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DEMOGRAPHIC AND HEALTH SURVEYS - ZAMBIA 2001 - MEN'S QUESTIONNAIRE

IDENTIFICATION

LOCALITY NAME ___________________

NAME OF HOUSEHOLD HEAD ____________________

CLUSTER NUMBER ___

HOUSEHOLD NUMBER ___

PROVINCE _________________ ___

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 MAN _______________ ___

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 INCAPACITATED
7 OTHER (SPECIFY) _________

NEXT VISIT: (FOR INTERVIEWERS 1 AND 2)
DATE ______
TIME _____

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

TOTAL NO. OF VISITS __

LANGUAGE OF QUESTIONNAIRE

ENGLISH 01

LANGUAGE OF 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

SUPERVISOR
NAME ________ ___
DATE ________

FIELD EDITOR
NAME ________ ___
DATE ________
OFFICE EDITOR

KEYED BY

SECTION 1. RESPONDENT'S BACKGROUND

INFORMED CONSENT
Hello. My name is ____________ and I am working with the Central Board of Health and the Central Statistical Office. We are conducting a national survey about the health of men, women and children. We would very much appreciate your participation in this survey. I would like to ask you some questions about yourself and your family. This information will help the government to plan health services. The survey usually takes about 30 to 40 minutes to complete.
Whatever information you provide will be kept strictly confidential and will not be shown to other persons.

We hope that you will participate in this survey since your views are important.
At this time, do you want to ask me anything about the survey?

May I begin the interview now?

Signature of interviewer: ______________ Date: __________

RESPONDENT AGREES TO BE INTERVIEWED 1 (GO TO 101)
RESPONDENT DOES NOT AGREE TO BE INTERVIEWED 2 (END)

101. RECORD THE TIME.

HOUR ___
MINUTES ___

103. How long have you been living continuously in (NAME OF CURRENT PLACE OF RESIDENCE)?
IF LESS THAN ONE YEAR, RECORD '00' YEARS.

YEARS ___

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

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

LUSAKA 1
OTHER CITY 2
TOWN 3
VILLAGE 4

105. In the last 12 months, have you ever traveled away from your home community and slept away?

YES 1
NO 2 (GO TO 108)

106. In the last 12 months, on how many separate occasions have you traveled away from this community and slept away?

NUMBER OF TRIPS AWAY ____

107. In the last 12 months, have you been away from your home community for more than 1 month at a time?

YES 1
NO 2

108. In what month and year were you born?

MONTH _____
DOES NOT KNOW MONTH 98
YEAR ______
DOES NOT KNOW YEAR 9998

109. How old were you at your last birthday?
COMPARE AND CORRECT 108 AND/OR 109 IF INCONSISTENT.

AGE IN COMPLETED YEARS _______

110. Have you ever attended school?

YES 1
NO 2 (GO TO 114)

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

PRIMARY 1
SECONDARY 2
HIGHER 3

112. What is the highest grade you completed at that level?

GRADE ____

113. CHECK 111:

PRIMARY (GO TO 114)
SECONDARY OR HIGHER (GO TO 117)

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

CANNOT READ AT ALL 1
ABLE TO READ ONLY PARTS OF SENTENCE 2
ABLE TO READ WHOLE SENTENCE 3
NO CARD WITH REQUIRED LANGUAGE (SPECIFY LANGUAGE) _______ 4

115. Have you ever participated in a literacy program or any other program that involves learning to read or write (not including primary school)?

YES 1
NO 2

116. CHECK 114:

CODE '2', '3' OR '4' CIRCLED (GO TO 117)
CODE '1' CIRCLED (GO TO 118)

117. Do you read a newspaper almost every day, at least once a week, less than once a week or not at all?

ALMOST EVERY DAY 1
AT LEAST ONCE A WEEK 2
LESS THAN ONCE A WEEK 3
ALMOST NEVER/NOT AT ALL 4

118. Do you listen to the radio almost every day, at least once a week, less than once a week or not at all?

ALMOST EVERY DAY 1
AT LEAST ONCE A WEEK 2
LESS THAN ONCE A WEEK 3
ALMOST NEVER/NOT AT ALL 4

119. Do you watch television almost every day, at least once a week, less than once a week or not at all?

ALMOST EVERY DAY 1
AT LEAST ONCE A WEEK 2
LESS THAN ONCE A WEEK 3
ALMOST NEVER/NOT AT ALL 4

120. Are you currently working?

YES 1 (GO TO 123)
NO 2

121. Have you done any work in the last 12 months?

YES 1 (GO TO 123)
NO 2

122. What have you been doing for most of the time over the last 12 months?

GOING TO SCHOOL/STUDYING 1 (GO TO 129)
LOOKING FOR WORK 2 (GO TO 129)
INACTIVE 3 (GO TO 129)
COULD NOT WORK/HANDICAPPED 4 (GO TO 129)
OTHER (SPECIFY) _______ 6 (GO TO 129)

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

OCCUPATION______________ ___

124. CHECK 123:

WORKS IN AGRICULTURE (GO TO 125)
DOES NOT WORK IN AGRICULTURE (GO TO 126)

125. Do you work mainly on your own land or on family land, or do you work on land that you rent from someone else, or do you work on someone else's land?

OWN LAND 1
FAMILY LAND 2
RENTED LAND 3
SOMEONE ELSE'S LAND 4

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

NUMBER OF MONTHS _______

127. Are you paid in cash or kind for this work or are you not paid at all?

CASH ONLY 1
CASH AND KIND 2
IN KIND ONLY 3 (GO TO 129)
NOT PAID 4 (GO TO 129)

128. On average, how much of your household's expenditures do your earnings pay for: almost none, less than half, about half, more than half, or all?

ALMOST NONE 1
LESS THAN HALF 2
ABOUT HALF 3
MORE THAN HALF 4
ALL 5
NONE, HIS INCOME IS ALL SAVED 6

129. What is your religion?

CATHOLIC 1
PROTESTANT 2
MUSLIM 3
OTHER (SPECIFY) ________ 6

130. What tribe do you belong to?

TRIBE________________ ____

SECTION 2. REPRODUCTION

201. Now I would like to ask about any children you have had during your life. I am interested only in the children that are biologically yours. Do not include any adopted children or any children who are not your own natural children. Have you ever fathered any children with any woman?

YES 1
NO 2 (GO TO 206)
DON'T KNOW 8 (GO TO 206)

202. Do you have any sons or daughters that you have fathered 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 you have fathered 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 fathered a son or a daughter who was born alive but later died?
IF NO, PROBE: Any baby who cried or showed signs of life but did not survive?

YES 1
NO 2 (GO TO 208)
DON'T KNOW 8 (GO TO 208)

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

BOYS DEAD ______
GIRLS DEAD ______

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

TOTAL CHILDREN ________

209. CHECK 208:
Just to make sure that I have this right: you have fathered TOTAL ___ children during your life. Is that correct?

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

210. CHECK 208:

HAS HAD MORE THAN ONE CHILD (GO TO 211)
HAS HAD ONLY ONE CHILD (GO TO 213)
HAS NOT HAD ANY CHILDREN (GO TO 301)

211. Do the children that you have fathered all have the same biological mother?

YES 1 (GO TO 213)
NO 2

212. In all how many women have you fathered children with?

NUMBER OF WOMEN ____

213. How old were you when your (first) child was born?

AGE IN YEARS ___

214. At the time when this child was born, were you married to the child's
mother?

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

301. Which ways or methods have you heard about?
FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK: Have you ever heard of (METHOD)?

