REPUBLIC OF YEMEN

MINISTRY OF PLANNING AND DEVELOPMENT

CENTRAL STATISTICAL ORGANIZATION

YEMEN DEMOGRAPHIC AND CHILD HEALTH SURVEY

IDENTIFICATION

GORVERNORATE____

DISTRICT ____

URBAN/RURAL____

CLUSTER NAME____

CLUSTER NUMBER____

HOUSEHOLD NUMBER____

LINE NUMBER OF WOMEN____

INTERVIEWER VISITS

FIRST VISIT
NAME OF INTERVIEWER
DATE OF VISIT
STARTING TIME
ENDING TIME
DURATION OF INTERVIEW

RESULT

NEXT VISIT
DATE
TIME

SECOND VISIT
NAME OF INTERVIEWER
DATE OF VISIT
STARTING TIME
ENDING TIME
DURATION OF INTERVIEWER

RESULT

NEXT VISIT
DATE
TIME

FINAL VISIT
NAME OF INTERVIEWER
DATE OF VISIT
STARTING TIME
ENDING TIME
DURATION OF INTERVIEW

FIELD EDITING
NAME
DATE

OFFICE EDITING
NAME
DATE

DATA ENTRY
NAME
DATE

KEYED BY

SECTION 1. RESPONDENT'S RESOURCES

101) RECORD THE TIME.

102) First I would like to ask some questions about you. In what month and year were you born?

103) How old were you at your last birthday? COMPARE AND CORRECT 102 AND/OR 103 IF INCONSISTENT. IF RESPONDENT IS 55 OR MORE YEARS OF AGE, END INTERVIEW.

104) Have you always lived in (NAME OF PLACE)?

105) How long have you been living continuously in (NAME OF PLACE)?

106) Why did you come to (NAME OF PLACE)?

107) Was this before you were first married or after?

108) Was the place you were living in before coming to (NAME OF PLACE): a city, a town, or a village?

109) For most of the time until you were 12 years old, did you live in a city, a town, a large village, or a small village?

110) Have you ever attended or are you now attending school?

111) What (is/was) the highest level of education you attended?

112) What was the highest grade (year) you successfully completed at that level?

113) CHECK 111 AND 112

114) Can you read a letter or newspaper?

115) Can you write a letter, for example?

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

117) Do you watch television?

118) What is the suitable time for watching television?

119) Do you listen to radio?

120) What is the suitable time for listening to radio? CIRCLE ALL ANSWERS METIONED

121) Before you were first married, did you ever do any work regularly for which you were paid in cash?

122) When you were working then, what did you do with most of the money that you earned?

123) Was the money used mainly to prepare for marriage?

124) Since you were first married, have you ever done any work for cash?

125) Are you now doing any work for cash?

126) In this work, are you working on your own, for a family member, or for someone else?

127) Do you assist any family member in his/her work?

128) Do you assist someone not in the family in his/her work?

129) What kind of work do you mainly do? WRITE RESPONSE EXACTLY AS GIVEN

130) How many hours did you work in the past week?

131) CHECK 123

132) If a good opportunity for working for cash was available, would you want to work in the future?

SECTION 2. MARRIAGE AND CO-RESIDENCE

201) Are you now married, widowed, divorced, or separated?

202) Does your husband have another wife? IF 'YES': How many?

203) Have you been married only once or more than once?

204) Is (was) there a blood relation between you and your (last) husband? IF 'YES': What is (was) the type of this relation?

205) Is (was) there a blood relation between you and your (FIRST) husband? IF 'YES': What is (was) the type of this relation?

206) In what month and year did you and your (first) husband begin to live together "zifaf"?

207) At what age did you and your (first) husband begin to live together "zifaf"?

208) At the time you first married, did you and your (first) husband have your own home or did you begin by living in someone else's home?

209) At the time of your (first) marriage, did anyone else live with you?

210) With whom did you live (who lived with you) for at least six months after you (first) married? CIRCLE ALL RESPONSES MENTIONED

211) CHECK 210

212) For how long did you live together with (SPECIFY) at that time?

