Survey Text

Afghanistan 2015 Ethiopia 2016 Myanmar 2015 Tanzania 2015
Angola 2015 Ghana 2008 Namibia 2013 Togo 2013
Benin 2017 India 2015 Nepal 2011 Uganda 2006
Burkina Faso 2010 Jordan 2007 Nepal 2016 Uganda 2011
Burundi 2016 Jordan 2012 Nigeria 2008 Uganda 2016
Cameroon 2004 Jordan 2017 Nigeria 2018 Zambia 2007
Cameroon 2011 Kenya 2014 Pakistan 2012 Zambia 2013
Cameroon 2018 Malawi 2004 Pakistan 2017 Zambia 2018
Chad 2014 Malawi 2010 Rwanda 2005 Zimbabwe 2005
Congo (Democratic Republic) 2007 Malawi 2016 Rwanda 2014 Zimbabwe 2010
Congo (Democratic Republic) 2013 Mali 2006 Senegal 2017 Zimbabwe 2015
Cote d'Ivoire 2011 Mali 2012 South Africa 1998
Egypt 2005 Mali 2018 South Africa 2016
Egypt 2014 Mozambique 2011 Tanzania 2010
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Afghanistan 2015
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1321. Who has done any of these things to physically hurt you while you were pregnant? Anyone else?

RECORD ALL MENTIONED.

CURRENT HUSBAND A
MOTHER/STEP-MOTHER B
FATHER/STEP-FATHER C
SISTER/BROTHER D
DAUGHTER/SON E
OTHER RELATIVE F
FORMER HUSBAND G
MOTHER-IN-LAW H
FATHER-IN-LAW I
OTHER IN-LAW J
TEACHER K
EMPLOYER/SOMEONE AT WORK L
POLICE/SOLDIER M
OTHER__________X

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Angola 2015
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1323) Has anyone ever hit, slapped, kicked or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1325)

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Benin 2017
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1521) Who has done any of these things to physically hurt you while you were pregnant?
Anyone else?
Record all mentioned

Current husband/partner A
Mother/Step-mother B
Father/Step-father C
Sister/Brother D
Daughter/Son E
Other relative F
Former husband/partner G
Current boyfriend H
Ex-boyfriend I
Mother-in-law J
Father-in-law K
Other in-laws L
Teacher M
Employer/someone at work N
Police/soldier O

Other (specify) X

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Burkina Faso 2010
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1320. Has anyone ever hit, slapped, kicked or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1322)

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Burundi 2016
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1520) Has anyone ever hit, slapped, kicked or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1522)

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Cameroon 2004
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1120) Has anyone ever hit, slapped, kicked or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1122)

1121) How has done any of these things to physically hurt you while you were pregnant?

Anyone else?

RECORD ALL MENTIONED.

CURRENT HUSBAND/PARTNER A
MOTHER B
FATHER C
STEP-MOTHER D
STEP-FATHER E
SISTER F
BROTHER G
DAUGHTER H
SON I
LAST/EX-HUSBAND/EX-PARTNER J
CURRENT BOYFRIEND K
FORMER BOYFRIEND L
MOTHER-IN-LAW M
FATHER-IN-LAW N
OTHER FEMALE RELATIVE/IN-LAW O
OTHER MALE RELATIVE/IN-LAW P
FEMALE FRIEND/ACQUAINTANCE Q
MALE FRIEND/ACQUAINTANCE R
TEACHER S
EMPLOYER T
STRANGER U
OTHER (SPECIFY): ___ X

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Cameroon 2011
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1119) Who physically harmed you while you were pregnant?

Anyone else?

RECORD ALL MENTIONED.

CURRENT HUSBAND/PARTNER A
MOTHER B
FATHER C
FATHER'S NEW WIFE D
MOTHER'S NEW HUSBAND E
SISTER/BROTHER F
SON/DAUGHTER G
OTHER RELATIVE H
EX-HUSBAND/EX-PARTNER I
CURRENT BOYFRIEND J
EX-BOYFRIEND K
MOTHER-IN-LAW L
FATHER-IN-LAW M
OTHER RELATIVE BY MARRIAGE N
TEACHER O
HEALTH PROFESSIONAL P
EMPLOYER/SOMEONE AT WORK Q
POLICE/SOLIDER/OFFICER R
PRIEST/RELIGIOUS LEADER S
STRANGER T
NEIGHBOR U
RELATION/ADMIRER V
OTHER (SPECIFY): ___ X

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Cameroon 2018
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1520. Has any one ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (SKIP TO 1522)

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Chad 2014
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1120) Has anyone ever hit, slapped, kicked or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 -SKIP TO 1122

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Congo (Democratic Republic) 2007
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1012) Has anyone ever hit, slapped, kicked or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1014)

1013) Who has done any of these things to physically hurt you while you were pregnant?
Anyone else?
RECORD ALL MENTIONED.

