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DEMOGRAPHIC AND HEALTH SURVEY-REPUBLIC OF RWANDA 2000-MAN'S QUESTIONNAIRE

IDENTIFICATION

PLACE NAME_____

NAME OF HEAD OF HOUSEHOLD____

PREFECTURE (ADMINISTRATIVE CENTER)____

TOWN OR MUNICIPALITY____

SECTOR____

SUB-SECTOR____

HOUSEHOLD NUMBER___

URBAN/RURAL

URBAN 1
RURAL 2

LARGE CITY, OTHER CITY, OR RURAL?

KIGALI 1
OTHER CITY 2
RURAL 3

NAME AND LINE NUMBER OF MAN___

INTERVIEWER VISITS

FIRST VISIT (REPEAT FOR SECOND AND THIRD VISITS)
DATE____
INTERVIEWER NAME____
RESULT___

RESULT

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

NEXT VISIT (FOR INTERVIEWERS 1 AND 2)
DATE___
TIME___

FINAL VISIT
DAY___
MONTH___
YEAR: 2000
NAME___
RESULT___

TOTAL NUMBER OF VISITS___

LANGUAGE OF INTERVIEW:

KINYARWANDA 1
OTHER LANGUAGE_____ 2

INTERPRETER USED?

YES 1
NO 2

FIELD EDITOR
NAME___
DATE___

SUPERVISOR
NAME___
DATE___

OFFICE EDITOR____

KEYED BY___

SECTION 1. RESPONDENT'S BACKGROUND

INTRODUCTION AND CONSENT

INFORMED CONSENT

Hello, my name is _____ and I work for (NAME OF ORGANIZATION). We are conducting a national survey on the health of men, women, and children. We hope you will participate in this survey. I would like to ask you some questions about your health and your family. This information will help the government to plan health services. The interview takes generally between 10 and 20 minutes. The information that you provide will be kept strictly confidential and will not be shared with anyone.

Participation is voluntary and you can refuse to answer any particular question or all the questions. We hope, however, that you will participate in this survey as your opinion is important to us.

Do you have any questions about the survey? May I begin the interview?

SIGNATURE OF INTERVIEWER:_______
DATE:______

RESPONDENT AGREES TO BE INTERVIEWED 1 (GO TO 101)
RESPONDENT DOES NOT AGREE TO BE INTERVIEWED 2 (END INTERVIEW)

101. RECORD THE TIME.

HOUR____
MINUTES____

102. To begin, I would like to ask you some questions about yourself and your household. Until the age of 12, did you mostly live in Kigali, in another city, or in a rural area?

KIGALI 1
OTHER CITY 2
RURAL 3

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

NUMBER OF YEARS_____

ALWAYS 95 (GO TO 107)
VISITOR (GO TO 107)

104. Just before moving here, did you live in the city of Kigali, another city, or a rural area?

CITY OF KIGALI 1
ANOTHER CITY 2
RURAL AREA 3

104A. In the past 12 months, have you been away from your community for more than a month at a time?

YES 1
NO 2
?

104B. In the past 12 months, how many times did you travel and sleep outside your community?

NUMBER OF TRIPS____

107. In what month and year were you born?

MONTH____
DON'T KNOW MONTH 98
YEAR_____
DON'T KNOW YEAR 9998

108. How old were you at your last birthday?
COMPARE AND CORRECT 107 AND/OR 108 IF INCONSISTENT

AGE IN COMPLETED YEARS____

109. Have you ever attended school?

YES 1
NO 2 (GO TO 113)

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

PRIMARY 1
POST-PRIMARY 2
SECONDARY 3
HIGHER 4

111. What was the last (class/year) you successfully completed at this level?

CLASS_____

112. CHECK 110:

PRIMARY (GO TO 113)
POST-PRIMARY AND HIGHER (GO TO 116)

113. Now I would like you to read this sentence to me; read as much as you can.
SHOW CARD TO RESPONDENT

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

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

YES 1
NO 2

115. CHECK 113:

CODE '2 ', '3' OR '4' CIRCLED (GO TO 116)
CODE '1' CIRCLED (GO TO 117)

116. Do you read a newspaper or magazine 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

117. Do you listen to the radio 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

118. Do you watch television 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

119. Do you currently have a job, whatever it may be, for which you earn money?

YES 1 (GO TO 122)
NO 2

120. In the past 12 months, have you had a job, whatever it might be, for which you earned money?

YES 1 (GO TO 122)
NO 2

121. What have you been doing for most of the time over the last 12 months?

GOING TO SCHOOL 1 (GO TO 131)
LOOKING FOR WORK 2 (GO TO 131)
RETIRED 3 (GO TO 131)
UNABLE TO WORK/HANDICAPPED 4 (GO TO 131)
OTHER (SPECIFY) _______ 6 (GO TO 131)

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

OCCUPATION____

123. CHECK 122:

WORKS IN AGRICULTURE (GO TO 124)
DOES NOT WORK IN AGRICULTURE (GO TO 125)

124. Do you work mainly on your own land or on family land, 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
SHARED LAND 5

125. Do you do this work for family member, somebody else, or are you self-employed?

FOR FAMILY MEMBER 1
FOR SOMEBODY ELSE 2
ON HIS OWN 3

126. Do you usually work throughout the year, seasonally, or only from time to time?

THROUGHOUT THE YEAR 1 (GO TO 128)
SEASONALLY/ PART OF THE YEAR 2
FROM TIME TO TIME 3

127. During the last 12 months, how many months did you work?

NUMBER OF MONTHS_____

128. How many people, including yourself, depend on the money you earn?

NUMBER OF PEOPLE___

129. Do you think what you earn is sufficient for your needs (and for the needs of your dependents)?

YES 1
NO 2

130. On average, how much of your household expenses are paid with the money you earn: almost none, less than half, nearly half, more than half, or all?

