Data Cart

Your data extract

0 variables
0 samples
View Cart

SOUTH AFRICAN DEMOGRAPHIC AND HEALTH SURVEY
WOMEN QUESTIONNAIRE

IDENTIFICATION
PROVINCE
DISTRICT
EA NUMBER
EA TYPE
SADHS CLUSTER NUMBER
HOUSEHOLD NUMBER
NAME AND LINE NUMBER OF WOMAN
NAME OF HOUSEHOLD HEAD

INTERVIEWER VISITS
FIRST VISIT
DATE
INTERVIEWER’S NAME
RESULT*

SECOND VISIT
DATE
INTERVIEWER’S NAME
RESULT*

THIRD VISIT
DATE
INTERVIEWER’S NAME
RESULT*

NEXT VISIT
DATE
TIME

FINAL VISIT
DAY
MONTH
YEAR
NAME RESULT

*RESULT CODES:

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

LANGUAGE
LANGUAGE OF QUESTIONNAIRE
LANGUAGE OF INTERVIEW
HOME LANGUAGE OF RESPONDENT

TRANSLATOR USED

YES = 1
NO = 2

LANGUAGE CODES

01 ENGLISH
02 AFRIKAANS
03 isiXHOSA
04 isi ZULU
05 SeSOTHO
06 SeTSWANA
07 SePEDI
08 SiSWATI
09 TshiVENDA
10 ZITSONGA
11 isiNDEBELA

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 large town, on a farm or in rural areas?

CITY 1
TOWN 2
RURAL/FARM 3

103 How long have you been living continuously in (NAME OF CURRENTPLACE OF RESIDENCE)?
IF LESS THAN 1 YEAR, WRITE ‘00’

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 town, or in the rural area /farm?

CITY 1
TOWN 2
RURAL/FARM 3

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 114)

109 What is the highest (standard/year) you completed?

LESS THAN ONE YEAR COMPLETED 00
SUB A/CLASS 1 71
SUB B/CLASS 2 72
STANDARD 1 01
STANDARD 2 02
STANDARD 3 03
STANDARD 4 04
STANDARD 5 05
STANDARD 6 06
STANDARD 7 07
STANDARD 8 08
STANDARD 9 09
STANDARD 10 10
FURTHER STUDIES INCOMPLETE 11
DIPLOMA/OTHER POSTSCHOOLCOMPLETE 12
FURTHER DEGREE COMPLETE 13

110 CHECK 106:

AGE 24 OR BELOW (GO TO 111)
AGE 25ABOVE (GO TO 114)

111 Are you currently attending school?

YES 1 (GO TO 114)
NO 2

112 What was the main reason you stopped attending school?

GOT PREGNANT 01
GOT MARRIED 02
TO CARE FOR YOUNGER CHILDREN 03
FAMILY NEEDED HELP ON FARM OR IN BUSINESS 04
COULD NOT PAY SCHOOL FEES 05
NEEDED TO EARN MONEY 06
GRADUATED/HAD ENOUGHSCHOOLING 07
DID NOT PASS ENTRANCE EXAMS 08
DID NOT LIKE SCHOOL 09
SCHOOL NOT ACCESSIBLE/TOO FAR 10
OTHER (SPECIFY) _______ 96
DON’T KNOW 98

114 Can you read and understand a letter or newspaper in your home language easily, with difficulty, or not at all?

EASILY 1
WITH DIFFICULTY 2
NOT AT ALL 3 (GO TO 116)

115 Have you read a newspaper or magazine in the last week?

YES 1
NO 2

116 Do you usually listen to a radio every day?

YES 1
NO 2

117 Do you usually watch television at least once a week?

YES 1
NO 2

119 Which race group do you consider yourself?

BLACK/AFRICAN 1
COLOURED 2
WHITE 3
ASIAN/INDIAN 4

120 CHECK Q.4 IN THE HOUSEHOLD QUESTIONNAIRE

THE WOMAN INTERVIEWED IS NOT A USUAL RESIDENT (GO TO 121)
THE WOMAN INTERVIEWED IS A USUAL RESIDENT (GO TO 201)

121 Now I would like to ask about the place in which you usually live.
What is the name of the place in which you usually live?

(NAME OF PLACE) __________

Is that a large city, town, or rural area /farm?

CITY 1
TOWN 2
RURAL/FARM 3

122 In which PROVINCE is that located?

EASTERN CAPE 01
FREE STATE 02
GAUTENG 03
KWAZULU/NATAL 04
MPUMALANGA 05
NORTHERN CAPE 06
NORTHERN PROVINCE 07
NORTH WEST 08
WESTERN CAPE 09
OTHER COUNTRY 10

123 Now I would like to ask about the household in which you usually live.
What is the main source of drinking water for members of your household?

PIPED WATER (tap), IN DWELLING 11
PIPED WATER (tap), IN SITE/YARD 12
PUBLIC TAP 13
WATER CARRIER/ TANKER 21
BOREHOLE/WELL 31
DAM /RIVER/STREAM/SPRING 32
RAIN-WATER TANK 41
BOTTLED WATER 51
OTHER (SPECIFY) _______ 96

125 What kind of toilet facility does your household have?

FLUSH TOILET (OWN) 11
FLUSH TOILET (SHARED) 12
BUCKET LATRINE 21
PIT LATRINE 22
NO FACILITY/BUSH/FIELD 31
OTHER (SPECIFY) ________ 96

126 Does your household have:
Electricity?
A radio?
A television?
A telephone?
A refrigerator?
A personal computer (PC)?
A washing machine?

ELECTRICITY
YES 1
NO 2
RADIO
YES 1
NO 2
TELEVISION
YES 1
NO 2
TELEPHONE
YES 1
NO 2
REFRIGERATOR
YES 1
NO 2
PERSONAL COMPUTER
YES 1
NO 2
WASHING MACHINE
YES 1
NO 2

127 Could you describe the main material of the walls of your home?

PLASTIC/CARDBOARD 11
MUD 12
MUD AND CEMENT 13
CORRUGATED IRON/ZINC 21
PREFAB 22
BARE BRICK/CEMENT BLOCK 23
PLASTER/FINISHED 31
OTHER (SPECIFY) ______________________96

SECTION 2. REPRODUCTION

Now I would like to ask you about all the pregnancies that you have had in your lifetime. By this I mean all the children born to you, whether they were born alive or dead, whether still living or not, whether living with you or elsewhere, and all the pregnancies that you have had that did not result in a live birth. I understand that it is not easy to talk about children who have died, or pregnancies that have terminated before full term, but it is extremely important that you tell us about all of them, so that we can develop programs that will help the Government of South Africa improve children’s health in the future.

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

YES 1
NO 2 (GO TO 206)

202 Do you have any sons or daughters to whom you have given birth who are 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 to whom you have given birth 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 given birth to a boy or girl who was born alive but later died?
IF NO, PROBE: Any baby who cried or showed signs of life but survived only a few hours or days?

YES 1
NO 2

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

BOYS DEAD ________
GIRLS DEAD _________

208 Women sometimes have pregnancies that do not result in a live born child. That is, a pregnancy can end very early, in a miscarriage or an abortion or the child can be born dead. Have you had any such pregnancy that did not result in a live birth?

YES 1
NO 2 (GO TO 210)

209 In all, how many such pregnancies have there been?

PREGNANCY LOSSES _______

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

TOTAL ________

211 CHECK 210:

ONE OR MORE PREGNANCIES (GO TO 213)
NO PREGNANCIES (GO TO 234)

213 Now I would like to ask you about all of your pregnancies, whether born alive, born dead, or lost before full term, starting with the first one you had.
RECORD ALL THE PREGNANCIES. RECORD TWINS AND TRIPLETS ON SEPARATE LINES.

214 Think back to the time of your (first/next) pregnancy.

215 Was that a single or multiple pregnancy?

SINGLE 1
MULTIPLE 2

216 Was the baby born alive, born dead, or lost before full term?

BORN ALIVE 1(SKIP TO 218)
BORNDEAD 2
LOST BEFORE FULL TERM 3(SKIP TO 225)

217 Did that baby cry, move, or breathe when it was born?

YES 1
NO2 (GO TO 225)

218 What was the name given to that child?

(NAME) _________

219 Is (NAME) a boy or a girl?

BOY 1
GIRL 2

220 In what month and year was (NAME) born?
PROBE: What is his/her birthday? OR: In what season was he/she born?

MONTH ______
YEAR 19___

221 Is (NAME) still alive?

YES 1
NO 2 (GO TO 224)

IF BORN ALIVE AND STILL LIVING:

222 How old was (NAME) at his/her last birthday?
RECORD AGE IN COMPLETED YEARS.

AGE IN YEARS _____

223 Is (NAME) living with you?

YES 1 (NEXT PREG.)
NO 2 (NEXT PREG.)

