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UGANDA DEMOGRAPHIC AND HEALTH SURVEY MAN'S QUESTIONNAIRE 1995

IDENTIFICATION

REGION _____

DISTRICT _____

COUNTY _____

SUB-COUNTY/TOWN _____

PARISH/RC2 NAME _____

EA NAME _____

UDHS NUMBER

URBAN/ RURAL

Urban 1
Rural 2

CITY/MUNICIPALITY/TOWN/COUNTRYSIDE

City 1
municipality 2
town 3
countryside 4

HOUSEHOLD NUMBER

NAME OF HOUSEHOLD HEAD ______

NAME AND LINE NUMBER OF MAN ______

NAME AND LINE NUMBER OF FIRST WIFE ______

NAME AND LINE NUMBER OF SECOND WIFE ______

NAME AND LINE NUMBER OF THIRD WIFE ______

NAME AND LINE NUMBER OF FOURTH WIFE ______

INTERVIEWER VISITS

FIRST VISIT:
DATE
INTERVIEWER'S NAME
RESULT

NEXT VISIT:
DATE
TIME

SECOND VISIT:
DATE
INTERVIEWER'S NAME
RESULT

NEXT VISIT:
DATE
TIME

THIRD VISIT:
DATE
INTERVIEWER'S NAME
RESULT

FINAL VISIT:
DAY
MONTH
YEAR
NAME
RESULT

TOTAL NUMBER OF VISITS

*RESULT CODES:

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

LANGUAGE OF QUESTIONNAIRE: ENGLISH

LANGUAGE USED IN INTERVIEW

LANGUAGE:
1 ATESO-KARAMOJONG
2 LUGANDA
3 LUGBARA
4 LUO
5 RUNYANKOLE-RUKIGA
6 RUNYORO-RUTORO
7 ENGLISH
8 OTHER

RESPONDENT'S LOCAL LANGUAGE

LANGUAGE:
1 ATESO-KARAMOJONG
2 LUGANDA
3 LUGBARA
4 LUO
5 RUNYANKOLE-RUKIGA
6 RUNYORO-RUTORO
7 ENGLISH
8 OTHER

TRANSLATOR USED

NOT AT ALL 1
SOMETIMES 2
ALL THE TIME 3

SUPERVISOR

NAME _______
DATE _______

FIELD EDITOR

NAME _______
DATE _______

OFFICE EDITOR

KEYED BY

SECTION 1. RESPONDENT'S BACKGROUND

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 city, in a municipality, in a town or in the countryside?

CITY (KAMPALA) 1
MUNICIPALITY 2
TOWN 3
COUNTRYSIDE 4

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

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

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

CITY (KAMPALA) 1
MUNICIPALITY 2
TOWN 3
COUNTRYSIDE 4

105) In what month and year were you born?

MONTH
DON'T KNOW MONTH 98
YEAR
DOES NOT KNOW YEAR 98

106) How old were you at your last birthday?

COMPARE AND CORRECT 105 AND/OR 106 IF INCONSISTENT.

AGE IN COMPLETED YEARS

107) Have you ever attended school?

YES 1
NO 2 (GO TO 111)

108) What is the highest level of school you attended: primary, junior, secondary or university?

PRIMARY 1
JUNIOR 2
SECONDARY 3
UNIVERSITY 4

109) What is the highest grade you completed at that level?

GRADE

110) CHECK 108:

PRIMARY
JUNIOR OR HIGHER (GO TO 112)

111) Would you please read this sentence?

SHOW SENTENCE TO RESPONDENT AND CIRCLE CORRECT CODE.

READ EASILY 1
WITH DIFFICULTY 2
NOT AT ALL 3 (GO TO 113A)

112) Do you usually read a newspaper or magazine at least once a week?

YES 1
NO 2

113A) How often do you listen to the radio?

EVERY DAY/ALMOST EVERY DAY 1
AT LEAST ONCE A WEEK 2
AT LEAST ONCE A MONTH 3
LESS THAN ONCE A MONTH 4
HARDLY/VIRTUALLY NEVER 5 (GO TO 114A)
DOES NOT KNOW 8 (GO TO 114A)

113B) What times do you usually listen to the radio? (CIRCLE ALL TIMES MENTIONED)

EARLY MORNING (6.00-8.00) A
MID MORNING (8.00-10.00) B
LATE MORNING (10.00-12.00) C
LUNCH TIME (12.00-14.00) D
AFTERNOON (14.00-16.00) E
LATE AFTERNOON (16.00-18.00) F
EARLY EVENING (18.00-20.00) G
LATE EVENING (20.00-STATION CLOSE) H
DOES NOT KNOW Z

113C) What day of the week do you usually like to listen to the radio? (CIRCLE ALL DAYS MENTIONED)

MONDAY A
TUESDAY B
WEDNESDAY C
THURSDAY D
FRIDAY E
SATURDAY F
SUNDAY G
DOES NOT KNOW Z

114A) How often do you watch television (TV)?

