REPUBLIC OF YEMEN
MINISTRY OF PUBLIC HEALTH AND POPULATION
CENTRAL STATISTICAL ORGANIZATION
NATIONAL HEALTH AND DEMOGRAPHIC SURVEY 2013

IDENTIFICATION

GOVERNORATE____

DIRECTORATE NAME____

SUB-DIRECTORATE NAME____

URBAN OR RURAL:

SECTOR NUMBER____

SECTION NUMBER____

CLUSTER NUMBER____

HOUSEHOLD NUMBER____

HOUSEHOLD CLUSTER NUMBER____

NAME OF HOUSEHOLD HEAD____

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
INT. NUMBER
RESULT*

TOTAL NUMBER OF VISITS

*RESULT CODES

FIELD EDITOR
NAME
SIGNATURE
DATE
CODE

SUPERVISOR
NAME
SIGNATURE
DATE
CODE

OFFICE EDITOR
NAME
SIGNATURE
DATE
CODE

KEYER
NAME
SIGNATURE
DATE
CODE

INTRODUCTION AND CONSENT

INFORMED CONSENT
Hello. My name is (INTERVIEWER'S NAME). I am working on the National Health and Demographic Survey which is implemented (by the Ministry of Public Health and Population and the Central Statistical Organization). We are conducting a survey about health all over Yemen. The information we collect will help the government to plan health services. Your household was selected for the survey. All of the answers you give will be confidential under Article (5) of the Statistics Law No. (28) for the year 1995 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.

Do you have any questions? May I begin the interview now?
SIGNATURE OF INTERVIEWER: ____ DATE: ____

RESPONDENT AGREES TO BE INTERVIEWED 1 (CONTINUE)
RESPONDENT DOES NOT AGREE TO BE INTERVIEWED 2 (END)

SECTION 1. RESPONDENT'S BACKGROUND

101) RECORD THE TIME.

102) In what month and year were you born?

103) How old were you on your last birthday? COMPARE AND CORRECT 102 AND/OR 103 IF INCONSISTENT.

104) Have you ever attended school?

105) What is the highest level of school you attended: primary, fundamental (preparatory, unified), diploma before secondary, secondary, diploma after secondary, or university/higher?

106) What is the highest (grade/year) you completed at that level?

IF COMPLETED LESS THAN ONE YEAR AT THAT LEVEL, RECORD '00'.

107) CHECK 105:

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

109) CHECK 108:

110) Do you read a newspaper or magazine every day, at least once a week, or not at all?

111) Do you listen to the radio every day, at least once a week, or not at all?

112) Do you watch television every day, at least once a week, or not at all?

112A) Are you currently married?

112B) What is your marital status now: are you widowed or divorced?

112C) Have you been married only once or more than once?

112D) CHECK 112C:

112E) How old were you when you started living with your (first) husband?

SECTION 2. REPRODUCTION

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

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

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

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

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

206) Have you ever given birth to a boy or girl who was born alive but died later? IF NO, PROBE: Any baby who cried or showed signs of life but did not survive?

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

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

209) CHECK 208: Just to make sure that I have this right: you have had in TOTAL ____ births during your life. Is that correct?

210) CHECK 208:

211) Now I would like to record the names of all your births, whether still alive or not, starting with the first one you had. RECORD NAMES OF ALL THE BIRTHS IN 212. RECORD TWINS ON SEPARATE ROWS. IF THERE ARE MORE THAN 12 BIRTHS, USE AN ADDITIONAL QUESTIONNAIRE, (STARTING WITH THE SECOND ROW AND CHANGE IT TO 13).

212) What name was given to your (first/next) baby?

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

214) Is (NAME) single or twins?

215) In what month and year was (NAME) born? PROBE: When is his/her birthday?

216) Is (NAME) still alive?

IF ALIVE:
217) How old was (NAME) at his/her last birthday? RECORD AGE IN COMPLETED YEARS.

218) Is (NAME) living with you?

219) RECORD HOUSEHOLD LINE NUMBER OF CHILD (RECORD '00' IF CHILD NOT LISTED IN HOUSEHOLD).