IF BORN ALIVE BUT NOW DEAD:
224 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 TWO YEARS; OR YEARS.

DAYS 1 _____
MONTHS 2 _______
YEARS 3 _______

IF BORN ALIVE BUT NOW DEAD:
224A Did (NAME) die from diarrhea?

YES 1(NEXT PREG.)
NO 2 (NEXT PREG.)
DK 8 (NEXT PREG.)

IF BORN DEAD OR LOST BEFORE FULL TERM:
225. In what year and month did this pregnancy end?

MONTH ____
YEAR 19____

226 How many months did the pregnancy last?

MONTHS ____ (NEXT PREG.)

228 FROM YEAR OF THIS PREGNANCY SUBTRACT YEAR OF PREVIOUS PREGNANCY. IS THE DIFFERENCE 2 OR MORE YEARS?

YES 1
NO 2 (NEXT PREG.)

229 Were there any other pregnancies between the previous pregnancy mentioned and this pregnancy?

YES 1
NO 2

230 FROM YEAR OF INTERVIEW SUBTRACT YEAR OF LAST PREGNANCY.
IS THE DIFFERENCE 2 YEARS OR MORE?

YES 1
NO 2 (GO TO 232)

231 Have you had any pregnancies since the last pregnancy mentioned?

YES 1 (GO TO 214)
NO 2

232 COMPARE 210 WITH NUMBER OF PREGNANCIES IN HISTORY ABOVE AND MARK:

NUMBERS ARE SAME
CHECK: FOR EACH PREGNANCY: YEAR IS RECORDED IN 220 OR 225.
FOR EACH LIVING CHILD: CURRENT AGE IS RECORDED IN 222.
FOR EACH DEAD CHILD: AGE AT DEATH IS RECORDED IN 224.
FOR EACH PREGNANCY LOSS: DURATION IS RECORDED IN 226.
FOR AGE AT DEATH 12 MONTHS OR 1 YR.: PROBE TO DETERMINE EXACT NUMBER OF MONTHS.
NUMBERS ARE DIFFERENT (PROBE AND RECONCILE)

.
233 CHECK 220 AND ENTER THE NUMBER OF BIRTHS SINCE JANUARY 1993. IF NONE, RECORD ‘0’.

234 Are you pregnant now?

YES 1
NO 2
UNSURE 8

235 How many months pregnant are you?

MONTHS _________

236 At the time you became pregnant, did you want to become pregnant then, did you want to wait until later, or did you not want to have any more children at all?

THEN 1
LATER 2
NOT WANT MORE CHILDREN 3

237 When did your last menstrual period start?

(DATE, IF GIVEN)________________________________
DAYS AGO 1 ____
WEEKS AGO 2 ____
MONTHS AGO 3 _____
YEARS AGO 4 ______
IN MENOPAUSE 994
BEFORE LAST BIRTH 995
NEVER MENSTRUATED 996

238 Do you have any of the following problems:
Wet yourself when you cough, sneeze or lift heavy weights?
Are you constantly wet?
Are you constantly soiled?

WET WHEN COUGH/SNEEZE
YES 1
NO 2
CONSTANTLY WET
YES 1
NO 2
CONSTANTLY SOILED
YES 1
NO 2

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?

01 PILL Women can take a pill every day.
SPONTANEOUS YES1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
02 IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
SPONTANEOUS YES1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
03 INJECTIONS Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
SPONTANEOUS YES1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
04 DIAPAGM, FOAM, JELLY Women can place a sponge, suppository, jelly, or cream in their vagina before sexual intercourse.
SPONTANEOUS YES1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
05 CONDOM Men can put a rubber sheath on their penis before sexual intercourse.
SPONTANEOUS YES1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
06 FEMALE STERILIZATION Women can have an operation to avoid having any more children.
SPONTANEOUS YES1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
07 MALE STERILIZATION Men can have an operation to avoid having any more children.
SPONTANEOUS YES1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
08 RHYTHM, CALENDAR METHOD 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 YES1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
09 WITHDRAWAL Men can be careful and pull out before climax.
SPONTANEOUS YES1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
10 HERBS. Women use natural herbs or Dutch remedies to avoid pregnancy
SPONTANEOUS YES1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
11 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
SPONTANEOUS YES 1
(SPECIFY) ________
(SPECIFY) ________
NO 3

302 Have you ever heard (METHOD)?

01 PILL Women can take a pill every day.
SPONTANEOUS YES1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
02 IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
SPONTANEOUS YES1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
03 INJECTIONS Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
SPONTANEOUS YES1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
04 DIAPAGM, FOAM, JELLY Women can place a sponge, suppository, jelly, or cream in their vagina before sexual intercourse.
SPONTANEOUS YES1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
05 CONDOM Men can put a rubber sheath on their penis before sexual intercourse.
SPONTANEOUS YES1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
06 FEMALE STERILIZATION Women can have an operation to avoid having any more children.
SPONTANEOUS YES1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
07 MALE STERILIZATION Men can have an operation to avoid having any more children.
SPONTANEOUS YES1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
08 RHYTHM, CALENDAR METHOD 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 YES1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
09 WITHDRAWAL Men can be careful and pull out before climax.
SPONTANEOUS YES1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
10 HERBS. Women use natural herbs or Dutch remedies to avoid pregnancy
SPONTANEOUS YES1
PROBED YES 2
NO 3 (GO TO NEXT METHOD)
11 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
SPONTANEOUS YES 1
(SPECIFY) ________
(SPECIFY) ________
NO 3

303 Have you ever used of (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 DIAPAGM, FOAM, JELLY Women can place a sponge, suppository, jelly, or cream in their vagina before sexual intercourse.
YES 1
NO 2
05 CONDOM Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
06 FEMALE STERILIZATION Women can have an operation to avoid having any more children.
Have you ever had an operation to avoid having any more children?
YES 1
NO 2
07 MALE STERILIZATION Men can have an operation to avoid having any more children.
Have you ever had a partner who had an operation to avoid having any more children?
YES 1
NO 2
08 RHYTHM, CALENDAR METHOD 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
09 WITHDRAWAL Men can be careful and pull out before climax.
YES 1
NO 2
10 HERBS. Women use natural herbs or Dutch remedies to avoid pregnancy
YES 1
NO 2
11 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1
NO 2
YES 1
NO 2

304 CHECK 303:

NOT A SINGLE “YES” (NEVER USED) (GO TO 305)
AT LEAST ONE “YES” (EVER USED) (SKIP TO308)

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

YES 1
NO 2 (GO TO 331)

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

308 Now I would like to ask you about the first time that you did something or used a method to avoid getting pregnant.
What was the first method you ever used?

PILL 01
IUD 02
INJECTIONS 03
DIAPHRAGM/FOAM/JELLY 04
CONDOM 05
FEMALE STERILIZATION 06
MALE STERILIZATION 07
RHYTHM/ CALENDER METHOD 08
WITHDRAWAL 09
HERB/REMEDIES 10
OTHER (SPECIFY) ______________ 96

309 How many living children did you have at that time, if any?
IF NONE, RECORD ‘00’.

NUMBER OF CHILDREN _______

309A How old were you when you first used something to avoid getting pregnant?

AGE ______

309B From whom did you first get information about methods to avoid pregnancy?

MOTHER A
SISTER B
FATHER C
OTHER RELATIVE D
FRIEND E
TEACHER F
NURSE G
DOCTOR H
POSTER/LEAFLET/MAGAZINE I
RADIO/TELEVISION J
OTHER (SPECIFY) _______________________ X

309C CHECK 309A:

AGE LESS THAN 19 YEARS (GO TO 209E)
AGE 19YEARS OR OLDER (GO TO 311)

309E Did your parent(s) or guardian give advice on contraceptives or explain how to use them?

