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2015-16 TANZANIA DEMOGRAPHIC AND HEALTH AND MALARIA INDICATORS SURVEYS - MAN'S QUESTIONNAIRE

UNITED REPUBLIC OF TANZANIA
NATIONAL BUREAU OF STATISTICS

IDENTIFICATION

PLACE NAME _________________

NAME OF HOUSEHOLD HEAD __________________

CLUSTER NUMBER _____

HOUSEHOLD NUMBER _____

NAME AND LINE NUMBER OF MAN _____

INTERVIEWER VISITS

FIRST VISIT (REPEAT FOR SECOND AND THIRD VISITS)

DATE _____
INTERVIEWER'S NAME __________
RESULT* ___

*RESULT CODES

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

NEXT VISIT

DATE _____
TIME _____

FINAL VISIT

DAY ____
MONTH _____
YEAR _____
INT. NO. _____
RESULT* ___

*RESULT CODES

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

TOTAL NUMBER OF VISITS ____

LANGUAGE OF QUESTIONNAIRE** ____
LANGUAGE OF QUESTIONNAIRE** __________
LANGUAGE OF INTERVIEW** _____

LANGUAGE CODES:

ENGLISH 01
KISWAHILI 02

TRANSLATOR USED

YES 1
NO 2

SUPERVISOR

NAME __________
NUMBER ______

FIELD EDITOR

NAME __________
NUMBER _____

OFFICE EDITOR

NUMBER ____

KEYED BY

NUMBER ____

INTRODUCTION AND CONSENT

Hello. My name is _____________. I am working with the NATION BUREAU OF STATISTICS. We are conducting a survey about health and other topics all over the UNITED REPUBLIC OF TANZANIA. The information we collect will help the government to plan health services. Your household was selected for the survey. The questions usually take about 20 minutes. All of the answers you give will be confidential and will not be shared with anyone other than members of our survey team. You don't have to be in the survey, but we hope you will agree to answer the questions since your views are important. If I ask you any question you don't want to answer, just let me know and I will go on to the next question or you can stop the interview at any time.
In case you need more information about the survey, you may contact the person listed on the card that has already been given to your household.

Do you have any questions?
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 INTERVIEWD 2 (END)

SECTION 1. RESPONDENT'S BACKGROUND

101. RECORD THE TIME.

HOURS ____
MINUTES ____

MORNING 1
AFTERNOON 2
EVENING 3

102. How long have you been living continuously in (NAME OF CURRENT CITY, TOWN OR VILLAGE OF RESIDENCE)?
IF LESS THAN ONE YEAR, RECORD '00' YEARS.

YEARS ____

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

103. Just before you moved here, did you live in a city, in a town, or in a rural area?

CITY 1
TOWN 2
RURAL AREA 3

104. Before you moved here, which region did you live in?

DODOMA 01
ARUSHA 02
KILIMANJARO 03
TANGA 04
MOROGORO 05
PWANI 06
DAR ES SALAAM 07
LINDI 08
MTWARA 09
RUVUMA 10
IRINGA 11
MBEYA 12
SINGIDA 13
TABORA 14
RUKWA 15
KIGOMA 16
SHINYANGA 17
KAGERA 18
MWANZA 19
MARA 20
MANYARA 21
NJOMBE 22
KATAVI 23
SIMIYU 24
GEITA 25
KASKAZINI UNGUJA 26
KUSINI UNGUJA 27
MJINI MAGHARIBI 28
KASKAZINI PEMBA 29
KUSINI PEMBA 30
OUTSIDE OF TANZANIA 96

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.

AGE IN COMPLETED YEARS _____

107. Have you ever attended school?

YES 1
NO 2 (GO TO 111)

108. What is the highest level of school you attended?

PRE-PRIMARY 0
PRIMARY 1
POST PRIMARY TRAINING 2
SECONDARY 'O' LEVEL 3
POST SECONDARY 'O' LEVEL TRAINING 4
SECONDARY 'A' LEVEL 5
POST SECONDARY 'A' LEVEL TRAINING 6
UNIVERSITY 7
DON'T KNOW 8

109. What is the highest grade you completed at that level?
IF COMPLETED LESS THAN ONE YEAR AT THAT LEVEL, RECORD '00'.

GRADE ____

110. CHECK 108:

CODES '0', '1', '2', '3', '4', OR '8' CIRCLED (GO TO 111)
CODES '5', '6', OR '7' CIRCLED (GO TO 113)

111. Now I would like you to read this sentence to me.
SHOW CARD TO RESPONDENT.
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 PART OF THE SENTENCE 2
ABLE TO READ WHOLE SENTENCE 3
NO CARD WITH REQUIRED LANGUAGE (SPECIFY LANGUAGE) _____ 4
BLIND/VISUALLY IMPAIRED 5

112. CHECK 111:

CODE '2', '3', OR '4' CIRCLED (GO TO 113)
CODE '1' OR '5' CIRCLED (GO TO 114)

113. Do you read a newspaper or magazine at least one a week. less than once a week or not at all?

AT LEAST ONCE A WEEK 1
LESS THAN ONCE A WEEK 2
NOT AT ALL 3

114. Do you listen to the radio at least once a week, less than once a week or not at all?

AT LEAST ONCE A WEEK 1
LESS THAN ONCE A WEEK 2
NOT AT ALL 3

115. Do you watch/listen to television at least once a week, less than once a week or not at all?

AT LEAST ONCE A WEEK 1
LESS THAN ONCE A WEEK 2
NOT AT ALL 3

116. Do you own a mobile telephone?

YES 1
NO 2 (GO TO 118)

117. Do you use your mobile phone for any financial transactions?

YES 1
NO 2

117A. Do you use your mobile phone for any health related issues?

