IDENTIFICATION
GOVERNORATE __________
PSU/SEGMENT NO. _____________
KISM/MARQAZ __________
BUILDING NO. ________________
SHIAKHA/VILLAGE __________
HOUSING UNIT NO___________
HOUSEHOLD NO. ___________
RURAL 2
LARGE CITY 1
SMALL CITY 2
TOWN 3
VILLAGE 4
NAME OF HOUSEHOLD HEAD _______________
ADDRESS IN DETAIL ______________
NAME OF WOMAN ______________
LINE NUMBER OF WOMAN ___________
INTERVIEWER VISITS
DATE _____
TEAM _____
INTERVIEWER _____
SUPERVISOR _____
ASSISTANT SUPERVISOR _____
RESULT ______
NOT AT HOME 2
POSTPONED 3
REFUSED 4
PARTLY COMPLETED 5
INCAPACITATED 6
OTHER (SPECIFY) _______ 7
NEXT VISIT:
DATE _____
TIME ________
FINAL VISIT
DAY ____
MONTH ____
YEAR ____
TEAM ____
INTERVIEWER _____
SUPERVISOR _____
ASSISTANT SUPERVISOR _____
RESULT _____
NOT AT HOME 2
POSTPONED 3
REFUSED 4
PARTLY COMPLETED 5
INCAPACITATED 6
OTHER (SPECIFY) _______ 7
TOTAL NUMBER OF VISITS __
NOT AT HOME 2
POSTPONED 3
REFUSED 4
PARTLY COMPLETED 5
INCAPACITATED 6
OTHER (SPECIFY) _______ 7
FIELD EDITOR
NAME _______
DATE _______
SIGNATURE _______
OFFICE EDITER
NAME _______
DATE _______
SIGNATURE _______
CODER
NAME _______
DATE _______
SIGNATURE _______
KEYER
NAME _______
DATE _______
SIGNATURE _______
SECTION 1. RESPONDENT'S BACKGROUND
NINUTES _____
102. First I would like to ask some questions about you and your household. For most of the time until you were 12 years old, did you live in Cairo, Giza, Alexandria, another city or town, or in a village?
(NAME OF LOCALITY AND GOVERNORATE) _____________
ALEXANDRIA 2
OTHER CITY/TOWN 3
VILLAGE 4
OUTSIDE EGYPT (SPECIFY) _________ 5
103. How long have you been living continuously in (NAME OF CURRENT PLACE OF RESIDENCE)?
ALWAYS 95 (GO TO 105)
VISITOR 96 (GO TO 105)
104. Just before you moved here, did you live in Cairo, Giza, Alexandria, another city or town, or in a village?
NAME OF LOCALITY AND GOVERNORATE ___________
ALEXANDRIA 2
OTHER CITY/TOWN 3
VILLAGE 4
OUTSIDE EGYPT (SPECIFY) ______ 5
105. In what month and year were you born?
DON'T KNOW MONTH 98
DON'T KNOW YEAR 98
106. How old were you at your last birthday? COMPARE AND CORRECT 105 AND/OR 106 IF INCONSISTENT.
107. What is your current marital status?
WIDOWED 2
DIVORCED 3
108. Have you ever attended school?
NO 2 (GO TO 118)
109. What is the highest level of school you attended?
PREPARATORY 2
SECONDARY 3
UPPER INTERMEDIATE 4
UNIVERSITY 5
MORE THAN UNIVERSITY 6
110. What is the highest grade which you successfully completed at level?
AGE 25 OR ABOVE (GO TO 117)
112. Are you currently attending school or the university?
NO 2
113. What was the main reason you stopped attending school (the university)?
TO CARE FOR YOUNGER CHILDREN 03
FAMILY NEEDED HELP ON FARM OR IN BUSINESS 04
COULD NOT PAY SCHOOL FEES/ EXPENSES 05
NEEDED TO EARN MONEY 06
GRADUATED/HAD ENOUGH SCHOOLING 07
DID NOT PASS ENTRANCE EXAMS 08
DID NOT LIKE SCHOOL 09
SCHOOL NOT ACCESSIBLE/TOO FAR 10
OTHER (SPECIFY) ________ 96
DON'T KNOW 98
114. While you were still enrolled in school, did you ever have to miss school because you had to help out at home or work?
NO 2 (GO TO 117)
115. Do you ever have to miss school because you have to help out at home or to work?
NO 2 (GO TO 117)
116. Would you say that this happens(ed), at least once every week, about once a month, or only a few times a year?
ABOUT ONCE A MONTH 2
A FEW TIMES PER YEAR 3
PREPARATORY OR HIGHER (GO TO 119)
118. Can you read and understand a letter or newspaper easily, with difficulty or not at all?
WITH DIFFICULTY 2
NOT AT ALL 3 (GO TO 120)
119. Do you usually read a newspaper or magazine at least once a week?
NO 2
120. How many hours on average do you listen to the radio each day? IF LISTENS LESS THAN 1 HOUR, WRITE "00".
ALL OF THE TIME 96
NEVER 97
NOT SURE/DON'T KNOW 98
121. How many hours on average do you watch television each day? IF WATCHES LESS THAN 1 HOUR, WRITE "00".
ALL OF THE TIME 96
NEVER 97
NOT SURE/DON'T KNOW 98
CHRISTIAN 2
OTHER (SPECIFY) _______6
123. CHECK QUESTION 007 IN THE HOUSEHOLD QUESTIONNAIRE.
THE WOMAN INTERVIEWED IS A USUAL RESIDENT (GO TO 201)
124. Now I would like to ask about the place in which you usually live. Do you usually live in Cairo, Giza, Alexandria, another city or town, or in a village?
NAME OF CITY/TOWN/VILLAGE __________
OUTSIDE EGYPT 5 (GO TO 126)
125. In which governorate is that located?
126. Now I would like to ask some questions about the household in which you usually live. In what type of dwelling does your household live?
FREE STANDING HOUSE 2
OTHER (SPECIFY) ________ 6
127. Is your dwelling owned by your household or not? IF OWNED: Is it owned solely by your household or jointly with someone else?
OWNED JOINTLY 2
RENTED 3
OTHER (SPECIFY) ______ 6
128. Could you describe the main material of the floor in your dwelling?
CERAMIC/MARBLE TILES 32
CEHENT TILES 33
CEMENT 34
WALL-TO-WALL CARPET 35
129. How many rooms are there in your dwelling (excluding the bathrooms, kitchen, and stairway areas)?
130. How many of the rooms are used for sleeping?
131. Is there a special room used only for cooking inside or outside the dwelling?
NO 2
132. What is the source of water your household uses for drinking?
PUBLIC TAP 12
PUBLIC WELL 22
OTHER (SPECIFY) ________ 96
133. How long does it take to go there, get water, and come back?
134. What kind of toilet facility does your household have?
TRADITIONAL WITH TANK FLUSH 12
TRADITIONAL WITH BUCKET FLUSH 13
PIT TOILET/LATRINE 21
NO FACILITY 31
OTHER (SPECIFY) _______ 96
135. Does the dwelling unit have electrical connections in all or only part of the dwelling unit?
YES, IN PART 2
HAS NO ELECTRICAL CONNECTIONS 3
136. Does your household have:
NO 2
NO 2
NO 2
NO 2
137. Does your household have:
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
138. Do you or any member of your household own:
NO 2
NO 2
NO 2
NO 2
201. Now I would like to ask about all the births you have had during your life. Have you ever given birth?
NO 2 (GO TO 206)
202. Do you have any sons or daughters to whom you have given birth who are now living with you?
NO 2 (GO TO 204)
203. How many sons live with you? And how many daughters live with you? IF NONE, RECORD '00'.
DAUGHTERS AT HOME __
204. Do you have any sons or daughters to whom you have given birth who are alive but do not live with you?
NO 2 (GO TO 206)
205. How many sons are alive but do not live with you? And how many daughters are alive but do not live with you? IF NONE, RECORD '00'.
DAUGHTERS ELSEWHERE __
206. Have you ever given birth to a boy or girl who was born alive but later died? IF NO, PROBE: Any baby who cried or showed any sign of life only survived a few hours or days?
NO 2 (GO TO 208)
207. In all, how many boys have died? And how many girls have died? IF NONE, RECORD '00'.
GIRLS DEAD __
208. SUM ANSWERS TO 203, 205, AND 207, AND ENTER TOTAL. IF NONE, RECORD '00'.
209. CHECK 208:
Just to make sure that I have this right: you have had in TOTAL _____ births during your life. Is that correct?