220) DEAD: How old was (NAME) when he/she died? IF '1 YR', PROBE: How many months old was (NAME)? RECORD DAYS IF LESS THAN 1 MONTH; MONTHS IF LESS THAN 2 YEARS, OR RECORD YEARS IF MORE THAN 2 YEARS.

221) Were there any other live births between (NAME OF PREVIOUS BIRTH) and (NAME), including any children who died after birth? (NOT ASKED FOR FIRST BIRTH)

222) Have you had any live births since the birth of (NAME OF LAST BIRTH)? IF YES, RECORD BIRTH(S) IN TABLE.

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

224) CHECK 215: ENTER THE NUMBER OF BIRTHS IN 2008 OR LATER. IF NONE, CIRCLE COE (0) AND GO TO 226.

225) FOR EACH BIRTH SINCE JANUARY 2008, ENTER 'B' IN THE MONTH OF BIRTH IN THE CALENDAR. WRITE THE NAME OF THE CHILD TO THE LEFT OF THE 'B' CODE. FOR EACH BIRTH, ASK THE NUMBER OF MONTHS THE PREGNANCY LASTED AND RECORD 'P' IN EACH OF THE PRECEDING MONTHS ACCORDING TO THE DURATION OF PREGNANCY. (NOTE: THE NUMBER OF 'P's MUST BE ONE LESS THAN THE NUMBER OF MONTHS THAT THE PREGNANCY LASTED.)

226) Are you pregnant now?

227) How many months pregnant are you? RECORD NUMBER OF COMPLETED MONTHS. ENTER 'P's IN THE CALENDAR, BEGINNING WITH THE MONTH OF INTERVIEW AND FOR THE TOTAL NUMBER OF COMPLETED PREGNANCY MONTHS.

228) When you got pregnant, did you want to get pregnant at that time?

229) Did you want to have a baby later on or did you not any any (more) children?

230) Have you ever had a pregnancy that miscarried, was aborted, or ended in stillbirth?

231) When was the last pregnancy that miscarried, was aborted, or ended in stillbirth?

232) CHECK 231:

233) How many months pregnant were you when the last such pregnancy ended? (pregnancy that miscarried, was aborted, or ended in stillbirth)
RECORD NUMBER OF COMPLETED MONTHS. ENTER 'T' IN THE CALENDAR IN THE MONTH THAT THE PREGNANCY TERMINATED AND 'P' FOR THE REMAINING NUMBER OF COMPLETED MONTHS.

234) Since January 2008, have you had any other pregnancies that did not result in a live birth?

235) ASK THE DATE AND THE DURATION OF PREGNANCY FOR EACH EARLIER NON-LIVE BIRTH PREGNANCY BACK TO JANUARY 2008
ENTER 'T' IN THE CALENDAR IN THE MONTH THAT EACH PREGNANCY TERMINATED AND 'P' FOR THE REMAINING NUMBER OF COMPLETED MONTHS FOR EACH PREGNANCY THAT MISCARRIED, WAS ABORTED, OR END IN STILLBIRTH.

236) Did you have any miscarriages, abortions, or stillbirths that ended before 2008?

237) When did the last pregnancy that terminated before 2008 end?

237A) How old were you when you had your first menstrual period?

238) When did your last menstrual period start?

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)?

301A) CHECK 112A, 112B:

302) CHECK 226:

303) Are you currently doing something or using any method to delay or avoid getting pregnant?

304) Which method are you using? CIRCLE ALL MENTIONED. IF MORE THAN ONE METHOD MENTIONED, FOLLOW SKIP INSTRUCTION FOR HIGHEST METHOD IN LIST.

307) In what facility did the sterilization take place? PROBE TO IDENTIFY THE TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

308) In what month and year was the sterilization performed?

308A) Since what month and year have you been using (CURRENT METHOD) without stopping? PROBE: For how long have you been using (CURRENT METHOD) NOW WITHOUT STOPPING?