EVERY DAY/ALMOST EVERY DAY 1
AT LEAST ONCE A WEEK 2
AT LEAST ONCE A MONTH 3
LESS THAN ONCE A MONTH 4
HARDLY/VIRTUALLY NEVER 5 (GO TO 115)
DOES NOT KNOW 8 (GO TO 115)

114B) What times do you usually watch TV? (CIRCLE ALL TIMES MENTIONED)

EARLY MORNING (6.00-8.00) A
MID MORNING (8.00-10.00) B
LATE MORNING (10.00-12.00) C
LUNCH TIME (12.00-14.00) D
AFTERNOON (14.00-16.00) E
LATE AFTERNOON (16.00-18.00) F
EARLY EVENING (18.00-20.00) G
LATE EVENING (20.00-STATION CLOSE) H
DOES NOT KNOW Z

114C) What days of the week do you usually watch TV? (CIRCLE ALL DAYS MENTIONED)

MONDAY A
TUESDAY B
WEDNESDAY C
THURSDAY D
FRIDAY E
SATURDAY F
SUNDAY G
DOES NOT KNOW Z

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

____________________________

116) CHECK 115:

WORKS IN AGRICULTURE
DOES NOT WORK IN AGRICULTURE (GO TO 118)

117) Do you work mainly on your own land or on family land, or do you rent land, or work on someone else's land?

OWN LAND 1
FAMILY LAND 2
RENTED LAND 3
SOMEONE ELSE'S LAND 4
LABOR ON SOMEONE ELSE'S FARM LAND 5
PUBLIC LAND 6

118) Do you earn cash for this work?

YES 1
NO 2

119) What is your religion?

CATHOLIC 1
PROTESTANT 2
MUSLIM 3
SEVENTH DAY ADVENTIST 4
OTHER (SPECIFY) _________ 6

120) What is your nationality?

UGANDAN 01
RWANDESE 02
SUDANESE 03
KENYAN 04
ZAIRIAN 05
TANZANIAN 06
OTHER (SPECIFY) ________ 96

121) What is your tribe?

ACHOLI 01
ALUR 02
BAAMBA 03
BACHOPE 04
BADAMA 05
BAFUMBIRA 06
BAGANDA 07
BAGISU 08
BAGWE 09
BAGWERE 10
BAHORORO 11
BAKIGA 12
BAKONJO 13
BANYANKOLE 14
BANYARWANDA 15
BANYOLE 16
BANYORO 17
BARULLI 18
BARUNDI 19
BASOGA 20
BATORO 21
BATWA 22
ITESO 23
KAKWA 24
KARIMOJANG 25
KUMAM 26
LANGI 27
LENOU 28
LUGBARA 29
MADI 30
NUBIAM 31
SAMIA 32
SEBEI 33
OTHER (SPECIFY) _________ 96

SECTION 2. REPRODUCTION

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

YES 1
NO 2 (GO TO 206)

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

YES 1
NO 2 (GO TO 204)

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

SONS AT HOME
DAUGHTERS AT HOME

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

YES 1
NO 2 (GO TO 206)

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

SONS ELSEWHERE
DAUGHTERS ELSEWHERE

206) Have you ever had a son or daughter who was born alive but later died?

IF NO, ASK: Any baby who cried or showed signs of life but survived only a few hours or days?

YES 1
NO 2 (GO TO 208)

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

BOYS DEAD
GIRLS DEAD

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

TOTAL

209) CHECK 208:

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

YES
NO (PROBE AND CORRECT 201-208 AS NEEDED)

SECTION 3. CONTRACEPTION

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

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

301) Which ways or methods have you heard about?

302) Have you ever heard of (METHOD)?

