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DEMOGRAPHIC AND HEALTH SURVEYS - ZAMBIA 1992 - WOMEN'S QUESTIONNAIRE

IDENTIFICATION

PROVINCE _________________ ___

DISTRICT _____________________ ___

CSA NUMBER ___

SEA NUMBER ___

HOUSEHOLD NUMBER ___

NAME OF HOUSEHOLD HEAD _______________ ___

URBAN/RURAL

URBAN = 1
RURAL = 2

LUSAKA/OTHER CITY/TOWN/VILLAGE

LUSAKA = 1
OTHER CITY = 2
TOWN = 3
VILLAGE = 4

NAME AND LINE NUMBER OF WOMAN _______________ ___

INTERVIEWER VISITS

FIRST VISIT (REPEAT FOR SECOND AND THIRD VISITS)
DATE ______________
INTERVIEWER'S NAME _______________
RESULT

RESULT* ______________

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

NEXT VISIT:
DATE ______
TIME _____

FINAL VISIT
DAY ____
MONTH ____
YEAR ___
NAME ___
RESULT ____

TOTAL NUMBER OF VISITS __

LANGUAGE OF QUESTIONNAIRE

ENGLISH 01

LANGUAGE USED IN INTERVIEW

01 ENGLISH
02 BEMBA
03 KAONDE
04 LOZI
05 LUNDA
06 LUVALE
07 NYANJA
08 TONGA
09 OTHER

RESPONDENT'S LOCAL LANGUAGE

01 ENGLISH
02 BEMBA
03 KAONDE
04 LOZI
05 LUNDA
06 LUVALE
07 NYANJA
08 TONGA
09 OTHER

TRANSLATOR USED

1 = NOT AT ALL
2 = SOMETIME
3 = ALL THE TIME

FIELD EDITED BY
NAME ________
DATE ________

OFFICE EDITED BY
NAME ________
DATE ________

KEYED BY
NAME ________ ___
DATE ________

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 town, or in a village?

CITY 1
TOWN 2
VILLAGE 3

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

YEARS ___

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

104. Just before you moved here, did you live in a city, in a town, or in a village?

CITY 1
TOWN 2
VILLAGE 3

105. In what month and year were you born?

MONTH ___
DON'T KNOW MONTH 98
YEAR __
DON'T KNOW YEAR 98

106. How old were you at your last birthday?
COMPARE AND CORRECT 105 AND/OR 106 IF INCONSISTENT.

AGE IN COMPLETED YEARS ___

107. Have you ever attended school?

YES 1
NO 2 (GO TO 111)

108. What is the highest level of school you attended: primary, secondary, or higher?

PRIMARY 1
SECONDARY 2
HIGHER 3

109. How many years did you complete at that level?

COMMENT ____________________
YEARS ___

110. CHECK 108:

PRIMARY (GO TO 111)
SECONDARY OR HIGHER (GO TO 112)

111. Can you read and understand a letter or newspaper easily, with difficulty, or not at all?

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

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

YES 1
NO 2

113. Do you usually listen to a radio at least once a week?

YES 1
NO 2

114. Do you usually watch television at least once a week?

YES 1
NO 2

115. What is your religion?

CATHOLIC 1
PROTESTANT 2
MUSLIM 3
OTHER (SPECIFY)________ 4

116. What tribe do you belong to?

TRIBE__________________ ___

117. CHECK Q.4 IN THE HOUSEHOLD QUESTIONNAIRE

THE WOMAN INTERVIEWED IS NOT A USUAL RESIDENT (GO TO 118)
THE WOMAN INTERVIEWED IS A USUAL RESIDENT (GO TO 201)

118. Now I would like to ask about the place in which you usually live. Do you usually live in a city, in a town, or in a village?

LUSAKA, LARGE CITY 1
SMALL CITY 2
TOWN 3
VILLAGE 4

119. In which province is that located?

CENTRAL 1
COPPERBELT 2
EASTERN 3
LUAPULA 4
LUSAKA 5
NORTHERN 6
NORTH-WESTERN 7
SOUTHERN 8
WESTERN 9
OUTSIDE ZAMBIA/OTHER 0

120. Now I would like to ask about the household in which you usually live. What is the source of water your household uses for handwashing and dishwashing?

PIPED WATER
PIPED INTO HOME OR PLOT 11 (GO TO 122)
PUBLIC TAP 12
WELL WATER
WELL IN RESIDENCE/YARD/PLOT 21 (GO TO 122)
PUBLIC WELL 22
SURFACE WATER
SPRING 31
RIVER/STREAM 32
POND/LAKE 33
RAINWATER 41 (GO TO 122)
TANKER TRUCK 51
BOTTLED WATER 61 (GO TO 122)
OTHER (SPECIFY) _______ 71

121. How long does it take to go there, get water, and come back?

MINUTES ___
ON PREMISES 996

122. Does your household get drinking water from this same source?

YES 1 (GO TO 124)
NO 2

123. What is the source of drinking water for members of your household?

PIPED WATER
PIPED INTO HOME OR PLOT 11
PUBLIC TAP 12
WELL WATER
WELL IN RESIDENCE/YARD/PLOT 21
PUBLIC WELL 22
SURFACE WATER
SPRING 31
RIVER/STREAM 32
POND/LAKE 33
RAINWATER 41
TANKER TRUCK 51
BOTTLED WATER 61
OTHER (SPECIFY) _______ 71

124. What kind of toilet facility does your household have?

FLUSH TOILET
OWN FLUSH TOILET 11
SHARED FLUSH TOILET 12
PIT TOILET/LATRINE
TRADITIONAL PIT TOILET 21
VENTILATED IMPROVED PIT (VIP) LATRINE 22
NO FACILITY/BUSH/FIELD 31
OTHER (SPECIFY) ________ 41

125. Does your household have:

Electricity?
A radio?
A television?
A refrigerator?

ELECTRICITY
YES 1
NO 2
RADIO
YES 1
NO 2
TELEVISION
YES 1
NO 2
REFRIGERATOR
YES 1
NO 2

126. How many rooms in your household are used for sleeping?

ROOMS ___

127. Could you describe the main material of the floor of your home?

NATURAL FLOOR
EARTH/SAND 11
RUDIMENTARY FLOOR
WOOD PLANKS/BOARDS 21
FINISHED FLOOR
PARQUET OR POLISHED WOOD 31
TERRAZO TILE 32
PVC TILES 33
CEMENT 34
CARPET 35
OTHER (SPECIFY) _____________ 41

128. Does any member of your household own:

A bicycle?
A motorcycle?
A car?

BICYCLE
YES 1
NO 2
MOTORCYCLE
YES 1
NO 2
CAR
YES 1
NO 2

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?

