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REPUBLIC OF SENEGAL - DEMOGRAPHIC AND HEALTH SURVEY (EDSII), 1992/1993
WOMAN'S QUESTIONNAIRE

IDENTIFICATION

PLACE NAME (COMMUNE/VILLAGE) _____
NAME OF HEAD OF HOUSEHOLD_____
CLUSTER NUMBER_____
HOUSEHOLD NUMBER_____
REGION_____

URBAN/RURAL:

URBAN 1
RURAL 2

REGION:

DAKAR (REGION OF DAKAR NOT RURAL) 1
LARGE CITY (THIES, KAOLACK, ZIGUINCHOR, SAINT-LOUIS, DJOURB) 2
CITY (OTHER COMMUNES) 3
COUNTRYSIDE (RURAL) 4

NAME/LINE NUMBER OF THE WOMAN

_____

NAME/LINE NUMBER OF THE HUSBAND

____

INTERVIEWER VISITS

FIRST VISIT (REPEAT FOR SECOND AND THIRD INTERVIEWERS)
DATE__
INTERVIEWER NAME____
RESULT___

RESULTS___

1 COMPLETED
2 NOT AT HOME
3 POSTPONED
4 REFUSED
5 PARTIALLY FILLED OUT
6 ILL/INCAPACITATED
7 OTHER (SPECIFY) ____

NEXT VISIT
DATE_____
TIME_____

FINAL VISIT
DAY_____
MONTH_____
YEAR _____
INTERVIEWER_____
RESULT_____

TOTAL NUMBER OF VISITS_____

LANGUAGE OF QUESTIONNAIRE:

FRENCH 1
WOLOF 2

USE OF INTERPRETER:

YES 1
NO 2

LANGUAGE OF INTERVIEW:

W 1
P 2
S 3
M 4
ALN 5
F 6

SUPERVISOR
NAME_____
DATE_____

FIELD EDITOR
NAME_____
DATE_____

OFFICE EDITOR_____
KEYED BY_____

SECTION 1. SOCIO-DEMOGRAPHIC CHARACTERISTICS OF THE RESPONDENT

101. RECORD THE TIME:

HOUR_____
MINUTES_____

102. To begin, I would like to ask you questions about yourself and your household. Until the age of 12 years, did you live the majority of time in a big city, in a city or in a rural area?

DAKAR 1
LARGE CITY 2
CITY 3
COUNTRYSIDE 4
FOREIGN COUNTRY 5

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

YEARS_____

ALWAYS 95 (GO TO 105)
VISITOR 96 (GO TO 105)

104. Just before you moved here, did you live in Dakar, another capital, a city, or village?
IF A CITY, ASK THE NAME OF THE CITY.

DAKAR 1
LARGE CITY 2
CITY 3
COUNTRYSIDE 4
FOREIGN COUNTRY 6

105. In which month and in which year were you born?

MONTH _____
DOESN'T KNOW MONTH 98
YEAR _____
DOESN'T KNOW YEAR 98

106. How old are you currently?
COMPARE AND CORRECT 105 AND/OR 106 IF INCONSISTENT.

AGE IN COMPLETED YEARS_____

107. Did you go to school?

YES 1
NO 2 (GO TO 111)

108. What is the highest level of school you attended: primary, secondary or superior?

PRIMARY 1
SECONDARY 2
SUPERIOR 3

109. What is the last (year/grade) that you achieved at this level?

GRADE _____

110. CHECK 108:

PRIMARY (GO TO 111)
SECONDARY OR MORE (GO TO 112)

111. Can you read and understand a letter or a newspaper easily, with difficulty or not at all?

EASILY 1
WITH DIFFICULTY 2
NOT AT ALL 3 (GO TO 113)

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

YES 1
NO 2

113. Are you Senegalese?

YES 1
NO 2 (GO TO 115)

114. What is your ethnicity?

WOLOF/LEBOU 01
POULAR 02
SERER 03
MANDINGUE/SOCE/MALINKE 04
DIOLA 05
OTHERS (SPECIFY) _____06

115. CHECK 04 IN THE HOUSEHOLD TABLE:

THE RESPONDENT IS NOT A RESIDENT (GO TO 116)
THE RESPONDENT IS A RESIDENT (GO TO 201)

Now I would like to ask you some questions about the place you usually live.

116. Do you usually live in Dakar, in a large city, a city or the countryside?
IF CITY: In which city do you live?

NAME OF CITY _____
DAKAR 1
LARGE CITY 2
CITY 3
COUNTRYSIDE 4
FOREIGN COUNTRY 5 (GO TO 118)

117. In which region is this?

REGION____

Now I would like to ask you some questions about the household in which you usually live.

118. What is the main source of water that the members of your household use to wash their hands and to wash the dishes?

PIPED WATER
PIPED INTO THE DWELLING/YARD/LOT 11 (GO TO 120)
PUBLIC TAP/STANDPIPE 12
OPEN WELL
OPEN WELL IN DWELLING/YARD/PLOT 21 (GO TO 120)
OPEN PUBLIC WELL 22
PROTECTED WELL 23
SURFACE WATER
RIVER/STREAM/BROOK 31
SWAMP/LAKE/POND 32
SPRING 33
DAM 34
RAINWATER 41 (GO TO 120)
TANKER TRUCK 51
BOTTLED WATER 61 (GO TO 120)
OTHER (SPECIFY) ____ 71

119. How long does it take to go there, get water, and come back?

MINUTES____
ON SITE 996

120. Do the members of your household get water from the same origin to drink?

YES 1 (GO TO 122)
NO 2

121. From where does the drinking water for your household come?

PIPED WATER
PIPED INTO THE DWELLING/YARD/LOT 11
PUBLIC TAP/STANDPIPE 12
OPEN WELL
OPEN WELL IN DWELLING/YARD/PLOT 21
OPEN PUBLIC WELL 22
PROTECTED WELL 23
SURFACE WATER
RIVER/STREAM/BROOK 31
SWAMP/LAKE/POND 32
SPRING 33
DAM 34
RAINWATER 41
TANKER TRUCK 51
BOTTLED WATER 61
OTHER (SPECIFY) _____ 71

122. What kind of toilet facility do the members of your household use?

FLUSH
PERSONAL FLUSH 11
COMMUNAL FLUSH 12
PIT/LATRINE
PIT 21
LATRINES 22
NO FACILITY IN THE HOUSEHOLD 31
OTHER (SPECIFY) _____41

123. Does your household have:

Electricity?
Radio?
Television?
Refrigerator or freezer?
Video?

ELECTRICITY
YES 1
NO 2
RADIO
YES 1
NO 2
TELEVISION
YES 1
NO 2
REFRIGERATOR/FREEZER
YES 1
NO 2
VIDEO
YES 1
NO 2

124. How many rooms in your household do you use to sleep in?

ROOMS_____

125. Could you describe the floor of your dwelling?

NATURAL MATERIAL
EARTH/SAND 11
DUNG 12
FINISHED FLOOR
PARQUET OR POLISHED WOOD 31
VINYLE OR LINO/ASPHALT 32
TILE 33
CEMENT 34
CARPET 35
OTHER (SPECIFY) ______41

126. Is there anyone in your household who owns:

A bicycle?
A scooter or motorcycle?
A car?

BICYCLE?
YES 1
NO 2
SCOOTER OR MOTORCYCLE?
YES 1
NO 2
CAR ?
YES 1
NO 2

SECTION 2. REPRODUCTION

Now I would like to ask about all of the births you have had during your life.

201. Have you ever given birth?

YES 1
NO 2 (GO TO 206)

202. Do you have any sons or daughters to whom you have given birth and 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 to whom you have given birth and 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?
How many daughters are alive but do not live with you?
IF NONE, RECORD '00'.

SONS ELSEWHERE _____
DAUGHTERS ELSEWHERE_____

206. Have you given birth to a son or daughter who was born alive but later died?
IF NO, PROBE: Any who cried and showed signs of life at birth but did not survive?

YES 1
NO 2 (GO TO 208)

207. How many sons have died?
And how many daughters have died?
IF NONE, RECORD '00'.

SONS DEAD_____
DAUGHTERS DEAD_____

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

TOTAL___

209. CHECK 208:
Just to be 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 201-208 AS NECESSARY)

210. CHECK 208:

ONE OR MORE BIRTH (GO TO 211)
NONE (GO TO 223)

Now I would like to make a list of all your births, whether still alive or not, starting with the first one you had.