01 PILL Women can take a pill every day.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
02 IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
03 INJECTIONS Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
04 IMPLANTS Women can have several small rods placed in their upper arm by a doctor or nurse which can prevent pregnancy for several years.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
05 DIAPHRAGM, FOAM, JELLY Women can place a sponge, suppository, diaphragm, jelly, or cream inside themselves before intercourse.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
06 CONDOM Men can use a rubber sheath during sexual intercourse.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
07 FEMALE STERILIZATION Women can have an operation to avoid having any more children.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
08 MALE STERILIZATION Men can have operation to avoid having any more children.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
09 RYTHYM, COUNTING DAYS Every month that a woman is sexually active she can avoid having sexual intercourse on the days of the month she is most likely to get pregnant.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
10 NATURAL FAMILY PLANNING A woman can take her temperature every day or check her vaginal mucus to tell which days to avoid having sexual intercourse.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
11 WITHDRAWAL Men can be careful and pull out before climax.
SPONTANEOUS YES 1
PROBED YES 2
NO 3
12 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
SPONTANEOUS YES 1 (SPECIFY) _________
NO 3

303) Have you ever used (METHOD)?

01 PILL Women can take a pill every day.
YES 1
NO 2
02 IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
03 INJECTIONS Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
YES 1
NO 2
04 IMPLANTS Women can have several small rods placed in their upper arm by a doctor or nurse which can prevent pregnancy for several years.
YES 1
NO 2
05 DIAPHRAGM, FOAM, JELLY Women can place a sponge, suppository, diaphragm, jelly, or cream inside themselves before intercourse.
YES 1
NO 2
06 CONDOM Men can use a rubber sheath during sexual intercourse.
YES 1
NO 2
07 FEMALE STERILIZATION Women can have an operation to avoid having any more children: Have you ever had a partner who had an operation to avoid having children?
YES 1
NO 2
08 MALE STERILIZATION Men can have operation to avoid having any more children: Have you ever had an operation to avoid having any more children?
YES 1
NO 2
09 RYTHYM, COUNTING DAYS Every month that a woman is sexually active she can avoid having sexual intercourse on the days of the month she is most likely to get pregnant.
YES 1
NO 2
10 NATURAL FAMILY PLANNING A woman can take her temperature every day or check her vaginal mucus to tell which days to avoid having sexual intercourse.
YES 1
NO 2
11 WITHDRAWAL Men can be careful and pull out before climax.
YES 1
NO 2
12 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1 (SPECIFY) _________
NO 2

304) CHECK 303:

NOT A SINGLE "YES" (NEVER USED)
AT LEAST ONE "YES" (EVER USED) (GO TO 307)

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

YES 1
NO 2 (GO TO 401)

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

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

YES 1
NO 2 (GO TO 401)

308) Which method are you using? Anything else?

RECORD FIRST, SECOND, THIRD AND FOURTH PARTNER IN SEPERATE COLUMNS

1ST WIFE
PILL 01
IUD 02
INJECTIONS 03
IMPLANTS/NORPLANT 04
DIAPHRAGM/FOAM/JELLY 05
CONDOM 06
FEMALE STERILIZATION 07
MALE STERILIZATION 08
RHYTHM, COUNTING DAY 09
NATURAL FP, MUCUS 10
WITHDRAWAL 11
NO (OTHER) METHOD 95
OTHER (SPECIFY) _________ 96
2ND WIFE
PILL 01
IUD 02
INJECTIONS 03
IMPLANTS/NORPLANT 04
DIAPHRAGM/FOAM/JELLY 05
CONDOM 06
FEMALE STERILIZATION 07
MALE STERILIZATION 08
RHYTHM, COUNTING DAY 09
NATURAL FP, MUCUS 10
WITHDRAWAL 11
NO (OTHER) METHOD 95
OTHER (SPECIFY) _________ 96
3RD WIFE
PILL 01
IUD 02
INJECTIONS 03
IMPLANTS/NORPLANT 04
DIAPHRAGM/FOAM/JELLY 05
CONDOM 06
FEMALE STERILIZATION 07
MALE STERILIZATION 08
RHYTHM, COUNTING DAY 09
NATURAL FP, MUCUS 10
WITHDRAWAL 11
NO (OTHER) METHOD 95
OTHER (SPECIFY) _________ 96
4TH WIFE
PILL 01
IUD 02
INJECTIONS 03
IMPLANTS/NORPLANT 04
DIAPHRAGM/FOAM/JELLY 05
CONDOM 06
FEMALE STERILIZATION 07
MALE STERILIZATION 08
RHYTHM, COUNTING DAY 09
NATURAL FP, MUCUS 10
WITHDRAWAL 11
NO (OTHER) METHOD 95
OTHER (SPECIFY) _________ 96

SECTION 4. MARRIAGE AND SEXUAL BEHAVIOUR

401) PRESENCE OF OTHERS AT THIS POINT.