213) What was the longest period you lived together with (any) of them?

SECTION 3. REPRODUCTION AND CHILD SURVIVAL

301) During your lifetime, have you ever given birth to a baby born alive?

302) Do you have any sons or daughters to whom you have given birth who are now living with you?

303) How many sons live with you? And how many daughters live with you? IF NONE, ENTER "00"

304) Do you have any sons or daughters to whom you have given birth and who are alive but not living with you?

305) 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 ENTER "00"

306) Have you ever given birth to a boy or a girl who was born alive but later died? IF NO, PROBE: Any (other) boy or girl who cried or showed any sign of life, but only survived a few hours or days?

307) How many boys have died? And how many girls have died? IF NONE ENTER "00"

308) SUM ANSWERS TO 303, 305, AND 307 AND ENTER TOTAL.

309) CHECK 308: Just to make sure that I have this right, you have had in total ____ live births during your life. Is this correct?

310) CHECK 308

311) Now I would like to talk to you about your births, whether still alive or not, starting with the first one you had. RECORD NAMES OF ALL BIRTHS IN 313. IF NO NAME WAS GIVEN, PUT "X" IN 313. RECORD TWINS ON SEPARATE LINES AND MARK WITH A BRACKET. ASK 314 THROUGH 318 AS APPROPRIATE FOR EACH BIRTH. AFTER RECORDING ALL BIRTHS WOMAN HAS HAD, GO TO 319.

312) BIRTH ORDER

313) What name was given to your (first, etc) baby?

314) Is (NAME) a boy or a girl?

315A) In what year was (NAME) born?

IF DON'T KNOW, ASK: How many years ago?

315B) And in what month?

IF DON'T KNOW, ASK: In what season?

316) Is (NAME) still living?

317) IF DEAD: How old was (NAME) when he/she died?

RECORD DAYS IF LESS THAN 1 MONTH; MONTHS IF LESS THAN 2 YEARS; OR YEARS

318) Was year of birth derived from a document?

319) COMPARE 308 AND 309 WITH NUMBER OF BIRTHS IN TABLE ABOVE AND MARK:

320) In addition to the pregnancies which ended in live births, have you had any other pregnancy which ended in a miscarriage, still birth, or an abortion? PROBE: Any other pregnancy which lasted only a few weeks or months?

321) Have you had any pregnancy which ended in a miscarriage, still birth, or abortion? PROBE: Any other pregnancy which lasted only a few weeks or months?

322) How many pregnancies ended in still births? IF NONE, ENTER "00"

323) How many pregnancies ended in miscarriages and abortions? IF NONE, ENTER "00"

324) Are you pregnant now?

325) For how many months have you been pregnant?

326) How long ago did your last menstrual period start?

327) At what age did you have your first menstrual period?

328) CHECK 324

329) CHECK "LIVE BIRTHS TABLE."

SECTION 4. ANTENATAL CARE: CURRENT PREGNANCY

401) Did you see anyone for a check-up on this pregnancy?

402) How many months were you pregnant when you had your first check-up?

403) Was there any complaint which led you to have a check-up?

404) How many check-ups did you have since you became pregnant?

405) Have you seen any of the following persons during the check-up(s) on your pregnancy?

406) How many weeks ago was the last check-up?

407) Where did you have the last check-up?

408) How long did it take to get to (PLACE IN 407)?

409) How did you go to (PLACE IN 407)?

410) How long did you have to wait at (NAME OF PLACE) for check-up?

411A) Were you satisfied with the care you got during your last check-up in (PLACE IN 407)?

411B) IF ANSWER IN 411A IS "NO," ASK ABOUT THE REASON FOR DISSATISFACTION WITH CARE RECEIVED. CIRCLE ALL RESPONSES MENTIONED

412) What was the main reason for not having a check-up for the current pregnancy?

413) Are you taking now any of the following?