211. RECORD THE NAMES OF ALL THE BIRTHS IN 212.
RECORD TWINS AND TRIPLETS ON SEPARATE LINES.

212. What name was given to your first/next baby?

NAME____

213. Was (NAME) a single or multiple birth?

SING 1
MULT 2

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

BOY 1
GIRL 2

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

MONTH__
YEAR___

216. Is (NAME) still alive?

YES 1
NO 2 (GO TO 220)

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 (GO TO NEXT BIRTH)
NO 2

IF THE CHILD IS LESS THAN 15 YEARS OLD:

219. With whom does s/he live?
IF 15 YEARS OR OLDER, GO TO THE NEXT BIRTH.

FATHER 1
OTHER RELATIVE 2
SOMEONE ELSE 3 (GO TO THE NEXT BIRTH)

220. IF DEAD: How old was (NAME) when he/she died?
IF '1 YEAR' PROBE: How old was (NAME) in months?
RECORD IN DAYS IF LESS THAN 1 MONTH;
IN MONTHS IF LESS THAN 2 YEARS; OR IN YEARS.

DAYS 1____
MONTHS 2____
YEARS 3____

221. COMPARE 208 WITH THE NUMBER OF BIRTH RECORDED IN THE ABOVE TABLE AND MARK:

NUMBERS ARE THE SAME
CHECK: FOR EACH BIRTH: THE YEAR OF BIRTH IS RECORDED
CHECK: FOR EVERY LIVING CHILD: THE CURRENT AGE IS RECORDED
CHECK: FOR EACH DECEASED CHILD: THE AGE AT DEATH IS RECORDED
CHECK: FOR AGE OF DEATH LESS THAN 24 MONTHS: PROBE TO DETERMINE THE EXACT NUMBER OF MONTHS
NUMBERS ARE DIFFERENT (PROBE AND CORRECT)

222. CHECK 215 AND RECORD THE NUMBER OF BIRTHS SINCE JANUARY 1987:
IF NONE, RECORD '00'.

NUMBER OF BIRTHS _____

223. Are you currently pregnant?

YES 1
NO 2 (GO TO 226)
NOT SURE 8 (GO TO 226)

224. How many months pregnant are you?

NUMBER OF MONTHS____

225. At the moment you became pregnant, did you want to become pregnant at that time, did you want to wait until later, or did you not want to become pregnant?

THEN 1
LATER 2
NOT AT ALL 3

226. How long ago did your last period begin?

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

IN MENOPAUSE 994
BEFORE THE LAST BIRTH 995
NEVER HAD PERIOD 996

227. Between the first day of a menstrual period and the next menstrual period, are there times when a woman is more likely to get pregnant?

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

228. At what time during the menstrual cycle does a woman have the best chance to get pregnant?

DURING HER PERIOD 1
JUST AFTER HER PERIOD 2
IN THE MIDDLE OF THE CYCLE 3
JUST BEFORE HER PERIOD BEGINS 4
OTHER (SPECIFY) _____ 5
DOESN'T KNOW 8

SECTION 3. CONTRACEPTION

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

301. CIRCLE CODE '1' ON LINE 302 FOR EACH METHOD MENTIONED SPONTANEOUSLY. THEN CONTINUE DOWN THE COLUMN READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE '2' IF THE METHOD IS RECOGNIZED AND CODE '3' IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE '1' OR '2' CIRCLED IN 302, ASK 303-304 BEFORE GOING ON TO THE NEXT QUESTION.

302. Have you ever heard of (METHOD)?

01. PILL Women can take a pill every day to avoid becoming pregnant.
SPONTANEOUS YES 1
YES DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
02. IUD Women can have a loop or a coil placed inside them by a doctor or a nurse to avoid becoming pregnant.
SPONTANEOUS YES 1
YES DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
03. INJECTIONS Women can have an injection by a doctor, mid-wife or nurse to avoid becoming pregnant during many months
SPONTANEOUS YES 1
YES DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
04. 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.
SPONTANEOUS YES 1
YES DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
05. SPERMICIDES/DIAPHRAGM/JELLY Women can place a diaphragm in their vagina before sexual intercourse.
SPONTANEOUS YES 1
YES DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
06. CONDOM Men can put a rubber sheath on their penis during sexual intercourse.
SPONTANEOUS YES 1
YES DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
07. FEMALE STERILIZATION Women can have an operation to avoid having any (more) children.
SPONTANEOUS YES 1
YES DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
08. MALE STERILIZATION Men can have an operation to avoid having any (more) children.
SPONTANEOUS YES 1
YES DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
09. RHYTHM METHOD Every month that a woman is sexually active, she can avoid pregnancy by not having intercourse on the days of the month she is most likely to get pregnant.
SPONTANEOUS YES 1
YES DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
10. WITHDRAWAL Men can be careful to pull out before climax.
SPONTANEOUS YES 1
YES DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
11. Have you heard of other ways or methods that women or men can use to avoid pregnancy? LIST UP TO THREE METHODS.
(SPECIFY) _____
SPONTANEOUS YES 1
NO 3

303. Have ever used (METHOD)?

01. PILL Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2
02. IUD Women can have a loop or a coil placed inside them by a doctor or a nurse to avoid becoming pregnant.
YES 1
NO 2
03. INJECTIONS Women can have an injection by a doctor, mid-wife or nurse to avoid becoming pregnant during many months
YES 1
NO 2
04. 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
05. SPERMICIDES/DIAPHRAGM/JELLY Women can place a diaphragm in their vagina before sexual intercourse.
YES 1
NO 2
06. CONDOM Men can put a rubber sheath on their penis during sexual intercourse.
YES 1
NO 2
07. FEMALE STERILIZATION Women 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
08. MALE STERILIZATION Men can have an operation to avoid having any (more) children.
YES 1
NO 2
09. RHYTHM METHOD Every month that a woman is sexually active, she can avoid pregnancy by not having intercourse on the days of the month she is most likely to get pregnant.
YES 1
NO 2
10. WITHDRAWAL Men can be careful to pull out before climax.
YES 1
NO 2
11. OTHER METHOD(S) (SPECIFY) _____
YES 1
NO 2

304. Do you know where you could go to get (METHOD)?

01. PILL Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2
02. IUD Women can have a loop or a coil placed inside them by a doctor or a nurse to avoid becoming pregnant.
YES 1
NO 2
03. INJECTIONS Women can have an injection by a doctor, mid-wife or nurse to avoid becoming pregnant during many months
YES 1
NO 2
04. 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
05. SPERMICIDES/DIAPHRAGM/JELLY Women can place a diaphragm in their vagina before sexual intercourse.
YES 1
NO 2
06. CONDOM Men can put a rubber sheath on their penis during sexual intercourse.
YES 1
NO 2
07. FEMALE STERILIZATION Women can have an operation to avoid having any more children.
YES 1
NO 2
08. MALE STERILIZATION Men can have an operation to avoid having any more children.
YES 1
NO 2
09. RHYTHM METHOD Every month that a woman is sexually active, she can avoid pregnancy by not having intercourse on the days of the month she is most likely to get pregnant. Do you know where you can get advice on how to practice the rhythm method?
YES 1
NO 2

305. CHECK 303:

NOT A SINGLE "YES" (NEVER USED) (GO TO 306)
AT LEAST ONE "YES" (EVER USED) (GO TO 308)

306. Have you ever used anything or tried in any way to delay or avoid pregnancy?

YES 1
NO 2 (GO TO 324)

307. What did you do or use?
CORRECT 303-304 (AND 302 IF NECESSARY).

Now I would like to talk about the first time you did or used something to avoid getting pregnant.

308. How many living children did you have at that time?
IF NONE, RECORD '00'.

NUMBER OF CHILDREN ____

309. CHECK 223:

NOT PREGNANT OR NOT SURE (GO TO 310)
PREGNANT (GO TO 324)

310. CHECK 303:

WOMAN NOT STERILIZED (GO TO 311)
WOMAN STERILIZED (GO TO 312A)

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

YES 1
NO 2 (GO TO 324)

312. What method are you using?
312A. CIRCLE '08' FOR FEMALE STERILIZATION.

PILL 01
IUD 02 (GO TO 318)
INJECTIONS 03 GO TO 318
IMPLANTS 04 (GO TO 318)
DIAPHRAGM/FOAM/JELLY 05 (GO TO 318)
CONDOM 06 (GO TO 318)
CONDOM/SPERMICIDES 07 (GO TO 318)
FEMALE STERILIZATION 08 (GO TO 318)
MALE STERILIZATION 09 (GO TO 318)
RHYTHM METHOD 10 (GO TO 323)
WITHDRAWAL 11 (GO TO 323)
OTHER (SPECIFY) ____ 12 (GO TO 323)

313. At the time that you began using the pill for the first time, did you consult a doctor, midwife or nurse?

YES 1
NO 2
DOESN'T KNOW 8

314. At the time that you got the pill for the first time, did you consult a doctor, midwife or nurse?

YES 1
NO 2

315. Could I see the box of the pill you are currently using?
RECORD THE BRAND NAME.

BOX SEEN 1
BRAND NAME ____ (GO TO 317)
BOX NOT SEEN 2

316. What is the brand name of the pill you are currently using?
RECORD THE BRAND NAME.

THE BRAND NAME_____
DOESN'T KNOW 98

317. How much does a (box/cycle) of pills cost you?

PRICE____

FREE 9996
DOESN'T KNOW 9998

318. CHECK 312:

SHE/HE STERILIZED: Where did the sterilization take place?