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

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

YES, CURRENTLY MARRIED 1 (GO TO 405)
YES, LIVING WITH A WOMAN 2 (GO TO 405)
NO, NOT IN UNION 3

403) Have you ever been married or living with a woman?

YES 1
NO 2 (GO TO 409)

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

SEPARATED 1 (GO TO 407)
DIVORCED 2 (GO TO 407)
WIDOWED 3 (GO TO 407)

405) How many wives do you have?

NUMBER

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

MONTH
DOES NOT KNOW MONTH 98
YEAR (GO TO 409)
DOES NOT KNOW YEAR 98

408) How old were you when you started living with her?

AGE

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

YES 1
NO 2 (GO TO 411)

410) How many regular partners do you have (aside from your wife/wives)?

NUMBER

411) CHECK 402 AND 409

MARRIED OR LIVING WITH A WOMAN OR HAS A REGULAR PARTNER
NOT MARRIED AND NO REGULAR PARTNER (GO TO 414)

412) Now I need to ask you some questions about sexual activity in order to gain a better understanding of some family planning issues.

When was the last time you had sexual intercourse with your (wife/regular partner)?

IF RESPONDENT HAS BOTH WIFE AND REGULAR PARTNER, ASK WHEN HE LAST HAD SEX WITH EITHER.

NEVER 000 (GO TO 414)
DAYS AGO 1
WEEKS AGO 2
MONTHS AGO 3
YEARS AGO 4

413) For that sexual intercourse, was a condom used?

YES 1
NO 2

414) Have you had sexual intercourse with anyone (else) in the last 6 months? (I mean, with someone other than your wife or regular partner that you mentioned earlier)

YES 1
NO 2 (GO TO 417)

415) With how many different people have you had sexual intercourse in the last 6 months (apart from your wife or regular partners)?

NUMBER

416) Was a condom used with any of these women?

YES, EACH PERSON 1
YES, SOME PERSON 2
NO, WITH NO ONE 3

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

NEVER 000 (GO TO 424)
DAYS AGO 1
WEEKS AGO 2
MONTHS AGO 3
YEARS AGO 4

418) For that last sexual intercourse, did you give money, gifts or favours in return for sex?

CASH 1
GIFT 2
BOTH CASH AND GIFT 3
NONE 4

419) Was this person someone you had met before or someone you met for the first time?

MET BEFORE 1
MET FOR FIRST TIME 2

420) Was a condom used for that last sexual intercourse?

YES 1 (GO TO 421A)
NO 2

421) What was the main reason that you did not use a condom that time?

NO KNOWLEDGE ABOUT CONDOM 01
CONDOMS NOT AVAILABLE 02
CONDOM TOO COSTLY 03
WANTED MORE CHILDREN 04
TRUST EACH OTHER 05
PARTNER DOES NOT APPROVE 06
CONDOM USE IS CUMBERSOME 07
OTHER (SPECIFY) _________ 96
DOES NOT KNOW 98

421A) CHECK 412 AND 417

HAD SEX IN LAST 4 WEEKS
NO SEX IN LAST 4 WEEKS (GO TO 424)

422) In the last four weeks, how many times have you had sexual intercourse?

NUMBER OF TIMES
DOES NOT KNOW 98

423) Was a condom used on any of these occasion? IF YES: Was it each time or sometimes?

YES, EACH TIME 1
YES, SOMETIMES 2
NEVER 3

424) Who did you have sex with the last time you had sexual intercourse? Was it with (your wife / the woman you are living with) or was it with someone else?

SPOUSE 1
REGULAR PARTNER 2
SOMEONE ELSE 3
NO ONE / NEVER HAD SEX 4

425) CHECK 303:

DID NOT USE CONDOM AS CONTRACEPTIVE METHOD
USED CONDOM AS CONTRACEPTIVE METHOD (GO TO 428)

426) Do you know where you can get condoms?

