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SUDAN DEMOGRAPHIC AND HEALTH SURVEY
INDIVIDUAL QUESTIONNAIRE

IDENTIFICATION

REGION
PROVINCE
PLACE NAME
URBAN/RURAL

urban=l
rural=2

CLUSTER NUMBER
HOUSEHOLD NUMBER
NAME AND LINE NUMBER OF WOMAN

INTERVIEWER VISITS

INTERVIEWER VISITS
FIRST VISIT
DATE
INTERVIEWER’S NAME
RESULT**

SECOND VISIT
DATE
INTERVIEWER’S NAME
RESULT**

THIRD VISIT
DATE
INTERVIEWER’S NAME
RESULT**

NEXT VISIT
DATE
TIME

FINAL VISIT
MONTH
YEAR

TOTAL NUMBER OF VISITS

**RESULT CODES:

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

FIELD EDITED BY
NAME
DATE

OFFICER EDITED BY
NAME
DATE

CODED BY
NAME
DATE

KEYED BY
NAME
DATE

ALL INFORMATION COLLECTED IS CONFIDENTIAL AND IS ONLY FOR RESEARCH

SECTION 1. RESPONDENT’S BACKGROUND

103 RECORD THE TIME.

HOUR ______
MINUTES _____

104 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 village or a town?

VILLAGE 1
TOWN 2

104A What was the name of the province in which you lived as child?
RECORD NAME OF PROVINCE, OR IF PLACE WAS OUTSIDE OF SUDAN, NAME OF COUNTRY.

NAME OF PLACE ______

105 How long have you been living continuously in NAME OF VILLAGE OR TOWN)?

ALWAYS 95 (GO TO 107)
VISITOR 96 (GO TO 107)
YEARS _______

106 Just before you moved here, did you live in a village or a town?

VILLAGE 1
TOWN 2

106A I What was the name of the province in which you lived just before you moved here?
RECOMD NAME OF PROVINCE OR IF PLACE WAB OUTBIDE OF SUDAN, NAME OF COUNTRY.

NAME OF PLACE ______

106B What was the reason for you move?

DROUGHT/DESERTIFICATION I
FAMINE 2
EMPLOYMENT 3
SECURITY 4
MARRIAGE 5
OWN OR BETTER HOME 6
OTHER (SPECIFY) _______ 7

107 In what month and year were you born?

MONTH* ______
DON’T KNOW MONTH 98
YEAR
DON’T KNOW YEAR 98

*FALL=21, WINTER=22, SUMMER=23

108 How old are you now in completed years? AGE IN COMPLETED YEARS?
COMPARE AND CORRECT 107 AND/OR 108 IF INCONSISTENT.

AGE IN COMPLETED YEARS ________

108A Are you married, widowed, divorced, or separated?

MARRIED 1
WODOWED 2
DIVORCED/SEPAERATED 3

109 Have you ever attended school?

YES 1
NO 2 (GO TO 113)

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

PRIMARY 1
JUNIORSECONDARY 2
HIGHER SECONDARY 3
HIGHER EDUCATION 4

111 What is the highest grade you completed at that level?

GRADE _______

112 CHECK110:

PRIMARY (GO TO 113)
JUNIOR, SECONDARYOR HIGHER (GO TO 114)

113 Can you read a letter or newspaper easily, with difficulty, or not at art?

EASILY 1
WITH DIFFICULTY 2
NOT AT ALL 3

114 Do you usually listen to a radio at least once a week?

YES 1
NO 2

115 What is the major source of water for members of your household?

PIPED INTORESIDENCE 01
PIPED OUTSIDE 02
PUBLICWELL 03
RIVER, SURFACEWATER 04
VENDOR 05
RAINWATER 06
OTHER (SPECIFY) ________07

117 What kind of toilet facility does your household have?

FLUSH I
BUCKET 2
PIT 3
OTHER (SPECIFY) ________ 4
NO FACILITIES 5

120 Does your house have:
Electricity?
A radio?
A television?
A refrigerator?

ELECTRICITY
YES 1
NO 2
RADIO
YES 1
NO 2
TELEVISION
YES 1
NO 2
REFRIGERATOR
YES 1
NO 2

120A What kind of cooking fuel do you use?

GAS 1
ELECTRICITY 2
CHARCOAL 3
WOOD 4
OTHER (SPECIFY) _____ 5

121 Does any member of your household own:
A bicycle?
A motorcycle?
A car?
A tractor?

BYCICLE
YES 1
NO 2
MOTORCYCLE
YES 1
NO 2
CAR
YES 1
NO 2
TRACTOR
YES 1
NO 2

122 MAIN MATERIAL OF THE FLOOR.
RECORD OBSERVATION.

CERAMIC TILES 1
EARTH/SAND 2
CEMENT 3
BRICK 4
OTHER (SPECIFY) _______ 6

122A I MAIN MATERIAL OF THE WALLS.
RECORD OBSERVATION.

BRICK 1
MUD 2
CEMENT/CONCRETE 3
STRAW 4
OTHER (SPECIFY) 6

130 What is your religion?

MOSLEM 1
CHRISTIAN 2
OTHER (SPECIFY) ______ 3

SECTION 2. REPRODUCTION

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

YES 1
NO 2 (GO TO 206)

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

YES 1
NO 2 (GO TO 204)

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

SONS AT HOME _________
DAUGHTERS AT HOME ____________

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

YES 1
NO 2 (GO TO 206)

205 How many sons are alive but do not live with you?
And how many daughters are alive but do not live with you?
IF NONE, ENTER ‘00’.

SONS ELSEWHERE _______
DAUGHTERS ELSEWHERE ________

206 Have you ever given birth to a boy or girl who was born alive but later died?
IF NO, PROBE: Any (other) boy or girl 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?
And how many girls have died?
IF NONE, ENTER ‘00’.

BOYS DEAD ________
GIRLS DEAD _________

208 SUM ANSWERS TO 203, 205, AND 207, AND ENTER TOTAL. IF NONE, ENTER ‘00’.

TOTAL _______

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

YES (GO TO 210)
NO (PROBE AND CORRECT 201-209 AS NECESSARY.)

210 CHECK 208:

ONE OR MORE BIRTHS
NO BIRTHS (GO TO 220)

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

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

(NAME) ________

213 Is (NAME) a boy or a girl?

BOY 1
GIRL 2

214 In what month and year was (NAME) born?
PROBE: What is his/her birthday? OR: In what season?

MONTH ______
YEAR _______

SEASON CODES: FALL=21, WINTER=22, SUMMER=23

215 Is (NAME) still alive?

YES 1(GO TO 217)
NO 2 (GO TO 216)

216 220 IF DEAD:
How old was (NAME) when he/she died?
RECORD DAYS IF LESS THAN 1 MONTH; MONTHS IF LESS THAN TWO YEARS; OR YEARS.