YES 1
NO 2

311 CHECK 303:

WOMAN NOT STERILIZED (GO TO 312)
WOMAN STERILIZED (GO TO 314A)

312 CHECK 234:

NOT PREGNANT OR UNSURE (GO TO 313)
PREGNANT (GO TO 331)

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

YES 1
NO 2 (GO TO 331)

314 Which method are you using?
314A CIRCLE ‘06’ FOR FEMALE STERILIZATION.

PILL 01
IUD 02
INJECTIONS 03
DIAPHRAGM/FOAM/JELLY 04
CONDOM 05
FEMALE STERILIZATION 06
MALE STERILIZATION 07
RHYTHM, CALENDER METHOD 08
WITHDRAWAL 09
HERB/REMEDIES 10
OTHER (SPECIFY) ________________________ 96

318 Where did the sterilization take place?
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
DAY HOSPITAL/CLINIC/COMMUNITY HEALTH CENTRE 12
FAMILY PLANNING CLINIC 13
OTHER PUBLIC (SPECIFY) __________________16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PRIVATE DOCTOR 23
OTHER PRIVATE MEDICAL (SPECIFY) ___________ 26
OTHER (SPECIFY) ____________________96
DON’T KNOW 98

319 Do you regret that (you/your partner) had the operation not to have any (more) children?

YES 1
NO 2 (GO TO 321)

320 Why do you regret the operation?

RESPONDENT WANTS ANOTHER CHILD 01
PARTNER WANTS ANOTHER CHILD 02
SIDE EFFECTS 03
CHILD DIED 04
OTHER (SPECIFY)_______________________96

321 In what month and year was the sterilization performed?

MONTH ______
YEAR ______ (GO TO 335)

323 How do you determine which days of your monthly cycle not to have sexual relations?

BASED ON CALENDAR 01
BASED ON BODY TEMPERATURE 02
BASED ON CERVICAL MUCUS
(BILLINGS METHOD) 03
BASED ON BODY TEMPERATURE
AND CERVICAL MUCUS 04
NO SPECIFIC SYSTEM 05
OTHER (SPECIFY) ____________________96

328 Where did you obtain (METHOD) the last time?
IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFYTHE TYPE OF SOURCE AND CIRCLE THE APPROPRIATECODE.

(NAME OF PLACE) _________
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
DAY HOSPITAL/CLINIC/COMMUNITY HEALTH CENTRE 12
FAMILY PLANNING CLINIC 13
OTHER PUBLIC (SPECIFY) __________________16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PRIVATE DOCTOR 23
OTHER PRIVATE MEDICAL (SPECIFY) ___________ 26
OTHER SOURCE
SHOP 31 (GO TO 330A)
CHURCH 32 (GO TO 330A)
FRIEND/RELATIVE 33 (GO TO 330A)
OTHER (SPECIFY) __________________ 96 (GO TO 330A)

330 Do you agree with the following statements about the family planning service you use?

The staff shout and scold
AGREE 1
DISAGREE 2
The staff do not explain much about the Family Planning method
AGREE 1
DISAGREE 2
The staff ignore problems which you report
AGREE 1
DISAGREE 2
The staff are unfriendly
AGREE 1
DISAGREE 2

330A People select the place where they get family planning services for various reasons.
What were the reasons you went to (NAME OF PLACE IN Q.328) instead of some other place you know about?
RECORD ALL RESPONSES AND CIRCLE CODES.
What is the Main Reason?

ACCESS-RELATED REASONS
CLOSER TO HOME A
CLOSER TO MARKET/WORK B
AVAILABILITY OF TRANSPORT C
SERVICE-RELATED REASONS
STAFF MORE COMPETENT/FRIENDLY D
CLEANER FACILITY E
OFFERS MORE PRIVACY F
SHORTER WAITING TIME G
LONGER HRS. OF SERVICE H
USE OTHER SERVICES AT THE FACILITY I
LOWER COST/CHEAPER J
WANTED ANONYMITY K
OTHER (SPECIFY) _____________________ X
DON’T KNOW Z

330B Over the last 12 months have you had a break in your contraceptive use for any reason?

YES 1
NO 2 (GO TO 335)

330C Over the last 12 months, why have you had a break in your contraceptive use?

WAS PREGNANT 01 (GO TO 335)
NO BOYFRIEND/SEXUALLY INACTIVE 02 (GO TO 335)
WANTED TO SEE MENSTRUATION 03 (GO TO 335)
HEALTH REASONS 04 (GO TO 335)
OTHER (SPECIFY) ___________________ 96 (GO TO 335)

331 What are the main reasons you are not using a method of contraception to avoid pregnancy?
RECORD ALL MENTIONED
What is the Main Reason?

NEVER HAD SEX A
FERTILITY-RELATED REASONS
NOT HAVING SEX B
INFREQUENT SEX C
MENOPAUSAL/HYSTERECTOMY DINFERTILE E
POSTPARTUM/BREASTFEEDING FWANTS (MORE) CHILDREN G
PREGNANT H
OPPOSITION TO USE
RESPONDENT OPPOSED I
HUSBAND/PARTNER OPPOSED J
OTHERS OPPOSED K
RELIGIOUS PROHIBITION L
LACK OF KNOWLEDGE
KNOWS NO METHOD M
KNOWS NO SOURCE N
METHOD-RELATED REASONS
HEALTH CONCERNS O
FEAR OF SIDE EFFECTS P
LACK OF ACCESS/TOO FAR Q
COST TOO MUCH R
INCONVENIENT TO USE S
INTERFERES WITH BODY’S NATURAL PROCESSES T
OUT OF STOCK U
OTHER (SPECIFY) _______________________X
DON’T KNOW Z

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

YES 1
NO 2 (GO TO 335)

333 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
DAY HOSPITAL/CLINIC/COMMUNITY HEALTH CENTRE 12
FAMILY PLANNING CLINIC 13
OTHER PUBLIC (SPECIFY) __________________16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PRIVATE DOCTOR 23
OTHER PRIVATE MEDICAL (SPECIFY) ___________ 26
OTHER SOURCE
SHOP 31
CHURCH 32
FRIEND/RELATIVE 33
OTHER (SPECIFY) __________________ 96

335 Have you visited any type of health facility for any reason in the last 12 months?

YES 1
NO 2 (GO TO 337)

336 Did any staff member at the health facility speak to you about family planning methods?

YES 1
NO 2

337 During which times of the monthly cycle does a woman have the greatest chance of becoming pregnant?

DURING HER PERIOD 01
RIGHT AFTER HER PERIOD HAS ENDED 02
IN THE MIDDLE OF THE CYCLE 03
JUST BEFORE HER PERIOD BEGINS 04
OTHER (SPECIFY) ______________________96
DON’T KNOW 98

338 I would like to ask you a question about the law on abortion in South Africa. Does the present law allow a woman in early pregnancy, which is up to 12 weeks, to have an abortion?

YES 1
NO 2
DON’T KNOW 8

SECTION 4A. PREGNANCY AND CHILD HEALTH

401 CHECK 233:

ONE OR MORE BIRTHS SINCE JAN. 1993 (GO TO 402)
NO BIRTHS SINCE JAN. 1993 (SKIP TO 465)

402 ENTER THE NAME, LINE NUMBER, AND SURVIVAL STATUS OF EACH BIRTH SINCE JANUARY 1993 IN THE TABLE.
ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH.
(IF THERE ARE MORE THAN 2 BIRTHS, USE ADDITIONAL QUESTIONNAIRES).
Now I would like to ask you some questions about your pregnancies and the health of all your children born in the last five years.
(We will talk about one child at a time.)

403 LINE NUMBER FROM Q214

LINE NUMBER _______

404 FROM Q218 AND Q221

NAME _____
ALIVE (GO TO 405)
DEAD (GO TO 405)

405 At the time you became pregnant with (NAME), did you want to become pregnant then, did you want to wait until later, or did you want no (more) children at all?

THEN 1 (SKIP TO 407)
LATER 2
NO MORE (SKIP TO 407)

406 How much longer would you like to have waited?

MONTHS 1 _____
YEARS 2 ______
KNOW 998

407 When you were pregnant with (NAME), did you go for antenatal care for this pregnancy?
IF YES: Whom did you see? Anyone else?
PROBE FOR THE TYPE OF PERSON AND RECORD ALL PERSONS SEEN.

HEALTH PROFESSIONAL
DOCTOR A
NURSE/MIDWIFE B
OTHER PERSON
TRADITIONAL BIRTH ATTENDANT D
OTHER (SPECIFY) ________________X
NO ONE Y (SKIP TO 410)

407A Where did you go the majority of times?
PROBE FOR THE ONE PLACE VISITED MOST OFTEN

PUBLIC HOSPITAL 01
PRIVATE HOSPITAL 02
PUBLIC CLINIC 03
PRIVATE CLINIC/SURGERY 04
PRIVATE MIDWIFE’S OFFICE 05
OTHER (SPECIFY) __________________ 96

408 How many months pregnant were you when you first received antenatal care?

MONTHS _____
DON’T KNOW 98

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

NO. OF TIMES _____
DON’T KNOW 98

410 When you were pregnant with (NAME) were you given an injection in the arm to prevent the baby from getting tetanus, that is, convulsions after birth?

