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PAKISTAN DEMOGRAPHIC AND HEALTH SURVEY 2017-18
EVER-MARRIED MAN'S QUESTIONNAIRE

PAKISTAN
NATIONAL INSTITUTE OF POPULATION STUDIES

IDENTIFICATION

PROVINCE/REGION

PUNJAB 1
SINDH 2
KPK 3
BALOCHISTAN 4
GB 5
ICT 6
AJK 7
FATA 8

DISTRICT ________

TEHSIL _______

NAME OF HOUSEHOLD HEAD ______

CLUSTER NUMBER ______

HOUSEHOLD NUMBER _________

NAME AND LINE NUMBER OF MAN _______

INTERVIEWER VISITS

FIRST VISIT
DATE _______
INTERVIWER'S NAME _______
RESULT* ______
NEXT VISIT DATE _____
TIME ______

SECOND VISIT
DATE _______
INTERVIWER'S NAME _______
RESULT* ______
NEXT VISIT DATE _____
TIME ______

THIRD VISIT
DATE _______
INTERVIWER'S NAME _______
RESULT* ______
NEXT VISIT DATE _____
TIME ______

FINAL VISIT
DAY _____
MONTH ______
YEAR _____
INT. NO. _______
RESULT* _______

TOTAL NUMBER OF VISITS _________

*RESULT CODES

1 COMPLETED
2 NOT AT HOME
3 POSTPONED
4 REFUSED
5 PARTLY COMPLETED
6 INCAPACITATED
7 OTHER (SPECIFY) _________

LANGUAGE OF QUESTIONNAIRE** 01
LANGUAGE OF QUESTIONNAIRE** ENGLISH
LANGUAGE OF INTERVIEW** ______
NATIVE LANGUAGE OF RESPONDENT** __________

TRANSLATOR USED

YES 1
NO 2

**LANGUAGE CODES

01 ENGLISH
02 URDU
03 SINDHI
04 PUNJABI
05 SARAIKI
06 BALUCHI
07 PUSHTO
08 OTHER

SUPERVISOR
NAME ________
NUMBER ___________

FIELD EDITOR
NAME _______
NUMBER ______

KEYED BY
NUMBER _________

INTRODUCTION AND CONSENT

Asalum-o-Alaikum. My name is _________. I am working with National Institute of Population Studies. We are conducting a survey about health and other topics all over Pakistan. The information we collect will help the government to plan health services. Your household was selected for the survey. The questions usually take about 30 to 35 minutes. All of the answers you give will be confidential and will not be shared with anyone other than members of our survey team. You don't have to be in the survey, but we hope you will agree to answer the questions since yours views are important. If I ask you any question you don't want to answer, just let me know and I will go on to the next question or you can stop the interview at any time.
In case you need more information about the survey, you may contact the person listed on the card that has already been given to your household.
Do you have any questions?
May I begin the interview now?

SIGNATURE OF INTERVIEWER __________
DATE ___________

RESPONDENT AGREES TO BE INTERVIEWED 1
RESPONDENT DOES NOT AGREE TO BE INTERVIEWED 2 (END)

SECTION 1. RESPONDENT'S BACKGROUND

101) RECORD THE TIME

HOURS ________
MINUTES _______

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)

109) What is the highest class you completed? IF COMPLETED LESS THAN CLASS ONE, RECORD '00.' IF MA, MPHIL, PHD, MBBS, OR BSC/4 YEARS, WRITE '16.'

CLASS _______

110) CHECK 109:

CLASS 00-09 (CONTINUE)
CLASS 10 OR HIGHER (GO TO 113)

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 PART OF THE SENTENCE 2
ABLE TO READ WHOLE SENTENCE 3
NO CARD WITH REQUIRED LANGUAGE (SPECIFY LANGUAGE) __________ 4
BLIND/VISUALLY IMPAIRED 5

112) CHECK 111:

CODE '2,' '3,' OR '4' CIRCLED
CODE '1' OR '5' CIRCLED (GO TO 114)

113) Do you read a newspaper or magazine at least once a week, less than once a week or not at all?

AT LEAST ONCE A WEEK 1
LESS THAN ONCE A WEEK 2
NOT AT ALL 3

114) Do you listen to the radio at least once a week, less than once a week, or not at all?

AT LEAST ONCE A WEEK 1
LESS THAN ONCE A WEEK 2
NOT AT ALL 3

115) Do you watch television at least once a week, less than once a week, or not at all?

AT LEAST ONCE A WEEK 1
LESS THAN ONCE A WEEK 2
NOT AT ALL 3

116) Do you own a mobile telephone?

YES 1
NO 2 (GO TO 118)

117) Do you use your mobile phone for any financial transactions?

YES 1
NO 2

118) Do you have an account in a bank or other financial institution that you yourself use?

YES 1
NO 2

119) Have you ever used the internet?

YES 1
NO 2 (GO TO 121A)

120) In the last 12 months, have you used the internet?
IF NECESSARY, PROBE FOR USE FROM ANY LOCATION, WITH ANY DEVICE.

