Survey Text

Afghanistan 2015 Ethiopia 2016 Mali 2018 Senegal 2017
Angola 2015 Ghana 2008 Mozambique 2011 Tanzania 2010
Bangladesh 2007 India 2005 Myanmar 2015 Tanzania 2015
Benin 2017 India 2015 Namibia 2013 Uganda 2006
Burkina Faso 2010 Jordan 2007 Nepal 2011 Uganda 2011
Burundi 2016 Jordan 2012 Nepal 2016 Uganda 2016
Cameroon 2011 Jordan 2017 Nigeria 2008 Zambia 2007
Chad 2014 Kenya 2008 Nigeria 2013 Zambia 2013
Congo (Democratic Republic) 2007 Kenya 2014 Nigeria 2018 Zambia 2018
Congo (Democratic Republic) 2013 Liberia 2007 Pakistan 2012 Zimbabwe 2005
Cote d'Ivoire 2011 Malawi 2010 Pakistan 2017 Zimbabwe 2010
Egypt 2005 Malawi 2016 Rwanda 2010 Zimbabwe 2015
Egypt 2014 Mali 2012 Rwanda 2014
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Afghanistan 2015
Survey form view entire document:  text 
1305A. Did your (last) husband ever do any of the following things to you:

a) push you, shake you, or throw something at you?
YES 1 (FOLLOW UP WITH 1305B)
NO 2
b) slap you?
YES 1 (FOLLOW UP WITH 1305B)
NO 2
c) twist your arm or pull your hair?
YES 1 (FOLLOW UP WITH 1305B)
NO 2
d) punch you with his fist or with something that could hurt you?
YES 1 (FOLLOW UP WITH 1305B)
NO 2
e) kick you, drag you, or beat you up?
YES 1 (FOLLOW UP WITH 1305B)
NO 2
f) try to choke you or burn you on purpose?
YES 1 (FOLLOW UP WITH 1305B)
NO 2
g) threaten to attack you with a knife, gun, or other weapon?
YES 1 (FOLLOW UP WITH 1305B)
NO 2
h) physically force you to have sexual intercourse with him when you did not want to?
YES 1 (FOLLOW UP WITH 1305B)
NO 2
i) physically force you to perform any other sexual acts you did not want to?
YES 1 (FOLLOW UP WITH 1305B)
NO 2
j) force you with threats or in any other way to perform sexual acts you did not want to?
YES 1 (FOLLOW UP WITH 1305B)
NO 2

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Angola 2015
Survey form view entire document:  text 
1306. A. (Does/did) your (last) husband/partner ever:

A) PUSH YOU, SHAKE YOU, OR THROW SOMETHING AT YOU?
YES 1 (GO TO PART B)
NO 2 (GO TO NEXT QUESTION)
B) SLAP YOU?
YES 1 (GO TO PART B)
NO 2 (GO TO NEXT QUESTION)
C) TWIST YOUR ARM OR PULL YOUR HAIR?
YES 1 (GO TO PART B)
NO 2 (GO TO NEXT QUESTION)
D) PUNCH YOU WITH HIS FIST OR WITH SOMETHING THAT COULD HURT YOU?
YES 1 (GO TO PART B)
NO 2 (GO TO NEXT QUESTION)
E) KICK YOU, DRAG YOU OR BEAT YOU UP?
YES 1 (GO TO PART B)
NO 2 (GO TO NEXT QUESTION)
F) TRY TO CHOKE YOU OR BURN YOU ON PURPOSE?
YES 1 (GO TO PART B)
NO 2 (GO TO NEXT QUESTION)
G) THREATEN OR ATTACK YOU WITH A KNIFE, GUN OR ANY OTHER WEAPON?
YES 1 (GO TO PART B)
NO 2 (GO TO NEXT QUESTION)
H) PHYSICALLY FORCE YOU TO HAVE SEXUAL INTERCOURSE WITH HIM AGAINST YOUR WILL?
YES 1 (GO TO PART B)
NO 2 (GO TO NEXT QUESTION)
I) FORCE YOU TO PERFORM ANY OTHER SEXUAL ACTS AGAINST YOUR WILL?
YES 1 (GO TO PART B)
NO 2 (GO TO NEXT QUESTION)
J) THREATEN YOU IN SOME OTHER WAY TO PERFORM A SEXUAL ACT AGAINST YOUR WILL?
YES 1 (GO TO PART B)
NO 2 (GO TO NEXT QUESTION)

B. How often did this happen during the last 12 months: often, only sometimes, or not at all?

A) PUSH YOU, SHAKE YOU, OR THROW SOMETHING AT YOU?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
B) SLAP YOU?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
C) TWIST YOUR ARM OR PULL YOUR HAIR?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
D) PUNCH YOU WITH HIS FIST OR WITH SOMETHING THAT COULD HURT YOU?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
E) KICK YOU, DRAG YOU OR BEAT YOU UP?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
F) TRY TO CHOKE YOU OR BURN YOU ON PURPOSE?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
G) THREATEN OR ATTACK YOU WITH A KNIFE, GUN OR ANY OTHER WEAPON?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
H) PHYSICALLY FORCE YOU TO HAVE SEXUAL INTERCOURSE WITH HIM AGAINST YOUR WILL?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
I) FORCE YOU TO PERFORM ANY OTHER SEXUAL ACTS AGAINST YOUR WILL?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
J) THREATEN YOU IN SOME OTHER WAY TO PERFORM A SEXUAL ACT AGAINST YOUR WILL?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3

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Bangladesh 2007
Survey form view entire document:  text 
1110) Did you tell anyone about your husband hurting you?

YES 1
NO 2 (GO TO 1112)

1111) Whom did you tell? RECORD ALL MENTIONED.

FRIEND A
FATHER/MOTHER B
BROTHER/SISTER C
AUNT/UNCLE D
CHILDREN E
MOTHER-IN-LAW F
FATHER-IN-LAW G
OTHER RELATIVE H
POLIC I
DOCTOR/HEALTHWORKER J
MOULAVI/CLERIC K
COUNSELOR L
NGO/FEMALE M
LOCAL LEADER N
NEIGHBOUR O
OTHER (SPECIFY)____ X

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Benin 2017
Survey form view entire document:  text 
1505) a) Did your (last) (husband/partner) ever do any of the following things to you:
b) How often did this happen during the last 12 months: often, only sometimes, or not in the last 12 months?

a) Ever push you, shake you, or throw something at you?
Yes 1
No 2
Often 1
Sometimes 2
Not in the last 12 months 3
b) Ever slap you?
Yes 1
No 2
Often 1
Sometimes 2
Not in the last 12 months 3
c) Ever twist your arm or pull your hair?
Yes 1
No 2
Often 1
Sometimes 2
Not in the last 12 months 3
d) Ever punch you with his fist or with something that could hurt you?
Yes 1
No 2
Often 1
Sometimes 2
Not in the last 12 months 3
e) Ever kick you, drag you, or beat you up?
Yes 1
No 2
Often 1
Sometimes 2
Not in the last 12 months 3
f) Ever intentionally try to chock you or burn you?
Yes 1
No 2
Often 1
Sometimes 2
Not in the last 12 months 3
g) Ever threaten you with a knife, gun, or other type of weapon?
Yes 1
No 2
Often 1
Sometimes 2
Not in the last 12 months 3
h) Ever physically force you to have sexual intercourse with him even when you did not want to?
Yes 1
No 2
Often 1
Sometimes 2
Not in the last 12 months 3
i) Ever physically force you to perform other sexual acts you did not want to?
Yes 1
No 2
Often 1
Sometimes 2
Not in the last 12 months 3
j) Ever force you with threats or in any other way to perform sexual acts you did not want to?
Yes 1
No 2
Often 1
Sometimes 2
Not in the last 12 months 3

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Burkina Faso 2010
Survey form view entire document:  text 
1306. Now if you will permit me, I need to ask some more questions about your relationship with your (last) husband/partner:

1306A. (Does/did) your last husband/partner ever:

a) Push you, shake you, or throw something at you?

YES 1 (GO TO 1306B-a)
NO 2 (GO TO 1306A-b)

b) Slap you or twist your arm?

YES 1 (GO TO 1306B-b)
NO 2 (GO TO 1306A-c)

c) Punch you with his fist or with something that could hurt you?

YES 1 (GO TO 1306B-c)
NO 2 (GO TO 1306A-d)

d) Kick you or drag you?

YES 1 (GO TO 1306B-d)
NO 2 (GO TO 1306A-e)

e) Try to strangle you or burn you?

YES 1 (GO TO 1306B-e)
NO 2 (GO TO 1306A-f)

f) Threaten you with a knife, gun, or other type of weapon?

YES 1 (GO TO 1306B-f)
NO 2 (GO TO 1306A-g)

g) Attack you with a knife, gun, or other type of weapon?

YES 1 (GO TO 1306B-g)
NO 2 (GO TO 1306A-h)

h) Physically force you to have sexual intercourse with him even when you did not want to?

YES 1 (GO TO 1306B-h)
NO 2 (GO TO 1306A-i)

i) Force you to perform other sexual acts you did not want to?