NO (PROBE AND CORRECT 201-209 AS NECESSARY)
NO BIRTHS (GO TO 227)
211. Now I would like to record the names of all your births, whether still alive or not, starting with the first one you had.
RECORD NAMES OF ALL THE BIRTHS IN 212. RECORD TWINS AND TRIPLETS ON SEPARATE LINES AND MARK WITH A BRACKET. COMPLETE 213-221 FOR EACH BIRTH. USE ADDITIONAL FORMS IF THERE ARE MORE THAN TEN BIRTHS. AFTER COMPLETING ALL BIRTHS, GO TO 222.
212. What name was given to your (first/next...) baby?
213. RECORD SINGLE OR MULTIPLE STATUS.
MULT 2
214. Is (NAME) a boy or a girl?
GIRL 2
215. In what month and year was (NAME) born?
PROBE: What is his/her birthday? In what season was he/she born?
NO 2 (GO TO 219)
217. IF ALIVE: How old was (NAME) at his/her last birthday? RECORD AGE IN COMPLETED YEARS.
218. IF ALIVE: Is (NAME) living with you?
NO 2 (GO TO 220)
219. IF DEAD: How old was (NAME) when he/she died?
IF '1 YR.', PROBE: How many months old was (NAME)?
RECORD DAYS IF LESS THAN 1 MONTH; MONTHS IF LESS THAN TWO YEARS; OR YEARS.
MONTHS 2 ____
YEARS 3 ____
220. FROM YEAR OF BIRTH OF (NAME) SUBTRACT YEAR OF PREVIOUS BIRTH. IS THE DIFFERENCE 4 OR MORE? [ask for all but first child]
NO 2 (NEXT BIRTH)
221. Were there any other live births between (NAME OF PREVIOUS BIRTH) and (NAME)? CORRECT IF NECESSARY. [ask for all but first child]
NO 2 (NEXT BIRTH)
222. FROM YEAR OF INTERVIEW SUBTRACT YEAR OF LAST BIRTH. IS THE DIFFERENCE 4 YEARS OR MORE?
NO 2 (GO TO 224)
223. Have you had any live births since the birth of (NAME OF LAST BIRTH)?
NO 2
224. COMPARE 208 WITH NUMBER OF BIRTHS IN HISTORY ABOVE AND MARK:
IF NUMBERS ARE SAME, CHECK:
FOR EACH LIVING CHILD: CURRENT AGE IS RECORDED.
FOR EACH DEAD CHILD: AGE AT DEATH IS RECORDED.
FOR AGE AT DEATH 12 MONTHS OR 1 YEAR: PROBE TO DETERMINE EXACT NUMBER OF MONTHS.
225. CHECK 215 AND ENTER THE NUMBER OF BIRTHS SINCE JANUARY 1990. IF NONE, RECORD '0' AND GO TO 227.
226. FOR EACH BIRTH SINCE JANUARY 1990, ENTER 'B' IN THE MONTH OF BIRTH IN COLUMN 1 OF THE CALENDAR AND 'P' IN EACH OF THE 8 PRECEDING MONTHS. WRITE NAME TO THE RIGHT OF THE 'B' CODE.
NO 2 (GO TO 231)
UNSURE 8 (GO TO 231)
228. How many months pregnant are you?
229. ENTER "P" IN COLUMN 1 OF CALENDAR IN MONTH OF INTERVIEW AND IN EACH PRECEDING MONTH PREGNANT.
230. At the time you became pregnant, did you want to become pregnant then, did you want to wait until later, or did you not want to become pregnant at all?
LATER 2
NOT AT ALL 3
231. Many women have pregnancies that do not end in a live birth. Have you ever had a miscarriage?
NO 2
232. Sometimes women have an abortion if a pregnancy is not planned. Have you ever had an abortion?
NO 2
233. Sometimes a baby is still born, that is, the baby does not breathe or show any sign of life. Have you ever had a still birth?
NO 2
NEVER HAD MISCARRIAGE, ABORTION, OR STILL BIRTH (GO TO 250)
235. When did the last such pregnancy end?
YEAR ___
236. Did that pregnancy end in a miscarriage, abortion or still birth?
ABORTION 2
STILL BIRTH 3
LAST PREGNANCY ENDED BEFORE JANUARY 1990 (GO TO 250)
238. How many months pregnant were you when the last pregnancy ended?
RECORD NUMBER OF COMPLETED MONTHS. ENTER THE APPROPRIATE CODE IN THE CALENDAR FOR THE MONTH THAT THE PREGNANCY ENDED: 'M' FOR MISCARRIAGE, 'A' FOR ABORTION OR 'S' FOR STILL BIRTH. ENTER 'P' FOR THE REMAINING NUMBER OF COMPLETED MONTHS.
239. Have you ever had any other pregnancies which did not result in a live birth?
NO 2 (GO TO 241)
240. ASK THE DATE AND THE DURATION OF PREGNANCY FOR EACH EARLIER PREGNANCY BACK TO JANUARY 1990. IN THE CALENDAR, ENTER THE APPROPRIATE CODE FOR THE OUTCOME OF THE PREGNANCY IN THE MONTH THAT EACH PREGNANCY ENDED: 'M' FOR MISCARRIAGE, 'A' FOR ABORTION OR 'S' FOR STILL BIRTH. ENTER 'P' FOR THE REMAINING NUMBER OF COMPLETED MONTHS.
NO ABORTION SINCE JANUARY 1990 (GO TO 250)
242. Now I would like to ask you some questions about the last pregnancy which you had that ended in an abortion. Did anyone help you to have the abortion? RECORD ALL RESPONSES.
NURSE/MIDWIFE B
FRIEND/RELATIVE D
NO ONE Y
243. Did the abortion occur at home or somewhere else?
OTHER HOME 2
PUBLIC HEALTH FACILITY 3
PRIVATE HEALTH FACILITY 4
OTHER (SPECIFY) _________ 6
244. Sometimes women experience health problems after having an abortion. Did you have any health problems afterwards?
NO 2 (GO TO 250)
245. What health problems did you have?
HEAVY BLEEDING 2
OTHER (SPECIFY) ________ 6
246. Did you seek care from anyone afterwards?
NO 2 (GO TO 250)
247. From whom did you seek care? RECORD ALL RESPONSES.
NURSE/MIDWIFE B
FRIEND/RELATIVE D
NO ONE Y
248. Were you hospitalized for the problem that you had after the abortion?
NO 2 (GO TO 250)
249. For how many nights were you hospitalized?
250. When did your last menstrual period start?
WEEKS AGO 2 __
MONTHS AGO 3 ___
YEARS AGO 4 ___
IN MENOPAUSE 994
BEFORE LAST BIRTH 995
NEVER MENSTRUATED 996 (GO TO 252)
251. How old were you when you had your first menstrual period?
DON'T KNOW 98
252. Between the first day of a period (i.e., menstrual cycle) and the first day of her next period, are there certain times when a woman is more likely to become pregnant then other times? PROBE: Are there any days during this time when a woman is more likely to become pregnant than on other days?
NO 2 (GO TO 301)
DON'T KNOW 8 (GO TO 301)
253. During which time of the monthly cycle (between the first day of a period and the first day of the next period) is a woman most likely to become pregnant? PROBE: What are the days of each month when a woman should be more careful so as not to get pregnant?
RIGHT AFTER HER PERIOD HAS ENDED 2
IN THE MIDDLE OF THE CYCLE 3
JUST BEFORE HER PERIOD BEGINS 4
OTHER (SPECIFY) ________ 6
DON'T KNOW 8
SECTION 3. CONTRACEPTIVE KNOWLEDGE AND USE
301. Now I would like to talk about family planning - the various ways or methods that a couple can use to delay or avoid a pregnancy. Which ways or methods have you heard about?
CIRCLE CODE 1 IN 302 FOR EACH METHOD MENTIONED SPONTANEOUSLY. THEN PROCEED DOWN THE COLUMN, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 2 IF METHOD IS RECOGNIZED, AND CODE 3 IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE 1 OR 2 CIRCLED IN 302, ASK 303-304 BEFORE PROCEEDING TO THE NEXT METHOD.