YES 1
NO 2 (GO TO 121A)

121) During the last one month, how often did you use the internet: almost every day, at least once a week, less than once a week, or not at all?

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

121A) What is your mother tongue?

URDU 01
PUNJABI 02
SINDHI 03
PUSHTO 04
BALOCHI 05
ENGLISH 06
BARAUHI 07
SIRAIKI 08
HINDKO 09
KASHMIRI 10
SHINA 11
BRUSHASKI 12
WAKHI 13
CHITRALI/KHWAR 14
BALTI 15
PAHARI 16
POTOWARI 17
MARWARI 18
FARSI 19
OTHER 96

SECTION 2. REPRODUCTION

201) Now I would like to ask about any children you have had during your life. I am interested in all of the children that are biologically yours, even if they are not legally yours or do not have your last name. Have you ever fathered any children with your wife/wives?

YES 1
NO 2 (GO TO 206)
DON'T KNOW 8 (GO TO 206)

202) Do you have any sons or daughters who are now living with you?

YES 1
NO 2 (GO TO 204)

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

SONS AT HOME _________

b) And how many daughters live with you? IF NONE, RECORD '00.'

DAUGHTERS AT HOME _____

204) Do you have any sons or daughters who are alive but do not live with you?

YES 1
NO 2 (GO TO 206)

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

SONS ELSEWEHRE ________

b) And how many daughters are alive but do not live with you? IF NONE, RECORD '00.'

DAUGHTERS ELSEWHERE _________

206) Do you have a son or a daughter who was born alive but later died? IF NO, PROBE: Any baby who cried, who made any movement, sound, or effort to breathe, or who showed any other signs of life even if for a very short time?

YES 1
NO 2 (GO TO 208)
DON'T KNOW 8 (GO TO 208)

207) a) How many boys have died? IF NONE, RECORD '00.'

BOYS DEAD ________

b) And how many girls have died? IF NONE, RECORD '00.'

GIRLS DEAD ________

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

TOTAL CHILDREN _______

209) CHECK 208:

HAS HAD MORE THAN ONE CHILD
HAS HAD ONLY ONE CHILD (GO TO 211)
HAS NOT HAD ANY CHILDREN (GO TO 301)

210) Did all of the children have the same biological mother?

YES 1
NO 2

211) CHECK 208:

HAS HAD MORE THAN ONE CHILD: a) How old were you when your first child was born?

HAS HAD ONLY ONE CHILD: b) How old were you when your child was born?
AGE IN YEARS ________

212) CHECK 203 AND 205:

AT LEAST ONE LIVING CHILD (CONTINUE)
NO LIVING CHILDREN (GO TO 301)

213) CHECK 203 AND 205:

MORE THAN ONE LIVING CHILD: a) How old is your youngest child?

ONLY ONE LIVING CHILD: b) How old is your child?
AGE IN YEARS _______

214) CHECK 213:

(YOUNGEST) CHILD IS AGE 0-2 YEARS (CONTINUE)
(YOUNGEST) CHILD IS AGE 3 YEARS OR OLDER (GO TO 301)

215) CHECK 203 AND 205

MORE THAN ONE LIVING CHILD: a) What is the name of your youngest child?

ONLY ONE LIVING CHILD: b) What is the name of your child?
NAME OF (YOUNGEST) CHILD ___________

216) When (NAME)'s mother was pregnant with (NAME), did she have any antenatal check-ups?

YES 1
NO 2 (GO TO 218)
DON'T KNOW 8 (GO TO 218)

217) Were you ever present during any of those antenatal check-ups or did you just accompany your wife to any of those antenatal checkups?

PRESENT DURING CHECKUP 1
ONLY ACCOMPANIED 2
NOT PRESENT/NOT ACCOMPANIED 3

218) Was (NAME) born in a hospital or health facility?

HOSPITAL/HEALTH FACILITY 1
OTHER 2

219) When a child has diarrhea, how much should he or she be given to drink: more than usual, about the same as usual, less than usual, or nothing to drink at all?

MORE THAN USUAL 1
ABOUT THE SAME 2
LESS THAN USUAL 3
NOTHING TO DRINK 4
DON'T KNOW 8

SECTION 3. CONTRACEPTION

301) 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. Have you ever heard of (METHOD)?