01 FEMALE STERILISATION Women can have an operation to avoid having any more children.
YES 1
NO 2
02 MALE STERILISATION Men can have an operation to avoid having any more children.
YES 1
NO 2
03 PILL Women can take a pill every day to avoid becoming pregnant.
YES 1
NO 2
04 IUD Women can have a loop or coil placed inside them by a doctor or a nurse.
YES 1
NO 2
05 INJECTABLES Women can have an injection by a health provider which stops them from becoming pregnant for one or more months.
YES 1
NO 2
06 IMPLANTS Women can have several small rods placed in their upper arm by a doctor or nurse which can prevent pregnancy for one or more years.
YES 1
NO 2
07 CONDOM Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
08 FEMALE CONDOM Women can place a sheath in their vagina before sexual intercourse.
YES 1
NO 2
09 FOAM TABLETS, DIAPHRAGM OR JELLY Women can place a suppository, jelly, diaphragm or cream in their vagina before intercourse.
YES 1
NO 2
10 LACTATIONAL AMENORRHEA METHOD (LAM) Up to 6 months after childbirth, a woman can use a method that requires that she breastfeeds frequently, day and night, and that her menstrual period has not returned.
YES 1
NO 2
11 RHYTHM OR NATURAL FAMILY PLANNING Every month that a woman is sexually active she can avoid pregnancy by not having sexual intercourse on the days of the month she is most likely to get pregnant.
YES 1
NO 2
12 WITHDRAWAL Men can be careful and pull out before climax.
YES 1
NO 2
13 EMERGENCY CONTRACEPTION Women can take pills up to three days after sexual intercourse to avoid becoming pregnant.
YES 1
NO 2
14 Have you heard of any other ways or methods that women or men can
use to avoid pregnancy?
YES 1 (SPECIFY) ____
NO 2

302. Have you ever used (METHOD)?

02 MALE STERILISATION Men 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 CONDOM Men can put a rubber sheath on their penis before sexual intercourse.
YES 1
NO 2
11 RHYTHM OR NATURAL FAMILY PLANNING Every month that a woman is sexually active she can avoid pregnancy by not having sexual intercourse on the days of the month she is most likely to get pregnant.
YES 1
NO 2
DON'T KNOW 8
12 WITHDRAWAL Men can be careful and pull out before climax.
YES 1
NO 2

303. CHECK 301(01), 301(3), AND 301(5):

CODE '1' CIRCLED FOR ANY METHOD (GO TO 304)
CODE '1' NOT CIRCLED FOR ANY METHOD (GO TO 308)

304. Now I want to talk to you about contraceptive methods that women can use to delay or avoid becoming pregnant?

CHECK 301(03): KNOWS PILL
YES (GO TO 305 PILL)
NO (GO TO 304 IN NEXT COLUMN)
CHECK 301(05): KNOWS INJECTABLES
YES (GO TO 305 INJECTABLES)
NO (GO TO 304 IN NEXT COLUMN)
CHECK 301(01): KNOWS FEMALE STERILIZATION
YES (GO TO 305 FEMALE STERILIZATION)
NO (GO TO 304 IN NEXT COLUMN)

305. In your opinion, is (METHOD) a good method for a couple to use if they want to plan their family?

PILL
YES 1
NO 2 (GO TO 307)
DEPENDS/UP TO THEM 3
DON'T KNOW 8 (GO TO 304 IN NEXT COLUMN)
INJECTABLES
YES 1
NO 2 (GO TO 307)
DEPENDS/UP TO THEM 3
DON'T KNOW 8 (GO TO 304 IN NEXT COLUMN)
FEMALE STERILIZATION: In your opinion, is female sterilization a good method for a couple to use if they do not want any more children?
YES 1
NO 2 (GO TO 307)
DEPENDS/UP TO THEM 3
DON'T KNOW 8 (GO TO 308)

306. Why do you think (METHOD) is a good method for a couple to use if they want to plan their family?
RECORD ALL REASONS MENTIONED.

PILL
SIMPLE TO USE A (GO TO 304 IN NEXT COLUMN)
EFFECTIVE B (GO TO 304 IN NEXT COLUMN)
AFFORDABLE C (GO TO 304 IN NEXT COLUMN)
NO/FEW SIDE EFFECTS D (GO TO 304 IN NEXT COLUMN)
CAN STOP WHEN CHILDREN DESIRED E (GO TO 304 IN NEXT COLUMN)
NO NEED FOR MEDICAL PERSONNEL F (GO TO 304 IN NEXT COLUMN)
OTHER (SPECIFY) ____________ X (GO TO 304 IN NEXT COLUMN)
DON'T KNOW Y (GO TO 304 IN NEXT COLUMN)
INJECTABLES
SIMPLE TO USE A (GO TO 304 IN NEXT COLUMN)
EFFECTIVE B (GO TO 304 IN NEXT COLUMN)
AFFORDABLE C (GO TO 304 IN NEXT COLUMN)
NO/FEW SIDE EFFECTS D (GO TO 304 IN NEXT COLUMN)
CAN STOP WHEN CHILDREN DESIRED E (GO TO 304 IN NEXT COLUMN)
GET EVERY 2-3 MONTHS, NO DAILY WORRY F (GO TO 304 IN NEXT COLUMN)
OTHER (SPECIFY) ____________ X (GO TO 304 IN NEXT COLUMN)
DON'T KNOW Y (GO TO 304 IN NEXT COLUMN)
FEMALE STERILIZATION
Why do you think female sterilization is a good method for a couple to use if they do not want any more children?
EFFECTIVE B (GO TO 308)
AFFORDABLE C (GO TO 308)
NO/FEW SIDE EFFECTS D (GO TO 308)
NO RISK OF GETTING PREGNANT AGAIN G (GO TO 308)
OTHER (SPECIFY) ____________ X (GO TO 308)
DON'T KNOW Y (GO TO 308)

307. Why do you think (METHOD) is not a good method for a couple to use if they want to plan their family?
RECORD ALL REASONS MENTIONED.

PILL
TOO EXPENSIVE A (GO TO 304 IN NEXT COLUMN)
AGAINST RELIGION B (GO TO 304 IN NEXT COLUMN)
MAY HARM WOMEN'S HEALTH C (GO TO 304 IN NEXT COLUMN)
HAS SIDE EFFECTS D (GO TO 304 IN NEXT COLUMN)
INCREASES PROMISCUITY E (GO TO 304 IN NEXT COLUMN)
CAN CAUSE STERILITY F (GO TO 304 IN NEXT COLUMN)
METHOD CAN FAIL G (GO TO 304 IN NEXT COLUMN)
BABY IN DANGER IF PREGNANCY OCCURS H (GO TO 304 IN NEXT COLUMN)
INVOLVES DOCTOR/MED. PERSONNEL I (GO TO 304 IN NEXT COLUMN)
OTHER (SPECIFY) ____________ X (GO TO 304 IN NEXT COLUMN)
DON'T KNOW Y (GO TO 304 IN NEXT COLUMN)
INJECTABLES
TOO EXPENSIVE A (GO TO 304 IN NEXT COLUMN)
AGAINST RELIGION B (GO TO 304 IN NEXT COLUMN)
MAY HARM WOMEN'S HEALTH C (GO TO 304 IN NEXT COLUMN)
HAS SIDE EFFECTS D (GO TO 304 IN NEXT COLUMN)
INCREASES PROMISCUITY E (GO TO 304 IN NEXT COLUMN)
CAN CAUSE STERILITY F (GO TO 304 IN NEXT COLUMN)
METHOD CAN FAIL G (GO TO 304 IN NEXT COLUMN)
BABY IN DANGER IF PREGNANCY OCCURS H (GO TO 304 IN NEXT COLUMN)
INVOLVES DOCTOR/MED. PERSONNEL I (GO TO 304 IN NEXT COLUMN)
OTHER (SPECIFY) ____________ X (GO TO 304 IN NEXT COLUMN)
DON'T KNOW Y (GO TO 304 IN NEXT COLUMN)
FEMALE STERILIZATION
Why do you think female sterilization is not a good method for a couple to use if they do not want any more children?
TOO EXPENSIVE A
AGAINST RELIGION B
MAY HARM WOMEN'S HEALTH C
HAS SIDE EFFECTS D
INCREASES PROMISCUITY E
CANNOT HAVE CHILDREN AGAIN F
METHOD CAN FAIL G
INVOLVES DOCTOR/MED. PERSONNEL I
CAN LEAD TO MED. COMPLICATIONS J
OTHER (SPECIFY) ____________ X
DON'T KNOW Y

308. Now I would like to ask you about a woman's risk of pregnancy.
From one menstrual period to the next, are there certain days when a woman is more likely to become pregnant if she has sexual relations?