414) Since the beginning of this pregnancy, have you been given any injection to prevent the baby from getting convulsions after birth, i.e., an anti-tetanus shot? IF YES: How many injections did you have?

415) Since you have been pregnant, did you have any of the following conditions?

416) Does anyone help you now with your usual daily chores? IF "YES": Who is helping you? CIRCLE ALL APPLICABLE CODES

417) When you have your baby do you expect anyone to help you looking after the baby? IF "YES": Who? IF MORE THAN ONE PERSON, PROBE AND CIRLE PERSON EXPECTED TO PROVIDE MOST HELP.

418) Where do you plan to deliver your baby?

419) Who will assist you with the delivery?

420) How much would the delivery cost?

421) Would you prefer to have a boy or a girl?

422) Do you plan to breastfeed your baby? IF "YES": For how long?

423) CHECK "LIVE BIRTHS TABLE."

SECTION 5. MATERNAL CARE: THE LAST FIVE YEARS

CHECK BIRTH HISTORY TABLE AND ENTER NAMES OF ALL CHILDREN BORN IN THE "LAST FIVE YEARS," STARTING WITH "LAST LIVE BIRTH."

501) LIN NUMBER OF CHILD IN "BIRTH HISTORY TABLE"

502) SURVIVAL STATUS: CHECK 316

503) When you were pregnant with (NAME), did you see anyone for a check-up on the pregnancy?

504) Was there any complaint which led you to have the check-up?

505) How long were you pregnant with (NAME) when you had the first check-up?

506) How many check-ups did you have during the pregnancy?

507) Whom did you usually see? RECORD THE MOST QUALIFIED

508) Where did you usually have the check-up(s)?

509) What was the main reason for not having a check-up on the pregnancy?

510A) When you were pregnant with (NAME) were you given any injection to prevent the baby from getting convulsions after birth, i.e., an anti-tetanus shot?

510B) How many shots?

511) Where was (NAME) delivered?

512) Who assisted with the delivery of (NAME)? RECORD THE MOST QUALIFIED

513) Was the delivery normal or were there any complications?

514) CHECK 511

515) Why did you have the delivery of (NAME) at (hospital/clinic)?

516) Did you have a cesarean section while delivering (NAME)?

517) Why did you not have the delivery of (NAME) at a public hospital or a private clinic? CIRCLE MAIN REASON

518) How was the umbilical cord cut?

519A) How was the cord stump treated?

519B) Was (NAME) born on time (9 months) or before time?

520) When (NAME) was born, was his/her weight normal, below normal, or above normal?

521) Was (NAME) weighed at the time of birth?

522) How much was the weight in grams?

523) During the six-week period (i.e., Nifath period) following the birth of (NAME), did you see anyone for a check-up on your health? IF "YES": Whom did you see? RECORD THE MOST QUALIFIED

524) How many months after the birth of (NAME) did your period return

SECTION 6. CHILD FEEDING

CHECK BIRTH HISTORY TABLE AND ENTER NAMES OF ALL CHILDREN BORN IN THE "LAST FIVE YEARS," STARTING WITH "LAST LIVE BIRTH."

LINE NUMBER OF CHILD IN "BIRTH HISTORY TABLE"

SURVIVAL STATUS: CHECK 316

601) Did you ever feed (NAME) at the breast?

602) How soon after the birth of (NAME) did you start breastfeeding?

603) Why did you never breastfeed (NAME)?

604) Have you ever given (NAME) powdered milk on a regular basis? IF 'YES': How old was the child when you started on a regular basis?

605) Have you ever given (NAME) animal milk such as cow's , goat's, or camel's milk on a regular basis? IF "YES": How old was the child when you started on a regular basis?

606) Have you ever given (NAME) solid or mushy food on a regular basis? IF "YES": How old was the child when you started on a regular basis?

607) CHECK 316 AND 601 AND CIRCLE APPROPRIATE CODE.

608) Are you still breastfeeding (NAME)?

609) How many times did you breastfeed (NAME) yesterday during the daylight hours?

610) How many times did you breastfeed (NAME) last night between sunset and sunrise?