01 FEMALE STERILIZATION. Women can have 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.
YES 1
NO 2
03 IUD. Women can have a loop or coil placed inside them by a doctor or a nurse which can prevent pregnancy up to ten years.
YES 1
NO 2
04 INJECTABLES. Women can have an injection by a health provider that stops them from becoming pregnant for one or more months.
YES 1
NO 2
05 IMPLANTS. Women can have one or more small rods placed in their upper arm by a doctor, nurse, or LHV which can prevent pregnancy up to five years.
YES 1
NO 2
06 PILL. Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2
07 CONDOM. Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
09 EMERGENCY CONTRACEPTION. As an emergency measure, within three days after they have unprotected sexual intercourse, women can take special pills to prevent pregnancy.
YES 1
NO 2
10 STANDARD DAYS METHOD. A woman uses a string of colored beads to know the days she can get pregnant. On the days she can get pregnant, she uses a condom or does not have sexual intercourse.
YES 1
NO 2
11 LACTATIONAL AMENORRHEA METHOD (LAM). Up to six months after childbirth, before the menstrual period has returned, women use a method requiring frequent breastfeeding day and night.
YES 1
NO 2
12 RHYTHM METHOD. To avoid pregnancy, women do not have sexual intercourse on the days of the month they think they can get pregnancy.
YES 1
NO 2
13 WITHDRAWAL. Men can be careful and pull out before climax.
YES 1
NO 2
14 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES, MODERN METHOD (SPECIFY) ________ A
YES, TRADITIONAL METHOD (SPECIFY) _______ B
NO Y

302) In the last few months have you:

a) Heard about family planning on the radio?
YES 1
NO 2
b) Seen anything about family planning on the television?
YES 1
NO 2
c) Read about family planning in a newspaper or magazine?
YES 1
NO 2
d) Received a voice or text message about family planning on a mobile phone?
YES 1
NO 2

302AA) CHECK 302:

HEARD MESSAGE (ANY YES IN 302) (CONTINUE)
NOT HEARD MESSAGE (GO TO 303)

302BB) What messages did it convey to you? Anything else? RECORD ALL MENTIONED.

LIMITING THE FAMILY A
DISADVANTAGES OF GETTING MARRIED AT A YOUNG AGE B
SPACING BIRTHS C
USE OF CONTRACEPTION D
FAMILY WELFARE E
MATERNAL AND CHILD HEALTH F
LESS CHILDREN MEANS PROSPEROUS LIFE G
MORE CHILDREN MEANS POVERTY AND STARVATION H
IMPORTANCE OF BREASTFEEDING I
IMPORTANCE OF GIRLS' EDUCATION J
REPRODUCTION IN MATERNAL DEATHS K
OTHER (SPECIFY) __________ X
DON'T KNOW/DO NOT REMEMBER Z

302CC) Do you think that the message you heard was effective or not effective in encouraging couples to use family planning?

EFFECTIVE 1
NOT EFFECTIVE 2
DON'T KNOW 8

303) In the last few months, have you discussed family planning with a health worker or health
professional?

YES 1
NO 2

304) Now I would like to ask you about a woman's risk of pregnancy. From one menstrual period to the next, are there certain days when a woman is more likely to become pregnant when she has sexual relations?

YES 1
NO 2 (GO TO 306)
DON'T KNOW 8 (GO TO 306)

305) 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

306) After the birth of a child, can a woman become pregnant before her menstrual period has returned?

YES 1
NO 2
DON'T KNOW 8

307) I will now read you some statements about contraception. Please tell me if you agree or disagree with each one.

a) Contraception is a woman's concern and a man should not have to worry about it.
AGREE 1
DISAGREE 2
DON'T KNOW 8
b) Women who use contraception may become promiscuous.
AGREE 1
DISAGREE 2
DON'T KNOW 8

307AA) Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2

SECTION 4. MARRIAGE AND SEXUAL ACTIVITY

401) Are you currently married?

YES, CURRENTLY MARRIED 1 (GO TO 404)
NO, NOT IN UNION 2

403) What is your marital status now: are you widowed, divorced, or separated?

WIDOWED 1 (GO TO 410)
DIVORCED 2 (GO TO 410)
SEPARATED 3 (GO TO 410)

404) Is your wife living with you now or is she staying elsewhere?

LIVING WITH HIM 1
STAYING ELSEWHERE 2

405) Do you have other wives?

YES (MORE THAN ONE WIFE) 1
NO (ONLY ONE WIFE) 2 (GO TO 407)

406) Altogether, how many wives do you have?

TOTAL NUMBER OF WIVES _______

407) CHECK 405: RECORD THE NAME OF THE LINE NUMBER FROM THE HOUSEHOLD QUESTIONNAIRE FOR EACH WIFE. IF WOMAN IS NOT LSITED IN THE HOUSEHOLD, RECORD '00.'

ONE WIFE: a) Please tell me the name of your wife.

MORE THAN ONE WIFE: b) Please tell me the name of each of your wives.
NAME _________
LINE NUMBER _______

NAME _______
LINE NUMBER _______

NAME __________
LINE NUMBER ________

408) How old was (NAME) on her last birthday?

AGE _______

AGE ______

AGE ________

409) CHECK 407:

ONE WIFE (CONTINUE)
MORE THAN ONE WIFE (GO TO 411)

410) Have you been married or lived with a woman only once or more than once?

MORE THAN ONCE 1
ONLY ONCE 2

411) CHECK 405 AND 410:

BOTH ARE CODE '2': a) In what month and year did you start living with your wife?