ALMOST NONE 1
LESS THAN HALF 2
NEARLY HALF 3
MORE THAN HALF 4
ALL 5
NOTHING, ALL REVENUE IS SAVED 6

131. Have you ever drunk alcohol?

YES 1
NO 2 (GO TO 136)

132. Have you ever gotten drunk after drinking alcoholic beverages?

YES 1
NO 2

133. In the past three months, how many days did you drink alcoholic beverages?

NUMBER OF DAYS_____
NONE/NEVER 97 (GO TO 136)

134. CHECK 132:

YES, HAS BEEN DRUNK (GO TO 135)
NO, NEVER BEEN DRUNK (GO TO 136)

135. Over the past 3 months, how many times have you been drunk?

NUMBER OF TIMES____
NONE/NEVER 97

136. During the last 3 months, have you had an injection?

YES 1
NO 2 (GO TO 201)

137. During the last 3 months, how many times have you had an injection?

NUMBER OF INJECTIONS____
EACH DAY 96

138. The last time you had an injection who gave you the shot?

HEALTHCARE PROFESSIONAL 1
PHARMACIST 2
TRADITIONAL HEALER 3
FRIEND/RELATIVE 4
YOURSELF 5
OTHER 6 (SPECIFY)________

SECTION 2: REPRODUCTION

201. Now, I would like to ask about your children. I am interested only in the children that are biologically yours. Do you have or did you have children?

YES 1
NO 2 (GO TO 206)

202. Do you have any sons or daughters that you have fathered who are now living with you?

YES 1
NO 2 (GO TO 204)

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

SONS AT HOME___
DAUGHTERS AT HOME____

204. Do you have any sons or daughters whom you have fathered who are still 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? How many daughters are alive but do not live with you?
IF NONE, RECORD '00'.

SONS ELSEWHERE_____
DAUGHTERS ELSEWHERE____

206. Have you ever fathered a son or a daughter who was born alive but later died?
IF NO, PROBE: Any baby who cried or showed signs of life but only survived a few hours or days?

YES 1
NO 2 (GO TO 208)

207. How many boys have died? 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:
I want to make sure I have this right: during your life, you have had in TOTAL _____ children of which you were the father. Is that correct?

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

210. CHECK 208:

HAD MORE THAN ONE CHILD (GO TO 211)
ONLY HAD ONE CHILD (GO TO 213)
HAS NOT HAD ANY CHILDREN (GO TO 214)

211. Do all the children of whom you are the father have the same biological mother?

YES 1 (GO TO 213)
NO 2

212. In all, with how many women have you fathered children?

NUMBER OF WOMEN_____

213. In what month and year was your first child born?

MONTH_____
YEAR_____

214. Now I would like to ask you about the risks of pregnancy. Between one menstrual cycle and the next, is there a time when a woman is more likely to get pregnant than others if she has sexual relations?

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

215. 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
IN THE MIDDLE OF 2 PERIODS 4
OTHER (SPECIFY)_______ 5
DON'T KNOW 6

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
02) MALE STERILIZATION: Men can have an operation to avoid having any more children.
YES 1
NO 2
03) PILL: Women can take a pill every day.
YES 1
NO 2
04) IUD: Women can have an IUD placed inside them by a doctor or a nurse.
YES 1
NO 2
05) INJECTABLES: Women can have an injection by a health provider which stops them from becoming pregnant for one or more 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 diaphragm in their vagina before sexual 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/PERIODIC ABSTINENCE: 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) MORNING AFTER PILL: 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? 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 a partner who 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 an operation to avoid having any more children?
YES 1
NO 2
03) PILL: Women can take a pill every day.
YES 1
NO 2
04) IUD: Women can have an IUD placed inside them by a doctor or a nurse.
YES 1
NO 2
05) INJECTABLES: Women can have an injection by a health provider which stops them from becoming pregnant for one or more 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 diaphragm in their vagina before sexual 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/PERIODIC ABSTINENCE: 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) MORNING AFTER PILL: 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 401)

304. Have you or any of your partners ever used a method or tried in any way to delay or avoid getting pregnant?

YES 1
NO 2 (GO TO 401)

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

SECTION 4. MARRIAGE AND SEXUAL ACTIVITY

401. Are you currently married or living with a woman?

YES, CURRENTLY MARRIED 1
YES, LIVING WITH A WOMAN 2 (GO TO 404)
NO, NOT IN UNION 3 (GO TO 406)

402. How many wives do you currently have?

NUMBER OF WIVES____

403. Are there other women with whom you live as if you were married?

YES 1
NO 2 (GO TO 405)

404. With how many women do you live as if you were married?

NUMBER OF LIVE-IN PARTNERS____

405. WRITE THE LINE NUMBER OF HIS WIFE/PARTNER OR HIS WIVES/PARTNERS FROM THE HOUSEHOLD QUESTIONNAIRE. IF A WIFE/PARTNER IS NOT LISTED IN THE HOUSEHOLD SCHEDULE, RECORD '00' IN THE CORRESPONDING BOXES. THE NUMBER OF LINES FILLED IN MUST BE EQUAL TO THE NUMBER OF WIVES AND PARTNERS.

IF THE SUM OF 402 AND 404 IS EQUAL TO 1: Please tell me the name of your wife/partner.

NAME___
LINE NUMBER_____
WIFE 1 (GO TO 409)
PARTNER 2 (GO TO 409)

IF THE SUM OF 402 AND 404 IS EQUAL TO 2 OR MORE: Please tell me the names of your wives and live-in partners. LIST UP TO 7 WIVES/PARTNERS.

NAME___
LINE NUMBER____
WIFE 1 (GO TO 410)
PARTNER 2 (GO TO 410)

406. Do you currently have a regular sexual partner, an occasional sexual partner, or no sexual partner at all?

REGULAR SEX PARTNER 1
OCCASIONAL SEX PARTNER 2
NO SEX PARTNER 3

407. Have you ever been married or lived with a woman?

YES, FORMERLY MARRIED 1
YES, LIVED WITH A WOMAN 2 (GO TO 409)
NO 3 (GO TO 414)

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

WIDOWED 1
DIVORCED 2
SEPARATED 3

409. Have you been married or have you lived with a woman once or more than once?

ONCE 1
MORE THAN ONCE 2 (GO TO 411)

410. Have you been married to or lived with a woman other than those we just listed?

YES 1
NO 2 (GO TO 412)

411. In total, in your whole life, how many women have you been married to or lived with as if married?

NUMBER OF WOMEN____

412. CHECK 401, 409:

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

MARRIED/LIVED WITH A WOMAN MORE THAN ONCE: Now, we are going to talk about your first wife/partner. In what month and year did you start living with her?

MONTH_____
DON'T KNOW MONTH 98
YEAR____ (GO TO 414)
DON'T KNOW YEAR 9998

413. How old were you when you started living with her?

AGE______

414. Now I would like 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 443)
AGE IN YEARS _____
FIRST TIME WHEN STARTED LIVING WITH FIRST WIFE/PARTNER 96

415. When was the last time you had sexual relations with a woman?
RECORD IN ''NUMBER OF YEARS'' ONLY IF MORE THAN 12 MONTHS OR ONE YEAR.