USES ANOTHER METHOD: Where did you get (METHOD) the last time?

NAME OF PLACE__
PUBLIC SECTOR
HOSPITAL 11
HEALTH CENTER/PMI 12
HEALTH POST/FREE CLINIC 13
PRIVATE MEDICAL SECTOR
CLINIC/PRIVATE HOSPITAL 21
PHARMACY 22
PRIVATE DOCTOR 23
OTHER PRVATE SECTOR
BOUTIQUE/MARKET 31
CHURCH 32 (GO TO 321)
FRIEND/RELATIVE 33 (GO TO 321)
AUXILIARY 41 (GO TO 321)
OTHER (SPECIFY) _____51 (GO TO 321)
DOESN'T KNOW 98 (GO TO 321)

319. How long does it take to go from your house to this place?
IF LESS THAN '2' HOURS, RECORD THE ANSWER IN MINUTES.
OTHERWISE, RECORD IN HOURS.

MINUTES 1____
HOURS 2____

DOESN'T KNOW 9998

320. Is it easy to get there?

EASY 1
DIFFICULT 2

321. CHECK 312:

SHE/HE STERILIZED (GO TO 322)
USES ANOTHER METHOD (GO TO 323)

322. In which month and in which year did the sterilization take place?

MONTH ____
YEAR ____ (GO TO 334)

323. For how many months have you been using (METHOD) continuously?
IF LESS THAN 1 MONTH, RECORD '00'.

MONTHS_____ (GO TO 329)
8 YEARS OR MORE (GO TO 329)

324. Do you intend to use, in the future, a modern family planning method to delay or avoid becoming pregnant?

YES 1 (GO TO 326)
NO 2
DOESN'T KNOW 8 (GO TO 330)

325. What is the main reason you do not intend to use a method to delay or avoid pregnancy?

WANTS CHILDREN 01 (GO TO 330)
LACK OF INFORMATION 02 (GO TO 330)
PARTNER DISAPPROVES 03 (GO TO 330)
TOO EXPENSIVE 04 (GO TO 330)
SECONDARY EFFECTS 05 (GO TO 330)
HEALTH PROBLEMS 06 (GO TO 330)
HARD TO GET 07 (GO TO 330)
RELIGION 08 (GO TO 330)
OPPOSED TO FAMILY PLANNING 09 (GO TO 330)
FATALISTIC 10 (GO TO 330)
OTHER PEOPLE DISAPPROVE 11 (GO TO 330)
INFREQUENT SEX 12 (GO TO 330)
DIFFICULTY GETTING PREGNANT 13 (GO TO 330)
MENOPAUSE/HYSTERECTOMY 14 (GO TO 330)
INCONVENIENT TO USE 15 (GO TO 330)
NOT MARRIED 16 (GO TO 330)
OTHER (SPECIFY) _____17 (GO TO 330)
DOESN'T KNOW 98 (GO TO 330)

326. Do you intend to use, in the next 12 months, a method?

YES 1
NO 2
DOESN'T KNOW 8

327. When you would use a method, what method would you prefer to use?

PILL 01
IUD 02
INJECTIONS 03
IMPLANTS 04
DIAPHRAGM/FOAM/JELLY 05
CONDOM 06
CONDOM/SPERMICIDES 07
FEMALE STERILIZATION 08
MALE STERILIZATION 09
RHYTHM METHOD 10 (GO TO 330)
WITHDRAWAL 11 (GO TO 330)
OTHER (SPECIFY) ____12 (GO TO 330)
DOESN'T KNOW 98 (GO TO 330)

328. Where can you procure (METHOD CITED IN 327)?

NAME OF PLACE_____
PUBLIC SECTOR
HOSPITAL 11 (GO TO 332)
HEALTH CENTER/PMI 12 (GO TO 332)
HEALTH POST/FREE CLINIC 13 (GO TO 332)
PRIVATE MEDICAL SECTOR
CLINIC/PRIVATE HOSPITAL 21 (GO TO 332)
PHARMACY 22 (GO TO 332)
PRIVATE DOCTOR 23 (GO TO 332)
OTHER PRIVATE SECTOR
SHOP/MARKET 31 (GO TO 332)
CHURCH 32 (GO TO 334)
FRIEND/RELATIVE 33 (GO TO 334)
AUXILIARY 41 (GO TO 334)
OTHER (SPECIFY) ____51 (GO TO 334)
DOESN'T KNOW 98 (GO TO 330)

329. CHECK 312:

USES RHYTHM METHOD/WITHDRAWAL/OTHER TRAD. METHOD (GO TO 330)
USES A MODERN METHOD (GO TO 334)

330. Do you know of a place where you could get a family planning method?

YES 1
NO 2 (GO TO 334)

331. What places do you know of?

NAME OF PLACE_____
PUBLIC SECTOR
HOSPITAL 11
HEALTH CENTER/PMI 12
HEALTH POST/FREE CLINIC 13
PRIVATE MEDICAL SECTOR
CLINIC/PRIVATE HOSPITAL 21
PHARMACY 22
PRIVATE DOCTOR 23
OTHER PRIVATE SECTOR
MARKET/SHOP 31
CHURCH 32 (GO TO 334)
FRIEND/RELATIVE 33 (GO TO 334)
AUXILIARY 41 (GO TO 334)
OTHER (SPECIFY) _____51 (GO TO 334)

332. How long does it take you to get to this place from your house?
IF LESS THAN '2' HOURS, RECORD IN MINUTES.
OTHERWISE, RECORD IN HOURS.

MINUTES 1_____
HOURS 2_____

DOESN'T KNOW 9998

333. Is it easy or difficult to get to the place where you feel most at ease?

EASY 1
DIFFICULT 2
DOESN'T KNOW 8

334. In the last month, did you hear a message about family planning on

The radio?
The television?

RADIO
YES 1
NO 2
TELEVISION
YES 1
NO 2

335. Do you find it acceptable or not acceptable that family planning be discussed on the radio or television?

ACCEPTABLE 1
NOT ACCEPTABLE 2
NO OPINION 8

336. Do you listen to the radio at least once a week?

YES 1
NO 2 (GO TO 339)

337. What times do you prefer to listen to the radio?
IF NO PREFERENCE, RECORD '98'.

FIRST CHOICE____
SECOND CHOICE____
THIRD CHOICE____

338. In which languages are the radio programs that you most often listen to?

WOLOF A
POULAR B
SERER C
MANDIGUE D
DIOLA E
FRENCH F
OTHER LANGUAGE (SPECIFY) ____G

339. Do you watch television at least once a week?

YES 1
NO 2 (GO TO 342)

340. What times do you prefer to watch television?
IF NO PREFERENCE, RECORD '98'.

FIRST CHOICE____
SECOND CHOICE____
THIRD CHOICE____

341. In which languages are the television programs that you most often watch?

WOLOF A
POULAR B
SERER C
MANDIGUE D
DIOLA E
FRENCH F
OTHER LANGUAGE (SPECIFY) _____G

342. Do you approve or disapprove of family planning being discussed on the radio or television?

APPROVES 1
DISAPPROVES 2
NO OPINION 8

343. CHECK 303:

AT LEAST ONE 'YES' (USES A METHOD) (GO TO 344)
NO 'YES' (NEVER USED) (GO TO 347)

344. When you began to use your last method (or current method), who decided? You alone? Your husband alone? Both? Or another person?