YES 1 (GO TO 1306B-i)
NO 2 (GO TO 1307)

1306B. How many times did this happen during the last 12 months?
IF WIDOW, DIVORCED, OR SEPARATED, RECORD '95'.

a) Push you, shake you, or throw something at you?

NUMBER OF TIMES _____ (RETURN TO 1306A-b)
WIDOWED, DIVORCED, OR SEPARATED 95 (RETURN TO 1306A-b)

b) Slap you or twist your arm?

NUMBER OF TIMES _____ (RETURN TO 1306A-c)
WIDOWED, DIVORCED, OR SEPARATED 95 (RETURN TO 1306A-c)

c) Punch you with his fist or with something that could hurt you?

NUMBER OF TIMES _____ (RETURN TO 1306A-d)
WIDOWED, DIVORCED, OR SEPARATED 95 (RETURN TO 1306A-d)

d) Kick you or drag you?

NUMBER OF TIMES _____ (RETURN TO 1306A-e)
WIDOWED, DIVORCED, OR SEPARATED 95 (RETURN TO 1306A-e)

e) Try to strangle you or burn you?

NUMBER OF TIMES _____ (RETURN TO 1306A-f)
WIDOWED, DIVORCED, OR SEPARATED 95 (RETURN TO 1306A-f)

f) Threaten you with a knife, gun, or other type of weapon?

NUMBER OF TIMES _____ (RETURN TO 1306A-g)
WIDOWED, DIVORCED, OR SEPARATED 95 (RETURN TO 1306A-g)

g) Attack you with a knife, gun, or other type of weapon?

NUMBER OF TIMES _____ (RETURN TO 1306A-h)
WIDOWED, DIVORCED, OR SEPARATED 95 (RETURN TO 1306A-h)

h) Physically force you to have sexual intercourse with him even when you did not want to?

NUMBER OF TIMES _____ (RETURN TO 1306A-i)
WIDOWED, DIVORCED, OR SEPARATED 95 (RETURN TO 1306A-i)

i) Force you to perform other sexual acts you did not want to?

NUMBER OF TIMES _____ (GO TO 1307)
WIDOWED, DIVORCED, OR SEPARATED 95 (GO TO 1307)

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Burundi 2016
Survey form view entire document:  text 
1505)

A. Did your (last) (husband/partner) ever do any of the following things to you:
B. How often did this happen during the last 12 months: often, only sometimes, or not at all?

a) push you, shake you, or throw something at you?
A.
YES 1
NO 2
B.
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
b) slap you?
A.
YES 1
NO 2
B.
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
c) twist your arm or pull your hair?
A.
YES 1
NO 2
B.
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
d) punch you with his fist or with something that could hurt you?
A.
YES 1
NO 2
B.
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
e) kick you, drag you, or beat you up?
A.
YES 1
NO 2
B.
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
f) try to chock you or burn you?
A.
YES 1
NO 2
B.
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
g) threaten you with a knife, gun, or other type of weapon?
A.
YES 1
NO 2
B.
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
h) physically force you to have sexual intercourse with him even when you did not want to?
A.
YES 1
NO 2
B.
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
i) physically force you to perform other sexual acts you did not want to?
A.
YES 1
NO 2
B.
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
j) Force you with threats or in any other way to perform sexual acts you did not want to?
A.
YES 1
NO 2
B.
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3

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Cameroon 2011
Survey form view entire document:  text 
1105)
A. Has your husband/partner ever done any of the following to you?

a) Shoved or shook you or thrown something at you?

YES 1 (GO TO B FOR SAME QUESTION)
NO 2 (GO TO NEXT QUESTION)

b) Slapped you?

YES 1 (GO TO B FOR SAME QUESTION)
NO 2 (GO TO NEXT QUESTION)

c) Twisted your arm or pulled your hair?

YES 1 (GO TO B FOR SAME QUESTION)
NO 2 (GO TO NEXT QUESTION)

d) Hit you with his fist or anything else that might hurt you?

YES 1 (GO TO B FOR SAME QUESTION)
NO 2 (GO TO NEXT QUESTION)

e) Have he ever kicked you, dragged you, or beaten you?

YES 1 (GO TO B FOR SAME QUESTION)
NO 2 (GO TO NEXT QUESTION)

f) Tried to strangle you or burn you?

YES 1 (GO TO B FOR SAME QUESTION)
NO 2 (GO TO NEXT QUESTION)

g) Threatened you with a knife, a pistol, or other type of weapon?

YES 1 (GO TO B FOR SAME QUESTION)
NO 2 (GO TO NEXT QUESTION)

h) Physically forced you to have sexual relations when you did not want to?

YES 1 (GO TO B FOR SAME QUESTION)
NO 2 (GO TO NEXT QUESTION)

i) Forced you to perform sexual acts that you did not want to perform?

YES 1 (GO TO B FOR SAME QUESTION)
NO 2 (GO TO NEXT QUESTION)

CHECK 603: ONLY ASK IF THE RESPONDENT IS NOT A WIDOW.

B: In the last 12 months, has this happened often, sometimes, or never?

a) Shoved or shook you or thrown something at you?

OFTEN 1
SOMETIMES 2
NEVER 3

b) Slapped you?

OFTEN 1
SOMETIMES 2
NEVER 3

c) Twisted your arm or pulled your hair?

OFTEN 1
SOMETIMES 2
NEVER 3

d) Hit you with his fist or anything else that might hurt you?

OFTEN 1
SOMETIMES 2
NEVER 3

e) Has he ever kicked you, dragged you, or beaten you?

OFTEN 1
SOMETIMES 2
NEVER 3

f) Tried to strangle you or burn you?

OFTEN 1
SOMETIMES 2
NEVER 3

g) Threatened you with a knife, a pistol, or other type of weapon?

OFTEN 1
SOMETIMES 2
NEVER 3

h) Physically forced you to have sexual relations when you did not want to?

OFTEN 1
SOMETIMES 2
NEVER 3

i) Forced you to perform sexual acts that you did not want to perform?

OFTEN 1
SOMETIMES 2
NEVER 3

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Chad 2014
Survey form view entire document:  text 
1105) a) Did your (last) (husband/partner) ever do any of the following things to you:
b) How often did this happen during the last 12 months: often, only sometimes, or not at all?

a) push you, shake you, or throw something at you?

EVER
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3

b) slap you?

EVER
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3

c) twist your arm or pull your hair?

EVER
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3

d) punch you with his fist or with something that could hurt you?

EVER
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3

e) kick you, drag you, or beat you up?

EVER
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3

f) try to chock you or burn you?

EVER
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3

g) threaten you with a knife, gun, or other type of weapon?

EVER
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3

h) physically force you to have sexual intercourse with him even when you did not want to?

EVER
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3

i) physically force you to perform other sexual acts you did not want to?

EVER
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3

j) Force you with threats or in any other way to perform sexual acts you did not want to?

EVER
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3

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Congo (Democratic Republic) 2007
Survey form view entire document:  text 
1005) 5A) (Does/did) your (last) husband/partner ever:

a) Push you, shake you, or throw something at you?
YES 1
NO 2 (GO TO B)
b) slap you or twist your arm?
YES 1
NO 2 (GO TO C)
c) punch you with his fist or with something that could hurt you?
YES 1
NO 2 (GO TO D)
d) kick you or drag you?
YES 1
NO 2 (GO TO E)
e) try to strangle you or burn you?
YES 1
NO 2 (GO TO F)
f) threaten you with a knife, gun, or other type of weapon?
YES 1
NO 2 (GO TO G)
g) attack you with a knife, gun, or other type of weapon?
YES 1
NO 2 (GO TO H)
h) physically force you to have sexual intercourse with him even when you did not want to?
YES 1
NO 2 (GO TO I)
i) force you to perform other sexual acts you did not want to?
YES 1
NO 2 (GO TO 1006)

5B) How many times did this happen during the last 12 months?

a) Push you, shake you, or throw something at you?
NUMBER OF TIMES ___
IF WIDOWED, DIVORCED OR SEPARATED 95
b) slap you or twist your arm?
NUMBER OF TIMES ___
IF WIDOWED, DIVORCED OR SEPARATED 95
c) punch you with his fist or with something that could hurt you?
NUMBER OF TIMES ___
IF WIDOWED, DIVORCED OR SEPARATED 95
d) kick you or drag you?
NUMBER OF TIMES ___
IF WIDOWED, DIVORCED OR SEPARATED 95
e) try to strangle you or burn you?
NUMBER OF TIMES ___
IF WIDOWED, DIVORCED OR SEPARATED 95
f) threaten you with a knife, gun, or other type of weapon?
NUMBER OF TIMES ___
IF WIDOWED, DIVORCED OR SEPARATED 95
g) attack you with a knife, gun, or other type of weapon?
NUMBER OF TIMES ___
IF WIDOWED, DIVORCED OR SEPARATED 95
h) physically force you to have sexual intercourse with him even when you did not want to?
NUMBER OF TIMES ___
IF WIDOWED, DIVORCED OR SEPARATED 95
i) force you to perform other sexual acts you did not want to?
NUMBER OF TIMES ___
IF WIDOWED, DIVORCED OR SEPARATED 95

