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DEMOGRAPHIC AND HEALTH SURVEYS -- TANZANIA 1999 - WOMAN'S QUESTIONNAIRE

IDENTIFICATION

REGION___

DISTRICT___

WARD___

E.A. NUMBER___

TRCHS CLUSTER NUMBER___

HOUSEHOLD NUMBER___

DAR ES SALAAM, SMALL CITY, TOWN, RURAL/VILLAGE

DAR ES SALAAM 1
SMALL CITY* 2
TOWN 3
RURAL/VILLAGE 4

*(Small cities are: Mwanza, Arusha, Morogoro, Dodoma, Moshi, Tanga, Iringa, Mbeya and Tabora. All other urban areas are towns.)

NAME OF HOUSEHOLD HEAD___

NAME AND LINE NUMBER OF WOMAN___

INTERVIEWER VISITS

FIRST VISIT (REPEAT FOR SECOND AND THIRD VISITS)
DATE___
INTERVIEWER'S NAME____
RESULT___

RESULT____

COMPLETED 1
NOT AT HOME 2
POSTPONED 3
REFUSED 4
PARTLY COMPLETED 5
INCAPACITATED 6
OTHER (SPECIFY)__________7

NEXT VISIT (FOR INTERVIEWERS 1 AND 2)
DATE______
TIME______

FINAL VISIT
DAY____
MONTH____
YEAR 19___
INTER. ID NUMBER___
RESULT___

TOTAL NUMBER OF VISITS_____

SUPERVISOR
NAME____
DATE______

FIELD EDITOR
NAME____
DATE______

OFFICE EDITOR_____
KEYED BY____

SECTION 1. RESPONDENT'S BACKGROUND

INTRODUCTION

Hello. My name is __________ and I am working with the National Bureau of Statistics. We are conducting a national survey about the health of women and children. We would very much appreciate your participation in this survey. I would like to ask you about your health (and the health of your children). This information will help the government to plan health services. The survey usually takes between 20 and 45 minutes to complete. Whatever information you provide will be kept strictly confidential and will not be shown to other persons.

Participation in this survey is voluntary and you can choose not to answer any individual question or all of the questions. However, we hope that you will participate in this survey since your views are important.

At this time, do you want to ask me anything about the survey?
May I begin the interview now?

Signature of interviewer:______
Date:_______

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

101. RECORD THE TIME.

HOUR_____
MINUTES_____
MORNING 1
AFTERNOON 2
EVENING, NIGHT 3

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, 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)?
IF LESS THAN ONE YEAR, RECORD '00' YEARS.

YEARS____

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

104. Just before you moved here, did you live in Dar es Salaam, 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____
DON'T KNOW MONTH 98
YEAR____
DON'T KNOW YEAR 9998

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

YES 1
NO 2 (GO TO 111)

107. Have you ever attended school?

YES 1
NO 2 (GO TO 111)

108. What is the highest formal school you completed?

LESS THAN ONE 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 96

110. CHECK 108:

STANDARD 8 OR LESS (GO TO 111)
FORM 1 OR HIGHER (GO TO 114)

111. Now I would like you to read out loud as much of this sentence as you can.
SHOW CARD TO RESPONDENT.

CANNOT READ AT ALL 1 (GO TO 115)
ABLE TO READ ONLY PARTS OF SENTENCE 2
ABLE TO READ WHOLE SENTENCE 3
NO CARD, REFUSED, OTHER 4

114. Do you read a newspaper or magazine almost every day, at least once a week, less than once a week or not at all?

ALMOST EVERY DAY 1
AT LEAST ONCE A WEEK 2
LESS THAN ONCE A WEEK 3
NOT AT ALL 4

115. Do you listen to the radio almost every day, at least once a week, less than once a week or not at all?

ALMOST EVERY DAY 1
AT LEAST ONCE A WEEK 2
LESS THAN ONCE A WEEK 3
NOT AT ALL 4

116. Do you watch television almost every day, at least once a week, less than once a week or not at all?

ALMOST EVERY DAY 1
AT LEAST ONCE A WEEK 2
LESS THAN ONCE A WEEK 3
NOT AT ALL 4

117. What is your religion?

MOSLEM 1
CATHOLIC 2
PROTESTANT 3
NONE 4
OTHER 6

SECTION 2: REPRODUCTION

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

YES 1
NO 2 (GO TO 206)

202. Do you have any sons or daughters to whom you have given birth 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 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 ever given birth to a boy or girl 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? 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 ____ 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 BIRTHS (GO TO 211)
NO BIRTHS (GO TO 226)

211. Now I would like to record the names of all your births, whether still alive or not, starting with the first one you had.
RECORD 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. Were any of these births twins?

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
NO 2

219. IF ALIVE: RECORD HOUSEHOLD LINE NUMBER OF CHILD.
RECORD '00' IF CHILD NOT LISTED IN HOUSEHOLD.

LINE NUMBER___ (GO TO NEXT BIRTH)

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

DAYS____1
MONTHS____2
YEARS_____3

221. Were there any other live births between (NAME OF PREVIOUS BIRTH) and (NAME)?
[Repeat question for all births, excluding the most recent birth]

YES 1
NO 2

222. Have you had any live births since the birth of (NAME OF LAST BIRTH)?

YES 1
NO 2

223. COMPARE 208 WITH NUMBER OF BIRTHS IN HISTORY ABOVE AND MARK:

NUMBERS ARE SAME
CHECK:
FOR EACH BIRTH: YEAR OF BIRTH IS RECORDED.
FOR EACH LIVING CHILD: CURRENT AGE IS RECORDED.
FOR EACH DEAD CHILD: AGE AT DEATH IS RECORDED.
FOR AGE AT DEATH 12 MONTHS OR 1 YR: PROBE TO DETERMINE EXACT NUMBER OF MONTHS.
NUMBERS ARE DIFFERENT (PROBE AND RECONCILE)

224. CHECK 215 AND ENTER THE NUMBER OF BIRTHS IN 1994 OR LATER.
IF NONE, RECORD '0'.

BIRTHS___

226. Are you pregnant now?

YES 1
NO 2 (GO TO 230)
UNSURE 8 (GO TO 230)

227. How many months pregnant are you?
RECORD NUMBER OF COMPLETED MONTHS.

MONTHS___

228. 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 (more) children at all?

THEN 1
LATER 2
NOT AT ALL 3

229. Did you sleep under a bednet last night?
IF YES: Was the bednet ever treated with a chemical to avoid mosquitos?

YES, TREATED BEDNET 1
YES, UNTREATED BEDNET 2
NO 3

230. Altogether how many pregnancies have you ever had?

INCLUDE ALL BIRTHS, MISCARRIAGES, ABORTIONS, AND CURRENT PREGNANCY. MULTIPLE BIRTHS= 1 PREGNANCY.

TOTAL PREGNANCIES___

231. When did your last menstrual period start?

DATE IF GIVEN______
DAYS AGO 1
WEEKS AGO 2
MONTHS AGO 3
YEARS AGO 4
IN MENOPAUSE/HAS HAD HYSTERECTOMY 994
BEFORE LAST BIRTH 995
NEVER MENSTRUATED 996

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.