YES 1
NO 2
DON’T KNOW 8

412 Where did you give birth to (NAME)?

(NAME OF PLACE) ___________________
HOME 11
PUBLIC SECTOR
GOVT. HOSPITAL 21
DAY HOSP/CLINIC COMMUNITY HEALTH CENTER 22
GOVT. MOU 23
OTHER PUBLIC (SPECIFY) _________ 26
PRIVATE MEDICAL SECTOR
PVT. HOSPITAL/CLINIC 31
OTHER PRIVATE MEDICAL (SPECIFY) ____________ 36
OTHER (SPECIFY) ______________ 96

413 Who assisted with the delivery of (NAME)? Anyone else?
PROBE FOR THE TYPE OF PERSON AND RECORD ALL PERSONS ASSISTING.

HEALTH PROFESSIONAL
DOCTOR A
NURSE/MIDWIFE B
OTHER PERSON
TRADITIONAL BIRTH ATTENDANT D
RELATIVE/FRIEND E
OTHER (SPECIFY) _______________X
NO ONE Y

415 Was (NAME) delivered by caesarian section?

YES 1
NO 2

417 Was (NAME) weighed at birth?

YES 1
NO 2 (SKIP TO 419)

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

GRAMS FROM CARD 1 _____
GRAMS FROM RECALL 2 ______
DON’T KNOW 99998

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

YES 1 (SKIP TO 421)
NO 2 (SKIP TO 422)

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

YES 1
NO 2 (SKIP TO 424)

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

MONTHS _____
DON’T KNOW 98

422 CHECK 234:
RESPONDENT PREGNANT?

NOT PREGNANT (GO TO 423)
PREG NANT OR UNSURE (SKIP TO 424)

423 Have you resumed sexual relations since the birth of (NAME)?

YES 1
NO 2 (SKIP TO 425)

424 For how many months after the birth of (NAME) did you not have sexual relations?

MONTHS ______
DON’T KNOW 98

425 Did you ever breastfeed (NAME)?

YES 1
NO 2 (SKIP TO 431)

426 How long after birth did you first put (NAME) to the breast?
IF LESS THAN 1 HOUR, RECORD ‘00’ HOURS.
IF LESS THAN 24 HOURS, RECORD HOURS.
OTHERWISE, RECORD DAYS.

IMMEDIATELY 000
HOURS 1
DAYS 2

427 CHECK 404: CHILD ALIVE?

ALIVE (GO TO 428)
DEAD (SKIP TO 429)

428 Are you still breastfeeding (NAME)?

YES 1 (SKIP TO 432)
NO 2

429 For how many months did you breastfeed (NAME)?

MONTHS 2
DON’T KNOW 98

430 Why did you stop breastfeeding (NAME)?

MOTHER ILL/WEAK 01
CHILD ILL/WEAK 02
CHILD DIED 03
NIPPLE/BREAST PROBLEM . 04
NOT ENOUGH MILK 05
MOTHER WORKING 06
CHILD REFUSED 07
WEANING AGE/AGE TO
STOP 08
BECAME PREGNANT 09
STARTED USING
CONTRACEPTION 10
OTHER (SPECIFY) ____________________96

431 CHECK 404: CHILD ALIVE?

ALIVE (SKIP TO 434)
DEAD (GO BACK TO 405 IN NEXT COLUMN OR, IF NO MORE BIRTHS, GO TO 440)

432 How many times did you breastfeed last night between sunset and sunrise?
IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER

NUMBER OF NIGHTTIME FEEDINGS _______

433 How many times did you breastfeed yesterday during the daylight hours?
IF ANSWER IS NOT NUMERIC PROBE FOR APPROXIMATE NUMBER.

NUMBER OF DAYLIGHT FEEDINGS ______

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

YES 1
NO 2
DON’T KNOW 8

435 At any time yesterday or last night, was (NAME) given any of the following:
Plain water?
Sugar water/Juice
Herbal tea/Rooibos?
Baby formula?
Any kind of milk?
Any other liquid?
Any food made from [MAIZE or RICE or WHEAT], such as PORRIDGE or BREAD
Eggs, fish or poultry?
Meat?
Fruits or vegetables?
Any other solid or semi-solid foods?

PLAIN WATER
YES 1
NO 2
DK 8
SUGAR WATER/JUICE
YES 1
NO 2
DK 8
HERBAL/ROOIBOS TEA
YES 1
NO 2
DK 8
BABY FORMULA
YES 1
NO 2
DK 8
ANY KIND OF MILK
YES 1
NO 2
DK 8
OTHER LIQUIDS
YES 1
NO 2
DK 8
FOOD MADE FROM MAIZE/RICE/WHEAT
YES 1
NO 2
DK 8
EGGS/FISH/POULTRY
YES 1
NO 2
DK 8
MEAT
YES 1
NO 2
DK 8
FRUITS OR VEG
YES 1
NO 2
DK 8
OTHER SOLID/SEMI-SOLID FOODS
YES 1
NO 2
DK 8

436 CHECK 435:
FOOD OR LIQUID GIVEN YESTERDAY?

“YES” TO ONE MORE (GO TO 437)
“NO/DK” TO ALL (SKIP TO 439)

437 (Aside from breast-feeding,) how many times did (NAME) eat yesterday, including both meals and snacks?
IF 7 OR MORE TIMES, RECORD ‘7’.

NUMBER OF TIMES ________
DON’T KNOW 8

439 GO BACK TO 405 IN NEXT COLUMN; OR, IF NO MORE BIRTHS, GO TO 440.

SECTION 4B: IMMUNIZATION AND HEALTH

440 ENTER THE NAME, LINE NUMBER, AND SURVIVAL STATUS OF EACH BIRTH SINCE JANUARY 1993 IN THE TABLE.
ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH.
(IF THERE ARE MORE THAN 2 BIRTHS, USE ADDITIONAL QUESTIONNAIRES).

441 LINE NUMBER FROM Q214

LINE NUMBER ______

442 FROM Q218 AND Q221

NAME ______
ALIVE (GO TO 443)
DEAD (GO TO 442 IN NEXT COLUMN; OR, IF NO MORE BIRTHS, GO TO 465.)

443 Do you have a card where (NAME’S) vaccinations are written down?
IF YES: May I see it please?

YES, SEEN 1 (SKIP TO 445)
YES, NOT SEEN 2 (SKIP TO 447)
NO CARD 3

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

YES 1 (SKIP TO 447)
NO 2 (SKIP TO 447)

445 (1) COPY VACCINATION DATE FOR EACH VACCINE FROM THE CARD
(2) WRITE ‘44’ IN ‘DAY’ COLUMN IF CARD SHOWS THAT A VACCINATION WAS GIVEN, BUT NO DATE IS RECORDED

BCG
DAY _____
MO _____
YR _____
Polio 0 (at birth)
DAY _____
MO _____
YR _____
Polio 1
DAY _____
MO _____
YR _____
Polio 2
DAY _____
MO _____
YR _____
Polio 3
DAY _____
MO _____
YR _____
DPT 1
DAY _____
MO _____
YR _____
DPT 2
DAY _____
MO _____
YR _____
DPT 3
DAY _____
MO _____
YR _____
Hep. B 1
DAY _____
MO _____
YR _____
Hep. B 2
DAY _____
MO _____
YR _____
Hep. B 3
DAY _____
MO _____
YR _____
Measles
DAY _____
MO _____
YR _____

446 Did (NAME) receive any vaccinations that are not recorded on this card?
RECORD ‘YES’ ONLY IF RESPONDENT MENTIONES BCG, POLIO 0-3, DPT 1-3, AND/OR MEASLES VACCINE(S).

YES 1 (PROBE FOR VACCINATIONS AND WRITE ‘66’ IN THE CORRESPONDING DAY COLUMN IN 445)
NO 2 (SKIP TO 450)
DON’T KNOW 8 (SKIP TO 450)

447 Did (NAME) ever receive any vaccinations to prevent him/her from getting diseases?

YES 1
NO 2 (SKIP TO 450)
DON’T KNOW 8 (SKIP TO 450)

448 Please tell me if (NAME) received any of the following vaccinations:
448A A BCG vaccination against tuberculosis, that is, an injection in the left arm or shoulder that caused a scar?

YES 1
NO 2
DON’T KNOW 8

448B Polio vaccine, that is, drops in the mouth?

YES 1
NO 2 (SKIP TO 448E)
DON’T KNOW 8 (SKIP TO 448E)

448C How many times?