YES 1
NO 2

118. Do you have an account in a bank or other financial institution that you yourself use?

YES 1
NO 2

118A. Do you use VICOBA as financial scheme?

YES 1
NO 2

119. Have you ever used the internet?

YES 1
NO 2 (GO TO 124)

120. In the last 12 months, have you used the internet?
IF NECESSARY, PROBE FOR USE FROM ANY LOCATION, WITH ANY DEVICE.

YES 1
NO 2 (GO TO 124)

121. During the last one month, how often did you use the internet: 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

124. In the last 12 months, how many times have you been away from home for one or more nights?

NUMBER OF TIMES ____
NONE 00 (GO TO 201)

125. In the last 12 months, have you been away from home for more than one month at a time?

YES 1
NO 2

SECTION 2. REPRODUCTION

201. Now I would like to ask about any children you have had during your life. I am interested in all of the children that are biologically yours, even if they are not legally yours or do not have your last name. 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. a) How many sons live with you?
b) And how many daughters live with you?
IF NONE, RECORD '00'.

a) SONS AT HOME _____
b) 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. a) How many sons are alive but do not live with you?
b) And how many daughters are alive but do not live with you?
IF NONE, RECORD '00'.

a) SONS ELSEWHERE _____
b) 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, who made any movement, sound, or effort to breathe, or who showed any other signs of life even if for a very short time?

YES 1
NO 2 (GO TO 208)
DON'T KNOW 8 (GO TO 208)

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

a) BOYS DEAD _____
b) GIRLS DEAD _____

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

TOTAL CHILDREN _____

209. CHECK 208:

HAS HAD MORE THAN ONE CHILD (GO TO 210)
HAS HAD ONLY ONE CHILD (GO TO 211)
HAS NOT HAD ANY CHILDREN (GO TO 301)

210. Did all of the children you have fathered have the same biological mother?

YES 1
NO 2

211. CHECK 208:

HAS HAD MORE THAN ONE CHILD:
a) How old were you when your first child was born?

HAS HAD ONLY ONE CHILD:
b) How old were you when you child was born?

AGE IN YEARS _____

212. CHECK 203 AND 205:

AT LEAST ONE LIVING CHILD (GO TO 213)
NO LIVING CHILDREN (GO TO 301)

213. CHECK 203 AND 205:

MORE THAN ONE LIVING CHILD:
a) How old is your youngest child?

ONLY ONE LIVING CHILD:
b) How old is your child?

AGE IN YEARS _____

214. CHECK 213:

(YOUNGEST) CHILD IS AGE 0-2 YEARS (GO TO 215)
(YOUNGEST) CHILD IS AGE 3 YEARS OR OLDER (GO TO 301)

215. CHECK 203 AND 205:

MORE THAN ONE LIVING CHILD:
a) What is the name of your youngest child?

ONLY ONE LIVING CHILD:
b) What is the name of your child?

(NAME OF (YOUNGEST) CHILD) __________________

216. When (NAME)'s mother was pregnant with (NAME), did she have any antenatal check-ups?

YES 1
NO 2 (GO TO 218)
DON'T KNOW 8 (GO TO 218)

217. Were you ever present during any of those antenatal check-ups?

PRESENT 1
NOT PRESENT 2

218. Was (NAME) born in a hospital or health facility?

HOSPITAL/HEALTH FACILITY 1
OTHER 2

219. When a child has diarrhea, how much should he or she be given to drink: more than usual, about the same as usual, less than usual, or nothing to drink at all?

MORE THAN USUAL 1
ABOUT THE SAME 2
LESS THAN USUAL 3
NOTHING TO DRINK 4
DON'T KNOW 8

SECTION 3. CONTRACEPTION

301. 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. Have you ever heard of (METHOD)?