309) CHECK 215, 231 AND 308/308A: ANY BIRTH OR PREGNANCY TERMINATION AFTER MONTH AND YEAR OF START USE OF CONTRACEPTION IN 308/308A

310) CHECK 308/308A:

311) I would like to ask you some questions about the times you or your husband may have used a method to avoid getting pregnant during the last few years.
USE CALENDAR TO PROBE FOR EARLIER PERIODS OF USE AND NONUSE, STARTING WITH MOST RECENT USE, BACK TO JANUARY 2008. USE NAMES OF CHILDREN, DATES OF BIRTH, AND PERIODS OF PREGNANCY AS REFERENCE POINTS.
IN COLUMN 1, ENTER METHOD USE CODE OR '0' FOR NONUSE IN EACH BLANK MONTH.
ILLUSTRATIVE QUESTIONS: When was the last time you used a method? Which method was that? When did you start using that method? How long after the birth of (NAME)? How long did you use the method then?
IN COLUMN 2, ENTER CODES FOR DISCONTINUATION NEXT TO THE LAST MONTH OF USE. NUMBER OF CODES IN COLUMN (2) MUST BE SAME AS NUMBER OF INTERRUPTIONS OF METHOD USE IN COLUMN (1).
ASK WHY SHE STOPPED USING THE METHOD. IF A PREGNANCY FOLLOWED, ASK WHETHER SHE BECAME PREGNANT UNINTENTIONALLY WHILE USING THE METHOD OR DELIBERATELY STOPPED TO GET PREGNANT.
ILLUSTRATIVE QUESTIONS: Why did you stop using the (METHOD)? Did you become pregnant while using (METHOD), or did you stop to get pregnant, or did you stop for some other reason? IF DELIBERATELY STOPPED TO BECOME PREGNANT, ASK: How many months did it take you to get pregnant after you stopped using (METHOD)? AND ENTER '0' IN EACH SUCH MONTH IN COLUMN (1).

312) CHECK THE CALENDAR (FOR INTERVIEWER: USE OF ANY CONTRACEPTIVE METHOD IN ANY MONTH?)

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

314) CHECK 304: CIRCLE METHOD CODE: IF MORE THAN ONE METHOD CODE CIRCLED IN 304, CIRCLE CODE FOR HIGHEST METHOD IN LIST.

315) You first started using (CURRENT METHOD) in (DATE FROM 3008/308A). Where did you get it at that time?
PROBE TO IDENTIFY THE TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE. (NAME OF PLACE) ____

315A) Where did you learn how to use the rhythm/lactational amenorrhea method?
PROBE TO IDENTIFY THE TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE. (NAME OF PLACE) ____

316) CHECK 304: CIRCLE METHOD CODE: IF MORE THAN ONE METHOD CODE CIRCLED IN 304, CIRCLE CODE FOR HIGHEST METHOD IN LIST.

317) At that time, were you told about side effects or problems you might have with the method?

317A) When you got sterilized, were you told about side effects or problems you might have with the method?

318) Were you ever told by a health or family planning worker about side effects or problems you might have with the method?

319) Were you told what to do if you experienced side effects or problems?

320) CHECK 314:

321) Were you ever told by a health or family planning worker about other methods of family planning that you could use?

322) CHECK 304: CIRCLE METHOD CODE: IF MORE THAN ONE METHOD CODE CIRCLED IN 304, CIRCLE CODE FOR HIGHEST METHOD IN LIST.

323) Where did you obtain (CURRENT METHOD) the last time? PROBE TO IDENTIFY THE TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE. (NAME OF PLACE)____

323A) What is the main reason for not using a method of family planning?

324) Do you know of a place where you can obtain a method of family planning?

325) Where is that? Any other place? PROBE TO IDENTIFY EACH TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

326) In the last 12 months, were you visited by a fieldworker who talked to you about family planning?

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

328) Did any staff member at this health facility speak to you about family planning methods?

SECTION 4. PREGNANCY AND POSTNATAL CARE

401) CHECK 224:

402) CHECK 215: ENTER IN THE TABLE THE BIRTH HISTORY NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH IN 2008 OR LATER. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 3 BIRTHS, USE LAST 2 COLUMNS OF ADDITIONAL QUESTIONNAIRES).
Now I would like to ask some questions about your children born in the last five years. We will talk about each separately.