YES 1
NO 2 (GO TO 206)

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

YES 1
NO 2 (GO TO 204)

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

SONS AT HOME _____
DAUGHTERS AT HOME ______

204. Do you have any sons or daughters 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 a girl who was born alive but later died?
IF NO, PROBE: Any baby who cried or showed any sign of life but only survived a few hours or days?

YES 1
NO 2 (GO TO 208)

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

BOYS DEAD ___
GIRLS DEAD ___

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

TOTAL ___

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

YES (GO TO 210)
NO (PROBE AND CORRECT 201-208 AS NECESSARY)

210. CHECK 208:

ONE OR MORE BIRTHS (GO TO 211)
NO BIRTHS (GO TO 223)

211. Now I would like to talk to you about all of your births, whether still alive or not, starting with the first one you had.
RECORD NAMES OF ALL THE BIRTHS IN 212. RECORD TWINS AND TRIPLETS ON SEPARATE LINES.

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

NAME___________

213. RECORD SINGLE OR MULTIPLE BIRTH STATUS.

SING 1
MULT 2

214. Is (NAME) a boy or a girl?

BOY 1
GIRL 2

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

MONTH __________
YEAR __________

216. Is (NAME) still alive?

YES 1
NO 2 (GO TO 220)

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

AGE IN YEARS __

218. IF ALIVE: Is (NAME) living with you?

YES 1 (GO TO NEXT BIRTH)
NO 2

219. IF LESS THAN 15 YRS. OF AGE: With whom does he/she live?
IF MORE THAN 15 YRS. OF AGE: GO TO NEXT BIRTH.

FATHER 1 (GO TO NEXT BIRTH)
OTHER RELATIVE 2 (GO TO NEXT BIRTH)
SOMEONE ELSE 3 (GO TO NEXT BIRTH)

220. IF DEAD: How old was he/she 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 ____

221. COMPARE 208 WITH NUMBER OF BIRTHS IN HISTORY ABOVE AND MARK:

NUMBERS ARE SAME
CHECK:
FOR EACH BIRTH: YEAR OF BIRTH IS RECORDED. __
FOR EACH LIVING CHILD: CURRENT AGE IS RECORDED. __
FOR EACH DEAD CHILD: AGE AT DEATH IS RECORDED. __
FOR AGE AT DEATH 12 MONTHS: PROBE TO DETERMINE EXACT NUMBER OF MONTHS. __
NUMBERS ARE DIFFERENT (PROBE AND RECONCILE)

222. CHECK 215 AND ENTER THE NUMBER OF BIRTHS SINCE JANUARY 1987.
IF NONE, RECORD '0'.

NUMBER OF BIRTHS___

223. Are you pregnant now?

YES 1
NO 2 (GO TO 226)
UNSURE 8 (GO TO 226)

224. How many months pregnant are you?

MONTHS _______

225. 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 become pregnant at all?

THEN 1
LATER 2
NOT AT ALL 3

226. When did your last menstrual period start?

DAYS AGO 1 __
WEEKS AGO 2 ___
MONTHS AGO 3 ___
YEARS AGO 4 ___

IN MENOPAUSE 994
BEFORE LAST BIRTH 995
NEVER MENSTRUATED 996

227. Between the first day of a woman's period and the first day of her next period, are there certain times when she has a greater chance of becoming pregnant than other times?

YES 1
NO 2 (GO TO 301)
DON'T KNOW 3 (GO TO 301)

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

DURING HER PERIOD 1
RIGHT AFTER HER PERIOD HAS ENDED 2
IN THE MIDDLE OF THE CYCLE 3
JUST BEFORE HER PERIOD BEGINS 4
OTHER (SPECIFY) _____ 5
DON'T KNOW 8

SECTION 3. CONTRACEPTION

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

CIRCLE CODE 1 IN 302 FOR EACH METHOD MENTIONED SPONTANEOUSLY.
THEN PROCEED DOWN THE COLUMN, 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 302, ASK 303-304 BEFORE PROCEEDING TO THE NEXT METHOD.

302. Have you ever heard of (METHOD)?
READ DESCRIPTION OF EACH METHOD.

METHOD 01 PILL: Women can take a pill every day.
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 02 IUD: Women can have a loop or coil placed inside them by a doctor or a nurse.
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 03 INJECTIONS: Women can have an injection by a doctor or nurse which stops them from becoming pregnant for several months.
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 04 FOAMING TABLET/JELLY: Women can place a sponge, suppository, diaphragm, jelly, or cream inside them before intercourse.
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 05 CONDOM: Men can use a rubber sheath during sexual intercourse.
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 06 FEMALE STERILIZATION: Women can have an operation to avoid having any more children. This is also called 'turning the womb.'
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 07 MALE STERILIZATION: Men can have an operation to avoid having any more children.
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 08 NATURAL FAMILY PLANNING: Couples can avoid having sexual intercourse on certain days of the month when the woman is more likely to become pregnant?
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 09 WITHDRAWAL: Men can be careful and pull out before climax.
YES/SPONT 1
YES/PROBED 2
NO 3
METHOD 10 Have you heard of any other ways or methods that women or men can use to avoid pregnancy? LIST UP TO THREE METHODS
SPECIFY____
YES/SPONT 1
NO 3

303. Have you ever used (METHOD)?

METHOD 01 PILL: Women can take a pill every day.
YES 1
NO 2
METHOD 02 IUD: Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
METHOD 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
METHOD 04 FOAMING TABLET/JELLY: Women can place a sponge, suppository, diaphragm, jelly, or cream inside them before intercourse.
YES 1
NO 2
METHOD 05 CONDOM: Men can use a rubber sheath during sexual intercourse.
YES 1
NO 2
METHOD 06 FEMALE STERILIZATION: Women can have an operation to avoid having any more children. This is also called 'turning the womb.' Have you ever had an operation to avoid having any more children?
YES 1
NO 2
METHOD 07 MALE STERILIZATION: Men can have an operation to avoid having any more children.
YES 1
NO 2
METHOD 08 NATURAL FAMILY PLANNING: Couples can avoid having sexual intercourse on certain days of the month when the woman is more likely to become pregnant?
YES 1
NO 2
METHOD 09 WITHDRAWAL: Men can be careful and pull out before climax.
YES 1
NO 2
METHOD 10 Have you heard of any other ways or methods that women or men can use to avoid pregnancy?
YES 1
NO 2

304. Do you know where a person could go to get (METHOD)?

METHOD 01 PILL: Women can take a pill every day.
YES 1
NO 2
METHOD 02 IUD: Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
METHOD 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
METHOD 04 FOAMING TABLET/JELLY: Women can place a sponge, suppository, diaphragm, jelly, or cream inside them before intercourse.
YES 1
NO 2
METHOD 05 CONDOM: Men can use a rubber sheath during sexual intercourse.
YES 1
NO 2
METHOD 06 FEMALE STERILIZATION: Women can have an operation to avoid having any more children. This is also called 'turning the womb.'
YES 1
NO 2
METHOD 07 MALE STERILIZATION: Men can have an operation to avoid having any more children.
YES 1
NO 2
METHOD 08 NATURAL FAMILY PLANNING: Couples can avoid having sexual intercourse on certain days of the month when the woman is more likely to become pregnant: Do you know where a person can obtain advice on how to use natural family planning?
YES 1
NO 2

305. CHECK 303:

NOT A SINGLE 'YES' (NEVER USED) (GO TO 306)
AT LEAST ONE 'YES' (EVER USED) (GO TO 308)

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

YES 1
NO 2 (GO TO 324)

307. What have you used or done?
CORRECT 303-305 (AND 302 IF NECESSARY).

308. Now I would like to ask you about the time when you first did something or used a method to avoid getting pregnant. How many living children did you have at that time, if any?
IF NONE, RECORD '00'.