YES 1
NO 2 (GO TO 310)
DON'T KNOW 8 (GO TO 310)

309. Is this time just before her period begins, during her period, right after her period has ended, or halfway between two periods?

JUST BEFORE HER PERIOD BEGINS 1
DURING HER PERIOD 2
RIGHT AFTER HER PERIOD HAS ENDED 3
HALFWAY BETWEEN TWO PERIODS 4
OTHER (SPECIFY) ______ 6
DON'T KNOW 8

310. Do you think that a woman who is breastfeeding her baby can become pregnant?

YES 1
NO 2
DON'T KNOW/DEPENDS 8

311. CHECK 301(07) AND 302(07):
KNOWLEDGE AND USE OF CONDOMS

HAS HEARD OF AND USED CONDOMS (GO TO 312)
HAS HEARD OF CONDOMS BUT HAS NEVER USED (GO TO 323)
HAS NOT HEARD OF CONDOMS (GO TO 324)

312. Now I want to talk about condoms. How old were you when you used a condom for the first time?

AGE AT FIRST USE ___
DOES NOT REMEMBER 98

313. Why did you use a condom that first time?
PROBE: Any other reason?
RECORD ALL REASONS MENTIONED.

TO AVOID PREGNANCY A
TO AVOID GETTING AIDS/HIV B
TO AVOID GETTING AN STD C
TO AVOID INFECTING PARTNER D
TO EXPERIMENT/TRY A CONDOM E
OTHER (SPECIFY) ______________ X

314. Now when you have sex, do you use a condom every time, sometimes, or not at all?

EVERY TIME 1 (GO TO 316)
SOMETIMES 2
NOT AT ALL 3 (GO TO 316)
NOT HAVING SEX 4 (GO TO 316)

315. When do you use a condom?
PROBE: Any other times?
RECORD ALL SITUATIONS MENTIONED.

ON PARTNER'S FERTILE DAYS A
DURING WIFE'S/PARTNER'S MENSTRUATION B
WHEN NOT USING SOME OTHER METHOD C
WITH A STRANGER D
WITH A COMMERCIAL SEX WORKER E
WITH ANYONE OTHER THAN WIFE/REGULAR PARTNER F
WITH WIFE/REGULAR PARTNER G
OTHER (SPECIFY) ____________X

316. Have you ever experienced any problems with using condoms?
IF YES: What problems have you experienced?
PROBE: Any other problems?
RECORD ALL PROBLEMS MENTIONED.

TOO EXPENSIVE A
EMBARASSING TO BUY/OBTAIN B
DIFFICULT TO DISPOSE OF C
DIFFICULT TO PUT ON/TAKE OFF D
SPOILS THE MOOD E
DIMINISHES PLEASURE F
WIFE PARTNER OBJECTS/DOES NOT LIKE G
WIFE/PARTNER GOT PREGNANT H
INCONVENIENT TO USE/MESSY I
CONDOM BROKE J
OTHER (SPECIFY) ____________X
NO PROBLEM Y

317. CHECK 314:
CURRENT USE OF CONDOMS

EVERY TIME OR SOMETIMES (GO TO 318)
NOT AT ALL/NOT HAVING SEX (GO TO 323)

318. What brand of condom do you usually use?
ASK TO SEE CONDOM PACKET IF BRAND NOT KNOWN.

DUREX 01
MAXIMUM 02
JEANS 03
PARROT 04
AROUSER 05
SULTAN 06
PROTECTOR 07
LOVERS PLUS 08
CHISANGO 09
GENERIC/NO BRAND 10
OTHER (SPECIFY) ____________ 96
DON'T KNOW BRAND 98

319. Where do you usually obtain condoms?
IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

(NAME OF PLACE) _____________
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTRE 12
HEALTH POST 13
OTHER PUBLIC (SPECIFY) ______ 16

PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/SURGERY 21
MISSION HOSPITAL/SURGERY 22
PHARMACY 23
PRIVATE DOCTOR 24
WORK PLACE 25
OTHER PRIVATE MEDICAL (SPECIFY) ______ 26
OTHER SOURCE
SHOP 31
COMMUNITY-BASED AGENT/HEALTH WORKER 32
FRIEND/RELATIVE 33
SCHOOL 34
BAR, HOTEL 35
OTHER (SPECIFY) _______________ 96

320. How much do you usually pay for a packet of condoms?

COST PER PACKET ___

FREE 9995 (GO TO 323)
DON'T KNOW 9998 (GO TO 323)

321. How many condoms are in each packet?

NUMBER ___

321A. Would you prefer fewer condoms in each pack or more condoms in each pack or is it okay?

FEWER IN EACH PACK 1
MORE IN EACH PACK 2
OK AS IT IS 3

322. Do you think that at this price condoms are inexpensive, just affordable, or too expensive?

INEXPENSIVE 1
JUST AFFORDABLE 2
TOO EXPENSIVE 3

323. I will now read you some statements about condoms. Please tell me if you agree or disagree with each.

a) Condoms decrease a man's sexual pleasure.
AGREE 1
DISAGREE 2
DON'T KNOW 8
b) Condoms are very inconvenient to use.
AGREE 1
DISAGREE 2
DON'T KNOW 8
c) A condom can be reused.
AGREE 1
DISAGREE 2
DON'T KNOW 8
d) Condoms are effective in preventing HIV and other diseases.
AGREE 1
DISAGREE 2
DON'T KNOW 8
e) A woman has no right to tell a man to use a condom.
AGREE 1
DISAGREE 2
DON'T KNOW 8
f) Condoms are effective in preventing pregnancy.
AGREE 1
DISAGREE 2
DON'T KNOW 8

324. I will now read you some statements about contraception. Please tell me if you agree or disagree with each one.

a) Contraception is woman's business and a man should not have to worry about it.
AGREE 1
DISAGREE 2
DON'T KNOW 8
b) Being sterilized for a man is the same as being castrated.
AGREE 1
DISAGREE 2
DON'T KNOW 8
c) A woman is the one who gets pregnant so she should be the one to use family planning.
AGREE 1
DISAGREE 2
DON'T KNOW 8

SECTION 4. MARRIAGE AND SEXUAL ACTIVITY

401. Are you currently married or living with a woman?

YES, CURRENTLY MARRIED 1
YES, LIVING WITH A WOMAN 2 (GO TO 402A)
NO, NOT IN UNION 3 (GO TO 407)

402. How many wives do you have?
402A. How many women are you living with as if you are married?

NUMBER OF WIVES _____ (GO TO 409)

407. Have you ever been married or lived with a woman?

YES, FORMERLY MARRIED 1
YES, LIVED WITH A WOMAN 2
NO 4 (GO TO 416)

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

WIDOWED 1 (GO TO 411)
DIVORCED 2 (GO TO 411)
SEPARATED 3 (GO TO 411)

409. WRITE THE LINE NUMBERS FROM THE HOUSEHOLD QUESTIONNAIRE FOR EACH WIFE. IF A WIFE DOES NOT LIVE IN THE HOUSEHOLD, ENTER '00' IN THE LINE NUMBER BOXES. THE NUMBER OF LINES FILLED IN MUST BE EQUAL TO THE
NUMBER OF WIVES. (IF RESPONDENT HAS MORE THAN FIVE WIVES USE
ADDITIONAL QUESTIONNAIRE).