CURRENT HUSBAND/PARTNER A
MOTHER B
FATHER C
STEP-MOTHER D
STEP-FATHER/MOTHER'S PARTNER E
SISTER F
BROTHER G
DAUGHTER H
SON I
EX-HUSBAND/EX-PARTNER J
FRIEND/CURRENT SEXUAL PARTNER K
EX-FRIEND/EX-SEXUAL PARTNER K
MOTHER-IN-LAW (HUSBAND'S MOTHER) M
FATHER-IN-LAW (HUSBAND'S FATHER) N
OTHER FEMALE IN-LAWS O
OTHER MALE IN-LAWS P
FEMALE FRIEND/ACQUAINTANCE Q
MALE FRIEND/ACQUAINTANCE R
TEACHER S
EMPLOYER T
STRANGER U
POLICE/SOLDIER V
OTHER (SPECIFY) _____ X

THANK THE RESPONDENT FOR HER COOPERATION AND REASSURE HER ABOUT THE CONFIDENTIALITY OF HER ANSWERS. FILL OUT THE QUESTIONS BELOW WITH REFERENCE TO THE DOMESTIC VIOLENCE MODULE ONLY.


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Congo (Democratic Republic) 2013
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1320) Has anyone ever hit, slapped, kicked or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1322)

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Cote d'Ivoire 2011
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1220) Has anyone ever hit, slapped, kicked or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 -- (GO TO 1222)

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Egypt 2005
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914) Has any one ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 916)

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Egypt 2014
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1120. Has anyone ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1122)

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Ethiopia 2016
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1420. Has anyone ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1422)

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Ghana 2008
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1118. Has any one ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1120)

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India 2015
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1122. Has anyone ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1124)

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Jordan 2007
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1112) Has anyone ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1114)

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Jordan 2012
Survey form view entire document:  text 
1221. Who has done any of these things to physically hurt you while you were pregnant?
Anyone else?
RECORD ALL MENTIONED.

CURRENT HUSBAND A
MOTHER B
FATHER C
STEP-MOTHER D
STEP-FATHER E
BROTHER F
SISTER G
SON H
DAUGHTER I
EX-HUSBAND J
MOTHER-IN-LAW K
FATHER-IN-LAW L
OTHER FEMALE RELATIVE/IN-LAW M
OTHER MALE RELATIVE/IN-LAW N
FEMALE FRIEND/ACQUAINTANCE O
MALE FRIEND/ACQUAINTANCE P
FEMALE TEACHER Q
MALE TEACHER R
FEMALE EMPLOYER S
MALE EMPLOYER T
FEMALE STRANGER U
MALE STRANGER V
POLICE/SOLDIER W
OTHER (SPECIFY) _____ X

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Jordan 2017
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1320) Has any one ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (SKIP TO 1326)

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Kenya 2014
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1421) Who has done any of these things to physically hurt you while you were pregnant? Anyone else?

CURRENT HUSBAND/PARTNER A
MOTHER/STEP-MOTHER B
FATHER/STEP-FATHER C
SISTER/BROTHER D
DAUGHTER/SON E
OTHER RELATIVE F
FORMER HUSBAND/PARTNER G
CURRENT BOYFRIEND H
FORMER BOYFRIEND I
MOTHER-IN-LAW J
FATHER-IN-LAW K
OTHER IN-LAW L
TEACHER M
EMPLOYER/SOMEONE AT WORK N
POLICE/SOLDIER O
OTHER (SPECIFY) _________ X

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Malawi 2004
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DV20. Has anyone ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO DV21A)

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Malawi 2010
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1218. Has anyone ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1220)

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Malawi 2016
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1320. Has anyone ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1322)

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Mali 2006
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1020. Has anyone ever beaten, slapped, kicked or did something to physically attack you during (a/this) pregnancy?

YES 1
NO 2 (GO TO 1022)

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Mali 2012
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1420) Has anyone ever hit, slapped, kicked or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1422)

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Mali 2018
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1520) Has anyone ever hit, slapped, kicked or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (SKIP TO 1522)

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Mozambique 2011
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1217. Has anyone ever hit, slapped, kicked or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1219)

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Myanmar 2015
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1221) Who has done any of these things to physically hurt you while you were pregnant? Anyone else? RECORD ALL MENTIONED.

_____(SPECIFY)

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Namibia 2013
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1220) Has anyone ever hit, slapped, or kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1222)

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Nepal 2011
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1119) Has anyone ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1121)

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Nepal 2016
Survey form view entire document:  text 
1321. Who has done any of these things to physically hurt you while you were pregnant? Anyone else? RECORD ALL MENTIONED.

CURRENT HUSBAND/PARTNER A
MOTHER/STEP-MOTHER B
FATHER/STEP-MOTHER C
SISTER/BROTHER D
DAUGHTER/SON E
OTHER RELATIVE F
FORMER HUSBAND/PARTNER G
CURRENT BOYFRIEND H
FORMER BOYFRIEND I
MOTHER-IN-LAW J
FATHER-IN-LAW K
OTHER IN-LAW L
TEACHER M
EMPLOYER/SOMEONE AT WORK N
POLICE/SOLDIER O
OTHER (SPECIFY) ___ X

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Nigeria 2008
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1316. Has anyone ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1318)

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Nigeria 2018
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1520. Has anyone ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1522)

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Pakistan 2012
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1022) Who has done any of these things to physically hurt you while you were pregnant? Anyone else?
[CIRCLE ALL MENTIONED]

MOTHER A
STEP-MOTHER B
FATHER C
STEP-FATHER D
SISTER/BROTHER E
DAUGHTER/SON F
OTHER RELATIVE G
MOTHER-IN-LAW H
FATHER-IN-LAW I
OTHER-IN-LAW J
TEACHER K
EMPLOYER/SOMEONE AT WORK L
POLICE/SOLDIER M
OTHER (SPECIFY) ____ X

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Pakistan 2017
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1220) Has any one ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1222A)

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Rwanda 2005
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1020. Has any one ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1022)

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Rwanda 2014
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DV20) Has any one ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO DV22)

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Senegal 2017
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1522) Who has done any of these things to physically hurt you while you were pregnant?
Anyone else?

RECORD ALL MENTIONED.

CURRENT HUSBAND/PARTNER A
MOTHER/STEP-MOTHER B
FATHER/STEP-FATHER C
SISTER/BROTHER D
DAUGHTER/SON E
OTHER RELATIVE F
FORMER HUSBAND/PARTNER G
CURRENT BOYFRIEND H
EX-BOYFRIEND I
MOTHER-IN-LAW J
FATHER-IN-LAW K
OTHER IN-LAWS L
TEACHER M
EMPLOYER/SOMEONE AT WORK N
POLICE/SOLIDER O
OTHER (SPECIFY) ____ X

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South Africa 1998
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710 When you were pregnant, has anyone ever kicked, bitten, slapped, hit you with a fist, threaten you with a weapon, such as a knife, a stick, or a gun, or thrown something at you?

YES 1
NO 2
NEVER BEEN PREGNANT 3

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South Africa 2016
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1520A) Has anyone else ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2

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Tanzania 2010
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1019. Has any one ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1021)

1020. Who has done any of these things to physically hurt you while you were pregnant? Anyone else?
RECORD ALL MENTIONED.

CURRENT HUSBAND/LIVE-IN PARTNER A
MOTHER/STEP-MOTHER B
FATHER/STEP-FATHER C
SISTER/BROTHER D
DAUGHTER/SON E
OTHER RELATIVE F
FORMER HUSBAND/LIVE-IN PARTNER G
CURRENT BOYFRIEND H
FORMER BOYFRIEND I
MOTHER-IN-LAW J
FATHER-IN-LAW K
OTHER IN-LAW L
TEACHER M
EMPLOYER/SOMEONE AT WORK N
POLICE/SOLDIER O
OTHER (SPECIFY) _______ X

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Tanzania 2015
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1420) Has anyone ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1422)

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Togo 2013
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1420) Has anyone ever hit, slapped, kicked or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 - (SKIP TO 1422)

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Uganda 2006
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1118) Has anyone ever hit, slapped, kick, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1120)

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Uganda 2011
Survey form view entire document:  text 
1120) Has any one ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1122)

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Uganda 2016
Survey form view entire document:  text 
DV21) Who has done any of these things to physically hurt you while you were pregnant?
Anyone else?

RECORD ALL MENTIONED.

CURRENT HUSBAND/PARTNER A
MOTHER/STEP-MOTHER B
FATHER/STEP-FATHER C
SISTER/BORTHER D
DAUGHTER/SON E
OTHER RELATIVE F
FORMER HUSBAND/PARTNER G
CURRENT BOYFRIEND H
FORMER BOYRIEND I
MOTHER-IN-LAW J
FATHER-IN-LAW K
OTHER IN-LAW L
TEACHER M
EMPLOYER/SOMEONE AT WORK N
POLICE/SOLDIER O
OTHER (SPECIFY)_________X

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Zambia 2007
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1216. Has anyone ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1218)

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Zambia 2013
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1221) Has any one ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1223)

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Zambia 2018
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(1420) Has any one ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (SKIP TO 1422)

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Zimbabwe 2005
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1121) Has any one ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (SKIP TO 1123)

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Zimbabwe 2010
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1219) Has any one ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1221)

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Zimbabwe 2015
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1320. Has anyone ever hit, slapped, kicked, or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1322)