NUMBER OF TIMES ______
DON’T KNOW 8

448D When was the first polio vaccine given, just after birth or later?

JUST AFTER BIRTH 1
LATER 2

448E DPT vaccination, that is, an injection usually given at the same time as polio drops?

YES 1
NO 2 (SKIP TO 448G)
DON’T KNOW 8 (SKIP TO 448G)

448F How many times?

NUMBER OF TIMES _____
DON’T KNOW 8

448G An injection to prevent measles?

YES 1
NO 2
DON’T KNOW 8

448H An injection to prevent hepatitis?

YES 1
NO 2 (SKIP TO 450)
DON’T KNOW 8 (SKIP TO 450)

448I How many times?

NUMBER OF TIMES _____
DON’T KNOW 8

450 Has (NAME) been ill or feverish with a cough at any time in the last 2 weeks?

YES 1
NO 2 (SKIP TO 454
DON’T KNOW 8 (SKIP TO 454)

451 When (NAME) was ill with a cough, did he/she breathe with difficulty or faster than usual with short, fast breaths?

YES 1
NO 2
DON’T KNOW 8

452 Did you seek advice or treatment for the illness?

YES 1
NO 2 (SKIP TO 454)

453 Where did you seek advice or treatment? Anywhere else?
RECORD ALL MENTIONED.

(NAME OF PLACE) ___________________
PUBLIC SECTOR
GOVT. HOSPITAL A
DAY HOSP/CLINIC/COMMUNITY HEALTH CENTER B
MOBILE CLINIC D
COMM. HEALTH WORKER E
OTHER PUBLIC (SPECIFY) __________________ F
PRIVATE MEDICAL SECTOR
PVT. HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
OTHER PRIVATE MEDICAL (SPECIFY) __________________ J
PRIVATE MEDICAL SECTOR
PVT. HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
OTHER PRIVATE MEDICAL (SPECIFY) ___________________ J
OTHER SOURCE
SHOP K
TRAD. HEALER L
OTHER (SPECIFY) _______________ X

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

YES 1
NO 2 (SKIP TO 464)
DON’T KNOW 8 (SKIP TO 464)

455 Was there any blood in the stools?

YES 1
NO 2
DON’T KNOW 8

456 On the worst day of the diarrhea, how many bowel movements did (NAME) have?

NUMBER OF BOWEL MOVEMENTS ______
DON’T KNOW 98

457 Was he/she given the same amount to drink as before the diarrhea, or more, or less?

SAME 1
MORE 2
LESS 3
DON’T KNOW 8

458 Was he/she given the same amount of food to eat as before the diarrhea, or more, or less?

SAME 1
MORE 2
LESS 3
DON’T KNOW 8

459 When (NAME) had diarrhea, was he/she given any of the following to drink:
A fluid, made from a special rehydration packet?
Thin watery porridge?
Soup?
Home-made sugar-salt-water solution?
Milk or infant formula?
Yoghurt-based drink?
Black Tea?
Water?
Coke?
Any other liquid?

FLUID FROM ORS PKT
YES 1
NO 2
DK 8
THIN WATERY
YES 1
NO 2
DK 8
PORRIDGE
YES 1
NO 2
DK 8
SOUP
YES 1
NO 2
DK 8
SUG.-SALT-WAT. SOL
YES 1
NO 2
DK 8
MILK/INFANT FORM
YES 1
NO 2
DK 8
YOGHURT-BASED DR
YES 1
NO 2
DK 8
BLACK TEA
YES 1
NO 2
DK 8
WATER
YES 1
NO 2
DK 8
COKE
YES 1
NO 2
DK 8
OTHER LIQUID
YES 1
NO 2
DK 8

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

YES 1
NO 2 (SKIP TO 462)
DON’T KNOW 8 (SKIP TO 462)

461 What was given to treat the diarrhea? Anything else?
RECORD ALL MENTIONED.

HOMEMADE SUGAR-SALT-WATER SOLUTION A
PILL OR SYRUP B
INJECTION C
(I.V.) INTRAVENOUS D
HOME REMEDIES/HERBAL MEDICINES E
OTHER (SPECIFY) ____________________ X

462 Did you seek advice or treatment for the diarrhea?

YES 1
NO 2 (SKIP TO 464)

463 Where did you seek advice or treatment? Anywhere else?
RECORD ALL MENTIONED.

PUBLIC SECTOR
GOVT. HOSPITAL A
DAY HOSP/CLINIC/COMMUNITY HEALTH CENTER B
MOBILE CLINIC D
COMM. HEALTH WORKER E
OTHER PUBLIC (SPECIFY) __________________ F
PRIVATE MEDICAL SECTOR
PVT. HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
OTHER PRIVATE MEDICAL (SPECIFY) __________________ J
PRIVATE MEDICAL SECTOR
PVT. HOSPITAL/CLINIC G
PHARMACY H
PRIVATE DOCTOR I
OTHER PRIVATE MEDICAL (SPECIFY) ___________________ J
OTHER SOURCE
SHOP K
TRAD. HEALER L
OTHER (SPECIFY) _______________ X

464 GO BACK TO 442 IN NEXT COLUMN; OR, IF NO MORE BIRTHS, GO TO 465.

465 Now I am going to ask you some general questions about caring for children with diarrhea and cough.
When a child has diarrhea, should he/she be given less to drink than usual, about the same amount, or more than usual?

LESS TO DRINK 1
ABOUT SAME AMOUNT TO DRINK 2
MORE TO DRINK 3
DON’T KNOW 8

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

LESS TO EAT 1
ABOUT SAME AMOUNT TO EAT 2
MORE TO EAT 3
DON’T KNOW 8

467 When a child is sick with diarrhea, what signs of illness would tell you that he or she should be taken to a health facility or health worker?
RECORD ALL MENTIONED. DO NOT PROBE

REPEATED WATERY STOOLS A
ANY WATERY STOOLS B
REPEATED VOMITING C
ANY VOMITING D
BLOOD IN STOOLS E
FEVER F
MARKED THIRST G
NOT EATING/NOT DRINKING WELL H
GETTING SICKER/VERY SICK I
NOT GETTING BETTER J
SUNKEN FONTANELLE K
OTHER (SPECIFY) ________________________ X
DON’T KNOW Z

468 CHECK 459, ALL COLUMNS:

NO CHILD RECEIVED ORS (GO TO 469)
ANY CHILD RECEIVED ORS (GO TO 470)

469 Have you ever heard of a special product called ORSOL OR SOROL that you can get for the treatment of diarrhea?

YES 1
NO 2

470 When a child is sick with a cough, what signs of illness would tell you that he or she should be taken to a health facility or health worker?
RECORD ALL MENTIONED.

FAST BREATHING A
DIFFICULT BREATHING . B
NOISY BREATHING C
FEVER/HIGH TEMPERATURE D
UNABLE TO DRINK E
NOT EATING/NOT DRINKING WELL F
GETTING SICKER/VERY SICK G
NOT GETTING BETTER H
COUGHING A LOT I
OTHER (SPECIFY) ______________________ X
DON’T KNOW Z

SECTION 5. MARITAL AND SEXUAL RELATIONS

501 I PRESENCE OF OTHERS AT THIS POINT.

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

Now I am going to ask you some sensitive questions about your marital and sexual relations. All information you give me is completely confidential.

502 Are you currently married or living with a man?

YES, CURRENTLY MARRIED 1 (GO TO 507)
YES, LIVING WITH A MAN 2 (GO TO 507)
NO, NOT IN UNION 3

503 Do you currently have a regular sexual partner, an occasional sexual partner, or no sexual partner at all?

REGULAR SEXUAL PARTNER 1
TWO OR MORE REGULAR PARTNERS 2
OCCASIONAL SEXUAL PARTNER 3
NO SEXUAL PARTNER 4

504 Have you ever been married or lived with a man?

YES, FORMERLY MARRIED 1
YES, LIVED WITH A MAN 2 (GO TO 511)
NO 3 (GO TO 514)

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

WIDOWED 1 (GO TO 511)
DIVORCED 2 (GO TO 511)
SEPARATED 3 (GO TO 511)

507 Is your husband/partner living with you now or is he staying elsewhere?

LIVING WITH HER 1
STAYING ELSEWHERE 2

508 Does your husband have any other wives besides yourself?

YES 1
NO 2 (GO TO 511)
DON’T KNOW 8 (GO TO 511)

509 How many other wives does he have?

NUMBER OF OTHER WIVES ______
DON’T KNOW 98

511 Have you been married or lived with a man only once, or more than once?

ONCE 1
MORE THAN ONCE 2

512 CHECK 511:
MARRIED/LIVED WITH A MAN ONLY ONCE
In what month and year did you start living with your husband/partner?

MARRIED/LIVED WITH A MAN MORE THAN ONCE
Now we will talk about your first husband/partner. In what month and year did you start living with him?