CHECK 402:

ONLY 1 WIFE __
Please tell me the name of your wife.

MORE THAN 1 WIFE __
Please tell me the name of each woman that you are living with as if married, starting with the one you lived with first.

NAME AND LINE NUMBER OF WIFE IN HOUSEHOLD QUESTIONNAIRE
1 _____________ ___
2 _____________ ___
3 _____________ ___
4 _____________ ___
5 _____________ ___

410. CHECK 409:

ONLY ONE WIFE (GO TO 411)
MORE THAN 1 WIFE (GO TO 412)

411. Have you been married or lived with a woman only once, or more than once?

ONCE 1 (GO TO 414)
MORE THAN ONCE 2 (GO TO 413)

412. Have you ever been married to or lived as if married to any woman other than those you have just mentioned?

YES 1
NO 2 (GO TO 414A)

413. In total, how many women have you been married to or lived with as if married in your whole life?

NUMBER OF WOMEN _____ (GO TO 414A)

414. In what month an year did you start living with your wife?
414A. Now we will talk about your first wife. In what month and year did you start living with her?

MONTH _________
DOES NOT KNOW MONTH 98
YEAR ________ (GO TO 416)
DOES NOT KNOW YEAR 9998

415. How old were you when you started living with her?

AGE ________

416. Now I need to ask you some questions about sexual activity in order to gain a better understanding of some family life issues. How old were you when you first had sexual intercourse with a woman (if ever)?

NEVER 00 (GO TO 448)
AGE IN YEARS ___
FIRST TIME WHEN STARTED LIVING WITH (FIRST) WIFE 95

417. When was the last time you had sexual intercourse with a woman?
RECORD 'YEARS AGO' ONLY IF LAST INTERCOURSE WAS 12 MONTHS OR MORE AGO.

DAYS AGO 1 __
WEEKS AGO 2 __
MONTHS AGO 3 __
YEARS AGO 4 __ (GO TO 448)

418. The last time you had sexual intercourse with a woman, was a condom used?

YES 1
NO 2 (GO TO 420)

419. What was the main reason you used a condom on that occasion?

RESPONDENT WANTED TO PREVENT STD/HIV 01 (GO TO 424)
RESPONDENT WANTED TO PREVENT PREGNANCY 02 (GO TO 424)
RESPONDENT WANTED TO PREVENT BOTH STD/HIV AND PREGNANCY 03 (GO TO 424)
DID NOT TRUST PARTNER/FELT PARTNER HAD OTHER PARTNERS 04 (GO TO 424)
PARTNER REQUESTED/INSISTED 05 (GO TO 424)
OTHER (SPECIFY) ________ 96 (GO TO 424)
DON'T KNOW 98 (GO TO 424)

420. What was the main reason you did not use a condom that time?

NOT AVAILABLE AT PLACE WHERE USUALLY GETS THEM 01
COST TOO MUCH/NO MONEY 02
TRUSTED HIS PARTNER 03
PARTNER TESTED NEGATIVE/NO RISK OF DISEASE 04
RESPONDENT DOESN'T LIKE 05
PARTNER OBJECTED/REFUSED 06
PARTNER DRUNK/ON DRUGS 07
WANTED TO GET PREGNANT 08
OTHER (SPECIFY) ________ 96
DON'T KNOW 98

421. The last time you had sexual intercourse with a woman, did you or she use any method to avoid a pregnancy?

YES 1
NO 2 (GO TO 423)
UNSURE/DON'T KNOW 8 (GO TO 424)

422. What method was used?

FEMALE STERILIZATION 01 (GO TO 424)
MALE STERILIZATION 02 (GO TO 424)
PILL 03 (GO TO 424)
IUD 04 (GO TO 424)
INJECTABLES 05 (GO TO 424)
IMPLANTS 06 (GO TO 424)
FEMALE CONDOM 08 (GO TO 424)
DIAPHRAGM/FOAM/JELLY 09 (GO TO 424)
LACTATIONAL AMENORRHEA 10 (GO TO 424)
RHYTHM/NATURAL FAMILY PLANNING 11 (GO TO 424)
WITHDRAWAL 12 (GO TO 424)
OTHER (SPECIFY) _____ 96 (GO TO 424)
DON'T KNOW 98 (GO TO 424)

423. What is the main reason a method was not used?

CASUAL SEX PARTNER SO DOES NOT CARE 11
CONTRACEPTION IS WOMEN'S BUSINESS 12
FERTILITY-RELATED REASONS
PARTNER MENOPAUSAL/HAD HYSTERECTOMY 23
COUPLE IS INFERTILE 24
PARTNER WAS PREGNANT 25
PARTNER WAS POSTPARTUM AMENORRHEIC 26
PARTNER WAS BREASTFEEDING 27
WANTED (MORE) CHILDREN 28
OPPOSITION TO USE
RESPONDENT OPPOSED 31
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

424. What is your relationship to the woman with whom you last had sex?
IF WOMAN IS 'GIRLFRIEND' OR 'FIANCEE', ASK: Was your girlfriend/fiancee living with you when you last had sex?
IF YES, RECORD '01'. IF NO, RECORD '02'.

WIFE/COHABITING PARTNER 01 (GO TO 426)
WOMAN IS GIRLFRIEND/FIANCEE 02
OTHER FRIEND 03
CASUAL ACQUAINTANCE 04
RELATIVE 05
COMMERCIAL SEX CUSTOMER 06
OTHER (SPECIFY) ___________ 96

425. For how long have you had sexual relations with this woman?
IF ONLY HAD SEXUAL RELATIONS WITH THIS WOMAN ONCE, RECORD '01' DAYS.

DAYS 1 _____
WEEKS 2 _____
MONTHS 3 _____
YEARS 4 _____

425A. How old is this woman?

AGE OF PARTNER ___

426. Have you had sex with any other woman in the last 12 months?

YES 1
NO 2 (GO TO 445)

427. The last time you had sexual intercourse with another woman, was a condom used?

YES 1
NO 2 (GO TO 429)

428. What is the main reason you used a condom on that occasion?

RESPONDENT WANTED TO PREVENT STD/HIV 01 (GO TO 433)
RESPONDENT WANTED TO PREVENT PREGNANCY 02 (GO TO 433)
RESPONDENT WANTED TO PREVENT BOTH STD/HIV AND PREGNANCY 03 (GO TO 433)
DID NOT TRUST PARTNER/FELT PARTNER HAD OTHER PARTNERS 04 (GO TO 433)
PARTNER REQUESTED/INSISTED 05 (GO TO 433)
OTHER (SPECIFY) ________ 96 (GO TO 433)
DON'T KNOW 98 (GO TO 433)

429. What was the main reason you did not use a condom that time?

NOT AVAILABLE AT PLACE WHERE USUALLY GETS THEM 01
COST TOO MUCH/NO MONEY 02
TRUSTED HIS PARTNER 03
PARTNER TESTED NEGATIVE/NO RISK OF DISEASE 04
RESPONDENT DOESN'T LIKE 05
PARTNER OBJECTED/REFUSED 06
PARTNER DRUNK/ON DRUGS 07
WANTED TO GET PREGNANT 08
OTHER (SPECIFY) ________ 96
DON'T KNOW 98

430. The last time you had sexual intercourse with this woman, did you or she use any method to avoid a pregnancy?

YES 1
NO 2 (GO TO 432)
UNSURE/DON'T KNOW 8 (GO TO 433)

