnant in the future?

YES 1
NO 2 (GO TO 211)
DON'T KNOW 8 (GO TO 212)

210) Which method would you prefer to use?

PILL 01 (GO TO 212)
IUD 02 (GO TO 212)
INJECTIONS 03 (GO TO 212)
DIAPHRAGM/FOAM/GEL 04 (GO TO 212)
CONDOM 05 (GO TO 212)
FEMALE STERILIZATION 06 (GO TO 212)
MALE STERILIZATION 07(GO TO 212)
PERIODIC ABSTINENCE 08 (GO TO 212)
WITHDRAWAL 09 (GO TO 212)
GRIS-GRIS 10 (GO TO 212)
OTHER (SPECIFY): ___ 11 (GO TO 212)
NOT SURE 98 (GO TO 212)

211) What is the main reason you do not intend to use a method?

WANTS CHILDREN 01
LACK OF INFORMATION 02
PARTNER DISAPPROVES 03
COST TOO MUCH 04
SIDE EFFECTS 05
HEALTH PROBLEMS 06
HARD TO GET METHODS 07
RELIGION 08
OPPOSED TO FAMILY PLANNING 09
FATALIST 10
OTHER PEOPLE OPPOSED 11
INFREQUENT SEX 12
WIFE HAS DIFFICULTY GETTING PREGNANT 13
WIFE IS MENOPAUSAL/HAD HYSTERECTOMY 14
INCONVENIENT 15
CAN NOT/NO LONGER HAVE CHILDREN/STERILE 16
OTHER (SPECIFY): ___ 17
DON'T KNOW 98

212) Are you for or against information about family planning being provided on the radio and on television?

FOR 1
AGAINST 2
DON'T KNOW 8

213) In the last 12 months, have you attended any awareness sessions or talks about family planning?

YES 1
NO 2 (GO TO 301)

214) Where did you attend these sessions or talks?

HEALTH FACILITY 1
NEIGHBORHOOD 2
OTHER (SPECIFY): ___ 3
DON'T KNOW 8

SECTION 3: FERTILITY PREFERENCES

301) Do you have children?

YES 1
NO 2 (GO TO 303)

302) How many boys do you have?
How many girls do you have?

BOYS: ___
GIRLS: ___

303) CHECK 203:

NOT STERILIZED: ___
STERILIZED: ___ (GO TO 309)

304) Would you like to have (a/another) child or would you prefer to not have any (more) children?

HAVE (ANOTHER) CHILD 1
NO MORE/NONE 2
SAYS WIFE CAN'T GET PREGNANT 3
SAYS HE CAN'T HAVE CHILDREN (ANY LONGER) 4
UNDECIDED OR DON'T KNOW 8

305) Do you think that your spouse(s)/wife/wives approve or disapprove of couples using a method to avoid getting pregnant?

YES 1
NO 2
DON'T KNOW 3

306) How many times have you spoken with your spouse(s)/wife/wives about this subject in the past 12 months?

NEVER 1
ONCE OR TWICE 2
MORE OFTEN 3

307) Have you ever talked to your spouse(s)/wife/wives about how many children you would like to have?

YES 1
NO 2

308) Do you think your spouse(s)/wife/wives wants the same number of children that you want, or does she want more or fewer than you want?

SAME 1
MORE 2
LESS 3
DON'T KNOW 8

309) After childbirth, how much time should couples wait before starting to have sexual relations again, or doesn't matter?

MONTHS: ___1
YEARS: ___ 2
OTHER (SPECIFY): ___ 996

310) Should a mother wait until she has completely stopped breastfeeding before starting to have sexual relations again, or doesn't it matter?

WAIT 1
DOESN'T MATTER 2

311) In general, do you approve or disapprove of couples using a method to avoid getting pregnant?

APPROVE 1
DISAPPROVE 2

312) CHECK 301-302 AND CHECK THE BOX:

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

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

NUMBER: ___
OTHER (SPECIFY): ___ 96

313) RECORD THE TIME.

HOUR: ___
MINUTES: ___

INTERVIEWER'S OBSERVATIONS

TO BE FILLED IN AFTER COMPLETING INTERVIEW

COMMENTS ABOUT RESPONDENT___
COMMENTS ON SPECIFIC QUESTIONS____
ANY OTHER COMMENTS___
SUPERVISOR'S OBSERVATIONS___

NAME OF SUPERVISOR___
DATE____

EDITOR'S OBSERVATIONS___

NAME OF EDITOR____
DATE____