NUMBER OF CHILDREN _____

308A. CHECK 303 (B):

EVER USED NATURAL FAMILY PLANNING (GO TO 308B)
NEVER USED NATURAL FAMILY PLANNING (GO TO 309)

308B. You said that sometimes you have avoided having sexual intercourse on certain days of the month to avoid getting pregnant. How did you know which days to avoid sexual intercourse?

CALENDAR, COUNTING DAYS 1
CERVICAL MUCUS METHOD 2
TOOK TEMPERATURE DAILY 3
MUCUS AND TEMPERATURE 4
OTHER (SPECIFY) ____________ 5

309. CHECK 223:

NOT PREGNANT OR UNSURE (GO TO 310)
PREGNANT (GO TO 324)

310. CHECK 303:

WOMAN NOT STERILIZED (GO TO 311)
WOMAN STERILIZED (GO TO 312A)

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

YES 1
NO 2 (GO TO 324)

312. Which method are you using?
312A. CIRCLE '06' FOR FEMALE STERILIZATION.

PILL 01
IUD 02 (GO TO 318)
INJECTIONS 03 (GO TO 318)
DIAPHRAGM/FOAM/JELLY 04 (GO TO 318)
CONDOM 05 (GO TO 318)
FEMALE STERILIZATION 06 (GO TO 318)
MALE STERILIZATION 07 (GO TO 318)
NATURAL FAMILY PLANNING 08 (GO TO 323)
WITHDRAWAL 09 (GO TO 323)
OTHER (SPECIFY) _________ 10 (GO TO 323)

313. At the time you first started using the pill, did you consult a doctor or a nurse?

YES 1
NO 2
DON'T KNOW 8

314. At the time you last got pills, did you consult a doctor or a nurse?

YES 1
NO 2

315. May I see the package of pills you are using now?
RECORD NAME OF BRAND.

PACKAGE SEEN 1 (GO TO 317)
BRAND NAME ______________ ___ (GO TO 317)
PACKAGE NOT SEEN 2

316. Do you know the brand name of the pills you are using now?
RECORD NAME OF BRAND.

BRAND NAME _____________ ___
DON'T KNOW 98

317. How much does one (packet/cycle) of pills cost you?

COST ____

FREE 996
DON'T KNOW 998

318. CHECK 312:

SHE/HE STERILIZED: Where did the sterilization take place?

USING ANOTHER METHOD: Where did you obtain (METHOD) the last time?

RECORD MINES HOSPITAL OR CLINIC AS PRIVATE ('21')

(NAME OF PLACE) __________
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
FIELD WORKER 13 (GO TO 321)
MEDICAL PRIVATE SECTOR
PRIVATE HOSPITAL OR CLINIC 21
MISSION HOSPITAL OR CLINIC 22
PHARMACY 23
PRIVATE DOCTOR 24
MOBILE CLINIC 25 (GO TO 321)
FIELD WORKER 26 (GO TO 321)
OTHER PRIVATE SECTOR
SHOP 31
FRIENDS/RELATIVES 32 (GO TO 321)
OTHER (SPECIFY) _________________ 41 (GO TO 321)
DON'T KNOW 98 (GO TO 321)

319. How long does it take to travel from your home to this place?
IF LESS THAN 2 HOURS, RECORD MINUTES. OTHERWISE, RECORD HOURS.

MINUTES 1___
HOURS 2 __

DON'T KNOW 9998

320. Is it easy or difficult to get there?

EASY 1
DIFFICULT 2

321. CHECK 312:

SHE/HE STERILIZED (GO TO 322)
USING ANOTHER METHOD (GO TO 323)

322. In what month and year was the sterilization operation performed?

MONTH __ (GO TO 334)
YEAR __ (GO TO 334)

323. For how many months have you been using (CURRENT METHOD) continuously?
IF LESS THAN 1 MONTH, RECORD '00'.

MONTHS ___ (GO TO 329)
8 YEARS OR LONGER 96 (GO TO 329)

324. Do you intend to use a method to delay or avoid pregnancy at any time in the future?

YES 1 (GO TO 326)
NO 2
DON'T KNOW 8 (GO TO 330)

325. What is the main reason you do not intend to use a method?

WANTS CHILDREN 01 (GO TO 330)
LACK OF KNOWLEDGE 02 (GO TO 330)
PARTNER OPPOSED 03 (GO TO 330)
COST TOO MUCH 04 (GO TO 330)
SIDE EFFECTS 05 (GO TO 330)
HEALTH CONCERNS 06 (GO TO 330)
HARD TO GET METHODS 07 (GO TO 330)
RELIGION 08 (GO TO 330)
OPPOSED TO FAMILY PLANNING 09 (GO TO 330)
FATALISTIC 10 (GO TO 330)
OTHER PEOPLE OPPOSED 11 (GO TO 330)
INFREQUENT SEX 12 (GO TO 330)
DIFFICULT TO GET PREGNANT 13 (GO TO 330)
MENOPAUSAL/HAD HYSTERECTOMY 14 (GO TO 330)
INCONVENIENT 15 (GO TO 330)
NOT MARRIED 16 (GO TO 330)
OTHER (SPECIFY) ______ 17 (GO TO 330)
DON'T KNOW 98 (GO TO 330)

326. Do you intend to use a method within the next 12 months?

YES 1
NO 2
DON'T KNOW 8

327. When you use a method, which method would you prefer to use?

PILL 01
IUD 02
INJECTIONS 03
DIAPHRAGM/FOAM/JELLY 04
CONDOM 05
FEMALE STERILIZATION 06
MALE STERILIZATION 07
NATURAL FAMILY PLANNING 08 (GO TO 330)
WITHDRAWAL 09 (GO TO 330)
OTHER (SPECIFY) _________ 10 (GO TO 330)
UNSURE 98 (GO TO 330)