DAYS 1 _____
MONTHS 2 _______
YEARS 3 _______

(GO TO NEXT BIRTH)

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

AGE IN YEARS _______

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

YES 1
NO 2

219 COMPARE 208 WITH HUMBER OF BIRTHS IN HISTORY ABOVE AND MARK:
COMPARE 208 WITH NUMBER OF BIRTHS IN HISTORY ABOVE AND MARK:

NUMBERS ARE SAME
INTERVIEW:
FOR EACH LIVE BIRTH: YEAR OF BIRTH IS RECORDED.
FOR EACH LIVE CHILD: CURRENT AGE IS RECORDED.
FOR EACH DEAD CHILD: AGE AT DEATH IS RECORDED.
NUMBERS ARE DIFFERENT (PROBE AND RECONCILE)

220 Are you pregnant now?

YES 1
NO 2 (GO TO 225)
UNSURE 8 (GO TO 225)

221 For how many months have you been pregnant?

MONTHS ________

222 Since you become pregnant, have you been given any injection to prevent the baby from getting tetanus, that is, convulsions after birth?

YES 1 (GO TO 223)
NO 2 (GO TO 223)
DON’T KNOW 8

222A How many injections did you receive for this pregnancy?

NUMBER ______
DON’T KNOW 8

222B Where did you go to get the (last) injection?

GOVERNMENT HOSPITAL 01
GOVERNMENT HEALTH CENTER 02
DISPENSARY 04
DRESSING STATION 05
PRIMARY HEALTH UNIT 06
MOBILE CLINIC 07
PRIVATE DOCTOR 08
PRIVATE HOSPITAL 09
OTHER (SPECIFY) ______ 10
DON’T KNOW 98

223 Did you see anyone for a check on this pregnancy?

YES 1
NO 2 (GO TO 226)

224 Whom did you see?
PROBE FOR TYPE OF PERSON AND RECORD MOST QUALIFIED.

DOCTOR 1(GO TO 226)
TRAINED HEALTH WORKER/MIDWIFE 2(GO TO 226)
TRADITIONAL BIRTH ATTENDANT 3 (GO TO 226)
OTHER (SPECIFY) _____ 4(GO TO 226)

225 How tong ago did your last menstrual period start?

DAYS AGO 1 _____
WEEKS AGO 2 _____
MONTHS AGO 3______
YEARS AGO 4_____
BEFORE LAST BIRTH 995
NEVER MENSTRUATED 996

226 When during her monthly cycle do you think a woman has to be careful to avoid becoming pregnant?

DURING HER PERIOD 1
RIGHT AFTER HER PERIOD HAS ENDED 2
IN THE MIDDLE OF THE CYCLE 3
JUST BEFORE HER PERIOD BEGINS 4
AT ANY TIME 5
OTHER (SPECIFY) ________ 6
DR 8

227 Have you ever been circumcised?

YES 1
NO 2 (GO TO 230)

228 What type of circumcision did you have? Did you have pharonic, intermediate or sunna circumcision?

PHARONIC 1
INTERMEDIATE 2
SUNNA 3
OTHER (SPECIFY) ______ 4

229 Who performed the circumcision?

DOCTOR 1
TRAINED MIDWIFE 2
TRADITIONAL MIDWIFE 3
OTHER (SPECIFY) ______ 4

230 CHECK 203, 205 AND WRITE TOTAL NUMBER OF DAUGHTERS
Are all of your daughters circumcised?
PROBE AND MARK THE APPROPRIATE ANSWER

NO DAUGHTERS 1 (GO TO 232)
ALL ARE 2 (GO TO 232)
ELDER DAUGHTERS ARE 3
DAUGHTERS NOT OLD ENOUGH 4
DAUGHTERS OLD ENOUGH BUT
UNCIRCUMCISED 5

231 Do you plan to have all of your daughters circumcised?

YES 1
NO 2

232 I Do you think female circumcision should continue?

YES 1
NO 2 (GO TO 235)

233 What type of circumcision would you prefer?

PHARONIC 1
INTERMEDIATE 2
SUNNA 3
OTHER (SPECIFY) ______ 4

234 Why do you think female circumcision should be continued?
CIRCLE FIRST TWO REASONS MENTIONED.
IF ONLY ONE REASON GIVEN CIRCLE CODE 95 FOR THE SECOND REASON

GOOD TRADITION 01 (GO TO 238)
CUSTOM AND TRADITION 02(GO TO 238)
RELIGIOUS DEMAND 03(GO TO 238)
CLEANLINESS 04(GO TO 238)
BETTER MARRIAGE PROSPECTS 05(GO TO 238)
GREATER PLEASURE OF HUSBAND 06(GO TO 238)
PRESERVATION OF VIRGINITY/PREVENTION OF IMMORALITY 07(GO TO 238)
INCREASED FERTILITY 08(GO TO 238)
NEVER THINK ABOUT REASON 09(GO TO 238)
OTHER 10(GO TO 238)
NO SECOND REASON GIVEN 95(GO TO 238)

235 Why are you opposed to female circumcision?
CIRCLE FIRST TWO REASONS MENTIONED.IF ONLY ONE REASON GIVEN CIRCLE CODE 95 FOR THE SECOND REASON

RELIGIOUS PROHIBITION 01
FAILURE TO ACHEIVE SEXUAL SATISFACTION 02
MEDICAL COMPLICATIONS 03
PAINFUL PERSONAL EXPERIENCE 04
AGAINST DIGNITY OF WOMEN 05
OTHER (SPECIFY) _______ 06
NO SECOND REASON GIVEN 95

236 Why do you think this practice continues?

IGNORANCE OF CONSEQUENCES 01
FEAR OF SOCIAL CRITICISM 02
FEAR OF INITIATING SOCIALCHANGE 03
INFLUENCE OF PARENTS 04
INFLUENCE OF OLD WOMEN/GRANDMOTHERS 05
NON-ENFORCEMENT OF THE LAW 06
LACK OF GOVT EFFORTS TO ENLIGHTEN PEOPLE 07
INSUFFICIENT HEALTH EDUCATION 08
OTHER (SPECIFY) _____ 09