MONTH _____
DON’T KNOW MONTH 98
YEAR _____
DON’T KNOW YEAR 9998

513 How old were you when you started living with him?

AGE _____

514 How old were you when you had your first period?

AGE _____

515 Now I need to ask you some questions about sexual activity in order to gain a better understanding of some health and family planning issues.
When was the last time you had sexual intercourse (if ever)?

NEVER 000 (GO TO 608)
DAYS AGO 1 ____
WEEKS AGO 2 ____
MONTHS AGO 3 ____
YEARS AGO 4 ____ (GO TO 517)
BEFORE LAST BIRTH 996

515A Can you describe your relationship with the person you last had sexual intercourse with?

MARITAL PARTNER 01
OTHER REGULAR PARTNER 02
CASUAL ACQUAINTANCE 03
SOMEONE JUST MET 04
COMMERCIAL SEX WORKER 05
OTHER (SPECIFY) _________________ 96

516 CHECK 301 AND 302:
KNOW CONDOM
The last time you had sex, was a condom used?

DOES NOT KNOWS CONDOM
Some men use a condom, which means that they put a rubber sheath on their penis during sexual intercourse. The last time you had sex, was a condom used?

YES 1 (GO TO 516B)
NO 2
DON’T KNOW 8 (GO TO 516B)

516A If not, what are the reasons why you didn’t use one?
RECORD ALL MENTIONED
What is the Main Reason?

WANTS CHILDREN A
PERCEIVED LOW OR NO RISK OF STD/HIV B
RESPONDENT DISLIKE C
PARTNER DISLIKE D
CULTURAL/RELIGIOUS
PROHIBITION E
DID NOT KNOW CONDOMS F
DID NOT KNOW HOW TO USE CONDOM G
BAD PREVIOUS EXPERIENCE WITH CONDOM H
INCONVENIENT TO USE I
LACK OF SPONTANEITY J
DID NOT KNOW SOURCE OF CONDOMS K
EMBARRASSED TO GET L
INCONVENIENT TO GET M
DIDN’T HAVE A CONDOM N
COST TOO MUCH O
NO/LESS SENSATION WITH CONDOM P
SUGGESTS LACK OF TRUST OF PARTNER Q
SUGGESTS LACK OF LOVE OF PARTNER R
FEAR OF LOSING IT INSIDE S
WASTES SPERM T
RUBBER SMELL U
PARTNER OR SELF HAS BURNING/DISCOMFORT WHEN USING CONDOM V
PREFER SEX ‘FLESH TO FLESH’ W
CONDOM USE NOT COOL/MANLY/TRENDY Y
OTHER (SPECIFY) __________________________ X
DON’T KNOW Z

516B In the last 12 months, with how many different men have you had sexual intercourse?

NUMBER _______

517 Do you know of a place where you can get condoms?

YES 1
NO 2 (GO TO 519)

518 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
DAY HOSP/CLINIC COMMUNITY HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14
COMMUNITY HEALTH WORKER 15
OTHER PUBLIC (SPECIFY) ___________________ 16
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
PHARMACY 22
PRIVATE DOCTOR 23
OTHER PRIVATE
MEDICAL (SPECIFY) ________________ 26
OTHER SOURCE
SHOP 31
CHURCH 32
FRIENDS/RELATIVES 33
OTHER (SPECIFY) ______________ 36

519 How old were you when you first had sexual intercourse?

AGE _____
FIRST TIME WHEN MARRIED 96

SECTION 6. FERTILITY PREFERENCES

601 CHECK 314:

NEITHER STERILIZED (GO TO 602)
HE OR SHE STERILIZED (GO TO 612)

602 CHECK 234:
NOT PREGNANT OR UNSURE
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?

PREGNANT
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?

HAVE (A/ANOTHER) CHILD 1
NO MORE/NONE 2 (GO TO 604)
SAYS SHE CAN’T GET PREGNANT 3 (GO TO 606)
UNDECIDED/DON’T KNOW 8 (GO TO 604)

603 CHECK 234:
NOT PREGNANT OR UNSURE
How long would you like to wait from now before the birth of (a/another) child?

PREGNANT
After the child you are expecting now, how long would you like to wait before the birth of another child?

MONTHS 1 _____
YEARS 2 _____
SOON/NOW 993 (GO TO 606)
SAYS SHE CAN’T GET PREGNANT 994 (GO TO 606)
AFTER MARRIAGE 995
OTHER (SPECIFY)________________________ 996
DON’T KNOW 998

604 CHECK 234:

NOT PREGNANT OR UNSURE (GO TO 605)
PREGNANT (GO TO 607)

605 If you became pregnant in the next few weeks, would you be happy, unhappy, or would it not matter very much?

HAPPY 1
UNHAPPY 2
WOULD NOT MATTER 3

606 CHECK 313: USING A METHOD?

NOT ASKED (GO TO 607)
NOT CURRENTLY USING (GO TO 607)
CURRENTLY USING (GO TO 612)

607 Do you think you will use a method to delay or avoid pregnancy within the next 12 months?

YES 1 (GO TO 609)
NO 2
DON’T KNOW 8

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

YES 1
NO 2 (GO TO 610)
DON’T KNOW 8 (GO TO 610)

609 Which method would you prefer to use?

PILL 01 (GO TO 612)
IUD 02(GO TO 612)
INJECTIONS 03(GO TO 612)
DIAPHRAGM/FOAM/JELLY 04(GO TO 612)
CONDOM 05(GO TO 612)
FEMALE STERILIZATION 06(GO TO 612)
MALE STERILIZATION 07(GO TO 612)
CALENDER/RHYTHM 08(GO TO 612)
WITHDRAWAL 09(GO TO 612)
HERB/REMEDIES 10(GO TO 612)
OTHER (SPECIFY) ____________________ 96(GO TO 612)
UNSURE 98(GO TO 612)

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

FERTILITY-RELATED REASONS
INFREQUENT SEX 22
MENOPAUSAL/HYSTERECTOMY 23
INFERTILE 24
WANTS MORE CHILDREN 26
OPPOSITION TO USE
RESPONDENT OPPOSED 31
HUSBAND/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
COST TOO MUCH 54
INCONVENIENT TO USE 55
INTERFERES WITH BODY’S
NORMAL PROCESSES 56
OTHER (SPECIFY) ______________________96
DON’T KNOW 98

612 CHECK 216:
HAS LIVING CHILDREN
If you could go back to the time you did not have any children and could choose exactly the number of children to have in your whole life, how many would that be?

NO LIVING CHILDREN
If you could choose exactly the number of children to have in your whole life, how many would that be?

PROBE FOR A NUMERIC RESPONSE.

NUMBER _____
OTHER (SPECIFY) _________ 96

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

APPROVE 1
DISAPPROVE 2
NO OPINION 3

615 Is it acceptable or not acceptable to you for information on family planning to be provided:
On the radio?
On the television?

RADIO
ACCEPTABLE 1
NOT ACCEPTABLE 2
DK 8
TELEVISION
ACCEPTABLE 1
NOT ACCEPTABLE 2
DK 8

616 In the last few months have you heard about family planning and
sterilization:
On the radio?
On the television?
In a newspaper or magazine?
From a poster?
From leaflets or brochures?

RADIO
YES 1
NO 2
TELEVISION
YES 1
NO 2
NEWSPAPER OR MAGAZINE
YES 1
NO 2
POSTER
YES 1
NO 2
LEAFLETS OR BROCHURES
YES 1
NO 2

618 In the last few months have you discussed the practice of family planning with your friends, neighbours, or relatives?

YES 1
NO 2 (GO TO 620)

619 With whom? Anyone else?
RECORD ALL MENTIONED.

HUSBAND/PARTNER A
MOTHER B
FATHER C
SISTER(S) D
BROTHER(S) E
DAUGHTER F
MOTHER-IN-LAW G
FRIENDS/NEIGHBOURS H
OTHER (SPECIFY) ____________________ X

620 CHECK 502:

YES, CURRENTLY MARRIED (GO TO 621)
YES, LIVING WITH A MAN (GO TO 621)
NO, NOT IN UNION (GO TO 701)

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

APPROVES 1
DISAPPROVES 2
DON’T KNOW 8

622 How often have you talked to your husband/partner about family planning in the past year?

NEVER 1
ONCE OR TWICE 2
MORE OFTEN 3

623 Do you think your husband/partner wants the same number of children that you want, or does he want more or fewer than you want?

