IDENTIFICATION

NAME AND CODE OF DISTRICT ________________
NAME AND CODE OF VILLAGE/MUNICIPALITY __________

WARD NUMBER ____________
CLUSTER NUMBER __________

HOUSEHOLD NUMBER ______________

NAME OF HOUSEHOLD HEAD_____

NAME AND LINE NUMBER OF WOMAN ____________

INTERVIEWER VISITS

DATE

INTERVIEWER'S NAME ___________
INT. CODE ________

RESULT* ___

NEXT VISIT

LANGUAGE

LANGUAGE OF QUESTIONNAIRE: ENGLISH

LANGUAGE OF INTERVIEW

HOME LANGUAGE OF RESPONDENT

WAS A TRANSLATOR USED

SUPERVISOR

FIELD EDITOR

OFFICE EDITOR ___

KEYED BY ____

SECTION 1. RESPONDENT'S BACKGROUND

INFORMED CONSENT
Hello. My name is _______________ and I am working with the Ministry of Health. We are conducting a national survey about the health of women and children. We would very much appreciate your participation in this survey. I would like to ask you about your health (and the health of your children). This information will help the government to plan health services. The survey usually takes between 20 and 45 minutes to complete. Whatever information you provide will be kept strictly confidential and will not be shown to other persons.
Participation in this survey is voluntary and you can choose not to answer any individual question or all of the questions. However, we hope that you will participate in this survey since your views are important.
At this time, do you want to ask me anything about the survey? May I begin the interview now?

Signature of interview: __________________ Date:_____________

101. RECORD THE TIME

101A. COLLECT ANY RELEVANT DOCUMENTS THAT MAY HAVE INFORMATION ON THE RESPONDENT'S AGE AND HER CHILDREN'S AGE AND IMMUNIZATIONS.

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 the countryside?

103. How long have you been living continuously in (NAME OF CURRENT PLACE OF RESIDENCE)?

IF LESS THAN ONE YEAR, RECORD '00' YEARS

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

105. In what month and year were you born?

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

107. Have you ever attended school?

108. What is the highest grade you completed?

109. CHECK 108:

110. Now I would like you to read out loud as much of this sentence as you can.

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

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

112. CHECK 110:

113. Do you usually read a newspaper or magazine at least once a week?

114. Do you usually listen to the radio every day?

115. Do you usually watch television at least once a week?

116. What is your religion?

117. What is your caste?
WRITE IN SPACE PROVIDED. DO NOT FILL BOX. CODE WILL BE ENTERED BY FIELD EDITOR.

118. Are you currently married or are you widowed, divorced, or separated?

119. Is your husband living with you now or is he staying elsewhere?

120. How long has he been away without coming back?
IF LESS THAN 1 MONTH, WRITE 'OO'.

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

122. Does your husband have any other wives besides yourself?

123. How many other wives does he have?

123A. Are you the first, second, ....wife?

124. Have you been married only once, or more than once?

125. How old were you when you (first) got married?

126. CHECK 124:

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

SECTION 2: REPRODUCTION

Now I would like to ask about all the pregnancies you have had during your life. By this I mean all the children born to you, whether they were born alive or dead, whether they are still living or not, whether they live with you or somewhere else, and all the pregnancies which you have had that did not result in a live birth. I understand that it is not easy to talk about children who have died or pregnancies that ended before full term, but it is important that you tell us about all of them, so that we can develop programs to improve children's health.

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

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

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

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

205. How many sons are alive but do not live with you? And how many daughters are alive but do not live with you?

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 hours or days?

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

208. Women sometimes have pregnancies that do not result in a live born child. That is, a pregnancy can end early, in a miscarriage or the child can be born dead. Have you ever had a pregnancy that did not end in a live birth?

209. How many pregnancies have you had that did not end in a live birth?

210. SUM ANSWERS TO 203, 205, 207, AND 209 AND ENTER TOTAL.
IF NONE, RECORD '00'.

211. CHECK 210:
Just to make sure that I have this right: you have had in TOTAL _____ pregnancies during your life. Is that correct?

212. CHECK 210:

213. Now I would like to record all your pregnancies, whether born alive, born dead, or lost before birth. Start with the first pregnancy you had. RECORD ALL THE PREGNANCIES. RECORD TWINS AND TRIPLETS ON SEPARATE LINES.