237 What, in your opinion, is the best way to abolish the practice?

ENFORCED LEGISLATION 1
EDUC CAMPAIGNS FOR MEN 2
INVOLVEMENT OF FATHERS 3
IMPROVEMENT OF WOMENS STATUS 4
SEX EDUCATION 5
OTHER (SPECIFY) _______ 6

238 CHECK 108A:

MARRIED (GO TO 239)
WIDOWED, DIVORCED/SEPARATED (GO TO 241)

239 Is your husband in favor of continuation or discontinuation in of female circumcision?

FAVORS CONTINUATION 1
FAVORS DISCONTINUATION 2 (GO TO 241)
HAS NO OPIONION 3 (GO TO 241)
DK 8 (GO TO 241)

240 What type of female circumcision does your husband favors?

PHARONIC 1
INTERMEDIATE 2
SUMMA 3
OTHER 4
DK 8

241 I PRESENCE OF OTHERS AT THIS POINT.

CHILDREN UNDER 10
YES 1
NO 2
HUSBAND
YES 1
NO 2
OTHER MALES
YES 1
NO 2
OTHER FEMALES
YES 1
NO 2

SECTION 3: CONTRACEPTION

301 Now I would like to talk about a different topic. There are various ways or methods that a couple can use to delay or avoid a pregnancy. Which of these ways or methods have you heard about?
CIRCLE CODE 1 IN 302 FOR EACH METHOD MENTIONED SPONTANEODSLY. THEN PROCEED DOWN THE COLUMN, REAOING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED BPONTANEODSLY. CIRCLE CODE 2 IF METHOD IS RECOONIZED, AND CODE 3 IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE 1 OR 2 CIRCLED IN 302, ASK 303-305 BEFORE PROOEEDING TO THE NEXT METHOD.

302 Have you ever heard of (METHOD)? READ DESCRIPTION.

01 PILL Women can take a pill every day.
YES/SPONT 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
02 IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
YES/SPONT 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
03 INJECTIONS Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
YES/SPONT 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
04 JELLY/DIAPAGM/ FOAM Women can place a sponge, suppository, jelly, or cream in their vagina before sexual intercourse.
YES/SPONT 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
05 CONDOM Men can put a rubber sheath on their penis before sexual intercourse.
YES/SPONT 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
06 FEMALE STERILIZATION Women can have an operation to avoid having any more children.
YES/SPONT 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
07 MALE STERILIZATION Men can have an operation to avoid having any more children.
YES/SPONT 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
08 PERIODIC ABSTINENCE Couples can avoid having sexual intercourse on certain days of the month when the woman is most likely to become pregnant.
YES/SPONT 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
09 WITHDRAWAL Men can be careful and pull out before climax.
YES/SPONT 1
YES/PROBED 2
NO 3 (GO TO NEXT METHOD)
10 ANY OTHER MWTHODS? Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
1 (SPECIFY) ________
2 (SPECIFY) ________
3 (SPECIFY) ________
YES/SPONT 1
NO 3

303 Have you ever used (METHOD)?

01 PILL Women can take a pill every day.
YES 1
NO 2
02 IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
03 INJECTIONS Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
YES 1
NO 2
04 JELLY/DIAPAGM/ FOAM Women can place a sponge, suppository, jelly, or cream in their vagina before sexual intercourse.
YES 1
NO 2
05 CONDOM Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
06 FEMALE STERILIZATION Women can have an operation to avoid having any more children.
YES 1
NO 2
07 MALE STERILIZATION Men can have an operation to avoid having any more children.
YES 1
NO 2
08 PERIODIC ABSTINENCE Couples can avoid having sexual intercourse on certain days of the month when the woman is most likely to become pregnant.
YES 1
NO 2
09 WITHDRAWAL Men can be careful and pull out before climax.
YES 1 (GO TO 305 METHOD 09)
NO 2 (GO TO 305 METHOD 09)
10 ANY OTHER MWTHODS? Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1
NO 2
YES 1
NO 2
YES 1
NO 2

304 Where would you go to obtain (METHOD) if you wanted to use it? (CODES BELOW)

01 PILL Women can take a pill every day.
YES 1
NO 2
02 IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
03 INJECTIONS Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
YES 1
NO 2
04 JELLY/DIAPAGM/ FOAM Women can place a sponge, suppository, jelly, or cream in their vagina before sexual intercourse.
_______
OTHER _____
05 CONDOM Men can put a rubber sheath on their penis before sexual intercourse.
_______
OTHER _____
06 FEMALE STERILIZATION Women can have an operation to avoid having any more children.
_______
OTHER _____
07 MALE STERILIZATION Men can have an operation to avoid having any more children.
_______
OTHER _____
08 PERIODIC ABSTINENCE Couples can avoid having sexual intercourse on certain days of the month when the woman is most likely to become pregnant.
Where would you go to obtain advice on periodic abstinence?
_______
OTHER _____
09 WITHDRAWAL Men can be careful and pull out before climax.
_______
OTHER _____

CODES FOR 304

01 GOVERNMENT HOSPITAL
02 GOVERNMENT HEALTH CNTR
03 FAMILY PLANNING CLINIC
04 DISPENSARY
05 OTH, GOVT. HLTH FAC.
06 PHARMACY
07 MOBILE CLINIC
08 PRIVATE DOCTOR
09 PRIVATE HOSPITAL
10 FRIENDS AND RELATIVES
11 OTHERS (SPECIFY)
98 DON’T KNOW

305 In your opinion, what is the main problem, if any, with using (METHOD)? (COOES BELOW)

01 PILL Women can take a pill every day.
YES 1
NO 2
02 IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
03 INJECTIONS Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
YES 1
NO 2
04 JELLY/DIAPAGM/ FOAM Women can place a sponge, suppository, jelly, or cream in their vagina before sexual intercourse.
_______
OTHER _____
05 CONDOM Men can put a rubber sheath on their penis before sexual intercourse.
_______
OTHER _____
06 FEMALE STERILIZATION Women can have an operation to avoid having any more children.
_______
OTHER _____
07 MALE STERILIZATION Men can have an operation to avoid having any more children.
_______
OTHER _____
08 PERIODIC ABSTINENCE Couples can avoid having sexual intercourse on certain days of the month when the woman is most likely to become pregnant.
_______
OTHER _____
09 WITHDRAWAL Men can be careful and pull out before climax.
_______
OTHER _____

CODES FOR 305

02 HOT EFFECTIVE
03 HUSBAND DISAPPROVES
04 OTHERS DISAPPROVE
05 HEALTH CONCERNS
06 ACCESS/AVAILABILITY
07 COSTS TOO MUCH
08 INCONVENIENT TO USE
09 PERMANENT METHOD
11 RELIGION
12 OTHER (SPECIFY)
13 NONE
98 DONT KNOW

306 CHECK 303:

NOT A SINGLE "YES" (NEVER USED) (GO TO 307)
AT LEAST ONE "YES" (EVER USED) (SKIP TO 309)

307 J Rave you ever used anything or tried in any way to delay or avoid getting pregnant?
CIRCLE THE APPROPRIATE RESPONSE.