611) Do you breastfeed (NAME) whenever he/she wants or according to a fixed schedule?

612) When (NAME) has diarrhea, what do you do with breastfeeding? Do you continue without change, increase, decrease, or stop breastfeeding?

613) How many months did you breastfeed (NAME)?

614) Why did you stop breastfeeding him/her at that age? RECORD MAIN REASON

615) Did you stop breastfeeding suddenly or progressively?

616) When you weaned (NAME), did you put "Mor" or "Sabr" or any other thing of that type on the breast?

617) CHECK 316

618) Is (NAME) being given any of the following types of liquid and food?

619) Was (NAME) ever fed regularly from a bottle with a nipple?

620) How old was (NAME) when you began to feed him/her with a bottle?

SECTION 7. CAUSE OF DEATH FOR CHILDREN WHO DIED

CHECK BIRTH HISTORY TABLE AND ENTER NAMES OF ALL CHILDREN BORN IN THE "LAST FIVE YEARS," STARTING WITH "LAST LIVE BIRTH."

LINE NUMBER OF CHILD IN "BIRTH HISTORY TABLE"

701) CHECK 316 IN BIRTH HISTORY TABLE

702) DURING THE TWO WEEKS BEFOR (NAME) DIED, DID HE/SHE HAVE ANY OF THE FOLLOWING SYMPTOMS?

703) What was the main cause of his/her death?

704) Was anyone consulted before the death of (NAME)?

705) Who was consulted?

SECTION 8. FAMILY PLANNING AND CHILDBEARING ATTITUDES

801) How I would like to talk about a different topic. There are various methods that a couple can use to delay or avoid a pregnancy. Which of these methods or ways have you heard about? CIRCLE CODE 1 IN 802 FOR EACH METHOD MENTIONED SPONTANEOUSLY. THEN PROCEED DOWN THE COLUMN, READING THE NAME OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 2 IF THE METHOD IS RECOGNIZED, AND CODE 3 IF NOT RECOGNIZED. THEN FOR EACH METHOD WITH CODE 1 OR 2 CIRCLED IN 802, ASK 803.

804) CHECK 803

805) How many living sons and how many living daughters, if any, did you have when you first used a family planning method?

806) When you first began to use family planning, did you want to have another child but at a later time or did you want to stop childbearing?

807) CHECK 201

808) CHECK 325

809) Are you currently using any method of family planning?

810A) Which method are you using?

810B) Did you consult a doctor or a nurse when you started using it?

811) How much does one packet (cycle) of pills cost you?

812) Who obtained the packet (cycle) of pills the last time?

813) How much did it cost to have the IUD inserted?

814) Did you get the IUD at the place where you had it inserted or did you get it somewhere else?

815) How much did it cost to get the IUD at (PLACE WHERE IUD WAS BOUGHT)?

816) In what month and year did you (your husband) have the operation?

817A) Where did you (your husband) obtain the pill the last time?

817B) Where was the IUD which you are using now inserted?

817C) Where did you obtain the (METHOD)?

817D) Where did the sterilization take place?

818A) How much time does it take to go to this place?

818) Was there anything you particularly disliked about the services you (your husband) received from that source? IF "YES": What? RECORD MAIN REASON

819) CHECK 803

820) For how long have you been using (CURRENT METHOD) continuously?

821) Have you experienced any problems from using (CURRENT METHOD)?

822) What is the main problem you experienced?

823) Which was the last method of family planning you used?

824) CHECK 201

825) Do you intend to use a method of family planning at any time in the future?

826) Which method would you prefer to use?

827) When do you plan to begin using (METHOD)?

828) What is the main reason that you do not want to use a method of family planning?

829) Have you ever talked with your husband about family planning?

830) In your opinion, in general, does your husband approve or disapprove of couples using a method of family planning?

831) CHECK 325

832) After the child you are expecting, would you like to have another child or would you prefer not to have any more children?

833) Would you like to have a/another child or would you prefer not to have any (more) children?