CIRCLE CODE 1 IN 301 FOR EACH METHOD MENTIONED SPONTANEOUSLY. THEN PROCEED DOWN COLUMN 301, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY.

CIRCLE CODE 1 IF METHOD IS RECOGNIZED, AND CODE 2 IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE 1 CIRCLED IN 301, ASK 302.

301. Which ways or methods have you heard about?
FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK: Have you ever heard of (METHOD)?

01. FEMALE STERILISATION, TUBAL LIGATION, TL. Women can have an operation to avoid having any more children.
YES 1
NO 2
02. MALE STERILISATION, VASECTOMY. Men can have an operation to avoid having any more children.
YES 1
NO 2
03. PILL Women can take a pill every day.
YES 1
NO 2
04. IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
05. INJECTIONS Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
YES 1
NO 2
06. IMPLANTS Women can have several small rods placed in their upper arm by a doctor or nurse which can prevent pregnancy for several years.
YES 1
NO 2
07. CONDOM Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
08. FEMALE CONDOM Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
09. DIAPHRAGM, FOAM, OR JELLY Women can place a sponge, suppository, diaphragm, jelly or foam in their vagina before intercourse.
YES 1
NO 2
10. LACTATIONAL AMENORRHOEA METHOD (LAM) Up to 6 months after childbirth, a woman can use a method that requires that she breastfeeds frequently, day and night, and that her menstrual period has not returned.
YES 1
NO 2
11. RHYTHM OR CALENDAR METHOD Every month that a woman is sexually active she can avoid pregnancy by not having sexual intercourse on the days of the month she is most likely to get pregnant.
YES 1
NO 2
12. WITHDRAWAL Men can be careful and pull out before climax.
YES 1
NO 2
13. Have you heard of any other ways or methods that women or men can use to avoid pregnancy? LIST UP TO TWO METHODS.
(SPECIFY)________
YES 1
NO 2

302. Have you ever used (METHOD)?

01. FEMALE STERILISATION, TUBAL LIGATION, TL. Women can have an operation to avoid having any more children: Have you ever had an operation to avoid any more children?
YES 1
NO 2
02. MALE STERILISATION, VASECTOMY. Men can have an operation to avoid having any more children: Have you ever had a partner who had an operation to avoid having any more children?
YES 1
NO 2
03. PILL Women can take a pill every day.
YES 1
NO 2
04. IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
05. INJECTIONS Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
YES 1
NO 2
06. IMPLANTS Women can have several small rods placed in their upper arm by a doctor or nurse which can prevent pregnancy for several years.
YES 1
NO 2
07. CONDOM Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
08. FEMALE CONDOM Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
09. DIAPHRAGM, FOAM, OR JELLY Women can place a sponge, suppository, diaphragm, jelly or foam in their vagina before intercourse.
YES 1
NO 2
10. LACTATIONAL AMENORRHOEA METHOD (LAM) Up to 6 months after childbirth, a woman can use a method that requires that she breastfeeds frequently, day and night, and that her menstrual period has not returned.
YES 1
NO 2
11. RHYTHM OR CALENDAR METHOD Every month that a woman is sexually active she can avoid pregnancy by not having sexual intercourse on the days of the month she is most likely to get pregnant.
YES 1
NO 2
12. WITHDRAWAL Men can be careful and pull out before climax.
YES 1
NO 2
13. Have you used any other ways or methods that women can avoid pregnancy?
Have you used any other ways or methods that men can avoid pregnancy?
YES 1
NO 2

303. CHECK 302:

NOT A SINGLE "YES" (NEVER USED) (GO TO 304)
AT LEAST ONE "YES" (EVER USED) (GO TO 308)

304. Have you ever used anything or tried in any way to delay or avoid getting pregnant?

YES 1
NO 2 (GO TO 328)

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

308. CHECK 302 (01):

WOMAN NOT STERILISED (GO TO 309)
WOMAN STERILISED (GO TO 311A)

309. CHECK 226:

NOT PREGNANT OR UNSURE (GO TO 310)
PREGNANT (GO TO 328)

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

YES 1
NO 2 (GO TO 328)

311. Which method are you using?
311A. CIRCLE 'A' FOR FEMALE STERILISATION. IF MORE THAN ONE METHOD MENTIONED, FOLLOW SKIP INSTRUCTIONS FOR HIGHEST METHOD ON LIST.

FEMALE STERILISATION A
MALE STERILISATION B
PILL C (GO TO 319)
IUD D (GO TO 319)
INJECTIONS E (GO TO 319)
IMPLANTS F (GO TO 319)
CONDOM G (GO TO 319)
FEMALE CONDOM H (GO TO 319)
DIAPHRAGM/FOAM/JELLY I (GO TO 319)
LACT. AMEN. METHOD J (GO TO 319)
PERIODIC ABSTINENCE K (GO TO 319)
WITHDRAWAL L (GO TO 319)
OTHER (SPECIFY)____________X (GO TO 319)

313. Where did the sterilization take place?

IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

NAME OF PLACE________
GOVERNMENT/PUBLIC SECTOR
REGIONAL/CONSULTANT HOSP 11
DISTRICT HOSPITAL 12
GOVT. HEALTH CENTER 13
DISPENSARY/PARASTATAL FACILITY 14
VILLAGE HEALTH POST 15
PRIVATE MEDICAL SECTOR
RELIGIOUS ORGANIZATION FACILITY/MISSION HOSP 21
PRIVATE DOCTOR/CLINIC/HOSP 22
OTHER PRIVATE MEDICAL (SPECIFY)________________26
OTHER (SPECIFY)_______________96
DON'T KNOW 98

316. In what month and year was the sterilization performed?

MONTH___(GO TO 330)
YEAR___ (GO TO 330)

319. Where did you obtain (CURRENT METHOD) when you started using it?

GOVERNMENT/PUBLIC SECTOR
REGIONAL/CONSULTANT HOSP 11
DISTRICT HOSPITAL 12
GOVT. HEALTH CENTER 13
DISPENSARY/PARASTATAL FACILITY 14
VILLAGE HEALTH POST/WORKER 15
PRIVATE MEDICAL SECTOR
RELIGIOUS ORGANIZATION FACILITY/MISSION HOSP 21
PRIVATE DOCTOR/CLINIC/HOSP 22
PHARMACY/MEDICAL STORE 23
CBD WORKER 24
OTHER PRIVATE SECTOR
SHOP/KIOSK 31
CHURCH 32
FRIEND/RELATIVE/NEIGHBOR 33
HEALTH EDUCATION/BAR GIRLS 34
OTHER (SPECIFY)_______________96
DON'T KNOW 98

319B. For how many months have you been using (METHOD) continuously?
IF LESS THAN 1 MONTH RECORD '00'.

