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DEMOGRAPHIC AND HEALTH SURVEYS - TANZANIA 2004 - MAN???S QUESTIONNAIRE

IDENTIFICATION

REGION

DISTRICT

WARD

ENUMERATION AREA

NAME OF HEAD OF HOUSEHOLD

TDHS NUMBER

HOUSEHOLD NUMBER

LARGE CITY/SMALL CITY/TOWN/COUNTRYSIDE

LARGE CITY=1
SMALL CITY=2
TOWN=3
COUNTRYSIDE=4

LARGE CITIES ARE; DAR ES SALAAM AND MWANZA. SMALL CITIES ARE; ARUSHA, MOROGORO, DODOMA, MOSHI, TANGA, IRINGA MBEYA, SHINYANGA, TABORA, MJINI MAGHARIBI - ZANZIBAR. ALL OTHER URBAN AREAS ARE TOWN

NAME AND LINE NUMBER OF MAN

INTERVIEWER VISITS

FIRST VISIT (REPEAT FOR SECOND AND THIRD VISITS)
DATE
INTERVIEWER NAME
RESULT

RESULT*

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

NEXT VISIT
DATE
TIME

FINAL VISIT
DAY
MONTH
YEAR
INT. NUMBER
RESULT

TOTAL NUMBER OF VISITS

SURPERVISOR
NAME ___________

FIELD EDITOR
NAME ___________

OFFICE EDITOR

KEYED BY

SECTION 1. RESPONDENT???S BACKGROUND

INTRODUCTION AND CONSENT

INFORMED CONSENT
Hello. My name is _____________________________ and I am working with the National Bureau of Statistics. We are conducting a national survey about the health of men, women and children. We would very much appreciate your participation in this survey. I would like to ask you some questions related to health. This information will help the government to plan health services. The survey usually does not take too much time. 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. (1)
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)

101. RECORD THE TIME.

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 a D???Salaam/Mwanza, Other urban area or in rural area?

DSM/MWANZA 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 D???Salaam/Mwanza, Other urban area or in rural area?

DSM/MWANZA 1
OTHER URBAN AREA 2
RURAL AREA/VILLAGE 3

105. In the last 12 months, on how many separate occasions have you traveled away from your home community and slept away?

NUMBER OF TRIPS AWAY _____
NONE 00 (GO TO 107)

106. In the last 12 months, have you been away from your home community for more than 1 month at a time?

YES 1
NO 2

107. In what month and year were you born?

MONTH ____
DON???T KNOW MONTH 98
YEAR _____
DON???T KNOW YEAR 9998

108. How old are you in complete years?
COMPARE AND CORRECT 107 AND/OR 108 IF INCONSISTENT.

AGE IN COMPLETED YEARS _______

109. Have you ever attended school?

YES 1
NO 2 (GO TO 113)

110. What is the highest level of school you attended: primary, secondary, or higher? (2)

PREPRIMARY 0
PRIMARY 1
POST-PRIMARY TRAINING 2
SECONDARY 3
POST-SECONDARY TRAINING 4
UNIVERSITY 5

111. What is the highest (grade/form/year) you completed at that level? (2)

GRADE __________

112. CHECK 110:

PRIMARY (GO TO 113)
SECONDARY OR HIGHER (GO TO 116)

113. Now I would like you to read this sentence to me.
SHOW CARD TO RESPONDENT. (3)
IF RESPONDENT CANNOT READ WHOLE SENTENCE, PROBE:
Can you read any part of the sentence to me?

CANNOT READ AT ALL 1
ABLE TO READ ONLY PARTS OF SENTENCE 2
ABLE TO READ WHOLE SENTENCE 3
NO CARD WITH REQUIRED LANGUAGE (SPECIFY LANGUAGE) _________ 4
BLIND/VISUALLY IMPAIRED 5

114. Have you ever participated in a literacy program or any other program that involves learning to read or write (not including primary school)? (4)

YES 1
NO 2

115. CHECK 113:

CODE ???2???, ???3??? OR ???4??? CIRCLED (GO TO 116)
CODE ???1??? OR ???5??? CIRCLED (GO TO 117)

116. 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

117. 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

118. 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

119. Are you currently working?

YES 1 (GO TO 122)
NO 2

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

YES 1 (GO TO 122)
NO 2

121. What have you been doing for most of the time over the last 12 months?

GOING TO SCHOOL/STUDYIN 1 (GO TO 129)
LOOKING FOR WORK 2(GO TO 129)
RETIRED 3 (GO TO 129)
UNABLE TO WORK, ILL/HANDICAPPED 4 (GO TO 129)
HOUSEWORK/CHILDCARE 5 (GO TO 129)
OTHER (SPECIFY) _______ 6 (GO TO 129)

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

OCCUPATION_____________

123. CHECK 122:

WORKS IN AGRICULTURE (GO TO 124)
DOES NOT WORK IN AGRICULTURE (GO TO 125)

124. Do you work mainly on your own land or on 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

125. During the last 12 months, how many months did you work?

NUMBER OF MONTHS _______

126. 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(GO TO 129)
NOT PAID 4 (GO TO 129)

127. Who mainly decides how the money you earn will be used?

RESPONDENT 1
WIFE/PARTNER 2
RESPONDENT AND WIFE/PARTNER JOINTLY 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE JOINTLY 5

128. On average, how much of your household???s expenditures do your earnings pay for: almost none, less than half, about half, more than half, or all?

ALMOST NONE 1
LESS THAN HALF 2
ABOUT HALF 3
MORE THAN HALF 4
ALL 5
NONE, HIS INCOME IS ALL SAVED 6

129. What is your religion?

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

1 Wording of this paragraph should be modified in countries where participation is legally required.
2 Revise according to the local education system.
3 Each card should have four simple sentences appropriate to the country (e.g., ???Parents love their children???, ???Farming is hard work???,
???The child is reading a book???, ???Children work hard at school???). Cards should be prepared for every language in which respondents are likely to be literate.
4 In countries with an interest in measuring participation across a number of literacy programs, an additional multiple-response question may be included for men who participated in a literacy program (for example, ???What type of literacy programs have you participated in? PROBE: Any other programs????)

SECTION 2. REPRODUCTION

201. Now I would like to ask about any children you have had during your life. I am interested only in the children that are biologically yours. Have you ever fathered any children with any woman?

YES 1
NO 2 (GO TO 206)
DON???T KNOW 8 (GO TO 206)

202. Do you have any sons or daughters that you have fathered 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 that you have fathered 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 fathered a son or a daughter who was born alive but later died?
IF NO, PROBE: Any baby who cried or showed signs of life but did not survive?

YES 1
NO 2 (GO TO 208)
DON???T KNOW 8 (GO TO 208)

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

BOYS DEAD ________
GIRLS DEAD ________

208. (In addition to the children that you have just told me about), do you have:
a) any other living sons or daughters who are biologically your children but who are not legally yours or do not have your last name?
b) any other sons or daughters who died who were biologically your children but who were not legally yours or did not have your last name?