302. Have you ever heard of (METHOD)? READ DESCRIPTION OF EACH METHOD.
YES/PROBED 2
NO 3
YES/PROBED 2
NO 3
YES/PROBED 2
NO 3
YES/PROBED 2
NO 3
YES/PROBED 2
NO 3
YES/PROBED 2
NO 3
YES/PROBED 2
NO 3
YES/PROBED 2
NO 3
YES/PROBED 2
NO 3
YES/PROBED 2
NO 3
YES/PROBED 2
NO 3
NO 3
303. Have you ever used (METHOD)?
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
304. Do you know where a person could GO TO get (METHOD)?
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
AT LEAST ONE "YES" (EVER USED) (GO TO 309)
306. Have you ever used anything or tried in any way to delay or avoid getting pregnant?
NO 2
307. ENTER "0" IN COLUMN 1 OF CALENDAR IN EACH BLANK MONTH. (GO TO 353)
308. What have you used or done? CORRECT 303 - 305 (AND 302 IF NECESSARY).
309. What is the first thing you ever did or method you ever used to delay or avoid getting pregnant?
IUD 02
INJECTABLES 03
NORPLANT 04
DIAPHRAGM/FOAM/JELLY 05
CONDOM 06
FEMALE STERILIZATION 07
MALE STERILIZATION 08
PERIODIC ABSTINENCE 09 (GO TO 311)
WITHDRAWAL 10 (GO TO 311)
PROLONGED BREASTFEEDING 11 (GO TO 311)
OTHER (SPECIFY) ________ 96 (GO TO 311)
310. CHECK 309 FOR FIRST METHOD USED:
SHE/HE STERILIZED: Where did the sterilization?
USING IUD: Where did you have the IUD inserted for the first time?
USING ANOTHER METHOD: Where did you obtain (METHOD) the first time?
WRITE THE NAME AND THE ADDRESS OF THE SOURCE FROM WHICH THE RESPONDENT OBTAINED THE FIRST METHOD USED. IF NECESSARY PROBE TO IDENTIFY THE TYPE OF SOURCE AND THEN CIRCLE THE APPROPRIATE CODE.
NAME AND ADDRESS OF PLACE)____________
URBAN HEALTH UNIT 12
RURAL HOSPITAL 13
RURAL HEALTH UNIT 14
OTHER MOH UNIT 15
HEALTH INSURANCE ORGANIZATION 17
CURATIVE CARE ORGANIZATION 18
OTHER GOVERNMENTAL 19
CSI PROJECT 22
OTHER PVO 23
PRIVATE DOCTOR 25
PHARMACY 26
CHURCH HEALTH UNIT 32
OTHER VENDOR (SHOP, KIOSK, ETC.) 36
OTHER (SPECIFY) __________ 96
DON'T KNOW 98
311. At the time when you first used, how many living children did you have, if any? IF NONE, RECORD '00' AND GO TO 313.
312. How many sons did you have? How many daughters? IF NONE RECORD '00'.
DAUGHTERS __
313. When you first began to use family planning, did you want to have another (a) child but at a later time, or did you not want to have another (a) child at all?
DID NOT WANT ANOTHER CHILD 2
OTHER (SPECIFY) ______ 6
WIDOWED/DIVORCED (GO TO 346)
PREGNANT (GO TO 352)
316. CHECK 303 (FEMALE STERILIZATION):
WOMAN STERILIZED (GO TO 318A)
317. Are you currently doing something or using any method to delay or avoid getting pregnant?
NO 2 (GO TO 352)
318. Which method are you using?
318A. CIRCLE '07' FOR FEMALE STERILIZATION.
IUD 02
INJECTABLES 03
NORPLANT 04
DIAPHRAGM/FOAM/JELLY 05
CONDOM 06
FEMALE STERILIZATION 07
MALE STERILIZATION 08
PERIODIC ABSTINENCE 09 (GO TO 351)
WITHDRAWAL 10 (GO TO 351)
PROLONGED BREASTFEEDING 11 (GO TO 351)
OTHER (SPECIFY) ________ 96 (GO TO 351)
319. CHECK 318:
SHE/HE STERILIZED: Where did the sterilization take place?
USING IUD: Where did you have the IUD inserted?
USING ANOTHER METHOD: Where did you obtain (METHOD) the last time?
WRITE THE NAME AND THE ADDRESS OF THE SOURCE FROM WHICH THE RESPONDENT OBTAINED THE METHOD. PROBE IF NECESSARY TO IDENTIFY THE TYPE OF SOURCE AND THEN CIRCLE THE APPROPRIATE CODE.
NAME AND ADDRESS OF PLACE____________
URBAN HEALTH UNIT 12
RURAL HOSPITAL 13
RURAL HEALTH UNIT 14
OTHER MOH UNIT 15
HEALTH INSURANCE ORGANIZATION 17
CURATIVE CARE ORGANIZATION 18
OTHER GOVERNMENTAL 19
CSI PROJECT 22
OTHER PVO 23
PRIVATE DOCTOR 25
PHARMACY 26
CHURCH HEALTH UNIT 32
OTHER VENDOR (SHOP, KIOSK, ETC..) 36
OTHER (SPECIFY) __________ 96
DON'T KNOW 98 (GO TO 325)
320. How long does it take to travel from your home to this place? IF LESS THAN 2 HOURS, RECORD MINUTES. OTHERWISE, RECORD HOURS.
HOURS 2 ___
DELIVERED AT HOME 9995 (GO TO 322)
DON'T KNOW 9998
321. Is it easy or difficult to go there?
DIFFICULT 2
DON'T KNOW 8
322. At the time when you last got your (METHOD) at (CURRENT SOURCE), did you know about any other place where you could have obtained the method?
NO 2 (GO TO 325)
323. What place was that?
WRITE THE NAME AND ADDRESS OF THE SOURCE. PROBE IF NECESSARY TO IDENTIFY THE TYPE OF SOURCE AND THEN CIRCLE THE APPROPRIATE CODE.
NAME AND ADDRESS OF PLACE) ___________________
URBAN HEALTH UNIT 12
RURAL HOSPITAL 13
RURAL HEALTH UNIT 14
OTHER MOH UNIT 15
HEALTH INSURANCE ORGANIZATION 17
CURATIVE CARE ORGANIZATION 18
OTHER GOVERNMENTAL 19
CSI PROJECT 22
OTHER PVO 23
PRIVATE DOCTOR 25
PHARMACY 26
CHURCH HEALTH UNIT 32
OTHER VENDOR (SHOP, KIOSK, ETC.) 36
OTHER (SPECIFY) __________ 96
324. People select the place where they get family planning services for various reasons. What was the main reason you went to (NAME OF PLACE IN 319) instead of the other place you know about (NAME OF PLACE IN 323)?
RECORD RESPONSE AND CIRCLE CODE. _________
CLOSER TO MARKET/WORK 12
AVAILABILITY OF TRANSPORT 13
STAFF MORE POLITE/FRIENDLY 22
HAS FEMALE DOCTOR/STAFF 23
CLEANER FACILITY 24
OFFERS MORE PRIVACY 25
SHORTER WAITING TIME 26
OPEN LONGER/MORE CONVENIENT HOURS 27
USE OTHER SERVICES AT THE FACILITY 28
WANTED ANONYMITY 41
OTHER (SPECIFY) _______ 96
DON'T KNOW 98
USING PILL (GO TO 331)
USING OTHER METHODS (GO TO 343)
326. Did you get the IUD at the place where you had it inserted or did you buy it from somewhere else?
NO, FROM SOMEWHERE ELSE 2
327. From where did you buy the IUD?
WRITE THE NAME AND ADDRESS OF THE SOURCE. PROBE IF NECESSARY TO IDENTIFY THE TYPE OF SOURCE AND THEN CIRCLE THE APPROPRIATE CODE.
NAME AND ADDRESS OF PLACE ___________________
URBAN HEALTH UNIT 12
RURAL HOSPITAL 13
RURAL HEALTH UNIT 14
OTHER MOH UNIT 15
HEALTH INSURANCE ORGANIZATION 17
CURATIVE CARE ORGANIZATION 18
OTHER GOVERNMENTAL 19
CSI PROJECT 22
OTHER PVO 23
PRIVATE DOCTOR 25
PHARMACY 26
CHURCH HEALTH UNIT 32
OTHER VENDOR (SHOP, KIOSK, ETC.,) 36
OTHER (SPECIFY) __________ 96
DON'T KNOW 98
328. How much did it cost to buy the IUD from that place?
FREE 95
DON'T KNOW 98
329. How much did it cost to have the IUD inserted (including any extra fee for a physical examination)?
FREE 995
DON'T KNOW 998
330. Would you be willing to pay the following for an IUD (including all costs): (IF YES, CONTINUE WITH NEXT AMOUNT. IF NO, SKIP TO 351. FOR AMOUNT MORE THAN 200 POUNDS, SKIP TO 351 IF YES OR NO.)