NUMBER OF DAYS 1____
NUMBER OF WEEKS 2____
NUMBER OF MONTHS 3____
NUMBER OF YEARS 4____ (GO TO 443)

416. The last time that you had sexual relations with a woman, was a condom used?

YES 1
NO 2 (GO TO 418)
UNFAMILIAR WITH CONDOMS 8 (GO TO 418)

417. What was the main reason you used a condom at that time?

RESPONDENT WANTED TO PREVENT STD/HIV 1
RESPONDENT WANTED TO PREVENT PREGNANCY 2 (GO TO 421)
RESPONDENT WANTED TO PREVENT BOTH STD/HIV AND PREGNANCY 3 (GO TO 421)
DID NOT TRUST PARTNER/SUSPECTED PARTNER HAD OTHER PARTNERS 4
PARTNER REQUESTED/INSISTED 5
OTHER 6 (SPECIFY)______
DON'T KNOW 8

418. The last time you had sexual relations together, did you or your partner do something or use a method to avoid pregnancy?

YES 1
NO 2 (GO TO 420)
UNSURE/DON'T KNOW (GO TO 420)

419. What method was used to avoid pregnancy?

FEMALE STERILIZATION 01 (GO TO 421)
MALE STERILIZATION 02 (GO TO 421)
PILL 03 (GO TO 421)
IUD 04 (GO TO 421)
INJECTABLES 05 (GO TO 421)
IMPLANTS 06 (GO TO 421)
CONDOM 07 (GO TO 421)
FEMALE CONDOM 08 (GO TO 421)
DIAPHRAGM/ FOAM / JELLY 09 (GO TO 421)
LACTATIONAL AMENORRHEA METHOD (LAM) 10 (GO TO 421)
PERIODIC ABSTINENCE 11 (GO TO 421)
WITHDRAWAL 12 (GO TO 421)
OTHER 96 (SPECIFY)______ (GO TO 421)
DON'T KNOW 98 (GO TO 421)

420. What is the main reason you did not use a method of contraception to avoid pregnancy?

NOT HIS RESPONSIBILITY 11
OCCASIONAL SEX PARTNER 12
FERTILITY-RELATED REASONS
WIFE/PARTNER IN MENOPAUSE/HAD HYSTERECTOMY 21
COUPLE SUB-FECUND/STERILE 22
WIFE/PARTNER POSTPARTUM/BREASTFEEDING 23
WANTS (OTHER) CHILDREN 24
OPPOSITION TO USE
RESPONDENT OPPOSED 31
WIFE/PARTNER OPPOSED 32
OTHERS OPPOSED 33
RELIGIOUS PROHIBITION 34
LACK OF KNOWLEDGE
KNOWS NO METHOD 41
KNOWS NO SOURCE 42
METHOD-RELATED REASONS
HEALTH PROBLEMS 51
FEAR OF SIDE EFFECTS 52
LACK OF ACCESS / TOO FAR 53
COST TOO MUCH 54
INCONVENIENT TO USE 55
INTERFERES WITH BODY'S NATURAL PROCESSES 56
OTHER (SPECIFY)______ 96
DON'T KNOW 98

421. What is your relationship to the woman with whom you last had sexual intercourse?
IF "GIRLFRIEND'' OR "FIANC?E" ASK:
Was your girlfriend/fianc?e living with you when you last had sexual relations?
IF "YES", RECORD '1'
IF "NO", RECORD '2'

WIFE/ LIVE-IN PARTNER 1 (GO TO 423)
GIRLFRIEND/FIANC?E 2
FRIEND 3
CASUAL ACQUAINTANCE 4
PROSTITUTE 5
RELATIVE 6
OTHER (SPECIFY)______ 7

422. For how long have you had sexual relations with this woman?

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

423. In the past 12 months, have you had sex with anyone else?

YES 1
NO 2 (GO TO 440)

424. The last time you had sex with this other woman, was a condom used?

YES 1
NO 2 (GO TO 426)
UNSURE/DON'T KNOW 8 (GO TO 426)

425. What is the main reason you used a condom at that time?

RESPONDENT WANTED TO PREVENT STD/HIV 1
RESPONDENT WANTED TO PREVENT PREGNANCY 2 (GO TO 429)
RESPONDENT WANTED TO PREVENT BOTH STD/HIV AND PREGNANCY 3 (GO TO 429)
DID NOT TRUST PARTNER/SUSPECTED PARTNER HAD OTHER PARTNERS 4
PARTNER REQUESTED/INSISTED 5
OTHER 6 (SPECIFY)______
DON'T KNOW 8

426. The last time you had sexual relations with this woman, did you or your partner do something or use a method to avoid pregnancy?

YES 1
NO 2 (GO TO 428)
UNSURE/DON'T KNOW (GO TO 428)

427. What method was used to avoid pregnancy?

FEMALE STERILIZATION 01 (GO TO 429)
MALE STERILIZATION 02 (GO TO 429)
PILL 03 (GO TO 429)
IUD 04 (GO TO 429)
INJECTABLES 05 (GO TO 429)
IMPLANTS 06 (GO TO 429)
CONDOM 07 (GO TO 429)
FEMALE CONDOM 08 (GO TO 429)
DIAPHRAGM/ FOAM / JELLY 09 (GO TO 429)
LACTATIONAL AMENORRHEA METHOD (LAM) 10 (GO TO 429)
PERIODIC ABSTINENCE 11 (GO TO 429)
WITHDRAWAL 12 (GO TO 429)
OTHER 96 (SPECIFY)______ (GO TO 429)
DON'T KNOW 98 (GO TO 429)

428. What is the main reason you did not use a method of contraception to avoid pregnancy?

NOT HIS RESPONSIBILITY 11
OCCASIONAL SEX PARTNER 12
FERTILITY-RELATED REASONS
WIFE/PARTNER IN MENOPAUSE/HAD HYSTERECTOMY 21
COUPLE SUB-FECUND/STERILE 22
WIFE/PARTNER POSTPARTUM/BREASTFEEDING 23
WANTS (OTHER) CHILDREN 24
OPPOSITION TO USE
RESPONDENT OPPOSED 31
WIFE/ PARTNER OPPOSED 32
OTHERS OPPOSED 33
RELIGIOUS PROHIBITION 34
LACK OF KNOWLEDGE
KNOWS NO METHOD 41
KNOWS NO SOURCE 42
METHOD-RELATED REASONS
HEALTH PROBLEMS 51
FEAR OF SIDE EFFECTS 52
LACK OF ACCESS/TOO FAR 53
COST TOO MUCH 54
INCONVENIENT TO USE 55
INTERFERES WITH BODY'S NATURAL PROCESSES 56
OTHER (SPECIFY)_____ 96
DON'T KNOW 98