NO TO BOTH (GO TO 209)
OTHER (PROBE AND CORRECT 201-207 AS NECESSARY. )

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

TOTAL CHILDREN ________

210. CHECK 209:

HAS HAD MORE THAN ONE CHILD (GO TO 211)
HAS HAD ONLY ONE CHILD (GO TO 213)
HAS NOT HAD ANY CHILDREN (GO TO 301)

211. Do the children that you have fathered all have the same biological mother?

YES 1 (GO TO 213)
NO 2

212. In all, how many women have you fathered children with?

NUMBER OF WOMEN ______

213. How old were you when your (first) child was born?

AGE IN YEARS ______

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 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 IF APPLICABLE.

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

01 FEMALE STERILIZATION Women can have an operation to avoid having any more children.
YES 1
NO 2
02 MALE STERILIZATION Men 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
03 PILL Women can take a pill every day to avoid becoming pregnant.
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 INJECTABLES Women can have an injection by a health provider that stops them from becoming pregnant for one or more 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 one or more 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 Women can place a thin flexible disk in their vagina before intercourse.
YES 1
NO 2
10 FOAM OR JELLY Women can place a suppository, jelly, or cream in their vagina before sexual intercourse.
YES 1
NO 2
11 LACTATIONAL AMENORRHEA 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
12 RHYTHM OR PERIODIC ABSTINENCE 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
13 WITHDRAWAL Men can be careful and pull out before climax.
YES 1
NO 2
14 EMERGENCY CONTRACEPTION Women can take pills up to five days after sexual intercourse to avoid becoming pregnant.
YES 1
NO 2
15 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)?

02 MALE STERILIZATION Men 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
07 CONDOM Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
12 RHYTHM OR PERIODIC ABSTINENCE 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
DON???T KNOW 8
13 WITHDRAWAL Men can be careful and pull out before climax.
YES 1
NO 2

303. Now I would like to ask you about a woman???s risk of pregnancy. From one menstrual period to the next, are there certain days when a woman is more likely to become pregnant if she has sexual relations?

YES 1
NO 2 (GO TO 305)
DON???T KNOW 8 (GO TO 305)

304. Is this time just before her period begins, during her period, right after her period has ended, or halfway between two periods?

JUST BEFORE HER PERIOD BEGINS 1
DURING HER PERIOD 2
RIGHT AFTER HER PERIOD HAS ENDED 3
HALFWAY BETWEEN TWO PERIODS 4
OTHER (SPECIFY) _______ 6
DON???TKNOW 8

305. Do you think that a woman who is breastfeeding her baby can become pregnant?

YES 1
NO 2
DEPENDS 3
DON???T KNOW 8

306. I will now read you some statements about contraception. Please tell me if you agree or disagree with each one.

a) Contraception is women???s business and a man should not have to worry about it.
AGREE 1
DISAGREE 2
DON'T KNOW 8
b) Women who use contraception may become promiscuous.
AGREE 1
DISAGREE 2
DON'T KNOW 8
c) A woman is the one who gets pregnant so she should be the one to use contraception.
AGREE 1
DISAGREE 2
DON'T KNOW 8

307. CHECK 301(02) AND 302(02):
KNOWLEDGE AND USE OF MALE STERILIZATION (1)

HAS HEARD OF MALE STERILIZATION BUT IS NOT STERILIZED (GO TO 308)
OTHER (GO TO 401)

308. Once you have had all the children you want, would you yourself ever consider getting sterilized? (1)

WOULD CONSIDER 1(GO TO 401)
WOULD NOT CONSIDER 2
UNSURE/DEPENDS 3(GO TO 401)
WIFE ALREADY STERILIZED 4 (GO TO 401)

309. Why would you never consider getting sterilized? (1)
PROBE: Any other reasons?
RECORD ALL REASONS MENTIONED.

AGAINST RELIGION A
BAD FOR MAN???S HEALTH B
OPERATION NOT SAFE C
LESS INTRUSIVE WAYS AVAILABLE D
MAY WANT MORE CHILDREN /MAY WANT TO REPLACE CHILD WHO DIED E
MAY REMARRY SOME DAY F
LOSS OF WAGES G
LOSS OF SEXUAL FUNCTION H
LOSS OF MANLINESS I
OTHER (SPECIFY) ___________X

1 Question may be deleted in countries where male sterilization is not widely known, used, or promoted.

SECTION 4. MARRIAGE AND SEXUAL ACTIVITY (1)

401. Are you currently married or living with a woman as if married?

YES, CURRENTLY MARRIED 1
YES, LIVING WITH A WOMAN 2
NO, NOT IN UNION 3 (GO TO 406)

401A. Is your wife/partner living with you now or is she staying elsewhere?

LIVING TOGETHER 1
STAYING ELSEWHERE 2

401B. CHECK 401:

CURRENTLY MARRIED (GO TO 402)
LIVING WITH A WOMAN (GO TO 404)

402. Do you have one wife or more than one wife?
IF ONLY ONE WIFE, RECORD ???01???. IF MORE THAN ONE, ASK: How many wives do you currently have?

NUMBER OF WIVES ______

403. Are there any other women with whom you live as if married?

YES 1
NO 2 (GO TO 405)

404. Are you living with one (other) woman or more than one (other) woman as if married?
IF ONLY ONE LIVE-IN PARTNER, RECORD ???01???. IF MORE THAN ONE, ASK: How many women are you living with as if married?

NUMBER OF LIVE-IN PARTNERS _______

405. Apart from the woman/women you have already mentioned, do you currently have any other regular or occasional sexual partners?
IF ???YES???, PROBE TO IDENTIFY TYPE OF PARTNER.

REGULAR PARTNER(S) ONLY 1 (GO TO 409)
OCCASIONAL PARTNER(S) ONLY 2 (GO TO 409)
REGULAR AND OCCASIONAL PARTNERS 3 (GO TO 409)
NO SEXUAL PARTNER 4 (GO TO 409)

406. Do you currently have any regular sexual partners, occasional sexual partners, or do you have no sexual partner at all?
IF ???YES???, PROBE TO IDENTIFY TYPE OF PARTNER.

REGULAR PARTNER(S) ONLY 1
OCCASIONAL PARTNER(S) ONLY 2
REGULAR AND OCCASIONAL PARTNERS 3
NO SEXUAL PARTNER 4

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

YES, FORMERLY MARRIED ONLY 1
YES, LIVED WITH A WOMAN ONLY 2 (GO TO 411)
YES, BOTH 3
NO 4 (GO TO 416)

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

WIDOWED 1 (GO TO 411)
DIVORCED 2 (GO TO 411)
SEPARATED 3 (GO TO 411)

409. WRITE THE LINE NUMBERS FROM THE HOUSEHOLD QUESTIONNAIRE FOR EACH WIFE/PARTNER REPORTED IN QUESTIONS 402 AND 404 ONLY. IF A WIFE/PARTNER IS NOT LISTED IN THE HOUSEHOLD SCHEDULE, RECORD ???00??? IN THE LINE NUMBER BOXES. THE NUMBER OF LINES FILLED IN MUST BE EQUAL TO THE NUMBER OF WIVES AND PARTNERS. (IF RESPONDENT HAS MORE THAN FIVE WIVES/PARTNERS USE ADDITIONAL QUESTIONNAIRE(S).)