YES 1
NO 2 (GO TO 429)

427) 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) ____________________

PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
DISPENSARY/HEALTH UNIT 13
MOBILE CLINIC 14
FIELD WORKER 15
OTHER PUBLIC (SPECIFY) ____________ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY/DRUG STORE 22
PRIVATE DOCTOR 23
MOBILE CLINIC 24
FIELD WORKER 25
OTHER PRIVATE MEDICAL (SPECIFY) _________ 26
OTHER PRIVATE SECTOR
SHOP 31
CHURCH 32
FRIENDS/RELATIVES 33
OTHER (SPECIFY) ________ 96

428) Have you heard of a condom called 'Protector'?

YES 1
NO 2

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

LIKE MEN TO USE CONDOM 1
DON'T LIKE MEN TO USE CONDOM 2
DOES NOT MATTER 3
OTHER (SPECIFY) ____________ 6
DOES NOT KNOW 8

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

AGE
NEVER HAD SEX 95
FIRST TIME WHEN MARRIED 96

SECTION 5: FERTILITY PREFERENCES

501) CHECK 402 AND 409:

CURRENTLY IN UNION OR HAVING A REGULAR PARTNER
NOT CURRENTLY IN UNION NOR HAVING A REGULAR PARTNER (GO TO 504A)

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

WIFE 1
APPROVES 1
DISAPPROVES 2
DOES NOT KNOW 8
WIFE 2
APPROVES 1
DISAPPROVES 2
DOES NOT KNOW 8
WIFE 3
APPROVES 1
DISAPPROVES 2
DOES NOT KNOW 8
WIFE 4
APPROVES 1
DISAPPROVES 2
DOES NOT KNOW 8

503) Do you think your wives/partners wants the same number of children that you want, or does she want more or fewer that you want?

WIFE 1
SAME NUMBER 1
MORE CHILDREN 2
FEWER CHILDREN 3
DOES NOT KNOW 8
WIFE 2
SAME NUMBER 1
MORE CHILDREN 2
FEWER CHILDREN 3
DOES NOT KNOW 8
WIFE 3
SAME NUMBER 1
MORE CHILDREN 2
FEWER CHILDREN 3
DOES NOT KNOW 8
WIFE 4
SAME NUMBER 1
MORE CHILDREN 2
FEWER CHILDREN 3
DOES NOT KNOW 8

504A) CHECK 308

NEITHER STERILIZED
HE OR SHE STERILIZED (GO TO 511)

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

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

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

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

506) CHECK 307: USING A METHOD?

NOT ASKED
NOT CURRENTLY USING
CURRENTLY USING (GO TO 511)

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

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

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

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

509) Which method would you prefer to use?

PILL 01 (GO TO 511)
IUD 02 (GO TO 511)
INJECTIONS 03 (GO TO 511)
IMPLANTS 04 (GO TO 511)
DIAPHRAGM/FOAM/JELLY 05 (GO TO 511)
CONDOM 06 (GO TO 511)
FEMALE STERILIZATION 07 (GO TO 511)
MALE STERILIZATION 08 (GO TO 511)
PERIODIC ABSTINENCE 09 (GO TO 511)
WITHDRAWAL 10 (GO TO 511)
OTHER (SPECIFY) _________ 96 (GO TO 511)
UNSURE 98 (GO TO 511)

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

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

511) 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? PROBE FOR NUMERIC RESPONSE.
NUMBER
OTHER (SPECIFY) ___________ 96 (GO TO 513)
NO LIVING CHILDREN
If you could choose exactly the number of children to have in your whole life, how many would that be? PROBE FOR A NUMERIC RESPONSE.
NUMBER
OTHER (SPECIFY) ___________ 96 (GO TO 513)

512) How many of these children would you like to be boys and how many would you like to be girls?

NUMBER BOYS
NUMBER GIRLS
NUMBER EITHER
OTHER (SPECIFY) _________ 969696

513) In general, do you approve or disapprove of couples using a method to avoid pregnancy?

APPROVE 1
DISAPPROVE 2
NO OPINION 8

514) Is it acceptable or not acceptable to you for information on family planning to be provided:

On the radio?
ACCEPTABLE 1
NOT ACCEPTABLE 2
DOES NOT KNOW 8
On the television?
ACCEPTABLE 1
NOT ACCEPTABLE 2
DOES NOT KNOW 8

515) In the last six months have you heard or learned about family planning:

On the radio?
YES 1
NO 2
On the television?
YES 1
NO 2
In a newspaper or magazine?
YES 1
NO 2
From a poster?
YES 1
NO 2
From leaflets or brochures?
YES 1
NO 2

516) CHECK 515:

YES, HEARD FAMILY PLANNING PROGRAM ON THE RADIO
NO, DID NOT HEAR (GO TO 518)

517) Which program or message have you heard? Any others?