OTHER: b) Now I would like to ask about your first wife. In what month and year did you start living with her?
MONTH _________
DON'T KNOW MONTH 98
YEAR __________ (GO TO 413)
DON'T KNOW YEAR 9998

412) How old were you when you first started living with her?

AGE ________

413) CHECK FOR PRESENCE OF OTHERS. BEFORE CONTINUING, MAKE EVERY EFFORT TO ENSURE PRIVACY.

414) I would like to ask some questions about sexual activity in order to gain a better understanding of some important life issues. Let me assure you again that your answers are completely confidential and will not be told to anyone. If we should come to any question that you don't want to answer, just let me know and we will go to the next question. How old were you when you had sexual intercourse for the very first time?

NEVER HAD SEXUAL INTERCOURSE 00 (GO TO 501)
AGE IN YEARS ______

414A) CHECK 401:

CURRENTLY MARRIED
WIDOWED/DIVORCED/SEPARATED (GO TO 501)

415) I would like to ask you about your recent sexual activity. When was the last time you had sexual intercourse? IF LESS THAN 12 MONTHS, ANSWER MUST BE RECORDED IN DAYS, WEEKS, OR MONTHS. IF 12 MONTHS (ONE YEAR) OR MORE, ANSWER MUST BE RECORDED IN YEARS.

DAYS AGO 1 _______
WEEKS AGO 2 _______
MONTHS AGO 3 _______
YEARS AGO 4 ______

438) The last time you had sex did you or your wife use any method to avoid or prevent a pregnancy?

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

439) What method did you or your wife use? PROBE: Did you or your wife use any other method to prevent pregnancy?

FEMALE STERILIZATION A
MALE STERILIZATION B
IUD C
INJECTABLES D
IMPLANTS E
PILL F
CONDOM G
EMERGENCY CONTRACEPTION I
STANDARD DAYS METHOD J
LAM K
RHYTHM METHOD L
WITHDRAWAL M
OTHER MODERN METHOD X
OTHER TRADITIONAL METHOD Y

SECTION 5. FERTILITY PREFERENCES

501) CHECK 401:

CURRENTLY MARRIED (CONTINUE)
WIDOWED/DIVORCED/SEPARATED (GO TO 514)

502) CHECK 439:

MAN NOT STERILIZED (CONTINUE)
MAN STERILIZED (GO TO 514)

503) CHECK 407:

ONE WIFE (CONTINUE)
MORE THAN ONE WIFE (GO TO 509)

504) Is your wife currently pregnant?

YES 1
NO 2 (GO TO 507)
DON'T KNOW 8 (GO TO 507)

505) Now I have some questions about the future. After the child you and your wife are expecting now, would you like to have another child, or would you prefer not to have any more children?

HAVE ANOTHER CHILD 1
NO MORE 2 (GO TO 514)
UNDECIDED/DON'T KNOW 8 (GO TO 514)

506) 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 ________ (GO TO 514)
YEARS 2 ________ (GO TO 514)
SOON/NOW 993 (GO TO 514)
OTHER (SPECIFY) 996 _______(GO TO 514)
DON'T KNOW 998 (GO TO 514)

507) CHECK 208:

HAS FATHERED CHILDREN: a) Now I have some questions about the future. Would you like to have another child, or would you prefer not to have any more children?

HAS NOT FATHERED CHILDREN: b) Now I have some questions about the future. Would you like to have a child, or would you prefer not to have any children?
HAVE A/ANOTHER CHILD 1
NO MORE/NONE 2 (GO TO 514)
SAYS COUPLE CAN'T GET PREGNANT 3 (GO TO 514)
WIFE STERILIZED 4 (GO TO 514)
UNDECIDED/DON'T KNOW 8 (GO TO 514)

508) CHECK 208:

HAS FATHERED CHILDREN: a) How long would you like to wait from now before the birth of another child?

HAS NOT FATHERED CHILDREN: b) How long would you like to wait from now before the birth of a child?
MONTHS 1 ________ (GO TO 514)
YEARS 2 ________ (GO TO 514)
SOON/NOW 993 (GO TO 514)
SAYS COUPLE CAN'T GET PREGNANT 994 (GO TO 514)
OTHER (SPECIFY) 996 _______(GO TO 514)
DON'T KNOW 998 (GO TO 514)

509) Are any of your wives currently pregnant?

YES 1
NO 2 (GO TO 512)
DON'T KNOW 8 (GO TO 512)

510) Now I have some questions about the future. After the (child/children) you and your wives are expecting now, would you like to have another child, or would you prefer not to have any more children?

HAVE ANOTHER CHILD 1
NO MORE 2 (GO TO 514)
UNDECIDED/DON'T KNOW 8 (GO TO 514)

511) 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 ________ (GO TO 514)
YEARS 2 ________ (GO TO 514)
SOON/NOW 993 (GO TO 514)
OTHER (SPECIFY) 996 _______(GO TO 514)
DON'T KNOW 998 (GO TO 514)

512) CHECK 208:

HAS FATHERED CHILDREN: a) Now I have some questions about the future. Would you like to have another child, or would you prefer not to have any more children?

