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ONFP

DEMOGRAPHIC AND HEALTH SURVEY, 1988 INDIVIDUAL QUESTIONNAIRE

IDENTIFICATION

1) GOUVERNORAT [##translator note: unable to find translation, may be something related to government or governing] (Afifa says that this may be mean "province" like provinces in Canada)

2) NAME AND CLUSTER NUMBER____

3) HOUSEHOLD NUMBER____

4) LINE NUMBER OF WOMAN____

Visits

FIRST VISIT
5) DATE OF VISIT____

6) NAME OF INTERVIEWER____

7) RESULT

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

8) NEXT VISIT

DATE ____
TIME ____

SECOND VISIT
5) DATE OF VISIT____

6) NAME OF INTERVIEWER____

7) RESULT

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

8) NEXT VISIT

DATE ____
TIME ____

THIRD VISIT
5) DATE OF VISIT____

6) NAME OF INTERVIEWER____

7) RESULT

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

8) NEXT VISIT

DATE ____
TIME ____

MONTH ____
YEAR 88

INTERVIEWER CODE
RESULT

NUMBER OF VISITS

NAME ____

DATE ____

FIELD EDITED BY ____

OFFICE EDITED BY ____

KEYED BY ____

CODE KEYED ____

SECTION 1. RESPONDENT’S BACKGROUND

101) Record the number of persons listed in the household schedule

NUMBER OF PEOPLE ____

102) Record the number of children aged 5 and under listed in the household schedule who normally live in the household.

NUMBER OF CHILDREN AGED 5 AND UNDER ____

103) RECORD THE TIME:

HOURS ____
MINUTES ____

104) For most of the time until you were 12 years old, did you live in the countryside, in a town, or in a city?

LARGE CITY 1
SMALL CITY 2
COUNTRYSIDE 3

105) How long have you been living continuously in (NAME OF VILLAGE, TOWN, CITY)?

NAME OF LOCATION ____
ALWAYS 96 (GO TO 17)
YEARS ____

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


LARGE CITY 1
SMALL CITY 2
COUNTRYSIDE 3

107) Would you mind giving me the family’s civil registration booklet, a National ID card, a birth certificate, or a passport?

DOCUMENT OBTAINED:
NONE 1 (GO TO 109)
FAMILY BOOKLET 2
BIRTH CERTIFICATE 3
NATIONAL ID CARD/PASSPORT 4
OTHER (SPECIFY) 5

108) INTERVIEWER:
COPY THE MONTH AND YEAR OF BIRTH RECORDED ON THE DOCUMENT.

MONTH
YEAR (GO TO 110)

109) In what month and year were you born?

Month
Don’t know month 98
Year
Don’t know year 98

110) What is your age?
INTERVIEWER:
CORRECT AND COMPARE 108/109 AND 110 IF INCONSISTENT

YEARS COMPLETED ____

111) Have you ever attended school?

YES 1
NO 2 (GO TO 115)

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

PRIMARY 1
SECONDARY/PROFESSIONAL 2
HIGHER 3
OTHER 4

113) What is the highest (grade/form/year) you completed at that level?

Grade ____

114)
INTERVIEWER: CHECK 112 AND TICK THE APPROPRIATE BOX:

PRIMARY
SECONDARY/PROFESSIONAL, SUPERIOR, OR OTHER (GO TO 116)

115) Can you read a letter or a newspaper easily, with difficulty, or not at all?

EASILY 1
WITH DIFFICULTY 2
NOT AT ALL 3 (GO TO 117

116) Do you usually read a newspaper or a magazine once a week?

YES 1
NO 2

117) Do you watch television?

EVERY DAY 1
SEVERAL TIMES A WEEK 2
LESS OFTEN 3
NEVER 4

118) Do you listen to the radio?

EVERY DAY 1
SEVERAL TIMES A WEEK 2
LESS OFTEN 3
NEVER 4

119) Where does the water you drink come from?

PIPPED INTO RESIDENCE 1
PUBLIC TAP 2
PUBLIC/PRIVATE WELL 3
TANKER TRUCK, OTHER VENDER 4
SPRING, SURFACE WATER 5
BACKWATER, LAKE 6
OTHER (SPECIFY) 7

120) Where is your toilet?

TOILET INSIDE 1
PRIVATE TOILET OUTSIDE 2
COMMUNAL TOILET OUTSIDE 3
NO TOILET 4
OTHER (SPECIFY) 5

121) How do you light up the house?

ELECTRIC GRID (STEG) 1
GENERATOR 2
BATTERY 3
PETROLEUM LAMP 4
GAS LAMP 5
OIL LAMP 6
CANDLE 7
OTHER (SPECIFY) 8

122) What do you use to cook at home

ELECTRIC/GAS STOVE 1
GAS CAMPING STOVE 2
COAL 3
WOOD/TWIGS 4
OTHER (SPECIFY) 5

123) Does your house has: a radio, a television, a video, a refrigerator, a telephone?

Radio
YES 1
NO 2
Television
YES 1
NO 2
Video
YES 1
NO 2
Refrigerator
YES 1
NO 2
Telephone
YES 1
NO 2

124) Does a member of you household own:
A bicycle,
A motorcycle,
A scooter,
A car,
A small truck,
A big truck,
A Tractor,
A cariole,
A mule,
A horse,
A donkey.

BICYCLE
YES 1
NO 2
MOTOR SCOOTER
YES 1
NO 2
CAR
YES 1
NO 2
SMALL TRUCK
YES 1
NO 2
TRUCK
YES 1
NO 2
TRACTOR
YES 1
NO 2
CART
YES 1
NO 2
MULE/DONKEY/HORSE
YES 1
NO 2

125) The walls of the house you live in are built with which material?

STONES OR BRICKS FILLED WITH MORTAR 1
STONES FILLED WITH MORTAR 2
STONES OR BRICKS WITHOUT MORTAR 3
PACKED EARTH 4
PLANKS/ZINC SHEET METAL/REEDS 5
OTHER (SPECIFY) 6

126) What is the ceiling made of?

SLAB/FILLED BRICKS/PLANKS/TILES 1
BRANCHES COATED IN DIRT/SHEET METAL 2
UNCOATED BRANCHES 3
OTHER (SPECIFY) [##TRANSLATOR NOTE: NUMBER ILLEGIBLE]

127) How many rooms do you have in this house?

NUMBER ____

128) What is your status in this household: owner, rent-to-own, renter, free usage, other.

OWNER 1
RENT-TO-OWN 2
RENT 3
FREE USAGE 4
OTHER (SPECIFY) 5

SECTION 2. MARRIAGE

201) Are you now married, divorced, widowed or separated?

MARRIED 1
WIDOW 2
DIVORCED 3
SEPARATED 4

202) Have you been married just once or more?

ONLY ONCE 1
MORE THAN ONCE 2

203) In what month and year did you get married (the first time)?

MONTH
DON’T KNOW 98
YEAR (GO TO 205)
DON’T KNOW 98

204) How old were you when you got married (the first time)?

AGE ____

205) Is your father still alive?

FATHER ALIVE 1
FATHER DEAD 2

206) And your mother, is she still alive?