403) BIRTH HISTORY NUMBER FROM 212 IN BIRTH HISTORY

404) FROM 212 AND 216

405) When you got pregnant with (NAME), did you want to get pregnant at that time?

406) Did you want to have a baby later on, or did you not want any (more) children?

407) How much longer did you want to wait?

407A) During your pregnancy with (NAME), did you get any of the following symptoms:

408) Did you see anyone for antenatal care for this pregnancy?

409) Whom did you see? Anyone else? PROBE TO IDENTIFY EACH TYPE OF PERSON AND RECORD ALL MENTIONED.

410) Where did you receive antenatal care for this pregnancy? Anywhere else?
PROBE TO IDENTIFY EACH TYPE OF SOURCE. IF UNABLE TO DETERMINE IF (PUBLIC OR PRIVATE) SECTOR, WRITE THE NAME OF THE PLACE.

411) How many times did you receive antenatal care during this pregnancy?

412) How many times did you receive antenatal care during this pregnancy?

413) As part of your antenatal care during this pregnancy, were any of the following done at least once:

414) During (any of) your antenatal care visit(s), were you told about things to look out for that might suggest problems with the pregnancy?

415) During this pregnancy, were you given an injection in the arm to prevent the baby from getting tetanus, that is, convulsions after birth?

416) During this pregnancy, how many times did you get a tetanus injection?

417) CHECK 416:

418) At any time before this pregnancy, did you receive any tetanus injections?

419) Before this pregnancy, how many times did you receive a tetanus injection? IF 7 OR MORE TIMES, RECORD '7'.

420) How many years ago did you receive the last tetanus injection before this pregnancy?

421) During this pregnancy, were you given or did you buy any iron tablets or iron syrup?

422) During the whole pregnancy, for how many days did you take the tablets or syrup?
IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER OF DAYS.

423) During this pregnancy, did you take any drugs for intestinal worms?

424) During this pregnancy, did you take any drugs for (SP/Fansidar)>

430) When (NAME) was born, was he/she very large, larger than average, average, or smaller than average?

431) Was (NAME) weighed at birth?

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

433) Who assisted with the delivery of (NAME)? Anyone else?
PROBE FOR THE TYPE(S) OF PERSON(S) AND RECORD ALL MENTIONED. IF RESPONDENT SAYS NO ONE ASSISTED, PROBE TO DETERMINE WHETHER ANY ADULTS WERE PRESENT AT THE DELIVERY.

433A) During the birth of (NAME), did you get any of the following symptoms:

434) Where did you give birth to (NAME)? PROBE TO IDENTIFY THE TYPE OF SOURCE. IF UNABLE TO DETERMINE THE SECTOR WRITE THE NAME OF THE PLACE.

435) Was (NAME) delivered by caesarean, that is, did they cut your belly open to take the baby out?

435A) Before you left the health facility, did any health staff speak to you or advise you about family planning methods?

436) After delivery of (NAME), did anyone check on your health while you were still in the facility?

437) Did anyone check on your health after you left the facility?

437A) Why didn't you deliver in a health facility?

438) After delivery of (NAME), did anyone check on your health?

439) Who checked on your health at that time? PROBE FOR MOST QUALIFIED PERSON.

440) How long after delivery did the first check take place? IF LESS THAN ONE HOUR RECORD '00' IN 'HOURS'. IF LESS THAN ONE DAY, RECORD HOURS. IF LESS THAN ONE WEEK, RECORD DAYS.

442) In the two months after (NAME) was born, did any health care provider or a traditional birth attendant check on his/her health?

443) How many hours, days, or weeks after the birth of (NAME) did the first check take place?
IF LESS THAN ONE DAY, RECORD HOURS. IF LESS THAN ONE WEEK, RECORD DAYS.

444) Who checked on (NAME)'s health at that time? PROBE FOR MOST QUALIFIED PERSON.

445) Where did this first check of (NAME) take place? PROBE TO IDENTIFY THE TYPE OF SOURCE. IF UNABLE TO DETERMINE THE SECTOR WRITE THE NAME OF PLACE.