NO 2 (GO TO 351)
NO 2 (GO TO 351)
NO 2 (GO TO 351)
NO 2 (GO TO 351)
NO 2 (GO TO 351)
NO 2 (GO TO 351)
NO 2 (GO TO 351)
NO 2 (GO TO 351)
331. Now much does one cycle of pills cost you?
FREE 995
DON'T KNOW 998
332. May I see the package of pills you are using now? RECORD NAME OF BRAND.
BRAND NAME __________ (GO TO 334)
PACKAGE NOT SEEN 2
333. Do you know the brand name of the pills which you are using now? RECORD NAME OF BRAND.
DON'T KNOW 98
334. When was the last time you took a pill? IF LESS THAN 24 HOURS, WRITE '00'.
MORE THAN ONE MONTH AGO 95
TWO DAYS AGO OR LESS (GO TO 337)
336. Why aren't you taking the pill these days?
FORGOT 02
HEALTH REASONS 03
COST TOO MUCH 04
NO NEED TO TAKE DAILY 05
RAN OUT 06
MENSTRUATING 07
OTHER (SPECIFY) ________ 96
ALL OTHER SOURCES (GO TO 339)
338. Do you usually obtain the pill yourself? IF NO: Who obtains the method usually?
HUSBAND 02
CHILDREN 03
OTHER FEMALE RELATIVE(S) 04
OTHER MALE RELATIVE(S) 05
FRIEND(S) 06
OTHER (SPECIFY) ________ 96
339. Since you began using the pill this time, have you yourself ever gone to a pharmacy to obtain the method?
NO 2 (GO TO 351)
340. Now I would like to talk with you about the service which you received at the pharmacy. Did anyone at the pharmacy tell or show you how to use the pill?
NO 2
341. Did anyone at the pharmacy describe side effects or other problems which you might have while using the pill?
NO 2
342. Did anyone at the pharmacy ever tell you about other family planning methods which you might use?
NO 2 (GO TO 351)
343. How much did it cost to get your method? (IF LESS THAN 1 POUND, RECORD IN PIASTRES.)
COST (IN POUNDS) 2 ____
FREE 99995
DON'T KNOW 99998
NOT USING INJECTABLES (GO TO 346)
345. Would you be willing to pay the following for the injectables (including all costs): (IF YES, CONTINUE WITH NEXT AMOUNT. IF NO, SKIP TO 351. FOR AMOUNT MORE THAN 20 POUNDS, SKIP TO 351 IF YES OR NO.)
NO 2 (GO TO 351)
NO 2 (GO TO 351)
NO 2 (GO TO 351)
NO 2 (GO TO 351)
NO 2 (GO TO 351)
NO 2 (GO TO 351)
WOMAN NOT STERILIZED (GO TO 350)
347. In what month and year was the sterilization performed?
YEAR __
348. ENTER STERILIZATION METHOD CODE IN MONTH OF INTERVIEW IN COLUMN 1 OF CALENDAR AND IN EACH MONTH BACK TO THE DATE OF THE OPERATION OR TO JANUARY 1990 IF OPERATION OCCURRED BEFORE 1990.
STERILIZED SINCE JANUARY 1990 (GO TO 352)
WIDOWED/DIVORCED (GO TO 352)
351. ENTER METHOD CODE FROM 318 IN CURRENT MONTH IN COLUMN 1 OF CALENDAR. THEN DETERMINE WHEN SHE STARTED USING THIS METHOD THIS TIME. ENTER METHOD CODE IN EACH MONTH OF USE.
ILLUSTRATIVE QUESTIONS:
-When did you start using (METHOD) continuously?
-How long have you been using (METHOD) continuously?
352. I would like to ask some questions about all of the (other) periods in the last few years during which you or your husband used a method to avoid getting pregnant. PROBE FOR EARLIER PERIODS OF USE AND NONUSE, STARTING WITH THE MOST RECENT PERIOD OF USE AND GOING BACK TO JANUARY 1990. USE NAMES OF CHILDREN, DATES OF BIRTH, AND PERIODS OF PREGNANCY AS REFERENCE POINTS. RECORD PERIODS OF USE AND NONUSE IN COLUMN 1 OF THE CALENDAR. FOR EACH MONTH IN WHICH A METHOD WAS USED, ENTER THE CODE FOR THE METHOD; ENTER "0" IN THOSE MONTHS WHEN NO METHOD WAS USED.
ILLUSTRATIVE QUESTIONS -COLUMN 1:
-When was the last time you used a method? Which method was that?
-When did you start using that method? How long after the birth of (NAME)?
-How long did you use the method then?
FOR EACH PERIOD OF USE, ASK WHY SHE STOPPED USING THE METHOD. IF A PREGNANCY FOLLOWED, ASK WHETHER SHE BECAME PREGNANT UNINTENTIONALLY WHILE USING THE METHOD OR DELIBERATELY STOPPED TO GET PREGNANT. FOR EACH PERIOD OF USE, RECORD THE CODE FOR THE REASON FOR DISCONTINUATION IN COLUMN 2 OF THE CALENDAR NEXT TO LAST MONTH OF USE. NUMBER OF CODES ENTERED IN COLUMN 2 MUST BE THE SAME AS THE NUMBER OF INTERRUPTIONS OF CONTRACEPTIVE USE IN COLUMN 1.
ILLUSTRATIVE QUESTIONS -COLUMN 2:
-Why did you stop using the (METHOD)?
-Did you become pregnant while using (METHOD), or did you stop to get pregnant, or stop for some other reason?
IF DELIBERATELY STOPPED TO BECOHE PREGNANT, ASK:
"How many months did it take you to get pregnant after you stopped using (METHOD)? AND ENTER '0' IN EACH SUCH MONTH IN COLUMN 1.
WIDOWED/DIVORCED (GO TO 356)
CURRENTLY USING A MODERN METHOD (GO TO 360)
CURRENTLY USING PERIODIC ABSTINENCE, WITHDRAWAL OR OTHER TRADITIONAL METHOD (GO TO 356)
355. What is the main reason you are not using a method of contraception to avoid pregnancy?
INFREQUENT SEX 22
MENOPAUSAL/HYSTERECTOMY 23
SUBFECUND/INFECUND 24
POSTPARTUM/BREASTFEEDING 25
WANTS (MORE) CHILDREN 26
PREGNANT 27
HUSBAND OPPOSED 32
OTHERS OPPOSED 33
RELIGIOUS PROHIBITION 34
KNOWS NO SOURCE 42
FEAR OF SIDE EFFECTS 52
LACK OF ACCESS/TOO FAR 53
COST TOO MUCH 54
INCONVENIENT TO USE 55
INTERFERES WITH BODY'S NORMAL PROCESSES 56
DON'T KNOW 98
356. Do you know of a place where you can obtain a method of family planning?
NO 2 (GO TO 360)
357. Where is that? WRITE THE NAME AND ADDRESS OF THE SOURCE FROM WHICH THE RESPONDENT WOULD GET THE METHOD. PROBE IF NECESSARY TO IDENTIFY THE TYPE OF SOURCE AND THEN CIRCLE THE APPROPRIATE CODE.
NAME AND ADDRESS OF PLACE ___________________
URBAN HEALTH UNIT 12
RURAL HOSPITAL 13
RURAL HEALTH UNIT 14
OTHER MOH UNIT 15
HEALTH INSURANCE ORGANIZATION 17
CURATIVE CARE ORGANIZATION 18
OTHER GOVERNMENTAL 19
CSI PROJECT 22
OTHER PVO 23
PRIVATE DOCTOR 25
PHARMACY 26
CHURCH HEALTH UNIT 32
OTHER VENDOR (SHOP, KIOSK, ETC.,) 36
OTHER (SPECIFY) __________ 96
DON'T KNOW 98
358. How long does it take to travel from your home to this place? IF LESS THAN 2 HOURS, RECORD MINUTES. OTHERWISE, RECORD HOURS.
HOURS 2 ___
DELIVERED AT HOME 9995
DON'T KNOW 9998
359. Is it easy or difficult to get there?
DIFFICULT 2
DON'T KNOW 8
360. In the last year, were you visited by a health worker, raida rifia, or anyone else who talked to you about family planning?