YES 1
NO 2 (GO TO 316)

308 What have you used or done?
CORRECT 302-303 AND 06TAIN INFORHATIOM FOR 304 TO 306 AS NECESSARY.

309 CHECK 303:

EVER USED PERIOOIC ABSTINENCE (GO TO 310)
NEVER USED PERIOOIC ABSTINENCEF (GO TO 311)

310 The last time you used periodic abstinence, how did you determine on which days you had to abstain?

BASED ON CALENDAR 1
BASED ON BOOY TEMPERATURE 2
BASED ON CERVICAL MUCUS (BILLINGS) METHOO 3
BASED ON BOOY TEMPERATURE AND MUCUS 4
OTHER (SPECIFY) _____ 5
NO SPECIFIC SYSTEM 6

311 How many living children, if any, did you have when you first did something or used a method to avoid getting pregnant?
IF NONE ENTER 100 IN THE BOXES.

NUMBEROF CHILDREN _____

311A CHECK 108A:

MARRIED (GO TO 312)
WIDOWED, DIVORCED/SEPARATED (GO TO 315F)

312 CHECK 220:

NOT PREGNANT OR UHSURE (GO TO 313)
PREGNANT (GO TO 316)

313 Are you currently doing something or using any method to avoid getting pregnant?

YES 1
NO 2 (GO TO 315F)

314 Which method are you using?

PILL 01
IUD 02(GO TO 315)
INJECTIONS 03(GO TO 315)
JELLY/DIAPHRAGM/FOAM 04 (GO TO 315)
CONDOM 05(GO TO 315)
FEMALE STERILIZATION 06(GO TO 315A)
MALE STERILIZATION 07 (GO TO 315A)
PERIOOIC ABSTINENCE 08 (GO TO 315B)
WITHDRAWAL 09 (GO TO 319)
OTHER 10 (SPECIFY) ______ (GO TO 319)

314A Please show me the package of pills you are now using.
(RECORD NAME OF BRAND.)

BRAND NAME _____
NOT ABLE `TO SHOW 96

314B How much does one packet (cycle) of pills cost you?

COST _____
FREE 96
DONT KNOW 98

315 Where did you obtain (METHGO) the Last time?
315A Where did the sterilization take place?
515B Where did you obtain instructions for this method?

GOVERNMENT HOSPITAL 01
GOVERNMENT HEALTH CENTRE 02
FAMILY PLANNING CLINIC 03
DISPENSARY 04
OTH, GOVT. HLTH FAC 05
PHARMACY 06
MOBILE CLINIC 07
PRIVATE DOCTOR 08
PRIVATE HOSPITAL 09
FRIENDS AND RELATIVES 10
OTHERS (SPECIFY) 11 (GO TO 319)
DOHT KNOW 98 (GO TO 319)

315C Was there anything you particularly disliked about the (SOURCE OF LAST METHOD) or the services you received there?

NONE 1
TOO FAR 2
WAIT TOO LONG 3
NOT COMFORTABLE WITH STAFF 4
SERVICES EXPENSIVE 5
DESIRED METHOD UNAVAILABLE 6
OTHER (SPECIFY) ______7
UNSURE 8

315D CHECK 314:

USING PILL, INJECTIONS, DIAPHRAGM/FOAM/JELLY OR CONDOM (GO TO 315E)
USING ANY OTHER METHOD (GO TO 319)

315E Did you ever stop using your method because you could not get supplies at the (SOURCE OF CURRENT METHOD)?

YES 1
NO 2 (GO TO 319)

315F CHECK 208: ANY BIRTHS?

YES (GO TO 315G)
NO (GO TO 316)

315G Since your last birth have you done anything or used any method to avoid getting pregnant?

YES 1
NO 2 (GO TO 316)

315H What was the last method you used?

PILL 01
IUD 02
INJECTIONS 03
DIAPHRAGM/FOAM/JELLY 04
CONDOM 05
FEMALE STERILIZATION 06
MALE STERILIZATION 07
PERIOOIC ABSTINENCE 08 (GO TO 315J)
WITHDRAWAL 09 (GO TO 315K)
OTHER (SPECIFY) ______ (GO TO 315K)

315I Where did you obtain (METHO0) the last time?
315J Where did you obtain instructions for this method?

GOVERNMENT HOSPITAL 01
GOVERNMENT HEALTH CHTR E 02
FAMILY PLANNING CLINIC 03
DISPENSARY 04
OTH. GOVT. NLTN FAG 05
PHARMACY 06
MOBILE CLINIC 07
PRIVATE DOCTOR 08
PRIVATE HOSPITAL 09
FRIENDS AND RELATIVES 10
OTHERS (SPECIFY) 11
DK 98

315K* What was the main reason you stopped using (LAST METHOD) then?

TO BECOME PREGNANT 01
METHOD FAILED 02
HUSBAND DISAPPROVED 03
OTHERS DISAPPROVED 04
HEALTH CONCERNS 05
ACCESS/AVAILABILITY 06
COSTS TOO MUCH 07
INCONVENIENT TO USE 08
INFREQUENT SEX/HUSB. NOT PRES 10
RELIGION 11
OTHER (SPECIFY) _____ 12
DK 98

*Interviewers were instructed to skip to 319 if sterilization was the answer in 315H

316 Do you intend to use a method to avoid pregnancy at any time in the future?

YES 1
NO 2 (GO TO 319)
DK (GO TO 319)

317 Which method would you prefer to use?

PILL 01
IUD 02
INJECTIONS 03
DIAPHRAGM/FOAM/JELLY 04
CONDOM 05
FEMALE STERILIZATION 06
MALE STERILIZATION 07
PERIODIC ABSTINENCE 08
WITHDRAWAL 09
OTHER (SPECIFY) _____10
UNSURE 98

318 Do you intend to use (PREFERRED METHOD) in the next 12 months?

YES 1
NO 2
DK 8

319 It is acceptable or not acceptable to you for family planning information to be provided on radio or television?

ACCEPTABLE 1
NOT ACCEPTABLE 2
DK 8

SECTION 4, HEALTH AND BREASTFEEDING

401CHECK 214:

ONE OR MORE LIVE BIRTHS SINCE JAN. 1984 (GO TO 402)
NO LIVE BIRTHS SINCE JAN. 1984 (SKIP TO 445)

402 ENTER THE LINE NUMBER, NAME AND SURVIVAL STATUS OF EACH BIRTH SINCE JAN. 1984 IN THE TABLE. BEGIN WITH THE LAST BIRTH. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS.