410. CHECK: 402 AND 404
SUM OF 402 AND 404 = 1
Please tell me the name of your wife/partner.

SUM OF 402 AND 404 > 1
Please tell me the name of each (wife/partner that you live with as if married), starting with the one you lived with first.

WIFE/PARTNER NUMBER _________
NAME ________

LINE NUMBER IN HHOLD. QUEST.

________

STATUS:

WIFE 1
PARTNER 2

410A. How old was your wife/partner on her last birthday?

AGE _______

410B. CHECK 410:

ONLY ONE WIFE/PARTNER (GO TO 411)
MORE THAN ONE WIFE/PARTNER (GO TO 412)

411. Have you been married or lived with a woman only once or more than once?

ONCE 1 (GO TO 414)
MORE THAN ONCE 2 (GO TO 413)

412. Have you ever been married to or lived as if married to any woman other than those you have just mentioned?

YES 1
NO 2 (GO TO 414)

413. In total, how many women have you been married to or lived with as if married in your whole life?

NUMBER OF WOMEN ______

414. CHECK 410 AND 411:

ONLY ONE WIFE/PARTNER AND 411=1: In what month and year did you start living with your wife/partner?

OTHER: Now we will talk about your first wife/partner. In what month and year did you start living with her?

MONTH _______
DON???T KNOW MONTH 98
YEAR _______
DON???T KNOW YEAR 9998

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

AGE _____

416. 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?

NEVER 00
AGE IN YEARS ______ (GO TO 416B)
FIRST TIME WHEN STARTED LIVING WITH (FIRST) WIFE/PARTNER 95 (GO TO 416B)

416A. Do you intend to wait until you get married to have sexual intercourse for the first time?

YES 1 (GO TO 440)
NO 2 (GO TO 440)
DON???T KNOW/UNSURE 8 (GO TO 440)

416B. CHECK 108:

15-24 YEARS OLD (GO TO 416C)
25-49 YEARS OLD (GO TO 417)

416C. The first time you had sexual intercourse, was a condom used? (1)

YES 1
NO 2

416D. How old was the person you first had sexual intercourse with?

AGE OF PARTNER ________
DON???T KNOW 98

417. When was the last time you had sexual intercourse?
RECORD ???YEARS AGO??? ONLY IF LAST INTERCOURSE WAS ONE OR MORE YEARS AGO. IF 12 MONTHS OR MORE, ANSWER MUST BE RECORDED IN YEARS.

DAYS AGO 1 _______
WEEKS AGO 2 _______
MONTHS AGO 3 _______
YEARS AGO 4 _______ (GO TO 437A)

418. The last time you had sexual intercourse with this (second/third) person, was a condom used? (2)

YES 1
NO 2 (GO TO 421)

419. What was the main reason you used a condom on that occasion?

RESP. WANTED TO PREVENT STD/HIV . 01
RESP. WANTED TO PREVENT PREGNANCY 02
RESP. WANTED TO PREVENT BOTH STD/HIV AND PREGNANCY 03
DID NOT TRUST PARTNER FELT PARTNER HAD OTHER PARTNERS 04
PARTNER REQUESTED/INSISTED 05
OTHER (SPECIFY) ______________ 96
DON???T KNOW 98

420. Did you use a condom every time you had sexual intercourse with this person in the last 12 months?

YES 1
NO 2

421. CHECK 302(2):

RESP. NOT STERILIZED (GO TO 422)
RESP. STERILIZED (GO TO 426)

422. The last time you had sexual intercourse with this person, did you or she do something else or use any other method besides a condom to avoid a pregnancy?

YES 1
NO 2 (GO TO 425)
DON'T KNOW 8 (GO TO 426)

423. What method was used?

FEMALE STER 01 (GO TO 426)
PILL 02 (GO TO 426)
IUD 03 (GO TO 426)
INJECTABLES 04 (GO TO 426)
IMPLANTS 05 (GO TO 426)
FEMALE CONDOM 06 (GO TO 426)
DIAPHRAGM 07 (GO TO 426)
FOAM/JELLY 08 (GO TO 426)
LACT. AMEN 09 (GO TO 426)
PERIODIC ABST 10 (GO TO 426)
WITHDRAWAL 11 (GO TO 426)
OTHER (SPECIFY) ______________ 96 (GO TO 426)
DON???T KNOW 98 (GO TO 426)

425. What is the main reason a method was not used?

CASUAL SEX PARTNER SO DOES NOT CARE 11
CONTRACEPTION WOMEN???S BUSINESS 12
NOT NEEDED AS CONDOM USED TO PREVENT HIV/AIDS 13
FERTILITY-RELATED
WIFE/PARTNER HAD HYSTERECTOMY/ MENOPAUSAL 23
COUPLE SUBFECUND/INFECUND 24
WIFE/PARTNER WAS
PREGNANT 25
WIFE/PARTNER POSTPARTUM AMENORRHEIC 26
WIFE/PARTNER WAS BREASTFEEDING 27
WANTED (MORE) CHILDREN 28
OPPOSITION TO USE
RESPONDENT 31
WIFE/PARTNER 32
OTHERS 33
RELIGIOUS PROHIBITION 34
LACK OF KNOWLEDGE
KNOWS NO METHOD 41
KNOWS NO SOURCE 42
METHOD-RELATED
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
DON???T KNOW 98

426. The last time you had sexual intercourse with this (second/third) person, did you or this person drink alcohol?

YES 1
NO 2 (GO TO 428)

427. Were you or your partner drunk at that time?
IF YES: Who was drunk?

RESPONDENT ONLY 1
PARTNER ONLY 2
RESPONDENT AND
PARTNER BOTH 3
NEITHER 4

428. What was your relationship to this person with whom you had sexual intercourse?
IF GIRLFRIEND: Were you living together as if married?
IF YES, CIRCLE ???02???
IF NO, CIRCLE ???03???

HUSBAND/WIFE 01 (GO TO 434)
LIVE-IN PARTNER 02 (GO TO 434)
GIRLFRIEND NOT LIVING WITH RESPONDENT 03
CASUAL ACQUAINTANCE 04
COMMERCIAL SEX WORKER 05
OTHER (SPECIFY) ______________96

429. For how long (have you had/did you have) sexual relations with this person?

DAYS 1 _____
WEEKS 2 _____
MONTHS 3 ______
YEARS 4 ______

431. How old is this person?

AGE OF PARTNER ________
DON???T KNOW 98

434. Apart from [this person/these two people], have you had sexual intercourse with any other person in the last 12 months?

YES 1 (GO BACK TO 418 IN NEXT COLUMN)
NO 2 (GO TO 436A)

435. In total, with how many different people have you had sex in the last 12 months?
IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE.
IF NUMBER OF PARTNERS IS GREATER THAN 95, WRITE ???95.???