834) Would you prefer your next child to be a boy or a girl?

835) CHECK 303 AND 305

836) If you could choose exactly the number of children to have in your whole life, how many would that be?

837) 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?

838) CHECK 201

839) If your husband could choose exactly the number of children for you to have, without regard to the number of children that you already have, how many do you think that would be?

840) In your opinion, what level of education would you like (your daughter/a girl) to obtain?

841) In your opinion, what level of education would you like (your son/a boy) to obtain?

842) In your opinion, what is the most suitable age for (your daughter/a girl) have?

843) In your opinion, how many children should (your daughter/a girl) have?

844) Would you approve or disapprove of your daughter(s) (girls) working if a good opportunity for earning cash were available?

845) Do you approve or disapprove of female circumcision?

846) Why is that? CIRCLE THE MOST IMPORTANT REASON

847) What is the main reason for that?

SECTION 9. HUSBAND'S RESOURCES

901) How I would like to ask some questions about your (last/late) husband. Did he ever attend school?

902) What was the highest level of education he attended?

903) What was the highest grade (year) he completed at that level?

904) CHECK 902 AND 903

905) Can (could) he write a letter, for example?

906) Can (could) he write a letter, for example?

907) What is (was) his occupation; that is, what kind of work does (did) he mainly do?

908) CHECK 907

909) Does (did) your husband work mainly on his or family land, or on someone else's land?

910) Does (did) he work mainly for money or does (did) he work for a share of the crops?

911) Does (did) he earn a regular wage or salary?

912) CHECK 201

913) Does your husband have any additional or secondary job? IF 'YES': What does he do?

914) How old is your husband now?

915) Has your husband been living with you here continuously during the last three months or has he been away?

916) What is the reason for his absence?

917) In what country does he work now?

918) For how long has he been away?

INTERVIEWER'S OBSERVATIONS

A) DEGREE OF COOPERATION

B) PRIVACY OF INTERVIEW

C) IF "OTHERS" PRESENT: MARK WHETHER ANY OF THE FOLLOWING WERE PRESENT DURING THE INTERVIEW

CHILD HEALTH QUESITONNAIRE

CHECK "HOUSEHOLD ROSTER" AND ENTER NAME OF ALL CHILDREN UNDER FIVE YEARS OF AGE, STARTING WITH THE YOUNGEST.

100) LINE NUMBER OF CHILD IN "HOUSEHOLD SCHEDULE"

101) AGE OF CHILD

102) LINE NUMBER OF MOTHER IN "HOUSEHOLD SCHEDULE"

103) LINE NUMBER OF CHILD IN "BIRTH HISTORY"

104) NUMBER OF VISITS AND RESULT* OF INTERVIEW (SEE PRECEDING PAGE FOR CODES

105) LINE NUMBER OF PERSON ANSWERING THIS QUESTIONNAIRE FROM THE HOUSEHOLD SCHEDULE

106) Who is primarily responsible for the care of (NAME)?

107) LINE NUMBER OF CARETAKER

108) Do you (Does caretaker) give the care of (NAME) to another person when you leave home for an extended period, either for work, visiting shopping, or other reasons?

109) With whom do you leave (NAME)? RECORD ALL PERSONS MENTIONED AND ENTER LINE NUMBER OF EACH PERSON MENTIONED AS SHOW ON HOUSEHOLD ROSTER. IF PERSON MENTIONED NOT MEMBER OF HOUSEHOLD, CIRCLE 96.

110) SEE 109 AUNT/GRANDMOTHER MENTIONED AND LINE NUMBER OF EITHER OR BOTH IS 96

111) Where does (do) aunt (and/or grandmother) live?

112) Does the father of (NAME) play regularly with him/her, say, for a half-hour or more? IF IN HOUSEHOLD SCHEDULE 106, FATHER IS DECEASED, THEN DON'T ASK THE QUESTION, CIRCLE CODE 6.

SECTION 2. MORBIDITY: DIARRHEA

201) Now I would like to ask some questions about any illnesses your children might have had recently. Has (NAME) had diarrhea in the last 24 hours?