HAS NOT FATHERED CHILDREN: b) Now I have some questions about the future. Would you like to have a child, or would you prefer not to have any children?
HAVE A/ANOTHER CHILD 1
NO MORE/NONE 2 (GO TO 514)
SAYS COUPLE CAN'T GET PREGNANT 3 (GO TO 514)
WIFE/WIVES STERILIZED 4 (GO TO 514)
UNDECIDED/DON'T KNOW 8 (GO TO 514)

513) CHECK 208:

HAS FATHERED CHILDREN: a) How long would you like to wait from now before the birth of another child?

HAS NOT FATHERED CHILDREN: b) How long would you like to wait from now before the birth of a child?
MONTHS 1 ________ (GO TO 514)
YEARS 2 ________ (GO TO 514)
SOON/NOW 993 (GO TO 514)
SAYS COUPLE CAN'T GET PREGNANT 994 (GO TO 514)
OTHER (SPECIFY) 996 _______(GO TO 514)
DON'T KNOW 998 (GO TO 514)

514) CHECK 203 AND 205:

HAS LIVING CHILDREN: a) 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: b) If you could choose exactly the number of children to have in your whole life, how many would that be?
NONE 00 (GO TO 601)
NUMBER _____
OTHER (SPECIFY) __________ 96 (GO TO 601)

515) How many of these children would you like to be boys, and how many would you like to be girls and for how many would it not matter if it's a boy or a girl?

NUMBER OF BOYS ________
NUMBERS OF GIRLS _______
EITHER ________
OTHER (SPECIFY) ________ 96

SECTION 6. EMPLOYMENT AND GENDER ROLES

601) Have you done any work in the last seven days?

YES 1 (GO TO 604)
NO 2

602) Although you did not work in the last seven days, do you have any job or business from which you were absent for leave, illness, vacation, or any other such reason?

YES 1 (GO TO 6040
NO 2

603) Have you done any work in the last 12 months?

YES 1
NO 2 (GO TO 607)

604) What is your occupation? That is, what kind of work do you mainly do?

_________
_________
_________

605) 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

606) Are you paid in cash or kind for this work or are you not paid at all?

CASH ONLY 1
CASH AND KIND 2
KIND ONLY 3
NOT PAID 4

607) CHECK 401:

CURRENTLY MARRIED (CONTINUE)
WIDOWED/DIVORCED/SEPARATED (GO TO 612)

608) CHECK 606:

CODE '1' OR '2' CIRCLED (CONTINUE)
OTHER (GO TO 610)

609) Who usually decides how the money you earn will be used: you, your wife, or you and your wife jointly?

RESPONDENT 1
WIFE 2
RESPONDENT AND WIFE JOINTLY 3
OTHER (SPECIFY) _______ 6

610) Who usually makes decisions about health care for yourself: you, your wife, you and your wife jointly, or someone else?

RESPONDENT 1
WIFE 2
RESPONDENT AND WIFE JOINTLY 3
SOMEONE ELSE 4
OTHER (SPECIFY) _______ 6

611) Who usually makes decisions about making major household purchases?

RESPONDENT 1
WIFE 2
RESPONDENT AND WIFE JOINTLY 3
SOMEONE ELSE 4
OTHER (SPECIFY) _______ 6

612) Do you own this or any other house either alone or jointly with someone else?

ALONE ONLY 1
JOINTLY ONLY 2
BOTH ALONE AND JOINTLY 3
DOES NOT OWN 4 (GO TO 615)

613) Do you have a title deed for any house you own?

YES 1
NO 2 (GO TO 615)
DON'T KNOW 8 (GO TO 615)

614) Is your name on the title deed?

YES 1
NO 2
DON'T KNOW 8

614A) Do you have the autonomy to sell the house you own?

YES 1
NO 2

615) Do you own any agricultural or non-agricultural land either alone or jointly with someone else?

ALONE ONLY 1
JOINTLY ONLY 2
BOTH ALONE AND JOINTLY 3
DOES NOT OWN 4 (GO TO 618)

616) Do you have a title deed for any land you own?

YES 1
NO 2 (GO TO 618)
DON'T KNOW 8 (GO TO 618)

617) Is your name on the title deed?

YES 1
NO 2
DON'T KNOW 8

617A) Do you have the autonomy to sell the land you own?

YES 1
NO 2

618) In your opinion, is a husband justified in hitting or beating his wife in the following situations:

a) If she goes out without telling him?
YES 1
NO 2
DON'T KNOW 8
b) If she neglects the children?
YES 1
NO 2
DON'T KNOW 8
c) If she argues with him?
YES 1
NO 2
DON'T KNOW 8
d) If she refuses to have sex with him?
YES 1
NO 2
DON'T KNOW 8
e) If she burns the food?
YES 1
NO 2
DON'T KNOW 8
f) If she neglects the in-laws?
YES 1
NO 2
DON'T KNOW 8

SECTION 7. HIV/AIDS

701) Now I would like to talk about something else. Have you ever heard of HIV or AIDS?