MONTHS___
8 YEARS OR LONGER 96

327. Where did you obtain (CURRENT METHOD) the last time?

IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

NAME OF PLACE_____
GOVERNMENT/PUBLIC SECTOR
REGIONAL/CONSULTANT HOSP 11
DISTRICT HOSPITAL 12
GOVT. HEALTH CENTER 13
DISPENSARY/PARASTATAL FACILITY 14
VILLAGE HEALTH POST/WORKER 15
PRIVATE MEDICAL SECTOR
RELIGIOUS ORGANIZATION FACILITY/MISSION HOSP 21
PRIVATE DOCTOR/CLINIC/HOSP 22
PHARMACY/MEDICAL STORE 23
CBD WORKER 24
OTHER PRIVATE SECTOR
SHOP/KIOSK 31
CHURCH 32
FRIEND/RELATIVE/NEIGHBOR 33
HEALTH EDUCATION/BAR GIRLS 34
OTHER (SPECIFY)_______________96
DON'T KNOW 98

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

YES 1
NO 2 (GO TO 330)

329. Where is that?

IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

NAME OF PLACE_____
GOVERNMENT/PUBLIC SECTOR
REGIONAL/CONSULTANT HOSP 11
DISTRICT HOSPITAL 12
GOVT. HEALTH CENTER 13
DISPENSARY/PARASTATAL FACILITY 14
VILLAGE HEALTH POST/WORKER 15
PRIVATE MEDICAL SECTOR
RELIGIOUS ORGANIZATION FACILITY/MISSION HOSP 21
PRIVATE DOCTOR/CLINIC/HOSP 22
PHARMACY/MEDICAL STORE 23
CBD WORKER 24
OTHER PRIVATE SECTOR
SHOP/KIOSK 31
CHURCH 32
FRIEND/RELATIVE/NEIGHBOR 33
HEALTH EDUCATION/BAR GIRLS 34
OTHER (SPECIFY)_______________96
DON'T KNOW 98

330. In the last 12 months, were you visited by a field worker who talked to you about family planning?

YES 1
NO 2

331. In the last 12 months, have you attended a health facility for care for yourself (or your children)?

YES 1
NO 2 (GO TO 333)

332. Did any staff member at the health facility speak to you about family planning methods?

YES 1
NO 2

333. Have you seen or heard of the Green Star symbol?

YES 1
NO 2 (GO TO 401)
DOES NOT KNOW (GO TO 401)

334. What does the Green Star symbol mean to you?

FAMILY PLANNING 1
SOMETHING ELSE 2
DOES NOT KNOW 3

335. How did you learn about the Green Star?

BILLBOARDS A
POSTERS B
LEAFLETS C
RADIO D
CLINIC SIGN E
SERVICE PROVIDER F
OTHER (SPECIFY)________X

SECTION 4A. PREGNANCY, POSTNATAL CARE AND BREASTFEEDING

401. CHECK 224:

ONE OR MORE BIRTHS IN 1994 OR LATER (GO TO 402)
NO BIRTHS IN 1994 OR LATER (GO TO 485)

402. ENTER IN THE LINE NUMBER, NAME AND SURVIVAL STATUS OF EACH BIRTH IN 1994 OR LATER. ASK THE QUESTIONS ABOUT ALL THESE BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 2 BIRTHS, USE LAST COLUMN OF ADDITIONAL QUESTIONNAIRES).

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

403. LINE NUMBER FROM 212

LINE NUMBER___

404. FROM 212 AND 216

NAME_____
ALIVE___
DEAD___

405. At the time you became pregnant with (NAME) did you want to become pregnant then, did you want to wait until later, or did you not want to have any (more) children at all?

THEN 1 (GO TO 407)
LATER 2
NOT AT ALL 3 (GO TO 407)

406. How much longer would you like to have waited?

MONTHS 1___
YEARS 2___

DON'T KNOW 998

407. Did you see anyone for antenatal care for this pregnancy? IF YES: Whom did you see?
Anyone else?
PROBE FOR THE TYPE OF PERSON AND RECORD ALL PERSONS SEEN.
[Only for most recent birth]

HEALTH PROFESSIONAL
DOCTOR/MEDICAL ASST A
RURAL MEDICAL AIDE B
NURSE/MIDWIFE C
MCH AIDE D
OTHER PERSON
VILLAGE HEALTH WORKER E
TRAINED BIRTH ATTENDANT F
TRADITIONAL BIRTH ATTENDANT G
OTHER (SPECIFY)_______________X
NO ONE Y (GO TO 415)

408. How many months pregnant were you when you first received antenatal care during this pregnancy?
[Only for most recent birth]

MONTHS___
DON'T KNOW 98

409. How many times did you receive antenatal care during this pregnancy?
[Only for most recent birth]

NO. OF TIMES____
DON'T KNOW 98

410. CHECK 409:
NUMBER OF TIMES RECEIVED ANTENATAL CARE
[Only for most recent birth]

ONCE (GO TO 413)
MORE THAN ONCE OR DON'T KNOW (GO TO 411)

411. How many months pregnant were you when you the last time you received antenatal care?
[Only for most recent birth]

MONTHS___
DON'T KNOW 98

413. Were you told about the signs of pregnancy complications?
[Only for most recent birth]

YES 1
NO 2 (GO TO 414A)
DON'T KNOW 8 (GO TO 414A)

414. Were you told where to go if you had these complications?
[Only for most recent birth]

YES 1
NO 2
DON'T KNOW 8

414A. Do you have a card or other document with your immunizations listed?
IF YES: May I see it please?
[Only for most recent birth]

YES, SEEN 1
YES, NOT SEEN 2
NO 3
DON'T KNOW 8

415. During this pregnancy, were you given an injection in the arm to prevent the baby from getting tetanus, that is, convulsions after birth?
[Only for most recent birth]

YES 1
NO 2 (GO TO 416)
DON'T KNOW 8 (GO TO 416)

415A. During this pregnancy, how many times did you get this injection?
IF CARD SEEN, COPY FROM CARD.
[Only for most recent birth]

TIMES___
DON'T KNOW 8

416. During this pregnancy, were you given or did you buy any iron tablets or iron syrup?
[Only for most recent birth]

YES 1
NO 2
DON'T KNOW 8

420. During this pregnancy, were you given or did you buy any drugs to prevent you from getting malaria?
[Only for most recent birth]

YES 1
NO 2 (GO TO 422)
DON'T KNOW 8 (GO TO 422)

421. Which drug was that?
RECORD ALL MENTIONED.
[Only for most recent birth]

FANSIDAR A
CHLOROQUINE B
OTHER (SPECIFY)_______X
DOES NOT KNOW Z

422. When (NAME) was born, was he/she: very large, larger than average, average, smaller than average, or very small?

VERY LARGE 1
LARGER THAN AVERAGE 2
AVERAGE 3
SMALLER THAN AVERAGE 4
VERY SMALL 5
DON'T KNOW 8

423. Was (NAME) weighted at birth?

YES 1
NO 2 (GO TO 425)
DON'T KNOW 8 (GO TO 425)