ON THE RADIO AND TELEVISION.

KONOWEEKA A
ADVERTISEMENT FOR CONDOM/PILL B
OTHER (SPECIFY) _________ X

518) Do you think that the using of family planning will make a woman more promiscuous?

YES 1
NO 2
DOES NOT KNOW 8

519) Do you think that the using of family planning will make a man more promiscuous?

YES 1
NO 2
DOES NOT KNOW 8

520) What do you understand by the term "family planning"? RECORD ALL MENTIONED

ADVICE ON PRODUCING CHILDREN A
NOT TO HAVE MANY CHILDREN B
SPACING CHILDREN TO HAVE A MANAGEABLE FAMILY C
PLANNING A BRIGHT FUTURE D
PRODUCE FEW CHILDREN, EDUCATE AND FEED THEM E
OTHER (SPECIFY) __________ X
DOES NOT KNOW Z

521) In a relationship, who do you think should have the major role using family planning?

MAN 1
WOMAN 2
BOTH 3
IT DEPENDS 4
FAMILY PLANNING SHOULD NOT BE USED 5
DOES NOT KNOW 8

522) Who should be responsible in getting information about family planning?

MAN 1
WOMAN 2
BOTH 3
IT DEPENDS 4
FAMILY PLANNING SHOULD NOT BE USED 5
DOES NOT KNOW 8

523) Have you seen/heard about the Yellow Family Planning Flower?

YES 1
NO 2 (GO TO 601)
DOES NOT KNOW 8 (GO TO 601)

524) Can you describe it?

YELLOW FLOWER IN A CIRCLE 1
SMALL FAMILY INSIDE THE FLOWER 2
A MAN, WOMAN, AND TWO CHILDREN 3
OTHER (SPECIFY) _______________ 6
DOES NOT KNOW 8

525) What does it mean?

FP SERVICES ARE AVAILABLE 1
HIGH QUALITY SERVICES ARE AVAILABLE 2
OTHER (SPECIFY) ____________ 6
DOES NOT KNOW 8

SECTION 6. AIDS

601) Have you heard about disease that can be transmitted through sex?

YES 1
NO 2 (GO TO 606)

602) Which diseases do you know?

RECORD ALL RESPONSES

SYPHILIS/KABOTONGO A
GONORRHEA/NZIKO B
AIDS/SLIM DISEASE C
OTHER (SPECIFY) _________ W
OTHER (SPECIFY) _________ X
DOES NOT KNOW Z

603) CHECK 424:

HAS HAD SEX
HAS NEVER HAD SEX (GO TO 606)

604) During the last 12 months, did you have any of these diseases?

YES 1
NO 2 (GO TO 606)
DON'T KNOW 8 (GO TO 606)

605) Which?

RECORD ALL RESPONSES

SYPHILIS/KABOTONGO A
GONORRHEA/NZIKO B
AIDS/SLIM DISEASE C
OTHER (SPECIFY) _________ W
OTHER (SPECIFY) _________ X
DON'T KNOW Z

606) During the last 12 months, did you have a discharge from your penis?

YES 1
NO 2
DON'T KNOW 8

607) During the last 12 months, did you have a sore or ulcer on your penis?

YES 1
NO 2
DON'T KNOW 8

608) CHECK 605, 606 AND 607:

HAD ONE OR MORE DISEASES
NONE OF THE DISEASES (GO TO 614)

609) When you had the most recent episode of (DISEASE FROM 605, 606, AND 607) did you seek advice or treatment?

ADVICE/TREATMENT 1
SELF TREATMENT 2 (GO TO 610A)
DID NOT DO ANYTHING 8 (GO TO 610A)

610) Where did you seek advice or treatment? Any other place or person?

RECORD ALL MENTIONED

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
DISPENSARY/HEALTH UNIT C
MOBILE CLINIC D
FIELD WORKER E
OTHER PUBLIC (SPECIFY) ________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY/DRUG STORE H
PRIVATE DOCTOR I (GO TO 610B)
MOBILE CLINIC J
FIELD WORKER K
OTHER PRIVATE MEDICAL (SPECIFY) ________ L
OTHER PRIVATE SECTOR
SHOP M
CHURCH N
FRIENDS/RELATIVES O
TRADITIONAL HEALER P
OTHER (SPECIFY) _________ X
DON'T KNOW Z

610A) Why did not you seek advice or treatment?