YES 1
NO 2 (GO TO 727)

702) HIV is the virus that can lead to AIDS. Can people reduce their chance of getting HIV by having just one uninfected sex partner who has no other sex partners?

YES 1
NO 2
DON'T KNOW 8

703) Can people get HIV from mosquito bites?

YES 1
NO 2
DON'T KNOW 8

704) Can people reduce their chance of getting HIV by using a condom every time they have sex?

YES 1
NO 2
DON'T KNOW 8

705) Can people get HIV by sharing food with a person who has HIV?

YES 1
NO 2
DON'T KNOW 8

706) Can people get HIV by witchcraft or other supernatural means?

YES 1
NO 2
DON'T KNOW 8

707) Is it possible for a healthy-looking person to have HIV?

YES 1
NO 2
DON'T KNOW 8

708) Can HIV be transmitted from a mother to a baby:

a) During pregnancy?
YES 1
NO 2
DON'T KNOW 8
b) During delivery?
YES 1
NO 2
DON'T KNOW 8
c) By breastfeeding?
YES 1
NO 2
DON'T KNOW 8

709) CHECK 708:

AT LEAST ONE 'YES' (CONTINUE)
OTHER (GO TO 711)

710) Are there any special drugs that a doctor or a nurse can give a woman infected with HIV to reduce the risk of transmission to the baby?

YES 1
NO 2
DON'T KNOW 8

711) CHECK FOR PRESENCE OF OTHERS. BEFORE CONTINUING, MAKE EVERY EFFORT TO ENSURE PRIVACY.

712) I don't want to know the results, but have you ever been tested for HIV?

YES 1
NO 2 (GO TO 716)

713) How many months ago was your most recent HIV test?

MONTHS AGO _____
TWO OR MORE YEARS AGO 95

714) I don't want to know the results, but did you get the results of the test?

YES 1
NO 2

715) Where was the test done? PROBE TO IDENTIFY THE TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

NAME OF PLACE ___________

PUBLIC SECTOR
GOVERNMENT HOSPITAL 11 (GO TO 717A)
GOVERNMENT HEALTH CENTER 12 (GO TO 717A)
STAND-ALONE HTC CENTER 13 (GO TO 717A)
OTHER PUBLIC SECTOR (SPECIFY) ______ 16 (GO TO 717A)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR 21 (GO TO 717A)
STAND-ALONE HTC CENTER 22 (GO TO 717A)
PHARMACY 23 (GO TO 717A)
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ________ 26 (GO TO 717A)
OTHER SOURCE
HOME 31 (GO TO 717A)
WORKPLACE 32 (GO TO 717A)
OTHER (SPECIFY) _____________ 96 (GO TO 717A)

716) Do you know of a place where people can go to get an HIV test?

YES 1
NO 2 (GO TO 717A)

717) Where is that? Any other place? PROBE TO IDENTIFY THE TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

NAME OF PLACE ___________

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
STAND-ALONE HTC CENTER C
OTHER PUBLIC SECTOR (SPECIFY) _________ D
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR E
STAND-ALONE HTC CENTER F
PHARMACY G
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) _______ H
OTHER (SPECIFY) _______ X

717A) Do you think there is a treatment for HIV?

YES 1
NO 2 (GO TO 720)
DON'T KNOW/NOT SURE/DEPENDS 8 (GO TO 720)

717B) Do you know from where HIV treatment (Anti Retroviral Treatment) can be received?

YES 1
NO 2

720) Would you buy fresh vegetables from a shopkeeper or vendor if you know that this person had HIV?

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

721) Do you think children living with HIV should be allowed to attend school with children who do not have HIV?

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

722) Do you think people hesitate to take an HIV test because they are afraid of how other people will react if the test result is positive for HIV?

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

723) Do people talk badly about people living with HIV, or who are thought to be living with HIV?

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

724) Do people living with HIV, or thought to be living with HIV, lose the respect of other people?

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

724A) Do people living with HIV get discriminatory treatment from the health service providers?

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

725) Do you agree or disagree with the following statement: I would be ashamed if someone in my family had HIV.

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

726) Do you fear that you could get HIV if you come into contact with the saliva of a person living with HIV?

YES 1
NO 2
SAYS HE HAS HIV 3
DON'T KNOW/NOT SURE/DEPENDS 8

727) CHECK 701:

HEARD ABOUT HIV AIDS: a) Apart from HIV, have you heard about other infections that can be transmitted through sexual contact?

NOT HEARD ABOUT HIV OR AIDS: b) Have you heard about infections that can be transmitted through sexual contact?
YES 1
NO 2

728) CHECK 414:

HAS HAD SEXUAL INTERCOURSE (CONTINUE)
HAS NEVER HAD SEXUAL INTERCOURSE (GO TO 736)

729) CHECK 727: HEARD ABOUT OTHER SEXUALLY TRANSMITTED INFECTIONS?