328. Where can you get (METHOD MENTIONED IN 327)?

(NAME OF PLACE) __________
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11 (GO TO 332)
GOVERNMENT HEALTH CENTER 12 (GO TO 332)
FIELD WORKER 13 (GO TO 334)
MEDICAL PRIVATE SECTOR
PRIVATE HOSPITAL OR CLINIC 21 (GO TO 332)
MISSION HOSPITAL OR CLINIC 22 (GO TO 332)
PHARMACY 23 (GO TO 332)
PRIVATE DOCTOR 24 (GO TO 332)
MOBILE CLINIC 25 (GO TO 334)
FIELD WORKER 26 (GO TO 334)
OTHER PRIVATE SECTOR
SHOP 31 (GO TO 332)
FRIENDS/RELATIVES 32 (GO TO 334)
OTHER (SPECIFY) _________________ 41 (GO TO 332)
DON'T KNOW 98 (GO TO 330)

329. CHECK 312:

USING NATURAL FAMILY PLANNING, WITHDRAWAL, OTHER TRADITIONAL METHOD (GO TO 330)
USING A MODERN METHOD (GO TO 334)

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

YES 1
NO 2 (GO TO 334)

331. Where is that?

(NAME OF PLACE) __________
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
FIELD WORKER 13 (GO TO 334)
MEDICAL PRIVATE SECTOR
PRIVATE HOSPITAL OR CLINIC 21
MISSION HOSPITAL OR CLINIC 22
PHARMACY 23
PRIVATE DOCTOR 24
MOBILE CLINIC 25 (GO TO 334)
FIELD WORKER 26 (GO TO 334)
OTHER PRIVATE SECTOR
SHOP 31
FRIENDS/RELATIVES 32 (GO TO 334)
OTHER (SPECIFY) _________________ 41 (GO TO 332)
DON'T KNOW 98 (GO TO 330)

332. How long does it take to travel from your home to this place?
IF LESS THAN 2 HOURS, RECORD MINUTES. OTHERWISE, RECORD HOURS.

MINUTES 1___
HOURS 2 __

DON'T KNOW 9998

333. Is it easy or difficult to get there?

EASY 1
DIFFICULT 2

334. In the last month, have you heard a message about family planning on:

the radio?
television?

RADIO
YES 1
NO 2
TELEVISION
YES 1
NO 2

335. Is it acceptable to you for family planning information to be provided on:

the radio?
television?

RADIO
YES 1
NO 2
TELEVISION
YES 1
NO 2

SECTION 4A. PREGNANCY AND BREASTFEEDING

401. CHECK 222:

ONE OR MORE BIRTHS SINCE JAN.1987 (GO TO 402)
NO BIRTHS SINCE JAN.1987 (GO TO 501)

402. ENTER THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH SINCE JANUARY 1985* IN THE TABLE. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 3 BIRTHS, USE ADDITIONAL FORMS).

Now I would like to ask you some more questions about the health of all your children born in the past 5 years. (We will talk about one child at a time.)

LINE NUMBER FROM Q.212

LINE NUMBER _____

FROM Q.212

NAME ________________

403. 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 (GO TO 405)
LATER 2
NO MORE 3 (GO TO 405)

404. How much longer would you like to have waited?

MONTHS 1 __
YEARS 2 __

DON'T KNOW 998

405. When you were pregnant with (NAME), did you see anyone for antenatal care for this pregnancy?
IF YES: Whom did you see? Anyone else?
RECORD ALL PERSONS SEEN.

HEALTH PROFESSIONAL
DOCTOR A
NURSE/MIDWIFE B
CLINICAL OFFICER C
OTHER PERSON
TRAINED TRADITIONAL BIRTH ATTENDANT D
TRADITIONAL BIRTH ATTENDANT E
OTHER (SPECIFY) ________ F
NO ONE G (GO TO 409)

406. Were you given an antenatal card for this pregnancy?

YES 1
NO 2
DON'T KNOW 8

407. How many months pregnant were you when you first saw someone for an antenatal check on this pregnancy?

MONTHS _____
DON'T KNOW 98

408. How many antenatal visits did you have during this pregnancy?

NO. OF VISITS _____
DON'T KNOW 98

409. 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 (GO TO 411)
DON'T KNOW 8 (GO TO 411)

410. During this pregnancy, how many times did you get this injection?

TIMES __
DON'T KNOW 8

411. Where did you give birth to (NAME)?

HOME
YOUR HOME 11
OTHER HOME 12
PUBLIC SECTOR
GVT. HOSPITAL 21
GVT. HEALTH CENTER 22
PRIVATE SECTOR
PVT. HOSPITAL/CLINIC 31
MISSION HOSP./CLINIC 32
OTHER (SPECIFY) ____________ 41

412. 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
CLINICAL OFFICER C
OTHER PERSON
TRAINED TRADITIONAL BIRTH ATTENDANT D
TRADITIONAL BIRTH ATTENDANT E
RELATIVE F
OTHER (SPECIFY) ________ G
NO ONE H

413. Was (NAME) born on time or prematurely?

ON TIME 1
PREMATURELY 2
DON'T KNOW 8

414. Was (NAME) delivered by caesarian section?

YES 1
NO 2

415. When (NAME) was born, was he/she: very large, larger than average, average, smaller than average, or very small?

VERY LARGE 1
LARGER THAN AVERAGE 2
AVERAGE 3
SMALLER THAN AVERAGE 4
VERY SMALL 5
DON'T KNOW 8

416. Was (NAME) weighed at birth?

YES 1
NO 2 (GO TO 418)

417. How much did (NAME) weigh?

KILOGRAMS __.__
DON'T KNOW 98

418. Has your period returned since the birth of (NAME)?
[Last Birth Only]

YES 1 (GO TO 420)
NO 2 (GO TO 421)

419. Did your period return between the birth of (NAME) and your next pregnancy?
[Exclude Last Birth]

YES 1
NO 2 (GO TO 423)

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

MONTHS ______
DON'T KNOW 98

421. CHECK 223:
RESPONDENT PREGNANT?

NOT PREGNANT (GO TO 422)
PREGNANT OR UNSURE (GO TO 423)

422. Have you resumed sexual relations since the birth of (NAME)?
[Last Birth Only]

YES 1
NO 2 (GO TO 424)

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

MONTHS ___________
DON'T KNOW 98

424. Did you ever breastfeed (NAME)?

YES 1 (GO TO 426)
NO 2

425. Why did you not breastfeed (NAME)?

MOTHER ILL/WEAK 01 (GO TO 435)
CHILD ILL/WEAK 02 (GO TO 435)
CHILD DIED 03 (GO TO 435)
NIPPLE/BREAST PROBLEM 04 (GO TO 435)
INSUFFICIENT MILK 05 (GO TO 435)
MOTHER WORKING 06 (GO TO 435)
CHILD REFUSED 07 (GO TO 435)
OTHER (SPECIFY) _________ 08 (GO TO 435)

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.
[Last Birth Only]

IMMEDIATELY 000

HOURS 1 ______
DAYS 2 ______

427. CHECK 216:
CHILD ALIVE?

ALIVE (GO TO 428)
DEAD (GO TO 433)

428. Are you still breastfeeding (NAME)?
[Last Birth Only]

YES 1
NO 2 (GO TO 433)

429. How many times did you breastfeed last night between sunset and sunrise?
IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER.
[Last Birth Only]

NUMBER OF NIGHTTIME FEEDINGS ______

430. How many times did you breastfeed yesterday during the daylight hours?
IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER.
[Last Birth Only]

NUMBER OF DAYLIGHT FEEDINGS _________

431. At any time yesterday or last night was (NAME) given any of the following:
[Last Birth Only]

Plain water?
Sugar water?
Juice?
Tea?
Baby formula?
Fresh milk?
Tinned or powdered milk?
Other liquids?
Any solid or mushy food?