424. How much did (NAME) weigh?
RECORD WEIGHT FROM HEALTH CARD, IF AVAILABLE.

GRAMS FROM CARD 1_____
GRAMS FROM RECALL 2_____

DON'T KNOW 99998

425. Who assisted with the delivery of (NAME)?
Anyone else?

HEALTH PROFESSIONAL
DOCTOR/MEDICAL ASST A
RURAL MEDICAL AIDE B
NURSE/MIDWIFE C
MCH AIDE D
OTHER PERSON
VILLAGE HEALTH WORKER E
TRAINED BIRTH ATTENDANT F
TRADITIONAL BIRTH ATTENDANT G
RELATIVE/FRIEND H
OTHER (SPECIFY)_______________X
NO ONE Y (GO TO 415)

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

AT HOME 11 (GO TO 428)
GOV'T OR PARASTATAL
GOVT/PARA. HOSPITAL 21
GOVT/PAR. HEALTH CENTER 22
GOVT/PARA/ DISPENSARY 23
OTHER GOV'T (SPECIFY)_________26
PRIVATE/RELIGIOUS SECTOR
PVT. HOSPITAL/CLINIC 31
OTHER PVT. MEDICAL (SPECIFY)________36
OTHER (SPECIFY)______________96 (GO TO 428)

427. Was (NAME) delivered by caesarian section?

YES 1 (GO TO 432)
NO 2

428. After (NAME) was born, did a health professional check on your health?

YES 1
NO 2 (GO TO 432)

429. How many days or weeks after the delivery did the first check take place?
RECORD '00' DAYS IF SAME DAY.
[Only for most recent birth]

DAYS AFTER DEL 1____
WEEKS AFTER DEL 2____

DON'T KNOW 998

430. Who checked on your health at that time?
PROBE FOR THE MOST QUALIFIED PERSON.
[Only for most recent birth]

HEALTH PROFESSIONAL
DOCTOR/MEDICAL ASST 01
RURAL MEDICAL AIDE 02
NURSE/MIDWIFE 03
MCH AIDE 04
OTHER PERSON
VILLAGE HEALTH WORKER 05
TRAINED BIRTH ATTENDANT 06
TRADITIONAL BIRTH ATTENDANT 07
RELATIVE/FRIEND 08
OTHER (SPECIFY)_______________96
NO ONE 09

432. In the first two months after delivery, did you receive a vitamin A dose like this?
SHOW AMPULE/CAPSULE/SYRUP
[Only for most recent birth]

YES 1
NO 2

433. Has your period returned since the birth of (NAME)?
[Only for most recent birth]

YES 1 (GO TO 435)
NO 2 (GO TO 436)

434. Did your period return between the birth of (NAME) and your next pregnancy?
[Repeat question for all births, excluding the most recent birth]

YES 1
NO 2 (GO TO 438)

435. For how many months after the birth of (NAME) did you not have a period?

MONTHS___
DON'T KNOW 98

436. CHECK 226:
RESPONDENT PREGNANT?
[Only for most recent birth]

NOT PREGNANT (GO TO 437)
NOT PREGNANT OR UNSURE (GO TO 438)

437. Have you resumed sexual relations since the birth of (NAME)?
[Only for most recent birth]

YES 1
NO 2 (GO TO 439)

438. For how many months after the birth of (NAME) did you not have sexual relations?

MONTHS___
DON'T KNOW 98

439. Did you ever breastfeed (NAME)?

YES 1
NO 2 (GO TO 444)

441. CHECK 404:
CHILD ALIVE?

ALIVE (GO TO 442)
DEAD (GO TO 443)

442. Are you still breastfeeding (NAME)?

YES 1(GO TO 445)
NO 2

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

MONTHS___
DON'T KNOW 98

444. CHECK 404:
CHILD ALIVE?

ALIVE (GO TO 447)
DEAD (GO TO 405 IN NEXT COLUM OR, IF NO MORE BIRTHS, GO TO 451)

445. How many times did you breastfeed last night between sunset and sunrise?
IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER.

NUMBER OF NIGHTTIME FEEDINGS___

446. How many times did you breastfeed yesterday during the daylight hours?
IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER.

NUMBER OF DAYLIGHT FEEDINGS___

447. Did (NAME) drink anything from a bottle with a nipple yesterday or last night?

YES 1
NO 2
DON'T KNOW 8

448. Now I would like to ask you about the types of foods and liquids (NAME) was given yesterday. At any time yesterday or last night, was (NAME) given any of the following:

Plain Water?
Tinned, powered, or fresh milk or infant formula?
Tea, fruit juice, soda, sugar water?
Oral rehydration solution?
Any other liquids?
Vitamin, mineral supplements or medicine?
Any solid or semi-solid (mushy) food?

PLAIN WATER
YES 1
NO 2
DON'T KNOW 8
MILK, FORMULA
YES 1
NO 2
DON'T KNOW 8
TEA, JUICE, SODA
YES 1
NO 2
DON'T KNOW 8
ORS
YES 1
NO 2
DON'T KNOW 8
OTHER LIQUIDS
YES 1
NO 2
DON'T KNOW 8
VITAMINS, MEDICINE
YES 1
NO 2
DON'T KNOW 8
SOLID OR MUSHY FOOD
YES 1
NO 2
DON'T KNOW 8

450. GO BACK TO 405 IN NEXT COLUM; OR, IF NO MORE BIRTHS, GO TO 451.

SECTION 4B. IMMUNIZATION AND HEALTH

451. ENTER IN THE TABLE THE LINE NUMBER, NAME AND SURVIVAL STATUS OT EACH BIRTH IN 1994 OR LATER. (IF THERE ARE MORE THAN 2 BIRTHS, USE LAST COLUMN OF ADDITIONAL QUESTIONNAIRES.

452. LINE NUMBER FROM 212

LINE NUMBER OF LAST BIRTH____

453. FROM 212 AND 216

NAME OF LAST BIRTH_____
ALIVE (GO TO 454)
DEAD (GO TO 453 IN NEXT COLUMN OR, IF NO MORE BIRTHS, GO TO 481)

454. Has (NAME) ever received a Vitamin A dose like this?
SHOW AMPULE/CAPSULE/SYRUP.

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

454A. How many months ago did (NAME) take the last capsule?

MONTHS AGO___

454B. Where did (name) get this last dose of Vitamin A?

HEALTH CENTER/CLINIC 1
NATIONAL IMMUNIZATION DAY 2
OTHER 8

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

YES, SEEN 1 (GO TO 457)
YES, NOT SEEN 2 (GO TO 459)
NO CARD 3

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

YES 1 (GO TO 459)
NO 2 (GO TO 459)

457. COPY VACCINATION DATE FOR EACH VACCINE FROM THE CARD. WRITE '44' IN 'DAY' COLUMN IF CARD SHOWS THAT A VACCINATION WAS GIVEN, BUT NO DATE IS RECORDED.