214. ___

215. Think back to time of your first pregnancy. Was that a single of multiple pregnancy.

216. Was the baby born alive, born dead, or lost before birth?

217. Did that baby cry, move, or breathe when it was born?

218. What was the name given to that child?

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

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

221. Is (NAME) still alive?

222. IF BORN ALIVE AND STILL LIVING: How old was (NAME) at his/her last birthday?
RECORD IN AGE IN COMPLETED YEARS.

223. Is (NAME) living with you?

224. RECORD HOUSEHOLD LINE NUMBER OF CHILD (RECORD '00' IF CHILD NOT LISTED IN HOUSEHOLD)

225. IF BORN ALIVE BUT NOW 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 2 YEARS; OR YEARS.

226. IF BORN DEAD OR LOST BEFORE BIRTH: In what month and year did this pregnancy end?

227. How many months did the pregnancy last?
RECORD IN COMPLETED MONTHS.

228. Did you or someone else do anything to end this pregnancy?

229. Were there any other pregnancies between the previous pregnancy and this pregnancy?
(ASK FOR ALL EXCEPT FIRST PREGNANCY)

230. Have you had any pregnancy since the last pregnancy mentioned?

231. COMPARE 210 WITH NUMBER OF PREGNANCIES IN HISTORY ABOVE AND MARK:

232. CHECK 220 AND ENTER THE NUMBER OF LIVE BIRTHS SINCE BAISAKH 1, 2052.
IF NONE, RECORD '0'.

233. CHECK 118:

234. Are you pregnant now?

235. How many months pregnant are you?
RECORD NUMBER OF COMPLETED MONTHS.

236. 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?

237. When did your last menstrual period start?

238. From one menstrual period to the next, is there a time when a woman is more likely to become pregnant if she has sexual relations?

239. Is this time before her period begins, during her period, right after her period has ended, or half way between two periods?

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 3O1 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 SPONTANEOULY, ASK: Have you ever heard of (MEHOD)?

302. Have you ever used (METHOD)?

303. CHECK 302:

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

305. What have you used or done?

306. 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'.

307. CHECK 118:

308. CHECK 302 (01):

309. CHECK 234:

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

311. Which method are you using?
311A. CIRCLE 'A' FOR FEMALE STERILIZATION.
IF MORE THAN ONCE METHOD MENTIONED, CIRCLE ALL METHODS MENTIONED. IF MORE THAN ONCE METHOD MENTIONED, FOLLOW SKIP INSTURCTIONS FOR HIGHESTMETHOD ON LIST.

312. 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 312-317 ABOUT FEMALE STERILIZATION ONLY.

313. CHECK 311:

314. Do you regret that you/your husband had the operation?

315. Why do you regret the operation?

316. In what month and year was the sterilization performed?
316A. For how long have you been using (CURRENT METHOD) now without stopping?
PROBE: In what month and year did you start using (CURRENT METHOD) continuously?

317. CHECK 316/316A:

CIRCLE METHOD CODE:

IF MORE THAN ONCE METHOD CODE CIRCLED IN 311/311A, CIRLCE CODE FOR HIGHEST METHOD IN LIST.

319. Where did you obtain (CURRENT METHOD) when you started using it?

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

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

321. You obtained (CURRENT METHOD) from (SOURCE OF METHOD FROM 312 OR 319).
At any time, were you told about side effects or problems you might have with the method?

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

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

324. CHECK 321:

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

326. CHECK 311/311A:
CIRCLE METHOD CODE

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

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

328. How long does it take you to travel from your house to this place?

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

330. Where is that?

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.

Any other place?
RECORD ALL PLACES MENTIONED.

331. How long does it take you to travel from your house to the nearest place?

332. In the last 12 months, were you visited by a health worker who talked to you about family planning?

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

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

SECTION 4A. PREGNANCY, POSTNATAL CARE AND BREASTFEEDING

401. CHECK 232:

402. ENTER IN THE TABLE THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH SINCE BAISAKH 1, 2052 OR LATER. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH.
(IF THERE ARE MORE THAN 2 BIRTHS, USE THE LAST COLUMN OF ADDITIONAL QUESTIONNAIRES).