446) In the first two months after delivery, did you receive a vitamin A dose like (this/any of these)? SHOW COMMON TYPES OF AMPOULES/CAPSULES/SYRUPS.

447) Has your menstrual period returned since the birth of (NAME)?

448) Did your period return between the birth of (NAME) and your next pregnancy?

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

453) Did you ever breastfeed (NAME)?

454) CHECK 404: IS CHILD LIVING?

455) How long after birth did you first put (NAME) to the breast?
IF LESS THAN 1 HOUR, RECORD '000'. IF LESS THAN 24 HOURS, RECORD HOURS. OTHERWISE, RECORD DAYS.

456) In the first three days after delivery, was (NAME) given anything to drink other than breast milk?

457) What was (NAME) given to drink? Anything else? RECORD ALL LIQUIDS MENTIONED.

458) CHECK 404: IS CHILD LIVING?

459) Are you still breastfeeding (NAME)?

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

461) GO BACK TO 405 IN NEXT COLUMN; OR, IF NO MORE BIRTHS, GO TO 501.

SECTION 5. CHILD IMMUNIZATION, HEALTH AND NUTRITION

501) ENTER IN THE TABLE THE BIRTH HISTORY NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH IN 2008 OR LATER. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 3 BIRTHS, USE LAST 2 COLUMNS OF ADDITIONAL QUESTIONNAIRES). NOW, I WOULD LIKE TO ASK YOU SOME QUESTIONS ABOUT YOUR CHILDREN WHO BORN SINCE 2008 OR LATER, WE WILL TALK ABOUT EACH SEPARATELY

502) BIRTH HISTORY NUMBER FROM 212 IN BIRTH HISTORY

503) FROM 212 AND 216: NAME AND SURVIVAL STATUS

504) Do you have a vaccination card for (NAME)? IF YES: May I see it please?

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

506) COPY DATES FROM THE CARD. WRITE '44' IN 'DAY' COLUMN IF CARD SHOWS THAT A DOSE WAS GIVEN, BUT NO DATE IS RECORDED.

507) CHECK 506:

508) Has (NAME) had any vaccinations that are not recorded on this card, including vaccinations given in a national immunization day campaign? RECORD 'YES' ONLY IF THE RESPONDENT MENTIONS AT LEAST ONE OF THE VACCINATIONS IN 506 THAT ARE NOT RECORDED AS HAVING BEEN GIVEN.

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

510A) Please tell me if (NAME) had any of the following vaccinations: A BCG vaccination against tuberculosis, that is, an injection in the arm or shoulder that usually causes a scar?

510B) Was (NAME) given a polio vaccine immediately after birth or during the first month?

510C) Was the polio vaccine given in the first two weeks after birth or later?

510D) How many times was the polio vaccine given?

510E) Please tell me if (NAME) had any of the following vaccinations: A PENTA vaccination, that is, an injection given in the thigh or buttocks, sometimes at the same time as polio drops?

510F) How many times was the PENTA vaccination given?

510G) Please tell me if (NAME) had any of the following vaccinations: A measles injection that is, a shot in the arm at the age of 9 months or older - to prevent him/her from getting measles?

511) Within the last six months, was (NAME) given a vitamin A dose like (this/any of these)? SHOW COMMON TYPES OF AMPOULES/CAPSULES/SYRUPS.

512) In the last seven days, was (NAME) given iron pills, sprinkles with iron, or iron syrup like (this/any of these)?

513) Was (NAME) given any drug for intestinal worms in the last six months?

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

515) Was there any blood in the stools?

516) Now I would like to know how much (NAME) was given to drink during the diarrhea (including breast milk). Was he/she given less than usual to drink, about the same amount, or more than usual to drink? IF LESS, PROBE: Was he/she given much less than usual to drink or somewhat less?

517) When (NAME) had diarrhea, was he/she given less than usual to eat, about the same amount, more than usual, or nothing to eat? IF LESS, PROBE: Was he/she given much less than usual to eat or somewhat less?

518) Did you seek advice or treatment for the diarrhea from any source?