BCG
DAY___
MONTH___
YEAR___
POLIO0 (POLIO GIVEN AT BIRTH)
DAY___
MONTH___
YEAR___
POLIO1
DAY___
MONTH___
YEAR___
POLIO2
DAY___
MONTH___
YEAR___
POLIO 3
DAY___
MONTH___
YEAR___
DPT 1
DAY___
MONTH___
YEAR___
DPT 2
DAY___
MONTH___
YEAR___
DPT 3
DAY___
MONTH___
YEAR___
MEASLES (SURUA)
DAY___
MONTH___
YEAR___
VITAMIN A (MOST RECENT)
DAY___
MONTH___
YEAR___

458. Has (NAME) received any vaccinations that are not recorded on this card, including vaccinations received in a national immunization day campaign?

YES 1 (PROBE FOR VACCINATIONS AND WRITE '66' IN THE CORRESPONDING DAY COLUMN IN 457 AND GO TO 461)
NO 2 (GO TO 461)
DON'T KNOW 8 (GO TO 461)

459. Did (NAME) ever receive any vaccinations to prevent him/her from getting diseases, including vaccinations received in a national immunization day campaign?

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

460. Please tell me if (NAME) received any of the following vaccinations:

A) A BCG vaccination against tuberculosis, that is, an injection in the right shoulder that usually causes a scar?
YES 1
NO 2
DON'T KNOW 8
B) Polio vaccine, that is, drops in the mouth?
YES 1
NO 2 (GO TO 460E)
DON'T KNOW 8 (GO TO 460E)
C) When was the first polio vaccine received, just after birth or later?
JUST AFTER BIRTH 1
LATER 2
D) How many times was the polio vaccine received?
NUMBER OF TIMES___
E) DPT vaccination, that is, an injection given in the thigh or buttocks, sometimes at the same time as polio drops?
YES 1
NO 2 (GO TO 460G)
DON'T KNOW 8
F) How many times?
NUMBER OF TIMES____
G) An injection to prevent measles?
YES 1
NO 2
DON'T KNOW 8

461. Were any of the vaccinations (NAME) received during the last two years given as a part of a national immunization day campaign or a community health day?

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

462. At which national immunization day campaigns or community health day did (NAME) receive vaccinations?

AUG/SEPT 1999 (THIS YEAR) A
AUG/SEPT 1998 B
AUG/SEPT 1997 C
COMMUNITY HEALTH DAY D
SOME OTHER TIME E

462A. Has (NAME)'s birth ever been registered?

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

462B. Where was (NAME)'s birth registered?

GOVERNMENT REGISTRATION 1
HOSPITAL 2
VILLAGE REGISTRATION 3
DON'T KNOW 8

462C. Does (NAME) have a birth certificate?
IF YES: May I see please?

CHECK IF OFFICIAL BIRTH CERTIFICATE, NOT BAPTISM CERTIFICATE OR HOSPITAL CERTIFICATE.

YES, SEEN 1 (GO TO 463)
YES, NOT SEEN 2 (GO TO 463)
NO 3
DON'T KNOW 8 (GO TO 463)

462D. Why is (NAME)'s birth not registered?

COSTS TOO MUCH 1
MUST TRAVEL TOO FAR 2
DIDN'T KNOW IT SHOULD BE 3
LATE, DID NOT WANT TO PAY FINE 4
DOESN'T KNOW WHERE TO GO 5
OTHER 6

462E. Do you know where to go to register births?

YES 1
NO 2

463. Has (NAME) been ill with a fever at any time in the last two weeks?

YES 1
NO 2
DON'T KNOW 8

464. Has (NAME) had an illness with a cough at any time in the last two weeks?

YES 1
NO 2 (GO TO 466)
DON'T KNOW 8 (GO TO 466)

465. When (NAME) had an illness with a cough, did he/she breathe faster than usual with short, fast breaths?

YES 1
NO 2
DON'T KNOW 8

466. CHECK 463 AND 464:
FEVER OR COUGH?

"YES" IN 463 OR 464 (GO TO 467)
OTHER (GO TO 472)

467. Did you seek advice or treatment for the fever/cough from a doctor, nurse or at a medical facility?

YES 1
NO 2
DOES NOT KNOW 8

469. CHECK 463:
HAD FEVER?

"YES" IN 463 (GO TO 470)
"NO"/"DON'T KNOW" IN 463 (GO TO 472)

470. Did (NAME) take any drugs for the fever?

YES 1
NO 2 (GO TO 472)
DOES NOT KNOW 8 (GO TO 472)

471. What drugs did (NAME) take?
RECORD ALL MENTIONED. IF RESPONDENT DOES NOT KNOW TYPE OF DRUG, ASK TO SEE THE DRUG(S).

FANSIDAR A
CHLOROQUINE B
ASPIRIN C
IBUPROFEN/ACETAMINOPHEN D
OTHER_________(SPECIFY) X
DON'T KNOW Z

472. Has (NAME) had diarrhea in the last 2 weeks?

YES 1
NO 2 (GO TO 480)
DON'T KNOW 8 (GO TO 480)

473. When (NAME) had diarrhea, was he/she offered less than usual to drink, about the same amount, or more than usual to drink?
IF LESS, PROBE: Was he/she offered much less than usual to drink or somewhat less?

MUCH LESS 1
SOMEWHAT LESS 2
ABOUT THE SAME 3
MORE 4
NOTHING TO DRINK 5
DON'T KNOW 8

474. Was he/she offered less than usual to eat, about the same amount, or more than usual, or nothing to eat?
IF LESS PROBE: Was he/she offered much less than usual to eat or somewhat less?

MUCH LESS 1
SOMEWHAT LESS 2
ABOUT THE SAME 3
MORE 4
STOPPED FOOD 5
NEVER GAVE FOOD 6
DON'T KNOW 8

475. Was he/she given any of the following:

Breast milk?
Uji or soup?
Rice water, coconut milk or fruit juice?
A fluid made from a special packet called ORS or maji ya dawa kwa mtoto anayeharisha?
Fresh or tinned milk it infant formula?
Water?
Coke, tea, soda?
Nothing to drink?

BREAST MILK
YES 1
NO 2
DON'T KNOW 8
UJI/SOUP
YES 1
NO 2
DON'T KNOW 8
RICE WATER, COCONUT
YES 1
NO 2
DON'T KNOW 8
ORS PACKET
YES 1
NO 2
DON'T KNOW 8
MILK/FORMULA
YES 1
NO 2
DON'T KNOW 8
WATER
YES 1
NO 2
DON'T KNOW 8
COKE, TEA, SODA
YES 1
NO 2
DON'T KNOW 8
NOTHING TO DRINK
YES 1
NO 2
DON'T KNOW 8

476. Did you seek advice or treatment for the diarrhea from a doctor, nurse or at a medical facility?

YES 1
NO 2
DOES NOT KNOW 8

480. GO BACK TO 453 IN NEXT COLUMN; OR, IF NO MORE BIRTHS, GO TO 481.

481. Aside from the tetanus injections during you last pregnancy, did you receive any tetanus injection at any time before your pregnancy, either during a previous pregnancy or between pregnancies?