NUMBER OF PARTNERS _______
DON???T KNOW 98

436A. In the last 12 months, did you pay anyone in exchange for sex?

YES 1
NO 2 (GO TO 437A)

436B. The last time you paid for someone in exchange for sex, was a condom used?

YES 1
NO 2 (GO TO 438)

436C. Did you use a condom every time you paid someone to have sexual intercourse in the last 12 months?

YES 1 (GO TO 438)
NO 2 (GO TO 438)
DON???T KNOW/NOT SURE 8 (GO TO 438)

437A. Have you ever paid for sex?

YES 1
NO 2 (GO TO 438)

437B. How long ago was the last time you paid for sex?

DAYS AGO 1 _______
WEEKS AGO 2 _______
MONTHS AGO 3 _______
YEARS AGO 4 _______

437C. The last time that you paid for sex, was a condom used on that occasion?

YES 1
NO 2

438. In total, with how many different people have you had sex in your lifetime?
IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE.
IF NUMBER OF PARTNERS IS GREATER THAN 95, WRITE ???95.???

NUMBER OF PARTNERS ______
DON???T KNOW 98

440. If someone needs a condom, where can they get it?
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.
PROBE: Any other place?
RECORD ALL PLACES MENTIONED.

(NAME OF PLACE) ____________
REFERAL/SPEC. HOSPITAL B
REGIONAL HOSPITAL C
DISTRICT HOSPITAL D
HEALTH CENTRE E
DISPENSARY F
VILLAGE HEALTH POST (W G
CBD WORKER H
RELIGIOUS/VOLUNTARY
REFERAL/SPEC. HOSPITAL I
DISTRICT HOSPITAL J
GOVT. HEALTH CENTRE K
DISPENSARY L
PRIVATE
DISTRICT HOSPITAL M
HEALTH CENTRE N
DISPENSARY O
OTHER
NGO P
VCT CENTRE Q
OTHER (SPECIFY) _______ X
DON???T KNOW Z (GO TO 442)

441. If you wanted to, could you yourself get a condom?

YES 1
NO 2
DON???T KNOW 8

442. CHECK 302(07), 416C, 418, AND 436B:
USE OF CONDOMS

AT LEAST ONE ???YES??? (GO TO 443)
OTHER (GO TO 447)

443. How old were you when you used a condom for the first time?

AGE AT FIRST USE ______
DOES NOT REMEMBER 98

444. Why did you use a condom that first time?
PROBE: Any other reason?
RECORD ALL REASONS MENTIONED.

TO AVOID PREGNANCY A
TO AVOID GETTING AIDS/HIV B
TO AVOID GETTING AN STD C
TO AVOID INFECTING PARTNER D
TO EXPERIMENT/TRY A CONDOM E
OTHER (SPECIFY) ________ X

445. Have you ever experienced any problems with using condoms?
IF YES: What problems have you experienced?
PROBE: Any other problems?
RECORD ALL PROBLEMS MENTIONED.

DIFFICULT TO DISPOSE OF A
DIFFICULT TO PUT ON/TAKE OFF B
SPOILS THE MOOD C
DIMINISHES PLEASURE D
WIFE PARTNER OBJECTS/DOES NOT LIKE E
WIFE/PARTNER GOT PREGNANT F
INCONVENIENT TO USE/MESSY G
CONDOM BROKE H
OTHER (SPECIFY) _________ X
NO PROBLEM Y

447. I will now read you some statements about condom use. Please tell me if you agree or disagree with each.

a) Condoms diminish a man???s sexual pleasure.
AGREE 1
DISAGREE 2
DON'T KNOW 8
b) A condom is very inconvenient to use.
AGREE 1
DISAGREE 2
DON'T KNOW 8
c) A condom can be reused.
AGREE 1
DISAGREE 2
DON'T KNOW 8
d) A condom protects against disease.
AGREE 1
DISAGREE 2
DON'T KNOW 8
e) Buying condoms is embarrassing.
AGREE 1
DISAGREE 2
DON'T KNOW 8
f) A woman has no right to ask a man to use a condom.
AGREE 1
DISAGREE 2
DON'T KNOW 8

449. If someone needs a female condom, where can they get it?
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.
PROBE: Any other place?
RECORD ALL PLACES MENTIONED.

(NAME OF PLACE) __________
REFERAL/SPEC. HOSPITAL B
REGIONAL HOSPITAL C
DISTRICT HOSPITAL D
HEALTH CENTRE E
DISPENSARY F
VILLAGE HEALTH POST (W G
CBD WORKER H
RELIGIOUS/VOLUNTARY
REFERAL/SPEC. HOSPITAL I
DISTRICT HOSPITAL J
GOVT. HEALTH CENTRE K
DISPENSARY L
PRIVATE
DISTRICT HOSPITAL M
HEALTH CENTRE N
DISPENSARY O
OTHER
NGO P
VCT CENTRE Q
OTHER (SPECIFY) _______ X
DON???T KNOW Z (GO TO 501)

460. If you wanted to, could you yourself get a female condom? (3)

YES 1
NO 2
DON???T KNOW/UNSURE 8

1 In countries with an active female condom program, a question should be added on use of a female condom.
2 Coding categories to be developed locally and revised based on the pretest; however, the broad categories must be maintained.
3 Question may be deleted in countries where female condoms are not actively promoted.

SECTION 5. FERTILITY PREFERENCES

501. CHECK 410:

HAS ONE WIFE/ PARTNER (GO TO 502)
HAS MORE THAN ONE WIFE/ PARTNER (GO TO 502)
QUESTION GOPED (GO TO 505)

502. (Is your wife/partner/Are any of your wives/partners) currently pregnant?

YES 1
NO 2
UNSURE 3

503. CHECK 502:

YES, WIFE/WIVES/PREGNANT: Now I have some questions about the future. After the child(ren) your wife/wives/ partner(s) is/are expecting now, would you like to have another child or would you prefer not to have any more children at all?

NO WIFE/PARTNER PREGNANT OR UNSURE: Now I have some questions the future. Would you like to have (a/another) child, or would you prefer not to have any (more) children at all?

HAVE A/ANOTHER CHILD 1
NO MORE/NONE 2 (GO TO 505)
WIFE/WIVES INFECUND/STERILIZED 3 (GO TO 505)
UNDECIDED/DON???T KNOW 8 (GO TO 505)

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

MONTHS 1 ______
YEARS 2______

SOON/NOW 993
AFTER MARRIAGE 995
OTHER (SPECIFY) ________ 996
DON???T KNOW 998

505. 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?

NONE 00 (GO TO 507)
NUMBER ______
OTHER (SPECIFY) 96 (GO TO 507)

506. How many of these children would you like to be boys, how many would you like to be girls, and for how many would the sex not matter?

NUMBER OF BOYS _____
OTHER (SPECIFY) ________
NUMBER OF GIRLS_____
OTHER (SPECIFY) ________
NUMBER OF EITHER SEX_____
OTHER (SPECIFY) ________

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

APPROVE 1
DISAPPROVE 2
DON???T KNOW/UNSURE 8

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

a) On the radio?
b) On the television?
c) In a newspaper or magazine?