519) Where did you seek advice or treatment? Anywhere else? PROBE TO IDENTIFY EACH TYPE OF SOURCE. IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.

520) CHECK 519:

521) Where did you first seek advice or treatment? USE LETTER CODE FROM 519.

522) Was he/she given any of the following to drink at any time since he/she started having the diarrhea:

523) Was anything (else) given to treat the diarrhea?

524) What (else) was given to treat the diarrhea? Anything else? RECORD ALL TREATMENTS GIVEN.

525) Has (NAME) been ill with a fever at any time in the last 2 weeks?

526) At any time during the illness, did (NAME) have blood taken from his/her finger or heel for testing?

527) Has (NAME) had an illness with a cough at any time in the last 2 weeks?

528) When (NAME) had an illness with a cough, did he/she breathe faster than usual with short, rapid breaths or have difficulty breathing?

529) Was the fast or difficult breathing due to a problem in the chest or to a blocked or runny nose?

530) CHECK 525: HAD FEVER?

531) Now I would like to know how much (NAME) was given to drink (including breast milk) during the illness with a (fever/cough). Was he/she given less than usual to drink, about the same amount, or more than usual to drink? IF LESS, PROBE: Was he/she given much less than usual to drink or somewhat less?

532) When (NAME) had a (fever/cough), was he/she given less than usual to eat, about the same amount, more than usual, or nothing to eat?
IF LESS, PROBE: Was he/she given much less than usual to eat or somewhat less?

533) Did you seek advice or treatment for the illness from any source?

534) Where did you seek advice or treatment? Anywhere else? PROBE TO IDENTIFY EACH TYPE OF SOURCE. IF UNABLE TO DETERMINE THE SECTOR, WRITE THE NAME OF THE PLACE.

535) CHECK 534:

536) Where did you first seek advice or treatment? USE LETTER CODE FROM 524.

537) At any time during the illness, did (NAME) take any drugs for the illness?

538) What drugs did (NAME) take? Any other drugs? RECORD ALL MENTIONED.

552) GO BACK TO 503 IN NEXT COLUMN; OR, IF NO MORE BIRTHS, GO TO 553.

553) CHECK 215 AND 218, ALL ROWS: NUMBER OF CHILDREN BORN IN 2008 OR LATER LIVING WITH THE RESPONDENT

554) The last time (NAME FROM 553) passed stools, what was done to dispose of the stools?

555) CHECK 522(a) AND 522(b), ALL COLUMNS:

556) Have you ever heard of a special product called oral rehydration package or oral rehydration solution, you can get for the treatment of diarrhea?

557) CHECK 215 AND 218, ALL ROWS: NUMBER OF CHILDREN BORN IN 2010 OR LATER LIVING WITH THE RESPONDENT

558) Now I would like to ask you about liquids or foods that (NAME FROM 557) had yesterday during the day or at night. I am interested in whether your child had the item I mention even if it was combined with other foods. Did (NAME FROM 557) (drink/eat):

559) CHECK 558 (CATEGORIES "g" THROUGH "w"):

560) Did (NAME) eat any solid, semi-solid, or soft foods yesterday during the day or at night? IF 'YES' PROVE: What kind of solid, semi-solid or soft foods did (NAME) eat?

561) How many times did (NAME FROM 557) eat solid, semi-solid, or soft foods yesterday during the day or at night? IF 7 OR MORE TIMES, RECORD '7'.

561A) Now I would like to ask you about liquids or foods that you had yesterday during the day or at night. I am interested in whether you had the item I mention even if it was combined with other foods. Please don't mention spices such as hot pepper and herbs that are used in small amounts to improve food flavor, I will ask you specifically on this topic. Yesterday during the day or at night, did you drink/eat:

SECTION 7. FERTILITY PREFERENCES

701) CHECK 304:

702) CHECK 226:

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

704) 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?

705) CHECK 226:

706) CHECK 226:

707) CHECK 303: USING A CONTRACEPTIVE METHOD

708) CHECK 705:

709) CHECK 703 AND 704:

710) CHECK 303: USING A CONTRACEPTIVE METHOD

711) Do you think you will use a contraceptive method to delay or avoid pregnancy at any time in the future?