431. What method was used?
IF MORE THAN ONE METHOD USED, RECORD THE HIGHEST METHOD ON THE LIST.

FEMALE STERILIZATION 01 (GO TO 433)
MALE STERILIZATION 02 (GO TO 433)
PILL 03 (GO TO 433)
IUD 04 (GO TO 433)
INJECTABLES 05 (GO TO 433)
IMPLANTS 06 (GO TO 433)
FEMALE CONDOM 08 (GO TO 433)
DIAPHRAGM/FOAM/JELLY 09 (GO TO 433)
LACTATIONAL AMENORRHEA 10 (GO TO 433)
RHYTHM/NATURAL FAMILY PLANNING 11 (GO TO 433)
WITHDRAWAL 12 (GO TO 433)
OTHER (SPECIFY) _____ 96 (GO TO 433)
DON'T KNOW 98 (GO TO 433)

432. What is the main reason a method was not used?

CASUAL SEX PARTNER SO DOES NOT CARE 11
CONTRACEPTION IS WOMEN'S BUSINESS 12
FERTILITY-RELATED REASONS
PARTNER MENOPAUSAL/HAD HYSTERECTOMY 23
COUPLE IS INFERTILE 24
PARTNER WAS PREGNANT 25
PARTNER WAS POSTPARTUM AMENORRHEIC 26
PARTNER WAS BREASTFEEDING 27
WANTED (MORE) CHILDREN 28
OPPOSITION TO USE
RESPONDENT OPPOSED 31
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

433. What is your relationship to this woman?
IF WOMAN IS 'GIRLFRIEND' OR 'FIANCEE', ASK: Was your girlfriend/fiancee living with you when you last had sex?
IF YES, RECORD '01'. IF NO, RECORD '02'.

WIFE/COHABITING PARTNER 01 (GO TO 435)
WOMAN IS GIRLFRIEND/FIANCEE 02
OTHER FRIEND 03
CASUAL ACQUAINTANCE 04
RELATIVE 05
COMMERCIAL SEX CUSTOMER 06
OTHER (SPECIFY) ___________ 96

434. For how long have you had sexual relations with this woman?

DAYS 1 _______
WEEKS 2 ______
MONTHS 3 _____
YEARS 4 _____

434A. How old is this woman?

AGE OF PARTNER ___

435. Other than these two women, have you had sex with any other woman in the last 12 months?

YES 1
NO 2 (GO TO 445)

436. The last time you had sexual intercourse with this third woman, was a condom used?

YES 1
NO 2 (GO TO 438)

437. What is the main reason you used a condom on that occasion?

RESPONDENT WANTED TO PREVENT STD/HIV 01 (GO TO 442)
RESPONDENT WANTED TO PREVENT A PREGNANCY 02 (GO TO 442)
RESPONDENT WANTED TO PREVENT BOTH STD/HIV AND PREGNANCY 03 (GO TO 442)
DID NOT TRUST PARTNER/FELT PARTNER HAD OTHER PARTNERS 04 (GO TO 442)
PARTNER REQUESTED/INSISTED 05 (GO TO 442)
OTHER (SPECIFY) ________ 96 (GO TO 442)
DON'T KNOW 98 (GO TO 442)

438. What was the main reason you did not use a condom that time?

NOT AVAILABLE AT PLACE WHERE USUALLY GETS THEM 01
COST TOO MUCH/NO MONEY 02
TRUSTED HIS PARTNER 03
PARTNER TESTED NEGATIVE/NO RISK OF DISEASE 04
RESPONDENT DOESN'T LIKE 05
PARTNER OBJECTED/REFUSED 06
PARTNER DRUNK/ON DRUGS 07
WANTED TO GET PREGNANT 08
OTHER (SPECIFY) ________ 96
DON'T KNOW 98

439. The last time you had sexual intercourse with the third woman, did you or she do something or use any method to avoid a pregnancy?

YES 1
NO 2 (GO TO 441)
UNSURE/DON'T KNOW 8 (GO TO 442)

440. What method was used?
IF MORE THAN ONE METHOD USED, RECORD THE HIGHEST METHOD ON THE LIST.

FEMALE STERILIZATION 01 (GO TO 442)
MALE STERILIZATION 02 (GO TO 442)
PILL 03 (GO TO 442)
IUD 04 (GO TO 442)
INJECTABLES 05 (GO TO 442)
IMPLANTS 06 (GO TO 442)
FEMALE CONDOM 08 (GO TO 442)
DIAPHRAGM/FOAM/JELLY 09 (GO TO 442)
LACTATIONAL AMENORRHEA 10 (GO TO 442)
RHYTHM/NATURAL FAMILY PLANNING 11 (GO TO 442)
WITHDRAWAL 12 (GO TO 442)
OTHER (SPECIFY) _____ 96 (GO TO 442)
DON'T KNOW 98 (GO TO 442)

441. What is the main reason a method was not used?

CASUAL SEX PARTNER SO DOES NOT CARE 11
CONTRACEPTION IS WOMEN'S BUSINESS 12
FERTILITY-RELATED REASONS
PARTNER MENOPAUSAL/HAD HYSTERECTOMY 23
COUPLE IS INFERTILE 24
PARTNER WAS PREGNANT 25
PARTNER WAS POSTPARTUM AMENORRHEIC 26
PARTNER WAS BREASTFEEDING 27
WANTED (MORE) CHILDREN 28
OPPOSITION TO USE
RESPONDENT OPPOSED 31
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

442. What is your relationship to this woman?
IF WOMAN IS 'GIRLFRIEND' OR 'FIANCEE', ASK: Was your girlfriend/fiancee living with you when you last had sex?
IF YES, RECORD '01'. IF NO, RECORD '02'.

WIFE/COHABITING PARTNER 01 (GO TO 444)
WOMAN IS GIRLFRIEND/FIANCEE 02
OTHER FRIEND 03
CASUAL ACQUAINTANCE 04
RELATIVE 05
COMMERCIAL SEX CUSTOMER 06
OTHER (SPECIFY) ___________ 96

443. For how long have you had sexual relations with this woman?

DAYS 1 _______
WEEKS 2 ______
MONTHS 3 _____
YEARS 4 _____

443A. How old is this woman?

AGE OF PARTNER ___

444. In the last 12 months, how many women have you had sex with?

NUMBER OF PARTNERS _____

445. Have you ever paid for sex?

YES 1
NO 2 (GO TO 448)

446. How long ago was the last time you paid for sex?

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

447. The last time that you paid for sex, was a condom used on that occasion?

YES 1
NO 2

448. CHECK 319:
SOURCE OF CONDOMS

SOURCE NOT CIRCLED (GO TO 449)
SOURCE CIRCLED (GO TO 450)

449. Do you know of a place where a person can get male condoms?

YES 1
NO 2 (GO TO 453)

450. What places do you know of where a person can get male condoms?
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.
PROBE: Any other place?
RECORD ALL PLACES MENTIONED.

(NAME OF PLACE) ______________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
GOV'T HEALTH POST C
OTHER PUBLIC (SPECIFY) ______ D
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/SURGERY E
MISSION HOSPITAL/SURGERY F
PHARMACY G
PRIVATE DOCTOR H
WORK PLACE I
OTHER PRIVATE MEDICAL (SPECIFY) ______ J
OTHER SOURCE
SHOP K
COMMUNITY-BASED AGENT L
FRIENDS/RELATIVES M
SCHOOL N
BAR/HOTEL O
OTHER (SPECIFY) _______________ X

451. If you wanted to, could you yourself get a male condom?

YES 1 (GO TO 453)
NO 2
DON'T KNOW/UNSURE 8

452. Why not?

NO MONEY/TOO EXPENSIVE 1
EMBARASSED 2
NO TRANSPORT 3
OTHER (SPECIFY) ______________ 6

453. Do you think you could talk with your partner about using condoms?

YES 1
NO 2
DON'T KNOW/UNSURE 8

454. Have you ever seen or heard any messages about the MAXIMUM male condom?

YES 1
NO 2 (GO TO 456)

455. Where have you seen or heard messages about Maximum condoms?
RECORD ALL MENTIONED.

RADIO A
TV B
SHOP C
LEAFLETS/BOOKLETS D
POSTER E
COMMUNITY-BASED AGENT/HEALTH WORKER F
OTHER (SPECIFY) _____________ X

456. CHECK 301(08):
EVER HEARD OF FEMALE CONDOM

CODE '1' CIRCLED (GO TO 457)
CODE '2' CIRCLED (GO TO 501)

457. Do you know of a place where a person can get female condoms?

YES 1
NO 2 (GO TO 459)

458. 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.
PROBE: Any other place?
RECORD ALL PLACES MENTIONED.