429. What is your relationship to this woman?
IF "GIRLFRIEND'' OR "FIANC?E" ASK:
Was your girlfriend/fianc?e living with you when you last had sexual relations?
IF "YES", RECORD '1'
IF "NO", RECORD '2'

WIFE/ LIVE-IN PARTNER 1 (GO TO 431)
GIRLFRIEND/FIANC?E 2
FRIEND 3
CASUAL ACQUAINTANCE 4
PROSTITUTE 5
RELATIVE 6
OTHER (SPECIFY)_______ 7

430. For how long have you had sexual relations with this woman?

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

431. In the past 12 months, other than these two women, have you had sex with anyone else?

YES 1
NO 2 (GO TO 440)

432. The last time you had sex with this other woman, was a condom used?

YES 1
NO 2 (GO TO 434)
UNSURE/DON'T KNOW 8 (GO TO 434)

433. What is the main reason you used a condom at that time?

RESPONDENT WANTED TO PREVENT STD/HIV 1
RESPONDENT WANTED TO PREVENT PREGNANCY 2 (GO TO 437)
RESPONDENT WANTED TO PREVENT BOTH STD/HIV AND PREGNANCY 3 (GO TO 437)
DID NOT TRUST PARTNER/SUSPECTED PARTNER HAD OTHER PARTNERS 4
PARTNER REQUESTED/INSISTED 5
OTHER 6 (SPECIFY)_______
DON'T KNOW 8

434. The last time you had sexual relations with this woman, did you or your partner do something or use a method to avoid pregnancy?

YES 1
NO 2 (GO TO 436)
UNSURE/DON'T KNOW (GO TO 436)

435. What method was used to avoid pregnancy?

FEMALE STERILIZATION 01 (GO TO 437)
MALE STERILIZATION 02 (GO TO 437)
PILL 03 (GO TO 437)
IUD 04 (GO TO 437)
INJECTABLES 05 (GO TO 437)
IMPLANTS 06 (GO TO 437)
CONDOM 07 (GO TO 437)
FEMALE CONDOM 08 (GO TO 437)
DIAPHRAGM/ FOAM / JELLY 09 (GO TO 437)
LACTATIONAL AMENORRHEA METHOD (LAM) 10 (GO TO 437)
PERIODIC ABSTINENCE 11 (GO TO 437)
WITHDRAWAL 12 (GO TO 437)
OTHER 96 (SPECIFY)______ (GO TO 437)
DON'T KNOW 98 (GO TO 437)

436. What is the main reason you did not use a method of contraception to avoid pregnancy?

NOT HIS RESPONSIBILITY 11
OCCASIONAL SEX PARTNER 12
FERTILITY-RELATED REASONS
WIFE/PARTNER IN MENOPAUSE /HAD HYSTERECTOMY 21
COUPLE SUB-FECUND/STERILE 22
WIFE/PARTNER POSTPARTUM/BREASTFEEDING 23
WANTS (OTHER) CHILDREN 24
OPPOSITION TO USE
RESPONDENT OPPOSED 31
WIFE/ PARTNER OPPOSED 32
OTHERS OPPOSED 33
RELIGIOUS PROHIBITION 34
LACK OF KNOWLEDGE
KNOWS NO METHOD 41
KNOWS NO SOURCE 42
METHOD-RELATED REASONS
HEALTH PROBLEMS 51
FEAR OF SIDE EFFECTS 52
LACK OF ACCESS / TOO FAR 53
COST TOO MUCH 54
INCONVENIENT TO USE 55
INTERFERES WITH BODY'S NATURAL PROCESSES 56
OTHER (SPECIFY)_____ 96
DON'T KNOW 98

437. What is your relationship to this woman?
IF "GIRLFRIEND'' OR "FIANC?E" ASK:
Was your girlfriend/fianc?e living with you when you last had sexual relations with her?
IF "YES", RECORD '1'
IF "NO", RECORD '2'

WIFE/ LIVE-IN PARTNER 1 (GO TO 439)
GIRLFRIEND/FIANC?E 2
FRIEND 3
CASUAL ACQUAINTANCE 4
PROSTITUTE 5
RELATIVE 6
OTHER (SPECIFY)_____ 7

438. For how long have you had sexual relations with this woman?

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

439. In all, how many sexual partners have you had in the last 12 months?

NUMBER OF PARTNERS_____

440. Have you ever paid to have sexual relations?

YES 1
NO 2 (GO TO 443)

441. How long have you been paying to have sexual relations?

NUMBER OF DAYS 1____
NUMBER OF WEEKS 2____
NUMBER OF MONTHS 3____
NUMBER OF YEARS 4____

DON'T REMEMBER 998

442. The last time you paid for sex, was a condom used?

YES 1
NO 2

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

YES 1
NO 2 (GO TO 446)

444. 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.

NAME OF PLACE____
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14
INFIRMARY 15
FIELDWORKER 16
OTHER PUBLIC (SPECIFY)_____ 17
PRIVATE MEDICAL SECTOR
PRIVATE CLINIC/HOSPITAL 21
PHARMACY 22
PRIVATE DOCTOR 23
MOBILE CLINIC 24
FIELDWORKER 24
OTHER PRIVATE MEDICAL (SPECIFY)_____ 26
OTHER SOURCE
SHOP/KIOSK 31
CHURCH 32
RELATIVES/FRIENDS 33
OTHER (SPECIFY)_____ 96

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

YES 1
NO 2
DON'T KNOW/UNSURE 8

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

YES 1
NO 2 (GO TO 450)

447. 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.


NAME OF PLACE____

PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14
INFIRMARY 15
FIELDWORKER 16
OTHER PUBLIC (SPECIFY)______ 17
PRIVATE MEDICAL CENTER
PRIVATE HOSPITAL/CLINIC 21
PHARMACY 22
PRIVATE DOCTOR 23
MOBILE CLINIC 24
FIELDWORKER 24
OTHER PRIVATE MEDICAL (SPECIFY)______ 26
OTHER SOURCE
SHOP/KIOSK 31
CHURCH 32
RELATIVES/FRIENDS 33
OTHER (SPECIFY)______ 96

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

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

450. Do you know of a place where one can go on foot and get condoms?

YES 1
NO 2 (GO TO 501)

451. 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.