LINE NUMBER FROM Q.212

LINE NUMBER ________

FROM Q.212
FROM Q.215

NAME _________________
ALIVE (GO TO 403)
DEAD (GO TO 403)

403 When you were pregnant with (NAME) were you given an injection in the arm to prevent the baby from getting tetanus, that is, convulsions after birth?

YES 1
NO 2(SKIP TO 404)
DK 8(SKIP TO 404)

403A How many times did you get this injection?

TIMES ____
DK 8

404 When you were pregnant with (NAME), did you see anyone for a check on this pregnancy?
IF YES: Whom did you see?
PROBE FOR THE TYPE OF PERSON AND RECORD THE MOST QUALIFIED.

DOCTOR 1
TRAINED HEALTH WORKER/MIDWIFE 2
TRADITIONAL BIRTH ATTENDANT 3
OTHER (SPECIFY) ________ 4
NO ONE 5

405 Who assisted with the delivery of (NAME)?
PROBE FOR THE TYPE OF PERSON ANO RECORD THE MOST QUALIFIED.

DOCTOR 1
TRAINED HEALTH WORKER/MIDWIFE 2
TRADITIONAL BIRTH ATTENDANT 3
OTHER (SPECIFY) ________ 4
NO ONE 5

405A How many months after the birth of (NAME) did your period return?

MONTHS ____
NOT RETURNED 96

405B Have you resumed sexual relations since the birth of (NAME)?

YES (OR PREGN.) 1
NO 2 (SKIP TO 406)

405C How long after the birth of (NAME) did you resume sexual relations?

MONTHS ____
40 DAYS 96

406 Did you ever feed (NAME) at the breast?

YES 1 (SKIP TO 407)
NO 2

406A Why did you not feed (NAME) at the breast?

INCONVENIENT 01 (BACK TO 403, COL. 2)
HAD TO WORK 02 (BACK TO 403, COL. 2)
INSUFFICNT NILK 03(BACK TO 403, COL. 2)
BABY REFUSED 04(BACK TO 403, COL. 2)
CHILD DIED 05(BACK TO 403, COL. 2)
CHILD SICK 06(BACK TO 403, COL. 2)
OTHER (SPECIFY) 07(BACK TO 403, COL. 2)

407 Are you still breastfeeding (NAME)?
(IF DEAD, CIRCLE ‘2’)

YES 1 (BACK TO 403, COL.2)
NO (CHILD DEAD) 2

408 Now many months did you breastfeed (NAME)?

MONTHS _____
UNTIL DEATH 96 (BACK TO 403, COL. 2)

408A Why did you stop breastfeeding (NAME)?

INCONVENIENT 01 (BACK TO 403, COL. 2)
HAD TO WORK 02 (BACK TO 403, COL. 2)
INSUFFICNT NILK 03(BACK TO 403, COL. 2)
BABY REFUSED 04(BACK TO 403, COL. 2)
CHILD DIED 05(BACK TO 403, COL. 2)
CHILD SICK 06(BACK TO 403, COL. 2)
CH HAD DIARRNEA 07 (BACK TO 403, COL.2)
CH WEANING AGE 08 (BACK TO 403, COL.2)
BECAME PREONANT 09 (BACK TO 403, COL.2)
OTHER (SPECIFY) 10 (BACK TO 403, COL. 2)

412 CHECK407 COL. 1 FOR LAST BIRTH:

LAST CHILD STILL BREASTFED (GO TO 413)
NAME ________
LAST CHILD DEAD OR NO BREASTFEEDING NOW (GO TO 417A)
407 IS BLANK (GO TO 418)

415 At any time yesterday or last night, was (NAME OF LAST CHILD) given any of the following:
Sugar water?
Plain water?
Juice?
Powdered milk?
Cow’s or goat’s milk?
Bottled baby’s formula
Any other liquid?
Any solid or mushy food?

SUGAR WATER
YES 1
NO 2
PLAIN WATER
YES 1
NO 2
JUICE
YES 1
NO 2
POWERED MILK
YES 1
NO 2
COM’S OR GOAT’S MILK
YES 1
NO 2
BOTTLED BABY’S FORMULA
YES 1
NO 2
ANY OTHER LIQUID (SPECIFY) ______
YES 1
NO 2
ANY SOLID OR MUSHY FOOD
YES 1
NO 2

416 CHECK415:

WAS GIVEN FOOD OR LIQUID (GO TO 417)
NO FOOD OR LIQUID GIVEN (GO TO 417A)

417 Were any of these given in a bottle with a nipple?

YES 1
NO 2

417A Have you given (Did you give) (NAME OF LAST CHILD) milk other than breast milk on a regular daily basis?

YES 1
NO 2 (GO TO 417C)

417B How many months after the birth of (NAME OF LAST CHILD) did you start giving him/her any kind of milk other than breast milk?

MONTHS ______

417C Have you given (Did you give) (NAME OF LAST CHILD) solid or semi-solid food on a regular daily basis?

YES 1
NO 2 (GO TO 418)

417D How many months after the birth of (NAME OF LAST CHILD) did you start giving him/her the food?

MONTHS ______

418 At the time you became pregnant with (NAME), did you want to become pregnant then, did you want to wait until later, or did you want no (more) children at all?

THEN 1
LATER 2
NO MORE 3

419 ENTER THE NAME, LINE NUMBER, AND SURVIVAL STATUS OF EACH BIRTH SINCE JAN. 1984 BELOW. BEGIN WITH THE LAST BIRTH.
THE INFORMATION ABOUT THE CHILDREN IN THE TABLE SHOULD BE EXACTLY THE SAME AS THOSE AFTER Q. 402.
ASK THE QUESTIONS ONLY FOR LIVING CHILDREN.