RESPONDENT ALONE 1
HUSBAND ALONE 2
COUPLE 3
OTHER (SPECIFY) ____ 4

345. CHECK 223, 303, AND 311:

PREGNANT (GO TO 346)
NOT PREGNANT AND DOES NOT CURRENTLY USE (GO TO 346)
USES A METHOD OR IS STERILIZED (GO TO 347)

346. What are the reasons why you stopped using your last method?
CIRCLE THE CODES CORRESPONDING TO THE RESPONSES.

WANTED A CHILD A
SECONDARY EFFECTS B
GOT PREGNANT/CONTRACEPTION FAILED C
DIFFICULT TO GET D
EXPENSIVE E
RELATIVES DISAPPROVE F
RELIGION G
NOT HAVING SEXUAL INTERCOURSE H
NOT CONVENIENT I
OTHER (SPECIFY) _____J

347. Do you know that there are sexually transmitted diseases?

YES 1
NO 2 (GO TO 356)

348. Which sexually transmitted diseases do you know of?
CIRCLE THE CODES CORRESPONDING TO ALL MENTIONED.

SYPHILIS A
GONORRHEA/CHANCROID/ HOT URINE B
AIDS C
OTHER (SPECIFY) ______ D
DOESN'T KNOW E

349. In your opinion, can sexually transmitted diseases be prevented?

YES 1
NO 2 (GO TO 352)
DOESN'T KNOW 8 (GO TO 352)

350. Do you know a(any) way(s) to prevent sexually transmitted diseases?

YES 1
NO 2 (GO TO 352)

351. What way(s) of prevention do you know?
CIRCLE THE CORRESPONDING CODES FOR THE RESPONSES GIVEN.

ONLY ONE PARTNER A
LOYALTY TO PARTNERS B
CONDOM C
ABSTINENCE D
AVOID PROSTITUTES E
OTHER (SPECIFY) _____ F

352. In your opinion, can sexually transmitted diseases be treated?

YES 1
NO 2 (GO TO 355)
DOESN'T KNOW 8 (GO TO 355)

353. Do you know of a place/places where one could find a treatment for these illnesses?

YES 1
NO 2 (GO TO 355)

354. What place(s) do you know of?
CIRCLE THE CORRESPONDING CODES TO THE RESPONSES GIVEN.

HEALTH FACILITY A
HEALTH CARE PERSONNEL B
HEALER/WITCH DOCTOR C
OTHER (SPECIFY) _____ D

355. CHECK 348:

SYPHILIS NOT CITED (GO TO 356)
SYPHILIS CITED (CODE A) (GO TO 357)

356. Do you know of or have you heard of syphilis?

YES 1
NO 2

357. CHECK 348:

AIDS NOT CITED (GO TO 358)
AIDS CITED (CODE C) (GO TO 359)

358. Do you know of or have you heard of AIDS?

YES 1
NO 2 (GO TO 401)

359. Do you approve or disapprove of sharing information about AIDS on the radio or television?

APPROVES 1
DISAPPROVES 2
WITHOUT OPINION 8

360. From whom/where did you hear about AIDS during the last three months?
CIRCLE THE CORRESPONDING CODES TO THE RESPONSES GIVEN.

HUSBAND/PARTNER A
FRIENDS B
RELATIVE/FAMILY C
HEALTH SERVICES D
PHARMACY E
RADIO F (GO TO 362)
TELEVISION G (GO TO 362)
OTHER (SPECIFY) _____ H
DOESN'T KNOW I

361. Have you heard talk of AIDS on the radio or television during the last three months?

YES 1
NO 2
DOESN'T KNOW 8

362. In your opinion are there significant risks, average risks, weak risks, or are there no risks that you get AIDS?

SIGNIFICANT 1
AVERAGE 2
WEAK 3
NONE AT ALL 4
DOESN'T KNOW 8

363. Do you know of a way/ways that AIDS can be transmitted?

YES 1
NO 2 (GO TO 365)

364. What methods of transmission do you know of?
CIRCLE THE CORRESPONDING CODES TO ALL MENTIONED.

SEXUAL INTERCOURSE WITH PARTNER A
SEXUAL INTERCOURSE WITH PROSTITUTE B
SEXUAL INTERCOURSE WITH HOMOSEXUAL C
BLOOD TRANSFUSION D
INJECTION E
BREAST FEEDING F
BLADE/RAZOR G
TATOO H
OTHER (SPECIFY) _____ I

365. In your opinion, can AIDS be prevented?

YES 1
NO 2 (GO TO 367)
DOESN'T KNOW 8 (GO TO 367)

366. What do you/would you do to prevent AIDS?
CIRCLE THE CORRESPONDING CODES TO ALL MENTIONED.

ONLY ONE PARTNER A
LOYALTY TO PARTNERS B
CONDOM C
ABSTINENCE D
AVOID PROSTITUTES E
AVOID INJECTION F
AVOID TRANSFUSION G
OTHER (SPECIFY) _____ H

367. In your opinion, can AIDS be cured?

YES 1
NO 2 (GO TO 401)
DOESN'T KNOW 8 (GO TO 401)

368. In your opinion, where can someone get information on treating AIDS?
CIRCLE THE CORRESPONDING CODES TO ALL MENTIONED.

HEALTH FACILITY A
HEALTH CARE PERSONNEL B
HEALER/WITCH DOCTOR C
OTHER (SPECIFY) _____ D

SECTION 4. PREGNANCY AND BREAST FEEDING

401. CHECK 222:

ONE OR MORE BIRTHS SINCE JAN. 1987 (GO TO 402)
NO BIRTHS SINCE JAN. 1987 (GO TO 501)

402. WRITE THE LINE NUMBER, NAME AND SURVIVAL STATUS OF EACH BIRTH SINCE JAN. 1, 1987 RECODED IN THE REPRODUCTION TABLE. ASK THE QUESTIONS OF ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN THREE BIRTHS, USE ADDITIONAL QUESTIONNAIRES).

Now I would like to some questions about the health of all of your children born in the last five years. (We will talk about each separately).

LINE NUMBER FROM 212:

LINE NO._____

FROM 212 AND 216:

NAME_____
LIVING_____
DEAD_____

403. When you got pregnant with (NAME), did you want to get pregnant at moment, wait until later or did you not want to have any more children?

AT THAT MOMENT 1 (GO TO 405)
LATER 2
DIDN'T WANT MORE CHILDREN 3 (GO TO 405)
WITHOUT OPINION 8 (GO TO 405)

404. How long would you have liked to wait?

MONTH 1____
YEARS 2 ____

DOESN'T KNOW 998

405. When you were pregnant with (NAME), did you consult someone for prenatal care?
IF YES: Whom did you see? Anyone else?
CIRCLE THE CODES CORRESPONDING TO ALL MENTIONED.

HEALTH PROFESSIONAL
DOCTOR A
HEALTH CARE WORKER/MIDWIFE/ NURSE B
OTHER PERSONNEL
DOULA C
TRADITIONAL BIRTH ATTENDANT D
OTHER (SPECIFY) _____ E
NO ONE F (GO TO 409)

406. Did they give you a prenatal card for this pregnancy?

YES 1
NO 2
DOESN'T KNOW 8

407. How many months pregnant were you when you had your first prenatal consultation?

MONTHS_____
DOESN'T KNOW 98

408. How many times did you get consultation during this pregnancy?

NUMBER OF TIMES_____
DOESN'T KNOW 98

409. When you were pregnant with (NAME), did you get an injection in the arm to avoid getting tetanus, that is to say, to avoid having convulsions after the birth?

YES 1
NO 2 (GO TO 411)
DOESN'T KNOW 8 (GO TO 411)

410. During this pregnancy, how many times did you have this injection?

NUMBER OF TIMES_____
DOESN'T KNOW 8

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

HOME
RESPONDENT'S HOME 11
OTHER HOME 12
PUBLIC SECTOR
HOSPITAL 21
HEALTH CENTER 22
HEALTH POST 23
PRIVATE SECTOR
PRIVATE HOSPITAL/CLINIC 31
OTHER (SPECIFY) _____ 41

412. Who assisted you during the delivery of (NAME)? Anyone else?
RECORD ALL THE PEOPLE CITED.

HEALTH PROFESSIONAL
DOCTOR A
HEALTH WORKER/ NURSE /MIDEWIFE B
OTHER PERSONNEL
DOULA C
TRADITIONAL BIRTH ATTENDENT D
OTHER (SPECIFY) _____ E
NO ONE F

413. Was (NAME) born prematurely or at term?

AT TERM 1
PREMATURELY 2
DOESN'T KNOW 8

414. Did you give birth to (NAME) by cesarean section?

YES 1
NO 2

415. When (NAME) was born was s/he large, average or small?

LARGE 1
AVERAGE 2
SMALL 3
DOESN'T KNOW 8

416. Was (NAME) weighed at birth?

YES 1
NO 2 (FOR LAST BIRTH, GO TO 418; OTHER BIRTHS, GO TO 419)
DOESN'T KNOW 8 (FOR LAST BIRTH, GO TO 418; OTHER BIRTHS, GO TO 419)

417. How much did (NAME) weigh?

KILOGRAMS_____
DOESN'T KNOW 98

418. Has your period returned since the birth of (NAME)?
[ASK ONLY FOR MOST RECENT BIRTH]

YES 1 (GO TO 420)
NO 2 (GO TO 421)

419. Did your period return between the birth of (NAME) and your next pregnancy?
[DO NOT ASK FOR MOST RECENT BIRTH]

YES 1
NO 2 (GO TO 421)

420. For how long after the birth of (NAME) did you not have your period?

DAYS 1_____
MONTHS 2_____

DOESN'T KNOW 998

421. CHECK 223:
IS RESPONDENT PREGNANT?
[ASK ONLY FOR MOST RECENT BIRTH]

NOT PREGNANT (GO TO 422)
PREGNANT OR NOT SURE (GO TO 423)

422. Have you begun having sexual intercourse again since the birth of (NAME)?
[ASK ONLY FOR MOST RECENT BIRTH]

YES 1
NO 2 (GO TO 424)

423. How long after the birth of (NAME) did you begin to have sexual intercourse again?

DAYS 1____
MONTHS 2_____

DOESN'T KNOW 998

424. Did you breastfeed (NAME)?

YES 1 (FOR LAST BIRTH, GO TO 426; OTHER BIRTHS, GO TO 433)
NO 2

425. Why didn't you breast feed (NAME)?
[ASK ONLY FOR MOST RECENT BIRTH]

MOTHER ILL/WEAK 01 (GO TO 435)
CHILD ILL/WEAK 02 (GO TO 435)
CHILD DIED 03 (GO TO 435)
BREAST/NIPPLE PROBLEM 04 (GO TO 435)
INSUFFICIENT MILK 05 (GO TO 435)
WORKS 06 GO TO 435
CHILD REFUSED 07 (GO TO 435)
OTHER (SPECIFY) _____ 8 (GO TO 435)

426. How long after birth did you first put (NAME) to the breast?
[ASK ONLY FOR MOST RECENT BIRTH]

IF LESS THAN '1' HOUR, RECORD '00' HOURS.
IF LESS THAN '24' HOURS, RECORD HOURS.
OTHERWISE, RECORD IN DAYS.