RADIO
YES 1
NO 2
TELEVISION

YES 1
NO 2
NEWSPAPER OR MAGAZINE
YES 1
NO 2

508A. In the last six months have you heard about family planning:

a) On the radio?
b) On the television?
c) In a newspaper or magazine?
d) From a poster?
e) From billboards?
f) At community events?
g) From live drama?
h) From a doctor or nurse?
i) 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
BILLBOARD
YES 1
NO 2
COMMUNITY EVENT
YES 1
NO 2
DRAMA
YES 1
NO 2
DOCTOR/NURSE
YES 1
NO 2
HEALTH WORKER
YES 1
NO 2

509. 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: YES In the last 6 months, have you listened to:

a) Zinduka?
b) Twende na Wakati?
c) Other?

ZINDUKA
YES, SPONTANEOUS 1
YES, PROBED 2
NO 3
TWENDE NA WAKATI
YES, SPONTANEOUS 1
YES, PROBED 2
NO 3
OTHER
YES, SPONTANEOUS 1
YES, PROBED 2
NO 3

509A. CHECK 509:

LISTENED TO ZINDUKA (GO TO 509B)
HAS NOT LISTENED TO ZINDUKA (GO TO 509E)

509B. How often do you listen to Zinduka?

TWICE A WEEK 1
ONCE A WEEK 2
ONCE OR TWICE A MONTH 3
RARELY 4
DON???T KNOW 8

509C. 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 509E)
DON???T KNOW 8 (GO TO 509E)

509D. What did you do as a result of listening to Zinduka?

TALKED TO PARTNER A
TALKED TO A HEALTH WORKER B
TALKED TO SOMEONE ELSE C
RECORD ALL MENTIONED. VISITED A CLINIC FOR FAM. PLAN D
BEGAN USING A MOD. METHOD E
CONTINUED USING A MOD. METH F
OTHER (SPECIFY) ___________________ X

509E. CHECK 509:

LISTENED TO TWENDA NA WAKATI (GO TO 509F)
HAS NOT LISTENED TO TWENDA NA WAKATI (GO TO 510)

509F. How often do you listen to Twenda na Wakati?

TWICE A WEEK 1
ONCE A WEEK 2
ONCE OR TWICE A MONTH 3
RARELY 4

510. In the last few months, have you discussed the practice of family planning with your friends, neighbors, or relatives?

YES 1
NO 2 (GO TO 512)

511. With whom? Anyone else?
RECORD ALL PERSONS MENTIONED.

WIFE(WIVES)/PARTNER(S) A
MOTHER B
FATHER C
SISTER(S) D
BROTHER(S) E
DAUGHTER F
SON G
MOTHER(S)-IN-LAW H
FATHER(S)-IN-LAW I
FRIENDS/NEIGHBORS J
OTHER (SPECIFY) ________ X

512. In the last few months, have you discussed the practice of family planning with a health worker or health professional?

YES 1
NO 2

SECTION 6. PARTICIPATION IN HEALTH CARE

601. CHECK 209:

HAS HAD ONE OR MORE CHILDREN (GO TO 602)
HAS NOT HAD ANY CHILDREN (GO TO 617)

602. Please tell me the name and sex of your child (who was born most recently).

(NAME OF CHILD) ________
BOY 1
GIRL 2

603. In what month and year was (NAME OF CHILD) born?

MONTH ______
YEAR ______

604. Is (NAME OF CHILD) still living?

YES 1 (GO TO 606)
NO 2
DON???T KNOW 8 (GO TO 606)

605. How old was (NAME OF CHILD) when he/she died?
IF ???1 YEAR???, PROBE: How many months old was (NAME)?
RECORD DAYS IF LESS THAN 1 MONTH; MONTHS IF LESS THAN TWO YEARS; OR YEARS.

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

DON???T KNOW 998

606. What is the name of (NAME OF CHILD)???s mother?
WRITE THE CHILD???S MOTHER???S NAME AND HER LINE NUMBER FROM THE HOUSEHOLD QUESTIONNAIRE. IF THE MOTHER IS NOT LISTED IN THE HOUSEHOLD SCHEDULE RECORD ???00???
NAME OF CHILD???S MOTHER

LINE NUMBER IN HHD. QUEST ______

607. CHECK 603:

(LAST) CHILD BORN IN 1997 (1) OR LATER (GO TO 608)
(LAST) CHILD BORN IN 1996 (2) OR EARLIER (GO TO 617)

608. CHECK 606:

LINE NUMBER IS ???00??? (GO TO 609)
OTHER LINE NUMBER (GO TO 610)

609. What is your relationship with (NAME OF CHILD)???s mother?

CURRENT SPOUSE 01
FORMER SPOUSE 02
CURRENT LIVE-IN PARTNER 03
FORMER LIVE-IN PARTNER 04
REGULAR SEXUAL PARTNER 05
WOMAN IS GIRLFRIEND/FIANC??E 06
OCCASIONAL SEXUAL PARTNER 07
FRIEND/ACQUAINTANCE 08
OTHER (SPECIFY) _______ 96

610. ASK QUESTIONS 610-612 FIRST FOR PREGNANCY, THEN FOR DELIVERY, AND THEN FOR THE SIX WEEKS AFTER DELIVERY. ALL QUESTIONS REFER TO THE LAST BIRTH.

Now, think back to the time when (NAME OF CHILD???S MOTHER) was pregnant with (NAME OF CHILD).

PREGNANCY
610A: Did (NAME OF CHILD???S MOTHER) receive any antenatal care from a doctor or any health care provider when she was pregnant with (NAME OF CHILD)?

YES 1
NO 2 (GO TO 612)
DON'T KNOW 8 (GO TO 610B IN NEXT COLUMN)

DELIVERY
610B: Did a doctor or any health care provider assist with the delivery of (NAME OF CHILD)?

YES 1
NO 2 (GO TO 612)
DON'T KNOW 8 (GO TO 610B IN NEXT COLUMN)

SIX WEEKS AFTER DELIVERY
610C: Did (NAME OF CHILD???S MOTHER) receive any care for herself from a doctor or any health care provider during the six weeks after this delivery?

YES 1
NO 2 (GO TO 612)
DON'T KNOW 8 (GO TO 613)

611. Who mainly provided the money or goods or services to pay for this care?

FREE 01 (GO TO 610B IN NEXT COLUMN)
INSURANCE 02 (GO TO 610B IN NEXT COLUMN)
RESPONDENT 0 (GO TO 610B IN NEXT COLUMN)
CHILD???S MOTHER 04 (GO TO 610B IN NEXT COLUMN)
RESPONDENT AND CHILD???S MOTHER 05 (GO TO 610B IN NEXT COLUMN)
RESPONDENT???S FAMILY 06 (GO TO 610B IN NEXT COLUMN)
CHILD???S MOTHER???S FAMILY 07 (GO TO 610B IN NEXT COLUMN)
OTHER (SPECIFY) ____________ 96 (GO TO 610B IN NEXT COLUMN)

612. What was the main reason (NAME OF CHILD???S MOTHER) did not receive any advice or care from a doctor or other health care provider during (pregnancy/delivery/the six weeks after delivery)?