01. Female Sterilization.
PROBE: Women can have an operation to avoid having any more children.
YES 1
NO 2
02. Male Sterilization.
PROBE: Men can have an operation to avoid having any more children.
YES 1
NO 2
03. IUD.
PROBE: Women can have a loop or coil placed inside them by a doctor or a nurse which can prevent pregnancy for one or more years.
YES 1
NO 2
04. Injectables.
PROBE: Women can have an injection by a health provider that stops them from becoming pregnant for one or more months.
YES 1
NO 2
05. Implants.
PROBE: Women can have one or more 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
06. Pill.
PROBE: Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2
07. Condom.
PROBE: Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
08. Female Condom.
PROBE: Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
09. Emergency Contraception.
PROBE: As an emergency measure, within three to five days after they have unprotected sexual intercourse, women can take special pills to prevent pregnancy.
YES 1
NO 2
10. Standard Days Method.
PROBE: A woman uses a string of colored beads to know the days she can get pregnant. On the days she can get pregnant, she uses a condom or does not have sexual intercourse.
YES 1
NO 2
11. Lactational Amenorrhea Method (LAM).
PROBE: Up to six months after childbirth, before the menstrual period has returned, women use a method requiring frequent breastfeeding day and night.
YES 1
NO 2
12. Rhythm Method.
PROBE: To avoid pregnancy, women do not have sexual intercourse on the days of the month they think they can get pregnant.
YES 1
NO 2
13. Withdrawal.
PROBE: Men can be careful and pull out before climax.
YES 1
NO 2
14. Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
PROBE TO KNOW IF IT IS MODERN METHOD OR TRADITIONAL METHOD
YES, MODERN METHOD (SPECIFY) _____ 1
YES, TRADITIONAL METHOD (SPECIFY) _____ 2
NO 3

302. In the last few months have you:

a) Heard about family planning on the radio?
b) Seen anything about family planning on the television?
c) Read about family planning in a newspaper or magazine?
d) Received a voice or text message about family planning on a mobile phone?
e) Seen anything about family planning on a poster?
f) Seen anything about family planning on billboards?
g) Heard about family planning at community events?
h) Seen anything about family planning on a live drama?
i) Heard about family planning from a doctor or nurse?
j) Heard about family planning from a community health worker?
k) Read about family planning from internet?

a) RADIO
YES 1
NO 2
b) TELEVISION
YES 1
NO 2
c) NEWSPAPER OR MAGAZINE
YES 1
NO 2
d) MOBILE PHONE
YES 1
NO 2
e) POSTER
YES 1
NO 2
f) BILLBOARDS
YES 1
NO 2
g) COMMUNITY EVENTS
YES 1
NO 2
h) LIVE DRAMA
YES 1
NO 2
i) DOCTOR/NURSE
YES 1
NO 2
j) COMMUNITY HEALTH WORKER
YES 1
NO 2
k) INTERNET
YES 1
NO 2

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

YES 1
NO 2

304. 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 when she has sexual relations?

YES 1
NO 2 (GO TO 306)
DON'T KNOW 8 (GO TO 306)

305. 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'T KNOW 8

306. After the birth of a child, can a woman become pregnant before her menstrual period has returned?

YES 1
NO 2
DON'T KNOW 8

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

a) Contraception is a woman's concern and a man should not have to worry about it.
b) Women who use contraception may become promiscuous.

a) CONTRACEPTION WOMAN'S CONCERN
AGREE 1
DISAGREE 2
DON'T KNOW 8
b) WOMEN MAY BECOME PROMISCUOUS
AGREE 1
DISAGREE 2
DON'T KNOW 8

SECTION 4. MARRIAGE AND SEXUAL ACTIVITY

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

YES, CURRENTLY MARRIED 1 (GO TO 404)
YES, LIVING WITH A WOMAN 2 (GO TO 404)
NO, NOT IN UNION 3

402. Have you ever been married or lived together with a woman as if married?

YES FORMERLY MARRIED 1
YES, LIVED WITH A WOMAN 2
NO 3 (GO TO 413)

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

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

404. Is your (wife/partner) living with you now or is she staying elsewhere?

LIVING WITH HIM 1
STAYING ELSEWHERE 2

405. Do you have other wives or do you live with other women as if married?

YES (MORE THAN ONE WIFE) 1
NO (ONLY ONE WIFE 2 (GO TO 407)

406. Altogether, how many wives or live-in partners do you have?

TOTAL NUMBER OF WIVES AN LIVE-IN PARTNERS ____

407. CHECK 405:

ONE WIFE/PARTNER
a) Please tell me the name of (your wife/the woman you are living with as if married).

MORE THAN ONE WIFE/PARTNER
b) Please tell me the name of each of your wives or each woman you are living with as if married.

RECORD THE NAME AND THE LINE NUMBER FROM THE HOUSEHOLD QUESTIONNAIRE FOR EACH WIFE AND LIVE-IN PARTNER.
IF A WOMAN IS NOT LISTED IN THE HOUSEHOLD, RECORD '00'.
ASK 408 FOR EACH PERSON.

NAME ______
LINE NUMBER ______

408. How old was (NAME) on her last birthday?

AGE _____

409. CHECK 407:

ONE WIFE/PARTNER (GO TO 410)
MORE THAN ONE WIFE/PARTNER (GO TO 411)

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

MORE THAN ONCE 1
ONLY ONCE 2

411. CHECK 405 AND 410:

BOTH ARE CODE '2'
a) In what month and year did you start living with your (wife/partner)?