IMMEDIATELY 000

HOURS 1_____
DAYS 2_____

427. CHECK 216:
CHILD ALIVE?
[ASK ONLY FOR MOST RECENT BIRTH]

ALIVE (GO TO 428)
DECEASED (GO TO 433)

428. Are you still breast feeding (NAME)?
[ASK ONLY FOR MOST RECENT BIRTH]

YES
NO 2 (GO TO 433)

429. How many times did you breastfeed last night between sunset and sunrise?
IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER.
[ASK ONLY FOR MOST RECENT BIRTH]

NUMBER OF NIGHTTIME FEEDINGS_____

430. Yesterday, how many times did you breastfeed during the day?
IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER.
[ASK ONLY FOR MOST RECENT BIRTH]

NUMBER OF DAYTIME FEEDINGS_____

431. Did you give (NAME) any of the following foods yesterday or last night?
[ASK ONLY FOR MOST RECENT BIRTH]

WATER
YES 1
NO 2
JUICE
YES 1
NO 2
BOXED/POWDERED MILK
YES 1
NO 2
COW/GOAT MILK
YES 1
NO 2
QUIQUELIBA
YES 1
NO 2
OTHER LIQUID (SPECIFY) _____
YES 1
NO 2
GRAIN BROTH
YES 1
NO 2
CERELAC
YES 1
NO 2
SOLID FOODS
YES 1
NO 2

432. CHECK 431:
FOOD OR LIQUID GIVEN YESTERDAY:
[ASK ONLY FOR MOST RECENT BIRTH]

'YES' FOR ONE OR MORE (GO TO 437)
NOTHING AT ALL (GO TO 436)

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

MONTHS______
UNTIL S/HE DIED 96 (GO TO 436)

434. Why did you stop breast feeding (NAME)?

MOTHER ILL/WEAK 01
CHILD ILL/WEAK 02
CHILD DIED 03
BREAST/NIPPLE PROBLEM 04
INSUFFICIENT MILK 05
WORK 06
CHILD REFUSED 07
WEANING AGE 08
GOT PREGNANT 09
BEGAN TO USE CONTRACEPTION 10
OTHER (SPECIFY) _____ 11

435. CHECK 216:
IS CHILD LIVING?

LIVING (GO TO 437)
DEAD (GO TO 436)

436. Did you ever give (NAME) water or something else to eat (besides mother's milk)?

YES 1
NO 2 (GO TO 440)

437. How many months old was (NAME) when you began to give him one of these foods or drinks regularly?

Fresh milk/boxed milk (other than mother's)?
Water?
Quinquéliba?
Fruit juice?
Other liquids?
Other solid or broth foods?

IF LESS THAN A MONTH, RECORD '00.'

FRESH/BOXED MILK
AGE IN MONTHS____
NEVER GIVEN REGULARLY 96
WATER
AGE IN MONTHS____
NEVER GIVEN REGULARLY 96
QUINQUELIBA
AGE IN MONTHS____
NEVER GIVEN REGULARLY 96
FRUIT JUICE
AGE IN MONTHS____
NEVER GIVEN REGULARLY 96
OTHER LIQUIDS
AGE IN MONTHS____
NEVER GIVEN REGULARLY 96
OTHER SOLID/BROTH FOODS
AGE IN MONTHS____ (SECOND-LAST, THIRD-LAST, ETC. BIRTHS, GO TO 440)

NEVER GIVEN REGULARLY 96 (SECOND-LAST, THIRD-LAST, ETC. BIRTHS, GO TO 440)

438. CHECK 216:
CHILD ALIVE?
[ASK ONLY FOR MOST RECENT BIRTH]

ALIVE (GO TO 439)
DEAD (GO TO 440)

439. Did (NAME) drink something from a bottle yesterday or last night?
[ASK ONLY FOR MOST RECENT BIRTH]

YES 1
NO 2
DOESN'T KNOW 8

440. RETURN TO 402B IN THE FOLLOWING BIRTH/COLUMN OR, IF NO MORE BIRTHS, GO TO 441.

SECTION 4B. VACCINATION AND HEALTH

441. RECORD THE NAME AND NUMBER OF EACH BIRTH SINCE THE FIRST OF JANUARY 1987 IN THE TABLE. ASK QUESTIONS ABOUT ALL THE BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 3 BIRTHS, USE AN ADDITIONAL QUESTIONNAIRE).

LINE NUMBER FROM 212:

LINE NUMBER__

FROM 212 AND 216:

NAME__
LIVING ____
DEAD ____

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

YES, SEEN 1 (GO TO 460)
YES, NOT SEEN 2 (GO TO 446)
NO CARD 3

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

YES 1 (GO TO 446)
NO 1 (GO TO 446)

444. (1) COPY THE DATES FOR EACH VACCINATION FROM THE CARD.
(2) WRITE '44' IN 'DAY' COLUMN IF THE CARD SHOWS THAT A VACCINATION WAS GIVEN BUT NO DATE IS RECORDED.

BCG
DAY ____
MONTH ____
YEAR ____
POLIO 1
DAY ____
MONTH ____
YEAR ____
POLIO 2
DAY ____
MONTH ____
YEAR ____
POLIO 3
DAY ____
MONTH ____
YEAR ____
DPT 1
DAY ____
MONTH ____
YEAR ____
DPT 2
DAY ____
MONTH ____
YEAR ____
DPT 3
DAY ____
MONTH ____
YEAR ____
MEASLES
DAY ____
MONTH ____
YEAR ____
YELLOW FEVER
DAY ____
MONTH ____
YEAR ____

445. Has (NAME) received any immunizations not recorded on this card?
RECORD 'YES' ONLY IF RESPONDENT MENTIONS BCG, POLIO 1-3, DPT 1-3, MEASLES, AND/OR YELLOW FEVER VACCINES.

YES 1 (PROBE FOR VACCINATIONS AND WRITE '66' IN THE 'DAY' COLUMN IN 444) (GO TO 448)
NO 2 (GO TO 448)
DOESN'T KNOW 8 (GO TO 448)

446. Did (NAME) ever receive any vaccinations to prevent him/her from getting diseases?

YES 1
NO 2 (GO TO 448)
DOESN'T KNOW 8 (GO TO 448)

447. Tell me, please, if (NAME) received one of the following vaccinations:

A BCG vaccination against tuberculosis, that is, an injection in the arm or shoulder that usually causes a scar?
YES 1
NO 2
DOESN'T KNOW 8
Polio vaccine, that is, drops in the mouth?
IF YES: How many times?
YES 1
NO 2
DOESN'T KNOW 8
NUMBER OF TIMES__
An injection against the measles?
YES 1
NO 2
DOESN'T KNOW 8
An injection against yellow fever?
YES 1
NO 2
DOESN'T KNOW 8

448. CHECK 212 AND 216:
IS CHILD LIVING?

LIVING (GO TO 450)
DEAD (GO TO 449)

449. RETURN TO 424 FOR THE NEXT BIRTH OR, IF NO MORE BIRTHS, GO TO 480.

450. Has (NAME) suffered from a fever, at any moment, during the past two weeks?

YES 1
NO 2
DOESN'T KNOW 8

451. Has (NAME) suffered from a cough, at any moment, during the past two weeks?

YES 1
NO 2 (GO TO 455)
DOESN'T KNOW 8 (GO TO 455)

452. Has (NAME) suffered from a cough in the last 24 hours?

YES 1
NO 2
DOESN'T KNOW 8

453. How many days did the cough last?
IF LESS THAN A DAY, RECORD '00'.

DAYS_____

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

YES 1
NO 2
DOESN'T KNOW 8

455. CHECK 450 AND 451:
FEVER OR COUGH?

'YES' TO 450 OR 451 (GO TO 456)
OTHER (GO TO 460)