NAME OF PLACE____

PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
DBC AGENT 15
OTHER PUBLIC (SPECIFY)______ 16
PRIVATE MEDICAL SECTOR
PRIVATE CLINIC/HOSPITAL 21
PHARMACY 22
PRIVATE DOCTOR 23
ARBEF (RWANDAN ASSOCIATION FOR FAMILY WELFARE) CLINIC 24
OTHER PRIVATE MEDICAL (SPECIFY)_____ 26
OTHER SOURCE
SHOP/KIOSK 31
CHURCH 32
RELATIVES / FRIENDS 33
OTHER (SPECIFY)____ 96

452. How long does it take to get to this place on foot?

MINUTES___
ON PREMISES 996

SECTION 5. FERTILITY PREFERENCES

501. CHECK 401:

NOT CURRENTLY IN UNION (GO TO 502)
CURRENTLY MARRIED OR LIVING WITH A WOMAN (GO TO 503A)

502. CHECK 406:

NOT IN UNION BUT HAS REGULAR SEX PARTNER (GO TO 503)
ONLY HAS OCCASIONAL SEX PARTNER OR DOES NOT HAVE A SEX PARTNER (GO TO 505A)

503. CHECK 401, 405, AND 406:

A. HAS A WIFE OR LIVES WITH A WOMAN: Is your wife/live-in partner currently pregnant? Is one of your wives/live-in partners currently pregnant?

B. HAS A REGULAR SEX PARTNER: Is your regular sex partner currently pregnant? Is one of your regular sex partners currently pregnant?

YES 1
NO 2 (GO TO 505A)
DON'T KNOW/UNSURE 8 (GO TO 505A)

504. At the time your partner became pregnant did you want her to become pregnant then,
did you want to have a child later, or did you not want to have a child at all?

THEN 1 (GO TO 505B)
LATER 2 (GO TO 505B)
NOT AT ALL 3 (GO TO 505B)

505. CHECK 502 AND 503:

A. WIFE/PARTNER NOT PREGNANT OR UNSURE OR DOESN'T HAVE WIFE OR REGULAR SEX PARTNER: Now I have some questions about the future. Do you want to have a/another child, or would you prefer not to have a/another child?

B. WIFE/PARTNER PREGNANT: Now I have some questions about the future. After the child your wife/partner is expecting, would you like to have another child or would you prefer not to have another child?

HAVE A/ANOTHER CHILD 1
NO MORE/NONE 2 (GO TO 507)
SAYS WIFE/PARTNER CANNOT GET PREGNANT 3 (GO TO 507)
SAYS HE CANNOT HAVE MORE CHILDREN 4 (GO TO 507)
UNDECIDED/DON'T KNOW 8 (GO TO 507)

506. CHECK 502 AND 503:

WIFE/PARTNER NOT PREGNANT OR UNSURE OR DOESN'T HAVE WIFE OR REGULAR SEX PARTNER: How long do you want to wait before the birth of a child? How long do you want to wait before the birth of another child?

WIFE/PARTNER PREGNANT: After the birth of the child you are expecting, how long would you like to wait before the birth of another child?

MONTHS 1_____
YEARS 2____

SOON/NOW 993
SAYS WIFE/PARTNER CANNOT GET PREGNANT 994
AFTER MARRIAGE 995
OTHER (SPECIFY)______ 996
DON'T KNOW 998

507. CHECK 414, 416, 424, 426, 432, AND 434:
HAS USED A METHOD WITH AT LEAST ONE PARTNER

NOT ASKED (GO TO 508)
NOT USED WITH ANY PARTNER (GO TO 508)
USED WITH AT LEAST ONE PARTNER (GO TO 512)

508. In the next 12 months, do you think that you will use a method to delay or avoid pregnancy?

YES 1 (GO TO 510)
NO 2
DON'T KNOW 8

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

YES 1
NO 2 (GO TO 511)
DON'T KNOW 8 (GO TO 511)

510. What method would you prefer to use?

FEMALE STERILIZATION 01 (GO TO 512)
MALE STERILIZATION 02 (GO TO 512)
PILL 03 (GO TO 512)
IUD 04 (GO TO 512)
INJECTABLES 05 (GO TO 512)
IMPLANTS 06 (GO TO 512)
CONDOM 07 (GO TO 512)
FEMALE CONDOM 08 (GO TO 512)
DIAPHRAGM/ FOAM / JELLY 09 (GO TO 512)
LACTATIONAL AMENORRHEA METHOD (LAM) 10 (GO TO 512)
PERIODIC ABSTINENCE 11 (GO TO 512)
WITHDRAWAL 12 (GO TO 512)
OTHER (SPECIFY)_____ 96 (GO TO 512)
NOT SURE 98 (GO TO 512)

511. What is the main reason you thing you will never use a method?

NOT MARRIED 11
FERTILITY-RELATED REASONS
NOT HAVING SEX/INFREQUENT SEX 22
PARTNER IN MENOPAUSE/HAD HYSTERECTOMY 23
COUPLE SUB-FECUND/STERILE 24
WANTS AS MANY CHILDREN AS POSSIBLE 25
OPPOSITION TO USE
RESPONDENT OPPOSED 31
WIFE/PARTNER OPPOSED 32
OTHERS OPPOSED 33
RELIGIOUS PROHIBITION 34
LACK OF KNOWLEDGE
KNOWS NO METHOD 41
KNOWS NO SOURCE 42
METHOD-RELATED REASONS
HEALTH PROBLEMS 51
FEAR OF SIDE EFFECTS 52
LACK OF ACCESS/TOO FAR 53
COST TOO MUCH 54
INCONVENIENT TO USE 55
INTERFERES WITH BODY'S NATURAL PROCESSES 55
OTHER (SPECIFY)______ 96
DON'T KNOW 98

512. CHECK 203 AND 205:

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

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

PROBE FOR A NUMERIC RESPONSE.

NUMBER____
OTHER 95 (SPECIFY)______ (GO TO 514)

513. 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)____ 95
NUMBER OF GIRLS____
OTHER (SPECIFY)____ 95
NUMBER OF EITHER SEX____
OTHER (SPECIFY)____ 95

514. 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

515. In the past month, have you heard about family planning:

On the radio?
YES 1
NO 2
On television?
YES 1
NO 2
In newspapers or magazines?
YES 1
NO 2

517. In the past month, have you discussed the practice of family planning with your friend(s), neighbor(s), or relative(s)?

YES 1
NO 2 (GO TO 519)

518. With whom did you discuss it? Anyone else?
RECORD ALL MENTIONED

WIFE/PARTNER A
MOTHER B
FATHER C
SISTER(S)
BROTHER (S) E
DAUGHTER F
SON G
STEPMOTHER H
STEPFATHER I
FRIEND(S)/NEIGHBOR(S) J
OTHER (SPECIFY)______ X

519. CHECK 401, 402, AND 404:
MARITAL STATUS AND NUMBER OF WIVES/PARTNERS

YES, CURRENTLY MARRIED TO ONE WOMAN (GO TO 520)
YES, LIVING WITH ONLY ONE WOMAN (GO TO 520)
NOT IN UNION OR MARRIED/LIVING WITH MORE THAN ONE WOMAN (GO TO 601)

520. Now I would like to ask you about your wife's/partner's opinion on family planning. Would you say your wife/partner approves or disapproves of couples using a method to avoid getting pregnant?

APPROVE 1
DISAPPROVE 2
DON'T KNOW 8

521. In the last 12 months, how many times have you discussed the practice of family planning with your wife/partner?

NEVER 1
ONCE OR TWICE 2
MORE OFTEN 3

522. Do you think that your wife/partner wants the same number of children as you, more, or fewer than you want?

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

SECTION 6. PARTICIPATION IN HEALTH CARE

601. CHECK 201 AND 209:

HAS ONE OR MORE CHILDREN (GO TO 602)
HAS NOT HAD ANY CHILDREN (GO TO 701)

602. What is the name and sex of your last child?

NAME OF LAST CHILD___
BOY 1
GIRL 2

603. In what month and year was your last child born?

MONTH____
YEAR____

604. Is (NAME OF LAST CHILD) still alive?

YES 1 (GO TO 606)
NO 2

605. How old was (NAME OF LAST CHILD) when he or she died?

DAYS 1____
MONTHS 2____
YEARS 3____

606. Who is the mother of (NAME OF LAST CHILD)?
WRITE THE NAME OF THE MOTHER OF THE CHILD AND HER LINE NUMBER AS NOTED IN Q. 405. IF THE MOTHER IS NOT A MEMBER OF THE HOUSEHOLD, RECORD '00'.

NAME OF MOTHER OF LAST CHILD_____
LINE NUMBER_____

607. CHECK 603:

LAST CHILD BORN AFTER JANUARY 1995 (GO TO 608)
NO CHILD OR LAST CHILD BORN BEFORE JANUARY 1995 (GO TO 701)

608. CHECK 606:

MOTHER OF LAST CHILD DOES NOT LIVE IN HOUSEHOLD (CODE 00) (GO TO 609)
MOTHER OF LAST CHILD LIVES IN HOUSEHOLD (GO TO 610)

609. What is your relationship to (NAME OF MOTHER OF LAST CHILD)?

CURRENT WIFE/LIVE-IN PARTNER 1
FORMER WIFE 2
FORMER LIVE-IN PARTNER 3
REGULAR SEX PARTNER 4
OCCASIONAL SEX PARTNER 5
OTHER (SPECIFY)_____ 6

610. When (NAME OF MOTHER OF LAST CHILD) became pregnant with (NAME OF LAST CHILD), did you want to have a child then, did you want to have a child but later, or did you not want to have a/another child at all?

THEN 1 (GO TO 612)
LATER 2
NONE AT ALL 3 (GO TO 612)

611. How long would you liked to have waited?

MONTHS 1___
YEARS 2___

DID NOT WANT AT ALL 998

612. Did (NAME OF MOTHER OF LAST CHILD) go to a health establishment for antenatal care for this pregnancy?

YES 1
NO 2 (GO TO 614)
DON'T KNOW 8 (GO TO 614)

613. During this pregnancy, did you accompany (NAME OF MOTHER OF LAST CHILD) when she went to the establishment for antenatal care?

YES 1
NO 2

614. When (NAME OF MOTHER OF LAST CHILD) was pregnant, did you speak to a health professional about the health of the mother and her pregnancy?

YES 1
NO 2

615. During this pregnancy, how many times did you speak to (NAME OF MOTHER OF LAST CHILD) about her health and pregnancy?

OFTEN 1
SOMETIMES 2
NEVER 3

616. In your opinion, was this pregnancy normal or were there health complications more serious than those occurring in most pregnancies?

NORMAL PREGNANCY 1
COMPLICATIONS 2
UNSURE/DON'T KNOW 3

617. Where did (NAME OF MOTHER OF LAST CHILD) give birth to (NAME OF LAST CHILD)?

AT HOME 1 (GO TO 619)
GOVERNMENT HOSPITAL/HEALTH CENTER 2
PRIVATE HOSPITAL/HEALTH CENTER 3
OTHER (SPECIFY)______ 6 (GO TO 619)

618. When (NAME OF MOTHER OF LAST CHILD) gave birth, did you go with her to the (HOSPITAL/CLINIC/HEALTH CENTER)?

YES 1
NO 2

619. CHECK 603:

AGE OF LAST CHILD 2 MONTHS OR MORE (GO TO 620)
AGE OF LAST CHILD LESS THAN 2 MONTHS (GO TO 625)

620. In the two months following the birth of (NAME OF LAST CHILD), did (NAME OF MOTHER OF LAST CHILD) go to a health establishment to be examined or have her child examined?

YES 1
NO 2 (GO TO 622)
DON'T KNOW 8 (GO TO 622)

621. Did you accompany (NAME OF MOTHER OF LAST CHILD) during these visits?

YES 1
NO 2

622. During the first two months after the birth of (NAME OF LAST CHILD), did you speak to a health professional about the health of the baby or that of (NAME OF MOTHER OF LAST CHILD)?

YES 1
NO 2

623. During the first two months after the birth of (NAME OF LAST CHILD), did you speak often, sometimes, or never about her health and the baby's growth with (NAME OF MOTHER OF LAST CHILD)?