NO 2
361. Have you visited any governmental health facility for any reason during the past year?
NO 2 (GO TO 363)
362. Did any staff member at the health facility speak to you about family planning methods?
NO 2
363. Have you visited a private doctor or clinic for any reason during the past year?
NO 2 (GO TO 401)
364. Did the doctor or any other staff person speak to you about family planning methods?
NO 2
SECTION 4. FERTILITY PREFERENCES
DIVORCED/ WIDOWED (GO TO 415)
SHE OR HE STERILIZED (GO TO 412)
NOT PREGNANT OR UNSURE: Now I have some questions about the future. Would you like to have (a/another) child or would you prefer not to have any (more) children?
PREGNANT: Now I have some questions about the future. After the child you are expecting, would you like to have another child or would you prefer not to have any more children?
NO MORE/NONE 2 (GO TO 407)
SAYS SHE CAN'T GET PREGNANT 3 (GO TO 407)
UNDECIDED OR DON'T KNOW 4 (GO TO 405)
NOT PREGNANT OR UNSURE: How long would you like to wait from now before the birth of (a/another) child?
PREGNANT: How long would you like to wait after the birth of the child you are expecting before the birth of another child?
YEARS 2 __
SOON/NOW 994 (GO TO 407)
SAYS SHE CAN'T GET PREGNANT 995 (GO TO 407)
OTHER (SPECIFY) ______________________ 996
DON'T KNOW 998 (GO TO 409)
PREGNANT (GO TO 407)
406. If you became pregnant in the next few weeks, would you be happy, unhappy, or would it not matter very much?
UNHAPPY 2
WOULD NOT MATTER 3
407. CHECK 318: USING A METHOD?
CURRENTLY USING (GO TO 412)
408. Do you think you will use a method to delay or avoid pregnancy within the next 12 months?
NO 2
DON'T KNOW 8
409. Do you think you will use a method at any time in the future?
NO 2 (GO TO 411)
DON'T KNOW 8 (GO TO 411)
410. Which method would you prefer to use?
IUD 02 (GO TO 412)
INJECTABLES 03 (GO TO 412)
NORPLANT 04 (GO TO 412)
DIAPHRAGM/FOAM/JELLY 05 (GO TO 412)
CONDOM 06 (GO TO 412)
FEMALE STERILIZATION 07 (GO TO 412)
MALE STERILIZATION 08 (GO TO 412)
PERIODIC ABSTINENCE 09 (GO TO 412)
WITHDRAWAL 10 (GO TO 412)
PROLONGED BREASTFEEDING 11 (GO TO 412)
OTHER (SPECIFY) ________ 96 (GO TO 412)
UNSURE 98 (GO TO 412)
411. What is the main reason that you think you will never use a method?
MENOPAUSAL/HYSTERECTOMY 23
SUBFECUND/INFECUND 24
WANTS (MORE) CHILDREN 26
HUSBAND OPPOSED 32
OTHERS OPPOSED 33
RELIGIOUS PROHIBITION 34
KNOWS NO SOURCE 42
FEAR OF SIDE EFFECTS 52
LACK OF ACCESS/TOO FAR 53
COST TOO MUCH 54
INCONVENIENT TO USE 55
INTERFERES WITH BODY'S NORMAL PROCESSES 56
DON'T KNOW 98
412. In your family, who has the most influence in deciding whether or not to have another child -- you or your husband -- or do you have equal say?
BOTH HUSBAND AND RESPONDENT EQUAL 2
HUSBAND HAS MORE INFLUENCE 3
OTHER (SPECIFY) ______ 6
413. Have you and your husband ever discussed the number of children you would like to have?
NO 2
414. Do you think your husband wants the same number of children that you want, or does he want more or fewer than you want?
MORE CHILDREN 2
FEWER CHILDREN 3
DON'T KNOW 8
HAS LIVING CHILDREN: If you could go back to the time you did not have any children and could choose exactly the number of children to have in your whole life, how many would that be?
NO LIVING CHILD(REN): If you could choose exactly the number of children to have in your whole life, how many would that be?
OTHER (SPECIFY) _________ 96 (GO TO 417)
DON'T KNOW 98 (GO TO 417)
416. How many boys and how many girls?
GIRLS __
EITHER SEX __
OTHER ANSWER (SPECIFY) ____ 96
DON'T KNOW 98
417. Would you say that you approve or disapprove of couples using a method to avoid getting pregnant?
DISAPPROVE 2
NO OPINION 8
418. If couples wish to avoid pregnancy, do you approve or disapprove of their using:
DISAPPR 2
DK 8
DISAPPR 2
DK 8
DISAPPR 2
DK 8
DISAPPR 2
DK 8
DISAPPR 2
DK 8
APPROVES USING INJECTABLES/ DON'T KNOW (GO TO 421)
420. What is the main reason that you disapprove of the use of injectables?
CAUSES PERIODS TO BE IRREGULAR/ BLEEDING BETWEEN PERIOD 02
CAUSES HEAVY BLEEDING DURING PERIODS 03
CAUSES WOMAN TO RETAIN WATER 04
CAUSES WEAKNESS/TIREDNESS 05
CAUSES HEADACHES/DIZZINESS 06
NOT EFFECTIVE IN PREVENTING PREGNANCY 07
AGAINST RELIGION 08
OTHER (SPECIFY) _______ 96
DON'T KNOW 98
421. Is it acceptable or not acceptable to you for information on family planning to be provided:
NOT ACCEPTABLE 2
DK 8
NOT ACCEPT ABLE 2
DK 8
422. In the last few months have you heard about family planning:
NO 2
NO 2
NO 2
NO 2
NO 2
423. In the last few months have you discussed the practice of family planning with your friends, neighbors, or relatives?
NO 2 (GO TO 425)
424. With whom? Anyone else? RECORD ALL MENTIONED.
MOTHER B
FATHER C
SISTER(S) D
BROTHER(S) E
DAUGHTER F
MOTHER-IN-LAW G
FRIENDS/NEIGHBORS N
OTHER (SPECIFY) ______ X
425. There are many factors which help to influence the decision to use family planning. Can you tell me if any of the following ever caused you to seek information about family planning?
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
426. From what source did you first hear about family planning?
RADIO 02
NEWSPAPER/OTHER PUBLICATION 03
HUSBAND 04
OTHER RELATIVES OR FRIENDS 05
GOVERNMENT DOCTOR/CLINIC STAFF 06
PRIVATE DOCTOR/CLINIC STAFF 07
RAIDA RIFIA 08
DAYA 09
COMMUNITY MEETING 10
OTHER (SPECIFY) _____ 96
427. In general do you think that your religion allows couples to use family planning or forbids it?
FORBIDS 2
DOESN'T KNOW 8
WIDOWED/DIVORCED (GO TO 501)
429. Spouses do not always agree on everything. Now I want to ask you about your husband's views on family planning. Do you think that your husband approves or disapproves of couples using a method to avoid pregnancy?
DISAPPROVES 2
DON'T KNOW 3
430. How often have you talked to your husband about family planning in the past year?
ONCE OR TWICE 2
MORE OFTEN 3
SECTION 5. PREGNANCY AND BREASTFEEDING
NO BIRTHS SINCE JANUARY 1990 (GO TO 626)
502. ENTER THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH SINCE JANUARY 1990 IN THE TABLE. BEGIN WITH THE LAST BIRTH AND RECORD TWINS OR TRIPLETS IN SEPARATE COLUMNS. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 3 BIRTHS, USE ADDITIONAL FORMS).
Now I would like to ask you some more questions about the health of all your children born in the past 5 years. (We will talk about one child at a time.)
LIVING (GO TO 505)
DEAD (GO TO 505)
505. At the time you became pregnant with (NAME), did you want to become pregnant then, did you want to wait until later or did you not want (more) children at all?
LATER 2
NOT AT ALL 3 (GO TO 507)
506. How much longer would you have liked to have waited?
YEARS 2 __
DON'T KNOW 998
507. When you were pregnant with (NAME), did you see anyone for antenatal care for this pregnancy? IF YES: Whom did you see? Anyone else? RECORD ALL PERSONS SEEN.
NURSE/MIDWIFE B
NO ONE Y (GO TO 511)
508. Where did you receive the antenatal care? RECORD ALL PLACES.
GVT. HEALTH UNIT B
PVT. DOCTOR D
509. How many months pregnant were you when you first saw someone for an antenatal check on this pregnancy?
DON'T KNOW 98
510. How many times did you receive antenatal care during this pregnancy?
DON'T KNOW 98
511. When you were pregnant with (NAME), were you given any injection in the arm to prevent the baby from getting tetanus, that is, convulsions after birth?