YES 1
NO 2 (GO TO 484)
DOES NOT KNOW (GO TO 484)

482. How many doses did you receive before your last pregnancy?

NUMBER OF DOSES___

483. When did you receive the last dose?

YEARS AGO___
DOES NOT KNOW 98

484. When a child is ill, what signs of illness tell you that you should take the child to a health facility immediately?

CHILD DRINKING POORLY A
CHILD BECOMES SICKER B
CHILD DEVELOPS A FEVER C
CHILD HAS FAST BREATHING D
CHILD HAS DIFFICULT BREATHING E
CHILD HAS BLOODY STOOLS F
OTHER X
OTHER Y
DOES NOT KNOW Z

485. When a woman is pregnant, what signs indicate that she may have a serious problem or complication and she should get medical treatment immediately?

SHE HAS A FEVER A
SWOLLEN HANDS OR FEET B
SHE IS BLEEDING TOO MUCH C
OTHER X
OTHER Y
DOES NOT KNOW Z

486. How long should a mother breastfeed her baby without giving the baby any other food or liquid other than breast milk?

MONTHS___

OTHER 96
DOES NOT KNOW 98

SECTION 5 MARRIAGE AND SEXUAL ACTIVITY

501. Are you currently married or living with a man?

YES, CURRENTLY MARRIED 1 (GO TO 505)
YES, LIVING WITH A MAN 2 (GO TO 505)
NO, NOT IN UNION 3

502. Have you ever been married or lived with a man?

YES, FORMALLY MARRIED 1
YES, LIVED WITH A MAN 2 (GO TO 507)
NO 3 (GO TO 514)

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

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

505. Is your husband/partner living with you nor or is he staying elsewhere?

LIVING WITH HER 1
STAYING ELSEWHERE 2

506. RECORD THE HUSBAND'S NAME AND LINE NUMBER FROM THE HOUSEHOLD QUESTIONNAIRE. IF HE IS NOT LISTED IN THE HOUSEHOLD, RECORD '00'.

NAME_____
LINE NO. ____

507. Have you been married or lived with a man only once, or more than once?

ONCE 1
MORE THAN ONCE 2

508. CHECK 507:

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

MARRIED/LIVED WITH A MAN MORE THAN ONCE: Now, we will talk about your first husband/partner. In what month and year did you start living with him?

MONTH___
DON'T KNOW MONTH 98
YEAR___ (GO TO 514)
DON'T KNOW YEAR 9998

509. How old were you when you started living with him?

AGE____

514. Now I need to ask you some questions about sexual activity in order to gain a better understanding of some family life issues. How old were you when you first had sexual intercourse (if ever)?

NEVER 00 (GO TO 524)
AGE IN YEARS___
FIRST TIME WHEN STARTED LIVING WITH (FIRST) HUSBAND/PARTNER 96

515. When was the last time you had sexual intercourse?
RECORD 'YEARS AGO' ONLY IF LAST INTERCOURSE WAS ONE OR MORE YEARS AGO.

DAYS AGO 1___
WEEKS AGO 2___
MONTHS AGO 3___
YEARS AGO 4___ (GO TO 524)

516. The last time you had sexual intercourse, was a condom used?

YES 1
NO 2

517. What is your relationship to the man with whom you last had sex?
IF "BOYFRIEND" OR 'FIANCEE", ASK: Was your boyfriend/fiancé living with you when you last had sex?
IF YES, RECORD '1'. IF NO, RECORD '2'.

HUSBAND/COHABITATING PARTNER 1 (GO TO 519)
BOYFRIEND/FIANCEE 2
OTHER FRIEND 3
CASUAL ACQUAINTANCE 4
COMMERCIAL SEX WORKER 5
RELATIVE 6
OTHER_________(SPECIFY) 7

518. For how long have you had a sexual relationship with this man?

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

519. Have you had sex with anyone else in the last 12 months?

YES 1
NO 2 (GO TO 524)

520. The last time you had sexual intercourse with another man, was a condom used?

YES 1
NO 2

521. What is your relationship to this other man?
IF 'BOYFRIEND' OR 'FIANCEE', ASK: Was your boyfriend/fiancé living with you when you last had sex?
IF YES, RECORD '1'. IF NO, RECORD '2'.

HUSBAND/COHABITATING PARTNER 1 (GO TO 519)
BOYFRIEND/FIANCEE 2
OTHER FRIEND 3
CASUAL ACQUAINTANCE 4
COMMERCIAL SEX WORKER 5
RELATIVE 6
OTHER_________(SPECIFY) 7

522. For how long have you had a sexual relationship with this man?

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

523. In total, how many men have you had sex with in the last 12 months?

NUMBER OF PARTNERS____

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

YES 1
NO 2 (GO TO 526)

525. Where is that?

IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

NAME OF PLACE______
GOVERNMENT/PUBLIC SECTOR
REGIONAL/CONSULTANT HOSP 11
DISTRICT HOSPITAL 12
GOVT. HEALTH CENTER 13
DISPENSARY/PARASTATAL FACILITY 14
VILLAGE HEALTH POST/WORKER 15
PRIVATE MEDICAL SECTOR
RELIGIOUS ORGANIZATION FACILITY/MISSION HOSP 21
PRIVATE DOCTOR/CLINIC/HOSP 22
PHARMACY/MEDICAL STORE 23
CBD WORKER 24
OTHER PRIVATE SECTOR
SHOP/KIOSK 31
CHURCH 32
FRIEND/RELATIVE/NEIGHBOR 33
HEALTH EDUCATION/BAR GIRLS 34
OTHER (SPECIFY)_______________96
DON'T KNOW 98

526. Is it acceptable for a woman to ask a man to use a condom?

YES 1
NO 2
DOES NOT KNOW 8

527. What if a woman's husband has a sexually transmitted disease. Would it be acceptable for her to ask him to use a condom or to refuse to have sex with him?

YES 1
NO 2
DOES NOT KNOW 8

SECTION 6. FERTILITY PREFERENCES.

601. CHECK 311/311A:

NEITHER STERILIZED (GO TO 602)
HE OR SHE IS STERILIZED (GO TO 613)

602. CHECK 226:

NOT PREGNANT OR UNSURE: 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?

PREGNANT: Now I have some questions about the future. After the child you are expecting now, would you like to have another child, or would you prefer not to have any more children?

HAVE (A/ANOTHER) CHILD 1
NO MORE/NONE 2 (GO TO 604)
SAYS SHE CAN'T GET PREGNANT 3 (GO TO 609)
UNDECIDED/DON'T KNOW 8 (GO TO 608)

603. CHECK 226:

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

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

MONTHS 1___
YEARS 2____

SOON/NOW 993 (GO TO 609)
SAYS SHE CAN'T GET PREGNANT 994 (GO TO 609)
AFTER MARRIAGE 995 (GO TO 609)
OTHER________(SPECIFY) 996 (GO TO 609)
DON'T KNOW 998 (GO TO 609)

604. CHECK 226:

NOT PREGNANT OR UNSURE (GO TO 605)
PREGNANT (GO TO 610)

605. CHECK 310:
USING A METHOD?

NOT ASKED (GO TO 606)
NOT CURRENTLY USING (GO TO 606)
CURRENTLY USING (GO TO 608)

606. CHECK 603:

NOT ASKED (GO TO 607)
24 OR MORE MONTHS OR 02 OR MORE YEARS (GO TO 607)
00-23 MONTHS OR 00-01 YEAR (GO TO 610)

607. CHECK 602:

WANTS A/ANOTHER CHILD: You have said that you do not want (a/another) child soon, but you are not using any method to avoid pregnancy. Can you tell me why?

WANTS NO (MORE) CHILDREN: You have said that you do not want any (more) children, but you are not using any method to avoid pregnancy. Can you tell me why?

RECORD ALL MENTIONED.

NOT MARRIED A
FERTILITY-RELATED REASONS
NOT HAVING SEX B
INFREQUENT SEX C
MENOPAUSAL/HYSTERECTOMY D
SUBFECUND/INFECUND E
POSTPARTUM AMENORRHEIC F
BREASTFEEDING G
FATALISTIC H
OPPOSITION TO USE
RESPONDENT OPPOSED I
HUSBAND/PARTNER OPPOSED J
OTHERS OPPOSED K
RELIGIOUS PROHIBITION L
LACK OF KNOWLEDGE
KNOWS NO METHOD M
KNOWS NO SOURCE N
METHOD-RELATED REASONS
HEALTH CONCERNS O
FEAR OF SIDE EFFECTS P
LACK OF ACCESS/TOO FAR Q
COST TOO MUCH R
INCONVENIENT TO USE S
INTERFERES WITH BODY'S NATURAL PROCESS T
OTHER_________(SPECIFY) X
DON'T KNOW Z

608. In the next few weeks, if you discovered that you were pregnant, would that be a big problem, a small problem, or no problem for you?

IF WOMAN IS PREGNANT, DO NOT ASK, BUT WRITE 'PREGNANT'.

BIG PROBLEM 1
SMALL PROBLEM 2
NO PROBLEM 3
SAYS SHE CAN'T GET PREGNANT 4

609. CHECK 310:
USING A METHOD?

NOT ASKED (GO TO 610)
NOT CURRENTLY USING (GO TO 610)
CURRENTLY USING (GO TO 613)

610. Do you think you will use a method to delay or avoid pregnancy within the next 12 months?

YES 1 (GO TO 613)
NO 2
DOES NOT KNOW 8

612. What is the main reason that you think you will not use a method in the next 12 months?

NOT MARRIED A
FERTILITY-RELATED REASONS
NOT HAVING SEX B
INFREQUENT SEX C
MENOPAUSAL/HYSTERECTOMY D
SUBFECUND/INFECUND E
POSTPARTUM AMENORRHEIC F
BREASTFEEDING G
FATALISTIC H
OPPOSITION TO USE
RESPONDENT OPPOSED I
HUSBAND/PARTNER OPPOSED J
OTHERS OPPOSED K
RELIGIOUS PROHIBITION L
LACK OF KNOWLEDGE
KNOWS NO METHOD M
KNOWS NO SOURCE N
METHOD-RELATED REASONS
HEALTH CONCERNS O
FEAR OF SIDE EFFECTS P
LACK OF ACCESS/TOO FAR Q
COST TOO MUCH R
INCONVENIENT TO USE S
INTERFERES WITH BODY'S NATURAL PROCESS T
OTHER_________(SPECIFY) X
DON'T KNOW Z

613. CHECK 216:

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

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

APPROVE 1
DISAPPROVE 2
DON'T KNOW/UNSURE 3

617. 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 a leaflet or pamphlet?
From billboards?
At community events?
From live drama?
From a doctor or a nurse?

RADIO
YES 1
NO 2
TELEVISION
YES 1
NO 2
NEWSPAPER OR MAGAZINE
YES 1
NO 2
POSTER
YES 1
NO 2
LEAFLET OR PAMPHLET
YES 1
NO 2
BILLBOARDS
YES 1
NO 2
COMMUNITY EVENTS
YES 1
NO 2
LIVE DRAMA
YES 1
NO 2
DOCTOR OR A NURSE
YES 1
NO 2

618. In the last six months, what drama series have you listened to on the radio?

CIRCLE THE SERIES MENTIONED SPONTANEOUSLY. FOR THOSE NOT MENTIONED, ASK: In the last 6 months, have you listened to:

Zinduka, a radio show featuring a character named Dr. Kurwa?
Twende na Wakati, a show featuring a character named Mkwaju?
Geuza Mwendo?
Ukimwi Kifo?
Sema Naye?
Vijana wetu?

ZINDUKA
YES, SPONTANEOUS 1
YES, PROBED 2
NO 3
TWENDE NA WAKATI
YES, SPONTANEOUS 1
YES, PROBED 2
NO 3
GEUZA MWENDO
YES, SPONTANEOUS 1
YES, PROBED 2
NO 3
UKIMWI KIFO
YES, SPONTANEOUS 1
YES, PROBED 2
NO 3
SEMA NAYE
YES, SPONTANEOUS 1
YES, PROBED 2
NO 3
VIJANA WETU
YES, SPONTANEOUS 1
YES, PROBED 2
NO 3

618A. CHECK 618:

LISTENED TO ZINDUKA (GO TO 618B)
DID NOT LISTEN TO ZINDUKA (GO TO 618E)

618B. 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

618C. 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 618E)
DOES NOT KNOW 8 (GO TO 618E)

618D. 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
WENT TO CLINIC FOR FAM. PLAN D
BEGAN USING MODERN METHOD E
BEGAN USING CONDOMS F
OTHER______(SPECIFY) X

618E. CHECK 618:

LISTENED TO TWENDE (GO TO 618F)
DID NOT LISTEN TO TWENDE (GO TO 618I)

618F. 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

618G. As a result of listening to Twende na Wakati did you do anything or take any action related to family planning?

YES 1
NO 2 (GO TO 618I)
DOES NOT KNOW (GO TO 618I)

618H. What did you do as a result of listening to Twende na Wakati?
RECORD ALL MENTIONED.

TALKED TO PARTNER A
TALKED TO HEALTH WORKER B
TALKED TO SOMEONE ELSE C
WENT TO CLINIC FOR FAM. PLAN D
BEGAN USING MODERN METHOD E
BEGAN USING CONDOMS F
OTHER______(SPECIFY) X

618I. CHECK 618:

LISTENED TO VIJANA WETU (GO TO 618J)
DID NOT LISTEN TO VIJANA WETU (GO TO 619)

618J. How often do you listen to Vijana Wetu?

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

618K. As a result of listening to Vijana Wetu, did you do anything or take any action related to family planning?

YES 1
NO 2 (GO TO 619)
DOES NOT KNOW (GO TO 619)

618L. What did you do as a result of listening to Vijana Wetu?
RECORD ALL MENTIONED.