OFTEN 1
SOMETIMES 2
NEVER 3

624. In your opinion, is (NAME OF LAST CHILD) a healthy or unhealthy child?

HEALTHY 1
UNHEALTHY 2

625. Did (NAME OF LAST CHILD) receive vaccinations to protect him/her from certain illnesses?

YES 1
NO 2 (GO TO 628)
DON'T KNOW 8 (GO TO 628)

626. Were any vaccinations given at a health establishment?

YES 1
NO 2 (GO TO 628)

627. The last time that (NAME OF LAST CHILD) received a vaccination in a health establishment, who accompanied him/her?
RECORD ALL MENTIONED

RESPONDENT A
MOTHER OF CHILD B
MEMBER OF FAMILY (WOMAN) C
MEMBER OF FAMILY (MAN) D
OTHER (SPECIFY)_____ X

628. Has (NAME OF LAST CHILD) suffered from a fever, cough, or diarrhea during the past two weeks?

YES 1
NO 2 (GO TO 701)
DON'T KNOW 8 (GO TO 701)

629. Who takes care of (NAME OF LAST CHILD) when he/she is sick?
RECORD ALL MENTIONED

RESPONDENT A
MOTHER OF CHILD B
MEMBER OF FAMILY (WOMAN) C
MEMBER OF FAMILY (MAN) D
OTHER (SPECIFY)____ X

630. Was (NAME OF LAST CHILD) examined by a health professional when he or she was sick?

YES 1
NO 2 (GO TO 701)
DON'T KNOW 8 (GO TO 701)

631. Who decided that (NAME OF LAST CHILD) needed to be examined by a doctor?
RECORD ALL MENTIONED

RESPONDENT A
MOTHER OF CHILD B
MEMBER OF FAMILY (WOMAN) C
MEMBER OF FAMILY (MAN) D
OTHER (SPECIFY)_____ X

632. Were you present when (NAME OF LAST CHILD) was examined by a health professional?

YES 1
NO 2

633. Did you speak with the health professional about the child's illness?

YES 1
NO 2

SECTION 7. HIV/AIDS AND OTHER SEXUALLY TRANSMITTED DISEASES

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

YES 1
NO 2 (GO TO 718)

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

YES 1
NO 2 (GO TO 709)
DON'T KNOW 8 (GO TO 709)

703. What can be done? 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 PRACTITIONER M
AVOID SHARING RAZORS/BLADES N
OTHER (SPECIFY)______ W
OTHER (SPECIFY)______ X
DON'T KNOW Z

704. Can people reduce their chances of getting the AIDS virus by having just one sexual partner who has no other partners?

YES 1
NO 2
DON'T KNOW 8

705. Can a person get the AIDS virus by being bitten by mosquitoes?

YES 1
NO 2
DON'T KNOW 8

706. Can people reduce their chances of getting the AIDS virus by using a condom every time they have sex?

YES 1
NO 2
DON'T KNOW 8

707. Can a person reduce their chances of getting the AIDS virus by not sharing food with someone with AIDS?

YES 1
NO 2
DON'T KNOW 8

708. Can people protect themselves from the AIDS virus by abstaining from sex completely?

YES 1
NO 2
DON'T KNOW 8

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

YES 1
NO 2
DON'T KNOW 8

711. Do you personally know someone who has the AIDS virus or someone who has died of AIDS?

YES 1
NO 2

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

YES 1
NO 2 (GO TO 714)
DON'T KNOW 8 (GO TO 714)

713. When can the virus that causes AIDS can be transmitted from mother to child?
Can it be transmitted:

During pregnancy?
YES 1
NO 2
DON'T KNOW 8
During childbirth?
YES 1
NO 2
DON'T KNOW 8
While breastfeeding?
YES 1
NO 2
DON'T KNOW 8

714. CHECK 401:

YES, CURRENTLY MARRIED/LIVING WITH A WOMAN (GO TO 715)
NO, NOT IN UNION/DOES NOT LIVE WITH A WOMAN (GO TO 715A)

715. Have you ever talked about ways to avoid contracting the AIDS virus with your wife/live-in partner?

YES 1
NO 2
?

715A. In your opinion, is it acceptable or unacceptable to talk about AIDS:

On the radio?
ACCEPTABLE 1
UNACCEPTABLE 2
On television?
ACCEPTABLE 1
UNACCEPTABLE 2
In the newspapers?
ACCEPTABLE 1
UNACCEPTABLE 2

716. If a person learns that he/she is infected with the virus that causes AIDS, should that person be permitted to keep his/her condition a secret or should the information be shared with the community?

MAY BE KEPT SECRET 1
SHARED WITH THE COMMUNITY 2
DON'T KNOW/UNSURE 8

717. If someone in your family contracted the virus that causes AIDS, would you be willing to take care of him/her in your own household?

YES 1
NO 2
DON'T KNOW/UNSURE/DEPENDS 8

717A. Should people with AIDS who work with other people in shops, offices, or farms be allowed to continue their work or no?

CAN CONTINUE TO WORK 1
CANNOT CONTINUE TO WORK 2
DON'T KNOW/UNSURE/DEPENDS 8

717B. Should we educate children ages 12 to 14 on the use of condoms to avoid contracting AIDS?

YES 1
NO 2
DON'T KNOW/UNSURE/DEPENDS 8

717C. Have you ever been tested to see if you have the AIDS virus?

YES 1 (GO TO 717FX)
NO 2

717D. Would you like to be tested for the AIDS virus?

YES 1
NO 2
DON'T KNOW/UNSURE 8

717E. Do you know of a place where you can get tested for AIDS?

YES 1
NO 2 (GO TO 718)

717F. Where can you go for this test?
717FX. Where did you go for this test?
IF SOURCE IS A HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO DETERMINE 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
FIELDWORKER E
OTHER PUBLIC (SPECIFY)_____ F
PRIVATE MEDICAL SECTOR
PRIVATE CLINIC/HOSPITAL G
PHARMACY H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELDWORKER K
OTHER PRIVATE MEDICAL (SPECIFY)_______ L
OTHER SOURCE
SHOP M
CHURCH N
FAMILY/FRIENDS O
OTHER (SPECIFY)_______ X

718. (Apart from AIDS), have you heard of (other) infections that can be transmitted by sexual contact?