PLAIN WATER
YES 1
NO 2
SUGAR WATER
YES 1
NO 2
JUICE
YES 1
NO 2
TEA
YES 1
NO 2
BABY FORMULA
YES 1
NO 2
FRESH MILK
YES 1
NO 2
TINNED/POWDERED MILK
YES 1
NO 2
OTHER LIQUIDS
YES 1
NO 2
SOLID/MUSHY FOOD
YES 1
NO 2

432. CHECK 431:
FOOD OR LIQUID GIVEN YESTERDAY?
[Last Birth Only]

'YES' TO ONE OR MORE (GO TO 437)
'NO' TO ALL (GO TO 436)

433. For how many months did you breastfeed (NAME)?

MONTHS _________
UNTIL DIED 96 (GO TO 436)

434. Why did you stop breastfeeding (NAME)?

MOTHER ILL/WEAK 01
CHILD ILL/WEAK 02
CHILD DIED 03
NIPPLE/BREAST PROBLEM 04
INSUFFICIENT MILK 05
MOTHER WORKING 06
CHILD REFUSED 07
WEANING AGE 08
BECAME PREGNANT 09
STARTED USING CONTRACEPTION 10
OTHER (SPECIFY) _______ 11

435. CHECK 216:
CHILD ALIVE?

ALIVE (GO TO 437)
DEAD (GO TO 436)

436. Was (NAME) ever given water or anything else to drink or eat (other than breastmilk)?

YES 1
NO 2 (GO TO 440)

437. How many months old was (NAME) when you started giving the following on a regular basis?:
IF LESS THAN 1 MONTH, RECORD '00'.

Formula or milk other than breastmilk?
AGE IN MONTHS __
NOT GIVEN 96
Plain water?
AGE IN MONTHS __
NOT GIVEN 96
Other liquids?
AGE IN MONTHS __
NOT GIVEN 96
Any solid or mushy food?
AGE IN MONTHS __
NOT GIVEN 96

438. CHECK 216:
CHILD ALIVE?

ALIVE (GO TO 439)
DEAD (GO TO 440)

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

YES 1
NO 2
DON'T KNOW 8

440. GO BACK TO 403 FOR NEXT BIRTH; OR, IF NO MORE BIRTHS, GO TO FIRST COLUMN OF 441.

SECTION 4B. IMMUNIZATION AND HEALTH

441. ENTER THE LINE NUMBER AND NAME OF EACH BIRTH SINCE JANUARY 1987 IN THE TABLE. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS, BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 3 BIRTHS, USE ADDITIONAL FORMS).

LINE NUMBER FROM Q.212

NAME ________ ___

442. Do you have a card where (NAME'S) vaccinations are written down?
IF YES: May I see it, please?

YES, SEEN 1 (GO TO 444)
YES, NOT SEEN 2 (GO TO 446)
NO CARD 3

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

YES 1 (GO TO 446)
NO 2 (GO TO 446)

444. (1) COPY VACCINATION DATES FOR EACH VACCINE FROM THE CARD.
(2) WRITE '44' IN 'DAY' COLUMN IF CARD SHOWS A VACCINE WAS GIVEN BUT NO DATE WAS RECORDED.

BCG
DAY ___
MONTH _____
YEAR ______
POLIO 1
DAY ___
MONTH _____
YEAR ______
POLIO 2
DAY ___
MONTH _____
YEAR ______
POLIO 3
DAY ___
MONTH _____
YEAR ______
DPT 1
DAY ___
MONTH _____
YEAR ______
DPT 2
DAY ___
MONTH _____
YEAR ______
DPT 3
DAY ___
MONTH _____
YEAR ______
MEASLES
DAY ___
MONTH _____
YEAR ______

445. Has (NAME) received any vaccinations that are not recorded on this card?
RECORD 'YES' ONLY IF RESPONDENT MENTIONS BCG, DPT 1-3, POLIO 1-3 AND/OR MEASLES VACCINE(S).

YES 1 (PROBE FOR VACCINATIONS AND WRITE '66' IN THE CORRESPONDING DAY COLUMN IN 444) (GO TO 448)
NO 2 (GO TO 448)
DON'T KNOW 8 (GO TO 448)

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

YES 1
NO 2 (GO TO 448)
DON'T KNOW 8 (GO TO 448)

447. Please tell me if (NAME) (has) received any of the following vaccinations:

A BCG vaccination against tuberculosis, that is, an injection in the left forearm that caused a scar?

YES 1
NO 2
DON'T KNOW 8

Polio vaccine, that is, drops in the mouth?

YES 1
NO 2
DON'T KNOW 8

IF YES: How many times?

NUMBER OF TIMES___

DPT vaccine, given in the right thigh or buttock to prevent whooping cough?

YES 1
NO 2
DON'T KNOW 8

IF YES: How many times?

NUMBER OF TIMES___

An injection against measles?

YES 1
NO 2
DON'T KNOW 8

448. CHECK 216:
CHILD ALIVE?

ALIVE (GO TO 450)
DEAD (GO TO 449)

449. GO BACK TO 442 FOR NEXT BIRTH; OR, IF NO MORE BIRTHS, GO TO 480.

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

YES 1
NO 2
DON'T KNOW 8

451. Has (NAME) been ill with a cough at any time in the last 2 weeks?

YES 1
NO 2 (GO TO 455)
DON'T KNOW 8 (GO TO 455)

452. Has (NAME) been ill with a cough in the last 24 hours?

YES 1
NO 2
DON'T KNOW 8

453. For how many days has the cough lasted/did the cough last?
IF LESS THAN 1 DAY, WRITE '00'.

DAYS ____

454. When (NAME) had the illness with a cough, did he/she breathe faster than usual with short, rapid breaths?

YES 1
NO 2
DON'T KNOW 8

455. CHECK 450 AND 451:
FEVER OR COUGH?

'YES' IN EITHER 450 OR 451 (GO TO 456)
OTHER (GO TO 460)

456. Was anything given to treat the fever/cough?

YES 1
NO 2 (GO TO 458)
DON'T KNOW 8 (GO TO 458)