MOTHER ALIVE 1
MOTHER DEAD 2

207) Is your father-in-law (from your first marriage) still alive?

FATHER-IN-LAW ALIVE 1
FATHER-IN-LAW DEAD 2
DON’T KNOW 8

208) Is your mother-in-law (from your first marriage) still alive?

MOTHER-IN-LAW ALIVE 1
MOTHER-IN-LAW DEAD 2
DON’T KNOW 8

209)
INTERVIEWER: CHECK 205-206-207-208 AND TICK THE APPROPRIATE BOX

AT LEAST ONE PARENT DECEASED
ALL ALIVE OR DON’T KNOW (GO TO 212)

210) Was (MENTION PARENT) alive at the time you got married?
INTERVIEWER:
WHEN ASKING THE FOLLOWING QUESTION, NAME THE DECEASED PARENTS

Living
YES 1
NO 2
Father
YES 1
NO 2
Mother
YES 1
NO 2
Father-in-law
YES 1
NO 2
Mother-in-law
YES 1
NO 2

211) INTERVIEWER: CHECK 209 AND 210 AND TICK THE APPROPRIATE BOX

AT LEAST ONE PARENT LIVING AT MARRIAGE
NOT A SINGLE PARENT LIVING AT MARRIAGE (GO TO 216)

212) At the time you got married, did you and your husband live with any of these parents for at least six month in a permanent manner?

YES 1
NO 2 (GO TO 214)

213) For about how many years did you live together with a parent at that time before the parent died?

YEAR ____
UP TO NOW 96 (GO TO 216)
DON’T KNOW 98

214) INTERVIEWER: CHECK 201

CURRENTLY MARRIED
WIDOW, DIVORCED, SEPARATED (GO TO 216)

215) Are you now living with one of the parents and the parent died?

YES 1
NO 2

216) In how many localities have you and your (first) husband lived for at least six months since you were first married?

NUMBER OF LOCATIONS ____
DON’T KNOW 98

217) Are you related to your (first) husband?

PATERNAL COUSIN 1
MATERNAL COUSIN 2
OTHER RELATIVES 3
NO RELATIONSHIP 4

218) Are your father and mother related (or are your father-in-law and mother-in-law related)?
(Paternal cousin)
(Maternal cousin)

YES 1
NO 2

SECTION 3. FERTILITY AND INFANT MORTALITY

301) Now, I would like to ask about all the kids you have had during your life.
Have you ever had kids?

YES 1
NO 2 (GO TO 308)

302) Do you have any sons or daughters you have given birth to who are now living with you

YES 1
NO 2 (GO TO 305)

303) How many sons live with you now?
INTERVIEWER: RECORD 00 IF NONE

BOYS AT HOME ____

304) How many daughters live with you now?
INTERVIEWER: RECORD 00 IF NONE

GIRLS AT HOME ____

305) Do you have any sons or daughters who do not live with you now?

YES 1
NO 2 (GO TO 308)

306) How many sons you have who do not live with you now?
INTERVIEWER: RECORD 00 IF NONE

BOYS ELSEWHERE ____

307) How many daughters you have who do not live with you now?
INTERVIEWER: RECORD 00 IF NONE

GIRLS ELSEWHERE ____

308) Have you ever given birth to a boy or a girl who was born alive but later died?
Interviewer: If no, probe: Just to make sure I have this right; have you ever given birth to a boy or a girl who survived for few hours or days?

YES 1
NO 2 (GO TO 311)

309) How many boys have died?
INTERVIEWER: RECORD 00 IF NONE

BOYS DEAD____

310) How many girls have died?
INTERVIEWER: RECORD 00 IF NONE

GIRLS DEAD ____

311) INTERVIEWER: SUM ANSWERS TO 303, 304, 306, 307, 309, AND 310 AND ENTER TOTAL.

TOTAL ____

312) Just to make sure I have this right: you have had in TOTAL ….
(PROBE AND CORRECT 301 TO 312 IF NECESSARY)

YES 1
NO 2

313) INTERVIEWER: CHECK 311 AND TICK THE APPROPRIATE BOX

ONE OR MORE BIRTHS
NOT A SINGLE BIRTH (GO TO 324)

314) Now, I would like you to give me the names of all the boys and girls you gave birth to (whether still alive or not) starting with the first one you had.
INTERVIEWER: RECORD IN 315 THE NAMES OF ALL THE BIRTHS.

TABLE 1: INTERVIEWER, RECORD ALL CHILDREN IN ORDER STARTING WITH THE OLDEST.

315) What is the name of each one of them?
INTERVIEWER:
RECORD TWINS ON SEPARATE LINES AND CONNECT THEM WITH BRACKETS ON THE LEFT.

FIRST NAME ____

316) Is (NAME OF CHILD) a boy or girl?

BOY 1
GIRL 2

317) Can you please give me the family booklet if you have it, or a birth certificate of him or her.

NONE 1
FAMILY BOOKLET 2
BIRTH CERTIFICATE 3
NATIONAL IDENTIFICATION CARD/PASSPORT 4
OTHER DOCUMENT 5

318) What is the month and year of birth?

MONTH ____
YEAR ____
DON’T KNOW 98

319) Is child still living or dead?

YES 1
NO 2

320) IF STILL LIVING: How old is he/she?
INTERVIEWER: Get age in completed years

AGE____

321) Is he/she living with you now or not?
Does the child live in the household?

YES 1
NO 2

322) How old was he/she when he/she died?
IF DEAD: RECORD AGE IN DAYS IF LESS THAN A MONTH, IN MONTHS IF LESS THAN 2 YEARS, AND IN COMPLETED YEARS IF 2 YEARS OR MORE.

AGE AT DEATH ____
DON’T KNOW 98
DAY 1
MONTH 2
YEAR 3

323) INTERVIEWER: COMPARE 311 WITH THE NUMBER OF BIRTHS RECORDED IN TABLE 1 AND TICK THE APPROPRIATE BOX:

THE NUMBERS ARE THE SAME (GO TO 324)
THE NUMBERS ARE DIFFERENT (VERIFY AND CORRECT, THEN GO TO 324)

324) INTERVIEWER: CHECK 201:

MARRIED
WIDOW, DIVORCED, SEPARATED (GO TO 331)

325) Are you pregnant now or not?

YES 1
NO 2 (GO TO 331)
NOT SURE, DON’T KNOW 8 (GO TO 331)

326) For how many months have you been pregnant?

NUMBER OF MONTHS ____

327) Did you see a doctor or a nurse or someone else for a check on this pregnancy?

YES 1
NO 2 (GO TO 332)

328) How many times did you see someone for this pregnancy?

NUMBER ____

329) Where did your first check take place?
INTERVIEWER: PROBE AND RECORD THE LOCATION CODE OR THE MOST QUALIFIED PERSON.

DISPENSARY 1
MEDICAL FACILITY 2
HOSPITAL/MATERNITY 3
MOBILE UNIT 4
PRIVATE DOCTOR 5
KABLA ARBI 6 [##TRANSLATOR NOTE: DEFINITION NOT FOUND]
OTHER (SPECIFY) 7

330) How many months pregnant were you the first time you received antenatal care?

MONTHS____ (GO TO 332)
DON’T KNOW 98

331) How long ago did you last menstrual period start?

DAYS 1
WEEKS 2
MONTHS 3
BEFORE LAST PREGNANCY 995
NEVER MENSTRUATED 996
DON’T KNOW 998

332) When during her monthly cycle do you think a woman has the greatest chance of 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
DON’T KNOW 8

333) INTERVIEWER: Are there people present during this moment in the interview?

Children under 10 YEARS
YES 1
NO 2
Husband
YES 1
NO 2
OTHER MEN
YES 1
NO 2
OTHER WOMEN
YES 1
NO 2

SECTION 4: CONTRACEPTION

401) 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 one of these ways or methods have you heard about?
INTERVIEWER:
CIRCLE CODE 1 IN 402 FOR EACH METHOD MENTIONED SPONTANEOUSLY. THEN PROCEED DOWN THE COLUMN, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY, CIRCLING CODE 2 IF THE METHOD IS RECOGNIZED OR CODE 3 IF THE WOMAN DOES NOT RECOGNIZE IT. ASK 403 TO 405 FOR EACH METHOD RECOGNIZED BY THE WOMAN.

401) Method code

01) PILL Women can take a pill every day
YES, SPONTANEOUSLY 1
YES, AFTER ASKED
NO 3
02) IUD Women can have a loop or a coil placed inside them by a doctor or a nurse.
YES, SPONTANEOUSLY 1
YES, AFTER ASKED
NO 3
03): INJECTIONS Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
YES, SPONTANEOUSLY 1
YES, AFTER ASKED
NO 3
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, SPONTANEOUSLY 1
YES, AFTER ASKED
NO 3
05) ANY OTHER SCIENTIFIC METHOD Women can place a, suppository or cream inside them before intercourse or wash themselves with something after the intercourse.
YES, SPONTANEOUSLY 1
YES, AFTER ASKED
NO 3
06) CONDOM Men can use a rubber sheath during sexual intercourse.
YES, SPONTANEOUSLY 1
YES, AFTER ASKED
NO 3
07) FEMALE STERILIZATION Women can have an operation to avoid having any more children.
YES, SPONTANEOUSLY 1
YES, AFTER ASKED
NO 3
08) MALE STERILIZATION Men can have an operation to avoid having any more children.
YES, SPONTANEOUSLY 1
YES, AFTER ASKED
NO 3
09) PERIODIC ABSTICENCE Couples can avoid having sexual intercourse on certain days of the month when the woman is more likely to become pregnant.
YES, SPONTANEOUSLY 1
YES, AFTER ASKED
NO 3
10) WITHDRAWAL Men can be careful and pull out before climax.
YES, SPONTANEOUSLY 1
YES, AFTER ASKED
NO 3
11) ABORTION Women can abort willingly to avoid having a child.
YES, SPONTANEOUSLY 1
YES, AFTER ASKED
NO 3
12) OTHER METHODS Have you heard of any other ways or methods that women can use to avoid pregnancy?
YES, SPONTANEOUSLY 1 (GO TO 406)
YES, AFTER ASKED (GO TO 406)
NO 3 (GO TO 406)

402) Have you ever heard of this method?

YES, SPONTANEOUS 1
YES, DESCRIPTION 2
NO 3

403) Have you or your husband ever used this method?

YES 1
NO 2

404) Where would you go to obtain or use this method?

01 HOSPITAL/MATERNITY
02 CLINIC
03 DISPENSARY
04 MOBILE UNIT
05 FAMILY PLANNING CLINIC
06 MEDICAL-SOCIAL CENTER
07 PRIVATE DOCTOR’S OFFICE/CLINIC
08 PHARMACY
09 FRIENDS/NEIGHBORS/KABLA ARBI [##TRANSLATOR NOTE: TRANSLATION UNAVAILABLE]
10 OTHER
98 DON’T KNOW

405) In your opinion, what is the main problem, if any, with using this method?

01 NONE
02 DISRUPTS PERIOD
03 HEALTH CONCERNS
04 PREVIOUS BAD EXPERIENCE
05 METHOD INEFFECTIVE
06 DIFFICULT TO USE
07 UNCOMFORTABLE
08 RELIGIOUS REASONS
09 FORGETFULNESS
10 CONTRAINDICATED
11 IRREVERSIBLE
12 PROBLEMS WITH ACCESS
13 PROBLEMS WITH AVAILABILITY
14 OTHER
98 DON’T KNOW

406) INTERVIEWER: CHECK COLUMN 403 AND TICK THE APPROPRIATE BOX.

NOT A SINGLE YES IN 403, NEVER USED
AT LEAST ONE YES IN 403, USED CONTRACEPTION-GO TO 408A

407) Have you ever used anything or tried any way to delay or avoid getting pregnant?

YES 1
NO 2 (GO TO 437)

408) INTERVIEWER: CHECK 402 AND 403. CORRECT IF NECESSARY AND OBTAIN THE INFORMATION FOR 404 AND 405.
IF THE EXACT METHOD USED IS ALREADY ON TABLE 2, CIRCLE CODE 2 (YES AFTER DESCRIPTION).

(SPECIFY)

408A) INTERVIEWER: CHECK (403-10) AND TICK THE APPROPRIATE BOX.

HAS HAD AN ABORTION
HAS NOT HAD AN ABORTION (GO TO 409)

408B) Since you grew up (had your periods) to today, how many abortions did you willingly have?

NUMBER OF TIMES ____
DON’T KNOW 8

408C) Between this past Ramadan (Holy fasting month) and the one from the previous year, did you have any consented abortion?

YES 1
NO 2 (GO TO 408G)
DON’T KNOW 8 (GO TO 408G)

408D) How many?

NUMBER OF TIMES
DON’T KNOW 8

408E) Between this past Ramadan ([##translator note : Muslim holy fasting month) and the one from the previous year, did you have the abortion in a hospital or at a private (paying) clinic?

YES 1
NO 2 (GO TO 409)
DON’T KNOW (GO TO 409)

408f) How many times?

NUMBER OF TIMES ____
DON’T KNOW 8

408g) Where did you have your last consented abortion?

C.R.E.P.F 1 [##translator note: unable to translate]
HOSPITAL/MATERNITY 2
CLINIC/PRIVATE DOCTOR 3
OTHERS 4
DON’T KNOW 8

409) INTERVIEWER: CHECK 403 (09) AND TICK THE APPROPRIATE BOX

USED RHYTHM METHOD
NEVER USED RHYTHM METHOD-GO TO 411

410) The last time you used periodic abstinence, not having intercourse with your husband for specific days, how did you determine on which days you had to abstain?
Based on:

THE CALENDAR 1
BODY TEMPERATURE 2
M.A.O METHOD [##TRANSLATOR NOTE: UNABLE TO FIND TRANSLATION] 3
DIFFERENT COMBINATION 4
OTHER (SPECIFY) 5

411) How many living children, if any, did you have when you first did something or used a method to avoid getting pregnant?
INTERVIEWER:

IF NO CHILD, RECORD 00
NUMBER OF CHILDREN ____

412) INTERVIEWER: CHECK 201 AND TICK

CURRENTLY MARRIED
WIDOW, DIVORCED, SEPARATED-GO TO 441

413) INTERVIEWER: CHECK 325 AND TICK

NOT PREGNANT, NOT SURE, OR DON’T KNOW
CURRENTLY PREGNANT-GO TO 418

414) Are you or your husband currently doing something or using any method to avoid getting pregnant?

YES 1
NO 2 (GO TO 418)

415) Which method are you using?

PILL 01
IUD 02 (GO TO 419C)
INJECTIONS 03 (GO TO 419A)
IMPLANT 04 (GO TO 419A)
OTHER SCIENTIFIC METHOD 05 (GO TO 419A)
CONDOM 06 (GO TO 419A)
FEMALE STERILIZATION 07 (GO TO 417)
VASECTOMY 08 (GO TO 417)
PERIODIC ABSTINENCE 09 (GO TO 418)
WITHDRAWAL 10 (GO TO 418)
OTHER METHODS 12 (GO TO 418)

416) How much did it cost you in millime to use this contraceptive method?
PRICE IN MILLIME [##TRANSLATOR NOTE: MILLIME IS OLD TUNISIAN CURRENCY]

FREE 96
DON’T KNOW 98
ALL GO TO 419A

417) Do you know in which year and which month you did the tubal ligation surgery?
DATE:

MONTH ____
YEAR ____
GO TO 419B

418) In the last 12 months, did you or your husband go to a health facility to get some advice on how to avoid getting pregnant?

YES 1 (GO TO 419A)
NO 2 (GO TO 421)

419A) Where did you or your husband go the last time to get advice or obtain instructions for a method to avoid getting pregnant?

HOSPITAL/MATERNITY/SOCIAL SECURITY HEALTH FACILITY 01
CREPF [##TRANSLATOR NOTE: UNABLE TO TRANSLATE] 02
MOTHER-INFANT CENTER/DISPENSARY/MEDIO-SOCIO ENTITY 03
OUTPATIENT TREATMENT FACILITY 04
DOCTOR/MIDWIFE/PRIVATE CLINIC 05
PHARMACY 06
FRIENDS, KABLA, RELATIVE [##TRANSLATOR NOTE: DEFINITION NOT FOUND] 07
OTHER (SPECIFY) 08
DON’T KNOW 09

419B) And where did you do your tubal ligation surgery?

HOSPITAL/MATERNITY/SOCIAL SECURITY HEALTH FACILITY 01
CREPF [##TRANSLATOR NOTE: UNABLE TO TRANSLATE] 02
MOTHER-INFANT CENTER/DISPENSARY/MEDIO-SOCIO ENTITY 03
OUTPATIENT TREATMENT FACILITY 04
DOCTOR/MIDWIFE/PRIVATE CLINIC 05
PHARMACY 06
FRIENDS, KABLA, RELATIVE [##TRANSLATOR NOTE: DEFINITION NOT FOUND] 07
OTHER (SPECIFY) 08
DON’T KNOW 09

419C) And where did you put the device?

HOSPITAL/MATERNITY/SOCIAL SECURITY HEALTH FACILITY 01 (GO TO 420)
CREPF [##TRANSLATOR NOTE: UNABLE TO TRANSLATE] 02 (GO TO 420)
MOTHER-INFANT CENTER/DISPENSARY/MEDIO-SOCIO ENTITY 03 (GO TO 420)
OUTPATIENT TREATMENT FACILITY 04 (GO TO 420)
DOCTOR/MIDWIFE/PRIVATE CLINIC 05 (GO TO 420)
PHARMACY 06 (GO TO 421)
FRIENDS, KABLA, RELATIVE [##TRANSLATOR NOTE: DEFINITION NOT FOUND] 07 (GO TO 421)
OTHER (SPECIFY) 08 (GO TO 421)
DON’T KNOW 09 (GO TO 421)

420) Was there something you did not like in this health facility as to how they greeted you, or how they attended to you or anything else?

NOTHING TO REPORT 01
LONG WAIT 02
POOR GREETING/SERVICE 03
COSTS TOO MUCH 04
FAR AND ACCESS PROBLEMS 05
DIDN’T RECEIVE METHOD OR INFORMATION NEEDED 06
LACK OF CONFIDENCE/PERSON INCOMPETENT 07
DOESN’T WANT TO BE HELPED BY A MAN 08
NOT CLEAN 09
OTHER (SPECIFY) 10

421) INTERVIEWER: CHECK 325 AND TICK THE APPROPRIATE BOX.

NOT PREGNANT, NOT SURE, OR DON’T KNOW
CURRENTLY PREGNANT (GO TO 438)

422) INTERVIEWER: CHECK 414-415 AND TICK THE APPROPRIATE BOX

STERILIZED (GO TO 424)
CURRENTLY USING ANOTHER METHOD (GO TO 423)
NOT CURRENTLY USING A METHOD (GO TO 431)

423) For how long have you been using (CURRENT METHOD) without interruption?
(CURRENT METHOD FROM 415)

LENGTH:
NUMBER OF MONTHS ____
NUMBER OF YEARS ____

423A) Between this past Ramadan ([##translator note: Muslim holy fasting month) and the one from the previous year, how many times did you check on the (CURRENT METHOD) you use or on adding more of what you are getting?

NUMBER OF TIMES ____
OTHER ANSWER 96
DON’T KNOW 98

424) Have you had any problem or concern using (CURRENT METHOD)?
(CURRENT METHOD FROM 415)?

YES 1
NO 2 (GO TO 426)

425) What was the most important problem or difficulty you had using this method?

FAILED METHOD 01
DIFFICULTY OR FREQUENCY OF SEXUAL RELATIONS 02
HUSBAND OPPOSED 03
BAD EXPERIENCE OF RELATIVES/FRIENDS/NEIGHBORS 04
BAD MEDICAL FOLLOW UP 05
INTIMACY PROBLEMS DUE TO MALE PERSON 06
IRREVERSIBLE 07
VAGINAL DISCHARGE-PUS 08
BLOODY VAGINAL DISCHARGE 09
LOWER ABDOMINAL PAIN 10
OTHER PAIN 11
CARCINOGENIC EFFECT 12
OTHER HEALTH EFFECTS 13
OTHER (SPECIFY) 14

426) Did you use any other method to avoid getting pregnant (after your last pregnancy)?

YES 1
NO 2 (GO TO 441)

427) What method were you using (before the one you are using now)?

PILL 01
STERILIZATION 02
INJECTIONS 03
IMPLANT 04
VAGINAL METHOD 05
CONDOM 06
VASECTOMY 08
PERIODIC ABSTINENCE 09
WITHDRAWAL 10
ABORTION 11-GO TO 431
OTHER SPECIFY 12

428) In which year and which month did you start using this method:

MONTH ____
YEAR ____

429) How long have you used this method without interruption before stopping it?

MONTH ____
YEAR ____

430) What was the main reason you stopped using this method?
(METHOD FROM 427)

METHOD FAILED 01
DIFFICULT/FREQUENT SEXUAL RELATIONS 02
HUSBAND OPPOSED 03
BAD EXPERIENCE OF RELATIVES/FRIENDS/NEIGHBORS 04
PERIOD STOPPED 05
FORGOT 06
NOT PRACTICAL 07
EXPENSIVE 08
IRREVERSIBLE 09
ACCESSIBILITY PROBLEMS 10
AVAILABILITY PROBLEMS 11
BAD MEDICAL SUPERVISION OR FOLLOW UP 12
INTIMACY WITH MALE [##TRANSLATOR NOTE: THIS LINE USED ABBREVIATIONS I’M NOT FAMILIAR WITH, SO I’M UNCERTAIN OF THE PRECISE TRANSLATION] 13
VAGINAL DISCHARGE-PUS 14
BLOODY VAGINAL DISCHARGE 15
LOWER BACK PAIN 16
OTHER PAIN 17
CANCEROUS EFFECTS 18
OTHER HEALTH EFFECTS 19
OTHER (SPECIFY) 20

431) INTERVIEWER: CHECK 311 AND TICK THE APPROPRIATE BOX

AT LEAST ONE LIVE BIRTH
NOT A SINGLE LIVE BIRTH (GO TO 433)

432) Since your last pregnancy till now, have you used any method to avoid getting pregnant?

YES 1
NO 2 (GO TO 438)

433) What was the last method you used?

PILL 01
IUD (STERILIZATION) 02
INJECTIONS 03
IMPLANT 04
OTHER SCIENTIFIC METHOD 05
CONDOM 06
VASECTOMY 08
PERIODIC ABSTINENCE 09
WITHDRAWAL 10
ABORTION 11-GO TO 437
OTHER SPECIFY 12

434) Do you know in which month and which year you started using this method?
(METHOD LISTED IN 433)

MONTH
YEAR

435) How long have you used this method without interruption before stopping it?

NUMBER OF MONTHS
NUMBER OF YEARS

436) What was the main reason you stopped using this method?
(METHOD LISTED IN 433)

METHOD FAILED 01
DIFFICULT/FREQUENT SEXUAL RELATIONS 02
HUSBAND OPPOSED 03
BAD EXPERIENCE OF RELATIVES/FRIENDS/NEIGHBORS 04
PERIOD STOPPED 05
FORGOT 06
NOT PRACTICAL 07
EXPENSIVE 08
IRREVERSIBLE 09
ACCESSIBILITY PROBLEMS 10
AVAILABILITY PROBLEMS 11
BAD MEDICAL SUPERVISION OR FOLLOW UP 12
INTIMACY WITH MALE [##TRANSLATOR NOTE: THIS LINE USED ABBREVIATIONS I’M NOT FAMILIAR WITH, SO I’M UNCERTAIN OF THE PRECISE TRANSLATION] 13
VAGINAL DISCHARGE-PUS 14
BLOODY VAGINAL DISCHARGE 15
LOWER BACK PAIN 16
OTHER PAIN 17
CANCEROUS EFFECTS 18
OTHER HEALTH EFFECTS 19
OTHER (SPECIFY) 20

437) INTERVIEWER: CHECK 201 AND TICK

MARRIED
WIDOW, DIVORCED, OR SEPARATED-GO TO 441

438) Do you intend to use a method to avoid pregnancy at any time in the future.

YES 1
NO 2 (GO TO 441)
DON’T KNOW 8 (GO TO 441)

439) What is the method you intend to use?

PILL 01
IUD (STERILIZATION) 02
INJECTIONS 03
IMPLANT 04
OTHER SCIENTIFIC METHOD 05
CONDOM 06
VASECTOMY 08
PERIODIC ABSTINENCE 09
WITHDRAWAL 10
OTHER SPECIFY 12
DON’T KNOW 98

440) Do you intend to use this method in the next 12 months?

YES 1
NO 2
DON’T KNOW 8

441) In the last month, have you heard anything on the radio or the television, or any other gathering about family planning?

YES 1
NO 2 (GO TO 443)

442) Have you heard it once or more?

ONE TIME 1
MORE THAN ONCE 2

443) In your opinion, is it acceptable or not acceptable to you for family planning information to be provided on radio or television?

ACCEPTABLE 1
NOT ACCEPTABLE 2
DON’T KNOW 8

444) INTERVIEWER: CHECK TABLE 1 (318 TO 322) AND 325 THEN TICK THE APPROPRIATE BOX.
AT LEAST ONE LIVE BIRTH UNDER 5 YEARS, OR BORN SINCE MAY 1983, OR CURRENTLY PREGNANT
NOT A SINGLE LIVE BIRTH UNDER 5 YEARS, OR BORN SINCE MAY 1983 OR NOT CURRENTLY PREGNANT-GO TO 601

INTERVIEWER: NOW GO TO 445A AND TICK IN THE FIRST COLUMN IF THE WOMAN IS CURRENTLY PREGNANT OR NOT (325). THEN RECORD IN THE ORDER OF BIRTH STARTING WITH THE LAST THE NAMES (313) OF ALL THE CHILDREN BORN ALIVE SINCE JANUARY 1983 (318) OR UNDER 5 YEARS OLD.

445) INTERVIEWER: CHECK 406 AND TICK THE APPROPRIATE BOX
(ASK 446 TO 452 FOR EACH COLUMN) (ASK 451 FOR EACH COLUMN)
INTRODUCE THE SUBJECT BY SAYING [##TRANSLATOR NOTE: ARABIC TEXT]
(AFTER HAVING FILLED OUT 445, YOU MUST FILL OUT 445A)

HAS USED A CONTRACEPTIVE METHOD
HAS NEVER USED A CONTRACEPTIVE METHOD

445A) Now, I would like to ask you some questions in general about your health for the last 5 years.

446) Before getting pregnant with… and after your last pregnancy (if there had been a pregnancy) have you used a method to avoid getting pregnant?

YES 1
NO 2 (GO TO 451)

447) Do you remember the last method you used?
LAST METHOD

PILL 01
IUD (STERILIZATION) 02
INJECTIONS 03
IMPLANT 04
VAGINAL METHOD 05
CONDOM 06
VASECTOMY 08
PERIODIC ABSTINENCE 09
WITHDRAWAL 10
ABORTION 11
GO TO 451
OTHER, SPECIFY 12

447A) INTERVIEWER: CHECK
DID YOU USE ANY OTHER METHOD BEFORE?
RECORD THE CODE OF THE LAST METHOD HERE

NONE 00
LAST METHOD ____

448) How did you use the last method?
(CHECK 447)

MONTH ____
YEAR ____

449) Did you get pregnant while using this method?
(CHECK 447)

YES 1 (GO TO 452)
NO 2

450) Why did you stop using this method?
(CHECK 447)

TO GET PREGNANT 01 (GO NEXT COLUMN)
FAILED METHOD 02
FREQUENCY OF SEXUAL RELATIONS 03
HUSBAND OPPOSED 04
EFFECTS ON HEALTH 05
ACCESS PROBLEMS 06
AVAILABILITY PROBLEMS 07
COSTS TOO MUCH 08
DIFFICULTY USING 09
INTIMACY PROBLEMS 10
UP TO GOD 11
OTHER (SPECIFY) 12
DON’T KNOW 98

451) At the time you became pregnant, did you want to become pregnant then, did you want to wait until later, or did you not want to have any children at all?

THEN 1
LATER 2
NO MORE 3
(GO TO NEXT COLUMN)

452) Did you want to become pregnant until later, or did you not want to have any children at all?

LATER 1
NOT AT ALL 2
(GO TO NEXT COLUMN)

SECTION 5. HEALTH AND BREASTFEEDING

501) INTERVIEWER: CHECK TABLE 1 THEN RECORD THE LINE NUMBER (315) AND THE SURVIVAL STATE (319) OF ALL THE CHILDREN UNDER 5 YEARS OLD OR BORN BEFORE MAY 1983 (318).

502) When you were pregnant with (NAME) were you given any injection to prevent the baby from getting tetanus?

YES 1
NO 2
DON’T KNOW 8

503) When you were pregnant with (NAME) did you see anyone for a check on this pregnancy?

YES 1
NO 2 (GO TO 507)

504) How many times did you get checked?

NUMBER OF TIMES ____

505) Where did you go the last time you checked on your pregnancy with (NAME)?

DISPENSARY 1
MEDICAL FACILITY 2
HOSPITAL/MATERNITY 3
MOBILE UNIT 4
PRIVATE DOCTOR 5
KABLA ARBI 6 [##TRANSLATOR NOTE: DEFINITION NOT FOUND]
OTHER (SPECIFY) 7

506) Whom did you see? A doctor, a midwife, a nurse, a traditional birth attendant or someone else?
INTERVIEWER: RECORD THE MOST QUALIFIED PERSON:

DOCTOR 1
MIDWIFE 2
NURSE 3
KABLA ARBI 4 [##TRANSLATOR NOTE: DEFINITION NOT FOUND] (###TRANSLATOR AFIFA: TRADITIONAL BIRTH ATTENDANT)
OTHER (SPECIFY) 5

507) Where did you give birth when you delivered (NAME)? At a public hospital, a private doctor’s practice, at home or in another place?

PUBLIC 1
PRIVATE 2
AT HOME 3
OTHER 4

508) Who assisted with the delivery of (NAME)? A doctor, a midwife, a nurse, a traditional birth attendant or someone else?
INTERVIEWER: RECORD THE MOST QUALIFIED PERSON:

DOCTOR 1
MIDWIFE 2
NURSE 3
KABLA ARBI 4 [##TRANSLATOR NOTE: DEFINITION NOT FOUND]
OTHER (SPECIFY) 5

509) Did you feed (NAME) at the breast?

YES 1 (GO TO 512)
NO 2

510) Are you still breastfeeding (NAME)
INTERVIEWER: CHECK SURVIVAL STATE IN 501 AND CIRCLE CODE 3 IF DEAD.

YES 1 (GO TO 512)
NO 2
DEAD 3

511) How many months did you breastfeed (NAME)

DON’T KNOW MONTH
UP TO DEATH 96

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

DON’T KNOW MONTH
NOT YET 95

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

YES 1 (GO TO 514)
NO 2 (GO TO NEXT COLUMN)

514) How many months after the birth of (NAME) did you resume sexual relations?

MONTHS____
DON’T KNOW MONTH (GO TO NEXT COLUMN)

515)
INTERVIEWER: CHECK 509 AND 510 FOR THE LAST BIRTH AND TICK THE

APPROPRIATE SPACE
STILL BREASTFEEDING
NOT BREASTFEEDING (GO TO 523)
CHILD DEAD (GO TO 525)

516) How many times did you breastfeed last night between sundown and sunrise?

NUMBER OF TIMES ____
WHEN THE CHILD CRIES 95
SLEEPS WHILE FEEDING 96

517) How many times did you breastfeed yesterday during the daylight hours?

NUMBER OF TIMES ____
WHEN THE CHILD CRIES 95
ALL THE TIME 96

518) At any time yesterday during the daylight hours or last night, was (NAME OF LAST CHILD) given anything to drink or eat, such as:
Water?
Juice?
Tea?
Herbal tea?
Powdered milk?
Cow milk?
Goat milk?
Condensed milk?
Gruel?
Yogurt?
Flour?
Biscuit?
Something else?

WATER
YES 1
NO 2
JUICE
YES 1
NO 2
TEA/HERBAL TEA
YES 1
NO 2
POWDERED MILK
YES 1
NO 2
COW MILK
YES 1
NO 2
GOAT MILK
YES 1
NO 2
CONCENTRATED MILK
YES 1
NO 2
GRUEL
YES 1
NO 2
YOGURT
YES 1
NO 2
FLOUR/BISCUIT
YES 1
NO 2
OTHER (SPECIFY)
YES 1
NO 2

519) Do you feed your last child anything else than the milk from your breast?

YES 1
NO 2 (GO TO 521)

520) When you started giving your child other food (than your breast milk), how old was he?

NUMBER OF MONTHS ____

521) INTERVIEWER: CHECK 518 AND TICK THE APPROPRIATE BOX

AT LEAST ONE YES IN 518
NOT A SINGLE YES IN 518 (GO TO 525)

522) Were any of these given in a bottle with a nipple?

YES 1
NO 2
OTHER 8

523) Why did you stop breastfeeding your child (NAME)?

WEANING 01
CHILD ILL 02
REFUSED TO SUCKLE 03
MOTHER ILL 04
DOESN’T HAVE MILK 05
PREGNANT 06
PREFERS TO GIVE ARTIFICIAL MILK 07
WORKING 08
OTHER (SPECIFY) 09
ALL GO TO 525

524) How did you wean (NAME). Did you suddenly stop the food or did you stop the food gradually?

GRADUAL STOP 1
SUDDEN STOP 2

525) INTERVIEWER: CHECK TABLE 4 AND RECORD THE LINE NUMBER, NAME, AND SURVIVAL STATE OF ALL CHILDREN AGE 5 OR UNDER OR BORN SINCE MAY 1983.

526) Do you have a vaccines health card for (NAME)? May I see it please?

NO BOOKLET 1
YES, BUT NOT SEEN 2 (GO TO 528)
YES, SEEN 3

527)
INTERVIEWER:
RECORD THE VACCINATION DATES BASED ON THE VACCINATION CARD.

BCG
DAY____
MONTH____
YEAR____
DTCOQ 1
DAY____
MONTH____
YEAR____
POLIO 1
DAY____
MONTH____
YEAR____
DTCOQ 2
DAY____
MONTH____
YEAR____
POLIO 2
DAY____
MONTH____
YEAR____
DTCOQ 3
DAY____
MONTH____
YEAR____
POLIO 3
DAY____
MONTH____
YEAR____
DPT
DAY____
MONTH____
YEAR____
MEASLES
DAY____
MONTH____
YEAR____ (GO TO 529)

528) Has (NAME) ever had a vaccination for:
BCG
DTC/POLIO?
DTC/POLIO?
MEASLES?

BCG
YES 1
NO 2
DTC/POLIO (1)
YES 1
NO 2
DTC/POLIO (2)
YES 1
NO 2
DTC/POLIO (3)
YES 1
NO 2
MEASLES
YES 1
NO 2

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

YES 1
NO 2

530) Has (NAME) had diarrhea in the last two weeks?

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

531) How many days has he/she had diarrhea?

NUMBER OF DAYS ____

532) Did you breastfeed him/her while he/she was sick?

YES 1
NO 2
CHILD WEENED 3

533) While he/she was sick, did the diarrhea increase, or decrease or was it the same?

INCREASE 1
DECREASE 2
THE SAME 3
DON’T KNOW 8

534) Did you prepare something for him/her to help with diarrhea?

YES 1
NO 2 (GO TO 540)

535) What did you give him/her:

HOMEMADE WATER SUGAR AND SALT SOLUTION 1
RICE WATER 2
CARROT WATER 3
TEA/HERBAL TEA 4
OTHER (SPECIFY) 5
(GO TO 540)

536) Where did you learn to prepare water with sugar and salt?

HOSPITAL 1
MATERNITY 2
DISPENSARY 3
PRIVATE DOCTOR 4
RELATIVE/FRIEND/NEIGHBOR 5
OTHER (SPECIFY) 6

537) When you gave him/her the water sugar and salt solution, did his/her health 1. Improve, 2. worsened, 3. stayed the same?

IMPROVED 1
WORSENED 2
THE SAME 3

538)How much does he/she drink of this water daily?

1 LITER EVERY 24 HOURS 1
OTHER (SPECIFY) 2

539) How many days did you keep giving him/her this water to drink?

DAYS ____

540) When (NAME) had diarrhea, did you increase or decrease or kept his/her food the same?

INCREASED 1
DECREASED 2
THE SAME 3
NO SOLID FOOD BEFORE DIARRHEA 4
DON’T KNOW 8

541) Was (NAME) taken to a hospital, a maternity, a dispensary, a private doctor, a pharmacy or somewhere else during his last episode of diarrhea or did you not take him/her anywhere?

HOSPITAL 1
MATERNITY 1
DISPENSARY 1
PRIVATE DOCTOR 1
PHARMACY 1
OTHER (SPECIFY) 1

542) Which medication did he/she take?
An injection, pills, syrup, oralyte (##translator note: translation not found, but term is relate to something taken orally), or else?

INJECTION 1
PILLS 1
SYRUP 1
ORALYTE 1 [##TRANSLATOR NOTE: TRANSLATION NOT FOUND, BUT TERM RELATED TO THE MOUTH, SOME KIND OF ORALLY ADMINISTERED MEDICINE]
OTHERS 1
(GO TO NEXT COLUMN)

543) Have you ever heard of any blue fluid (oralyte) given to kids when having diarrhea?

YES 1
NO 2

544) Have you seen such a soluble envelope? (##translator note: I could not find the right term for this container but it seems to be some solution in a small packet)

YES 1
NO 2 (GO TO 553)

545) Would you mind telling me what it is for?

DIARRHEA 1
REHYDRATION 2
OTHER ANSWER 3
DON’T KNOW 8 (GO TO 553)

546) Have you used this soluble envelope/packet to treat your kid?

YES 1
NO 2 (GO TO 551)

547) How do you prepare the medication from this packet?

SPECIFY THE CONTAINER OR VOLUME OF WATER 1
CONTAINER SHOULD BE CLEAN 1
CLEAN WATER SHOULD BE USED 1
CONTENTS OF PACKET IS ADDED TO THE WATER 1
TO BE USED THAT SAME DAY AND THROW THE REST AWAY 1
OTHER ANSWER 1
DON’T KNOW 8

548) How much water do you use to prepare this medication?

1 LITER 1
BOTTLE OF COKE (75 CL) 2
BOTTLE OF COKE (25 CL) 3
CUP OF TEA 4
OTHER (SPECIFY) 5

549) Where do you get this packet?

HOSPITAL 1
MATERNITY 1
DISPENSARY 1
PRIVATE DOCTOR 1
PHARMACY 1
OTHER (SPECIFY) 1
DON’T KNOW 1

550) How much does a packet cost?

COST IN MILL. ____
FREE 9996
DON’T KNOW 9998

551) Do you have any of these packets at home?

YES 1
NO 2 (GO TO 553)

552) Would you mind if I see it?

SHOWED THE PACKET 1
DIDN’T SHOW THE PACKET 2

553) INTERVIEWER: CHECK TABLE 6 THEN RECORD THE LINE NUMBER, NAME AND SURVIVAL STATE OF ALL CHILDREN 5 YEARS OR UNDER OR BORN SINCE MAY 1983. ASK THE QUESTIONS ONLY FOR DECEASED CHILDREN.

TABLE 6: BIRTHS IN THE LAST 5 YEARS

554) When he/she died, did you notice:

SWELLING OF EXTREMITIES OR BODY 1
EXTREME THINNESS 1
HIGH FEVER 1
DIARRHEA 1
VOMITING 1
UNABLE TO OPEN MOUTH TO EAT 1
INTENSE AND PERSISTENT COUGH 1
RESPIRATORY ISSUE 1
JAUNDICE 1
OUTBREAK 1
CONVULSIONS (EYE REVULSIONS, AND LOSS OF CONSCIOUSNESS) 1
STIFF BODY 1
MUSCLE CONTRACTIONS 1
ACCIDENTS 1
INTOXICATION OR POISONING 1
OTHER (SPECIFY) 1

555) Do you know which illness he died of:

DIARRHEA 01
TUBERCULOSIS 02
RESPIRATORY ILLNESS 03
MENINGITIS 04
WHOOPING COUGH 05
TETANUS 06
MEASLES 07
DIPHTHERIA 08
TYPHOID 09
OTHER (SPECIFY) 10
DON’T KNOW 98
(GO TO NEXT COLUMN)

SECTION 6. FERTILITY PREFERENCES

601) INTERVIEWER: CHECK 403 (06-07) AND TICK THE APPROPRIATE BOX.

NEITHER STERILIZED
WIFE OR HUSBAND STERILIZED (GO TO 607)

602) INTERVIEWER: CHECK 201 AND TICK THE APPROPRIATE BOX.

MARRIED
WIDOW, DIVORCED, OR SEPARATED (GO TO 610)

603) Now, I would like to ask you some questions about the future.
INTERVIEWER: CHECK 325, TICK AND ASK THE APPROPRIATE QUESTION

NOT PREGNANT, NOT SURE, OR DON’T KNOW: Would you like to have any (more) children in the future?
YES (WANTS ANOTHER CHILD) 1
NO (DOESN’T WANT ANOTHER CHILD) 2
THINKS CAN’T GET PREGNANT ANYMORE 3 (GO TO 610)
UNDECIDED OR DON’T KNOW 8 (GO TO 610)
PREGNANT: After the child you are expecting now, would you like to have any more children in the future?
YES (WANTS ANOTHER CHILD) 1
NO (DOESN’T WANT ANOTHER CHILD) 2
THINKS CAN’T GET PREGNANT ANYMORE 3 (GO TO 610)
UNDECIDED OR DON’T KNOW 8 (GO TO 610)

604) What is the main reason you took this decision?

DOESN’T HAVE THE DESIRED NUMBER OF CHILDREN 1
WANTS CHILD OF ANOTHER SEX 2
OTHER YES 3
ECONOMIC REASONS 4 (GO TO 610)
HAS THE DESIRED NUMBER OF CHILDREN 5 (GO TO 610)
HEALTH 6 (GO TO 610)
OTHER NO 7 (GO TO 610)

605) How long do you want to wait from now before the birth of a (another) child?

TIME OF ATTEMPTS ____
MONTHS 1 (GO TO 610)
YEAR 2 (GO TO 610)
DON’T KNOW 998

606) INTERVIEWER: CHECK 319 BEFORE ASKING QUESTION 606.
How old should your youngest child be before the birth of another child?

AGE OF YOUNGEST CHILD IN YEARS ____
NO LIVING CHILDREN 96
DON’T KNOW 98
GO TO 610

607) Did you have a surgery for your last delivery or not? (a caesarean surgery)

YES 1
NO 2

608) Do you regret the surgery you did in order to avoid having more children (tubal ligation)

YES 1
NO 2 (GO TO 610)

609) Would you like to have another child or do you not want any more children?

YES (WANTS ANOTHER CHILD) 1
NO (DOESN’T WANT ANY MORE CHILDREN) 2
UNDECIDED OR DON’T KNOW 8

610) INTERVIEWER: CHECK 302 AND 305 TICK AND ASK THE APPROPRIATE QUESTION.

NO LIVING CHILDREN: If you could choose exactly the number of children to have in your whole life, how many would that be?
NUMBER ____
BETWEEN ____ AND ____
UP TO GOD 95
OTHER (SPECIFY) 96
DON’T KNOW 98
HAS LIVING CHILDREN: If you could go back to the time you did not have any children and could choose exactly the number of children to have in your whole life, how many would that be?
NUMBER ____
BETWEEN ____ AND ____
UP TO GOD 95
OTHER (SPECIFY) 96
DON’T KNOW 98

611) How many boys and girls would you like to have?

NUMBER OF BOYS ____
NUMBER OF GIRLS ____
UP TO GOD 95
OTHER (SPECIFY) 96
DON’T KNOW 98

SECTION 7. HUSBAND’S BACKGROUND AND WOMEN’S WORK

701) INTERVIEWER: CHECK 201, THEN LINK THE FOLLOWING QUESTIONS TO THE CURRENT HUSBAND OF THE RESPONDENT OR TO HER LAST HUSBAND IF SHE IS A WIDOW OR DIVORCED.
Now I would like to ask you some questions about the level of school your husband attended and his work (Last husband)

702) Did your husband ever attended school or not?

YES 1
NO 2 (GO TO 706)
DON’T KNOW 8 (GO TO 706)

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

PRIMARY 1
SECONDARY/PROFESSIONAL 2
HIGHER 3
OTHER 4
DON’T KNOW 8 (GO TO 706)

704) What is the highest grade he completed at that level?

LAST GRADE ____
DON’T KNOW 8

705) INTERVIEWER: Check 703 and tick the appropriate box

PRIMARY
SECONDARY/PROFESSIONAL/HIGHER OR OTHER (GO TO 707)

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

EASILY 1
WITH DIFFICULTY 2
NOT AT ALL 3

707) What kind of work does (did) your husband mainly do?
INTERVIEWER: RECORD EXACTLY THE PROFESSION PROVIDED.

(PROFESSION) ____
NEVER WORKED 98 (GO TO 709)

708) Where does (did) he work?

IN THE SAME PROVINCE 1
IN ANOTHER PROVINCE 2
ABROAD 3

709) INTERVIEWER: CHECK 707 AND TICK THE APPROPRIATE BOX

DOES NOT WORK IN AGRICULTURE (GO TO 710)
WORKS IN AGRICULTURE (GO TO 711)
HAS NEVER WORKED (GO TO 716)

710) Does he get paid regularly every week or every month?

YES 1
NO 2
OTHER 3 (GO TO 713)
DON’T KNOW 8

711) Does your husband work mainly on his or family land, or on someone’s land?

PERSONAL OR FAMILY FIELD 1 (GO TO 713)
OTHER 2

712) Does he work mainly for cash or does he work for something else?

IN CASH 1
SHARECROPPER (1/5-1/4) 2
DON’T KNOW 8

713) Interviewer: Check 201 and tick the appropriate box

MARRIED
WIDOWED, DIVORCED OR SEPARATED (GO TO 716)

714) In the last 12 months, did your husband work somewhere far that kept him away from you for more than a month?

YES 1
NO 2 (GO TO 716)

715) How long did he stay away from you?

NUMBER OF MONTHS ____

716) Before you married your first husband, did you yourself ever work regularly to earn money, other than on your family land or in a business run by your family?

YES 1
NO 2 (GO TO 718)

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

HIS FAMILY 1
HERSELF 2
EQUAL PARTS 3

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

YES 1
NO 2 (GO TO 720)

719) During the time when you have earned money, have you turned most of it over to your family or have you kept most of it for yourself?
Gives most to:

HIS FAMILY 1
HERSELF 2
EQUAL PARTS 3

720) Instead of the housework and serving the family, are you now working to earn money?

YES 1
NO 2

SECTION 8. BODY MEASUREMENTS

801) INTERVIEWER: RECORD THE EXACT TIME AT THE MOMENT:

HOURS____
MINUTES____

802) INTERVIEWER: CHECK TABLE 5 THEM RECORD THE LINE NUMBER, NAME, AND SURVIVAL STATE OF ALL THE CHILDREN AGE 3 TO 36 MONTHS OR BORN SINCE MAY 1985.

803) INTERVIEWER: CHECK 318 AND TRANSCRIBE THE DATE OF BIRTH

MONTH ____
YEAR ____

804) INTERVIEWER: VERIFY THAT THE CHILD IN QUESTION IS AVAILABLE FOR THE MEASUREMENTS BELOW.

AVAILABLE
NOT AVAILABLE (GO TO 806)

805) INTERVIEWER: ACCURATELY RECORD THE WEIGHT, HEIGHT, AND ARM AREA OF EACH CHILD.

WEIGHT KG, CG ____
HEIGHT CM, MM ____
ARM CM MM ____

806) REASON FOR UNAVAILABILITY

ABSENT DURING THE INTERVIEW 1
ILL 2
ASLEEP 3
REFUSED 4
OTHER (SPECIFY) 5

807) INTERVIEWER: RECORD:

A) THE NAME OF THE MEASURER ____
B) THE NAME OF THE ASSISTANT ____

808) INTERVIEWER: RECORD THE TIME AT THE END OF THE INTERVIEW:

HOURS ____
MINUTES ____

END OF INTERVIEW

INTERVIEWER: THANK THE RESPONDENT FOR HER COOPERATION.

INTERVIEWER’S OBSERVATIONS (TO BE COMPLETED AFTER THE INTERVIEW)
NAME ____
DATE ____

INSPECTOR’S OBSERVATIONS
NAME ____
DATE ____

SUPERVISOR’S OBSERVATIONS
NAME ____
DATE ____

FIELD EDITOR’S AND DATA INPUT OFFICER’S OBSERVATIONS
FIELD EDITOR’S NAME ____
DATE ____
DATA INPUT OFFICER’S NAME____
DATE ____