YES (CONTINUE)
NO (GO TO 731)

730) 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 disease which you got through sexual contact?

YES 1
NO 2
DON'T KNOW 8

731) Sometimes women experience an abnormal discharge from their penis. During the last 12 months, have you had an abnormal discharge from their penis?

YES 1
NO 2
DON'T KNOW 8

732) Sometimes men have a sore or ulcer near their penis. During the last 12 months, have you had a sore or ulcer near your penis?

YES 1
NO 2
DON'T KNOW 8

733) CHECK 730, 731 AND 732:

HAS HAD AN INFECTION (ANY 'YES')
HAS NOT HAD AN INFECTION OR DOES NOT KNOW (GO TO 736)

734) The last time you had (PROBLEM FROM 730/731/732), did you seek any kind of advice or treatment?

YES 1
NO 2 (GO TO 736)

735) Where did you go? Any other place? PROBE TO IDENTIFY THE TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

NAME OF PLACE ____________

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
STAND-ALONE HTC CENTER C
FAMILY PLANNING CLINIC D
MOBILE HTC SERVICES E
OTHER PUBLIC SECTOR (SPECIFY) _________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC/PRIVATE DOCTOR G
STAND-ALONE HTC CENTER H
PHARMACY I
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ________ J
OTHER SOURCE
SHOP K
OTHER (SPECIFY) _________ X

736) If a wife knows her husband has a disease that she can get during sexual intercourse, is she justified in asking that they use a condom when they have sex?

YES 1
NO 2
DON'T KNOW 8

737) Is a wife justified in refusing to have sex with her husband when she knows he has sex with women other than his wives?

YES 1
NO 2
DON'T KNOW 8

SECTION 8. OTHER HEALTH ISSUES

805) Now I would like to ask you some other questions relating to health matters. Have you had an injection for any reason in the last 12 months? IF YES: How many injections have you had? IF NUMBER OF INJECTIONS IS 90 OR MORE, OR DAILY FOR 3 MONTHS OR MORE, RECORD '90.' IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE.

NUMBER OF INJECTIONS ______
NONE 00 (GO TO 808)

806) Among these injections, how many were administered by a doctor, a nurse, a pharmacist, a dentist, or any other health worker? IF NUMBER OF INJECTIONS IS 90 OR MORE, OR DAILY FOR 3 MONTHS OR MORE, RECORD '90.' IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE.

NUMBER OF INJECTIONS _______
NONE 00 (GO TO 808)

807) The last time you got an injection from a health worker, did he/she take the syringe and needle from a new, unopened package?

YES 1
NO 2
DON'T KNOW 8

808) Do you currently smoke tobacco every day, some days, or not at all?

EVERY DAY 1 (GO TO 811)
SOME DAYS 2
NOT AT ALL 3 (GO TO 810)

809) In the past, have you smoked tobacco every day?

YES 1 (GO TO 812)
NO 2 (GO TO 812)

810) In the past, have you ever smoked tobacco every day, some days, or not at all?

EVERY DAY 1 (GO TO 812AA)
SOME DAYS 2 (GO TO 812AA)
NOT AT ALL 3 (GO TO 813)

811) On average, how many of the following products do you currently smoke each day? Also, let me know if you use the product, but not every day. IF RESPONDENT REPORTS USING THE PRODUCT BUT NOT EVERY DAY, RECORD '888.' IF THE PRODUCT IS NOT USED AT ALL, RECORD '000.'

a) Manufactured cigarettes?
NUMBER DAILY _______ (GO TO 812AA)
b) Hand-rolled cigarettes?
NUMBER DAILY _______ (GO TO 812AA)
c) Kreteks?
NUMBER DAILY _______ (GO TO 812AA)
d) Pipes full of tobacco?
NUMBER DAILY _______ (GO TO 812AA)
e) Cigars, cheroots, or cigarillos?
NUMBER DAILY _______ (GO TO 812AA)
f) Number of water pipe (hukka, sheesha) sessions?
NUMBER DAILY _______ (GO TO 812AA)
g) Any others?
NUMBER DAILY _______ (GO TO 812AA)
SPECIFY ____________

812) On average, how many of the following products do you currently smoke each week? Also, let me know if you use the product, but not every week. IF RESPONDENT REPORTS USING THE PRODUCT BUT NOT EVERY DAY, RECORD '888.' IF THE PRODUCT IS NOT USED AT ALL, RECORD '000.'

a) Manufactured cigarettes?
NUMBER WEEKLY _______
b) Hand-rolled cigarettes?
NUMBER WEEKLY _______
c) Kreteks?
NUMBER WEEKLY _______
d) Pipes full of tobacco?
NUMBER WEEKLY _______
e) Cigars, cheroots, or cigarillos?
NUMBER WEEKLY _______
f) Number of water pipe (hukka, sheesha) sessions?
NUMBER WEEKLY _______
g) Any others?
NUMBER WEEKLY _______
SPECIFY ____________

812AA) How old were you when you started smoking?

AGE IN YEARS ______
DON'T KNOW 98

813) Do you currently use smokeless tobacco every day, some days, or not at all?

EVERY DAY 1
SOME DAYS 2 (GO TO 815)
NOT AT ALL 3 (GO TO 815AA)

814) On average, how many times a day do you use the following products? Also, let me know if you the product, but not every day. IF RESPONDENT REPORTS USING THE PRODUCT BUT NOT EVERY DAY, RECORD '888.' IF THE PRODUCT IS NOT USED AT ALL, RECORD '000.'

a) Snuff, by mouth?
TIMES DAILY _____ (GO TO 815AA)
b) Snuff, by nose?
TIMES DAILY _____ (GO TO 815AA)
c) Chewing tobacco/nuswar?
TIMES DAILY _____ (GO TO 815AA)
d) Betel quid (paan) with tobacco?
TIMES DAILY _____ (GO TO 815AA)
e) Any others?
TIMES DAILY _____ (GO TO 815AA)
SPECIFY _________

815) On average, how many times a week do you use the following products? Also, let me know if you the product, but not every week. IF RESPONDENT REPORTS USING THE PRODUCT BUT NOT EVERY WEEK, RECORD '888.' IF THE PRODUCT IS NOT USED AT ALL, RECORD '000.'

a) Snuff, by mouth?
TIMES WEEKLY _____
b) Snuff, by nose?
TIMES WEEKLY _____
c) Chewing tobacco/nuswar?
TIMES WEEKLY _____
d) Betel quid (paan) with tobacco?
TIMES WEEKLY _____
e) Any others?
TIMES WEEKLY _____
SPECIFY _________

815AA) Do you currently use any types of drugs?

YES 1
NO 2

815BB) Have you ever heard of an illness called tuberculosis or TB?

YES 1
NO 2 (GO TO 815GG)

815CC) How does tuberculosis spread from one person to another? Any other ways? RECORD ALL MENTIONED.

THROUGH AIR WHEN COUGHING OR SNEEZING A
BY SHARING UTENSILS B
BY TOUCHING A PERSON WITH TB C
THROUGH SHARING FOOD D
THROUGH SEXUAL CONTACT E
THROUGH MOSQUITO BITES F
OTHER (SPECIFY) _________ X
DON'T KNOW Z

815DD) Can tuberculosis be cured?

YES 1
NO 2 (GO TO 815FF)
DON'T KNOW 8 (GO TO 815FF)

815EE) What is the duration of treatment of TB now a days? IF MORE THAN 7 MONTHS, RECORD 7.

MONTHS _____
DON'T KNOW 8

815FF) Have you ever been told by a doctor or nurse or LHV that god forbid you to have/had tuberculosis?

YES 1
NO 2

815GG) Have you ever heard of illness called Hepatitis B or C?

YES 1
NO 2 (GO TO 816)

815HH) Is there anything a person can do to avoid getting Hepatitis B or C?

YES 1
NO 2 (GO TO 815JJ)
DON'T KNOW 8 (GO TO 815JJ)

815II) What can a person do to avoid getting Hepatitis B or C? Any other ways? RECORD ALL MENTIONED.

PRACTICE SAFE SEX A
SAFE BLOOD TRANSFER B
USE DISPOSABLE SYRINGES C
AVOID CONTAMINATED FOOD/WASTE D
AVOID CONTACT WITH INFECTED PERSONS E
ENSURE INSTRUMENTS OF DENTISTS ARE PROPERLY STERILIZED F
OTHER (SPECIFY) ________ X
DON'T KNOW Z

815JJ) I don't want to know the results, but have you ever been tested for Hepatitis B or C?

YES 1
NO 2 (GO TO 816)

815KK) How many months ago was your most recent test for Hepatitis B or C?

MONTHS __________
TWO OR MORE YEARS 95

816) Are you covered by any health insurance?

YES 1
NO 2 (GO TO 817A)

817) What type of health insurance are you covered by? RECORD ALL MENTIONED.

MUTUAL HEALTH ORGANIZAITON/COMMUNITY-BASED HEALTH INSURANCE A
HEALTH INSURANCE THROUGH EMPLOYER B
SEHAT SAHULAT C
OTHER PRIVATELY PURCHASED COMMERCIAL HEALTH INSURANCE D
OTHER (SPECIFY) _________ X

817A) Do you receive any cash/kind benefit from Benazir Income Support Program through the government of Pakistan?

YES 1
NO 2

818) RECORD THE TIME.

HOURS _______
MINUTES ______

INTERVIEWER'S OBSERVATIONS

TO BE FILLED IN AFTER COMPLETING INTERVIEW

COMMENTS ABOUT INTERVIEW: ______________________

COMMENTS ON SPECIFIC QUESTIONS: _______________________

ANY OTHER COMMENTS: ______________________

SUPERVISOR'S OBSERVATIONS:_____________

EDITOR'S OBSERVATIONS ______________________