OTHER
b) Now I would like to ask about your first (wife/partner). In what month and year did you start living with her?

MONTH ____
DON'T KNOW MONTH 98
YEAR _____ (GO TO 413)
DON'T KNOW YEAR 9998

412. How old were you when you first started living with her?

AGE ____

413. CHECK FOR PRESENCE OF OTHERS. BEFORE CONTINUING, MAKE EVERY EFFORT TO ENSURE PRIVACY.

414. I would like to ask some questions about sexual activity in order to gain a better understanding of some important life issues. Let me assure you again that your answers are completely confidential and will not be told to anyone. If we should come to any question that you don't want to answer, just let me know and we will go to the next question. How old were you when you had sexual intercourse for the very first time?

NEVER HAD SEXUAL INTERCOURSE 00 (GO TO 501)
AGE IN YEARS ____

415. I would like to ask you about your recent sexual activity. When was the last time you had sexual intercourse?

IF LESS THAN 12 MONTHS, ANSWER MUST BE RECORDED IN DAYS, WEEKS OR MONTHS. IF 12 MONTHS (ONE YEAR) OR MORE, ANSWER MUST BE RECORDED IN YEARS.

DAYS AGO 1 ____
WEEKS AGO 2 ____
MONTHS AGO 3 ____
YEARS AGO 4 ____ (GO TO 501)

416. The last time you had sexual intercourse with this person, was a condom used?

YES 1
NO 2 (GO TO 438)

435. You told me that a condom was used the last time you had sex. What is the brand name of the condom used at that time?
IF BRAND NOT KNOWN, ASK TO SEE THE PACKAGE.

SALAMA 01
DUME 02
ROUGH RIDEF 03
FAMILA 04
CARE 05
LADY PEPETA 06
OTHER (SPECIFY) _____ 96
DON'T KNOW 98

436. From where did you/your partner obtain the condom the last time?
PROBE TO IDENTIFY TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

(NAME OF PLACE) _________________
GOVERNMENT/PARASTATAL
ZONAL/REFERRAL/SPECIALIZED HOSPITAL 11
REFERRAL REGIONAL HOSPITAL 12
REGIONAL HOSPITAL 13
DISTRICT HOSPITAL 14
HEALTH CENTRE 15
DISPENSARY 16
CLINIC 17
CHW 18
RELIGIOUS/VOLUNTARY
REFERRAL SPECIALIZED HOSPITAL 21
DISTRICT HOSPITAL 22
HOSPITAL 23
HEALTH CENTRE 24
DISPENSARY 25
CLINIC 26
PRIVATE
SPECIALIZED HOSPITAL 31
HOSPITAL 32
HEALTH CENTRE 33
DISPENSARY 34
CLINIC 35
OTHER
PHARMACY 41
ADDO 42
NGO 43
VCT CENTRE 44
SHOP/KIOSK 45
BAR 46
GUEST HOUSE/HOTEL 47
FRIEND/RELATIVE/NEIGHBOR 48
OTHER (SPECIFY) _____ 96
DON'T KNOW 98

437. The last time you had sex did you or your partner use any method other than a condom to avoid or prevent a pregnancy?

YES 1 (GO TO 439)
NO 2 (GO TO 440)
DON'T KNOW 8 (GO TO 440)

438. The last time you had sex did you or your partner use any method to avoid or prevent a pregnancy?

YES 1
NO 2 (GO TO 440)
DON'T KNOW 8 (GO TO 440)

439. What method did you or your partner use?
PROBE: Did you or your partner use any other method to prevent pregnancy?
RECORD ALL MENTIONED.

FEMALE STERILIZATION A (GO TO 501)
MALE STERILIZATION B (GO TO 501)
IUD C (GO TO 501)
INJECTABLES D (GO TO 501)
IMPLANTS E (GO TO 501)
PILL F (GO TO 501)
CONDOM G (GO TO 501)
FEMALE CONDOM H (GO TO 501)
EMERGENCY CONTRACEPTION I (GO TO 501)
STANDARD DAYS METHOD J (GO TO 501)
RHYTHM METHOD L (GO TO 501)
WITHDRAWAL M (GO TO 501)
OTHER MODERN METHOD X (GO TO 501)
OTHER TRADITIONAL METHOD Y (GO TO 501)

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

YES 1
NO 2

SECTION 5. FERTILITY PREFERENCES

501. CHECK 401:

CURRENTLY MARRIED OR LIVING WITH A PARTNER (GO TO 502)
NOT CURRENTLY MARRIED AND NOT LIVING WITH A PARTNER (GO TO 514)

502. CHECK 439:

MAN NOT STERILIZED/QUESTION NOT ASKED (GO TO 503)
MAN STERILIZED (GO TO 514)

503. CHECK 407:

ONE WIFE/PARTNER (GO TO 504)
MORE THAN ONE WIFE/PARTNER (GO TO 509)

504. Is your (wife/partner) currently pregnant?

YES 1
NO 2 (GO TO 507)
DON'T KNOW 8 (GO TO 507)

505. Now I have some questions about the future. After the child you and your (wife/partner) are expecting now, would you like to have another child, or would you prefer not to have any more children?