712) CHECK 216:

713) 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?

714) In the last few months have you:

716) CHECK 112A:

717) CHECK 303: USING A CONTRACEPTIVE METHOD

718) Would you say that using contraception is mainly your decision mainly your husband's decision, or did you both decide together?

719) CHECK IN 304:

720) Does your husband want the same number of children that you want, or does he want more or fewer than you want?

SECTION 8. HUSBAND'S BACKGROUND AND WOMAN'S WORK

801) CHECK 112A:

801A) Is your husband living with you now or is he staying elsewhere?

801B) RECORD THE HUSBAND'S NAME LINE NUMBER FROM THE HOUSEHOLD QUESTIONNAIRE, IF HE IS NOT LISTED IN THE HOUSEHOLD, RECORD '00'.

801C) Does your husband have other wives?

801D) Including yourself, in total, how many wives does he have?

801E) Are you the first, second, ? wife?

802) How old was your husband on his last birthday?

803) Did your (last) husband ever attend school?

804) What was the highest level of school he attended: primary, fundamental (preparatory, unified), diploma before secondary, secondary, diploma after secondary, or university/higher?

805) What was the highest (grade/form/year) he completed at that level?
IF COMPLETED LESS THAN ONE YEAR AT THAT LEVEL, RECORD '00'.

806) CHECK 801:

807) Aside from your own housework, have you done any work in the last seven days?

808) As you know, some women take up jobs for which they are paid in cash or kind. Others have a small business or work on the family farm or in the family business. In the last seven days, have you done any of these things or any other work?

809) 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, maternity leave, or any other such reason?

810) Have you done any work in the last 12 months?

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

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

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

814) Are you paid in cash or kind for this work or are you not paid at all?

815) CHECK 112A:

816) CHECK 814:

817) Who usually decides how the money you earn will be used: you, your husband, or you and your husband jointly?

818) Would you say that the money that you earn is more than what your husband earns, less than what he earns, or about the same?

819) Who usually decides how your husband's earnings will be used: you, your husband, or you and your husband jointly?

820) Who usually makes decisions about health care for yourself: you, your husband, you and your husband jointly, or someone else?

821) Who usually makes decisions about making major household purchases?

SECTION 9. HIV/AIDS

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

902) From your point of view, how AIDS is transmitted:

903) Can people reduce their chance of getting the AIDS virus by using a condom every time they have sex?

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

907) Can the virus that causes AIDS be transmitted from a mother to her baby:

909) CHECK 907:

910) Are there any special drugs 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?

930) Do you know of a place where people can go to get tested for the AIDS virus?

931) Where is that? Any other place? PROBE TO IDENTIFY EACH TYPE OF SOURCE. IF UNABLE TO DETERMINE IF THE SECTOR, WRITE THE NAME OF THE PLACE.

932) Would you buy fresh vegetables from a shopkeeper or vendor if you knew that this person had the AIDS virus?

933) If a member of your family got infected with the AIDS virus, would you want it to remain a secret or not?

934) If a member of your family got infected with the AIDS virus, would you be willing to care for her or him in your own household?

935) In your opinion, if a female teacher has the AIDS virus but is not sick, should she be allowed to continue teaching in the school?

937) CHECK 901:

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

941) Sometimes women experience a bad-smelling abnormal genital discharge. During the last 12 months, have you had a bad-smelling abnormal genital discharge?

942) Sometimes women have a genital sore or ulcer. During the last 12 months, have you had a genital sore or ulcer?

943) CHECK 940, 941, AND 942:

944) The last time you had (PROBLEM FROM 940/941/942), did you seek any kind of advice or treatment?

945) Where did you go? Any other place? PROBE TO IDENTIFY EACH TYPE OF SOURCE. IF UNABLE TO DETERMINE IF THE SECTOR, WRITE THE NAME OF THE PLACE

946) If a wife knows her husband has a disease that she can get during sexual intercourse, is she justified in asking that they use a condom when they have sex?

SECTION 10. OTHER HEALTH ISSUES

1001) 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.