457. What was given to treat the fever/cough?
Anything else?
RECORD ALL MENTIONED.

INJECTION A
ANTIBIOTIC (PILL OR SYRUP) B
ANTIMALARIAL (PILL OR SYRUP) C
COUGH SYRUP D
OTHER PILL OR SYRUP E
UNKNOWN PILL OR SYRUP F
HOME REMEDY/HERBAL MEDICINE G
OTHER (SPECIFY) _______ H

458. Did you seek advice or treatment for the fever/cough?

YES 1
NO 2 (GO TO 460)

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

PUBLIC SECTOR
GVT. HOSPITAL A
GVT. HEALTH CENTER B
COMMUNITY HEALTH WORKER C
MEDICAL PRIVATE SECTOR
PVT. HOSPITAL/CLINIC D
MISSION HOSP./CLINIC E
PHARMACY F
PRIVATE DOCTOR G
OTHER PRIVATE SECTOR
SHOP H
TRADITIONAL HEALER I
OTHER (SPECIFY) _____________ J

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

YES 1 (GO TO 462)
NO 2
DON'T KNOW 8

461. GO BACK TO 442 FOR NEXT BIRTH OR, IF NO MORE BIRTHS, GO TO 480.

462. Has (NAME) had diarrhea in the last 24 hours?
(3 OR MORE WATERY STOOLS)

YES 1
NO 2
DON'T KNOW 8

463. For how many days (has the diarrhea lasted/did the diarrhea last)?
IF LESS THAN 1 DAY, WRITE '00'.

DAYS ____

464. Was there any blood in the stools?

YES 1
NO 2
DON'T KNOW 8

465. CHECK 424/428:
LAST CHILD STILL BREASTFED?

YES (GO TO 466)
NO (GO TO 468)

466. During (NAME)'s diarrhea, did you change the frequency of breastfeeding?
[Last Birth Only]

YES
NO (GO TO 468)

467. Did you increase the number of breastfeeds or reduce them, or did you stop completely?
[Last Birth Only]

INCREASED 1
REDUCED 2
STOPPED COMPLETELY 3

468. (Aside from breastmilk) 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

469. Was anything given to treat the diarrhea?

YES 1
NO 2 (GO TO 471)
DON'T KNOW 8 (GO TO 471)

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

FLUID FROM ORS PACKET A
HOMEMADE SUGAR/SALT SOLUTION B
ANTIBIOTIC PILL OR SYRUP C
OTHER PILL OR SYRUP D
INJECTION E
(I.V.) INTRAVENOUS F
HOME REMEDIES/HERBAL MEDICINES G
OTHER (SPECIFY) _______ H

471. Did you seek advice or treatment for the diarrhea?

YES 1
NO 2 (GO TO 473)

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

PUBLIC SECTOR:
GVT. HOSPITAL A
GVT. HEALTH CENTER B
COMMUNITY HEALTH WORKER C
MEDICAL PRIVATE SECTOR
PVT. HOSPITAL/CLINIC D
MISSION HOSP./CLINIC E
PHARMACY F
PRIVATE DOCTOR G
OTHER PRIVATE SECTOR
SHOP H
TRADITIONAL HEALER I
OTHER (SPECIFY) _____________ J

473. CHECK 470:
ORS FLUID FROM PACKET MENTIONED?

NO, ORS FLUID NOT MENTIONED (GO TO 474)
YES, ORS FLUID MENTIONED (GO TO 475)

474. Was (NAME) given Madzi a Moyo (or UNICEF ORS packet) when he/she had the diarrhea?

YES 1
NO 2 (GO TO 476)
DON'T KNOW 8 (GO TO 476)

475. For how many days was (NAME) given Madzi a Moyo?
IF LESS THAN 1 DAY, RECORD '00'.

DAYS _____
DON'T KNOW 98

476. CHECK 470:
HOMEMADE SUGAR/SALT SOLUTION MENTIONED?

NO, HOME FLUID NOT MENTIONED (GO TO 477)
YES, HOME FLUID MENTIONED (GO TO 478)

477. Was (NAME) given a homemade fluid made from sugar, salt and water when he/she had the diarrhea?

YES 1
NO 2 (GO TO 479)
DON'T KNOW 8 (GO TO 479)

478. For how many days was (NAME) given the fluid made from sugar, salt and water?
IF LESS THAN 1 DAY, WRITE '00'.

DAYS _____
DON'T KNOW 98

479. GO BACK TO 442 FOR NEXT BIRTH; OR, IF NO MORE BIRTHS, GO TO 480.

480. CHECK 470 AND 474 (ALL COLUMNS):

ORS FLUID FROM PACKET GIVEN TO ANY CHILD (GO TO 484)
ORS FLUID FROM PACKET NOT GIVEN TO ANY CHILD OR 470 AND 474 NOT ASKED (GO TO 481)

481. Have you ever heard of a special product called Madzi a Moyo you can get for the treatment of diarrhea?

YES 1 (GO TO 483)
NO 2

482. Have you ever seen a packet like this before?
SHOW PACKET.

YES 1
NO 2 (GO TO 487)

483. Have you ever prepared a solution with one of these packets to treat diarrhea in yourself or someone else?
SHOW PACKET.

YES 1
NO 2 (GO TO 486)

484. The last time you prepared Madzi a Moyo, did you prepare the whole packet at once or only part of the packet?

WHOLE PACKET AT ONCE 1
PART OF PACKET 2 (GO TO 486)

485. How much water did you use to prepare Madzi a Moyo the last time you made it?

1/2 LITER 01
750 MLS 02
1 LITER 03
1 1/2 LITERS 04
2 LITERS 05
FOLLOWED PACKAGE INSTRUCTIONS 06
OTHER (SPECIFY) _____ 07
DON'T KNOW 98

486. Where can you get Madzi a Moyo packet?
PROBE: Anywhere else?
RECORD ALL PLACES MENTIONED.

PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
COMMUNITY HEALTH WORKER C
MEDICAL PRIVATE SECTOR
PRIVATE HOSPITAL/CLINIC D
MISSION HOSPITAL/CLINIC E
PHARMACY F
PRIVATE DOCTOR G
OTHER PRIVATE SECTOR
SHOP H
TRADITIONAL PRACTIONER I
OTHER (SPECIFY) _________________ J

487. CHECK 470 AND 477 (ALL COLUMNS):

HOME-MADE FLUID GIVEN TO ANY CHILD (GO TO 488)
HOME-MADE FLUID NOT GIVEN TO ANY CHILD OR 470 AND 477 NOT ASKED (GO TO 501)

488. Where did you learn to prepare the home fluid made from sugar, salt and water that was given to (NAME) when he/she had the diarrhea?

PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
COMMUNITY HEALTH WORKER 13
MEDICAL PRIVATE SECTOR
PRIVATE HOSPITAL/CLINIC 21
MISSION HOSPITAL/CLINIC 22
PHARMACY 23
PRIVATE DOCTOR 24
OTHER PRIVATE SECTOR
SHOP 31
TRADITIONAL PRACTIONER 32
OTHER (SPECIFY) _________________ 41

SECTION 5. MARRIAGE

501. Have you ever been married or lived with a man?

YES 1
NO 2 (GO TO 512)

502. Are you now married or living with a man, or are you now widowed, divorced, or no longer living together?

MARRIED 1
LIVING TOGETHER 2
WIDOWED 3 (GO TO 507)
DIVORCED 4 (GO TO 507)
NO LONGER LIVING TOGETHER 5 (GO TO 507)

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

LIVING WITH HER 1
STAYING ELSEWHERE 2

504. Does your husband/partner have any other wives besides yourself?

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

505. How many other wives does he have?

NUMBER___
DON'T KNOW 98 (GO TO 507)

506. Are you the first, second,... wife?

RANK ___

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

ONCE 1
MORE THAN ONCE 2

508. In what month and year did you start living with your (first) husband/partner?

MONTH ___
DON'T KNOW MONTH 98
YEAR ____
DON'T KNOW YEAR 98

509. How old were you when you started living with him?

AGE ____
DON'T KNOW AGE 98

510. CHECK 508 AND 509:
YEAR AND AGE GIVEN?

YES (GO TO 511)
NO (GO TO 513)

511. CHECK CONSISTENCY OF 508 AND 509:

YEAR OF BIRTH (105) ___ PLUS + AGE AT MARRIAGE (509) ___ =
CALCULATED YEAR OF MARRIAGE ___

IF NECESSARY, CALCULATE YEAR OF BIRTH:

CURRENT YEAR 92 MINUS - CURRENT AGE (106) ___ =
CALCULATED YEAR OF BIRTH ___

IS THE CALCULATED YEAR OF MARRIAGE WITHIN ONE YEAR OF THE REPORTED YEAR OF MARRIAGE (508)?

YES (GO TO 513)
NO (PROBE AND CORRECT 508 AND 509)

512. IF NEVER IN UNION: Have you ever had sexual intercourse?

YES 1
NO 2 (GO TO 517)

513. Now we need some details about your sexual activity in order to get a better understanding of family planning and fertility. How many times did you have sexual intercourse in the last four weeks?

TIMES ___

514. How many times in a month do you usually have sexual intercourse?

TIMES ___

515. When was the last time you had sexual intercourse?

DAYS AGO 1 __
WEEKS AGO 2 __
MONTHS AGO 3 __
YEARS AGO 4 __

BEFORE LAST BIRTH 996

516. How old were you when you first had sexual intercourse?

AGE __
FIRST TIME WHEN MARRIED 96

517. PRESENCE OF OTHERS AT THIS POINT.

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

SECTION 6. FERTILITY PREFERENCES

601. CHECK 312:

NEITHER STERILIZED (GO TO 602)
HE OR SHE STERILIZED (GO TO 607)

602. CHECK 502:

CURRENTLY MARRIED OR LIVING TOGETHER (GO TO 603)
NOT MARRIED/NOT LIVING TOGETHER (GO TO 614)

603. CHECK 223:

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, 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 610)
SAYS SHE CAN'T GET PREGNANT 3 (GO TO 610)
UNDECIDED OR DON'T KNOW 8 (GO TO 610)

604. CHECK 223:

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

PREGNANT: How long would you like to wait after the birth of the child you are expecting before the birth of another child?

MONTHS 1 ___ (GO TO 610)
YEARS 2 ___ (GO TO 610)

SOON/NOW 994 (GO TO 610)
SAYS SHE CAN'T GET PREGNANT 995 (GO TO 610)
OTHER (SPECIFY) _____ 996
DON'T KNOW 998

605. CHECK 216 AND 223:
HAS LIVING CHILD(REN) OR PREGNANT?

YES (GO TO 606)
NO (GO TO 610)

606. CHECK 223:

NOT PREGNANT OR UNSURE: How old would you like your youngest child to be when your next child is born?

PREGNANT: How old would you like the child you are expecting to be when your next child is born?

AGE OF CHILD YEARS ____ (GO TO 610)
DON'T KNOW 98 (GO TO 610)

607. Given your present circumstances, if you had to do it over again, do you think (you/your husband) would make the same decision to have an operation not to have any more children?

YES 1
NO 2

608. Do you regret that (you/your husband) had the operation not to have any (more) children?

YES 1
NO 2 (GO TO 614)

609. Why do you regret it?

RESPONDENT WANTS ANOTHER CHILD 1 (GO TO 614)
PARTNER WANTS ANOTHER CHILD 2 (GO TO 614)
SIDE EFFECTS 3 (GO TO 614)
OTHER REASON (SPECIFY) ____________ 4 (GO TO 614)

610. 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

611. 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

612. Have you and your husband/partner ever discussed the number of children you would like to have?

YES 1
NO 2

613. 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

614. How long should a couple wait before starting sexual intercourse after the birth of a baby?

MONTHS 1 __
YEARS 2 __

OTHER (SPECIFY) ________ 996

615. Should a mother wait until she has completely stopped breastfeeding before starting to have sexual relations again, or doesn't it matter?

WAIT 1
DOESN'T MATTER 2

616. In general, do you approve or disapprove of couples using a method to avoid getting pregnant?

APPROVE 1
DISAPPROVE 2

617. CHECK 216:

HAS LIVING CHILD(REN): 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?

RECORD SINGLE NUMBER OR OTHER ANSWER.

NUMBER ______
OTHER ANSWER (SPECIFY) ____________96

618. What do you think is the best number of months or years between the birth of one child and the birth of the next child?

MONTHS 1 __
YEARS 2 __

OTHER (SPECIFY) ______ 996

SECTION 7. HUSBAND'S BACKGROUND AND WOMAN'S WORK

701. CHECK 501:

EVER MARRIED OR LIVED TOGETHER (ASK QUESTIONS ABOUT CURRENT OR MOST RECENT HUSBAND/PARTNER) (GO TO 702)
NEVER MARRIED/NEVER LIVED TOGETHER (GO TO 708)

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

YES 1
NO 2 (GO TO 705)

703. What was the highest level of school he attended: primary, secondary, or higher?

PRIMARY 1
SECONDARY 2
HIGHER 3
DON'T KNOW 8 (GO TO 705)

704. How many years did he complete at that level?

COMMENT _____________________
YEARS ___
DON'T KNOW 98

705. What kind of work does (did) your (last) husband/partner mainly do?

OCCUPATION____________________ __

706. CHECK 705:

WORKS (WORKED) IN AGRICULTURE (GO TO 707)
DOES (DID) NOT WORK IN AGRICULTURE (GO TO 708)

707. (Does/Did) your husband/partner work mainly on his own land or family land, or (does/did) he rent land, or (does/did) he work on someone else's land?