403. LINE NUMBER FROM 214

404. FROM 218 AND 221

405. At any time you became pregnant with (NAME), did you want to become pregnant then, 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?

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

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.

408. How many months pregnant were you when you first received antenatal care for this pregnancy?

409. How many times did you receive antenatal care during this pregnancy?

410. CHECK 409:
NUMBER OF TIMES RECEIVED ANTENATAL CARE

411. How many months pregnant were you the last time you received antenatal care?

412. During this pregnancy, were any of the following done at least once?

413. Were you told about the signs of pregnancy complications?

414. Were you told where to go if you had these complications?

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

416. During this pregnancy, how many times did you get this injection?

417. During this pregnancy, were you given or did you buy any iron/folic acid tablets?
SHOW IRON FOLATE TABLETS.

418. During the whole pregnancy, for how many days did you take the tablets?

IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER OF DAYS.

419. During this pregnancy, did you have difficulty with your vision during the daylight?

420. During this pregnancy, did you suffer from night blindness [USE LOCAL TERM]?

421. During this pregnancy, did you eat less than usual, about the same, or more than you ate before you got pregnant?

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

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

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

425. Was (NAME) delivered by caesarian section?

426. Was a special safe delivery kit used?
SHOW SAFE DELIVERY KIT MARKETED BY CRS.

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

428. How many days or weeks after the delivery did the first check take place?
RECORD '00' DAYS IF SAME DAY.

429. Who checked your health at that time?
PROBE FOR MOST QUALIFIED PERSON.

430. Where did this first check take place?

431. In the first two months after delivery, did you receive a vitamin A dose like this?
SHOW CAPSULE.

432. Has your period returned since the birth of (NAME)?

433. Did your period return between the birth of (NAME) and your next pregnancy?
ASK FOR ALL EXCEPT FIRST PREGNANCY.

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

435. CHECK 234: RESPONDENT PREGNANT?

436. Have you resumed sexual relations since the birth of (NAME)?

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

438. Did you ever breastfeed (NAME)?

439. 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.

440. Did you give (NAME) the yellow milk from the breast or did you squeeze it out and throw it away before you first put (NAME) to the breast?

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

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

443. CHECK 404: CHILD ALIVE?

444. Are you still breastfeeding (NAME)?

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

446. CHECK 404: CHILD ALIVE?

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

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

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

449A. Was sugar added to any of the foods or liquids (NAME) ate yesterday?

450. 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.

451. GO BACK TO 405 IN NEXT COLUMN; OR, IF NO MORE BIRTHS, GO TO 452.

SECTION 4B. IMMUNIZATION AND HEALTH

452. ENTER IN THE TABLE THE LINE NUMBER, NAME, AND SURVIVAL STATUS IF EACH BIRTH SINCE BAISAKH 1, 2052 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).

453. LINE NUMBER FROM 214.

454. FROM 218 AND 221

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

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

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.

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).

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

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

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

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

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

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

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

460F. How many times?

460G. An injection to prevent measles?

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

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

463. Do you remember the recent vitamin A capsule distribution?
IF NO, ASK: Does anyone in the household remember the event?
SPEAK TO THAT PERSON.

464. Did (NAME) receive a vitamin A capsule during the event in (Kartik/Baisakh)?
IF INTERVIEW IS BEFORE THE BAISAKH, ASK ABOUT KARTIK. IF INTERVIEW AFTER BAISAKH, ASK ABOUT BAISAKH.

465. Please tell me what happened when you took (NAME) for vitamin A?
SHOW CAPSULE. IF MENTIONS SPONTANEOUSLY, CIRCLE CODE '1'. FOR ALL NOT MENTIONED, PROBE, AND CIRCLE '2' IF YES AND '8' IF NO OR DON'T KNOW.

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

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

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

469. CHECK 466 AND 467:
FEVER OR COUGH?

470. Did you seek advice or treatment for the fever/cough?

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

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

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?

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?