HAVE ANOTHER CHILD 1
NO MORE 2 (GO TO 514)
UNDECIDED/DON'T KNOW 8 (GO TO 514)

506. 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 _____ (GO TO 514)
YEARS 2 _____ (GO TO 514)
SOON/NOW 993 (GO TO 514)
OTHER (SPECIFY) _____ 996 (GO TO 514)
DON'T KNOW 998 (GO TO 514)

507. CHECK 208:

HAS FATHERED CHILDREN:
a) Now I have some questions about the future. Would you like to have another child, or would you prefer not to have any more children?

HAS NOT FATHERED CHILDREN:
b) Now I have some questions about the future. Would you like to have a child, or would you prefer not have any children?

HAVE (A/ANOTHER) CHILD 1
NO MORE/NONE 2 (GO TO 514)
SAYS COUPLE CAN'T GET PREGNANT 3 (GO TO 514)
WIFE/PARTNER STERILIZED 4 (GO TO 514)
UNDECIDED/DON'T KNOW 8 (GO TO 514)

508. CHECK 208:

HAS FATHERED CHILDREN:
a) How long would you like to wait from now before the birth of another child?

HAS NOT FATHERED CHILDREN:
b) How long would you like to wait from now before the birth of a child?

MONTHS 1 _____ (GO TO 514)
YEARS 2 _____ (GO TO 514)
SOON/NOW 993 (GO TO 514)
SAYS COUPLE CAN'T GET PREGNANT 994 (GO TO 514)
OTHER (SPECIFY) _____ 996 (GO TO 514)
DON'T KNOW 998 (GO TO 514)

509. Are any of your (wives/partners) currently pregnant?

YES 1
NO 2 (GO TO 512)
DON'T KNOW 8 (GO TO 512)

510. Now I have some questions about the future. After the (child/children) you and your (wives/partners) are expecting now, would you like to have another child, or would you prefer not to have any more children?

HAVE ANOTHER CHILD 1
NO MORE 2 (GO TO 514)
UNDECIDED/DON'T KNOW 8 (GO TO 514)

511. 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 _____ (GO TO 514)
YEARS 2 _____ (GO TO 514)
SOON/NOW 993 (GO TO 514)
OTHER (SPECIFY) _____ 996 (GO TO 514)
DON'T KNOW 998 (GO TO 514)

512. CHECK 208:

HAS FATHERED CHILDREN:
a) Now I have some questions about the future. Would you like to have another child, or would you prefer not to have any more children?

HAS NOT FATHERED CHILDREN:
b) Now I have some questions about the future. Would you like to have a child, or would you prefer not have any children?

HAVE (A/ANOTHER) CHILD 1
NO MORE/NONE 2 (GO TO 514)
SAYS COUPLE CAN'T GET PREGNANT 3 (GO TO 514)
WIFE/PARTNER STERILIZED 4 (GO TO 514)
UNDECIDED/DON'T KNOW 8 (GO TO 514)

513. CHECK 208:

HAS FATHERED CHILDREN:
a) How long would you like to wait from now before the birth of another child?

HAS NOT FATHERED CHILDREN:
b) How long would you like to wait from now before the birth of a child?

MONTHS 1 _____
YEARS 2 _____
SOON/NOW 993
SAYS COUPLE CAN'T GET PREGNANT 994
OTHER (SPECIFY) _____ 996
DON'T KNOW 998

514. CHECK 203 AND 205:

HAS LIVING CHILDREN:
a) 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:
b) 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.

NONE 00 (GO TO 601)
NUMBER ____
OTHER (SPECIFY) _____ 96 (GO TO 601)

515. How many of these children would you like to be boys, how many would you like to be girls and for how many would it not matter if it's a boy or a girl?

NUMBER OF BOYS ____
NUMBER OF GIRLS ____
NUMBER OF EITHER ____
OTHER (SPECIFY) _____ 96

SECTION 6. EMPLOYMENT AND GENDER ROLES

601. Have you done any work in the last seven days?

YES 1 (GO TO 604)
NO 2

602. Although you did not work in the last seven days, do you have any job or business from which you were absent for leave, illness, vacation, or any other such reason?

YES 1 (GO TO 604)
NO 2

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

YES 1
NO 2 (GO TO 607)

604. What is your occupation? That is, what kind of work do you mainly do?

OCCUPATION _______________

605. 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

606. 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

607. CHECK 401:

CURRENTLY MARRIED OR LIVING WITH A PARTNER (GO TO 608)
NOT CURRENTLY MARRIED AND NOT LIVING WITH A PARTNER (GO TO 612)

608. CHECK 606:

CODE '1' OR '2' CIRCLED (GO TO 609)
ANY OTHER CODE (GO TO 610)

609. Who usually decides how the money you earn will be used: you, your (wife/partner) or you and your (wife/partner) jointly?