(NAME OF PLACE) ___________________
PUBLIC SECTOR
GOVERNMENT HOSPITAL A
GOVERNMENT HEALTH CENTER B
GOV'T HEALTH POST C
OTHER PUBLIC (SPECIFY) ______ D
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/SURGERY E
MISSION HOSPITAL/SURGERY F
PHARMACY G
PRIVATE DOCTOR H
WORK PLACE I
OTHER PRIVATE MEDICAL (SPECIFY) ______ J
OTHER SOURCE
SHOP K
COMMUNITY-BASED AGENT L
FRIENDS/RELATIVES M
SCHOOL N
BAR/HOTEL O
OTHER (SPECIFY) _______________ X

459. Which brand of female condom have you heard of?

CARE A
FEMIDOM B (GO TO 501)
NONE C (GO TO 501)
OTHER (SPECIFY) ________ X (GO TO 501)

460. Where have you seen or heard messages about CARE female condom?
RECORD ALL MENTIONED.

RADIO A
TV B
SHOP C
LEAFLETS/BOOKLETS D
POSTER E
COMMUNITY-BASED AGENT/HEALTH WORKER F
OTHER (SPECIFY) _____________ X

SECTION 5. FERTILITY PREFERENCES

501. CHECK 203 AND 205:
You told me that you have TOTAL ___ children. Would you like to have a (another) child or would you prefer not to have any more children at all?

HAVE A/ANOTHER CHILD 1
NO MORE/NONE 2 (GO TO 503)
WIFE INFERTILE OR STERILIZED 3 (GO TO 503)
UNDECIDED/DON'T KNOW 8 (GO TO 503)

502. How long would you like to wait from now before the birth of (a/another) child?

MONTHS 1 ___
YEARS 2 ___

SOON/NOW 993
AFTER MARRIAGE 995
OTHER (SPECIFY) _____________ 996
DON'T KNOW 998

503. Do you think you will use a contraceptive method to avoid pregnancy at any time in the future?

YES 1
NO 2 (GO TO 505)
DON'T KNOW/UNSURE 8 (GO TO 505)

504. Which contraceptive method would you prefer to use?

FEMALE STERILIZATION 01 (GO TO 507)
MALE STERILIZATION 02 (GO TO 507)
PILL 03 (GO TO 507)
IUD 04 (GO TO 507)
INJECTABLES 05 (GO TO 507)
IMPLANTS 06 (GO TO 507)
CONDOM 07 (GO TO 507)
FEMALE CONDOM 08 (GO TO 507)
DIAPHRAGM/FOAM/JELLY 09 (GO TO 507)
LACTATIONAL AMENORRHEA 10 (GO TO 507)
RHYTHM/NATURAL FAM. PLANNING 11 (GO TO 507)
WITHDRAWAL 12 (GO TO 507)
OTHER (SPECIFY) _____ 96 (GO TO 507)
UNSURE 98 (GO TO 507)

505. What is the main reason that you think you will not use a contraceptive method at any time in the future?

NOT MARRIED 11
FERTILITY-RELATED REASONS
INFREQUENT SEX/NO SEX 22 (GO TO 507)
WIFE(VES)/PARTNER(S) MENOPAUSAL/HAD HYSTERECTOMY 23 (GO TO 507)
COUPLE SUBFECUND/INFECUND 24 (GO TO 507)
WANTS AS MANY CHILDREN AS POSSIBLE 26 (GO TO 507)
OPPOSITION TO USE
RESPONDENT OPPOSED 31 (GO TO 507)
WIFE(VES)/PARTNER(S) OPPOSED 32 (GO TO 507)
OTHERS OPPOSED 33 (GO TO 507)
RELIGIOUS PROHIBITION 34 (GO TO 507)
LACK OF KNOWLEDGE
KNOWS NO METHOD 41 (GO TO 507)
KNOWS NO SOURCE 42 (GO TO 507)
METHOD-RELATED REASONS
HEALTH CONCERNS 51 (GO TO 507)
FEAR OF SIDE EFFECTS 52 (GO TO 507)
LACK OF ACCESS/TOO FAR 53 (GO TO 507)
COSTS TOO MUCH 54 (GO TO 507)
INCONVENIENT TO USE 55 (GO TO 507)
INTERFERES WITH BODY'S NORMAL PROCESSES 56 (GO TO 507)
OTHER _______ 96 (GO TO 507)
DON'T KNOW 98 (GO TO 507)

506. Would you ever use a contraceptive method if you were married?

YES 1
NO 2
DON'T KNOW 8

507. CHECK 203 AND 205:

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

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

PROBE FOR A NUMERIC RESPONSE.

NUMBER ____
OTHER (SPECIFY) ____ 96 (GO TO 509)

508. How many of these children would you like to be boys, how many would you like to be girls and for how many would the sex not matter?

NUMBER OF BOYS ___
OTHER (SPECIFY) ______ 96
NUMBER OF GIRLS___
OTHER (SPECIFY) ______ 96
NUMBER OF EITHER SEX___
OTHER (SPECIFY) ______ 96

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

APPROVE 1
DISAPPROVE 2
DON'T KNOW/UNSURE 8

510. CHECK 401:

YES, CURRENTLY MARRIED (GO TO 511)
YES, LIVING WITH A WOMAN (GO TO 511)
NO, NOT IN UNION (GO TO 514)

511. Now I want to ask you about your wife's/partner's views on family planning. Do you think that your wife/partner approves or disapproves of couples using a contraceptive method to avoid pregnancy?

APPROVES 1
DISAPPROVES 2
DON'T KNOW 8

512. How often have you talked to your wife/partner about family planning in the past year?

NEVER 1
ONCE OR TWICE 2
MORE OFTEN 3

513. Do you think your wife/partner wants the same number of children that you want, or does she want more or fewer than you want?

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

514. In the last few months have you heard about family planning:

On the radio?
On the television?
In a newspaper or magazine?

RADIO
YES 1
NO 2
TELEVISION
YES 1
NO 2
NEWSPAPER OR MAGAZINE
YES 1
NO 2

515. Have you ever heard of an oral contraception pill called Safeplan?

YES 1
NO 2
NOT SURE 8

516. In the last six months, have you listened to the following programs on the radio:

Your Health Matters?
Lifeline?
AIDS and the family?
Our neighborhood?

YOUR HEALTH MATTERS
YES 1
NO 2
LIFELINE
YES 1
NO 2
AIDS ANDTHE FAMILY
YES 1
NO 2
OUR NEIGHBORHOOD
YES 1
NO 2

517. In the last six months, have you seen any of the following programs on television?

Your Health Matters?
Lifeline?
Soul city?
X-plosion?

YOUR HEALTH MATTERS
YES 1
NO 2
LIFELINE
YES 1
NO 2
SOUL CITY
YES 1
NO 2
X-PLOSION
YES 1
NO 2

518. Have you ever seen a newspaper called 'Trendsetters' aimed at young people?

YES 1
NO 2
DON'T KNOW 8

519. Is there a Neighborhood Health Committee (NHC) in your neighborhood?

YES 1
NO 2 (GO TO 601)
DON'T KNOW 8 (GO TO 601)

520. Have you ever attended a meeting organized by the NHC?

YES 1
NO 2

SECTION 6. HEALTH ISSUES

601. CHECK 209:

HAS HAD ONE OR MORE CHILDREN (GO TO 602)
HAS NOT HAD ANY CHILDREN (GO TO 604)

602. Now I want to talk to you about some common childhood illnesses. When a child has diarrhea, should he/she be given less to drink than usual, about the same amount, or more than usual?

LESS 1
ABOUT THE SAME 2
MORE 3
DON'T KNOW 8

603. When a child is sick with a fever, what signs of illness would tell you that she or he should be taken to a health facility or a health worker?
PROBE: Any other signs?
RECORD ALL SIGNS MENTIONED.

FEVER FOR 2 OR MORE DAYS A
SEIZURES/SHAKING B
CHEST INDRAWING C
NOT EATING/NOT DRINKING WELL D
GETTING SICKER/VERY SICK E
NOT GETTING BETTER F
OTHER (SPECIFY) ___________ X
DON'T KNOW ANY SIGNS Z

604. Do you currently smoke cigarettes or tobacco?
IF YES: What type of tobacco do you smoke?
RECORD ALL TYPES MENTIONED.

YES, CIGARETTES A
YES, PIPE B
YES, OTHER TOBACCO C
NO Y

605. CHECK 604:

CODE 'A' CIRCLED (GO TO 606)
CODE 'A' NOT CIRCLED (GO TO 607)

606. In the last 24 hours, how many cigarettes did you smoke?

CIGARETTES _____

607. Have you ever drunk an alcohol-containing beverage?

YES 1
NO 2 (GO TO 701)

608. In the last 3 months, on how many days did you drink an alcohol-containing beverage?
IF EVERY DAY: RECORD '30'.

NUMBER OF DAYS _____
NONE 95

609. Have you ever gotten 'drunk' from drinking an alcohol-containing beverage?

YES 1
NO 2 (GO TO 701)

610. CHECK 608:

DRANK ALCOHOL ON AT LEAST ONE DAY (GO TO 611)
NONE (GO TO 701)

611. In the last 3 months, on how many occasions did you get 'drunk'?

NUMBER OF TIMES ___
NONE/NEVER 95

SECTION 7. AIDS AND OTHER SEXUALLY-TRANSMITTED INFECTIONS

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

YES 1
NO 2 (GO TO 724)

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

YES 1
NO 2 (GO TO 709)
DON'T KNOW 8 (GO TO 709)

703. What can a person do?
Anything else?
RECORD ALL MENTIONED.

ABSTAIN FROM SEX A
USE CONDOMS B
LIMIT SEX TO ONE PARTNER/STAY FAITHFUL TO ONE PARTNER C
LIMIT NUMBER OF SEX PARTNERS D
AVOID SEX WITH PROSTITUTES E
AVOID SEX WITH PERSONS WHO HAVE MANY PARTNERS F
AVOID SEX WITH HOMOSEXUALS G
AVOID SEX WITH PERSONS WHO INJECT DRUGS INTRAVENOUSLY H
AVOID BLOOD TRANSFUSIONS I
AVOID INJECTIONS J
AVOID SHARING RAZORS/BLADES K
AVOID KISSING L
AVOID MOSQUITO BITES M
SEEK PROTECTION FROM TRADITIONAL HEALER N
OTHER (SPECIFY) _______ W
OTHER (SPECIFY) _______ X
DON'T KNOW Z

704. Can people reduce their chances of getting the AIDS virus by having just one sex partner who has no other partners?

YES 1
NO 2
DON'T KNOW 8

705. Can a person get the AIDS virus from mosquito bites?

YES 1
NO 2
DON'T KNOW 8

706. Can people reduce their chances of getting the AIDS virus by using a condom every time they have sex?

YES 1
NO 2
DON'T KNOW 8

707. Can a person get the AIDS virus by sharing food with a person who has AIDS?

YES 1
NO 2
DON'T KNOW 8

709. Is it possible for a healthy-looking person to have the AIDS virus?

YES 1
NO 2
DON'T KNOW 8

710. Do you know someone personally who has the virus that causes AIDS or someone who died of AIDS?

YES 1
NO 2

711. Can the virus that causes AIDS be transmitted from a mother to a child?

YES 1
NO 2 (GO TO 713)
DON'T KNOW 8 (GO TO 713)

712. Can the virus that causes AIDS be transmitted from a mother to her child…

During pregnancy?
During delivery?
By breastfeeding?

DURING PREGNANCY
YES 1
NO 2
DON'T KNOW 8
DURING DELIVERY
YES 1
NO 2
DON'T KNOW 8
BY BREASTFEEDING
YES 1
NO 2
DON'T KNOW 8

712A. Is there anything that can be done to reduce the chances that a mother would transmit the AIDS virus to her child?

YES 1
NO 2
DON'T KNOW 8

713. CHECK 401:

YES, CURRENTLY MARRIED/LIVING WITH A WOMAN (GO TO 714)
NO, NOT IN UNION (GO TO 715)

714. Have you ever talked with your wife/woman you are living with about ways to prevent getting the virus that causes AIDS?
IF MORE THAN ONE WIFE, ASK ABOUT ANY OF HIS WIVES.

YES 1
NO 2

715. In your opinion, is it acceptable or unacceptable for AIDS to be discussed:

on the radio?
on the TV?
in newspapers?done

ON THE RADIO
ACCEPTABLE 1
NOT ACCEPTABLE 2
ON THE TV
ACCEPTABLE 1
NOT ACCEPTABLE 2
IN NEWSPAPERS
ACCEPTABLE 1
NOT ACCEPTABLE 2

716. If a member of your family got infected with the virus that causes AIDS, would you want it to remain a secret or not?

YES 1
NO 2
DON'T KNOW/UNSURE 8

717. If a relative of yours became sick with the virus that causes AIDS, would you be willing to care for her or him in your own household?

YES 1
NO 2
DON'T KNOW/UNSURE/DEPENDS 8

718. If a worker is sick with AIDS, should he/she be allowed to work?

ALLOWED 1
NOT ALLOWED TO WORK 2
DON'T KNOW/UNSURE/DEPENDS 8

718A. If you knew that a shopkeeper or food seller has the AIDS virus, would you buy food items from them?

YES 1
NO 2
DON'T KNOW/UNSURE/DEPENDS 8

718B. In the last six months, have you seen any adverts about sexual abstinence, condom use or HIV/AIDS?

YES 1
NO 2 (GO TO 719)
DON'T KNOW/NOT SURE 8 (GO TO 719)

718C. Can you describe which ones?
DO NOT READ RESPONSES TO RESPONDENT.
RECORD ALL MENTIONED.

YOU CLEVER GIRL A
BOYS SAYING WHY THEY ABSTAIN FROM SEX B
SAY NO TO SEX/VIRGIN POWER/VIRGIN PRIDE C
ICE IS AT BRAII/ICE GETS STD D
ICE FIXING CAR/FRIEND TELLS HIM TO USE CONDOM EVERY TIME E
CHRISTINE BRAIDING HAIR/FRIENDS SAY USE CONDOM F
BOYS PLAYING BASKETBALL/ONE HIV PLUS/CAN'T TELL WHICH ONE G
GIRLS WALKING/ONE HIV PLUS/CAN'T TELL WHICH ONE H
OTHER (SPECIFY) __________________ X

719. Should youth age 12-14 be taught about using a condom to avoid AIDS?

YES 1
NO 2
DON'T KNOW/UNSURE/DEPENDS 8

719A. Do you think your chances of getting AIDS are small, moderate, great, or do you think that you have no chance of getting it at all?

SMALL 1
MODERATE 2 (GO TO 720)
GREAT 3 (GO TO 720)
NO RISK AT ALL 4
HAS AIDS 5 (GO TO 720)

719B. Why do you think your chances of getting AIDS are low?
RECORD ALL MENTIONED.