456. Was something given to treat the fever/cough?

YES 1
NO 2 (GO TO 458)
DOESN'T KNOW 8 (GO TO 458)

457. What was given to treat the fever/cough?
Anything else?
CIRCLE THE CODES CORRESPONDING TO THE RESPONSES GIVEN.

INJECTION A
ANTIBIOTIC (PILL OR SYRUP) B
ANTI-MALARIA (PILL OR SYRUP) C
COUGH SYRUP D
OTHER PILL OR SYRUP E
UNKNOWN PILL OR SYRUP F
HOME REMEDY/MEDICINAL PLANTS G
OTHER (SPECIFY) _____ H

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

YES 1
NO 2 (GO TO 460)

459. Where did you seek advice or treatment?
Where else?
RECORD EVERYTHING MENTIONED.

PUBLIC SECTOR
HOSPITAL A
HEALTH CENTER B
HEALTH POST C
HEALTH CARE WORKER D
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC E
PHARMACY F
PRIVATE DOCTOR G
COMMUNITY HEALTH CARE WORKER H
OTHER SOURCE
SHOP I
TRADITIONAL HEALER J
OTHER (SPECIFY) _____ K

460. Has (NAME) had diarrhea during the past two weeks?

YES 1 (GO TO 462)
NO 2
DOESN'T KNOW 8

461. RETURN TO 442 FOR THE NEXT BIRTH: OR IF THERE ARE NO MORE BIRTHS, GO TO 480.

462. Has (NAME) had diarrhea in the last 24 hours?

YES 1
NO 2
DOESN'T KNOW 8

463. How many days did the diarrhea last?
IF LESS THAN 1 DAY, RECORD '00'.

DAYS_____

464. Was there blood in the stools?

YES 1
NO 2
DOESN'T KNOW 8 (SECOND-LAST, THIRD-LAST, ETC. BIRTHS, GO TO 468)

465. CHECK 428:
CHILD STILL BREAST FEEDING?
[ASK ONLY FOR MOST RECENT BIRTH]

YES (GO TO 466)
NO (GO TO 468)

466. When (NAME) had diarrhea, did you change the number of breast feedings/feedings?
[ASK ONLY FOR MOST RECENT BIRTH]

YES 1
NO 2 (GO TO 468)

467. Did you increase or reduce the number, or did you completely stop?
[ASK ONLY FOR MOST RECENT BIRTH]

INCREASED 1
REDUCED 2
COMPLETELY STOPPED 3

468. Did you give him/her less or more to drink (besides breast milk) than before the diarrhea?

SAME 1
MORE 2
LESS 3
DOESN'T KNOW 8

469. Was something given to (NAME) treat diarrhea?

YES 1
NO 2 (GO TO 471)
DOESN'T KNOW 8 (GO TO 471)

470. What was given to treat the diarrhea?
Anything else?
RECORD EVERYTHING MENTIONED.

LIQUID FROM ORS PACKET A
RECOMMENDED LIQUID MADE AT HOME B
ANTIBIOTIC PILL OR SYRUP C
OTHER PILL OR SYRUP D
INJECTION E
(IV) INTRAVENOUS/SERUM F
HOME REMEDIES/MEDICINAL PLANTS G
OTHER (SPECIFY) _____ H

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

YES 1
NO 2 (GO TO 473)

472. Where did you ask for advice or treatment?
Anywhere else?
CIRCLE THE CORRESPONDING CODES FOR ALL THE RESPONSES.

PUBLIC SECTOR
HOSPITAL A
HEALTH CENTER/PMI B
HEALTH POST/FREE CLINIC C
HEALTH CARE WORKER D
PRIVATE MEDICAL SECTOR
CLINIC/PRIVATE HOSPITAL E
PHARMACY F
PRIVATE DOCTOR G
PRIVATE NURSE/CONFES H
OTHER PRIVATE SECTOR
SHOP/MARKET I
TRADITIONAL HEALER J
OTHER (SPECIFY) K _____

473. CHECK 470:
LIQUID FROM ORS PACKET CITED?

NO, ORS PACKET NOT CITED (GO TO 474)
YES, ORS PACKET CITED (GO TO 475)

474. Did (NAME) receive (LOCAL NAME FOR ORS SOLUTION) to fight diarrhea?

YES 1
NO 2 (GO TO 476)
DOESN'T KNOW 8 (GO TO 476)

475. During how many days did (NAME) receive (LOCAL NAME)?
IF LESS THAN 1 DAY, RECORD '00'.

NUMBER OF DAYS _____
DOESN'T KNOW 98

476. CHECK 470:
LIQUID RECOMMENDED AND PREPARED AT HOME CITED?

NO, HOMEMADE LIQUID NOT CITED (GO TO 477)
YES, HOMEMADE LIQUID CITED (GO TO 478)

477. Did (NAME) get a liquid recommended by health care personnel and prepared at home with (RECOMMENDED INGREDIENTS) when s/he had diarrhea?

YES 1
NO 2 (GO TO 479)
DOESN'T KNOW 8 (GO TO 479)

478. During how many days did s/he receive prepared (RECOMMENDED INGREDIENTS) when s/he had diarrhea?

NUMBER OF DAYS_____
DOESN'T KNOW 98

479. RETURN TO 460 FOR THE NEXT CHILD, OR IF THERE ARE NO MORE CHILDREN, GO TO 480.

480. CHECK 470 AND 474 (ALL COLUMNS):

ORS SOLUTION GIVEN TO A CHILD (GO TO 484)
ORS SOLUTION FROM A PACKET WASN'T GIVEN TO ANY CHILD (GO TO 481)

481. Have you ever heard of a special product called (LOCAL NAME) that you can get to treat diarrhea?

YES 1 (GO TO 483)
NO 2

482. Have you ever seen a packet like this before?
SHOW THE PACKET.

YES 1
NO 2 (GO TO 487)

483. Have you ever prepared a solution with one of these packets to treat diarrhea for yourself or someone else?
SHOW PACKET.

YES 1
NO 2 (GO TO 486)

484. The last time you prepared (LOCAL NAME), did you prepare the whole packet at once or only a part of the packet?

THE WHOLE PACKAGE AT ONCE 1
PART OF THE PACKET 2 (GO TO 486)

485. How much water did you use to prepare (LOCAL NAME) the last time you prepared it?

1/2 LITER 01
1 LITER 02
1 1/2 LITER 03
2 LITERS 04
ACCORDING TO THE INSTRUCTIONS ON THE PACKET 05
OTHER (SPECIFY) _____ 06
DOESN'T KNOW 98

486. Where can you get (LOCAL NAME) packet?
PROBE: Anywhere else?
CIRCLE THE CODE CORRESPONDING TO ALL RESPONSES GIVEN.

PUBLIC SECTOR
HOSPITAL A
HEALTH CENTER/PMI B
HEALTH POST/FREE CLINIC C
COMMUNITY HEALTH CARE WORKER D
PRIVATE MEDICAL SECTOR
CLINIC/PRIVATE HOSPITAL E
PHARMACY F
PRIVATE DOCTOR G
PRIVATE NURSE/CONFES H
OTHER PRIVATE SECTOR
SHOP/BOUTIQUE I
TRADITIONAL HEALER J
OTHER (SPECIFY) _____K

487. CHECK 470 AND 477 (ALL COLUMNS):

RECOMMENDED LIQUID PREPARED AT HOME/GIVEN TO CHILD (GO TO 488)

RECOMMENDED LIQUID PREPARED AT HOME AND NOT GIVEN TO CHILD OR 470 AND 477 NOT ASKED (GO TO 501)

488. Where did you learn to prepare the recommended liquid made at home with (RECOMMENDED INGREDIENTS) that you gave to (NAME) when s/he had diarrhea?
CIRCLE THE CODE CORRESPONDING TO ALL RESPONSES GIVEN.