NOT NECESSARY 01
NOT CUSTOMARY 02
RESPONDENT DIDN???T ALLOW 03
TOO COSTLY 04
TOO FAR/NO TRANSPORT 05
POOR SERVICE 06
LACK OF KNOWLEDGE 07
OTHER (SPECIFY) _________ 96
(GO TO 610B IN NEXT COLUMN)

613. At any time while (NAME OF CHILD???S MOTHER) was pregnant with (NAME OF CHILD), did you yourself talk with a doctor or any other health care provider about the health of the mother or of the pregnancy?

YES 1
NO 2

614. CHECK 602 AND 604:

NAME OF (LAST) CHILD ____________
(LAST) CHILD LIVING (GO TO 615)
(LAST) CHILD NOT LIVING OR DON???T KNOW (GO TO 617)

615. Does (NAME OF CHILD) live with you in your household?

YES 1
NO 2 (GO TO 617)

616. In your household who usually decides what to do if the (NAME OF CHILD) is ill?
RECORD ALL PERSONS MENTIONED.

RESPONDENT A
CHILD???S MOTHER B
WIFE/PARTNER WHO IS NOT CHILD???S
MOTHER C
FEMALE RELATIVE D
MALE RELATIVE E
OTHER (SPECIFY) _______ X
CHILD HAS NEVER BEEN ILL Y

617. Now, I want to talk to you about pregnancy and the health of children. Sometimes a pregnancy can have complications that lead to miscarriage or even death. What are some of the signs and symptoms that indicate that a pregnancy may be in danger?
PROBE: Any other signs or symptoms?
RECORD ALL SIGNS AND SYMPTOMS MENTIONED.

VAGINAL BLEEDING A
HIGH FEVER B
ABDOMINAL PAIN C
SWELLING OF HANDS AND FEET D
DIFFICULT LABOR FOR MORE THAN 12 HOURS E
CONVULSIONS F
OTHER (SPECIFY) _______ X
DON???T KNOW ANY SIGNS OR SYMPTOMS Z

618. When a child has diarrhea, should he/she be given less to drink than usual, about the same amount, or more than usual?

NOTHING 1
LESS 2
ABOUT THE SAME 3
MORE 4
DON???T KNOW 8

619. Have you ever heard of a special product called [LOCAL NAME FOR ORS PACKET] you can get for the treatment of diarrhea?

YES 1
NO 2

619A. Have you ever heard of female circumcision?

YES 1 (GO TO 619C)
NO 2

619B. In a number of countries, there is a practice in which a girl may have part of her genitals cut. Have you heard about this practice?

YES 1
NO 2 (GO TO 620)

619C. Do you think that this practice should be continued, or should it be discontinued?

CONTINUED 1
DISCONTINUED 2
DEPENDS 3
DON???T KNOW 8

620. Now, please tell me about yourself. Do you currently smoke cigarettes or tobacco? (3)
IF YES: What type of tobacco do you smoke?
RECORD ALL TYPES MENTIONED.

YES, CIGARETTES A
YES, PIPE B
YES, OTHER TOBACCO C
NO Y

621. CHECK 620:

CODE ???A??? CIRCLED (GO TO 622)
CODE ???A??? NOT CIRCLED (GO TO 623)

622. In the last 24 hours, how many cigarettes did you smoke?

CIGARETTES ______

623. Have you had an injection for any reason in the last six months?
IF YES: How many injections did you have?
IF NUMBER OF INJECTIONS IS GREATER THAN 94,
OR DAILY FOR 3 MONTHS OR MORE, RECORD ???95???.
IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE.

NUMBER OF INJECTIONS ______
NONE 00 (GO TO 627)

624. Among these injections, how many were administered by a doctor, a nurse, a pharmacist, a dentist, or any other health workers?
IF NUMBER OF INJECTIONS IS GREATER THAN 94,
OR DAILY FOR 3 MONTHS OR MORE, RECORD ???95???.
IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE.

NUMBER OF INJECTIONS ______
NONE 00 (GO TO 627)

625. The last time you had an injection, where did you go for the injection to be given?

GOVERNMENT/PARASTATAL
REFERAL/SPEC. HOSPITAL 11
REGIONAL HOSPITAL 12
DISTRICT HOSPITAL 13
HEALTH CENTRE 14
DISPENSARY 15
VILLAGE HEALTH POST (WO 16
CBD WORKER 17
RELIGIOUS/VOLUNTARY
REFERAL/SPEC. HOSPITAL 21
DISTRICT HOSPITAL 22
GOVT. HEALTH CENTRE 23
DISPENSARY 24
PRIVATE
DISTRICT HOSPITAL 31
HEALTH CENTRE 32
DISPENSARY 33
OTHER
PHARMACY 41
NGO 42
VCT CENTER 43
OTHER (SPECIFY) ____________________ 96

626. The last time you had an injection, did the person who gave you the injection take the syringe and needle from a new, unopened package?

YES 1
NO 2
DON'T KNOW 8

627. Some ethnic groups circumcise their males and some ethnic groups do not. Are you circumcised?

YES 1
NO 2
DON'T KNOW 8

SECTION 7. HIV/AIDS AND OTHER SEXUALLY TRANSMITTED INFECTIONS

701. Now I would like to talk about something else. Have you ever heard of an illness called AIDS?

YES 1
NO 2 (GO TO 733)

702. Can people reduce their chances of getting the AIDS virus by having just one uninfected sex partner who has no other sex partners?

YES 1
NO 2
DON???T KNOW 8

703. (1) Can people get the AIDS virus from mosquito bites?

YES 1
NO 2
DON???T KNOW 8

704. By using condoms each time they have sex, can people reduce their chances of being infected with the AIDS virus?

YES 1
NO 2
DON???T KNOW 8

705. (1) Can people be infected with the AIDS virus by eating from the same plate as someone who is sick with AIDS?

YES 1
NO 2
DON???T KNOW 8

706. Can people reduce their chances of being infected with the AIDS virus if they stop having sex altogether?

YES 1
NO 2
DON???T KNOW 8

707. (1) Can people get the AIDS virus because of witchcraft or other supernatural means?

YES 1
NO 2
DON???T KNOW 8

708. What else can a person do in order to avoid or reduce their chances of being infected by the AIDS virus?
Anything else?
RECORD ALL WAYS 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
AVOID SEX WITH PERSONS WHO INJECT DRUGS INTRAVENOUSLY H
AVOID BLOOD TRANSFUSIONS I
AVOID INJECTIONS J
AVOID SHARING RAZORS/BLADES K
AVOID KISSING L
AVOID MOSQUITO BITES M
SEEK PROTECTION FROM TRADITIONAL PRACTITIONER N
OTHER (SPECIFY) _________________ W
OTHER (SPECIFY) _________________ X
NOTHING ELSE Y
DON???T KNOW Z

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

YES 1
NO 2
DON???T KNOW 8

711. Is it possible for a child to be infected by the AIDS virus:

During pregnancy?
During delivery?
By breastfeeding?

DURING PREG
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

712. CHECK 711:

AT LEAST ONE ???YES??? (GO TO 713)
OTHER (GO TO 714)

713. Are there any special medications that a doctor or a nurse can give to a woman infected with the AIDS virus to reduce the risk of transmission to the baby?

YES 1
NO 2
DON???T KNOW 8

714. Is there any special medication that people infected with the AIDS virus can get from a doctor or a nurse?

YES 1
NO 2
DON???T KNOW 8

724. I don???t want to know the results, but have you ever been tested to see if you have the AIDS virus?

YES 1
NO 2 (GO TO 729)

725. When was the last time you were tested?

LESS THAN 12 MONTHS AGO 1
12 - 23 MONTHS AGO 2
2 OR MORE YEARS AGO 3

726. The last time you had the test, did you yourself ask for the test, was it offered to you and you accepted, or was it required?

ASKED FOR THE TEST 1
OFFERED AND ACCEPTED 2
REQUIRED 3

727. I don???t want to know the results, but did you get the results of the test?

YES 1
NO 2

728. Where was the test done? (3)
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/PARASTATAL
REFERAL/SPEC. HOSPITAL 11(GO TO 731)
REGIONAL HOSPITAL 12 (GO TO 731)
DISTRICT HOSPITAL 13 (GO TO 731)
HEALTH CENTRE 14(GO TO 731)
DISPENSARY 15(GO TO 731)
VILLAGE HEALTH POST (WO 16 (GO TO 731)
CBD WORKER 17 (GO TO 731)
RELIGIOUS/VOLUNTARY
REFERAL/SPEC. HOSPITAL 21(GO TO 731)
DISTRICT HOSPITAL 22 (GO TO 731)
GOVT. HEALTH CENTRE 23 (GO TO 731)
DISPENSARY 24 (GO TO 731)
PRIVATE
DISTRICT HOSPITAL 31 (GO TO 731)
HEALTH CENTRE 32 (GO TO 731)
DISPENSARY 33 (GO TO 731)
OTHER
PHARMACY 41 (GO TO 731)
NGO 42 (GO TO 731)
VCT CENTER 43 (GO TO 731)
OTHER (SPECIFY) ____________________ 96 (GO TO 731)

729. Do you know of a place where people can go to get tested for the virus that causes AIDS?

YES 1
NO 2 (GO TO 731)

730. Where is that? (3)
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.
Any other place?
RECORD ALL SOURCES MENTIONED.

(NAME OF PLACE) __________
GOVERNMENT/PARASTATAL
REFERAL/SPEC. HOSPITAL B
REGIONAL HOSPITAL C
DISTRICT HOSPITAL D
HEALTH CENTRE E
DISPENSARY F
VILLAGE HEALTH POST (W G
CBD WORKER H
RELIGIOUS/VOLUNTARY
REFERAL/SPEC. HOSPITAL I
DISTRICT HOSPITAL J
GOVT. HEALTH CENTRE K
DISPENSARY L
PRIVATE
DISTRICT HOSPITAL M
HEALTH CENTRE N
DISPENSARY O
OTHER
NGO P
VCT CENTRE Q
OTHER (SPECIFY) _______ X

731. If you learn that a fresh food vendor has the AIDS virus, but is not sick, would you buy fresh food from him/her?

YES 1
NO 2
DON???T KNOW 8

731A. And if she/he is sick?

YES 1
NO 2
DON???T KNOW 8

732. If a member of your family has been infected with the AIDS virus, but is not sick, would you want it to remain a secret within the family, or not a secret?

YES, REMAIN A SECRET 1
NO 2
DON'T KNOW/NOT SURE/DEPENDS 8

733. If a relative of yours became sick with the virus that causes AIDS, would you be willing to care for her or him in your own household?

YES 1
NO 2
DON'T KNOW/NOT SURE/DEPENDS 8

734. In your opinion, if a female teacher has been infected with the AIDS virus, but is not sick, should she continue teaching?

SHOULD CONTINUE 1
SHOULD NOT CONTINUE 2
DON'T KNOW/NOT SURE/DEPENDS 8

734A. In your opinion, if a male teacher has been infected with the AIDS virus, should he continue teaching?

SHOULD CONTINUE 1
SHOULD NOT CONTINUE 2
DON'T KNOW/NOT SURE/DEPENDS 8

735. Do you personally know someone who has been denied health services in the last 12 months because he or she is suspected to have the AIDS virus or has the AIDS virus?

YES 1
NO 2
DON'T KNOW ANYONE WITH AIDS 3 (GO TO 740)
DON???T KNOW 8

736. Do you personally know someone who has been denied involvement in social events, religious services, or community events in the last 12 months because he or she is suspected to have the AIDS virus or has the AIDS virus?

YES 1
NO 2
DON???T KNOW 8

737. Do you personally know someone who has been verbally abused or teased in the last 12 months because he or she is suspected to have the AIDS virus or has the AIDS virus?

YES 1
NO 2
DON???T KNOW 8

738. CHECK 735, 736, AND 737:

OTHER (GO TO 739)
AT LEAST ONE ???YES??? (GO TO 740)

739. Do you personally know someone who is suspected to have the AIDS virus or who has the AIDS virus?

YES 1
NO 2

740. Do you agree or disagree with the following statement: People with the AIDS virus should be ashamed of themselves.

AGREE 1
DISAGREE 2
DON???T KNOW/NO OPINION 8

741. Do you agree or disagree with the following statement:
People with the AIDS virus should be blamed for bringing the disease into the community.

AGREE 1
DISAGREE 2
DON???T KNOW/NO OPINION 8

742. Should children age 12-14 be taught about using a condom to avoid AIDS?

AGREE 1
DISAGREE 2
DON???T KNOW/NO OPINION 8

743. Should children age 12-14 be taught to wait until they get married to have sexual intercourse in order to avoid AIDS?

AGREE 1
DISAGREE 2
DON???T KNOW/NO OPINION 8

744. Do you believe that young men should wait until they are married to have sexual intercourse?

AGREE 1
DISAGREE 2
DON???T KNOW/NO OPINION 8

745. Do you believe that young women should wait until they are married to have sexual intercourse?

AGREE 1
DISAGREE 2
DON???T KNOW/NO OPINION 8

746. Do you believe that married men should only have sex with their wives?

AGREE 1
DISAGREE 2
DON???T KNOW/NO OPINION 8

747. Do you think that most men you know have sex only with their wives?

AGREE 1
DISAGREE 2
DON???T KNOW/NO OPINION 8

747. Do you believe that married women should only have sex with their husbands?

AGREE 1
DISAGREE 2
DON???T KNOW/NO OPINION 8

749. Do you think that most women you know have sex only with their husbands?

AGREE 1
DISAGREE 2
DON???T KNOW/NO OPINION 8

750. CHECK 701:

HEARD ABOUT AIDS: Apart from AIDS, have you heard about other infections that can be transmitted through sexual contact?

NOT HEARD ABOUT AIDS: Have you heard about infections that can be transmitted through sexual contact?

YES 1
NO 2 (GO TO 753)

751. If a man has a sexually transmitted disease, what symptoms might he have? Any others?
RECORD ALL SYMPTOMS MENTIONED.

ABDOMINAL PAIN A
GENITAL DISCHARGE/DRIPPING B
FOUL SMELLING DISCHARGE C
BURNING PAIN ON URINATION D
REDNESS/INFLAMMATION IN GENITAL AREA E
SWELLING IN GENITAL AREA F
GENITAL SORES/ULCERS G
GENITAL WARTS H
GENITAL ITCHING I
BLOOD IN URINE J
LOSS OF WEIGHT K
IMPOTENCE L
OTHER (SPECIFY) _________________ W
OTHER (SPECIFY) _________________ X
NO SYMPTOMS Y
DON???T KNOW Z

752. If a woman has a sexually transmitted disease, what symptoms might she have? Any others?
RECORD ALL SYMPTOMS MENTIONED.

ABDOMINAL PAIN A
GENITAL DISCHARGE/DRIPPING B
FOUL SMELLING DISCHARGE C
BURNING PAIN ON URINATION D
REDNESS/INFLAMMATION IN GENITAL AREA E
SWELLING IN GENITAL AREA F
GENITAL SORES/ULCERS G
GENITAL WARTS H
GENITAL ITCHING I
BLOOD IN URINE J
LOSS OF WEIGHT K
IMPOTENCE L
OTHER (SPECIFY) _________________ W
OTHER (SPECIFY) _________________ X
NO SYMPTOMS Y
DON???T KNOW Z

753. CHECK 416:

HAS HAD SEXUAL INTERCOURSE (GO TO 754)
HAS NOT HAD SEXUAL INTERCOURSE (GO TO 801)

754. CHECK 750:

HEARD ABOUT INFECTION TRANSMITTED THROUGH SEXUAL CONTACT (GO TO 755)
HAS NOT HEARD ABOUT INFECTION TRANSMITTED THROUGH SEXUAL CONTACT (GO TO 756)

755. Now I would like to ask you some questions about your health in the last 12 months. During the last 12 months, have you had a disease which you got through sexual contact?

YES 1
NO 2
DON???T KNOW 8

756. Sometimes men experience an abnormal discharge from their penis. During the last 12 months, have you had an abnormal discharge from your penis?

YES 1
NO 2
DON???T KNOW 8

757. Sometimes men have a sore or ulcer on or near their penis. During the last 12 months, have you had a sore or ulcer on or near your penis?

YES 1
NO 2
DON???T KNOW 8

758. CHECK 755, 756, AND 757:

HAS HAD AN INFECTION (ANY ???YES???) (GO TO 759)
HAS NOT HAD AN INFECTION OR DOES NOT KNOW (GO TO 801)

759. The last time you had (PROBLEM FROM 755/756/757), did you seek any kind of advice or treatment?

YES 1
NO 2

760. Where did you go? Any other place?
RECORD ALL SOURCES MENTIONED.

GOVERNMENT/PARASTATAL
REFERAL/SPEC. HOSPITAL B
REGIONAL HOSPITAL C
DISTRICT HOSPITAL D
HEALTH CENTRE E
DISPENSARY F
VILLAGE HEALTH POST (W G
CBD WORKER H
RELIGIOUS/VOLUNTARY
REFERAL/SPEC. HOSPITAL I
DISTRICT HOSPITAL J
GOVT. HEALTH CENTRE K
DISPENSARY L
PRIVATE
DISTRICT HOSPITAL M
HEALTH CENTRE N
DISPENSARY O
OTHER
NGO P
VCT CENTRE Q
OTHER (SPECIFY) _______ X

(1) If 703, 705 and/or 707 do not apply to the local context, replace the question using a specific local misconception. At least two questions related to misconceptions are needed.
(2) For fieldwork in 2005 and 2006, the year should be 2003 and 2004, respectively.
(3) Coding categories to be developed locally and revised based on the pretest; however, the broad categories must be maintained.

SECTION 8. ATTITUDES TOWARDS GENDER ROLES

801. In a couple, who do you think should have the greater say in BOTH DON???T each of the following decisions: the husband, the wife or both equally:

a) making large household purchases?
HUSBAND 1
WIFE 2
BOTH EQUALLY 3
DON???T KNOW, DEPENDS 8
b) making small daily household purchases?
HUSBAND 1
WIFE 2
BOTH EQUALLY 3
DON???T KNOW, DEPENDS 8
c) deciding when to visit family, friends or relatives?
HUSBAND 1
WIFE 2
BOTH EQUALLY 3
DON???T KNOW, DEPENDS 8
d) deciding what to do with the money she earns for her work?
HUSBAND 1
WIFE 2
BOTH EQUALLY 3
DON???T KNOW, DEPENDS 8
e) deciding how many children to have and when to have them?
HUSBAND 1
WIFE 2
BOTH EQUALLY 3
DON???T KNOW, DEPENDS 8

802. Sometimes a husband is annoyed or angered by things that his wife/partner does. In your opinion, is a husband justified in hitting or beating his wife in the following situations...

a) If she goes out without telling him?
YES 1
NO 2
DON???TKNOW, DEPENDS 8
b) If she neglects the children?
YES 1
NO 2
DON???TKNOW, DEPENDS 8
c) If she argues with him?
YES 1
NO 2
DON???TKNOW, DEPENDS 8
d) If she refuses to have sex with him?
YES 1
NO 2
DON???TKNOW, DEPENDS 8
e) If she burns the food?
YES 1
NO 2
DON???TKNOW, DEPENDS 8

803. When a wife knows her husband has a sexually transmitted disease, is she justified in asking that they use a condom?

YES 1
NO 2
DON???T KNOW 8

804. Husbands and wives do not always agree on everything. Please tell me if you think a wife is justified in refusing to have sex with her husband if...

a) She is tired and not in the mood?
YES 1
NO 2
DON???TKNOW, DEPENDS 8
b) She has recently given birth?
YES 1
NO 2
DON???TKNOW, DEPENDS 8
c) She knows her husband has sex with other women? (1)
YES 1
NO 2
DON???TKNOW, DEPENDS 8
d) She knows her husband has a sexually transmitted disease?
YES 1
NO 2
DON???TKNOW, DEPENDS 8

805. Do you think that if a woman refuses to have sex with her husband when he wants her to, he has the right to...

a) Get angry and reprimand her?
YES 1
NO 2
DON???TKNOW, DEPENDS 8
b) Refuse to give her money or other means of financial support?
YES 1
NO 2
DON???TKNOW, DEPENDS 8
c) Use force and have sex with her even if she doesn???t want to?
YES 1
NO 2
DON???TKNOW, DEPENDS 8
d) Go and have sex with another woman?
YES 1
NO 2
DON???TKNOW, DEPENDS 8

806. RECORD THE TIME.

HOUR ______
MINUTES ______

1 In polygynous societies, the phrase ???other women??? should be replaced by the phrase ???women other than his wives.???