SAME NUMBER 1
MORE CHILDREN 2
FEWER CHILDREN 3
DON’T KNOW 8

624 Who makes the decisions about using methods to avoid pregnancy?

REPONDENT DECIDES 01
HUSBAND/PARTNER DECIDES 02
JOINTLY 03
OTHER (SPECIFY) _________________ 96

SECTION 7: TREATMENT OF WOMEN IN THE HOUSEHOLD

Now I would like to ask you some difficult questions about how you have been treated in your life by other people.

701 CHECK 502:

MARRIED, LIVING WITH A MAN (GO TO 702)
NO UNION (GO TO 703)

702 Within the last year, has your partner/husband regularly not provided money you need for food, rent or bills but has money for other things?

YES 1
NO 2

703 Over the last year, has anyone ever kicked, bitten, slapped, hit you with a fist, threaten you with a weapon, such as a knife, a stick, or a gun, or thrown something at you?

YES 1 (GO TO 705)
NO 2
NO ANSWER 3

704 Have any of your boyfriends or husbands ever kicked, bitten, slapped, hit you with a fist, threaten you with a weapon, such as a knife, a stick, or a gun, or thrown something at you?

YES 1 (GO TO 707)
NO 2 (GO TO 712)
NO ANSWER 3 (GO TO 712)

705 Can you tell me who has done this to you? Anyone else?
RECORD ALL MENTIONED
PROBE IF NOT MENTIONED

CURRENT HUSBAND/PARTNER A
FORMER HUSBAND/PARTNER B
BOYFRIEND C
FATHER D
BROTHER E
SON F
DAUGHTER G
MOTHER H
FATHER-IN-LAW I
MOTHER-IN-LAW J
OTHER MALE RELATIVE K
OTHER FEMALE RELATIVE L
MANAGER/FOREMAN/EMPLOYER M
ASSAILANT N
OTHER (SPECIFY) ____________________ X
NO ANSWER Y

706 Who is the person who did or does beat you most often?

CURRENT HUSBAND/PARTNER 01
FORMER HUSBAND/PARTNER 02
BOYFRIEND 03
FATHER 04
BROTHER 05
SON 06
DAUGHTER 07
MOTHER 08
FATHER-IN-LAW 09
MOTHER-IN-LAW 10
OTHER MALE RELATIVE 11
OTHER FEMALE RELATIVE 12
MANAGER/FOREMAN/EMPLOYER 13
OTHER (SPECIFY) ____________________ 96
NO ANSWER 98

707 Is or was this person always, sometimes or never “on something” (drugs or alcohol) when he/she did this to you?

ALWAYS 1
SOMETIMES 2
NEVER 3
NO ANSWER 8

708 In the past one year, approximately how many times did this happen to you?
IF NONE WRITE ‘00’

TIMES ____
NO ANSWER 96

709 Have you ever left a husband/partner because you were being beaten?

YES 1
NO 2

710 When you were pregnant, has anyone ever kicked, bitten, slapped, hit you with a fist, threaten you with a weapon, such as a knife, a stick, or a gun, or thrown something at you?

YES 1
NO 2
NEVER BEEN PREGNANT 3

711 In the past year, have you ever been so seriously hurt during a beating that you needed medical attention even if you did not see a doctor?

YES 1
NO 2
NO ANSWER 3

712 Has anyone ever forced you to have sexual intercourse against your will by threatening, holding you down or hurting you in some way?

YES 1 (GO TO 715)
NO 2

713 Has anyone ever persuaded you to have sexual intercourse when you did not want to?

YES 1
NO 2 (GO TO 718)

715 Did this happen before you were 15 years old?

YES 1
NO 2
NO ANSWER 3

716 How old were you when this first happened?

AGE _____

717 Who did this to you?

FATHER 01
OTHER MALE RELATIVE 02
BROTHER 03
FAMILY FRIEND/LODGER 04
LANDLORD/FARMER 05
SCHOOL TEACHER/PRINCIPAL 06
MAN/BOY FROM NEIGHBOURHOOD/SCHOOL/CHURCH 07
MANAGER/FOREMAN/EMPLOYER 08
STEPFATHER/MOTHER’S BOYFRIEND 09
BOYFRIEND/HUSBAND 10
STRANGER/RECENT ACQUAINTANCE 11
OTHER (SPECIFY) _______________________ 96

718 Before you were 15 years old, did any man touch you against your will in a sexual way, such as unwanted touching, kissing, grabbing or fondling?

YES 1
NO 2 (GO TO 721)
NO ANSWER 3 (GO TO 721)

719 How old were you when this first happened?

AGE ______

720 Who did this to you?

FATHER 01
OTHER MALE RELATIVE 02
BROTHER 03
FAMILY FRIEND/LODGER 04
LANDLORD/FARMER 05
SCHOOL TEACHER/PRINCIPAL 06
MAN/BOY FROM NEIGHBOURHOOD/SCHOOL/CHURCH 07
MANAGER/FOREMAN/EMPLOYER 08
STEPFATHER/MOTHER’S BOYFRIEND 09
BOYFRIEND/HUSBAND 10
STRANGER/RECENT ACQUAINTANCE 11
OTHER (SPECIFY) ______________________ 96

721 Before you were 15 years old, did any man force you to touch his private parts against your will?

YES 1
NO 2 (GO TO 724)
NO ANSWER 8 (GO TO 724)

722 How old were you when this first happened?

AGE ______

723 Who did this to you?

FATHER 01
OTHER MALE RELATIVE 02
BROTHER 03
FAMILY FRIEND/LODGER 04
LANDLORD/FARMER 05
SCHOOL TEACHER/PRINCIPAL 06
MAN/BOY FROM NEIGHBOURHOOD/SCHOOL/CHURCH 07
MANAGER/FOREMAN/EMPLOYER 08
STEPFATHER/MOTHER’S BOYFRIEND 09
BOYFRIEND/HUSBAND 10
STRANGER/RECENT ACQUAINTANCE 11
OTHER (SPECIFY) __________________ 96

724 Have you tried to get help from services of any kind because of beatings or other bad treatment?

YES 1
NO 2 (GO TO 726)

725 What do or did you use?

SHELTER A
COUNSELLING B
WOMEN’S CENTRE C
SOCIAL WORKER D
POLICE E
CLINIC/HOSPITAL F
OTHER (SPECIFY) _____________________ X

726 Would you have liked to have had help from a service that was not available?

YES 1
NO 2 (GO TO 801)

727 What service would have been helpful to you?

SHELTER A
COUNSELLING B
WOMEN’S CENTRE C
SOCIAL WORKER D
POLICE E
CLINIC/HOSPITAL F
OTHER (SPECIFY) ____________________ X

SECTION 8: AIDS

801 Have you ever heard of an illness called AIDS?

YES 1
NO 2 (GO TO 901)

802 How much information about HIV/AIDS did you obtain from each of the following sources:
Answer each question with a lot, some or none
a) TV?
b) Radio?
c) Newspaper?
d) Pamphlets?
e) Health Workers?
f) Friends?
g) Partner(s)?
h) Relatives?

RADIO
A LOT 1
SOME 2
NONE 3
NEWSPAPER
A LOT 1
SOME 2
NONE 3
PAMPHLETS
A LOT 1
SOME 2
NONE 3
HEALTH WORKERS
A LOT 1
SOME 2
NONE 3
FRIENDS
A LOT 1
SOME 2
NONE 3
PARTNER(S)
A LOT 1
SOME 2
NONE 3
RELATIVES
A LOT 1
SOME 2
NONE 3

803 I am going to read out some statements about protection against HIV/AIDS. For each statement, please tell me whether you think it is true or not.
People can protect themselves from HIV/AIDS by:
a) having a good diet
b) staying with one faithful partner
c) avoiding public toilets
d) using condoms during sexual intercourse
e) avoiding touching a person who has AIDS
f) avoiding sharing food with a person who has AIDS
g) avoiding being bitten by mosquitos or similar insects
h) making sure any injection they have is done with a clean needle
I) avoid sharing razor blades

DIET
TRUE 1
NOT TRUE 2
DON’T KNOW 8
FAITHFUL
TRUE 1
NOT TRUE 2
DON’T KNOW 8
AVOID TOILETS
TRUE 1
NOT TRUE 2
DON’T KNOW 8
CONDOMS
TRUE 1
NOT TRUE 2
DON’T KNOW 8
AVOID TOUCH
TRUE 1
NOT TRUE 2
DON’T KNOW 8
AVOID SHARED FOOD
TRUE 1
NOT TRUE 2
DON’T KNOW 8
AVOID MOSQUITOS
TRUE 1
NOT TRUE 2
DON’T KNOW 8
CLEAN INJECTION
TRUE 1
NOT TRUE 2
DON’T KNOW 8
AVOID RAZOR
TRUE 1
NOT TRUE 2
DON’T KNOW 8

804 Do you think that a person infected with the AIDS virus always shows symptoms or can such a person look perfectly healthy?