NO 2 (GO TO 513)
DON'T KNOW 8 (GO TO 513)
512. During this pregnancy, how many times did you get this injection?
DON'T KNOW 8
513. Where did you give birth to (NAME)?
OTHER HOME 12
GVT. HEALTH UNIT 22
514. CHECK 513: GAVE BIRTH AT HEALTH FACILITY
GAVE BIRTH ELSEWHERE (SKIP TO 516)
515. Did you plan to deliver at the health facility or were you referred to the facility because you were having problems at delivery? IF REFERRED: Who suggested that you go to the facility? RECORD ALL MENTIONED.
NURSE/MIDWIFE B
RELATIVES/FRIENDS D
PLANNED TO GO TO HEALTH FACILITY Y
516. Who assisted with the delivery of (NAME)? Anyone else? PROBE FOR THE TYPE OF PERSON AND RECORD ALL PERSONS ASSISTING.
NURSE/MIDWIFE B
RELATIVES/FRIENDS D
NO ONE Y
517. CHECK 516: ASSISTED AT DELIVERY BY DAYA
NOT ASSISTED BY DAYA (GO TO 519)
518. I have some photographs to show you. Did the daya who helped you at delivery carry a box or bag like any of the ones in these photos? IF YES: Which did the daya carry?
[Most Recent Birth within the last 5 years]
PHOTO B 2
PHOTO C 3
NO 5
DON'T KNOW 8
519. Around the time of the birth of (NAME), did you have any of the following problems:
NO 2
NO 2
NO 2
NO 2
520. Was (NAME) delivered by caesarian section?
NO 2
521. When (NAME) was born, was he/she very large, larger than average, average, smaller than average, or very small?
LARGER THAN AVERAGE 2
AVERAGE 3
SMALLER THAN AVERAGE 4
VERY SMALL 5
DON'T KNOW 8
522. Was (NAME) weighed at birth?
NO 2 (GO TO 524)
523. How much did (NAME) weigh?
DON'T KNOW 99998
524. Has your period returned since the birth of (NAME)?
[Most Recent Birth within the last 5 years]
NO 2 (GO TO 527)
525. Did your period return between the birth of (NAME) and your next pregnancy?
[Exclude Most Recent Birth within the last 5 years]
NO 2 (SKIP TO 529)
526. For how many months after the birth of (NAME) did you not have a period?
DON'T KNOW 98
527. CHECK 227: RESPONDENT PREGNANT?
[Most Recent Birth within the last 5 years]
PREGNANT OR UNSURE (GO TO 529)
528. Have you resumed sexual relations since the birth of (NAME)?
[Most Recent Birth within the last 5 years]
NO 2 (GO TO 530)
529. For how many months after the birth of (NAME) did you not have sexual relations?
DON'T KNOW 98
530. Did you ever breastfeed (NAME)?
NO 2 (GO TO 536)
531. How long after birth did you first put (NAME) to the breast? IF LESS THAN 1 HOUR, RECORD '00'. IF LESS THAN 24 HOURS, RECORD HOURS. OTHERWISE, RECORD DAYS.
HOURS 1 __
DAYS 2 __
532. CHECK 504 OR 216: CHILD LIVING?
DEAD (SKIP TO 534)
533. Are you still breastfeeding (NAME)?
NO 2
534. For how many months did you breastfeed (NAME)?
DON'T KNOW 98
535. Why did you stop breastfeeding (NAME)?
CHILD ILL/WEAK 02
CHILD DIED 03
NIPPLE/ BREAST PROBLEM 04
NOT ENOUGH MILK 05
MOTHER WORKING 06
CHILD REFUSED 07
WEANING AGE/ AGE TO STOP 08
BECAME PREGNANT 09
STARTED TO USE CONTRACEPTION 10
OTHER (SPECIFY) ______ 96
DEAD (GO BACK TO 505 FOR NEXT BIRTH. IF NO OTHER BIRTHS, GO TO 601)
537. How many times did you breastfeed (NAME) last night between sunset and sunrise? IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER.
538. How many times did you breastfeed (NAME) yesterday during the daylight hours? IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE NUMBER.
539. Did (NAME) drink anything from a bottle with a nipple yesterday or last night?
NO 2
DON'T KNOW 8
540. At any time yesterday or last night was (NAME) given any of the following?
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
541. CHECK 540: FOOD OR LIQUID GIVEN YESTERDAY?
"NO" TO ALL (GO TO 544)
542. (Aside from breastfeeding), how many times did (NAME) eat yesterday, including both meals and snacks? IF 7 OR MORE TIMES, RECORD '7'.
DON'T KNOW 8
543. On how many days during the past seven days was (NAME) given any of following?
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
544. GO BACK TO 505 FOR NEXT BIRTH; OR IF NO MORE BIRTHS; GO TO 601.
SECTION 6. INMUNIZATION AND HEALTH
601. ENTER THE LINE NUMBER AND NAME OF EACH BIRTH SINCE JANUARY 1990 IN THE TABLE. RECORD TWINS OR TRIPLETS IN SEPERATE COLUMNS. ASK THE QUESTIONS ABOUT ALL OF THESE BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 3 BIRTHS, USE ADDITIONAL FORMS).
DEAD (GO TO 603 FOR NEXT BIRTH. IF NO OTHER BIRTH, GO TO 626.)
604. Do you have a birth certificate where (NAME's) vaccinations are written down? IF YES: May I see it, please?
YES, BUT NOT SEEN 2 (GO TO 608)
NO CERTIFICATE 3
605. Did you ever have a vaccination certification for (NAME)?
NO 2 (GO TO 608)
606. (1) COPY VACCINATION DATES FOR EACH VACCINE FROM THE CERTIFICATE.
(2) WRITE '44' IN 'DAY' COLUMN IF CERTIFICATE SHOWS A VACCINATION WAS GIVEN BUT NO DATE WAS RECORDED.
MONTH ___
YEAR __
MONTH ___
YEAR __
MONTH ___
YEAR __
MONTH ___
YEAR __
MONTH ___
YEAR __
MONTH ___
YEAR __
MONTH ___
YEAR __
MONTH ___
YEAR __
MONTH ___
YEAR __
MONTH ___
YEAR __
MONTH ___
YEAR __
607. Has (NAME) received any vaccinations that are not recorded on this certificate? RECORD 'YES' ONLY IF RESPONDENT MENTIONS BCG, DPT 1-3, POLIO 1-3, MEASLES AND/OR HEPATITIS 1-3 VACCINE(S).
NO 2 (GO TO 610)
DON'T KNOW 8 (GO TO 610)
608. Did (NAME) ever receive any vaccinations to prevent him/her from getting diseases?
NO 2 (GO TO 610)
DON'T KNOW 8 (GO TO 610)
609. Please tell me if (NAME) (has) received any of the following vaccinations:
NO 2
DON'T KNOW 8
IF YES: How many times?
NO 2
DON'T KNOW 8
IF YES: How many times?
NO 2
DON'T KNOW 8
NO 2
DON'T KNOW 8
IF YES: How many times?
NO 2
DON'T KNOW 8
610. Has (NAME) been ill with a fever at any time in the last 2 weeks?
NO 2
DON'T KNOW 8
611. Has (NAME) been ill with a cough at any time in the last 2 weeks?
NO 2 (GO TO 615)
DON'T KNOW 8 (GO TO 615)
612. When (NAME) had the illness with a cough, did he/she breathe faster than usual with short, rapid breaths?
NO 2
DON'T KNOW 8
613. Did you seek advice or treatment for the cough?
NO 2 (GO TO 615)
614. Where did you seek advice or treatment? Anywhere else? RECORD ALL MENTIONED.
GVT. HEALTH UNIT B
PRIVATE DOCTOR D
PHARMACY E
OTHER (SPECIFY) _______ X
615. Has (NAME) had diarrhea in the last two weeks?
NO 2 (GO TO 625)
DON'T KNOW 8 (GO TO 625)
616. Was there any blood in the stools?
NO 2
DON'T KNOW 8
617. On the worst day of the diarrhea, how many bowel movements did (NAME) have?
DON'T KNOW 98
618. Was he/she given the same amount to drink as before the diarrhea, or more, or less?
MORE 2
LESS 3
DON'T KNOW 8
619. Was he/she given the same amount of food to eat as before the diarrhea, or more, or less?
MORE 2
LESS 3
DON'T KNOW 8
620. Was (NAME) given a fluid made from a special packet called mahloul moalget el gaffaf to drink?
NO 2
DON'T KNOW 8
621. Was anything else given to treat the diarrhea?
NO 2 (GO TO 623)
DON'T KNOW 8 (GO TO 623)
622. What was given to treat the diarrhea? Anything else? RECORD ALL MENTIONED.
ANTIBIOTIC (PILL OR SYRUP) B
OTHER PILL OR SYRUP C
INJECTION
(I.V.) INTRAVENOUS D
HOME REMEDIES/ HERBAL MEDICINES E
OTHER (SPECIFY) _____ X
623. Did you seek advice or treatment for the diarrhea?
NO 2 (GO TO 625)
624. Where did you seek advice or treatment? Anywhere else? RECORD ALL MEHTIONED.
GVT, HEALTH UNIT B
PRIVATE DOCTOR D
PHARMACY E
OTHER (SPECIFY) _______ X
625. GO BACK TO 603 FOR NEXT BIRTH; OR, IF NO MORE BIRTHS, GO TO 626.
626. When s child has diarrhea, should he/she be given less to drink than usual, about the same amount, or more than usual?