ABSTAIN FROM SEX A
USE CONDOMS B
HAS ONLY 1 SEX PARTNER C
LIMITED NUMBER OF PARTNERS D
PARTNER HAS NO OTHER PARTNERS E
NO BLOOD TRANSFUSIONS/INJECTIONS F
OTHER (SPECIFY) _______ X

720. Have you ever been tested to see if you have the AIDS virus?

YES 1 (GO TO 723A)
NO 2

721. Would you want to be tested for the AIDS virus?

YES 1
NO 2
DON'T KNOW/UNSURE/DEPENDS 8

722. Do you know a place where you could go to get an AIDS test?

YES 1
NO 2 (GO TO 724)

723. Where can you go for the test?
RECORD ONLY FIRST RESPONSE GIVEN.
723A. Where did you go for the test?

IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.

(NAME OF PLACE) __________________
PUBLIC SECTOR
GOVERNMENT HOSPITAL 11
GOVERNMENT HEALTH CENTER 12
HEALTH POST 13
OTHER PUBLIC (SPECIFY) ______ 16

PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC 21
MISSION HOSPITAL/CLINIC 22
PHARMACY 23
PRIVATE DOCTOR 24
WORK PLACE 25
OTHER PRIVATE MEDICAL (SPECIFY) ______ 26
OTHER (SPECIFY) ______________ 96

724. (Apart from AIDS), have you heard about other infections that can be transmitted through sexual contact?

YES 1
NO 2 (GO TO 727)

725. If a man has a sexually transmitted disease, what symptoms might he have?
Any others?
RECORD ALL SYMPTOMS MENTIONED.

ABDOMINAL PAIN A
GENITAL DISCHARGE/DRIPPING B
FOUL SMELLING DISCHARGE C
BURNING PAIN ON URINATION D
REDNESS/INFLAMMATION IN GENITAL AREA E
SWELLING IN GENITAL AREA F
GENITAL SORES/ULCERS G
GENITAL WARTS H
GENITAL ITCHING I
BLOOD IN URINE J
LOSS OF WEIGHT K
IMPOTENCE L
OTHER (SPECIFY) ________ W
OTHER (SPECIFY) ________ X
NO SYMPTOMS Y
DON'T KNOW Z

726. If a woman has a sexually transmitted disease, what symptoms might she have?
Any others?
RECORD ALL SYMPTOMS MENTIONED.

ABDOMINAL PAIN A
GENITAL DISCHARGE B
FOUL SMELLING DISCHARGE C
BURNING PAIN ON URINATION D
REDNESS/INFLAMMATION IN GENITAL AREA E
SWELLING IN GENITAL AREA F
GENITAL SORES/ULCERS G
GENITAL WARTS H
GENITAL ITCHING I
BLOOD IN URINE J
LOSS OF WEIGHT K
HARD TO GET PREGNANT/HAVE A CHILD L
OTHER (SPECIFY) ________ W
OTHER (SPECIFY) ________ X
NO SYMPTOMS Y
DON'T KNOW Z

727. CHECK 416:

HAS HAD SEXUAL INTERCOURSE (GO TO 728)
HAS NOT HAD SEXUAL INTERCOURSE (GO TO 801)

728. Now I would like to ask you some questions about your health in the last 12 months. During the last 12 months, have you had a sexually-transmitted disease?

YES 1
NO 2
DON'T KNOW 8

729. Sometimes, men experience a discharge from their penis. During the last 12 months, have you had a sore or ulcer on or near your penis.

YES 1
NO 2
DON'T KNOW 8

730. Sometimes men have a sore or ulcer on or near their penis. During the last 12 months, have you had a sore or ulcer on or near your penis?

YES 1
NO 2
DON'T KNOW 8

731. CHECK 728/729/730:

HAS HAD AN INFECTION (GO TO732)
HAS NOT HAD AN INFECTION OR DOES NOT KNOW (GO TO 801)

732. The last time you had (a sexually transmitted disease/discharge/sore), did you seek any kind of advice or treatment?

YES 1
NO 2 (GO TO 734)

733. The last time you had (a sexually transmitted disease/discharge/sore), did you do any of the following? Did you....

Go to a clinic, hospital or private doctor?
Consult a traditional healer?
Seek advice or buy medicines in a shop or pharmacy?
Ask for advice from friends or relatives?

CLINIC/HOSPITAL
YES 1
NO 2
TRADITIONAL HEALER
YES 1
NO 2
SHOP/PHARMACY
YES 1
NO 2
FRIENDS/RELATIVES
YES 1
NO 2

734. When you had (a sexually transmitted disease/discharge/sore), did you inform the person(s) with whom you were having sex?

YES 1
NO 2
SOME/NOT ALL 3
DID NOT HAVE A PARTNER 4 (GO TO 801)

735. When you had (a sexually transmitted disease/discharge/sore),did you do something to avoid infecting your sexual partner(s)?

YES 1
NO 2 (GO TO 801)
PARTNER(S) ALREADY INFECTED 3 (GO TO 801)

736. What did you do to avoid infecting your partner(s)? Did you....

Use medicine?
Stop having sex?
Use a condom when having sex?

USE MEDICINE
YES 1
NO 2
STOP SEX
YES 1
NO 2
USE CONDOM
YES 1
NO 2

SECTION 8. ATTITUDES TOWARD WOMEN

801. In a couple, who do you think should have the greater say in each of the following decisions: the husband, the wife or both equally:

a) making large household purchases?
HUSBAND 1
WIFE 2
BOTH 3
DON'T KNOW/DEPENDS 8
b) deciding when to visit family, friends or relatives?
HUSBAND 1
WIFE 2
BOTH 3
DON'T KNOW/DEPENDS 8
c) deciding what to do with the money she earns for her work?
HUSBAND 1
WIFE 2
BOTH 3
DON'T KNOW/DEPENDS 8
d) deciding how many children to have and when to have them?
HUSBAND 1
WIFE 2
BOTH 3
DON'T KNOW/DEPENDS 8

802. Sometimes a husband is annoyed or angered by things that his wife does. In your opinion, is a husband justified in hitting or beating his wife in the following situations:

If she goes out without telling him?
If she neglects the children?
If she argues with him?
If she refuses to have sex with him?
If she cooks bad food or the food is late?

GOES WITH MAN
YES 1
NO 2
DON'T KNOW 8
NEGL.CHILDREN
YES 1
NO 2
DON'T KNOW 8
ARGUES
YES 1
NO 2
DON'T KNOW 8
REFUSES SEX
YES 1
NO 2
DON'T KNOW 8
BAD/LATE FOOD
YES 1
NO 2
DON'T KNOW 8

803. Husbands and wives do not always agree on everything. Please tell me if you think a wife is justified in refusing to have sex with her husband when:

She knows her husband has a sexually transmitted disease?
She knows her husband has sex with other women?
She has recently given birth?
She is tired or not in the mood?

HAS STD
YES 1
NO 2
DON'T KNOW 8
OTHER WOMEN
YES 1
NO 2
DON'T KNOW 8
RECENT BIRTH
YES 1
NO 2
DON'T KNOW 8
TIRED/MOOD
YES 1
NO 2
DON'T KNOW 8

804. Do you think that if a woman refuses to have sex with her husband when he wants her to, he has the right to...

Get angry and reprimand her?
Refuse to give her money or other means of financial support?
Use force and have sex with her even if she does not want to?
Go and have sex with another woman

GET ANGRY
YES 1
NO 2
DON'T KNOW 8
REFUSE MONEY
YES 1
NO 2
DON'T KNOW 8
RAPE HER
YES 1
NO 2
DON'T KNOW 8
ANOTHER WOMAN
YES 1
NO 2
DON'T KNOW 8

805. RECORD THE TIME.

HOURS ___
MINUTES ___