RESPONDENT 1
WIFE/PARTNER 2
RESPONDENT AND WIFE/PARTNER JOINTLY 3
OTHER (SPECIFY) _____ 6

610. Who usually makes decisions about health care for yourself: you, your (wife/partner), you and your (wife/partner) jointly, or someone else?

RESPONDENT 1
WIFE/PARTNER 2
RESPONDENT AND WIFE/PARTNER JOINTLY 3
SOMEONE ELSE 4
OTHER 6

611. Who usually makes decisions about making major household purchases?

RESPONDENT 1
WIFE/PARTNER 2
RESPONDENT AND WIFE/PARTNER JOINTLY 3
SOMEONE ELSE 4
OTHER 6

612. Do you own this or any other house either alone or jointly with someone else?

ALONE ONLY 1
JOINTLY ONLY 2
BOTH ALONE AND JOINTLY 3
DOES NOT OWN 4 (GO TO 615)

613. Do you have a title deed for any house you own?

YES 1
NO 2 (GO TO 615)
DON'T KNOW 8 (GO TO 615)

615. Do you own any agricultural or non-agricultural land either alone or jointly with someone else?

ALONE ONLY 1
JOINTLY ONLY 2
BOTH ALONE AND JOINTLY 3
DOES NOT OWN 4 (GO TO 618)

616. Do you have a title deed for any land you own?

YES 1
NO 2 (GO TO 618)
DON'T KNOW 8 (GO TO 618)

617. Is your name on the title deed?

YES 1
NO 2
DON'T KNOW 8

618. 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?
b) If she neglects the children?
c) If she argues with him?
d) If she refuses to have sex with him?
e) If she burns the food?

GOES OUT
YES 1
NO 2
DON'T KNOW 8
NEGLECTS CHILDREN
YES
NO 2
DON'T KNOW 8
ARGUES
YES 1
NO 2
DON'T KNOW 8
REFUSES SEX
YES 1
NO 2
DON'T KNOW 8
BURNS FOOD
YES 1
NO 2
DON'T KNOW 8

SECTION 8. OTHER HEALTH ISSUES

801. Some men are circumcised, that is the foreskin is completely removed from the penis. Are you circumcised?

YES 1
NO 2 (GO TO 805)
DON'T KNOW 8 (GO TO 805)

802. How old were you when you got circumcised?

AGE IN COMPLETED YEARS ____
DURING CHILDHOOD (LESS THAN 5 YEARS) 95
DON'T KNOW 98

803. Who did the circumcision?

TRADITIONAL PRACTITIONER/FAMILY/FRIEND 1
HEALTH WORKER/PROFESSIONAL 2
OTHER 3
DON'T KNOW 8

804. Where was it done?

HEALTH FACILITY 1
HOME OF A HEALTH WORKER/PROFESSIONAL 2
CIRCUMCISION DONE AT HOME 3
RITUAL SITE 4
OTHER HOME/PLACE 5
DON'T KNOW 8

805. Now I would like to ask you some other questions relating to health matters. Have you had an injection for any reason in the last 12 months?

IF YES: How many injections have you had?

IF NUMBER OF INJECTIONS IS 90 OR MORE, OR DAILY FOR 3 MONTHS OR MORE, RECORD '90'. IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE.

NUMBER OF INJECTIONS ____
NONE 00 (GO TO 808)

806. Among these injections, how many were administered by a doctor, a nurse, a pharmacist, a dentist, or any other health worker?
IF NUMBER OF INJECTIONS IS 90 OR MORE, OR DAILY FOR 3 MONTHS OR MORE, RECORD '90'. IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE.

NUMBER OF INJECTIONS ____
NONE 00 (GO TO 808)

807. The last time you got an injection from a health worker, did he/she take the syringe and needle from a new, unopened package?

YES 1
NO 2
DON'T KNOW 8

808. Do you currently smoke tobacco every day, some days, or not at all?

EVERY DAY 1 (GO TO 811)
SOME DAYS 2
NOT AT ALL 3 (GO TO 810)

809. In the past, have you smoked tobacco ever day?

YES 1 (GO TO 812)
NO 2 (GO TO 812)

810. In the past, have you ever smoked tobacco every day, some days, or not at all?

EVERY DAY 1 (GO TO 813)
SOME DAYS 2 (GO TO 813)
NOT AT ALL 3 (GO TO 813)

811. On average, how many of the following products do you currently smoke each day? Also, let me know if you use the product, but not every day.
IF RESPONDENT REPORTS USING THE PRODUCT BUT NOT EVERY DAY, RECORD '888'. IF THE PRODUCT IS NOT USED AT ALL, RECORD '000'.