ABOUT SAME AMOUNT TO DRINK 2
MORE TO DRINK 3
DON'T KNOW 8
627. When a child has diarrhea, should he/she be given less to eat than usual, about the same amount, or more than usual?
ABOUT SAME AMOUNT TO EAT 2
MORE TO EAT 3
DON'T KNOW 8
628. When a child is sick with diarrhea, what signs of illness would tell you that he or she should be taken to a health facility or health worker? RECORD ALL MENTIONED.
ANY WATERY STOOLS B
REPEATED VOMITING C
ANY VOMITING D
BLOOD IN STOOLS E
FEVER F
SUNKEN EYES G
DRY/YELLOW SKIN H
MARKED THIRST I
NOT EATING/NOT DRINKING WELL J
GETTING SICKER/VERY SICK K
NOT GETTING BETTER L
OTHER (SPECIFY) _____ X
DON'T KNOW Z
629. When a child is sick with a cough, what signs of illness would tell you that he or she should be taken to a health facility or health worker? RECORD ALL MENTIONED,
DIFFICULT BREATHING B
NOISY BREATHING C
STRONG COUGH/FREQUENT COUGH D
FEVER E
UNABLE TO DRINK F
NOT EATING/NOT DRINKING WELL G
GETTING SICKER/VERY SICK N
NOT GETTING BETTER I
OTHER (SPECIFY) ______ X
DON'T KNOW Z
ANY CHILD RECEIVED ORS (GO TO 701)
631. Have you ever heard of a special product called mahloul moalget el-gaffaf you can get for the treatment of diarrhea?
NO 2
SECTION 7. SCHOOLING OF CHILDREN
NO LIVING CHILDREN BORN BETWEEN JANUARY 1980 AND DECEMBER 1989: GO TO 713
702. ENTER THE LINE NUMBER AND NAME OF EACH LIVING CHILD BORN BETWEEN JANUARY 1980 AND DECEMBER 1989. BEGIN WITH THE YOUNGEST CHILD. ASK THE QUESTIONS ABOUT ALL OF THESE CHILDREN. IF THERE ARE MORE THAN 4 CHILDREN, USE ADDITIONAL QUESTIONNAIRES.
Now I would like to ask you some questions about the education of your children who are between six and fifteen years of age. We will talk about one child at a time.
705. Is (NAME) currently enrolled in school?
NO 2 (GO TO 711)
706. Does he/she attend a private day school, a private boarding school, a government school or Al-Azhar school?
PRVT BOARD 2
GOVERNMENT 3
AL-AZHAR 4
707. Sometimes children miss school because they are ill. How many days in the last month did (NAME) miss school due to illness? RECORD '00' IF NO DAYS MISSED.
708. Sometimes children miss school to help the family or to work. Has (NAME) ever missed school because he/she was needed by the family to:
NO 2
NO 2
NO 2
"NO" TO ALL QUESTIONS (GO TO 712)
710. How many days in the last month did (NAME) miss school for any of these reasons? RECORD '00' IF NO DAYS MISSED.
711. What is the main reason (NAME) is not enrolled in school?
TOO YOUNG 02
MARRIAGE AGE 03
SCHOOL NOT USEFUL 04
FAILED EXAMS 05
EXPELLED 06
TOO FAR 07
TOO EXPENSIVE 08
BOYS/GIRLS IN SCHOOL 09
(MALE/FEMALE) TEACHERS 10
HAS ENOUGH SCHOOLING 11
NEED AT HOME 12
NEED IN FARM/ BUSINESS 13
OTHER (SPECIFY) ______ 96
712. GO BACK TO 705 FOR NEXT CHILD; OR, IF NO MORE CHILDREN, GO TO 713.
713. If parents have one son and one daughter and can send only one child to the university, which child should they send?
DAUGHTER 2 (GO TO 715)
DEPEND ON THE CHILDREN'S CAPABILITIES 3 (GO TO 801)
NOT SURE 8 (GO TO 801)
714. Why should they send the son rather than the daughter? RECORD ALL RESPONSES.
BOY NEEDS EDUCATION FOR FUTURE JOB, GIRL WILL MARRY B (GO TO 801)
BOY WILL BE RESPONSIBLE FOR A FAMILY BUT SOMEONE WILL ALWAYS TAKE CARE OF A GIRL C (GO TO 801)
BOYS ARE MORE INTELLIGENT THAN GIRLS D (GO TO 801)
OTHER (SPECIFY) ______ X (GO TO 801)
NOT SURE Y (GO TO 801)
715. Why should they send the daughter rather than the son? PROBE: Any other reason? RECORD ALL RESPONSES.
A GIRL NEEDS EDUCATION TO FIND A GOOD HUSBAND B
GIRLS NEED EDUCATION OTHERWISE THEY ARE POWERLESS C
GIRLS NEED EDUCATION TO HAVE A GOOD FUTURE BUT BOYS CAN MANAGE FOR THEMSELVES D
GIRLS ARE MORE INTELLIGENT THAN BOYS E
GIRLS NEED EDUCATION IN CASE THEY HAVE TO PROVIDE FOR THE FAMILY F
OTHER (SPECIFY) _______ X
NOT SURE Y
SECTION 8. FEMALE CIRCUMCISION
801. Now I would like to talk to you about another topic. Have you ever heard about female circumcision?
NO 2 (GO TO 901)
802. Have you yourself ever been circumcised?
NO 2 (GO TO 814)
803. How old were you when you were circumcised?
DON'T KNOW 98
804. Who performed the circumcision? IF DOCTOR, PROBE: Was the doctor male or female?
FEMALE DOCTOR 02
TRAINED NURSE/MIDWIFE 03
DAYA 04
BARBER 05
GHAGARIA 06
OTHER (SPECIFY) _________ 96
DON'T KNOW 98
805 Where was the circumcision performed?
PRIVATE HOSPITAL/CLINIC 2
GOVERNMENT HOSPITAL/CLINIC 3
RELATIVE/NEIGHBOR'S HOUSE 4
BARBER'S KIOSK 5
OTHER (SPECIFY) _______ 6
DON'T KNOW 8
806. Do you know what tool was used in the circumcision?
SCALPEL 2
SCISSORS 3
DON'T KNOW 8
807. Was the circumcision carried out under anesthetic? IF YES, PROBE: What type--local or general?
GENERAL 2
WITHOUT ANESTHESIA 3
DON'T KNOW 8
808. Was the vaginal area sewn closed or almost closed (during the circumcision)?
NO 2 (GO TO 810)
DON'T KNOW 8
809. Did the vaginal area have to be cut open when you began menstruating or first married?
NO 2
DON'T KNOW 8
810. Did you have any complications at the time of the circumcision or afterwards?
NO 2 (GO TO 814)
DON'T KNOW 8 (GO TO 814)
811. What were those complications? PROBE: Were there any other complications? RECORD ALL RESPONSES.
BLEEDING B
INFECTION/FEVER C
DIFFICULTY IN PASSING URINE/ URINE RETENTION D
SWELLING/FAILURE TO HEAL E
SHOCK F
OTHER (SPECIFY) _________ X
812. Did you receive any health care for those complications?
NO 2 (GO TO 814)
813. What kinds of health care did you receive? RECORD ALL RESPONSES.
SUTURING B
BLOOD TRANSFUSION C
MEDICINE/INJECTION D
OTHER (SPECIFY) ________ X
HAS NO LIVING DAUGHTER (GO TO 830)
815. Have any of your daughters been circumcised? IF YES: How many?
NUMBER CIRCUMCISED ____
NO DAUGHTERS CIRCUMCISED 95 (GO TO 827)
816. Which of your daughters was circumcised most recently?
INTERVIEWER: CHECK 212 AND RECORD THE LINE NUMBER FOR THE DAUGHTER.