TALKED TO PARTNER A
TALKED TO HEALTH WORKER B
TALKED TO SOMEONE ELSE C
WENT TO CLINIC FOR FAM. PLAN D
BEGAN USING MODERN METHOD E
BEGAN USING CONDOMS F
OTHER______(SPECIFY) X

619. In the last 6 months, have you heard or seen a message about Salama condoms?

YES 1
NO 2 (GO TO 621)
DOES NOT KNOW (GO TO 621)

620. Where did you hear or see the message about Salama condoms?
DO NOT READ CODES. RECORD ALL MENTIONED.

RADIO A
TELEVISION B
NEWSPAPER OR MAGAZINE C
POSTER D
LEAFLET OR PAMPHLET E
BILLBOARD F
COMMUNITY EVENT G
LIVE DRAMA H
SALES REPRESENTATIVE I
OTHER X

621. CHECK 501:

YES, CURRENTLY MARRIED (GO TO 622)
YES, CURRENTLY LIVING WITH A MAN (GO TO 622)
NO, NOT IN UNION (GO TO 701)

622. Now I want to ask you about your husband's/partner's views on family planning.
Do you think that your husband/partner approves or disapproves of couples using a method to avoid pregnancy?

APPROVES 1
DISAPPROVES 2
DON'T KNOW 8

623. How often have you talked to your husband/partner about family planning in the last year?

NEVER 1
ONCE OR TWICE 2
MORE OFTEN 3

SECTION 7. WOMAN'S WORK

701. Aside from your own housework, are you currently working?

YES 1 (GO TO 704)
NO 2

702. As you know, some women take up jobs for which they are paid in cash or kind. Others sell things, have a small business or work on the family farm or in the family business. Are you currently doing any of these things or any other work?

YES 1 (GO TO 704)
NO 2

703. Have you done any work in the last 12 months?

YES 1
NO 2 (GO TO 801)

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

OCCUPATION____________

705. CHECK 704:

WORKS IN AGRICULTURE (GO TO 706)
DOES NOT WORK IN AGRICULTURE (GO TO 707)

706. Do you work mainly on your own or family land, or do you work on land that you rent from someone else, or do you work on someone else's land?

OWN LAND 1
FAMILY LAND 2
RENTED LAND 3
SOMEONE ELSE'S LAND 4

707. Do you do this work for a member of your family, for someone else, or are you self-employed?

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

708. Do you usually work throughout the year, or do you work seasonally, or only once in a while?

THROUGHOUT THE YEAR 1
SEASONALLY/PART OF THE YEAR 2
ONCE IN A WHILE 3

709. Are you paid in cash or kind for this work or are you not paid at all?

CASH ONLY 1
CASH AND KIND 2
IN KIND ONLY 3
NOT PAID 4

SECTION 8: AIDS AND OTHER SEXUALLY TRANSMITTED DISEASES

801. Now I would like to talk about something else. Have you ever heard of the virus HIV or an illness called AIDS?

YES 1
NO 2 (GO TO 821)

802. Is there anything a person can do to avoid getting infected with HIV, the virus that causes AIDS?

YES 1
NO 2 (GO TO 809)
DON'T KNOW 8 (GO TO 809)

803. What can a person do?
Anything else?
RECORD ALL MENTIONED.

ABSTAIN FROM SEX A
USE CONDOMS B
LIMIT SEX TO ONE PARTNER/STAY FAITHFUL TO ONE PARTNER C
LIMIT NUMBER OF SEXUAL PARTNERS D
AVOID SEX WITH PROSTITUTES E
AVOID SEX WITH PERSONS WHO HAVE MANY PARTNERS F
AVOID SEX WITH HOMOSEXUALS G
INJECT DRUGS INTRAVENOUSLY H
AVOID BLOOD TRANSFUSIONS I
AVOID INJECTIONS J
AVOID KISSING K
AVOID MOSQUITO BITES L
SEEK PROTECTION FROM TRADITIONAL HEALER M
AVOID SHARING RAZORS/BLADES N
OTHER__________ W
OTHER__________ X
DON'T KNOW Z

804. Can people protect themselves from getting the AIDS virus by having just one sex partner who has no other partners?

YES 1
NO 2
DON'T KNOW 8

805. Can a person get the AIDS virus from mosquito bites?

YES 1
NO 2
DON'T KNOW 8

806. Can people protect themselves from getting the AIDS virus by using a condom every time they have sex?

YES 1
NO 2
DON'T KNOW 8

807. Can people protect themselves from getting the AIDS virus by not sharing food with a person who has AIDS?

YES 1
NO 2
DON'T KNOW 8

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

YES 1
NO 2
DON'T KNOW 8

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

YES 1
NO 2
DON'T KNOW 8

811. Do you know someone personally who has the virus that causes AIDS or someone who died from AIDS?

YES 1
NO 2

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

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

813. When can the virus that causes AIDS be transferred from a mother to a child? Can it be transmitted?

During pregnancy?
During delivery?
During breastfeeding?

PREGNANCY
YES 1
NO 2
DON'T KNOW 8
DURING DELIVERY
YES 1
NO 2
DON'T KNOW 8
BREASTFEEDING
YES 1
NO 2
DON'T KNOW 8

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

SMALL 1
MODERATE 2 (GO TO 816)
GREAT 3 (GOT TO 816)
NO RISK AT ALL 4
DOES NOT KNOW 8 (GO TO 817)
HAS AIDS 6 (GO TO 817)

815. Why do you think that you have (NO CHANCE/SMALL CHANCE) of getting AIDS?
Any other reasons?
RECORD ALL MENTIONED.

NO SEXUAL INTERCOURSE A (GO TO 817)
PARTNER HAS NO OTHER WOMEN B (GO TO 817)
SLEEPS ONLY WITH ONE PARTNER C (GO TO 817)
USES CONDOMS D (GO TO 817)
OTHER__________(SPECIFY) X (GO TO 817)

816. Why do you think that you have a (MODERATE/GREAT) risk of getting AIDS?
Any other reasons?
RECORD ALL MENTIONED.

HAS MULTIPLE PARTNERS A
PARTNER HAS OTHER WOMEN B
DOES NOT USE CONDOMS C
HAD INJECTION, BLOOD TRANSFUS D
OTHER__________(SPECIFY) X

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

YES 1 (GO TO 821)
NO 2
DOES NOT KNOW/NOT SURE 8

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

YES 1
NO 2 (GO TO 820)
DOES NOT KNOW/NOT SURE 8 (GO TO 820)

819. Why haven't you gotten tested for the AIDS virus?

DOES NOT KNOW WHERE TO GO A
COSTS TOO MUCH B
AFRAID TO GET RESULTS C
DOES NOT HAVE TIME TO GO D
OTHER__________(SPECIFY) X

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

YES 1
NO 2

821. Do you know any methods that can protect against pregnancy as well as protecting against sexual diseases?

PILL, ORAL CONTRACEPTIVE 1
CONDOM 2
OTHER__________(SPECIFY) 6
DOES NOT KNOW ANY METHODS 8

822. RECORD THE TIME.

HOUR___
MINUTES___
MORNING 1
AFTERNOON 2
EVENING, NIGHT 3

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: ____