YES 1
NO 2 (GO TO 721)

719. If a man has a sexually transmitted disease, what symptoms might he have? Any others?
RECORD ALL MENTIONED.

ABDOMINAL PAIN A
GENITAL DISCHARGE/DRIPPING B
FOUL SMELLING DISCHARGE C
BURNING PAIN ON URINATION D
REDNESS/INFLAMMATION IN GENITAL AREA E
SWELLING IN GENITAL AREA F
GENITAL SORES/ULCERS G
GENITAL WARTS H
BLOOD IN URINE I
LOSS OF WEIGHT J
IMPOTENCE K
NO SYMPTOMS L
OTHER (SPECIFY)_____ W
OTHER (SPECIFY)______ X
DON'T KNOW Z

720. If a woman has a sexually transmitted disease, what symptoms might she have? Any others?
RECORD ALL MENTIONED.

ABDOMINAL PAIN A
GENITAL DISCHARGE/DRIPPING B
FOUL SMELLING DISCHARGE C
BURNING PAIN ON URINATION D
REDNESS/INFLAMMATION IN GENITAL AREA E
SWELLING IN GENITAL AREA F
GENITAL SORES/ULCERS G
GENITAL WARTS H
BLOOD IN URINE I
LOSS OF WEIGHT J
INABILITY TO GET PREGNANT K
NO SYMPTOMS L
OTHER (SPECIFY)_____ W
OTHER (SPECIFY)______ X
DON'T KNOW Z

721. CHECK 414:

HAS HAD SEXUAL RELATIONS (GO TO 722)
HAS NOT HAD SEXUAL RELATIONS (GO TO 801)

722. Now, I would like to ask you questions about your health in the past 12 months. In the past 12 months, have you had a sexually transmitted disease?

YES 1
NO 2
DON'T KNOW 8

723. Sometimes men have an abnormal discharge from their penis. In the past 12 months, have you had an abnormal discharge from your penis?

YES 1
NO 2
DON'T KNOW 8

724. Sometimes men have a genital sore or ulcer in near their penis. In the past 12 months, have you had a genital sore or ulcer?

YES 1
NO 2
DON'T KNOW 8

725. CHECK 722, 723, 724:

HAS HAD AN INFECTION (GO TO 726)
HAS NOT HAD AN INFECTION (GO TO 801)

726. The last time you had (INFECTION FROM 722/723/724), did you seek advice or treatment?

YES 1
NO 2 (GO TO 728)

727. The last time you had (INFECTION FROM 722/723/724), did you do any of the following?
Did you:

Seek advice from health personnel in a clinic or hospital?
YES 1
NO 2
Seek advice or treatment from a traditional healer?
YES 1
NO 2
Seek advice or purchase drugs from a store or pharmacy?
YES 1
NO 2
Seek advice from friends or relatives?
YES 1
NO 2

728. When you had (INFECTION FROM 722/723/724), did you inform the person(s) with whom you were having sex?

YES 1
NO 2
SOME/NOT ALL 3

729. When you had (INFECTION FROM 722/723/724), did you do anything to avoid infecting your sexual partner(s)?

YES 1
NO 2 (GO TO 801)
PARTNER ALREADY INFECTED 3 (GO TO 801)

730. What did you do to avoid infecting your partner(s)?
Did you:

Stop having sex?
YES 1
NO 2
Use a condom during sex?
YES 1
NO 2
Take drugs?
YES 1
NO 2

SECTION 8. ATTITUDES TOWARDS GENDER ROLES

Now I would like to ask you questions about relations between husbands and wives. People have very different opinions on this subject and I would like to know what you think.

801. When a husband cannot provide enough money, do you think it is acceptable for his wife to work outside the home to earn money?

WORK ACCEPTABLE 1 (GO TO 803)
NOT ACCEPTABLE 2
NO OPINION/DON'T KNOW 8

802. When, for whatever reason, a husband cannot provide enough money for the family, do you think it is acceptable for his wife to work outside the home to earn money?

WORK ACCEPTABLE 1
NOT ACCEPTABLE 2
NO OPINION/DON'T KNOW 8

803. Within a couple, do you think a woman should have a say in the following decisions?

a) Receiving health care?
YES 1
NO 2
DON'T KNOW/DEPENDS 3
b) Purchases of important things for the household?
YES 1
NO 2
DON'T KNOW/DEPENDS 3
c) Purchases for daily household needs?
YES 1
NO 2
DON'T KNOW/DEPENDS 3
d) Visits to the family, friends, or relatives?
YES 1
NO 2
DON'T KNOW/DEPENDS 3
e) What to do with the money she earns?
YES 1
NO 2
DON'T KNOW/DEPENDS 3

804. Sometimes a husband is annoyed or angered by things that his wife does. 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/DEPENDS 3
b) If she neglects the children?
YES 1
NO 2
DON'T KNOW/DEPENDS 3
c) If she discusses her opinions with him?
YES 1
NO 2
DON'T KNOW/DEPENDS 3
d) If she refuses to have sex with him?
YES 1
NO 2
DON'T KNOW/DEPENDS 3
e) If she burns the food?
YES 1
NO 2
DON'T KNOW/DEPENDS 3

805. Please tell me if you think it is normal for a woman to refuse to have sex with her husband/ partner when:

a) She is tired or not in the mood?
YES 1
NO 2
DON'T KNOW/DEPENDS 3
b) She has recently given birth?
YES 1
NO 2
DON'T KNOW/DEPENDS 3
c) She knows that her husband/partner has a sexually transmitted disease?
YES 1
NO 2
DON'T KNOW/DEPENDS 3
d) She knows that her husband/partner has sex with other women?
YES 1
NO 2
DON'T KNOW/DEPENDS 3

806. Do you think that if a wife refuses to have sexual relations with her husband he has the right to?:

a) Become angry and reprimand her?
YES 1
NO 2
DON'T KNOW/DEPENDS 3
b) Refuse to give her money or other financial support?
YES 1
NO 2
DON'T KNOW/DEPENDS 3
c) Resort to force and have intercourse with her even if she does not want to?
YES 1
NO 2
DON'T KNOW/DEPENDS 3

807. In a household, who, according to you, should have the primary responsibility for disciplining the children: the man, the woman, or both?

MAN 1
WOMAN 2
BOTH 3
EITHER PARENT 4
OTHER (SPECIFY) _____ 5
DON'T KNOW/DEPENDS 8

808. Within a couple, who, according to you, should have the primary responsibility for watching and caring for the children?

MAN 1
WOMAN 2
BOTH 3
EITHER PARENT 4
OTHER (SPECIFY)_____ 5
DON'T KNOW/DEPENDS 8

809. In a couple, who, according to you, should have the primary responsibility for cooking, cleaning, and washing dishes and laundry every day?

MAN 1
WOMAN 2
BOTH 3
EITHER PARENT 4
OTHER (SPECIFY)_____ 5
DON'T KNOW/DEPENDS 8

809A. Have you ever beaten, hit, kicked, or done anything else to physically attack your (last) wife/partner when she had not beaten or attacked you physically?

YES 1 (GO TO 811)
NO 2

810. As far as you remember, did your father ever beat your mother?

YES 1
NO 2
DON'T KNOW/DON'T REMEMBER 8

811. 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:____