202) Has (NAME) had diarrhea in the last two weeks?

203) For how many days did the last episode of diarrhea last?

204) How many days ago did the diarrhea start?

205) Was (is) the diarrhea mild or sever?

206) During this (the last) episode of diarrhea, how many liquid stools did (NAME) have on worst day?

207) Was there blood and/or mucus in the stools?

208) Did (NAME) also have fever?

209) Did he/she experience vomiting?

210) Did he/she also experience dehydration?

211) When (NAME) had diarrhea then, was he/she given more, less, or the same amount of liquid as before the diarrhea?

212) Was (NAME) given either a home solution of sugar, salt, and water to drink, or a solution made from an ORS packet? IF "YES": Which?

213) For how many days was (NAME) given (home solution/special packet)?

214) The last time (NAME) was given (home solution/special packet), did he/she get better, worse, or was there no change?

215) Was (NAME) given more, less, or the same amount of solid food as was given before he/she had diarrhea?

216) Was (NAME) taken to any of the following persons or places during the last episode of diarrhea?

217) CHECK 216

218) What treatment did (NAME) receive there in the last visit? CIRCLE ALL TREATMENTS MENTIONED

219) Why was (NAME) not taken somewhere for treatment during the last episode of diarrhea? RECORD MAIN REASON

220) CHECK 212

221) Have you ever heard of a special product called ORS (LOCAL NAME) you can get for the treatment of diarrhea?

222) Have you ever prepared one of the ORS packets for yourself or for someone else?

223) The last time you used ORS, how much water did you use to prepare the packet?

224) Did you use boiled water, bottled water, or other water to prepare the packet (the last time)?

225) Where can you get ORS packets? MARK ALL ANSWERS GIVEN

226) How much do (you think) the packets cost?

SECTION 3. MORBIDITY: OTHER ILLNESS

301) Did (NAME) have a cough at any time during the last two weeks?

302) For how many days did he/she have the cough the last time?

303) Did (NAME) also experience difficulty in breathing when he/she had the cough?

304) How was (NAME) treated from the cough or shortness of breath? CIRCLE ALL TREATMENTS MENTIONED.

305) Was the advice of the following persons sought on how to treat the cough? READ OUT LIST

306) Did (NAME) have fever at any time during the last two weeks?

307) How was (NAME) treated from the fever? CIRCLE ALL TREATMENTS MENTIONED

308) Was the advice of any of the following sought on how to treat his/her from the fever? READ OUT LIST

309) Did he/she have pus coming from his/her ears during the last two weeks?

310) Did he/she have pus coming from his/her eyes during the last two weeks?

311) Did (NAME) have any (other) illness during the last two weeks?

312) hat was this illness?

313) Did (NAME) ever have the measles?

314) How old was (NAME) when he/she had the measles?

SECTION 4: IMMUNIZATION

401) Is there an immunization card (or local equivalent) for (NAME)? IF "YES": May I see it please?

402) RECORD DATES OF IMMUNIZATIONS FROM CARD. IF ALL DATES GIVEN, GO TO NEXT CHILD ELSE GO TO 403

403) Has (NAME) ever been given any "vaccination drops" in the mouth to protect him/her against illness?

404) How many times has (NAME) been given these drops?

405) Has (NAME) ever been given "vaccination injections" to protect him/her from getting diseases?

406) SEE 402, 403, AND 405

407) Why was (NAME) not (fully) immunized?

SECTION 5. ACCIDENTS

501) Has (NAME) ever been involved in a serious accident?

502) When did this accident happen?

503) What was this accident?

504) What was the external cause of this accident?

505) Where did this accident happen to (NAME)?

506) Was there any long-term implication resulting from the accident?

507) What was it?

SECTION 6. WEIGHT AND HEIGHT

601) WEIGHT (IN KILOGRAMS)

602) LENGTH/HEIGHT (IN CENTIMETERS)

603) STATE REASON IF UNABLE TO RECORD

604) TIME