a) Manufactured cigarettes?
b) Hand-rolled cigarettes?
c) Kreteks?
d) Pipes full of tobacco?
e) Cigars, cheroots, or cigarillos?
f) Number of water pipe sessions?
g) Any others? (SPECIFY) ________

a) MANUFACTURED CIGARETTES
NUMBER DAILY _____ (GO TO 813)
b) HAND-ROLLED CIGARETTES
NUMBER DAILY _____ (GO TO 813)
c) KRETEKS
NUMBER DAILY _____ (GO TO 813)
d) PIPES FULL OF TOBACCO
NUMBER DAILY _____ (GO TO 813)
e) CIGARS, CHEROOTS, OR CIGARILLOS
NUMBER DAILY _____ (GO TO 813)
f) PIPE SESSIONS NUMBER OF WATER
NUMBER DAILY _____ (GO TO 813)
g) OTHERS
NUMBER DAILY _____ (GO TO 813)

812. On average, how many of the following products do you currently smoke each week? Also, let me know if you use the product, but not every week.
IF RESPONDENT REPORTS USING THE PRODUCT BUT NOT EVERY WEEK, RECORD '888'. IF THE PRODUCT IS NOT USED AT ALL, RECORD '000'.

a) Manufactured cigarettes?
b) Hand-rolled cigarettes?
c) Kreteks?
d) Pipes full of tobacco?
e) Cigars, cheroots, or cigarillos?
f) Number of water pipe sessions?
g) Any others? (SPECIFY) ________

a) MANUFACTURED CIGARETTES
NUMBER WEEKLY _____
b) HAND-ROLLED CIGARETTES
NUMBER WEEKLY _____
c) KRETEKS
NUMBER WEEKLY _____
d) PIPES FULL OF TOBACCO
NUMBER WEEKLY _____
e) CIGARS, CHEROOTS, OR CIGARILLOS
NUMBER WEEKLY _____
f) PIPE SESSIONS NUMBER OF WATER
NUMBER WEEKLY _____
g) OTHERS
NUMBER WEEKLY _____

813. Do you currently use smokeless tobacco every day, some days, or not at all?

EVERY DAY 1
SOME DAYS 2 (GO TO 815)
NOT AT ALL 3 (GO TO 815A)

814. On average, how many times a day do you use the following products? Also, let me know if you use the product, but not every day.

IF RESPONDENT REPORTS USING THE PRODUCT BUT NOT EVERY DAY, RECORD '888'. IF THE PRODUCT IS NOT USED AT ALL, RECORD '000'.

a) Snuff, by mouth?
b) Snuff, by nose?
c) Chewing tobacco?
d) Betel quid with tobacco?
e) Any others? (SPECIFY) _____

a) SNUFF, BY MOUTH
TIMES DAILY _____ (GO TO 815A)
b) SNUFF, BY NOSE
TIMES DAILY _____ (GO TO 815A)
c) CHEWING TOBACCO
TIMES DAILY ______ (GO TO 815A)
d) BETEL QUID WITH TOBACCO
TIMES DAILY ______ (GO TO 815A)
e) ANY OTHERS
TIMES DAILY _____ (GO TO 815A)

814. On average, how many times a week do you use the following products? Also, let me know if you use the product, but not every week.

IF RESPONDENT REPORTS USING THE PRODUCT BUT NOT EVERY WEEK, RECORD '888'. IF THE PRODUCT IS NOT USED AT ALL, RECORD '000'.

a) Snuff, by mouth?
b) Snuff, by nose?
c) Chewing tobacco?
d) Betel quid with tobacco?
e) Any others? (SPECIFY) _____

a) SNUFF, BY MOUTH
TIMES WEEKLY _____
b) SNUFF, BY NOSE
TIMES WEEKLY _____
c) CHEWING TOBACCO
TIMES WEEKLY _____
d) BETEL QUID WITH TOBACCO
TIMES WEEKLY ______
e) ANY OTHERS
TIMES WEEKLY _____

815A. Have you ever consumed a drink that contains alcohol such as beer, wine, spirit, fermented cider or local brewers such as mbege, ulanzi, gongo/chang'aa etc?

YES 1
NO 2 (GO TO 816)

815B. In the last 12 months, how frequently have you had at least one drink?

DAILY 1
WEEKLY 2
MONTHLY 3
LESS THAN ONCE A MONTH 4
NEVER DRUNK 5

816. Are you covered by any health insurance?

YES 1
NO 2 (GO TO 1001)

817. What type of health insurance are you covered by.
RECORD ALL MENTIONED.

MUTUAL HEALTH ORGANIZATION/COMMUNITY-BASED HEALTH INSURANCE A
HEALTH INSURANCE THROUGH EMPLOYER B
SOCIAL SECURITY C
OTHER PRIVATELY PURCHASED COMMERCIAL HEALTH INSURANCE D
OTHER (SPECIFY) _____ X

SECTION 10. MALARIA

1001. In your opinion, what is the most serious health problem in your community?

HIV/AIDS 01
TUBERCULOSIS 02
MALARIA 03
MALNUTRITION 04
DIABETES 05
CANCER 06
FLU 07
ROAD TRAFFIC ACCIDENTS 08
DIARRHEA 09
HEART DISEASE 10
OTHER (SPECIFY) _____ 96
DON'T KNOW 98

