Survey Text

Afghanistan 2015 Ghana 2008 Namibia 2006 Senegal 2015
Angola 2015 Ghana 2014 Namibia 2013 Senegal 2016
Benin 2006 Guinea 2005 Niger 2006 Senegal 2017
Benin 2011 Guinea 2012 Niger 2012 Tanzania 2004
Burkina Faso 2003 Kenya 2003 Nigeria 2003 Tanzania 2010
Burkina Faso 2010 Kenya 2008 Nigeria 2008 Tanzania 2015
Burundi 2010 Kenya 2014 Nigeria 2013 Uganda 2006
Burundi 2016 Madagascar 2008 Pakistan 2006 Uganda 2011
Cameroon 2004 Malawi 2004 Pakistan 2017 Uganda 2016
Cameroon 2011 Malawi 2010 Rwanda 2005 Zambia 2001
Cameroon 2018 Malawi 2016 Rwanda 2010 Zambia 2007
Congo (Democratic Republic) 2007 Mali 2006 Rwanda 2014 Zambia 2013
Congo (Democratic Republic) 2013 Mali 2012 Senegal 2005 Zambia 2018
Cote d'Ivoire 2011 Mozambique 2003 Senegal 2010 Zimbabwe 2005
Ethiopia 2005 Mozambique 2011 Senegal 2012 Zimbabwe 2010
Ghana 2003 Myanmar 2015 Senegal 2014 Zimbabwe 2015
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Afghanistan 2015
Survey form view entire document:  text 
135. Who slept under this mosquito net last night?
RECORD THE PERSON'S NAME AND LINE NUMBER FROM THE HOUSEHOLD SCHEDULE.

NAME_______________
LINE NO.____

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Angola 2015
Survey form view entire document:  text 
137) Who slept under this mosquito net last night?
RECORD THE PERSON'S LINE NUMBER FROM THE HOUSEHOLD SCHEDULE.

NAME____
LINE NUMBER ___

138) GO BACK TO 129 FOR NEXT NET; OR, IF NO MORE NETS, GO TO 139


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Benin 2006
Survey form view entire document:  text 
136 Who slept under this mosquito net last night?

RECORD THE PERSON'S LINE NUMBER FROM THE HOUSEHOLD SCHEDULE.

NAME_____________
LINE NO. ____________

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Benin 2011
Survey form view entire document:  text 
135. (7) Who slept under this mosquito net last night?

RECORD THE PERSON'S NAME AND LINE NUMBER FROM THE HOUSEHOLD SCHEDULE. RECORD UP TO FOUR PEOPLE.

NAME ____
LINE NO. ____

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Burkina Faso 2003
Survey form view entire document:  text 
31. Who slept under this mosquito net last night?
RECORD THE LINE NUMBER ACCORDING TO THE LIST OF HOUSEHOLD MEMBERS. REPEAT FOR ALL WHO SLEPT UNDER NET.

LINE NUMBER ____

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Burkina Faso 2010
Survey form view entire document:  text 
135. (7) Who slept under this mosquito net last night?

RECORD THE PERSON'S NAME AND LINE NUMBER FROM THE HOUSEHOLD SCHEDULE. RECORD UP TO FOUR PEOPLE.

NAME ____
LINE NO. ____

202. LINE NUMBER COLUMN 11
NAME FROM COLUMN 2

LINE NUMBER ____
NAME ____

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Burundi 2010
Survey form view entire document:  text 
135. (7) Who slept under this mosquito net last night?

RECORD THE PERSON'S NAME AND LINE NUMBER FROM THE HOUSEHOLD SCHEDULE. RECORD UP TO FOUR PEOPLE.

NAME ____
LINE NO. ____

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Burundi 2016
Survey form view entire document:  text 
137) Who slept under the mosquito net last night?

RECORD THE PERSON'S LINE NUMBER FROM THE HOUSEHOLD SCHEDULE.

NAME_________
LINE NUMBER___

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Cameroon 2004
Survey form view entire document:  text 
32D) Who slept under this mosquito net last night?

RECORD THE RESPECTIVE LINE NUMBER FROM THE HOUSEHOLD SCHEDULE.

NAME: ___
LINE NUMBER: ___
NAME: ___
LINE NUMBER: ___
NAME: ___
LINE NUMBER: ___
NAME: ___
LINE NUMBER: ___
NAME: ___
LINE NUMBER: ___

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Cameroon 2011
Survey form view entire document:  text 
135. (7) Who slept under this mosquito net last night?

RECORD THE PERSON'S NAME AND LINE NUMBER FROM THE HOUSEHOLD SCHEDULE. RECORD UP TO FOUR PEOPLE.

NAME ____
LINE NO. ____

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Cameroon 2018
Survey form view entire document:  text 
137. Who slept under the mosquito net last night?
RECORD THE PERSON'S NAME AND LINE NUMBER FROM HOUSEHOLD SCHEDULE.

NAME ___
LINE NO. __

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Congo (Democratic Republic) 2007
Survey form view entire document:  text 
136 Who slept under this mosquito net last night?

RECORD THE PERSON'S LINE NUMBER FROM THE HOUSEHOLD SCHEDULE.

NAME_____________
LINE NO. ____________

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Congo (Democratic Republic) 2013
Survey form view entire document:  text 
130) OBSERVE OR ASK THE BRAND/TYPE OF MOSQUITO NET.
IF BRAND IS UNKNOWN AND YOU CANNOT OBSERVE THE NET, SHOW PICTURES OF TYPICAL NET TYPES/BRANDS TO RESPONDENT

LONG-LASTING INSECTICIDE-TREATED NET (LLIN)
PERMANET 2.0 11 (GO TO 134)
OLYSET 12 (GO TO 134)
DURANET 13 (GO TO 134)
INTERCEPTOR BRAND 14 (GO TO 134)
YORKOOL LN BRAND 15 (GO TO 134)
LIFENET 16 (GO TO 134)
MAGNET 17 (GO TO 134)
NETPROTECT 19 (GO TO 134)
OTHER/DON'T KNOW BRAND 21 (GO TO 134)
OTHER BRAND 96
DON'T KNOW BRAND 98

134) Did anyone sleep under this mosquito net last night?

YES 1
NO 2 (GO TO 136)
DON'T KNOW 8 (GO TO 136)

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Cote d'Ivoire 2011
Survey form view entire document:  text 
135. (7) Who slept under this mosquito net last night?

RECORD THE PERSON'S NAME AND LINE NUMBER FROM THE HOUSEHOLD SCHEDULE. RECORD UP TO FOUR PEOPLE.

NAME ____
LINE NO. ____

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Ethiopia 2005
Survey form view entire document:  text 
136 Who slept under this mosquito net last night?

RECORD THE PERSON'S LINE NUMBER FROM THE HOUSEHOLD SCHEDULE.

NAME_____________
LINE NO. ____________

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Ghana 2003
Survey form view entire document:  text 
32D. Who slept under this mosquito bed net last night? RECORD THE RESPECTIVE LINE NUMBER FROM THE HOUSEHOLD SCHEDULE.

NAME ____
LINE NO____

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Ghana 2008
Survey form view entire document:  text 
136 Who slept under this mosquito net last night?

RECORD THE PERSON'S LINE NUMBER FROM THE HOUSEHOLD SCHEDULE.

NAME_____________
LINE NO. ____________

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Ghana 2014
Survey form view entire document:  text 
135. (7) Who slept under this mosquito net last night?

RECORD THE PERSON'S NAME AND LINE NUMBER FROM THE HOUSEHOLD SCHEDULE. RECORD UP TO FOUR PEOPLE.

NAME ____
LINE NO. ____

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Guinea 2005
Survey form view entire document:  text 
136 Who slept under this mosquito net last night?

RECORD THE PERSON'S LINE NUMBER FROM THE HOUSEHOLD SCHEDULE.

NAME_____________
LINE NO. ____________

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Guinea 2012
Survey form view entire document:  text 
135. (7) Who slept under this mosquito net last night?

RECORD THE PERSON'S NAME AND LINE NUMBER FROM THE HOUSEHOLD SCHEDULE. RECORD UP TO FOUR PEOPLE.

NAME ____
LINE NO. ____

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Kenya 2003
Survey form view entire document:  text 
34B. Who slept under this mosquito net last night? Anyone else?

WRITE THE LINE NUMBERS FROM THE HOUSEHOLD SCHEDULE.
IF NO ONE SLEPT UNDER THE NET, WRITE '00'.

LINE NO. __

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Kenya 2008
Survey form view entire document:  text 
136 Who slept under this mosquito net last night?

RECORD THE PERSON'S LINE NUMBER FROM THE HOUSEHOLD SCHEDULE.

NAME_____________
LINE NO. ____________

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Kenya 2014
Survey form view entire document:  text 
135) Who slept under this mosquito net last night?

RECORD THE PERSON'S NAME AND LINE NUMBER FROM THE HOUSEHOLD SIGNATURE.

NAME _________
LINE NO. ______

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Madagascar 2008
Survey form view entire document:  text 
136 Who slept under this mosquito net last night?

RECORD THE PERSON'S LINE NUMBER FROM THE HOUSEHOLD SCHEDULE.

NAME_____________
LINE NO. ____________

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Malawi 2004
Survey form view entire document:  text 
35E. Who slept under this mosquito net last night?
RECORD THE RESPECTIVE LINE NUMBER FROM THE HOUSEHOLD SCHEDULE.

NAME ____________
LINE NUMBER __

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Malawi 2010
Survey form view entire document:  text 
136 Who slept under this mosquito net last night?

RECORD THE PERSON'S LINE NUMBER FROM THE HOUSEHOLD SCHEDULE.

NAME_____________
LINE NO. ____________

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Malawi 2016
Survey form view entire document:  text 
137. (9) Who slept under this mosquito net last night?

RECORD THE PERSON'S NAME AND LINE NUMBER FROM HOUSEHOLD SCHEDULE.

NAME______________
LINE NO. __ __
NAME______________
LINE NO. __ __
NAME______________
LINE NO. __ __
NAME______________
LINE NO. __ __

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Mali 2006
Survey form view entire document:  text 
136 Who slept under this mosquito net last night?

RECORD THE PERSON'S LINE NUMBER FROM THE HOUSEHOLD SCHEDULE.

NAME_____________
LINE NO. ____________

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Mali 2012
Survey form view entire document:  text 
135) Who slept under the mosquito net last night?
RECORD THE PERSONS' LINE NUMBER FROM THE HOUSEHOLD SCHEDULE

NAME________
LINE NUMBER_______

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Mozambique 2003
Survey form view entire document:  text 
68. Did (NAME) sleep under a hammock/bed-net last night?

YES 1
NO 2

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Mozambique 2011
Survey form view entire document:  text 
135. (7) Who slept under this mosquito net last night?

RECORD THE PERSON'S NAME AND LINE NUMBER FROM THE HOUSEHOLD SCHEDULE. RECORD UP TO FOUR PEOPLE.

NAME ____
LINE NO. ____

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Myanmar 2015
Survey form view entire document:  text 
135. Who slept under this mosquito net last night?
RECORD THE PERSON'S NAME AND LINE NUMBER FROM HOUSEHOLD SCHEDULE.

NAME _______
LINE NO. ____

NAME _______
LINE NO. ____

NAME _______
LINE NO. ____

NAME _______
LINE NO. ____

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Namibia 2006
Survey form view entire document:  text 
136. Who slept under this mosquito net last night? RECORD THE PERSON'S LINE NUMBER FROM THE HOUSEHOLD SCHEDULE.

NAME _____
LINE NO. ____

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Namibia 2013
Survey form view entire document:  text 
135. (7) Who slept under this mosquito net last night?

RECORD THE PERSON'S NAME AND LINE NUMBER FROM THE HOUSEHOLD SCHEDULE. RECORD UP TO FOUR PEOPLE.

NAME ____
LINE NO. ____

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Niger 2006
Survey form view entire document:  text 
136 Who slept under this mosquito net last night?

RECORD THE PERSON'S LINE NUMBER FROM THE HOUSEHOLD SCHEDULE.

NAME_____________
LINE NO. ____________

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Niger 2012
Survey form view entire document:  text 
135. (7) Who slept under this mosquito net last night?

RECORD THE PERSON'S NAME AND LINE NUMBER FROM THE HOUSEHOLD SCHEDULE. RECORD UP TO FOUR PEOPLE.

NAME ____
LINE NO. ____

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Nigeria 2003
Survey form view entire document:  text 
30F. Who slept under this mosquito net last night?
RECORD RESPECTIVE LINE NUMBER FROM THE HOUSEHOLD SCHEDULE.

LINE NO. __
NAME _____________

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Nigeria 2008
Survey form view entire document:  text 
136 Who slept under this mosquito net last night?

RECORD THE PERSON'S LINE NUMBER FROM THE HOUSEHOLD SCHEDULE.

NAME_____________
LINE NO. ____________

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Nigeria 2013
Survey form view entire document:  text 
135. (7) Who slept under this mosquito net last night?

RECORD THE PERSON'S NAME AND LINE NUMBER FROM THE HOUSEHOLD SCHEDULE. RECORD UP TO FOUR PEOPLE.

NAME ____
LINE NO. ____

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Pakistan 2006
Survey form view entire document:  text 
136 Who slept under this mosquito net last night?

RECORD THE PERSON'S LINE NUMBER FROM THE HOUSEHOLD SCHEDULE.

NAME_____________
LINE NO. ____________

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Pakistan 2017
Survey form view entire document:  text 
137) Who slept under this mosquito net last night? RECORD THE PERSON'S NAME AND LINE NUMBER FROM HOUSEHOLD.

NAME _______
LINE NO. _______

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Rwanda 2005
Survey form view entire document:  text 
136 Who slept under this mosquito net last night?

RECORD THE PERSON'S LINE NUMBER FROM THE HOUSEHOLD SCHEDULE.

NAME_____________
LINE NO. ____________

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Rwanda 2010
Survey form view entire document:  text 
135. (7) Who slept under this mosquito net last night?

RECORD THE PERSON'S NAME AND LINE NUMBER FROM THE HOUSEHOLD SCHEDULE. RECORD UP TO FOUR PEOPLE.

NAME ____
LINE NO. ____

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Rwanda 2014
Survey form view entire document:  text 
AGE

7. How old is (NAME)?
IF 95 OR MORE, RECORD '95'.

IN YEARS ___ ___

137. (9) Who slept under this mosquito net last night?

RECORD THE PERSON'S NAME AND LINE NUMBER FROM HOUSEHOLD SCHEDULE.

NAME______________
LINE NO. __ __
NAME______________
LINE NO. __ __
NAME______________
LINE NO. __ __
NAME______________
LINE NO. __ __

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Senegal 2005
Survey form view entire document:  text 
32E. Who slept under this net last night?
RECORD THE LINE NUMBER FROM THE HOUSEHOLD TABLE.
RECORD UP TO FIVE PEOPLE PER NET.

NAME _____
LINE NO. _____

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Senegal 2010
Survey form view entire document:  text 
135. (7) Who slept under this mosquito net last night?

RECORD THE PERSON'S NAME AND LINE NUMBER FROM THE HOUSEHOLD SCHEDULE. RECORD UP TO FOUR PEOPLE.

NAME ____
LINE NO. ____

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Senegal 2012
Survey form view entire document:  text 
135. (7) Who slept under this mosquito net last night?

RECORD THE PERSON'S NAME AND LINE NUMBER FROM THE HOUSEHOLD SCHEDULE. RECORD UP TO FOUR PEOPLE.

NAME ____
LINE NO. ____

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Senegal 2014
Survey form view entire document:  text 
21) I would like to ask you some questions about the health of the members of your household. Does (NAME) suffer from any type of chronic illness?

1 YES
2 NO (GO TO 28)

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Senegal 2015
Survey form view entire document:  text 
137. (9) Who slept under this mosquito net last night?

RECORD THE PERSON'S NAME AND LINE NUMBER FROM HOUSEHOLD SCHEDULE.

NAME______________
LINE NO. __ __
NAME______________
LINE NO. __ __
NAME______________
LINE NO. __ __
NAME______________
LINE NO. __ __

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Senegal 2016

No questionnaire text is available for this sample.


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Senegal 2017
Survey form view entire document:  text 
137) Who slept under the mosquito net last night?
RECORD THE PERSONS' NAME AND LINE NUMBER FROM THE HOUSEHOLD SCHEDULE.

NAME ____
LINE NUMBER _____

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Tanzania 2004
Survey form view entire document:  text 
32E. Who slept under this mosquito net last night?
RECORD THE RESPECTIVE LINE NUMBER FROM THEHOUSEHOLD SCHEDULE.

NAME _______
LINE NO. _______

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Tanzania 2010
Survey form view entire document:  text 
135. (7) Who slept under this mosquito net last night?

RECORD THE PERSON'S NAME AND LINE NUMBER FROM THE HOUSEHOLD SCHEDULE. RECORD UP TO FOUR PEOPLE.

NAME ____
LINE NO. ____

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Tanzania 2015
Survey form view entire document:  text 
AGE

7. How old is (NAME)?
IF 95 OR MORE, RECORD '95'.

IN YEARS ___ ___

137. (9) Who slept under this mosquito net last night?

RECORD THE PERSON'S NAME AND LINE NUMBER FROM HOUSEHOLD SCHEDULE.

NAME______________
LINE NO. __ __
NAME______________
LINE NO. __ __
NAME______________
LINE NO. __ __
NAME______________
LINE NO. __ __

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Uganda 2006
Survey form view entire document:  text 
136 Who slept under this mosquito net last night?

RECORD THE PERSON'S LINE NUMBER FROM THE HOUSEHOLD SCHEDULE.

NAME_____________
LINE NO. ____________

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Uganda 2011
Survey form view entire document:  text 
135. (7) Who slept under this mosquito net last night?

RECORD THE PERSON'S NAME AND LINE NUMBER FROM THE HOUSEHOLD SCHEDULE. RECORD UP TO FOUR PEOPLE.

NAME ____
LINE NO. ____

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Uganda 2016
Survey form view entire document:  text 
137) Who slept under this mosquito net last night?

RECORD THE PERSON'S NAME AND LINE NUMBER FROM HOUSEHOLD SCHEDULE.

NET #1
NAME _____
LINE NO. ___
NET #2
NAME _____
LINE NO. ___
NET #3
NAME _____
LINE NO. ___

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Zambia 2001
Survey form view entire document:  text 
40. Who slept under this mosquito net last night?
RECORD RESPECTIVE LINE NUMBER FROM THE HOUSEHOLD SCHEDULE.

LINE NO. __

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Zambia 2007
Survey form view entire document:  text 
136 Who slept under this mosquito net last night?

RECORD THE PERSON'S LINE NUMBER FROM THE HOUSEHOLD SCHEDULE.

NAME_____________
LINE NO. ____________

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Zambia 2013
Survey form view entire document:  text 
135. (7) Who slept under this mosquito net last night?

RECORD THE PERSON'S NAME AND LINE NUMBER FROM THE HOUSEHOLD SCHEDULE. RECORD UP TO FOUR PEOPLE.

NAME ____
LINE NO. ____

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Zambia 2018
Survey form view entire document:  text 
(137) Who slept under this mosquito net last night?

RECORD THE PERSON'S NAME AND LINE NUMBER FROM HOUSEHOLD SCHEDULE. (REPEAT FOR 3 NETS)

NAME _______________
LINE NO. _____
NAME _______________
LINE NO. _____
NAME _______________
LINE NO. _____

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Zimbabwe 2005
Survey form view entire document:  text 
136 Who slept under this mosquito net last night?

RECORD THE PERSON'S LINE NUMBER FROM THE HOUSEHOLD SCHEDULE.

NAME_____________
LINE NO. ____________

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Zimbabwe 2010
Survey form view entire document:  text 
135. (7) Who slept under this mosquito net last night?

RECORD THE PERSON'S NAME AND LINE NUMBER FROM THE HOUSEHOLD SCHEDULE. RECORD UP TO FOUR PEOPLE.

NAME ____
LINE NO. ____

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Zimbabwe 2015
Survey form view entire document:  text 
135. Who slept under this mosquito net last night?

RECORD THE PERSON'S NAME AND LINE NUMBER FROM HOUSEHOLD.

NAME ___
LINE NUMBER ___