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Congo (Democratic Republic) 2013
Survey form view entire document:  text 
1305) A) Did your (last) (husband/partner) ever do any of the following things to you:

a) Push you, shake you, or throw something at you?
YES 1 (GO TO B)
NO 2
b) Slap you?
YES 1 (GO TO B)
NO 2
c) Twist your arm or pull your hair?
YES 1 (GO TO B)
NO 2
d) Punch you with his fist or with something that could hurt you?
YES 1 (GO TO B)
NO 2
e) Kick you, drag you, or beat you up?
YES 1 (GO TO B)
NO 2
f) Try to chock you or burn you?
YES 1 (GO TO B)
NO 2
g) Threaten you with a knife, gun, or other type of weapon?
YES 1 (GO TO B)
NO 2
h) Physically force you to have sexual intercourse with him even when you did not want to?
YES 1 (GO TO B)
NO 2
i) Physically force you to perform other sexual acts you did not want to?
YES 1 (GO TO B)
NO 2
j) Force you with threats or in any other way to perform sexual acts you did not want to?
YES 1 (GO TO B)
NO 2

B) How often did this happen during the last 12 months: often, only sometimes, or not at all?

a) Push you, shake you, or throw something at you?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
b) Slap you?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
c) Twist your arm or pull your hair?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
d) Punch you with his fist or with something that could hurt you?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
e) Kick you, drag you, or beat you up?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
f) Try to chock you or burn you?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
g) Threaten you with a knife, gun, or other type of weapon?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
h) Physically force you to have sexual intercourse with him even when you did not want to?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
i) Physically force you to perform other sexual acts you did not want to?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
j) Force you with threats or in any other way to perform sexual acts you did not want to?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3

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Cote d'Ivoire 2011
Survey form view entire document:  text 
1206) Now if you will permit me, I need to ask some more questions about your relationship with your (last) husband/partner.

1206a) (Does/did) your last husband/partner ever:
1206b) How many times did this happen during the last 12 months?

a) push you, shake you, or throw something at you?
YES 1
NO 2
A) NUMBER OF TIMES__________
IF WIDOW, DIVORCED, OR SEPARATED 95
b) slap you or twist your arm?
YES 1
NO 2
A) NUMBER OF TIMES_________
IF WIDOW, DIVORCED, OR SEPARATED 95
c) punch you with his fist or with something that could hurt you?
YES 1
NO 2
A) NUMBER OF TIMES______________
IF WIDOW, DIVORCED, OR SEPARATED 95
d) kick you or drag you?
YES 1
NO 2
A) NUMBER OF TIMES______________
IF WIDOW, DIVORCED, OR SEPARATED 95
e) try to strangle you or burn you?
YES 1
NO 2
A) NUMBER OF TIMES_____________
IF WIDOW, DIVORCED, OR SEPARATED 95
f) threaten you with a knife, gun, or other type of weapon?
YES 1
NO 2
A) NUMBER OF TIMES___________
IF WIDOW, DIVORCED, OR SEPARATED 95
g) attack you with a knife, gun, or other type of weapon?
YES 1
NO 2
A) NUMBER OF TIMES____________
IF WIDOW, DIVORCED, OR SEPARATED 95
h) physically force you to have sexual intercourse with him even when you did NOt want to?
YES 1
NO 2
A) NUMBER OF TIMES__________
IF WIDOW, DIVORCED, OR SEPARATED 95
i) force you to perform other sexual acts you did not want to?
YES 1
NO 2
A) NUMBER OF TIMES_____________
IF WIDOW, DIVORCED, OR SEPARATED 95

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Egypt 2005
Survey form view entire document:  text 
905B) How often did this happen during the last 12 months: often, only sometimes, or not at all?

1) push you, shake you, or throw something at you?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
NA 5
2) slap you or twist your arm?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
NA 5
3) punch you with his fist or with something that could hurt you?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
NA 5
4) kick you or drag you?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
NA 5
5) try to strangle you or burn you?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
NA 5
6) threaten you with a knife, gun, or other type of weapon?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
NA 5
7) attack you with a knife, gun, or other type of weapon?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
NA 5
8) physically force you to have sexual intercourse with him when you did not want to?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
NA 5

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Egypt 2014
Survey form view entire document:  text 
1105(A). Did your (last) husband ever do any of the following things to you:

a) push you, shake you, or throw something at you?
YES 1 (GO TO 1105B)
NO 2
b) slap you?
YES 1 (GO TO 1105B)
NO 2
c) twist your arm or pull your hair?
YES 1 (GO TO 1105B)
NO 2
d) punch you with his fist or with something that could hurt you?
YES 1 (GO TO 1105B)
NO 2
e) kick you, drag you, or beat you up?
YES 1 (GO TO 1105B)
NO 2
f) try to choke you or burn you on purpose?
YES 1 (GO TO 1105B)
NO 2
g) threaten to attack you with a knife, gun, or other weapon?
YES 1 (GO TO 1105B)
NO 2
h) physically force you to have sexual intercourse with him when you did not want to?
YES 1 (GO TO 1105B)
NO 2
i) physically force you to perform any other sexual acts did you not want to?
YES 1 (GO TO 1105B)
NO 2
j) force you with threats or in any other way to perform sexual acts you did not want to?
YES 1 (GO TO 1105B)
NO 2

1105B. How often did this happen during the last 12 months: often, only sometimes, or not at all?

a) push you, shake you, or throw something at you?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
b) slap you?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
c) twist your arm or pull your hair?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
d) punch you with his fist or with something that could hurt you?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
e) kick you, drag you, or beat you up?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
f) try to choke you or burn you on purpose?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
g) threaten to attack you with a knife, gun, or other weapon?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
h) physically force you to have sexual intercourse with him when you did not want to?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
i) physically force you to perform any other sexual acts did you not want to?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
j) force you with threats or in any other way to perform sexual acts you did not want to?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3

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Ethiopia 2016
Survey form view entire document:  text 
1405A. Did your (last) (husband/partner) ever do any of the following things to you:

a. Push you, shake you, or throw something at you?
YES 1 (GO TO 1405B)
NO 2 (GO TO b)
b. Slap you?
YES 1 (GO TO 1405B)
NO 2 (GO TO c)
c. Twist your arm or pull your hair?
YES 1 (GO TO 1405B)
NO 2 (GO TO d)
d. Punch you with his fist or with something that could hurt you?
YES 1 (GO TO 1405B)
NO 2 (GO TO e)
e. Kick you, drag you, or beat you up?
YES 1 (GO TO 1405B)
NO 2 (GO TO f)
f. Try to choke you or burn you on purpose?
YES 1 (GO TO 1405B)
NO 2 (GO TO g)
g. Threaten or attack you with a knife, gun, or other weapon?
YES 1 (GO TO 1405B)
NO 2 (GO TO h)
h. Physically force you to have sexual intercourse with him when you did not want to?
YES 1 (GO TO 1405B)
NO 2 (GO TO i)
i. Physically force you to perform any other sexual acts you did not want to?
YES 1 (GO TO 1405B)
NO 2 (GO TO j)
j. Force you with threats or in any other way to perform sexual acts you did not want to?
YES 1 (GO TO 1405B)
NO 2 (GO TO 1406)

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Ghana 2008
Survey form view entire document:  text 
1105. A (Does/did) your (last) husband/partner ever do any of the following things to you:

a) push you, shake you, or throw something at you?
YES 1 (TO B)
NO 2
b) slap you?
YES 1 (TO B)
NO 2
c) twist your arm or pull your hair?
YES 1 (TO B)
NO 2
d) punch you with his fist or with something that could hurt you?
YES 1 (TO B)
NO 2
e) kick you, drag you or beat you up?
YES 1 (TO B)
NO 2
f) try to choke you or burn you on purpose?
YES 1 (TO B)
NO 2
g) threaten or attack you with a knife, gun, or any other weapon?
YES 1 (TO B)
NO 2
h) physically force you to have sexual intercourse with him even when you did not want to?
YES 1 (TO B)
NO 2
i) force you to perform any sexual acts you did not want to?
YES 1 (TO B)
NO 2

B How often did this happen during the last 12 months: often, only sometimes, or not at all?

a) push you, shake you, or throw something at you?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
b) slap you?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
c) twist your arm or pull your hair?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
d) punch you with his fist or with something that could hurt you?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
e) kick you, drag you or beat you up?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
f) try to choke you or burn you on purpose?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
g) threaten or attack you with a knife, gun, or any other weapon?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
h) physically force you to have sexual intercourse with him even when you did not want to?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
i) force you to perform any sexual acts you did not want to?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3

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India 2005
Survey form view entire document:  text 
1005A. (Does/did) your (last) husband ever do any of the following things to you:

a. Slap you?
YES 1 (GO TO 1005B)
NO 2
b. Twist your arm or pull your hair?
YES 1 (GO TO 1005B)
NO 2
c. Push you, shake you, or throw something at you?
YES 1 (GO TO 1005B)
NO 2
d. Punch you with his fist or with something that could hurt you?
YES 1 (GO TO 1005B)
NO 2
e. Kick you, drag you or beat you up?
YES 1 (GO TO 1005B)
NO 2
f. Try to choke you or burn you on purpose?
YES 1 (GO TO 1005B)
NO 2
g. Threaten or attack you with a knife, gun, or any other weapon?
YES 1 (GO TO 1005B)
NO 2
h. Physically force you to have sexual intercourse with him even when you did not want to?
YES 1 (GO TO 1005B)
NO 2
i. Force you to perform any sexual acts you did not want to?
YES 1 (GO TO 1005B)
NO 2

CHECK 301: ASK ONLY IF RESPONDENT IS NOT A WIDOW:

1005B. How often did this happen during the last 12 months: often, only sometimes, or not at all?

a. Slap you?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
b. Twist your arm or pull your hair?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
c. Push you, shake you, or throw something at you?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
d. Punch you with his fist or with something that could hurt you?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
e. Kick you, drag you or beat you up?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
f. Try to choke you or burn you on purpose?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
g. Threaten or attack you with a knife, gun, or any other weapon?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
h. Physically force you to have sexual intercourse with him even when you did not want to?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
i. Force you to perform any sexual acts you did not want to?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3

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India 2015
Survey form view entire document:  text 
1107A. Now if you will permit me, I need to ask some more questions about your relationship with you (last) husband. (Does/did) your (last) husband ever:

a. Push you, shake you, or throw something at you?
YES 1 (GO TO 1107B-a)
NO 2 (GO TO 1107A-b)
b. Twist your arm or pull your hair?
YES 1 (GO TO 1107B-b)
NO 2 (GO TO 1107A-c)
c. Slap you?
YES 1 (GO TO 1107B-c)
NO 2 (GO TO 1107A-d)
d. Punch you with his fist or with something that could hurt you?
YES 1 (GO TO 1107B-d)
NO 2 (GO TO 1107A-e)
e. Kick you, drag you or beat you up?
YES 1 (GO TO 1107B-e)
NO 2 (GO TO 1107A-f)
f. Try to choke you or burn you on purpose?
YES 1 (GO TO 1107B-f)
NO 2 (GO TO 1107A-g)
g. Threaten to attack you with a knife, gun, or any other weapon?
YES 1 (GO TO 1107B-g)
NO 2 (GO TO 1107A-h)
h. Physically force you to have sexual intercourse with him even when you did not want to?
YES 1 (GO TO 1107B-h)
NO 2 (GO TO 1107A-i)
i. Physically force you to perform any other sexual acts you did not want to?
YES 1 (GO TO 1107B-i)
NO 2 (GO TO 1107A-j)
j. Force you with threats or in any other way to perform sexual acts you did not want to?
YES 1 (GO TO 1107B-j)
NO 2

1107B. How often did this happen during the last 12 months: often, only sometimes, or not at all?

a. Push you, shake you, or throw something at you?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
b. Twist your arm or pull your hair?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
c. Slap you?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
d. Punch you with his fist or with something that could hurt you?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
e. Kick you, drag you or beat you up?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
f. Try to choke you or burn you on purpose?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
g. Threaten to attack you with a knife, gun, or any other weapon?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
h. Physically force you to have sexual intercourse with him even when you did not want to?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
i. Physically force you to perform any other sexual acts you did not want to?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
j. Force you with threats or in any other way to perform sexual acts you did not want to?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3

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Jordan 2007
Survey form view entire document:  text 
1105)

(Does/ did) your (last) husband ever do any of the following to you:

1) push you, shake you, or throw something at you?
YES 1
NO 2 (GO TO 1105(2))
How often did this happen during the last 12 months: often only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
NOT APPLICABLE 4
2) slap you or twist your arm?
YES 1
NO 2 (GO TO 1105(3))
How often did this happen during the last 12 months: often only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
NOT APPLICABLE 4
3) punch you with his fist or with something that could hurt you?
YES 1
NO 2 (GO TO 1105(4))
How often did this happen during the last 12 months: often only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
NOT APPLICABLE 4
4) kick you, drag you, or beat you up?
YES 1
NO 2 (GO TO 1105(5))
How often did this happen during the last 12 months: often only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
NOT APPLICABLE 4
5) try to choke you or burn you on purpose?
YES 1
NO 2 (GO TO 1105(6))
How often did this happen during the last 12 months: often only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
NOT APPLICABLE 4
6) threaten you with a knife, gun, or any other weapon?
YES 1
NO 2 (GO TO 1105(7))
How often did this happen during the last 12 months: often only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
NOT APPLICABLE 4
7) attack you with a knife, gun, or any other weapon?
YES 1
NO 2 (GO TO 1105(8))
How often did this happen during the last 12 months: often only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
NOT APPLICABLE 4
8) physically force you to have sexual intercourse with him even when you did not want to?
YES 1
NO 2 (GO TO 1106)
How often did this happen during the last 12 months: often only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
NOT APPLICABLE 4

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Jordan 2012
Survey form view entire document:  text 
1205.
A. Did your (last) husband ever do any of the following things to you:
B. How often did this happen during the last 12 months: often, only sometimes, or not at all?

a) push you, shake you, or throw something at you?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
b) slap you?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
c) twist your arm or pull your hair?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
d) punch you with his fist or with something that could hurt you?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
e) kick you, drag you, or beat you up?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
f) try to choke you or burn you on purpose?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
g) threaten or attack you with a knife, gun, or other weapon?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
h) physically force you to have sexual intercourse with him when you did not want to?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3

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Jordan 2017
Survey form view entire document:  text 
1305)
A. Did your (last) husband ever do any of the following things to you:

a. push you, shake you, or throw something at you?
YES (CONTINUE 1305Ba)
NO (CONTINUE TO 1305Ab)
b. slap you?
YES (CONTINUE 1305Bb)
NO (CONTINUE TO 1305Ac)
c. twist your arm or pull your hair?
YES (CONTINUE 1305Bc)
NO (CONTINUE TO 1305Ad)
d. punch you with his fist or with something that could hurt you?
YES (CONTINUE 1305Bd)
NO (CONTINUE TO 1305Ae)
e. kick you, drag you, or beat you up?
YES (CONTINUE 1305Be)
NO (CONTINUE TO 1305Af)
f. try to choke you or burn you on purpose?
YES (CONTINUE 1305Bf)
NO (CONTINUE TO 1305Ag)
g. threaten or attack you with a knife, gun, or other weapon?
YES (CONTINUE 1305Bg)
NO (CONTINUE TO 1305Ah)
h. physically force you to have sexual intercourse with him when you did not want to?
YES (CONTINUE 1305Bh)
NO (CONTINUE TO 1306)

B. How often did this happen during the last 12 months: often, only sometimes, or not at all?

a. push you, shake you, or throw something at you?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
b. slap you?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
c. twist your arm or pull your hair?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
d. punch you with his fist or with something that could hurt you?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
e. kick you, drag you, or beat you up?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
f. try to choke you or burn you on purpose?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
g. threaten or attack you with a knife, gun, or other weapon?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
h. physically force you to have sexual intercourse with him when you did not want to?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3

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Kenya 2008
Survey form view entire document:  text 
1205. A - (Does/did) your (last) husband/partner ever do any of the following things to you:

a) push you, shake you, or throw something at you?
YES 1 (GO TO B)
NO 2
b) slap you?
YES 1 (GO TO B)
NO 2
c) twist your arm or pull your hair?
YES 1 (GO TO B)
NO 2
d) punch you with his fist or with something that could hurt you?
YES 1 (GO TO B)
NO 2
e) kick you, drag you or beat you up?
YES 1 (GO TO B)
NO 2
f) try to choke you or burn you on purpose?
YES 1 (GO TO B)
NO 2
g) threaten or attack you with a knife, gun, or any other weapon?
YES 1 (GO TO B)
NO 2
h) physically force you to have sexual intercourse with him even when you did not want to?
YES 1 (GO TO B)
NO 2
i) force you to perform any sexual acts you did not want to?
YES 1 (GO TO B)
NO 2

B - How often did this happen during the last 12 months: often, only sometimes, or not at all?

a) push you, shake you, or throw something at you?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
b) slap you?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
c) twist your arm or pull your hair?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
d) punch you with his fist or with something that could hurt you?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
e) kick you, drag you or beat you up?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
f) try to choke you or burn you on purpose?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
g) threaten or attack you with a knife, gun, or any other weapon?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
h) physically force you to have sexual intercourse with him even when you did not want to?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
i) force you to perform any sexual acts you did not want to?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3

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Kenya 2014

No questionnaire text is available for this sample.


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Liberia 2007
Survey form view entire document:  text 
1005A) (Does/did) your (last) husband/partner ever do any of the following things to you:

a) push you, shake you, or throw something at you?
YES 1
NO 2
b) slap you?
YES 1
NO 2
c) twist your arm or pull your hair?
YES 1
NO 2
d) punch you with his fist or with something that could hurt you?
YES 1
NO 2
e) kick you, drag you or beat you up?
YES 1
NO 2
f) try to choke you or burn you on purpose?
YES 1
NO 2
g) threaten or attack you with a knife, gun, or any other weapon?
YES 1
NO 2
h) physically force you to do men business with him even when you did not want to?
YES 1
NO 2
i) force you to do any sexual acts you did not want to?
YES 1
NO 2

1005B) CHECK 604: ASK ONLY IF RESPONDENT IS NOT A WIDOW

How often did this happen during the last 12 months: often, only sometimes, or not at all?

a) push you, shake you, or throw something at you?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
b) slap you?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
c) twist your arm or pull your hair?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
d) punch you with his fist or with something that could hurt you?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
e) kick you, drag you or beat you up?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
f) try to choke you or burn you on purpose?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
g) threaten or attack you with a knife, gun, or any other weapon?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
h) physically force you to do men business with him even when you did not want to?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
i) force you to do any sexual acts you did not want to?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3

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Malawi 2010
Survey form view entire document:  text 
1205A. (Does/did) your (last) husband/partner ever do any of the following things to you:

a) push you, shake you, or throw something at you?
YES 1
NO 2
b) slap you?
YES 1
NO 2
c) twist your arm or pull your hair?
YES 1
NO 2
d) punch you with his fist or with something that could hurt you?
YES 1
NO 2
e) kick you, drag you or beat you up?
YES 1
NO 2
f) try to choke you or burn you on purpose?
YES 1
NO 2
g) threaten or attack you with a knife, gun, or any other weapon?

YES 1
NO 2
h) physically force you to have sexual intercourse with him even when you did not want to?
YES 1
NO 2
i) force you to perform any sexual acts you did not want to?
YES 1
NO 2

1205B. How often did this happen during the last 12 months: often, only sometimes, or not at all?

a) push you, shake you, or throw something at you?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
b) slap you?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
c) twist your arm or pull your hair?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
d) punch you with his fist or with something that could hurt you?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
e) kick you, drag you or beat you up?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
f) try to choke you or burn you on purpose?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
g) threaten or attack you with a knife, gun, or any other weapon?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
h) physically force you to have sexual intercourse with him even when you did not want to?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
i) force you to perform any sexual acts you did not want to?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3

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Malawi 2016
Survey form view entire document:  text 
1305A. Did your (last) (husband/partner) ever do any of the following things to you:

a. Push you, shake you, or throw something at you?
YES 1 (GO TO 1305B)
NO 2 (GO TO b)
b. Slap you?
YES 1 (GO TO 1305B)
NO 2 (GO TO c)
c. Twist your arm or pull your hair?
YES 1(GO TO 1305B)
NO 2 (GO TO d)
d. Punch you with his fist or with something that could hurt you?
YES 1 (GO TO 1305B)
NO 2 (GO TO e)
e. Kick you, drag you, or beat you up?
YES 1 (GO TO 1305B)
NO 2 (GO TO f)
f. Try to choke you or burn you on purpose?
YES 1 (GO TO 1305B)
NO 2 (GO TO g)
g. Threaten or attack you with a knife, gun, or other weapon?
YES 1 (GO TO 1305B)
NO 2 (GO TO h)
h. Physically force you to have sexual intercourse with him when you did not want to?
YES 1 (GO TO 1305B)
NO 2 (GO TO i)
i. Physically force you to perform any other sexual acts you did not want to?
YES 1 (GO TO 1305B)
NO 2 (GO TO j)
j. Force you with threats or in any other way to perform sexual acts you did not want to?
YES 1 (GO TO 1305B)
NO 2 (GO TO 1306)

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Mali 2012
Survey form view entire document:  text 
1405A) Did your (last) (husband/partner) ever do any of the following things to you:

1405B) IF YES: How often did this happen during the last 12 months: often, only sometimes, or not at all?

a) push you, shake you, or throw something at you?
b) slap you?
c) twist your arm or pull your hair?
d) punch you with his fist or with something that could hurt you?
e) kick you, drag you, or beat you up?
f) try to choke you or burn you on purpose?
g) threaten you or attack you with a knife, gun, or other type of weapon?
h) physically force you to have sexual intercourse with him even when you did not want to?
i) physically force you to perform other sexual acts you did not want to?
j) force you with threats or in any other way to perform sexual acts you did not want to?

a) PUSH YOU, SHAKE YOU, OR THROW SOMETHING AT YOU?
YES 1 (GO TO NEXT RESPONSE SET)
NO 2 (GO TO 1404A-B)
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
b) SLAP YOU?
YES 1 (GO TO NEXT RESPONSE SET)
NO 2 (GO TO 1404A-C)
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
c) TWIST YOUR ARM OR PULL YOUR HAIR?
YES 1 (GO TO NEXT RESPONSE SET)
NO 2 (GO TO 1404A-D)
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
d) PUNCH YOU WITH HIS FIST OR WITH SOMETHING THAT COULD HURT YOU?
YES 1 (GO TO NEXT RESPONSE SET)
NO 2 (GO TO 1404A-E)
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
e) KICK YOU, DRAG YOU, OR BEAT YOU UP?
YES 1 (GO TO NEXT RESPONSE SET)
NO 2 (GO TO 1404A-F)
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
f) TRY TO CHOKE YOU OR BURN YOU ON PURPOSE?
YES 1 (GO TO NEXT RESPONSE SET)
NO 2 (GO TO 1404A-G)
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
g) THREATEN YOU OR ATTACK YOU WITH A KNIFE, GUN, OR OTHER TYPE OF WEAPON?
YES 1 (GO TO NEXT RESPONSE SET)
NO 2 (GO TO 1404A-H)
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
h) PHYSICALLY FORCE YOU TO HAVE SEXUAL INTERCOURSE WITH HIM EVEN WHEN YOU DID NOT WANT TO?
YES 1 (GO TO NEXT RESPONSE SET)
NO 2 (GO TO 1404A-I)
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
i) PHYSICALLY FORCE YOU TO PERFORM OTHER SEXUAL ACTS YOU DID NOT WANT TO?
YES 1 (GO TO NEXT RESPONSE SET)
NO 2 (GO TO 1404A-J)
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
j) FORCE YOU WITH THREATS OR IN ANY OTHER WAY TO PERFORM SEXUAL ACTS YOU DID NOT WANT TO?
YES 1 (GO TO NEXT RESPONSE SET)
NO 2 (GO TO 1406)
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3

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Mali 2018
Survey form view entire document:  text 
1505) a) Did your (last) (HUSBAND/PARTNER) ever do any of the following things to you:
b) How often did this happen during the last 12 months: often, only sometimes, or not in the last 12 months?

A) PUSH YOU, SHAKE YOU, OR THROW SOMETHING AT YOU?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
B) SLAP YOU?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
C) TWIST YOUR ARM OR PULL YOUR HAIR?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
D) PUNCH YOU WITH HIS FIST OR WITH SOMETHING THAT COULD HURT YOU?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
E) KICK YOU, DRAG YOU, OR BEAT YOU UP?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
F) INTENTIONALLY TRY TO CHOCK YOU OR BURN YOU?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
G) THREATEN YOU WITH A KNIFE, GUN, OR OTHER TYPE OF WEAPON?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
H) PHYSICALLY FORCE YOU TO HAVE SEXUAL INTERCOURSE WITH HIM EVEN WHEN YOU DID NOT WANT TO?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
I) PHYSICALLY FORCE YOU TO PERFORM OTHER SEXUAL ACTS YOU DID NOT WANT TO?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
J) FORCE YOU WITH THREATS OR IN ANY OTHER WAY TO PERFORM SEXUAL ACTS YOU DID NOT WANT TO?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3

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Mozambique 2011
Survey form view entire document:  text 
1205. A. (Does/did) your (last) husband/partner ever:

a) Push you, shake you, or throw something at you?
YES 1
NO 2
b) Slap you?
YES 1
NO 2
c) Twist your arm or pull your hair?
YES 1
NO 2
d) Punch you with his fist or with something that could hurt you?
YES 1
NO 2
e) Kick you, drag you or beat you up?
YES 1
NO 2
f) Try to choke you or burn you on purpose?
YES 1
NO 2
g) Threaten or attack you with a knife, gun or any other weapon?
YES 1
NO 2
h) Physically force you to have sexual intercourse with him even when you did not want to?
YES 1
NO 2
i) Force you to perform any sexual acts you did not want to?
YES 1
NO 2

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Myanmar 2015
Survey form view entire document:  text 
1205) A: Did your (last) husband ever do any of the following things to you:
B: How often did this happen during the last 12 months: often, only sometimes, or not at all?

a) push you, shake you, or throw something at you?
YES 1
NO 2 (GO TO 1205b)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
b) slap you?
YES 1
NO 2 (GO TO 1205c)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
c) twist your arm or pull your hair?
YES 1
NO 2 (GO TO 1205d)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
d) punch you with his fist or something that could hurt you?
YES 1
NO 2 (GO TO 1205e)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
e) kick you, drag you, or beat you up?
YES 1
NO 2 (GO TO 1205f)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
f) try to choke you or burn you on purpose?
YES 1
NO 2 (GO TO 1205g)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
g) threaten or attack you with a knife, gun, or other weapon?
YES 1
NO 2 (GO TO 1205h)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
h) physically force you to have sexual intercourse with him when you did not want to?
YES 1
NO 2 (GO TO 1205i)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
i) physically force you to perform any other sexual acts you did not want to?
YES 1
NO 2 (GO TO 1205j)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
j) force you with threats or in any other way to perform sexual acts you did not want to?
YES 1
NO 2 (GO TO 1206)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3

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Namibia 2013
Survey form view entire document:  text 
1205) A) Did your (last) (husband/partner) ever do any of the following things to you:

a) Push you, shake you, or throw something at you?
YES 1
NO 2
b) Slap you?
YES 1
NO 2
c) twist your arm or pull your hair?
YES 1
NO 2
d) punch you with his fist or with something that could hurt you?
YES 1
NO 2
e) kick you, drag you, or beat you up?
YES 1
NO 2
f) try to choke you or burn you on purpose?
YES 1
NO 2
g) threaten or attack you with a knife, gun, or other weapon?
YES 1
NO 2
h) physically force you to have sexual intercourse with him when you did not want to?
YES 1
NO 2
i) physically force you to perform any other sexual acts you did not want to?
YES 1
NO 2
j) force you with threats or in any other way to perform sexual acts you did not want to?
YES 1
NO 2

B) How often did this happen during the last 12 months: often, only sometimes, or not at all?

a) push you, shake you, or throw something at you?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
b) slap you?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
c) twist your arm or pull your hair?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
d) punch you with his first or with something that could hurt you?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
e) kick you, drag you, or beat you up?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
f) try to choke you or burn you on purpose?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
g) threaten or attack you with a knife, gun, or other weapon?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
h) physically force you to have sexual intercourse with him when you did not want to?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
i) physically force you to perform any other sexual acts you did not want to?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
j) force you with threats or in any other way to perform sexual acts you did not want to?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3

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Nepal 2011
Survey form view entire document:  text 
1106)
A: (Does/did) your (last) husband/partner ever do any of the following things to you:
B: How often did this happen during the last 12 months: often, only sometimes, or not at all?

a) push you, shake you, or throw something at you?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
b) slap you?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
c) twist your arm or pull your hair?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
d) punch you with his fist or with something that could hurt you?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
e) kick you, drag you or beat you up?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
f) try to choke you or burn you on purpose?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
g) threaten or attack you with a knife, gun, or any other weapon?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
h) physically force you to have sexual intercourse with him even when you did not want to?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
i) force you to perform any sexual acts you did not want to?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT AT ALL 3

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Nepal 2016
Survey form view entire document:  text 
1305A. Did your (last) (husband/partner) ever do any of the following things to you:

a. push you, shake you, or throw something at you?
YES 1 (GO TO 1305B)
NO 2
b. slap you?
YES 1 (GO TO 1305B)
NO 2
c. twist your arm or pull your hair?
YES 1 (GO TO 1305B)
NO 2
d. punch you with his fist or with something that could hurt you?
YES 1 (GO TO 1305B)
NO 2
e. kick you, drag you, or beat you up?
YES 1 (GO TO 1305B)
NO 2
f. try to choke you or burn you on purpose?
YES 1 (GO TO 1305B)
NO 2
g. threaten or attack you with a knife, gun, or other weapon?
YES 1 (GO TO 1305B)
NO 2
h. physically force you to have sexual intercourse with him when you did not want to?
YES 1 (GO TO 1305B)
NO 2
i. physically force you to perform any other sexual acts you did not want to?
YES 1 (GO TO 1305B)
NO 2
j. force you with threats or in any other way to perform sexual acts you did not want to?
YES 1 (GO TO 1305B)
NO 2

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Nigeria 2008
Survey form view entire document:  text 
1306A. (Does/did) your (last) husband ever do any of the following things to you:

a) slap you?
YES 1 (GO TO 1306B a)
NO 2
b) twist your arm or pull your hair?
YES 1 (GO TO 1306B b)
NO 2
c) push you, shake you, or throw something at you?
YES 1 (GO TO 1306B c)
NO 2
d) punch you with his fist or with something that could hurt you?
YES 1 (GO TO 1306B d)
NO 2
e) kick you, drag you or beat you up?
YES 1 (GO TO 1306B e)
NO 2
f) try to choke you or burn you on purpose?
YES 1 (GO TO 1306B f)
NO 2
g) threaten or attack you with a knife, gun, or any other weapon?
YES 1 (GO TO 1306B g)
NO 2
h) physically force you to have sexual intercourse with him even when you did not want to?
YES 1 (GO TO 1306B h)
NO 2
i) force you to perform any sexual acts you did not want to?
YES 1 (GO TO 1306B i)
NO 2

1306B. CHECK 603: ASK ONLY IF RESPONDENT IS NOT A WIDOW
How often did this happen during the last 12 months: often, only sometimes, or not at all?

a) slap you?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
b) twist your arm or pull your hair?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
c) push you, shake you, or throw something at you?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
d) punch you with his fist or with something that could hurt you?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
e) kick you, drag you or beat you up?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
f) try to choke you or burn you on purpose?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
g) threaten or attack you with a knife, gun, or any other weapon?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
h) physically force you to have sexual intercourse with him even when you did not want to?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
i) force you to perform any sexual acts you did not want to?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3

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Nigeria 2013
Survey form view entire document:  text 
1305A) Did your (last) (husband/partner) ever do any of the following things to you:

a) push you, shake you, or throw something at you?
YES 1
NO 2
b) slap you?
YES 1
NO 2
c) twist your arm or pull your hair?
YES 1
NO 2
d) punch you with his fist or with something that could hurt you?
YES 1
NO 2
f) try to choke you or burn you on purpose?
YES 1
NO 2
g) threaten or attack you with a knife, gun, or other weapon?
YES 1
NO 2
h) physically force you to have sexual intercourse with him when you did not want to?
YES 1
NO 2
i) physically force you to perform any other sexual acts you did not want to?
YES 1
NO 2
j) force you with threats or in any other way to perform sexual acts you did not want to?
YES 1
NO 2

1305B) How often did this happen during the last 12 months: often, only sometimes, or not at all?

a) push you, shake you, or throw something at you?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
b) slap you?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
c) twist your arm or pull your hair?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
d) punch you with his fist or with something that could hurt you?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
f) try to choke you or burn you on purpose?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
g) threaten or attack you with a knife, gun, or other weapon?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
h) physically force you to have sexual intercourse with him when you did not want to?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
i) physically force you to perform any other sexual acts you did not want to?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
j) force you with threats or in any other way to perform sexual acts you did not want to?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3

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Nigeria 2018
Survey form view entire document:  text 
1505A. Did your (last) (husband/partner) ever do any of the following things to you:

a) push you, shake you, or throw something at you?

EVER
YES 1
NO 2
OFTEN
YES 1
NO 2
SOMETIMES
YES 1
NO 2
NOT IN THE LAST 12 MONTHS
YES 1
NO 2

b) slap you?

EVER
YES 1
NO 2
OFTEN
YES 1
NO 2
SOMETIMES
YES 1
NO 2
NOT IN THE LAST 12 MONTHS
YES 1
NO 2

c) twist your arm or pull your hair?

EVER
YES 1
NO 2
OFTEN
YES 1
NO 2
SOMETIMES
YES 1
NO 2
NOT IN THE LAST 12 MONTHS
YES 1
NO 2

d) punch you with his fist or with something that could hurt you?

EVER
YES 1
NO 2
OFTEN
YES 1
NO 2
SOMETIMES
YES 1
NO 2
NOT IN THE LAST 12 MONTHS
YES 1
NO 2

e) kick you, drag you, or beat you up?

EVER
YES 1
NO 2
OFTEN
YES 1
NO 2
SOMETIMES
YES 1
NO 2
NOT IN THE LAST 12 MONTHS
YES 1
NO 2

f) try to choke you or burn you on purpose?

EVER
YES 1
NO 2
OFTEN
YES 1
NO 2
SOMETIMES
YES 1
NO 2
NOT IN THE LAST 12 MONTHS
YES 1
NO 2

g) threaten or attack you with a knife, gun, or other weapon?

EVER
YES 1
NO 2
OFTEN
YES 1
NO 2
SOMETIMES
YES 1
NO 2
NOT IN THE LAST 12 MONTHS
YES 1
NO 2

h) physically force you to have sexual intercourse with him when you did not want to?

EVER
YES 1
NO 2
OFTEN
YES 1
NO 2
SOMETIMES
YES 1
NO 2
NOT IN THE LAST 12 MONTHS
YES 1
NO 2

i) physically force you to perform any other sexual acts you did not want to do?

EVER
YES 1
NO 2
OFTEN
YES 1
NO 2
SOMETIMES
YES 1
NO 2
NOT IN THE LAST 12 MONTHS
YES 1
NO 2

j) force you with threats or in any other way to preform sexual acts you did not want to?

EVER
YES 1
NO 2
OFTEN
YES 1
NO 2
SOMETIMES
YES 1
NO 2
NOT IN THE LAST 12 MONTHS
YES 1
NO 2

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Pakistan 2012
Survey form view entire document:  text 
1006)
A. Did your (last) husband:
B. How often did this happen in the last 12 months: often, only sometimes, or not at all?

a) push you, shake you, or throw something at you?

YES 1
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
NO RESPONSE 4
NO 2

b) slap you?

YES 1
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
NO RESPONSE 4
NO 2

c) twist your arm or pull your hair?

YES 1
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
NO RESPONSE 4
NO 2

d) punch you with his fist or with something that could hurt you?

YES 1
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
NO RESPONSE 4
NO 2

e) kick you, drag you, or beat you up?

YES 1
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
NO RESPONSE 4
NO 2

f) try to choke you or burn you on purpose?

YES 1
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
NO RESPONSE 4
NO 2

g) threaten to attack you with a knife, gun, or other weapon?

YES 1
OFTEN 1
SOMETIMES 2
NOT IN THE LAST 12 MONTHS 3
NO RESPONSE 4
NO 2

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Pakistan 2017
Survey form view entire document:  text 
1205) Did you (last) husband ever do any of the following things to you:

a) push you, shake you, or throw something at you?
YES 1
NO 2 (GO TO b)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
b) slap you?
YES 1
NO 2 (GO TO c)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
c) twist your arm or pull your hair?
YES 1
NO 2 (GO TO d)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
d) punch you with his fist or with something that could hurt you?
YES 1
NO 2 (GO TO e)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
e) kick you, drag you, or beat you up?
YES 1
NO 2 (GO TO f)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
f) try to choke you or burn you on purpose?
YES 1
NO 2 (GO TO g)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
g) threaten or attack you with a knife, gun, or other weapon?
YES 1
NO 2 (GO TO h)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
h) physically force you to have sexual intercourse with him when you did not want to?
YES 1
NO 2 (GO TO i)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
i) physically force you to perform any other sexual acts you did not want?
YES 1
NO 2 (GO TO j)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
j) force you with threats or in any other way to perform sexual acts you did not want to?
YES 1
NO 2 (GO TO 1206)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3

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Rwanda 2010
Survey form view entire document:  text 
1205) (Does/did) your (last) husband/partner ever do any of the following things to you:

a) push you, shake you, or throw something at you?
YES 1
NO 2 (GO TO 1205b)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
b) slap you?
YES 1
NO 2 (GO TO 1205c)
How often did this happen during the last 12 months: often only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
c) twist your arm or pull your hair?
YES 1
NO 2 (GO TO 1205d)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
d) punch you with his fist or with something that could hurt you?
YES 1
NO 2 (GO TO 1205e)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
e) kick you, drag you or beat you up?
YES 1
NO 2 (GO TO 1205f)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
f) try to choke you or burn you on purpose?
YES 1
NO 2 (GO TO 1205g)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
g) threaten or attack you with a knife, gun, or any other weapon?
YES 1
NO 2 (GO TO 1205h)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT AT ALL3
h) physically force you to have intercourse with him even when you did not want to?
YES 1
NO 2 (GO TO 1205i)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
i) force you to perform any sexual acts you did not want to?
YES 1
NO 2 (GO TO 1206)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3

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Rwanda 2014
Survey form view entire document:  text 
DV16) CHECK 601 AND 602:

EVER MARRIED/EVER LIVED WITH A MAN

From the time you were 15 years old has anyone other than (your/any) (husband/partner) hit you, slapped you, kicked you, or done anything else to hurt you physically?
YES 1
NO 2 (GO TO DV19)
REFUSED TO ANSWER/NO ANSWER 3 (GO TO DV19)

NEVER MARRIED/NEVER LIVED WITH A MAN

From the time you were 15 years old has anyone hit you, slapped you, kicked you, or done anything else to hurt you physically?
YES 1
NO 2 (GO TO DV19)
REFUSED TO ANSWER/NO ANSWER 3 (GO TO DV19)

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Senegal 2017
Survey form view entire document:  text 
1506) A) Did your (last) (husband/partner) ever do any of the following things to you:
b) How often did this happen during the last 12 months: often, only sometimes, or not at all?

a) push you, shake you, or throw something at you?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
b) slap you?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
c) twist your arm or pull your hair?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
d) punch you with his fist or with something that could hurt you?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
e) kick you, drag you, or beat you up?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
f) try to choke you or burn you?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
g) threaten you with a knife, gun, or other type of weapon?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
h) physically force you to have sexual intercourse with him even when you did not want to?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
i) physically force you to perform other sexual acts you did not want to?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
j) Force you with threats or in any other way to perform sexual acts you did not want to?
YES 1
NO 2
OFTEN 1
SOMETIMES 2
NOT AT ALL 3

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Tanzania 2010
Survey form view entire document:  text 
1006A. (Does/did) your (last) husband/partner ever do any of the following things to you:

a) push you, shake you, or throw something at you?
YES 1
NO 2
b) slap you?
YES 1
NO 2
c) twist your arm or pull your hair?
YES 1
NO 2
d) punch you with his fist or with something that could hurt you?
YES 1
NO 2
e) kick you, drag you or beat you up?
YES 1
NO 2
f) try to choke you or burn you on purpose?
YES 1
NO 2
g) threaten or attack you with a knife, gun, or any other weapon?
YES 1
NO 2
h) physically force you to have sexual intercourse with him even when you did not want to?
YES 1
NO 2
i) force you to perform any sexual acts you did not want to?
YES 1
NO 2

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Tanzania 2015
Survey form view entire document:  text 
1405)

A. Did your (last) (husband/partner) ever do any of the following things to you:

a) push you, shake you, or throw something at you?
YES 1 (GO TO Ba)
NO 2 (GO TO Ab)
b) slap you?
YES 1 (GO TO Bb)
NO 2 (GO TO Ac)
c) twist your arm or pull your hair?
YES 1 (GO TO Bc)
NO 2 (GO TO Ad)
d) punch you with his fist or with something that could hurt you?
YES 1 (GO TO Bd)
NO 2 (GO TO Ae)
e) kick you, drag you, or beat you up?
YES 1 (GO TO Be)
NO 2 (GO TO Af)
f) try to choke you or burn you on purpose?
YES 1 (GO TO Bf)
NO 2 (GO TO Ag)
g) threaten or attack you with a knife, gun, or other weapon?
YES 1 (GO TO Bg)
NO 2 (GO TO Ah)
h) physically force you to have sexual intercourse with him when you did not want to?
YES 1 (GO TO Bh)
NO 2 (GO TO Ai)
i) physically force you to perform any other sexual acts you did not want to?
YES 1 (GO TO Bi)
NO 2 (GO TO Aj)
j) force you with threats or in any other way to perform sexual acts you did not want to?
YES 1 (GO TO Bj)
NO 2 (GO TO 1406)

B. How often did this happen during the last 12 months: often, only sometimes, or not at all?

a) push you, shake you, or throw something at you?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
b) slap you?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
c) twist your arm or pull your hair?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
d) punch you with his fist or with something that could hurt you?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
e) kick you, drag you, or beat you up?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
f) try to choke you or burn you on purpose?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
g) threaten or attack you with a knife, gun, or other weapon?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
h) physically force you to have sexual intercourse with him when you did not want to?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
i) physically force you to perform any other sexual acts you did not want to?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
j) force you with threats or in any other way to perform sexual acts you did not want to?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3

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Uganda 2006
Survey form view entire document:  text 
1105) (Does/did) your (last) husband/partner ever do any of the following things to you:

a) push you, shake you, or throw something at you?
YES 1
NO 2
How often did this happen during the last 12 months: often, only sometimes, or not at all? (CHECK 603 AND ASK ONLY IF RESPONDENT IS NOT A WIDOW)
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
b) slap you?
YES 1
NO 2
How often did this happen during the last 12 months: often, only sometimes, or not at all? (CHECK 603 AND ASK ONLY IF RESPONDENT IS NOT A WIDOW)
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
c) twist your arm or pull your hair?
YES 1
NO 2
How often did this happen during the last 12 months: often, only sometimes, or not at all? (CHECK 603 AND ASK ONLY IF RESPONDENT IS NOT A WIDOW)
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
d) punch you with his first or with something that could hurt you?
YES 1
NO 2
How often did this happen during the last 12 months: often, only sometimes, or not at all? (CHECK 603 AND ASK ONLY IF RESPONDENT IS NOT A WIDOW)
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
e) kick you, drag you or beat you up?
YES 1
NO 2
How often did this happen during the last 12 months: often, only sometimes, or not at all? (CHECK 603 AND ASK ONLY IF RESPONDENT IS NOT A WIDOW)
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
f) try to choke you or burn you on purpose?
YES 1
NO 2
How often did this happen during the last 12 months: often, only sometimes, or not at all? (CHECK 603 AND ASK ONLY IF RESPONDENT IS NOT A WIDOW)
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
g) threaten or attack you with a knife gun, or any other weapon?
YES 1
NO 2
How often did this happen during the last 12 months: often, only sometimes, or not at all? (CHECK 603 AND ASK ONLY IF RESPONDENT IS NOT A WIDOW)
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
h) physically force you to have sexual intercourse with him even when you did not want to?
YES 1
NO 2
How often did this happen during the last 12 months: often, only sometimes, or not at all? (CHECK 603 AND ASK ONLY IF RESPONDENT IS NOT A WIDOW)
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
i) force you to perform any sexual acts you did not want to?
YES 1
NO 2
How often did this happen during the last 12 months: often, only sometimes, or not at all? (CHECK 603 AND ASK ONLY IF RESPONDENT IS NOT A WIDOW)
OFTEN 1
SOMETIMES 2
NOT AT ALL 3

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Uganda 2011
Survey form view entire document:  text 
1105) A) Did your (last) husband/partner ever do any of the following things to you:

a) push you, shake you, or throw something at you?
YES 1
B) How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
NO 2
b) slap you?
YES 1
B) How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
NO 2
c) twist your arm or pull your hair?
YES 1
B) How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
NO 2
d) punch you with his fist or with something that could hurt you?
YES 1
B) How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
NO 2
e) kick you, drag you, or beat you up?
YES 1
B) How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
NO 2
f) try to choke you or burn you on purpose?
YES 1
B) How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
NO 2
g) threaten or attack you with a knife, gun, or other weapon?
YES 1
B) How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
NO 2
h) physically force you to have sexual intercourse with him when you did not want to?
YES 1
B) How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
NO 2
i) physically force you to perform any other sexual acts you did not want to?
YES 1
B) How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
NO 2
j) force you with threats or in any other way to perform sexual acts you did not want to?
YES 1
B) How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
NO 2

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Uganda 2016
Survey form view entire document:  text 
DV05) A. Did your (last) (husband/partner) ever do any of the following things to you:

a) push you, shake you, or throw something at you?
YES 1
NO 2
b) slap you?
YES 1
NO 2
c) twist your arm or pull your hair?
YES 1
NO 2
d) punch you with his fist or with something that could hurt you?
YES 1
NO 2
e) kick you, drag you, or beat you up?
YES 1
NO 2
f) try to choke you or burn you on purpose?
YES 1
NO 2
g) threaten or attack you with a knife, gun, or other weapon?
YES 1
NO 2
h) physically force you to have sexual intercourse with him when you did not want to?
YES 1
NO 2
i) physically force you to perform any other sexual acts you did not want to?
YES 1
NO 2
j) force you with threats or in any other way to perform sexual acts you did not want to?
YES 1
NO 2

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Zambia 2007
Survey form view entire document:  text 
1206A. (Does/did) your (last) husband ever do any of the following things to you:

a) slap you?

YES 1
NO 2

b) twist your arm or pull your hair?

YES 1
NO 2

c) push you, shake you, or throw something at you?

YES 1
NO 2

d) punch you with his fist or with something that could hurt you?

YES 1
NO 2

e) kick you, drag you or beat you up?

YES 1
NO 2

f) try to choke you or burn you on purpose?

YES 1
NO 2

g) threaten or attack you with a knife, gun, or any other weapon?

YES 1
NO 2

h) physically force you to have sexual intercourse with him even when you did not want to?

YES 1
NO 2

i) force you to perform any sexual acts you did not want to?

YES 1
NO 2

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Zambia 2013
Survey form view entire document:  text 
1205B) How often did this happen during the last 12 months: often, only sometimes, or not at all?

a) Say or do something to humiliate you in front of others?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
b) Threaten to hurt or harm you or someone you care about?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3
c) Insult you or make you feel bad about yourself?
OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS 3

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Zambia 2018
Survey form view entire document:  text 
(1405) Did your (last) (husband/partner) ever do any of the following things to you:

a) push you, shake you, or throw something at you?

YES 1 (SKIP TO (B))
NO 2


b) slap you?

YES 1 (SKIP TO (B))
NO 2


c) twist your arm or pull your hair?

YES 1 (SKIP TO (B))
NO 2


d) punch you with his fist or with something that could hurt you?

YES 1 (SKIP TO (B))
NO 2


e) kick you, drag you, or beat you up?

YES 1 (SKIP TO (B))
NO 2


f) try to choke you or burn you on purpose?

YES 1 (SKIP TO (B))
NO 2


g) threaten or attack you with a knife, gun, or other weapon?

YES 1 (SKIP TO (B))
NO 2


h) physically force you to have sexual intercourse with him when you did not want to?

YES 1 (SKIP TO (B))
NO 2


i) physically force you to perform any other sexual acts you did not want to?

YES 1 (SKIP TO (B))
NO 2


j) force you with threats or in any other way to perform sexual acts you did not want to?

YES 1 (SKIP TO (B))
NO 2

B. How often did this happen during the last 12 months: often, only sometimes, or not at all?

OFTEN 1
SOMETIMES 2
NOT IN LAST 12 MONTHS

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Zimbabwe 2005
Survey form view entire document:  text 
1106A) (Does/did) your (last) husband/partner ever do any of the following things to you:

a. Push you, shake you, throw something at you, or twist your arm or pull your hair?
YES 1
NO 2
b. Slap you?
YES 1
NO 2
c. Punch you with his fist or with something that could hurt you, kick you, drag you, or beat you up?
YES 1
NO 2
d. Try to choke you or burn you on purpose?
YES 1
NO 2
e. Threaten you with a knife, gun, or any other weapon?
YES 1
NO 2
f. Attack you with a knife, gun, or any other weapon?
YES 1
NO 2
g. Physically force you to have sexual intercourse with him?
YES 1
NO 2
h. Force you to perform any other sexual acts?
YES 1
NO 2

1106B) CHECK 601: ASK ONLY IF RESPONDENT IS CURRENTLY MARRIED/LIVING WITH A MAN, SEPARATED, OR DIVORCED. EXCLUDE WIDOWED WOMEN.

How often did this happen during the last 12 months: often, only sometimes, or not at all?

a. Push you, shake you, throw something at you, or twist your arm or pull your hair?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
b. Slap you?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
c. Punch you with his fist or with something that could hurt you, kick you, drag you, or beat you up?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
d. Try to choke you or burn you on purpose?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
e. Threaten you with a knife, gun, or any other weapon?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
f. Attack you with a knife, gun, or any other weapon?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
g. Physically force you to have sexual intercourse with him?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
h. Force you to perform any other sexual acts?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3

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Zimbabwe 2010
Survey form view entire document:  text 
1206) (Does/did) your (last) (husband/partner) ever do any of the following things to you:

a) Push you, shake you, or throw something at you?
YES 1
NO 2 (go to 1206b)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMTETIMES 2
NOT AT ALL 3
b) Slap you?
YES 1
NO 2 (GO TO 1206c)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
c) Twist your arm or pull your hair?
YES 1
NO 2 (GO TO 1206d)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
d) Punch you with his fist or with something that could hurt you?
YES 1
NO 2 (GO TO 1206e)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
e) Kick you, drag you or beat you up?
YES 1
NO 2 (GO TO 1206f)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
f) Try to choke you or burn you on purpose?
YES 1
NO 2 (GO TO 1206g)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
g) Threaten or attack you with a knife, gun, or any other weapon?
YES 1
NO 2 (GO TO 1206h)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
h) Physically force you to have sexual intercourse with him even when you did not want to?
YES 1
NO 2 (GO TO 1206h)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
OFTEN 1
SOMETIMES 2
NOT AT ALL 3
i) Force you to perform any sexual acts you did not want to?
YES 1
NO 2 (GO TO 1207)
How often did this happen during the last 12 months: often, only sometimes, or not at all?
SOMETIMES 1
OFTEN 2
NOT AT ALL 3

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Zimbabwe 2015
Survey form view entire document:  text 
1305A. Did your (last) (husband/partner) ever do any of the following things to you:

a. push you, shake you, or throw something at you?
YES 1 (GO TO 1305B)
NO 2 (GO TO b)
b. slap you?
YES 1 (GO TO 1305B)
NO 2 (GO TO c)
c. twist your arm or pull your hair?
YES 1 (GO TO 1305B)
NO 2 (GO TO d)
d. punch you with his fist or with something that could hurt you?
YES 1 (GO TO 1305B)
NO 2 (GO TO e)
e. kick you, drag you, or beat you up?
YES 1 (GO TO 1305B)
NO 2 (GO TO f)
f. try to choke you or burn you on purpose?
YES 1 (GO TO 1305B)
NO 2 (GO TO g)
g. threaten or attack you with a knife, gun, or other weapon?
YES 1 (GO TO 1305B)
NO 2 (GO TO h)
h. physically force you to have sexual intercourse with him when you did not want to?
YES 1 (GO TO 1305B)
NO 2 (GO TO i)
i. physically force you to perform any other sexual acts you did not want to?
YES 1 (GO TO 1305B)
NO 2 (GO TO j)
j. force you with threats or in any other way to perform sexual acts you did not want to?
YES 1 (GO TO 1305B)
NO 2 (GO TO 1306)