ALWAYS SHOWS SYMPTOMS 1
CAN LOOK HEALTHY 2
DON’T KNOW 8

804A I am going to ask you some questions about the need for people to be informed about their HIV/AIDS status:
a) should people with AIDS be told about their status?
b) should people diagnosed HIV positive be told about their status?
c) should HIV/AIDS patients tell their partner(s) about their status?
d) should the reporting of AIDS status to health authorities be made mandatory by law?
e) should the reporting of HIV status to health authorities be made mandatory by law?

TOLD ABOUT AIDS
TRUE 1
NOT TRUE 2
DON’T KNOW 8
TOLD ABOUT HIV
TRUE 1
NOT TRUE 2
DON’T KNOW 8
TELL PARTNERS
TRUE 1
NOT TRUE 2
DON’T KNOW 8
REPORT AIDS
TRUE 1
NOT TRUE 2
DON’T KNOW 8
REPORT HIV
TRUE 1
NOT TRUE 2
DON’T KNOW 8

805 Do you personally know someone who has been diagnosed with HIV/AIDS or who has died of AIDS?

YES 1
NO 2 (GO TO 901)

805A How much assistance and support do you think AIDS patients receive from each of the following:
Answer the questions with a lot, some or none.
a) employers?
b) co-workers?
c) insurance companies?
d) health workers?
e) friends?
f) partner(s)?
g) relatives?

A) EMPLOYERS
A LOT 1
SOME 2
NONE 3
B) CO-WORKERS
A LOT 1
SOME 2
NONE 3
C) INSURANCE C.
A LOT 1
SOME 2
NONE 3
D) HEALTH WORKERS
A LOT 1
SOME 2
NONE 3
E) FRIENDS
A LOT 1
SOME 2
NONE 3
F) PARTNER(S)
A LOT 1
SOME 2
NONE 3
G) RELATIVES 1 23
A LOT 1
SOME 2
NONE 3

SECTION 9 - MATERNAL MORTALITY

901 Now I would like to ask 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

902 CHECK 901:

TWO OR MORE BIRTHS (GO TO 903)
ONLY ONE BIRTH (RESPONDENT ONLY) (GO TO 1001)

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

NUMBER OF PRECEDING BIRTHS ________

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

________

905 Is (NAME) male or female?

MALE 1
FEMALE 2

906 Is (NAME) still alive?

YES 1
NO 2 (GO TO 908)
DK 8 (GO TO NEXT BIRTH)

907 How old is (NAME)?

________ (GO TO NEXT BIRTH)

908 In what year did (NAME) die?

________ (GO TO NEXT BIRTH)
DK 9998

909 How many years ago did (NAME) die?

________ (GO TO NEXT BIRTH)

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

________ (IF MALE OR DIED BEFORE AGE 12 GO TO NEXT BIRTH)

911Was (NAME) pregnant when she died?

YES 1(GO TO 914)
NO 2

912 Did (NAME) die during childbirth?

YES 1(GO TO 915)
NO 2

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

YES 1
NO 2 (GO TO 915)

914 Was her death due to complications of pregnancy or childbirth?

YES 1
NO 2

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

________ (GO TO NEXT BIRTH)

SECTION 10. HUSBAND’S BACKGROUND, WOMAN’S WORK AND RESIDENCE

1001 CHECK 502 AND 504:

CURRENTLY MARRIED/LIVING WITH A MAN (GO TO 1002)
FORMERLY MARRIED/LIVED WITH A MAN (GO TO 1003)
NEVER MARRIED AND NEVER IN UNION (GO TO 1009)

1002 How old was your husband/partner on his last birthday?

AGE _____

1003 Did your (last) husband/partner ever attend school?

YES 1
NO 2 (GO TO 1005)

1004 What was the highest (standard/year) he completed at school?

LESS THAN 1 YEAR COMPLETED 00
SUB A/CLASS 1
SUB B/CLASS 2
STANDARD 1
STANDARD 2
STANDARD 3
STANDARD 4
STANDARD 5
STANDARD 6
STANDARD 7
STANDARD 8
STANDARD 9
STANDARD 10
FURTHER STUDIES INCOMPLETE 11
DIPLOMA/OTHER POSTSCHOOL COMPLETE 12
FURTHER DEGREE COMPLETE 13
DON’T KNOW 98

1005 Does your husband/partner currently work?

YES 1
NO 2
DON’T KNOW 8

1006 What (is/was) your (last) husband/partner’s occupation?
That is, what kind of work (does/did) he mainly do?

__________

1009 Aside from your own housework, are you currently working for money?

YES 1 (GO TO 101)
NO 2

1010 As you know, some women take up jobs for which they are paid in cash or kind. Others sell things, have a small business or work on the family farm or in the family business.
Are you currently doing any of these things or any other work?

YES 1 (GO TO 101)
NO 2

1011 Have you done any work in the last 12 months?

YES 1
NO 2 (GO TO 102)

1012 What is your occupation, that is, what kind of work do you mainly do?

__________

1015 Do you do this work for a family business, are you employed by someone outside the family or are you self-employed?

FOR FAMILY MEMBER 1
FOR SOMEONE ELSE 2
SELF-EMPLOYED 3

1016 Do you usually work throughout the year, or do you work seasonally, or only once in a while?

THROUGHOUT THE YEAR 1 (GO TO 1018)
SEASONALLY/PART OF THE YEAR 2
ONCE IN A WHILE 3 (GO TO 1019)

1017 During the last 12 months, how many months did you work?

NUMBER OF MONTHS _____

1018 During the last 12 months, how many days a week did you usually work (in the months that you worked)?

NUMBER OF DAYS ______ (GO TO 1020)

1019 During the last 12 months, approximately how many days did you work?

NUMBER OF DAYS _____

1020 Do you earn cash for your work?
PROBE: Do you make money for working?

YES 1
NO 2 (GO TO 1023)

1021 How much do you usually earn for this work?
PROBE: Is this by the day, by the week, or by the month?

PER HOUR 1 _____
PER DAY 2 _____
PER WEEK 3 ______
PER MONTH 4 ______
PER YEAR 5 ______
OTHER (SPECIFY) _____________________ 9999996

1022 CHECK 502:
YES, CURRENTLY MARRIED
YES, LIVING WITH A MAN
Who mainly decides how the money you earn will be used: you, your husband/partner, you and your husband/partner jointly, or someone else?

NOT IN UNION
Who mainly decides how the money you earn will be used: you, someone else, or you and someone else jointly?

RESPONDENT DECIDES 1
HUSBAND/PARTNER DECIDES 2
JOINTLY WITH HUSBAND/PARTNER 3
SOMEONE ELSE DECIDES 4
JOINTLY WITH SOMEONE ELSE 5

1023 Do you usually work at home or away from home?

HOME 1
AWAY 2

1024 CHECK 222 AND 223: IS A CHILD LIVING AT HOME WHO IS AGE 5 OR LESS?

YES (GO TO 1025)
NO (GO TO 1026)

1025 Who usually takes care of (NAME OF YOUNGEST CHILD AT HOME) while you are working?

RESPONDENT 01
HUSBAND/PARTNER 02
OLDER FEMALE CHILD 03
OLDER MALE CHILD 04
OTHER RELATIVES 05
NEIGHBORS 06
FRIENDS 07
SERVANTS/HIRED HELP 08
CHILD IS IN SCHOOL 09
INSTITUTIONAL CHILD CARE 10
HAS NOT WORKED
SINCE LAST BIRTH 95
OTHER (SPECIFY)____________________96

1026 RECORD THE TIME

HOURS ________
MINUTES _______

INTERVIEWERS OBSERVATION

Comments about the respondent/s: ____________________________________________________________________

Comments on Specific Questions: ____________________________________________________________________

Any other comments:

SUPERVISOR’S OBSERVATION
Name of Supervisor: _____________________________________
Date_____________

EDITOR’S OBSERVATIONS
Name of Editor: _________________________________________
Date: ______________