420 Do you have an immunization card for (NAME)?
IF YES: May I see it please?

YES, SEEN 1
YES, NOT SEEN/NOT CLEAR 2 (SKIP TO 422)
NO CARD 3(SKIP TO 422)

421 RECORD DATES OF IMMUNIZATIONS FROM HEALTH CARD.

BCG
NOT GIVEN 1
DA ___
MO _____
YR ______
POLIO 0
NOT GIVEN 1
DA ___
MO _____
YR ______
POLIO 1
NOT GIVEN 1
DA ___
MO _____
YR ______
POLIO 2
NOT GIVEN 1
DA ___
MO _____
YR ______
POLIO 3
NOT GIVEN 1
DA ___
MO _____
YR ______
DPT 1
NOT GIVEN 1
DA ___
MO _____
YR ______
DPT 2
NOT GIVEN 1
DA ___
MO _____
YR ______
DPT 3
NOT GIVEN 1
DA ___
MO _____
YR ______
MEASLES
NOT GIVEN 1
DA ___
MO _____
YR ______

422 Please tell me if (NAME) received any of the following vaccinations?
A. BCG, an injection in the arm?

YES, SCAR SEEN 1
NO SCAR PRESENT 2
CHILD AWAY 3
NO/DK 8

B. Polio, drops by mouth? IF YES: How many times?

YES, TIMES _____
NO/DK 8

C. DPT. IF YES: How many times?

YES, TIMES _____
NO/DK 8

D. An injection against measles? IF YES: How many times?

YES, TIMES _____
NO/DK 8

424 CHECK 422:

SOME VACCINATION (GO TO 425)
NO VACCINATION (SKIP TO 426)

425 Where did (NAME) receive most of the vaccines?

GOVERNMENT HOSP 01
HEALTH CENTER 02
MOBILE CLINIC 03
PRIVATE DOCTOR 04
PRIVATE CLINIC 05
DISPENSARY 06
DRESSING STATION 07
PRIMARY HEALTH FAC 08
OUTREACH STATION 09
OTHER (SPECIFY) ______ 10
DK 98

426 Has (NAME) had fever during the test two weeks?

YES 1
NO 2
DK 8

427 Has (NAME) been ill with cough at any time during the last two weeks?

YES 1
NO 2 (SKIP TO 430)
DK 8 (SKIP TO 430)

429 When (NAME) had cough did he/she breathe faster than usual?

YES 1
NO 2
DK 8

430 CHECK 426 AND 427:

FEVERE (GO TO 431)
COUGH (GO TO 431)
NEITHER (SKIP TO 433)

431 From whom, if anyone, did you seek advice or treatment fever/cough?

GOVERNMENT HOSP 1
HEALTH CENTER 1
MOBILE CLINIC 1
PRIVATE DOCTOR 1
PRIVATE CLINIC 1
DISPENSARY 1
DRESSING STATION 1
PRIMARY HEALTH FAC 1
OUTREACH STATION 1
OTHER (SPECIFY) ______ 1
DK 1
NO ONE 1

432 What was given to treat the fever/cough, if anything? Anything else?
(CIRCLE EACH MENTIONED)

NO TREATMENT 1
ANTIBIOTIC PILL 1
ANTIBIOTIC SYRUP 1
OTHER PILL OR OTHER SYRUP 1
INJECTION 1
(I.V.) INTRAVENOUS 1
HOME REMEMDIES/HEARAL MEDICINES 1
OTHER (SPECIFY) _______ 1

433 Has (NAME) diarrhea now or had it in the last 24 hours?

YES 1(SKIP TO 435)
NO 2

434 Has (NAME) had diarrhea in the test two weeks?

YES 1
NO 2 (BACK TO 420. COL. 2)
DK 8 (BACK TO 420. COL. 2)

435 Now I have some question about (NAME’s) last episode of diarrhea. How many days ago did the diarrhea start?

DAYS ____
DK 98

436 Was there any blood in the stools?

YES 1
NO 2
DK 8

437 CHECK 407:
LAST CHILD STILL BREASTFED?

YES 1 (GO TO 438)
NO 2 (SKIP TO 439)

438 During the diarrhea, did you continue breastfeading as usual, or did you increase the number of feeds or reduce it, or did you stop completely?

MORE 1
LESS 2
SAME 3
STOPPED BREASTFEEDING 4

439 (Aside from breastmilk) Was he/she given the same amount to drink as before the diarrheae or more, or less?

MORE 1
LESS 2
SAME 3
DK 8

440 Was (NANE) given more, less, or the same amount of solid food as was given before he/she had diarrhea?

MORE 1
LESS 2
SAME 3
STOPPED SOLID FOODS 4
SOLID FOOD NOT YET GIVEN 5
DK 8

441 Was (NAME) given solution made from a special packet?
SHON PACKET

YES 1 (SKIP TO 443)
NO 2

442 Was (NAME) given a special home fluid made from sugar, salt and water?

YES 1
NO 2
DK 8

443 What was given for diarrhea, if anything, (other than the mixture you mentioned)?

NO TREATMENT 1
ANTIBIOTIC PILL 1
ANTIBIOTIC SYRUP 1
OTHER PILL OR OTHER SYRUP 1
INJECTION 1
(I.V.) INTRAVENOUS 1
MORE REMEDIES/HERBAL MEDICINES 1
OTHER (SPECIFY) ______ 1

444 From whom, if anyone, did you seek advice or treatment of diarrhea?

GOVERNMENT HOSP 1 (ALL BACK TO 420, COL. 2)
HEALTH CENTER 1 (ALL BACK TO 420, COL. 2)
MOBILE CLINIC 1 (ALL BACK TO 420, COL. 2)
PRIVATE DOCTOR 1 (ALL BACK TO 420, COL. 2)
PRIVATE CLINIC 1 (ALL BACK TO 420, COL. 2)
DISPENSARY 1 (ALL BACK TO 420, COL. 2)
DRESSING STATION 1 (ALL BACK TO 420, COL. 2)
PRIMARY HEALTH FAC 1 (ALL BACK TO 420, COL. 2)
OUTREACH STATION 1 (ALL BACK TO 420, COL. 2)
OTHER (SPECIFY) ______ 1 (ALL BACK TO 420, COL. 2)
DK 1 (ALL BACK TO 420, COL. 2)
NO ONE 1 (ALL BACK TO 420, COL. 2)

445 CHECK 441:

ORS SOLUTION NOT GIVEN OR441 NOT ASKED (GO TO 446)
ORS SOLUTION GIVEN (GO TO 448)

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

YES 1
NO 2

447 Have you ever seen a packet of ORS Like this before?
SHOW PACKET.

YES 1
NO 2 (GO TO 455)

448 Have you ever prepared one of these ORS packets for yourself or for someone else?

YES 1
NO 2 (GO TO 452)

449 In what kind of container did you prepare the mixture of the packet and the water?

JUG 1
BOTTLE 2
GLASS 3
CUP 4
COOKING POT 5
OTHER (SPECIFY) _______ 6

450 Please fill the container the way you filled it the last time you prepared one packet of the mixture.
LET THE RESPONDENT POUR THE FLUID INTO HER VESSEL, THEN POUR THE FLUID INTO YOUR MEASURING CONTAINER AND RECORD THE QUANTITY OF FLUID IN ML.