PUBLIC SECTOR
HOSPITAL A
HEALTH CENTER/PMI B
HEALTH POST/FREE CLINIC C
COMMUNITY HEALTH CARE WORKER D
PRIVATE MEDICAL SECTOR
CLINIC/PRIVATE HOSPITAL E
PHARMACY F
PRIVATE DOCTOR G
PRIVATE NURSE/CONFES H
OTHER PRIVATE SECTOR
SHOP/BOUTIQUE I
TRADITIONAL HEALER J
OTHER (SPECIFY) _____K

SECTION 5. MARRIAGE AND SEXUAL ACTIVITY

501. Are you currently married?

YES 1 (GO TO 504)
NO 2

502. Are you celibate, widowed, divorced or do you live in union with someone?

LIVES IN UNION 1 (GO TO 504)
WIDOWED 2 (GO TO 508)
DIVORCED 3 (GO TO 508)
SEPARATED 4 (GO TO 508)
CELIBATE 5

503. Have you ever lived with someone?

YES 1 (GO TO 508)
NO 2 (GO TO 513)

504. Is your husband/partner living with you now or is he staying elsewhere?

LIVE TOGETHER 1
LIVES ELSEWHERE 2

505. Besides yourself, does your husband/partner have other wives/partners?

YES 1
NO 2 (GO TO 508)
DOESN'T KNOW 8 (GO TO 508)

506. How many wives or partners does he have?

NUMBER _____
DOESN'T KNOW 8

507. Are you the first, second...wife?

RANK_____

6 OR MORE 6
DOESN'T KNOW 8

508. How many times have you been married or lived with a man?

NUMBER _____
6 OR MORE 6

509. In which month and in which year did you consummate your union with your (first) husband/partner?

MONTH_____
DOESN'T KNOW MONTH 98
MARRIAGE NOT CONSUMMATED 96 (GO TO 513)
YEAR_____
DOESN'T KNOW YEAR 9998
MARRIAGE NOT CONSUMMATED 96 (GO TO 513)

510. How old were you when you consummated your union with your (first) husband/partner?

AGE _____
DOESN'T KNOW AGE 98

511. CHECK 509 AND 510:
YEAR AND AGE GIVEN?

YES (GO TO 512)
NO (GO TO 514)

512. CHECK 509 AND 510:

BIRTH YEAR (105) _____
(PLUS) AGE AT MARRIAGE (510) _____
(EQUALS) CALCULATED YEAR OR MARRIAGE_____

IF NECESSARY, CALCULATE THE BIRTH YEAR:

CURRENT YEAR_____
(MINUS) CURRENT AGE (106) _____
(EQUALS) CALCULATED BIRTH YEAR_____

IS THE CALCULATED YEAR OF MARRIAGE, GIVE OR TAKE A YEAR, THE SAME AS THE YEAR OR MARRIAGE RECORDED (509)?

YES (GO TO 514)
NO (CHECK AND CORRECT 509 AND 510) (GO TO 514)

IF NEVER BEEN IN UNION OR FIRST UNION NOT CONSUMMATED:

513. Have you ever had sexual intercourse?

YES 1
NO 2 (GO TO 518)

Now we need some information on your sexual activity in order to better understand family planning and fertility.

514. How many times have you had sexual intercourse in the last four weeks?

NUMBER OF TIMES____

515. How many times a month do you normally have sexual intercourse?

NUMBER OF TIMES__

516. When did you last have sexual intercourse?

IT WAS...DAYS AGO 1_____
IT WAS...WEEKS AGO 2_____
IT WAS...MONTHS AGO 3_____
IT WAS...YEARS AGO 4_____

BEFORE THE LAST BIRTH 996

517. How old were you the first time you had sexual intercourse?

AGE_____
FIRST TIME IN MARRIAGE 96

518. PRESENCE OF OTHER PEOPLE:

CHILDREN LESS THAN 10 YEARS
YES 1
NO 2
HUSBAND
YES 1
NO 2
OTHER MEN
YES 1
NO 2
OTHER WOMEN
YES 1
NO 2

519. RECORD THE RESPONDENT'S REACTION:

NOT BOTHERED 1
A LITTLE BOTHERED 2
HOSTILE 3

SECTION 6. FERTILITY PREFERENCES

601. CHECK 312:

NEITHER STERILIZED (GO TO 602)
HE OR SHE STERILIZED (GO TO 607)

602. CHECK 501 AND 502:

CURRENTLY MARRIED OR LIVING IN UNION (GO TO 603)
NOT MARRIED/NOT LIVING IN UNION (GO TO 614)

603. CHECK 223:

NOT PREGNANT OR NOT SURE: Now I have a few questions about the future. Would you like to have (a/another) child, or would you prefer not to have (other) children at all?

PREGNANT: Now I have a few questions about the future. After the child that you are expecting, would you like to have (a/another) child, or would you prefer not to have (other) children at all?

HAVE (A/ANOTHER) CHILD 1
NO MORE/NONE 2 (GO TO 610)
SAYS SHE CANNOT GET PREGNANT 3 (GO TO 610)
NOT SURE/DOESN'T KNOW 8 (GO TO 610)

604. CHECK 223:

NOT PREGNANT OR NOT SURE: How long would you like to wait from now before the birth of (a/another) child?

PREGNANT: After the birth of the child you are expecting, how long would you like to wait from now before the birth of (a/another) child?

MONTHS 1_____ (GO TO 610)
YEARS 2_____ (GO TO 610)

SOON/NOW 994 (GO TO 610)
SAYS SHE CANNOT GET PREGNANT 995 (GO TO 610)
OTHER (SPECIFY) _____996
DOESN'T KNOW 998

605. CHECK 216 AND 223:
HAS LIVING CHILD(REN) OR PREGNANT?

YES (GO TO 606)
NO (GO TO 610)

606. CHECK 223:

NOT PREGNANT OR NOT SURE: How old do you want your youngest child to be before the birth of your next child?

PREGNANT: How old do you want the child you are expecting to be before the birth of your next child?

AGE OF YOUNGEST IN YEARS_____ (GO TO 610)
DOESN'T KNOW 98 (GO TO 610)

607. In your current situation, if you could go back, would you (your husband/partner) make the same decision to be sterilized?

YES 1
NO 2

608. Do you regret that (you/your husband) had an operation to have no more children?

YES 1
NO 2 (GO TO 614)

609. Why do you regret it?

RESPONDENT WANTS ANOTHER CHILD 1 (GO TO 614)
PARTNER WANTS ANOTHER CHILD 2 (GO TO 614)
SECONDARY EFFECTS 3 (GO TO 614)
OTHER REASON (SPECIFY) _____4 (GO TO 614)

610. Do you think that your partner/husband approves or disapproves of using methods to avoid pregnancy?

APPROVES 1
DISAPPROVES 2
DOESN'T KNOW 8

611. How many times during the past year did you speak with your partner/husband about family planning?

NEVER 1
ONCE OR TWICE 2
MORE OFTEN 3

612. Have you discussed the number of children you would like to have with your husband/partner?

YES 1
NO 2

613. Do you think that your husband want the same number of children that you want, or does he want more or fewer than you want?

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

614. After the birth of a child, how long should a couple wait before having sexual intercourse again?

DAYS 1_____
MONTHS 2_____
YEARS 3_____
OTHER (SPECIFY) _____996

615. Should a mother wait until she has completely stopped breast feeding before having sexual intercourse, or is this not important?

WAIT 1
NOT IMPORTANT 2
DOESN'T KNOW 8

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

APPROVES 1
DISAPPROVES 2
NO OPINION 8

617. CHECK 216:

HAS LIVING CHILDREN: If you could go back to the time when 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: If you could choose exactly the number of children to have in your whole life, how many would that be?

PROBE FOR A NUMERIC RESPONSE.

NUMBER_____
OTHER (SPECIFY) _____96

618. In your opinion, what is the best interval in months or in years between the birth of a child and the birth of the next child?

MONTHS 1_____
YEARS 2_____

OTHER (SPECIFY) _____996

619. Have you ever had an undesired pregnancy?

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

620. What did you do about this pregnancy?

BROUGHT IT TO TERM 1
FAILURE INTERRUPTION 2
INTERRUPTION 3
OTHER (SPECIFY) _____4
DOESN'T KNOW 8

621. What is the main reason why you did not want this pregnancy?

ECONOMIC REASON 1
NOT MARRIED 2
DID NOT WANT CHILDREN 3
ABANDONED BY PARTNER 4
HEALTH REASONS 5
WANTED TO REST 6
NO RESPONSE 7
OTHER (SPECIFY) _____8

622. CHECK 303:

USED A METHOD (GO TO 623)
NEVER USED A METHOD (GO TO 624)

623. Have you ever gotten pregnant while using a contraceptive method?

YES 1
NO 2
NO RESPONSE 8

624. In your opinion, do women generally have abortions?

NEVER 1
SOMETIMES 2
OFTEN 3
VERY OFTEN 4
DOESN'T KNOW 8

625. In your opinion, what are the reasons why women have abortions?
CIRCLE THE CORRESPONDING CODES TO RESPONSES MENTIONED

FAILURE OF CONTRACEPTION A
NOT USING CONTRACEPTION B
IGNORANCE OF CONTRACEPTION C
OPPOSITION OF HUSBAND/FAMILY OF FAMILY PLANNING D
CARELESS SEXUAL BEHAVIORS E
OTHERS (SPECIFY) _____F
DOESN'T KNOW G

SECTION 7. HUSBAND'S BACKGROUND AND WOMAN'S WORK

701. CHECK 501 TO 503:

HAS BEEN MARRIED/HAS LIVED WITH A MAN (ASK QUESTIONS ABOUT THE CURRENT OR MOST RECENT HUSBAND/PARTNER) (GO TO 702)

NEVER MARRIED AND/OR NEVER LIVED WITH A MAN (GO TO 708)

702. Did your (last) husband attend school?

YES 1
NO 2 (GO TO 705)

703. What was the highest level of school that he achieved: primary, secondary or superior?

PRIMARY 1
SECONDARY 2
SUPERIOR 3
DOESN'T KNOW 8 (GO TO 705)

704. What was the last (year/grade) that he achieved at this level?

GRADE/YEAR_____
DOESN'T KNOW 98

705. What is/was your husband/partner's main occupation?

PARTNER'S OCCUPATION ______

706. CHECK 705:

WORKS/WORKED IN AGRICULTURE (GO TO 707)
DOES/DID NOT WORK IN AGRICULTURE (GO TO 708)

707. Does/did he work mainly on his own land or on family land, or did/does he work on land that he rents from someone else, on someone else's land?