EMBARRASSED 1
TOO EXPENSIVE/COSTLY 2
TREATMENT IS NOT AVAILABLE 3
DOES NOT KNOW WHERE TO GO 4
OTHER (SPECIFY) __________ 6

610B) CHECK 424:

HAS HAD SEX
HAS NEVER HAD SEX (GOT TO 614)

611) When you had the most recent episode of (DISEASE FROM 605, 606, AND 607) did you inform your partner?

YES 1
NO 2

612) When you had the most recent episode of (DISEASE FROM 605, 606, AND 607) did you do something not to infect your partner?

YES 1
NO 2 (GO TO 614)
PARTNER ALREADY INFECTED 3 (GO TO 614)

613) What did you do?

NO SEXUAL INTERCOURSE A
USED CONDOM B
TOOK MEDICINES C
OTHER (SPECIFY) __________ X

614) CHECK 602:

DID NOT MENTION 'AIDS'
MENTIONED 'AIDS' (GO TO 616)

615) Have you ever heard of an illness called AIDS?

YES 1
NO 2 (GO TO 701)

616) From which sources of information have you learned most about AIDS? Any other sources?

RECORD ALL MENTIONED.

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

617) How can a person get AIDS? Any other ways?

RECORD ALL RESPONSES

SEXUAL INTERCOURSE A
PAY FOR SEX (PROSTITUTES) B
HOMOSEXUAL CONTACT C
SEXUAL INTERCOURSE WITH MULTIPLE PARTNERS D
BLOOD TRANSFUSION E
UNSTERILIZED EQUIPMENT F
MOTHER TO CHILD (AT BIRTH) G
BREASTFEEDING H
KISSING I
MOSQUITO BITES J
OTHER (SPECIFY) _________ W
OTHER (SPECIFY) _________ X
DON'T KNOW Z

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

YES 1
NO 2 (GO TO 620)
DOES NOT KNOW (GO TO 620)

619) What can a person do to avoid getting AIDS or the virus that causes AIDS? Any other ways?

RECORD ALL MENTIONED

DO NOT HAVE SEX AT ALL A
USE CONDOMS DURING SEX B
DON'T HAVE SEX WITH PROSTITUTES C
DON'T HAVE SEX WITH HOMOSEXUALS D
DO NOT HAVE MANY SEX PARTNERS E
HAVE ONE FAITHFUL PARTNER (ZERO GRAZING) F
AVOID BLOOD TRANSFUSIONS G
AVOID UNSTERILIZED EQUIPMENT H
AVOID KISSING I
AVOID MOSQUITO BITES J
SEEK PROTECTION FROM TRADITIONAL HEALER K
DO NOT DRINK TOO MUCH ALCOHOL L
OTHER (SPECIFY) _________ W
OTHER (SPECIFY) _________ X
DON'T KNOW Z

620) Is it possible for a healthy-looking person to have the AIDS virus?

YES 1
NO 2
DOES NOT KNOW 8

621) Is AIDS a fatal disease, that is, do all people with AIDS die from the disease?

YES 1
NO 2
DOES NOT KNOW 8

622) Can AIDS be transmitted from mother to child?

YES 1
NO 2
DOES NOT KNOW 8

623) Can AIDS be transmitted through breastfeeding?

YES 1
NO 2
DOES NOT KNOW 8

624) Do you personally know someone who has AIDS or has died of AIDS?

YES 1
NO 2 (GO TO 625)
DOES NOT KNOW 8 (GO TO 625)

624A) What relationship to you?

SPOUSE A
SIBLINGS B
FRIENDS/RELATIVES C
NEIGHBOURS D
OTHERS (SPECIFY) __________ X

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

SMALL 1
MODERATE 2 (GO TO 627)
GREAT 3 (GO TO 627)
NO RISK AT ALL 4

626) Why do you think that you have (NO RISK/A SMALL CHANCE) of getting AIDS? Any other reasons?

RECORD ALL MENTIONED.

ABSTAIN FROM SEX A (GO TO 628)
USE CONDOMS DURING SEX B (GO TO 628)
HAVE ONLY ONE SEX PARTNER C (GO TO 628)
LIMITED NUMBER OF PARTNERS D (GO TO 628)
NO HOMOSEXUAL CONTACT E (GO TO 628)
NO BLOOD TRANSFUSIONS F (GO TO 628)
NO INJECTIONS G (GO TO 628)
OTHER (SPECIFY) __________ X (GO TO 628)
DOES NOT KNOW Z (GO TO 628)

627) Why do you think that you have a (MODERATE/GREAT) chance of getting AIDS? Any other reasons?

RECORD ALL MENTIONED.

DO NOT USE CONDOMS A
MULTIPLE SEX PARTNERS B
SPOUSE HAS MULTIPLE PARTNERS C
HOMOSEXUAL CONTACT D
HAD BLOOD TRANSFUSION E
HAD INJECTIONS F
OTHER (SPECIFY) _________ X
DOES NOT KNOW Z

628) Since you heard of AIDS, have you changed your sexual behaviour to prevent getting AIDS?

YES 1
NO 2 (GO TO 630)
DOES NOT KNOW 8 (GO TO 630)

629) What did you do? Anything else?

RECORD ALL MENTIONED

RESTRICTED SEX TO ONE PARTNER A
STARTED USING CONDOMS B
REDUCED NUMBER OF PARTNERS C
STOPPED ALL SEX D
NO MORE HOMOSEXUAL CONTACT E
STOPPED SEX WITH A PROSTITUTE F
OTHER (SPECIFY) __________ X
DOES NOT KNOW Z

630) Some people use a condom during sexual intercourse to avoid getting AIDS or other sexually transmitted diseases? Have you ever heard of this?

YES 1
NO 2 (GO TO 632)

630A) CHECK 424:

HAS HAD SEX
HAS NEVER HAD SEX (GO TO 632)

631) Have you ever used a condom during sex to avoid getting or transmitting diseases, such as AIDS?

YES 1
NO 2

632) Have you ever been tested to see if you have the AIDS virus?

YES 1 (GO TO 636)
NO 2
DOES NOT KNOW/NOT SURE 8

633) Would you like to be tested for the AIDS virus?

YES 1
NO 2
DOES NOT KNOW/NOT SURE 8

634) Do you know a place where you could go to get an AIDS test?

YES 1
NO 2 (GO TO 636)
DOES NOT KNOW/NOT SURE 8 (GO TO 636)

635) Where could you go?

GOVERNMENT AND PARASTATAL PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
DISPENSARY/HEALTH UNIT C
MOBILE CLINIC D
FILED WORKER E
OTHER PUBLIC (SPECIFY) _________ F
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC G
PHARMACY/DRUG STORE H
PRIVATE DOCTOR I
MOBILE CLINIC J
FIELD WORKER K
OTHER PRIVATE MEDICAL (SPECIFY) __________ L
OTHER PRIVATE SECTOR
SHOP M
CHURCH N
FRIENDS/RELATIVES O
OTHER (SPECIFY) _________ X
DOES NOT KNOW Z

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

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

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

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

SECTION 7. MATERNAL MORTALITY

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

How many children did your mother give birth to, including you?

NUMBER OF BIRTHS TO NATURAL MOTHER

702) CHECK 701:

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

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

NUMBER OF PRECEDIING BIRTHS

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

______________

705) Is (NAME) male or female?

MALE 1
FEMALE 2

706) Is (NAME) still alive?

YES 1
NO 2 (GO TO 708)
DON'T KNOW 8 (GO TO NEXT COLUMN)

707) How old is (NAME)?

YEARS (GO TO NEXT COLUMN)

708) In what year did (NAME) die?

YEAR (GO TO 710)
DON'T KNOW 98

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

YEARS

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

YEARS (IF MALE OR DIED BEFORE 12 YEARS OF AGE GO TO NEXT COLUMN)

711) Was (NAME) pregnant when she died?

YES 1 (GO TO 714)
NO 2

712) Did (NAME) die during childbirth?

YES 1 (GO TO 715)
NO 2

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

YES 1
NO 2 (GO TO 715)

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

YES 1
NO 2

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

716) RECORD THE TIME.

HOURS
MINUTES

INTERVIEWER'S OBSERVATIONS

To be filled in after completing interview

Comments about Respondent:

_________________________________

Comments on Specific Questions:

_________________________________

Any Other Comments:

_________________________________

SUPERVISOR'S OBSERVATIONS

_________________________________

Name of Supervisor: ______________________

Date: _________

EDITOR'S OBSERVATIONS

_________________________________

Name of Editor: __________________________

Date: _________