FULL UNICEF 1
PART UNICEF 2
FULL HYDRON 3
PART HYDRON 4
OTHER 8

451 When you prepared the solution of packet and water, did you add anything else to the mixture?
IF YES, ASK: What did you add?

SUGAR 1
JUICE 2
OTHER SWEETNERS (SPECIFY) ______ 3
OTHER (SPECIFY) _____ 4
ADDED NOTHING 5

452 Where can you get the ORS packets?
PROSE: Anywhere else?
CIRCLE ALL PLACES MENTIONED.

GOVERNMENT HOSPITAL 1
GOVERNMENT HEALTH CENTER 1
DISPENSARY 1
DRESSING STATION 1
PRIMARY HEALTH FACILITY 1
MOBILE CLINIC 1
PRIVATE DOCTOR 1
PRIVATE CLINIC 1
PHARMACY 1
SHOP 1
TRADITIONAL DOCTOR 1
OTHER (SPECIFY) _______ 1
DK 1

453 How much do (you think) the packets cost?

COST _____
FREE 96
DK 98

454 Do you have one of these packets in your house now? IF YES: Can I see the packet?

YES, SHOWS PACKET 1
YES, DOES NOT SHOW PACKET 2
NO PACKET IN HOUSE 3

455 Which places can you go if you want to get a vaccination for a child?

GOVERNMENT HOSPITAL 1
GOVERNMENT HEALTH CENTER 1
DISPENSARY 1
DRESSING STATION 1
PRIMARY HEALTH FACILITY 1
MOBILE CLINIC 1
PRIVATE DOCTOR 1
PRIVATE CLINIC 1
PHARMACY 1
SHOP 1
TRADITIONAL DOCTOR 1
OTHER (SPECIFY) _______ 1
DK 1

SECTION 5. MARRIAGE

502 CHECK 108A AND CIRCLE CURRENT MARITAL STATUS.

MARRIED 1
WIDOWED 2 (GO TO 507)
DIVORCED/SEPARATED 3 (GO TO 507)

503 Does your husband live with you or is he now staying elsewhere?

LIVING WITH HER 1
STAYING ELSEWHERE 2

504 Does your husband now have any other wives besides yourself?

YES 1
NO 2 (GO TO 507)

505 How many other wives does he have?

NUMBER ____
DK 8 (GO TO 507)

506 Are you currently the first, second, ... wife?

RANK _____

507 Have you been married only once, or more than once?

ONCE 1
MORE THAN ONCE 2

508 In what month and year did you start living with [ZAFAF] your (first) husband or partner?

MONTH ______
DK 98
YEAR _____ (GO TO 515)
DK YEAR 98

509 How old were you when you started living with [ZAFAF] him?

AGE _____

515 Right after you got married, did you and your (first) husband live with your parents or his parents for at least six months?

YES 1 (GO TO 516)
NO 2

515A Why not?

NO LIVING PARENT 1 (GO TO 517)
HAD OWN HOUSE 2 (GO TO 517)
OTHER (SPECIFY) ______ 3 (GO TO 517)

516 For about how many years did you live together with a parent at that time?

YES ______
UP TO THE PRESENT 96 (GO TO 518)

517Are you now living either with your parents or your (current) husband’s parents?

YES 1
NO 2

518 In how many villages or towns have you lived for six months or more since you were first married including this place?

NUMBER OF VILLAGES/TOWNS ______

518A CHECK 502:

CURRENTLY MARRIED (GO TO 521)
WIDOWED,DIVORCED/SEPARATED (GO TO 528)

521 Now we need some details about your sexual activity in order to get a better understanding of contraception and fertility.
Have you had sexual intercourse in the last four weeks?

YES 1
NO 2 (GO TO 523)

522 How many times did you have had sexual intercourse?

TIMES _____

523 When was the last time you had sexual intercourse?

DAYS AGO 1
WEEKS AGO 2
MONTHS AGO 3
YEARS AGO 4
BEFORE LAST BIRTH 996 (GO TO 528)

524 CHECK 220:

NOT PREGNANT OR UNSURE (GO TO 525)
PREGRANT (GO TO 528)

525 CHECK 313:

NOT USING CONTRACEPTION (GO TO 526)
USING CONTRACEPTION (GO TO 528)

526 If you became pregnant in the next few weeks, would you feel happy, unhappy, or would it not matter very much?

HAPPY 1 (GO TO 528)
UNHAPPY 2
WOULD NOT MATTER 3

527 Whet is the main reason that you are not using a method to avoid pregnancy?*

LACK OF KNOWLEDGE 01
OPPOSED TO FAMILY PLANNING 02
HUSBAND DISAPPROVES 03
OTHERS DISAPPROVE 04
HEALTH CONCERNS 05
ACCESS/AVAILABILITY 06
COSTS T~ MUCH 07
INCONVENIENT TO USE OE
INFREQUENT SEX 09
FATALISTIC 10
RELIGION 11
POSTPARTUM/BREASTFEEDING 12
MENOPAUSAL/SUBFECUND 13
OTHER (SPECIFY) ______ 14
DK 98

528 PRESENCE OF OTHERS AT THIS POINT.

CHILDREN UNDER 10
YES 1
NO 2
HUSBAND
YES 1
NO 2
OTHER MALES
YES 1
NO 2
OTHER FEMALES
YES 1
NO 2

SECTION 6. FERTILITY PREFERENCES

601 CHECK 502:

CURRENTLY MARRIED (GO TO 602)
WIDOWED, DIVORCED/SEPARATED (GO TO 609)

602 Now 1 have some questions about the future.
CHECK 220 AND MARK BOX.

NOT PREGNANT OR UNSURE
Would you like to have a (another) child or would you prefer not to have any (more) children?

PREGNANT
After the child you are expecting, would you like to have another child or would you prefer not to have any (more) children?

HAVE ANOTHER 1
NO MORE 2(GO TO 604A)
SAYS SHE CAN’T GET PREGNANT 3 (GO TO 604A)
UNDECIDED OR DK 8(GO TO 604A)

603 How long would you like to wait from now before the birth of a (another) child?

DURATION
MONTHS 1 _____ (GO TO 604A)
YEARS 2 ____ (GO TO 604A)
DK 998

604 CHECK 202 AND 204:
How old would your youngest child be?
IF NO LIVING CHILDREN, CIRCLE ‘96’.

AGE OF YOUNGEST YEARS _____
NO LIVING CHILDREN 96
DK 98

604A Do you think your husband would like to have a (another) child or do you think he would prefer not to have any more children?