HIS/FAMILY LAND 1
RENTED LAND 2
SOMEONE ELSE'S LAND 3

708. Aside from your own housework, are you currently working?

YES 1 (GO TO 710)
NO 2

709. 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
NO 2 (GO TO 717)

710. What is your occupation, that is, what kind of work do you do?

OCCUPATION____________________ __

711. In your current work, do you work for a member of your family, for someone else, or are you self-employed?

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

712. Do you earn cash for this work?
PROBE: Do you make money for working?

YES 1
NO 2

713. Do you do this work at home or away from home?

HOME 1
AWAY 2

714. CHECK 215/216/218:
HAS CHILD BORN SINCE JAN. 1987 AND LIVING AT HOME?

YES (GO TO 715)
NO (GO TO 717)

715. While you are working, do you usually have (NAME OF YOUNGEST CHILD AT HOME) with you, sometimes have him/her with you, or never have him/her with you?

USUALLY 1 (GO TO 717)
SOMETIMES 2
NEVER 3

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

HUSBAND/PARTNER 01
OLDER CHILD(REN) 02
OTHER RELATIVES 03
NEIGHBORS 04
FRIENDS 05
SERVANTS/HIRED HELP 06
CHILD IS IN SCHOOL 07
INSTITUTIONAL CHILDCARE 08
OTHER (SPECIFY) ________ 09

717. RECORD THE TIME

HOUR __
MINUTES __

SECTION 8. AIDS KNOWLEDGE

801. Now I have a few questions about a very important topic. Have you heard of an illness called AIDS?

YES 1
NO 2 (GO TO SECTION 9)

802. From which sources of information or persons have you heard about AIDS in the last month?
CIRCLE ALL MENTIONED.

RADIO A
TV B
NEWSPAPERS C
HEALTH WORKERS D
CHURCH E
FRIENDS/RELATIVES F
SCHOOLS/TEACHERS G
SLOGANS/PAMPHLETS/POSTERS H
COMMUNITY MEETINGS I
OTHER (SPECIFY) _____ J
NONE K

803. How is the AIDS virus transmitted?
CIRCLE ALL MENTIONED.

SEXUAL INTERCOURSE A
NEEDLES/BLADES/SKIN PUNCTURES B
MOTHER TO CHILD C
TRANSFUSION OF INFECTED BLOOD D
OTHER (SPECIFY) _____ E
DON'T KNOW F

804. Do you think that you can get AIDS from:

shaking hands with someone who has AIDS?
kissing someone who has AIDS?
wearing the clothes of someone who has AIDS?
sharing eating utensils with someone who has AIDS?
stepping on the urine or stool of someone who has AIDS?
mosquito, flea or bedbug bites?

HANDSHAKING
YES 1
NO 2
HUGGING
YES 1
NO 2
KISSING
YES 1
NO 2
SHARING CLOTHES
YES 1
NO 2
SHARING EATING UTENSILS
YES 1
NO 2
STEPPING ON URINE/STOOL
YES 1
NO 2
MOSQUITO/FLEA/BEDBUG BITES
YES 1
NO 2

805. Is it possible for a healthy looking person to be carrying the AIDS virus?

YES 1
NO 2
DON'T KNOW 8

806. Is it possible for a woman who has the AIDS virus to give birth to a child with the AIDS virus?

YES 1
NO 2
DON'T KNOW 8

807. Can AIDS be prevented?

YES 1
NO 2 (GO TO 809)
DON'T KNOW 8 (GO TO 809)

808. How can AIDS be prevented?
CIRCLE ALL MENTIONED.

STICK TO ONE PARTNER A
USE CONDOMS B
STERILIZE SYRINGES/NEEDLES C
OTHER (SPECIFY) ____________ D

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

PROVIDE MEDICAL TREATMENT 1
HELP RELATIVES PROVIDE CARE 2
ISOLATE/QUARANTINE/JAIL 3
NOT BE INVOLVED 4
OTHER (SPECIFY) ____________ 5

810. If your relative is suffering with AIDS, who would you prefer to care for him/her?

RELATIVES/FRIENDS 1
GOVERNMENT 2
RELIGIOUS ORG./MISSION 3
NOBODY/ABANDON 4
OTHER (SPECIFY) ____________ 5

SECTION 9. HEIGHT AND WEIGHT

901. CHECK 222:

ONE OR MORE BIRTHS SINCE JAN. 1987 (GO TO 902)
INTERVIEWER:
IN 902 (COLUMNS 2-4) RECORD THE LINE NUMBER FOR EACH CHILD BORN SINCE JANUARY 1987 AND STILL ALIVE.
IN 903 AND 904 RECORD THE NAME AND BIRTH DATE FOR THE RESPONDENT AND FOR ALL LIVING CHILDREN BORN SINCE JANUARY 1987. IN 906 AND 908 RECORD HEIGHT AND WEIGHT OF THE RESPONDENT AND THE LIVING CHILDREN.
(NOTE: ALL RESPONDENTS WITH ONE OR MORE BIRTHS SINCE JANUARY 1987 SHOULD BE WEIGHED AND MEASURED EVEN IF ALL OF THE CHILDREN HAVE DIED. IF THERE ARE MORE THAN 3 LIVING CHILDREN BORN SINCE JANUARY 1987, USE ADDITIONAL FORMS)
NO BIRTHS SINCE JAN. 1987 (END INTERVIEW)

902. LINE NO. FROM Q.212
[Children born within the last 5 years only]

LINE NUMBER___

903. NAME FROM Q.212 FOR CHILDREN

NAME___________

904. DATE OF BIRTH:
FROM Q.l05 FOR RESPONDENT
FROM Q.215 FOR CHILDREN, AND ASK FOR DAY OF BIRTH

RESPONDENT
MONTH ___
YEAR ___
CHILDREN
DAY ___
MONTH ___
YEAR ___

905. BCG SCAR ON LEFT FOREARM
[Children born within the last 5 years only]

SCAR SEEN 1
NO SCAR 2

906. HEIGHT (in centimeters)

HEIGHT____.__

907. WAS HEIGHT/LENGTH OF CHILD MEASURED LYING DOWN OR STANDING UP?
[Children born within the last 5 years only]

LYING 1
STANDING 2

908. WEIGHT (in kilograms)

WEIGHT____.__

909. DATE WEIGHED AND MEASURED

DAY ___
MONTH ___
YEAR __

910. RESULT

RESPONDENT
MEASURED 1
NOT PRESENT 3
REFUSED 4
OTHER (SPECIFY) _______ 6
CHILDREN
CHILD MEASURED 1
CHILD SICK 2
CHILD NOT PRESENT 3
CHILD REFUSED 4
MOTHER REFUSED 5
OTHER (SPECIFY) _________ 6

911. NAME OF MEASURER: __________ __
NAME OF ASSISTANT: _________ __

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
_________________________________