PERSONAL/FAMILIAL LAND 1
RENTED LAND 2
SOMEONE ELSE'S LAND 3

708. Aside from your housework, do you currently/did you work?

YES 1 (GO TO 710)
NO 2

709. As you know, some women take up jobs for which they are paid in cash or in kind. Others sell things, have a small business or work on the family farm or in a family business.
Do you currently do something like this or any other work?

YES 1
NO 2 (GO TO 801)

710. What is your main occupation, that is to say, what kind of work do you mainly do?

RESPONDENT'S OCCUPATION ______

711. In your current job, do you work for a family member, for someone else, or for yourself?

FOR A FAMILY MEMBER 1
FOR SOMEONE ELSE 2
SELF-EMPLOYED 3

712. Do you get a salary for this work?
PROBE: Do you get money for this work?

YES 1
NO 2

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

HOME 1
AWAY 2

714. CHECK 215/216/218:
HAD A CHILD BORN SINCE THE FIRST OF JANUARY 1987 AND LIVES AT THE HOME?

YES (GO TO 715)
NO (GO TO 801)

715. Is (NAME OF THE YOUNGEST CHILD AT HOME) with you while you work sometimes or never?

USUALLY 1 (GO TO 801)
SOMETIMES 2
NEVER 3

716. Who watches (NAME OF THE YOUNGEST CHILD AT HOME) while you work?

HUSBAND/PARTNER 01
OLDER CHILD(REN) 02
OTHER RELATIVES 03
NEIGHBORS 04
FRIENDS 05
SERVANT/AIDE 06
CHILD IS AT SCHOOL 07
KINDERGARTEN 08
OTHER (SPECIFY) _____09

SECTION 8. MATERNAL MORTALITY

Now I would like to ask you some questions about your brothers and sisters, that is to say, about all of the children born to your biological mother.

801. Please give me the names of your brothers and sisters that live with you, that are living elsewhere or that are dead.
RECORD THE NAMES OF ALL BROTHERS AND SISTERS.
IF RESPONDENT HAS NO SIBLINGS, GO TO 819.

[ASK QUESTIONS 802-814 FOR ALL OF RESPONDENT'S MOTHER'S BIRTHS]

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

NAME _____

803. Is (NAME) male or female?

MALE 1
FEMALE 2

804. Is (NAME) still alive?

YES 1
NO 2 (GO TO 806)
DOESN'T KNOW 8 (GO TO NEXT BIRTH)

805. How old is (NAME)?

AGE____ (IF LESS THAN 15 YEARS OLD, GO TO NEXT BIRTH)

805A. Has (NAME) been married?

YES 1(GO TO NEXT BIRTH)
NO 2 (GO TO NEXT BIRTH)

806. How many years has (NAME) been deceased?

YEARS_____

807. How old was (NAME) when he/she died?

AGE_____ (IF MAN OR WOMAN DECEASED BEFORE THE AGE OF 15 YEARS, GO TO NEXT BIRTH)

807A. Has (NAME) been married?

YES 1
NO 2

808. Was (NAME) pregnant when she died?

YES (GO TO 811)
NO 2

809. Did (NAME) die during childbirth?

YES 1 (GO TO 814)
NO 2

810. Did (NAME) die in the two months following a pregnancy or birth?

YES 1
NO 2 (GO TO 812)

811. Was (NAME)'s death due to the pregnancy/childbirth?

YES 1 (GO TO 814)
NO 2
DOESN'T KNOW 8

812. CHECK 806-807:
DEATH HAPPENED BETWEEN 15 AND 50 YEARS DURING THE PAST 20 YEARS?

YES (GO TO 813)
NO (GO TO 814)

813. What did (NAME) die from?

CAUSE OF DEATH ______

814. How many pregnancies did (NAME) have (including the one she died from) during her life?

NUMBER OF PREGNANCIES _____ (GO TO NEXT BIRTH)

[IF NO MORE BROTHERS OR SISTERS, GO TO 815]

815. I want to be sure that I understood. In all, your mother gave birth to ____children including yourself?

YES (GO TO 816)
NO (CHECK AND CORRECT) (GO TO 816)

816. Among your brothers, ____are dead?

YES (GO TO 817)
NO (CHECK AND CORRECT) (GO TO 817)

817. Among your sisters, ____are dead?

YES (GO TO 818)
NO (CHECK AND CORRECT) (GO TO 818)

818. Are there any of your sisters (of your own mother) 14 years or older living in this household?

YES (CHECK WITH THE RESPONDENT WHICH ELIGIBLE WOMEN IN THE HOUSEHOLD QUESTIONNAIRE ARE HER SISTERS AND RECORD HER/THEIR NUMBER(S) BELOW)
LINE NUMBER(S) ____
NO (GO TO 819)

819. RECORD THE TIME:

HOUR_____
MINUTES_____

SECTION 09

901. CHECK 215 AND 216:

BIRTH(S) SINCE JANUARY 1 1987
INTERVIEWER: IN 902 (COLUMNS 4-4) RECORD THE LINE NUMBER OF EACH CHILD BORN SINCE JANUARY 1 1987 AND STILL ALIVE. IN 903 AND 904, RECORD THE NAME AND THE DATE OF THE RESPONDENT'S BIRTH AND OF EACH LIVING CHILD BORN SINCE JANUARY 1 1987. IN 906 AND 908, RECORD THE HEIGHT AND WEIGHT OF THE RESPONDENT AND LIVING CHILDREN. (NOTE: ALL THE RESPONDENTS WITH BIRTHS SINCE THE FIRST OF JANUARY 1987 MUST BE WEIGHED AND MEASURED, EVEN IF ALL OF THE CHILDREN ARE DEAD). (IF THERE ARE MORE THAN 3 CHILDREN BORN SINCE JANUARY 1 1987, USE A SUPPLEMENTAL QUESTIONNAIRE)
NO BIRTH SINCE JANUARY 1 1897 (END OF INTERVIEW)

[ASK QUESTIONS 902-910 FOR RESPONDENT AND ALL OF HER CHILDREN BORN SINCE JANUARY 1, 1987]

902. LINE NUMBER FROM 212:
[ASK ONLY FOR CHILDREN]

_____

903. NAME FROM 212 FOR THE CHILDREN:

NAME_____

904. BIRTHDATE FROM 105 FOR THE RESPONDENT AND FROM 215 FOR THE CHILD(REN):

RESPONDENT:

MONTH__
YEAR__

CHILD(REN):

DAY__
MONTH__
YEAR__

905. BCG SCAR HIGH ON RIGHT SHOULDER?
[ASK ONLY FOR CHILDREN]

SCAR SEEN 1
NO SCAR 2

906. HEIGHT (IN CENTIMETERS):

CM _____

907. WERE THE CHILDREN MEASURED STANDING OR LYING DOWN?
[ASK ONLY FOR CHILDREN]

LYING DOWN 1
STANDING 2

908. WEIGHT (IN KILOGRAMS):

KG _____

909. DATE WEIGHED AND MEASURED:

DAY__
MONTH__
YEAR__

910. RESULT:

RESPONDENT:

MEASURED 1
ABSENT 3
REFUSED 4
OTHER (SPECIFY) _____6

CHILD:

CHILD MEASURED 1
CHILD ILL 2
CHILD ABSENT 3
CHILD REFUSED 4
MOTHER REFUSED 5
OTHER (SPECIFY) _____6

911. NAME OF OPERATOR _____
NAME OF ASSISTANT _____

INTERVIEWER'S OBSERVATIONS

FILL OUT AFTER HAVING ENDED THE INTERVIEW.

COMMENTS ABOUT THE RESPONDENT _____

COMMENTS ON PARTICULAR QUESTIONS _____

OTHER COMMENTS _____

SUPERVISOR'S OBSERVATIONS _____
NAME_____
DATE_____

OTHER OBSERVATIONS _____