1002) 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.

1003) The last time you got an injection from a health worker, did he/she take the syringe and needle from a new, unopened package?

1008) Many different factors can prevent women from getting medical advice or treatment for themselves. When you are sick and want to get medical advice or treatment, is each of the following a big problem or not?

1009) Are you covered by any health insurance?

1010) What type of health insurance are you covered by? PROBE: Any other health insurance? RECORD ALL MENTIONED.

1011) FISTULA: This series of questions is designed to obtain information on another health problem that affects women. Difficult vaginal delivery can lead to urine and fecal incontinence. This problem usually occurs after a difficult childbirth, but may also be the result of rape or pelvic surgery. Women with this problem are often subject o social discrimination. The following questions relate to women's knowledge of the problem and the reasons for the treatment.
Have you ever heard of this problem of which the woman experiences a constant leakage of urine or stool from the vagina during the day and night?

1012) Do you suffer or did you suffer from this problem?

1012A) Sometimes some ladies suffer from the constant leakage of urine or stool from your vagina during the day and night as a result of a difficult birth or surgery and this is called fistula. Do you suffer or did you suffer from this problem?

1013) Did this problem start after a normal delivery, a caesarean delivery, or after an operation or after anything else?

1014) Have you sought treatment for this condition?

1015) Why have you not sought treatment?

1016) From whom did you last seek treatment?

1017) Did your health improve after treatment?

1018) Did you get any type of tumors?

1019) When did you find out that you had a tumor?
RECORD THE YEAR AND THE MONTH IF DON'T KNOW MONTH CIRCLE 98

1020) Who discovered your tumor?

1021) In what part of your body did the tumor develop? RECORD IN WHICH PART OF THE BODY THE TUMOR EXIST.

1022) Have you sought treatment for this condition?

1023) Why have you not sought treatment?

1024) Did you have a biopsy or an ultrasound done to determine the type of tumor?

1025) What was the result of the biopsy or the ultrasound?

1026) Do you currently receive or did you receive in the past treatment for the malignant tumor (CANCER)?

SECTION 11: FEMALE CIRCUMCISION

1101) Have you ever heard of female circumcision?

1102) In some countries, there is a practice in which a girl may have part of her genitals cut. Have you ever heard about this practice?

1103) Have you yourself ever been circumcised?

1104) Was any flesh removed from your genital area?

1107) How old were you when you were circumcised? IF THE RESPONDENT DOES NOT KNOW THE EXACT AGE, PROVE TO GET AN ESTIMATE

1108) Who performed the circumcision?

1109) CHECK 213 AND 216:

1110) Have any of your daughters been circumcised? IF YES: How many?

1111) Which of your daughters was circumcised most recently? INTERVIEWER: CHECK 212 AND RECORD THE LINE NUMBER FOR THE DAUGHTER

1112) Now I would like to ask you what was done to (NAME OF THE DAUGHTER FROM Q. 1111).

1113) Was any flesh removed from the genital area?

1115) How old was (NAME OF THE DAUGHTER FROM Q. 1111) when the circumcision was done? IF THE RESPONDENT DOES NOT KNOW THE AGE, PROBE TO GET AN ESTIMATE.

1116) Who performed the circumcision?

1117) Do you have any daughter who is not circumcised?

1118) Do you intend to have any of your daughters circumcised in the future?

1119) Why do you intend to have any of your daughters circumcised? PROBE: Any other reasons? RECORD ALL MENTIONED.

1120) Do you believe that this practice is required by your religion?

1121) Do you think that this practice should be continued, or should it be stopped?

1122) Why do you think this practice should be stopped? PROBE: Any other reasons? RECORD ALL MENTIONED.

SECTION 12. OPINIONS ON DOMESTIC VIOLENCE

1201) What is your understanding of domestic violence, does that mean:

1202) Who are the people who commit the most violent acts against women?

1203) What is the place with the most violent acts?

1204) Does any form of violence cause damage?

1205) What is the most serious damage caused by violence?

1206) In your opinion, is a husband justified in hitting or beating his wife in the following situations:

1207) RECORD THE TIME.

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: ____