HAVE ANOTHER I
NO MORE 2
DK 8

607 Do you think that your husband approves ot disapproves of couples using a method to avoid pregnancy?

APPROVES 1
DISAPPROVES 2
DK 8

608 How often have you talked to your husband about family planning in the last year?

NEVER 1
ONCE OR TWICE 2
MORE OFTEN 3

609 In general, do you approve or disapprove of couples using a method to avoid pregnancy?

APPROVE 1
DISAPPROVE 2

610 CHECK 202 AND 204:
NO LIVING CHILDREN
If you could choose exactly the number of children to have in your whole life, how many would that be?
HAS LIVING CHILDREN
If you could go back to the time you did not have any children arid could choose exactly the number of children to have in your whole Life, how many would that be?
RECORD SINGLE HUMBER OR OTHER ANSWER.

NUMBER ______
OTHER ANSWER (SPECIFY) ______

SECTION 7. HUSBAND’S BACKGOUND

CHECK 502:

701 CURRENTLY MARRIED (USE PRESENT TENSE IN QUESTIONS 706-711)
DIVORCED OR WIDOWED (USE PAST TERSE IN QUESTIONS 706-711)

702Now I have some questions about your (most recent) husband. Did your husband ever attend school?

YES 1
NO 2 (GO TO 706)
DK 8 (GO TO 706)

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

PRIMARY 1
JUNIOR SECONDARY 2
HIGHER SECONDARY 3
HIGHER EDUCATION 4
DK 8 (GO TO 706)

704 What was the highest grade he completed at that level?

GRADE _____
DK

705 CHECK 703:

PRIMARY (GO TO 706)
SECONDARY OR HIGHER (GO TO 707)

706 Can (could) he read a letter or newspaper easily, with difficulty, or not at all?

EASILY 1
WITH DIFFICUCTY 2
NOT AT ALL 3

707 What is (was) the main job of your husband?

_________

708 CHECK707:

DOES (DID) NOT WORKS IN AGRICULTURE (GO TO 709)
WORKS (WORKED) IN AGRICULTURE (GO TO 710)

709 What is (was) the employment status of your husband? Is he an employee, employer, own account worker, or unpaid family business worker?

EMPLOYEE 1 (GO TO 712)
EMPLOYER 2(GO TO 712)
OWN ACCOUNT WORKER 3 (GO TO 712)
FAMILY BUSINESS (UNPAID) 4(GO TO 712)

710 Does (did) your husband work mainly on his or family land, or on someone else’s land?

HIS/FAMILY LAND 1 (GO TO 712)
SOMEONE ELSE’S LAND 2

711 Does (did) he work mainly for money or does (did) he work for a share of the crops?

MONEY 1
A SHARE OF CROPS 2

712 Before you married your (first) husband, did you your self ever work regularly to earn money, other than on farm or in a business run by your family

YES 1
NO 2 (GO TO 714)

713 When you were earning money then, did you turn most of it over to your family or did you keep most of it yourself?

FAMILY 1
SELF 2
BOTH 3

714 Since you were first married, have you ever worked regularly to earn money other than on a farm or in a business run by your family?

YES 1
NO 2 (GO TO 801)

717 Are you no, working to earn money other than on a farm or in a business run by your family?

YES 1
NO 2 (GO TO 801)

717A What is your job?

_____________

SECTION 8. MATERNAL MORTALITY

801 Now I would like to ask you about your brothers and sisters, that is, the children born to your own mother. Please tell me the names of all your brothers al sisters including those who have died end those who are living elsewhere.
RECORD NAMES OF ALL BROTHERS AND SISTERS.
IF NO BROTHERS AND SISTERS SKIP TO 816,

802 What name was given to your oldest (next oldest) brother or sister?

_____________

803 Is (NAME) male or female?

MALE 1
FEMALE 2

804 Is (NAME) still alive?

YES 1
NO 2 (GO TO 807)
DK 8 (GO TO NEXT BROTHER OR SISTER)

805 How old is (NAME)?

___________ (GO TO NEXT BROTHER OR SISTER)

807 Now many years ago did (NAME) die?

____________

808 How old was (NAME) when she/he died?
IF MALE OR DIED BEFORE 10 YEARS OF AGE, GO TO NEXT BROTHER OR SISTER.

____________

809 Has (NAME) ever married?

YES 1
NO 2 (GO TO NEXT BROTHER OR SISTER)

810 Did she die during pregnancy or childbirth?

YES 1(GO TO 812)
NO 2

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

YES 1
NO 2

812 How many children did (NAME) ever give birth to?

____________

813 What was name of her husband?

____________

814 Let me see if I have this right. You have a total of brothers and sisters including those who live elsewhere.

YES (GO TO 815)
NO (PROBE AND CORRECT)

815 Does any of your sister (from your mother) who are over 14 years old live now live in this house?

YES (CHECK WITH RESPONDENT WHICH OF THE ELIGIBLE WOMEN IN THE HOUSEHOLD QUESTIONNAIRE ARE HER SISTERS AND WRITE THEIR LINE NUMBERS BELOW.)
NO (SKIP TO 816)

816 RECORD THE TIME.

HOUR _____
MINUTES _____


SECTION 9. LANGUAGE INFORMATION AND OBSERVATIONS

901 WHAT IS THE RESPONDENT’S OWN LANGUAGE?

ARABIC 01
OTHER (SPECIFY) ______ 98

902 I IN WHAT LANGUAGE DID YOU CONDUCT THE INTERVIEW?

ARABIC 01
OTHER (SPECIFY) ______ 98

903 FOR HOW MUCH OF THE INTERVIEW DID YOU DEPEND ON A THIRD PERSON TO INTERPRET FOR YOU?

NONE OF THE INTERVIEW 1
SOHE OF THE INTERVIEW 2
HOST OF THE INTERVIEW 3

INTERVIEWER’S OBSERVATIONS

Person Interviewed:

Specific Questions:

Other Aspects:

I CERTIFY THAT I REVIEWED THE QUESTIONNAIRE IN THE RESPONDENT’S PLACE.

HOUR ____
MINUTES ______

Name of Interviewer:

SUPERVISORIS OBSERVATIONS

Name of Supervisor:
Date:

EDITOR’S OBSERVATIONS

Name of Field Editor:
Date:

Name of Keyer:
Date: