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UNITED REPUBLIC OF TANZANIA
BUREAU OF STATISTICS, PLANNING COMMISSION
TANZANIA DEMOGRAPHIC AND HEALTH SURVEY 2
MAN’S QUESTIONNAIRE

IDENTIFICATION

NAME OF HOUSEHOLD HEAD ______________________
CLUSTER NUMBER ___
HOUSEHOLD NUMBER ___
REGION ___________________ ___
DISTRICT __________________ ___
WARD __________________ ___

ENUMERATION AREA _______________ ___

LARGE CITY 1
SMALL CITY* 2
TOWN 3
COUNTRYSIDE 4

NAME AND LINE NUMBER OF MAN __________________ ___
NAME AND LINE NUMBER OF FIRST WIFE ___________________ ___
NAME AND LINE NUMBER OF SECOND WIFE ___________________ ___
NAME AND LINE NUMBER OF THIRD WIFE ___________________ ___
NAME AND LINE NUMBER OF FOURTH WIFE ___________________ ___

*SMALL CITIES ARE: MWANZA, ARUSHA, MOROGORO, DODOMA, MOSHI, TANGA, IRINGA, MBEYA, AND TABORA. ALL OTHER URBAN AREAS ARE TOWN.

INTERVIEWER VISITS
INTERVIEWER VISIT 1
DATE ______________
INTERVIEWER???S NAME _______________
RESULT* ______________

INTERVIEWER VISIT 2
DATE ______________
INTERVIEWER???S NAME _______________
RESULT* ______________

INTERVIEWER VISIT 3
DATE ______________
INTERVIEWER???S NAME _______________
RESULT* ______________

NEXT VISIT:
DATE ______
TIME _____

FINAL VISIT
DAY ____
MONTH ____
YEAR 96
ID NO. ___
RESULT ____

TOTAL NUMBER OF VISITS __

*RESULT CODES:

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

TRANSLATOR USED ___

1 NOT AT ALL
2 SOMETIME
3 ALL THE TIME

SUPERVISOR
NAME ________
DATE ________

FIELD EDITOR
NAME ________
DATE ________

OFFICE EDITOR

KEYED BY

SECTION 1. RESPONDENT???S BACKGROUND

101. RECORD THE TIME

MORNING/AM 1
AFTERNOON/PM 2
HOUR _______
MINUTES _______

102. First I would like to ask some questions about you and your household. For most of the time until you were 12 years old, did you live in Dar es Salaam city, another urban area or in a rural area?

DAR ES SALAAM 1
OTHER URBAN AREA 2
RURAL AREA/VILLAGE 3

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

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

104. Just before you moved here, did you live in Dar es Salaam city, another urban area or in a rural area?

DAR ES SALAAM 1
OTHER URBAN AREA 2
RURAL AREA/VILLAGE 3

105. In what month and year were you born?

MONTH ___
DOES NOT KNOW MONTH 98
YEAR __
DOES NOT KNOW YEAR 98

106. How old were you at your last birthday?
COMPARE AND CORRECT 105 AND/OR 106 IF INCONSISTENT.

AGE IN COMPLETED YEARS ___

107. Can you read and write kiswahili easily, with difficulty, or not at all?

EASILY 1
WITH DIFFICULTY 2
NOT AT ALL 3 (GO TO 109)

108. How often do you read a newspaper?

EVERYDAY/ALMOST EVERYDAY 1
AT LEAST ONCE A WEEK 2
AT LEAST ONCE A MONTH 3
ONCE A MONTH 4
HARDLY EVER/ACTUALLY NEVER 5
DOES NOT KNOW 8

109. Have you ever attended school?

YES 1
NO 2 (GO TO 113)

110. What is the highest formal school you completed?

LESS THAN 1 YEAR 00
STANDARD 1 01
STANDARD 2 02
STANDARD 3 03
STANDARD 4 04
STANDARD 5 05
STANDARD 6 06
STANDARD 7 07
STANDARD 8 08
FORM 1 09
FORM 2 10
FORM 3 11
FORM 4 12
FORM 5 13
FORM 6 14
UNIVERSITY 15
OTHER (SPECIFY) ________________ 96

111. CHECK 106:

AGE 24 OR BELOW __ (GO TO 112)
AGE 25 OR ABOVE __ (GO TO 113)

112. Are you currently attending school?

YES 1
NO 2

113. How often do you listen to the radio?

EVERYDAY/ALMOST EVERYDAY 1
AT LEAST ONCE A WEEK 2
AT LEAST ONCE A MONTH 3
ONCE A MONTH 4
HARDLY EVER/ACTUALLY NEVER 5
DOES NOT KNOW 8

114. Do you usually watch television at least once a week?

YES 1
NO 2

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

________________________ ___

116. CHECK 115:

WORKS (WORKED) IN AGRICULTURE __ (GO TO 117)
DOES (DID) NOT WORK IN AGRICULTURE __ (GO TO 118)

117. Do you work mainly on your own land or on family rent land, or borrow for share crop, government allocation, or shifting cultivation land?

OWN LAND 1
FAMILY RENT 2
BORROW SHARE CROP 3
GOVERNMENT ALLOCATION 4
SHIFTING CULTIVATION 5

118. What is your religion?

MOSLEM 1
CATHOLIC 2
PROTESTANT 3
NONE 4
OTHER (SPECIFY) ______________ 6

119. To which tribe do you belong to?
IF NOT TANZANIAN CITIZEN, WRITE NAME OF COUNTRY.

_______________ ___

SECTION 2. REPRODUCTION

201. Now I would like to ask about all the children you have had during your life.
I mean your own children, not ones you may have adopted or care for as a father but whose real father is someone else. Do you have children?

YES 1
NO 2 (GO TO 206)

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

YES 1
NO 2 (GO TO 204)

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

SONS AT HOME _______
DAUGHTERS AT HOME ______

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

YES 1
NO 2 (GO TO 206)

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

SONS ELSEWHERE ____
DAUGHTERS ELSEWHERE _____

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

YES 1
NO 2 (GO TO 208)

207. How many boys have died?
And how many girls have died?
IF NONE, RECORD ???00???.

BOYS DEAD ______
GIRLS DEAD ______

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

TOTAL ________

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

YES __ (GO TO SECTION 3)
NO __ (PROBE AND CORRECT 201-208 AS NEEDED)

SECTION 3. CONTRACEPTION

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

CIRCLE CODE 1 IN 301 FOR EACH METHOD MENTIONED SPONTANEOUSLY.
THEN PROCEED DOWN COLUMN 302, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY.
CIRCLE CODE 2 IF METHOD IS RECOGNIZED, AND CODE 3 IF NOT RECOGNIZED.
THEN, FOR EACH METHOD WITH CODE 1 OR 2 CIRCLED IN 301 OR 302, ASK 303.

301. Which ways or methods have you heard about?

METHOD 01 PILL Women can take a pill every day.
SPONTANEOUS YES 1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
METHOD 02 IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
SPONTANEOUS YES 1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
METHOD 03 INJECTABLES Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
SPONTANEOUS YES 1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
METHOD 04 IMPLANTS Women can have several small rods placed in their upper arm by a doctor or nurse which can prevent pregnancy for several years.
SPONTANEOUS YES 1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)1
METHOD 05 DIAPHRAGM, FOAM, JELLY Women can place a sponge, suppository, diaphragm, jelly, or cream inside themselves before intercourse.
SPONTANEOUS YES 1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
METHOD 06 CONDOM, RUBBER, RAINCOAT, DUREX A man can wear a rubber bag in his penis during sex to prevent pregnancy. The rubber bag is also used to prevent passing diseases such as AIDS and for cleanliness.
SPONTANEOUS YES 1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
METHOD 07 FEMALE STERILIZATION Women can have an operation to avoid having any more children.
SPONTANEOUS YES 1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
METHOD 08 MALE STERILIZATION Men can have an operation to avoid having any more children.
SPONTANEOUS YES 1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
METHOD 09 CALENDAR/SAFE PERIOD Couples can have sexual intercourse only during the safe period of the monthly cycle that is the times during monthly cycle when women is least likely to get pregnant.
SPONTANEOUS YES 1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
METHOD 10 MUCUS METHOD A woman can observe daily the state of the mucus and avoid sexual intercourse at the time when the mucus is colorless and extremely elastic.
SPONTANEOUS YES 1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
METHOD 11 WITHDRAWAL Men can be careful and pull out before climax.
SPONTANEOUS YES 1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
METHOD 12 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
SPONTANEOUS YES 1 (SPECIFY) ______________
PROBED YES 2
NO 3 (GO TO NEXT METHOD)

302. Have you ever heard of (METHOD)?

METHOD 01 PILL Women can take a pill every day.
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
METHOD 02 IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
METHOD 03 INJECTABLES Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
METHOD 04 IMPLANTS Women can have several small rods placed in their upper arm by a doctor or nurse which can prevent pregnancy for several years.
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
METHOD 05 DIAPHRAGM, FOAM, JELLY Women can place a sponge, suppository, diaphragm, jelly, or cream inside themselves before intercourse.
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
METHOD 06 CONDOM, RUBBER, RAINCOAT, DUREX A man can wear a rubber bag in his penis during sex to prevent pregnancy. The rubber bag is also used to prevent passing diseases such as AIDS and for cleanliness.
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
METHOD 07 FEMALE STERILIZATION Women can have an operation to avoid having any more children.
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
METHOD 08 MALE STERILIZATION Men can have an operation to avoid having any more children.
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
METHOD 09 CALENDAR/SAFE PERIOD Couples can have sexual intercourse only during the safe period of the monthly cycle that is the times during monthly cycle when women is least likely to get pregnant.
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
METHOD 10 MUCUS METHOD A woman can observe daily the state of the mucus and avoid sexual intercourse at the time when the mucus is colorless and extremely elastic.
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
METHOD 11 WITHDRAWAL Men can be careful and pull out before climax.
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
METHOD 12 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
NO 3

303. Have you ever used (METHOD)?

METHOD 01 PILL Women can take a pill every day.
YES 1
NO 2
METHOD 02 IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
METHOD 03 INJECTIONS Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
YES 1
NO 2
METHOD 04 IMPLANTS Women can have several small rods placed in their upper arm by a doctor or nurse which can prevent pregnancy for several years.
YES 1
NO 2
METHOD 05 DIAPHRAGM, FOAM, JELLY Women can place a sponge, suppository, diaphragm, jelly, or cream inside themselves before intercourse.
YES 1
NO 2
METHOD 06 CONDOM, RUBBER, RAINCOAT, DUREX A man can wear a rubber bag in his penis during sex to prevent pregnancy. The rubber bag is also used to prevent passing diseases such as AIDS and for cleanliness.
YES 1
NO 2
METHOD 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
METHOD 08 MALE STERILIZATION Men can have an operation to avoid having any more children: Have you ever had a partner who had an operation to avoid having children?
YES 1
NO 2
METHOD 09 CALENDAR/SAFE PERIOD Couples can have sexual intercourse only during the safe period of the monthly cycle that is the times during monthly cycle when women is least likely to get pregnant.
YES 1
NO 2
METHOD 10 MUCUS METHOD A woman can observe daily the state of the mucus and avoid sexual intercourse at the time when the mucus is colorless and extremely elastic.
YES 1
NO 2
METHOD 11 WITHDRAWAL Men can be careful and pull out before climax.
YES 1
NO 2
METHOD 12 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1
NO 2

304. CHECK 303:

NOT A SINGLE ???YES??? (NEVER USED) __ (GO TO 305)
AT LEAST ONE ???YES??? (EVER USED) __ (GO TO 307)

305. Have you ever done anything or tried in any way to delay or avoid having a child?

YES 1
NO 2 (GO TO 312)

306. What have you used or done?
CORRECT 303 AND 304 (AND 302 IF NECESSARY).

307. Are you currently doing something or using any method to delay or avoid having a child?

YES 1
NO 2 (GO TO 312)

308. Which method are you using?
RECORD FIRST, SECOND AND THIRD PARTNER IN SEPARATE COLUMNS.

PILL 01
IUD 02
INJECTIONS 03
IMPLANTS 04
DIAPHRAGM/FOAM/JELLY 05
CONDOM 06
FEMALE STERILIZATION 07
MALE STERILIZATION 08
CALENDAR/SAFE METHOD 09
MUCUS METHOD 10
WITHDRAWAL 11
NO (OTHER METHOD) 95
OTHER (SPECIFY) ____________ 96

309. CHECK 308 (ALL COLUMNS):

CONDOMS MARKED IN ANY COLUMN ___ (GO TO 310)
CONDOMS NOT MARKED IN ANY COLUMN ___ (GO TO 315)

310. Where did you obtain condoms the last time?
IF SOURCE IS HOSPITAL, HEALTH CENTRE, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

(NAME OF PLACE) ________________
GOVERNMENT AND PARASTATAL
REGIONAL/CONSULTANT HOSPITAL 11
DISTRICT HOSPITAL 12
HEALTH CENTRE 13
DISPENSARY/PARASTATAL FACILITY 14
VILLAGE HEALTH POST/WORKER 15
MEDICAL PRIVATE SECTOR
RELIGIOUS ORG. FACILITY 21
PRIV. DOCTOR/CLINIC/HOSPITAL 22
PHARMACY/MEDICAL STORE 23
CBD WORKER 24
OTHER PRIVATE SECTOR
SHOP 31
CHURCH 32
FRIENDS/RELATIVES/NEIGHBORS 33
OTHER (SPECIFY) ___________ 96
DOES NOT KNOW 98

311. What is the brand name of the condom you last used?
RECORD NAME OF BRAND.

BRAND NAME _______________ ___ (GO TO 315)
DOES NOT KNOW 98

312. What is the main reason you are not using a method of contraception to avoid pregnancy?

NOT MARRIED 11
FERTILITY-RELATED REASONS
NOT HAVING SEX 21
INFREQUENT SEX 22
MENOPAUSAL/HYSTERECTOMY 23
SUBFECUND/INFECUND 24
POSTPARTUM/BREASTFEEDING 25
WANTS MORE CHILDREN 26
OPPOSITION TO USE
RESPONDENT OPPOSED 31
HUSBAND OPPOSED 32
OTHERS OPPOSED 33
RELIGIOUS PROHIBITION 34
LACK OF KNOWLEDGE
KNOWS NO METHOD 41
KNOWS NO SOURCE 42
METHOD-RELATED REASONS
HEALTH CONCERNS 51
FEAR OF SIDE EFFECTS 52
LACK OF ACCESS/TOO FAR 53
COST TOO MUCH 54
INCONVENIENT TO USE 55
INTERFERES WITH BODY???S NORMAL PROCESSES 56
OTHER (SPECIFY) _______________ 96
DOES NOT KNOW 98

313. Do you know of a place where you can obtain a method of family planning?

YES 1
NO 2 (GO TO 315)

314. Where is that?
IF SOURCE IS HOSPITAL, HEALTH CENTRE, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

(NAME OF PLACE) ________________
GOVERNMENT AND PARASTATAL
REGIONAL/CONSULTANT HOSPITAL 11
DISTRICT HOSPITAL 12
HEALTH CENTRE 13
DISPENSARY/PARASTATAL FACILITY 14
VILLAGE HEALTH POST/WORKER 15
MEDICAL PRIVATE SECTOR
RELIGIOUS ORG. FACILITY 21
PRIV. DOCTOR/CLINIC/HOSPITAL 22
PHARMACY/MEDICAL STORE 23
CBD WORKER 24
OTHER PRIVATE SECTOR
SHOP 31
CHURCH 32
FRIENDS/RELATIVES/NEIGHBORS 33
OTHER (SPECIFY) ___________ 96

315. Have you seen or heard of the Green Star Logo (Symbol)?

YES 1
NO 2 (GO TO 401)
DOESN???T KNOW 8 (GO TO 401)

316. What does the Green Star Logo mean to you?

FAMILY PLANNING RELATED 1
NOT FAMILY PLANNING RELATED 2
DOESN???T KNOW 8

317. How did you learn about the Green Star?
CIRCLE ALL MENTIONED.

BILLBOARDS A
BUS B
POSTERS C
LEAFLETS D
RADIO E
CLINIC SIGN F
SERVICE PROVIDER G
OTHER (SPECIFY) _____________ X

SECTION 4. MARRIAGE AND SEXUAL BEHAVIOR

401. PRESENCE OF OTHERS AT THIS POINT.

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

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

YES, CURRENTLY MARRIED 1 (GO TO 407)
YES, LIVING WITH A WOMAN 2 (GO TO 407)
NO, NOT IN UNION 3

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

YES 1
NO 2 (GO TO 412)

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

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

407. How many wives do you have?

NUMBER ___
DOES NOT KNOW 98

410. In what month and year did you start living with your (first) wife/partner?

MONTH ___
DOES NOT KNOW MONTH 98
YEAR ___ (GO TO 412)
DOES NOT KNOW YEAR 98

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

AGE _________

412. CHECK 402:

MARRIED OR LIVING WITH A WOMAN __ (GO TO 413)
NOT MARRIED AND NOT LIVING WITH A WOMAN __ (GO TO 415)

413. Now I need to ask you some questions about sexual activity in order to gain a better understanding of some family planning issues.
When was the last time you had sexual intercourse with your wife?

DAYS AGO 1 __
WEEKS AGO 2 __
MONTHS AGO 3 __
YEARS AGO 4 __
BEFORE LAST BIRTH 996

414. For that sexual intercourse, did you use a condom?

YES 1
NO 2

415. Do you now have a regular partner (apart from your wife)? I mean someone with whom you have been having sex for about a year or more?

YES 1
NO 2 (GO TO 417)

416. How many such regular partners do you have (aside from your wife)?

NUMBER ___

416A. When was the last time you had sexual intercourse with the regular partner (other than your wife)?

DAYS AGO 1 __
WEEKS AGO 2 __
MONTHS AGO 3 __
YEARS AGO 4 __
BEFORE LAST BIRTH 996

416B. Did you use a condom for that sexual intercourse?

YES 1
NO 2

417. Have you had sexual intercourse with anyone (else) in the last 12 months? (I mean, with someone other than your wife or regular partner that you mentioned earlier?)

YES 1
NO 2 (GO TO 424)

418. With how many different women have you had sexual intercourse in the last 12 months (apart from your wife or regular partners)?

NUMBER OF WOMEN ___

419. When was the last time you had sexual intercourse (apart from your wife/regular partner)?

DAYS AGO 1 __
WEEKS AGO 2 __
MONTHS AGO 3 __
YEARS AGO 4 __
BEFORE LAST BIRTH 996

420. For the last sexual intercourse, did you give money, gifts or favours in return for sex?

YES 1
NO 2

421. Was this person someone you had met before or someone you met for the first time?

MET BEFORE 1
MET FOR FIRST TIME 2

422. Did you use a condom for that last sexual intercourse?

YES 1 (GO TO 424)
NO 2

423. What was the main reason that you did not use a condom that time?

__________________

424. CHECK 414, 416B OR 422:

CONDOMS USED WITH WIFE OR PARTNER(S) ___ (GO TO 424A)
DID NOT USE CONDOM WITH ANY ONE ___ (GO TO 424B)

424A. Last time you used a condom, where was that condom obtained?
IF SOURCE IS HOSPITAL, HEALTH CENTRE, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

(NAME OF PLACE) _________________________
GOVERNMENT AND PARASTATAL
REGIONAL/CONSULTANT HOSPITAL 11
DISTRICT HOSPITAL 12
HEALTH CENTRE 13
DISPENSARY/PARASTATAL FACILITY 14
VILLAGE HEALTH POST/WORKER 15
MEDICAL PRIVATE SECTOR
RELIGIOUS ORG. FACILITY 21
PRIV. DOCTOR/CLINIC/HOSPITAL 22
PHARMACY/MEDICAL STORE 23
CBD WORKER 24
OTHER PRIVATE SECTOR
SHOP 31
CHURCH 32
FRIENDS/RELATIVES/NEIGHBORS 33
OTHER (SPECIFY) ___________ 96
DOES NOT KNOW 98

424B. Have you heard of a condom called ???Salana????

YES 1
NO 2

425. Now think back to the past. How old were you when you had sexual intercourse for the first time?

AGE ___
NEVER HAD SEX 95 (GO TO 501)
FIRST TIME WHEN MARRIED 96

426. In the last four weeks, how many times have you had sexual intercourse?

NUMBER OF TIMES ___
DOES NOT KNOW 98

SECTION 5. FERTILITY PREFERENCES

501. CHECK 402, 415, AND 425:

CURRENTLY IN UNION OR HAVING A REGULAR PARTNER ___ (GO TO 502)
NOT CURRENTLY IN UNION NOR HAVING A REGULAR PARTNER OR NEVER HAD SEX ___ (GO TO 504A)

502. Spouses/partners do not always agree on everything. Now I want to ask you about your wife???s/partner???s views on family planning.
Do you think your wife/partner approves or disapproves of couples using a method to avoid pregnancy?

APPROVES 1
DISAPPROVES 2
DOES NOT KNOW 8

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

SAME NUMBER 1
MORE CHILDREN 2
FEWER CHILDREN 3
DOES NOT KNOW 8

503A. How often have you talked to your wife/partner about family planning in the past year?

NEVER 1
ONCE OR TWICE 2
MORE OFTEN 3
DOES NOT KNOW 8

503B. Have you and your wife/partner ever discussed the number of children you would like to have?

YES 1
NO 2
DOES NOT KNOW 8

503C. Who mainly decides how many children should you have?

HIMSELF 1
WIFE/PARTNER 2
BOTH 3
OTHER 6
DOES NOT KNOW 8

504A. CHECK 308

NEITHER STERILIZED ___ (GO TO 504B)
HE OR SHE STERILIZED ___ (GO TO 506)

504B. Now I have some questions about the future. Would you like to have (a/another) child or would you prefer not to have any (more) children?

HAVE (A/ANOTHER) CHILD 1
NO MORE/NONE 2 (GO TO 506)
HIS WIFE CAN???T GET PREGNANT 3 (GO TO 506)
HE CAN???T HAVE CHILDREN ANYMORE 4 (GO TO 506)
UNDECIDED OR DOES NOT KNOW 8 (GO TO 506)

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

MONTHS 1 __
YEARS 2 __
SOON/NOW 993
SHE OR HE CAN???T HAVE CHILDREN 994
AFTER MARRIAGE 995
OTHER (SPECIFY) ___________ 996
DOES NOT KNOW 998

506. CHECK 307: USING A METHOD?

NOT ASKED __ (GO TO 507)
NOT CURRENTLY USING __ (GO TO 507)
CURRENTLY USING __ (GO TO 512)

507. Do you intend to use a method to delay or avoid pregnancy within the next 12 months?

YES 1 (GO TO 509)
NO 2
DOES NOT KNOW 8

508. Do you intend to use a method at any time in the future?

YES 1
NO 2 (GO TO 510)
DOES NOT KNOW 8 (GO TO 510)

509. Which method would you prefer to use?

PILL 01 (GO TP 512)
IUD 02 (GO TP 512)
INJECTIONS 03 (GO TP 512)
IMPLANTS 04 (GO TP 512)
DIAPHRAGM/FOAM/JELLY 05 (GO TP 512)
CONDOM 06 (GO TP 512)
FEMALE STERILIZATION 07 (GO TP 512)
MALE STERILIZATION 08 (GO TP 512)
CALENDAR/SAFE PERIOD 09 (GO TP 512)
MUCUS METHOD 10 (GO TP 512)
WITHDRAWAL 11 (GO TP 512)
OTHER (SPECIFY) _____________ 96 (GO TP 512)
UNSURE 98 (GO TP 512)

510. What is the main reason you think you will never use a method?

NOT MARRIED 11
FERTILITY-RELATED REASONS
INFREQUENT/NO SEX 22 (GO TO 512)
MENOPAUSAL/HYSTERECTOMY 23 (GO TO 512)
SUBFECUND/INFECUND 24 (GO TO 512)
WANTS MORE CHILDREN 26 (GO TO 512)
OPPOSITION TO USE
RESPONDENT OPPOSED 31 (GO TO 512)
HUSBAND OPPOSED 32 (GO TO 512)
OTHERS OPPOSED 33 (GO TO 512)
RELIGIOUS PROHIBITION 34 (GO TO 512)
LACK OF KNOWLEDGE
KNOWS NO METHOD 41 (GO TO 512)
KNOWS NO SOURCE 42 (GO TO 512)
METHOD-RELATED REASONS
HEALTH CONCERNS 51 (GO TO 512)
FEAR OF SIDE EFFECTS 52 (GO TO 512)
LACK OF ACCESS/TOO FAR 53 (GO TO 512)
COST TOO MUCH 54 (GO TO 512)
INCONVENIENT TO USE 55 (GO TO 512)
INTERFERES WITH BODY???S NORMAL PROCESSES 56 (GO TO 512)
NO OTHER REASON 95 (GO TO 512)
OTHER (SPECIFY) _______________ 96 (GO TO 512)
DOES NOT KNOW 98 (GO TO 512)

511. Would you ever use a method if you were married?

YES 1
NO 2
DOES NOT KNOW 8

512. CHECK 203 AND 205:
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?

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 (GO TO 514)

513. How many of these children would you like to be boys and how many would you like to be girls?

BOYS:
NUMBER ___
OTHER (SPECIFY) ____________ 96

GIRLS:
NUMBER ___
OTHER (SPECIFY) ____________ 96

EITHER:
NUMBER ___
OTHER (SPECIFY) ____________ 96

514. In general, do you approve or disapprove of couples using a method to avoid getting pregnant?

APPROVE 1
DISAPPROVE 2 (GO TO 517)
NO OPINION 3 (GO TO 517)

515. Have you ever recommended family planning to a friend, relative, or anyone else?

YES 1
NO 2

516. If you wanted to get information on family planning, who would you like to talk to the most?

Family planning worker from your community?
Traditional Birth Attendant (TBA)?
Your wife or partner?
Friend?
Relative?
Religious leader?
Somebody else?

CBD WORKER 01
TBA 02
WIFE/PARTNER 03
FRIEND 04
RELATIVE 05
RELIGIOUS LEADERS 06
OTHER (SPECIFY) _________________ 96

517. Is it acceptable or not acceptable to you for information on family planning to be provided:

On the radio?
On the television?

RADIO
ACCEPTABLE 1
NOT ACCEPTABLE 2
DK 8
TELEVISION
ACCEPTABLE 1
NOT ACCEPTABLE 2
DK 8

518. In the last six months have you heard about family planning:

On the radio?
On the television?
In a newspaper or magazine?
From a poster?
From billboards?
At community events/logo launches?
From live drama?
From a doctor or nurse?
From a community health worker?

RADIO
YES 1
NO 2
TELEVISION
YES 1
NO 2
NEWSPAPER OR MAGAZINE
YES 1
NO 2
POSTER
YES 1
NO 2
BILLBOARDS
YES 1
NO 2
COMMUNITY EVENT/LOGO LAUNCHES
YES 1
NO 2
LIVE DRAMA
YES 1
NO 2
DOCTOR OR NURSE
YES 1
NO 2
COMMUNITY HEALTH WORKER
YES 1
NO 2

519. In the past six months, what drama series have you listened to on the radio?
CIRCLE THE SERIES MENTIONED SPONTANEOUSLY. FOR SERIES NOT MENTIONED, ASK,
In the 6 months, have you listened to (NAME OF SERIES)?
Zinduka
Twende na Wakati
Ukweli Kuhusu Maisha
Other

ZINDUKA
YES SPONTANEOUS 1
YES PROBED 2
NO 3
TWENDE NA WAKATI
YES SPONTANEOUS 1
YES PROBED 2
NO 3
UKWELI KUHUSU MAISHA
YES SPONTANEOUS 1
YES PROBED 2
NO 3
OTHER
YES SPONTANEOUS 1
YES PROBED 2
NO 3

519A. CHECK 519:

LISTENED TO ZINDUKA ___ (GO TO 519B)
HAS NOT LISTENED TO ZINDUKA ___ (GO TO 519E)

519B. How often do you listen to Zinduka?

TWICE A WEEK 1
ONCE A WEEK 2
ONCE OR TWICE A MONTH 3
RARELY 4
DOES NOT KNOW 8

519C. As a result of listening to Zinduka, did you do anything or take any action related to family planning?

YES 1
NO 2 (GO TO 519E)
DOES NOT KNOW 8 (GO TO 519E)

519D. What did you do as a result of listening to Zinduka?
RECORD ALL MENTIONED.

TALKED TO PARTNER A
TALKED TO HEALTH WORKER B
TALKED TO SOMEONE ELSE C
VISITED A CLINIC FOR FAMILY PLANN D
BEGAN USING A MODERN METHOD E
CONTINUED USING A MODERN METHOD F
OTHER (SPECIFY) _______________ X
DOES NOT KNOW Z

519E. CHECK 519:

LISTENED TO TWENDE NA WAKATI ___ (GO TO 519F)
HAS NOT LISTENED TO TWENDE NA WAKATI ___ (GO TO 520)

519F. How often do you listen to Twende na Wakati?

TWICE A WEEK 1
ONCE A WEEK 2
ONCE OR TWICE A MONTH 3
RARELY 4
DOES NOT KNOW 8

520. In the last six months have you discussed family planning with your friends or relatives?

YES 1
NO 2 (GO TO 601)

521. With whom? Anyone else?
RECORD ALL MENTIONED.

WIFE/PARTNER A
MOTHER B
FATHER C
SISTER(S) D
BROTHER(S) E
DAUGHTER F
SONS G
MOTHER-IN-LAW H
FRIENDS I
OTHER (SPECIFY) ___________ X

SECTION 6. AIDS

601. CHECK 302(6):

HAS HEARD OF CONDOMS ___ (GO TO 602)
NEVER HEARD OF CONDOMS ___ (GO TO 609)

602. CHECK 303(06), 414, 416B, AND 422

HAS NEVER USED CONDOMS (ALL ARE ???NO???) ___ (GO TO 603)
HAS USED CONDOMS (AT LEAST ONE ???YES???) ___ (GO TO 604)

603. Have you ever seen a condom?

YES 1
NO 2

604. Do you know where you can get condoms?

YES 1
NO 2 (GO TO 606)

605. Where can you get condoms?
CIRCLE ALL MENTIONED.
PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

GOVERNMENT AND PARASTATAL
REGIONAL/CONSULTANT HOSPITAL A
DISTRICT HOSPITAL B
HEALTH CENTRE C
DISPENSARY/PARASTATAL FACILITY D
VILLAGE HEALTH POST/WORKER E
MEDICAL PRIVATE SECTOR
RELIGIOUS ORG. FACILITY F
PRIV. DOCTOR/CLINIC/HOSPITAL G
PHARMACY/MEDICAL STORE H
CBD WORKER I
OTHER PRIVATE SECTOR
SHOP J
CHURCH K
FRIENDS/RELATIVES/NEIGHBORS L
OTHER (SPECIFY) ___________ X
DOES NOT KNOW Z

606. How many times can a condom be used?

ONCE 1
MORE THAN ONCE 2
UNTIL IT BREAKS 3
OTHER (SPECIFY) _____________ 6
DOES NOT KNOW 8

607. Do you think that using condoms can give you AIDS?

YES 1
NO 2
DOES NOT KNOW 8

608. In general, do you think that most women like men to use condoms, they don???t like men to use condoms, or it does not matter?

LIKE MEN TO USE CONDOMS 1
DON???T LIKE MEN TO USE CONDOMS 2
DOES NOT MATTER 3
OTHER (SPECIFY) _____________ 6
DOES NOT KNOW 8

609. Have you heard about diseases that can be transmitted through sex?

YES 1
NO 2 (GO TO 611)

610. Which diseases do you know?
Any other diseases?

SYPHILIS A
GONORRHOEA B
AIDS C
GENITAL WARTS/CONDYLOMATA D
OTHER (SPECIFY) _____________ X
DON???T KNOW Z

611. CHECK 425:

HAS HAD SEX ___ (GO TO 612)
HAS NEVER HAD SEX ___ (GO TO 613A)

612. During the last 12 months, did you have any of these diseases?

YES 1
NO 2 (GO TO 622)
DON???T KNOW (GO TO 622)

613. Which of the diseases?
CIRCLE ALL MENTIONED.

SYPHILIS A
GONORRHOEA B
AIDS C
GENITAL WARTS/CONDYLOMATA D
OTHER (SPECIFY) _____________ X
DON???T KNOW Z

613A. During the last twelve months, did you have a discharge from your penis?

YES 1
NO 2
DON???T KNOW

613B. During the last twelve months, did you have a sore or ulcer on your penis?

YES 1
NO 2
DON???T KNOW

613C. CHECK 612, 613A, AND 613B

HAD ONE OR MORE DISEASES ___ (GO TO 617)
NONE OF THE DISEASES ___ (GO TO 622)

617. When you had this (DISEASE FROM Q.613) did you seek advice or treatment?

ADVICE/TREATMENT 1
SELF TREATMENT 2 (GO TO 619)
DID NOT DO ANYTHING 3 (GO TO 619)

618. Where did you seek advice or treatment?
Any other place or person?
RECORD ALL MENTIONED.

GOVERNMENT AND PARASTATAL
REGIONAL/CONSULTANT HOSPITAL A
DISTRICT HOSPITAL B
HEALTH CENTRE C
DISPENSARY/PARASTATAL FACILITY D
VILLAGE HEALTH POST/WORKER E
MEDICAL PRIVATE SECTOR
RELIGIOUS ORG. FACILITY F
PRIV. DOCTOR/CLINIC/HOSPITAL G
PHARMACY/MEDICAL STORE H
CBD WORKER I
OTHER PRIVATE SECTOR
SHOP J
CHURCH K
FRIENDS/RELATIVES/NEIGHBORS L
OTHER (SPECIFY) ___________ X

619. Did you tell your husband/partner that you had this (disease/discharge/sore)?

YES 1
NO 2

620. When you had this disease, did you do something so as not to infect your partner?

YES 1
NO 2 (GO TO 622)
PARTNER ALREADY INFECTED 3 (GO TO 622)

621. What did you do?
CIRCLE ALL MENTIONED.

NO SEXUAL INTERCOURSE A
USED CONDOMS B
TOOK MEDICINES C
TOLD HIM TO GO FOR MEDICAL HELP D
OTHER (SPECIFY) ______________ X

622. CHECK 610:

DID NOT MENTION AIDS OR QUESTION NOT ASKED ___ (GO TO 623)
MENTIONED ???AIDS??? ___ (GO TO 624)

623. Have you ever heard of an illness called AIDS?

YES 1
NO 2 (GO TP 701)

624. From which sources of information have you learned about AIDS?
Any other sources?
RECORD ALL MENTIONED.

RADIO A
TV B
NEWSPAPERS/MAGAZINES C
PAMPLETS/POSTERS D
HEALTH WORKERS E
MOSQUES/CHURCHES F
SCHOOLS/TEACHERS G
COMMUNITY MEETINGS H
FRIENDS/RELATIVES I
WORK PLACE J
OTHER (SPECIFY) ___________X

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

YES 1
NO 2 (GO TO 627)
DOES NOT KNOW 8 (GO TO 627)

626. What can a person do to avoid getting AIDS or the virus that causes AIDS?
Any other ways?
CIRCLE ALL MENTIONED.

DO NOT HAVE SEX AT ALL A
USE CONDOMS DURING SEX B
DON???T HAVE SEX WITH PROSTITUTES C
DO NOT HAVE SEX WITH HOMOSEXUALS D
DO NOT HAVE MANY SEX PARTNERS E
HAVE ONLY ONE SEX PARTNER F
AVOID BLOOD TRANSFUSIONS G
AVOID INJECTIONS H
MOTHERS DON???T HAVE CHILDREN I
AVOID KISSING J
AVOID MOSQUITO BITES K
SEEK PROTECTION FROM TRADITIONAL HEALER L
DO NOT DRINK TOO MUCH ALCOHOL M
OTHER (SPECIFY) ___________ X
DOES NOT KNOW Z

627. Do you think a person can protect themselves from getting AIDS by:

having a good diet?
staying with one faithful partner?
avoid stepping on the urine or stool of a person with AIDS?
using condoms?
avoiding touching a person who has AIDS?
not sharing eating utensils with a person with AIDS?
avoiding being bitten by mosquitos or other insects?
making sure any injection they have is done with a clean needle?

GOOD DIET
YES 1
NO 2
STAY WITH ONE PARTNER
YES 1
NO 2
AVOID URINE OR STOOL
YES 1
NO 2
USE CONDOMS
YES 1
NO 2
DON???T TOUCH PERSON WITH AIDS
YES 1
NO 2
DON???T SHARE UTENSILS
YES 1
NO 2
AVOID INSECT BITES
YES 1
NO 2
INJECTION WITH CLEAN NEEDLE
YES 1
NO 2

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

YES 1
NO 2
DOES NOT KNOW 8

629. Can AIDS be cured?

YES 1
NO 2
DOES NOT KNOW 8

630. Can AIDS be transmitted from mother to child?

YES 1
NO 2 (GO TO 631)
DOES NOT KNOW 8 (GO TO 631)

630A. How do you think that it can be transmitted?
CIRCLE ALL MENTIONED.

DURING PREGNANCY A
DURING DELIVERY B
THROUGH BREASTFEEDING C
OTHER (SPECIFY) ______________ X
DOES NOT KNOW Z

631. Does any member of your household have AIDS or has any member of your household died of AIDS?

YES 1 (GO TO 632)
NO 2
DOES NOT KNOW 8

631A. Do you personally know someone who has AIDS or has died of AIDS?

YES 1
NO 2
DOES NOT KNOW 8

632. Do you think your chances of getting AIDS are small, moderate, great, or no risk at all?

SMALL 1
MODERATE 2 (GO TO 634)
GREAT 3 (GO TO 634)
NO RISK AT ALL 4
DOES NOT KNOW 8 (GO TO 634A)
HAS AIDS 9 (GO TO 701)

633. Why do you think that you have (no risk/a small chance) of getting AIDS?
Any other reasons?
CIRCLE ALL MENTIONED.

NO SEXUAL INTERCOURSE A (GO TO 634A)
NO SEX WITH PROSTITUTES B (GO TO 634A)
SLEEP ONLY WITH SPOUSE/PARTNER C (GO TO 634A)
USE CONDOMS D (GO TO 634A)
NO INJECTIONS E (GO TO 634A)
NO BLOOD TRANSFUSIONS F (GO TO 634A)
OTHER (SPECIFY) ___________________X (GO TO 634A)
DOES NOT KNOW Z (GO TO 634A)

634. Why do you think that you have a (moderate/great) chance of getting AIDS?
Any other reasons?
CIRCLE ALL MENTIONED.

MULTIPLE SEX PARTNERS A
SEX WITH PROSTITUTES B
SPOUSE HAS MULTIPLE PARTNERS C
DO NOT USE CONDOMS D
HAD INJECTIONS E
HAD BLOOD TRANSFUSION F
OTHER (SPECIFY) ___________________X
DOES NOT KNOW Z

634A. CHECK 425:

HAS HAD SEX __ (GO TO 635)
HAS NEVER HAD SEX __ (GO TO 638)

635. Since you heard of AIDS, have you changed your sexual behavior to prevent getting AIDS?

YES 1
NO 2 (GO TO 637)
DOES NOT KNOW 8 (GO TO 637)

636. What did you do?
Anything else?
CIRCLE ALL MENTIONED.

ONE PARTNER A
STOPPED HAVING MANY SEX PARTNERS B
STOPPED SEX WITH PROSTITUTES C
STARTED USING CONDOMS D (GO TO 638)
USED CONDOMS MORE OFTEN E (GO TO 638)
ABSTINENCE (STOPPED HAVING SEX WITH ANYONE) F
OTHER (SPECIFY) __________________ X

637. Some people use a condom during sexual intercourse to avoid getting AIDS or other sexually transmitted diseases. Have you ever used a condom during sex to avoid getting or transmitting diseases, such as AIDS?

YES 1
NO 2

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

YES 1 (GO TO 641A)
NO 2
DOES NOT KNOW/NOT SURE 8

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

YES 1
NO 2
DOES NOT KNOW/NOT SURE 8

640. Do you know of a place where you could go to get an AIDS test?

YES 1
NO 2 (GO TO 642)
DOES NOT KNOW/NOT SURE 8 (GO TO 642)

641. Where could you go?
641A. Where did you go?

GOVERNMENT AND PARASTATAL
REGIONAL/CONSULTANT HOSPITAL A
DISTRICT HOSPITAL B
HEALTH CENTRE C
DISPENSARY/PARASTATAL FACILITY D
VILLAGE HEALTH POST/WORKER E
MEDICAL PRIVATE SECTOR
RELIGIOUS ORG. FACILITY F
PRIV. DOCTOR/CLINIC/HOSPITAL G
PHARMACY/MEDICAL STORE H
CBD WORKER I
OTHER PRIVATE SECTOR
SHOP J
CHURCH K
FRIENDS/RELATIVES/NEIGHBORS L
OTHER (SPECIFY) ___________ X
DOES NOT KNOW Z

642. What do you suggest is the most important thing the government should do for people who have AIDS?

PROVIDE MEDICAL TREATMENT 1
HELP RELATIVES PROVIDE CARE 2
ISOLATE/QUARANTINE/JAIL PEOPLE 3
NOT BE INVOLVED 4
OTHER (SPECIFY) ___________________ 6

643. If a member of your family is suffering from AIDS would you be willing to care for him or her at home?

YES 1
NO 2
DEPENDS 3
OTHER (SPECIFY) __________________ 6
NOT SURE/DO NOT KNOW 8

SECTION 7. MATERNAL MORTALITY

701. Now I would like to ask you some questions about your brothers and sisters, that is, all of the children born to your natural mother, including those who are living with you, those living elsewhere and those who have died.
How many children did your mother give birth to, including you?

NUMBER OF BIRTHS TO NATURAL MOTHER ______

702. CHECK 701:

TWO OR MORE BIRTHS __ (GO TO 703)
ONLY ONE BIRTH (RESPONDENT ONLY) __ (GO TO 716)

703. How many of these births did your mother have before you were born?

NUMBER OF PRECEDING BIRTHS ____

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

__________

705. Is (NAME) male or female?

MALE 1
FEMALE 2

706. Is (NAME) still alive?

YES 1
NO 2 (GO TO 708)
DON???T KNOW 8 (GO TO NEXT BROTHER OR SISTER)

707. How old is (NAME)?

__________ (GO TO NEXT BROTHER OR SISTER)

708. In what year did (NAME) die?

19___ (GO TO 710)
DON???T KNOW 98

709. How many years ago did (NAME) die?

__________

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

__________ (IF MALE OR DIED BEFORE 12 YEARS OF AGE GO TO NEXT BROTHER OR SISTER)

711. Was (NAME) pregnant when she died?

YES 1 (GO TO 714)
NO 2

712. Did (NAME) die during childbirth?

YES 1 (GO TO 715)
NO 2

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

YES 1
NO 2 (GO TO 715)

714. Was her death due to complications of pregnancy or childbirth?

YES 1
NO 2

715. How many children did (NAME) give birth to during her lifetime?

__________ (GO TO NEXT BROTHER OR SISTER)

IF NO MORE BROTHERS OR SISTERS, STOP.

716. RECORD THE TIME.

MORNING/AM 1
AFTERNOON/PM 2
HOUR _______
MINUTES _______

INTERVIEWER???S OBSERVATIONS
To be filled in after completing interview

Comments about Respondent:
______________________________

Comments on Specific Questions:
_______________________________

Any Other Comments:
_______________________________

SUPERVISOR???S OBSERVATIONS
_______________________________________________________________

Name of Supervisor: _________________________
Date: _____________

EDITOR???S OBSERVATIONS
_______________________________________________________________

Name of Editor: _____________________________
Date: _____________