475. Was he/she given a fluid made from a special packet such as Jeevan Jal to drink?

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

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

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

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

480. GO BACK TO 454 IN NEXT COLUMN; OR, IF NO MORE BIRTHS, GO TO 481.

481. CHECK 220 AND 223:
NUMBER IF CHILDREN BORN SINCE BAISAKH 1, 2052 AND LIVING WITH HER

482. What usually happens with your (youngest) child's stools when he/she does not use any toilet facility?

483. CHECK 475, ALL COLUMNS:

484. Have you ever heard of a special product called Jeevan Jal or NavaJeevan you can get for the treatment of diarrhea?

485. Have you ever seen a packet like these?
SHOW PACKET OF JEEVAL JAL, OTHER TYPES OF ORS.

486. CHECK 223:

487. When (your child/one of your children) is seriously ill, can you decide by yourself whether the child should be taken for medical treatment?
IF SAYS NO CHILD EVER 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?

488. 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, a small problem, or not a problem for you:

489. CHECK 220 AND 223:

490. Now I would like to ask you about liquids [NAME FROM Q. 489] drank over the last seven days, including yesterday.

How many days during the last seven days did [NAME] drink each of the following?

FOR EACH ITEM GIVEN AT LEAST ONCE IN LAST SEVEN DAYS, ASK: In total, how many times yesterday during the day or at night did [NAME] drink [ITEM]?

IF 7 OR MORE TIMES, RECORD '7'. IF DON'T KNOW, RECORD '8'.

491. Now I would like to ask you about the types of foods [NAME FROM Q. 489] ate over the last seven days, including yesterday.

How many days during the last seven days did [NAME] 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] eat [ITEM]?

IF 7 OR MORE TIMES, RECORD '7'. IF DON'T KNOW, RECORD '8'.

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

493. Do you smoke cigarettes or bidis or tobacco?

494. CHECK 493:

495. In the last 24 hours, how many cigarettes/bidis did you smoke?

SECTION 5. FERTILITY PREFERENCES

501. CHECK 118:

502. CHECK 311/311A:

503. CHECK 234:

504. CHECK 234:

505. CHECK 234:

506. CHECK 310: USING A METHOD?

507. CHECK 504:

508. CHECK 503:

PROBE: Any other reason?
RECORD ALL MENTIONED.

509. 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?

510. CHECK 310: USING A METHOD?

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

512. Which method would you prefer to use?

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

514. CHECK 221:

PROBE FOR A NUMERIC RESPONSE.

515. 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?

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

517. In the last few months, have you heard about family planning:

518. In the last few months, have you heard the following programs on the radio:

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

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

521. CHECK 118:

522. CHECK 311/311A:

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

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

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

526. CHECK 311/311A:

527. 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?

528. 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:

SECTION 6. HUSBAND'S BACKGROUND AND WOMAN'S WORK

601. CHECK 118:

602. How was your husband on his last birthday?

603. Did your (last) husband ever attend school?

604. What was the highest grade he completed?

605. CHECK 601:

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

607. 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?

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

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

610. CHECK 609:

611. 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?

612. Are you self-employed, employed by someone else, or do you do this work for a member of your family?

613. Do you usually work at home or away from home?

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

615. Are you paid in cash or kind for this work or are you not paid at all?

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

617. 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?

618. Do you own any land, either by yourself or jointly with someone else?

619. If you ever needed to, could you sell the land without anyone else's permission?

620. Do you own any livestock, such as goats or cows, either by yourself or jointly with someone else?

621. If you ever needed to, could you sell the animals without anyone else's permission?

622. Have you yourself ever taken a loan to start or expand a business?

623. How did you pay back the loan?

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

625. 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:

SECTION 7: AIDS AND SEXUAL BEHAVIOR

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

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

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

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

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

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

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

708. CHECK 118 AND 701:

709. Have you ever talked about ways to prevent getting the virus that causes AIDS with your husband?

710. 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?

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

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

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

714. Where is that?
IF SOURCE IS A HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

Any other place?
RECORD ALL MENTIONED.

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

716. RECORD THE TIME.

INTERVIEWER'S OBSERVATIONS

TO BE FILLED IN AFTER COMPLETING INTERVIEW

COMMENTS ABOUT RESPONDENT: __________________________________________

COMMENTS ABOUT SPECIFIC QUESTIONS: ______________________________________

ANY OTHER COMMENTS: ____________________________________

EDITOR'S OBSERVATIONS: ____________________

SUPERVISOR'S OBSERVATIONS: _________________________________

SENTENCES FOR LITERACY TEST