1002. Can you tell me the signs or symptoms of malaria in a young child?
RECORD ALL MENTIONED.

FEVER A
FEELING COLD B
CHILLS C
PERSPIRATION/SWEATING D
HEADACHE E
BODY ACHES F
POOR APPETITE G
VOMITING H
DIARRHEA I
WEAKNESS J
COUGHING K
OTHER (SPECIFY) _____ X
DOES NOT KNOW ANY Z

1003. Are there ways to avoid getting malaria?

YES 1
NO 2 (GO TO 1005)

1004. What are the ways to avoid getting malaria?
RECORD ALL MENTIONED.

SLEEP UNDER MOSQUITO NET A
USE MOSQUITO COILS B
USE INSECTICIDE SPRAY C
INDOOR RESIDUAL SPRAYING (IRS) D
KEEP DOORS/WINDOWS CLOSED E
USE INSECT REPELLANT F
KEEP SURROUNDINGS CLEAN G
CUT THE GRASS H
REMOVE STANDING WATER I
INTERMITTENT PREVENTIVE TREATMENT (IPTP) J
HOUSE SCREENING K
OTHER (SPECIFY) _____ X
DOES NOT KNOW ANY Z

1005. Can ACTs be obtained at your nearest health facility or pharmacy (duka la dawa muhimu)?

YES 1
NO 2
DON'T KNOW 8

1006A. In the past year, have you seen or heard any messages about malaria prevention?

YES 1
NO 2

1006B. In the past year, have you seen or heard any messages about malaria treatment?

YES 1
NO 2

1007. LOCATION OF INTERVIEW:

MAINLAND TANZANIA (GO TO 1008A)
ZANZIBAR (GO TO 1008B)

1008A. In the past year, have you ever heard or seen the phrase "Malaria Haikubaliki"?

YES 1 (GO TO 1009)
NO 2 (GO TO 1010)

1008B. In the past year, have you ever heard or seen the phrase "Maliza Malaria"?

YES 1
NO 2 (GO TO 1010)

1009. Where did you hear or see this phrase?
RECORD ALL MENTIONED.

RADIO A
BILLBOARD B
POSTER C
T-SHIRT D
LEAFLET/FACT SHEET/BROCHURE E
TELEVISION F
MOBILE VIDEO UNIT G
SCHOOL H
HEALTH CARE WORKER I
COMMUNITY EVENT/PRESENTATION J
FRIEND/NEIGHBOR/FAMILY MEMBER K
OTHER (SPECIFY) _____ X
DON'T KNOW Z

1010. In the past six months, were you visited by a health worker or volunteer who talked to you about malaria?

YES 1
NO 2

1011. Now I am going to read some statements and I would like you to tell me how much you agree or disagree with them. After I read each statement, please tell me whether you strongly agree with it, somewhat agree with it, somewhat disagree with it or strongly disagree.

1012. I can easily protect myself and my children from malaria. Do you strongly agree, somewhat agree, somewhat disagree, or strongly disagree?

STRONGLY AGREE 1
SOMEWHAT AGREE 2
SOMEWHAT DISAGREE 3
STRONGLY DISAGREE 4

1013. I can ensure that my children sleep under a treated net every single night of the year. Do you strongly agree, somewhat agree, somewhat disagree, or strongly disagree?

STRONGLY AGREE 1
SOMEWHAT AGREE 2
SOMEWHAT DISAGREE 3
STRONGLY DISAGREE 4

1014. I can easily hang my children's mosquito nets. Do you strongly agree, somewhat agree, somewhat disagree, or strongly disagree?

STRONGLY AGREE 1
SOMEWHAT AGREE 2
SOMEWHAT DISAGREE 3
STRONGLY DISAGREE 4

1015. It is important to sleep under a net every single night. Do you strongly agree, somewhat agree, somewhat disagree, or strongly disagree?

STRONGLY AGREE 1
SOMEWHAT AGREE 2
SOMEWHAT DISAGREE 3
STRONGLY DISAGREE 4

1016. Pregnant women are at high risk of getting malaria. Do you strongly agree, somewhat agree, somewhat disagree, or strongly disagree?

STRONGLY AGREE 1
SOMEWHAT AGREE 2
SOMEWHAT DISAGREE 3
STRONGLY DISAGREE 4

1017. Women should attend antenatal care early in their pregnancy. Do you strongly agree, somewhat agree, somewhat disagree, or strongly disagree?

STRONGLY AGREE 1
SOMEWHAT AGREE 2
SOMEWHAT DISAGREE 3
STRONGLY DISAGREE 4

INTERVIEWER'S OBSERVATIONS
TO BE FILLED IN AFTER COMPLETING INTERVIEW

COMMENTS ABOUT INTERVIEW: _________________________________

COMMENTS ON SPECIFIC QUESTIONS: _________________________________

ANY OTHER COMMENTS: _________________________________________

SUPERVISOR'S OBSERVATIONS: ____________________________________

EDITOR'S OBSERVATIONS: _____________________________________