817. How old was she when she was circumcised?
DON'T KNOW 98
818. Who performed the circumcision? IF DOCTOR, PROBE: Was the doctor male or female?
FEMALE DOCTOR 02
TRAINED NURSE/MIDWIFE 03
DAYA 04
BARBER 05
GHAGARIA 06
OTHER (SPECIFY) _______ 96
DON'T KNOW 98
819. Where was the circumcision performed?
PRIVATE HOSPITAL/CLINIC 2
GOVERNMENT HOSPITAL/CLINIC 3
RELATIVE/NEIGHBOR'S HOUSE 4
BARBER'S KIOSK 5
OTHER (SPECIFY) ______ 6
DON'T KNOW 8
820. Do you know what tool was used in the circumcision?
SCALPEL 2
SCISSORS 3
DON'T KNOW 8
821. Was the circumcision carried out under anesthetic? IF YES, PROBE: What type--local or general?
GENERAL 2
WITHOUT ANESTHESIA 3
DON'T KNOW 8
822. Was the vaginal area sewn closed or almost closed (during the circumcision)?
NO 2
DON'T KNOW 8
823. Did your daughter have any complications at the time of the circumcision or afterwards?
NO 2 (GO TO 829)
DON'T KNOW 8 (GO TO 829)
824. What were those complications? PROBE: Were there any other complications? RECORD ALL RESPONSES.
BLEEDING B
INFECTION/FEVER C
DIFFICULTY IN PASSING URINE/ URINE RETENTION D
SWELLING/FAILURE TO HEAL E
SHOCK F
OTHER (SPECIFY) ______ X
825. Did she receive any health care for the complications?
NO 2 (GO TO 829)
826. What kinds of health care did she receive? RECORD ALL RESPONSES.
SUTURING B (GO TO 829)
BLOOD TRANSFUSION C (GO TO 829)
MEDICINE/INJECTION D (GO TO 829)
OTHER (SPECIFY) ________ X (GO TO 829)
827 Do you intend to have any of your daughters circumcised?
NO 2
DON'T KNOW 8 (GO TO 829)
828. Why don't you intend to have your daughter circumcised?
AFRAID OF COMPLICATIONS B
AGAINST RELIGION C
BETTER MARRIAGE PROSPECTS D
GREATER PLEASURE FOR HUSBAND E
OTHER (SPECIFY) ______ X
829. Is (Was) there anyone who is encouraging (encouraged) you to have your daughter circumcised? Anyone else? RECORD ALL PERSONS MENTIONED.
RESPONDENT'S MOTHER B
HUSBAND'S MOTHER C
ANY OTHER RELATIVE OF RESPONDENT D
ANY OTHER RELATIVE OF HUSBAND E
FRIENDS/NEIGHBORS F
DAUGHTER HERSELF G
INFLUENCED BY TRADITION H
OTHER (SPECIFY) _____ X
NO ONE Y
830. Do you think female circumcision should be continued, or should it be discontinued?
DISCONTINUED 2 (GO TO 832)
DON'T KNOW 8 (GO TO 834)
831. Why do you think female circumcision should be continued? Any other reasons? RECORD ALL REASONS MENTIONED.
REQUIRED BY ISLAM/RELIGION B (GO TO 834)
CLEANLINESS C (GO TO 834)
BETTER MARRIAGE PROSPECTS D (GO TO 834)
GREATER PLEASURE OF HUSBAND E (GO TO 834)
PRESERVATION OF VIRGINITY F (GO TO 834)
PREVENTION OF ADULTERY G (GO TO 834)
OTHER (SPECIFY) ______ X (GO TO 834)
DON'T KNOW Y (GO TO 834)
832. Why do you think female circumcision should be discontinued? Any other reasons? RECORD ALL REASONS MENTIONED.
AGAINST RELIGION B
CAUSES MANY MEDICAL COMPLICATIONS C
PAINFUL PERSONAL EXPERIENCE D
AGAINST DIGNITY OF WOMEN E
PREVENTS SEXUAL SATISFACTION F
OTHER (SPECIFY) ____ X
DON'T KNOW Y
833. What do you think is the best way to stop the practice of female circumcision? RECORD ALL RESPONSES.
SEX EDUCATION B
EDUCATIONAL CAMPAIGN FOR PARENTS C
OTHER (SPECIFY) ____ X
834. I will read you some statements. Please tell me if you agree or do not agree?
DISAGREE 2
DK 8
DISAGREE 2
DK 8
DISAGREE 2
DK 8
DISAGREE 2
DK 8
DISAGREE 2
DK 8
DISAGREE 2
DK 8
DISAGREE 2
DK 8
SECTION 9. MARRIAGE AND HUSBAND'S BACKGROUND
901. Now I would like to ask some questions about your marriage(s). How many times have you been married?
902. In what month and year did you enter into a marriage contract with your first husband?
DON'T KNOW MONTH 98
DON'T KNOW YEAR 98
903. How old were you when you entered into the marriage contract with your first husband?
DON'T KNOW AGE 98
904. In what month and year did you start living with your (first) husband?
DON'T KNOW MONTH 98
DON'T KNOW YEAR 98
905. How old were you when you started living together with your (first) husband?
DON'T KNOW AGE 98
906. DETERMINE MONTHS MARRIED SINCE JANUARY 1990. ENTER "X" IN COLUMN 3 OF CALENDAR FOR EACH MONTH MARRIED AND ENTER "0" FOR EACH MONTH NOT MARRIED, SINCE JANUARY 1990. FOR WOMEN WHO ARE NOT CURRENTLY MARRIED OR WHO HAVE MARRIED MORE THAN ONCE: PROBE FOR DATE WIDOWED OR DIVORCED AND FOR STARTING DATE OF ANY SUBSEQUENT MARRIAGE.
907. What do you think is the ideal age for marriage for sons? And for daughters?
DOES NOT MATTER FOR SONS 95
DOES NOT MATTER FOR DAUGHTERS 95
DIVORCED (GO TO 910)
WIDOWED (GO TO 911)
909. RECORD THE LINE NUMBER OF THE WOMAN'S HUSBAND FROM THE HOUSEHOLD QUESTIONNAIRE. IF THE HUSBAND IS NOT PRESENT IN THE HOUSEHOLD, RECORD '00'.
910. How old was your (current/last) husband on his last birthday?
911. In what month and year was your husband born? COMPARE AND CORRECT 910 AND/OR 911 IF INCONSISTENT.
DON'T KNOW MONTH 98
DON'T KNOW YEAR 98
912. Before you got married, was your (last) husband related to you in any way through blood or marriage?
NO 2 (GO TO 914)
913. What type of relationship was it?
FIRST COUSIN ON MOTHERIS SIDE 02
SECOND COUSIN ON FATHER'S SIDE 03
SECOND COUSIN OR MOTHER'S SIDE 04
OTHER BLOOD RELATIVE 05
OTHER RELATIVE BY MARRIAGE 06
914. Did your (last) husband ever attend school?
NO 2 (GO TO 917)
915. What was the highest level of school he attended?
PREPARATORY 2
SECONDARY 3
UPPER INTERMEDIATE 4
UNIVERSITY 5
MORE THAN UNIVERSITY 6
DON'T KNOW 8 (GO TO 917)
916. What was the highest grade which he completed at that level?
DON'T KNOW 8
917. What kind of work does (did) your (last) husband mainly do? RECORD ANSWER IN DETAIL.
918. Does (did) your husband work for a member of his family, for someone else, or is he self-employed?
FOR SOMEONE ELSE 2
FOR HIMSELF 3 (GO TO 920)
919. Does (did) he earn a regular wage or salary?
NO 2
DOES (DID) NOT WORK IN AGRICULTURE (GO TO 1001)
921. (Does/did) your husband mainly work on his own land or family land, or (does/did) he rent land, or (does/did) he work on someone else's land?
RENTED LAND 2
SOMEONE ELSE'S LAND 3
SECTION 10. WOMAN'S WORK AND RESIDENCE
1001. As you know, some women take up jobs for which they are paid in cash or kind. Others sell things, have a small business or work on the family farm or in the family business. Before you married (for the first time), did you ever do any of these things or any other work?
NO 2
1002. Are you currently doing any of these things or any other work?
NO 2
1003. Have you done any work in the last 12 months?
NO 2 (GO TO 1020)
1004. What is your occupation, that is, what kind of work do you mainly do? RECORD ANSWER IN DETAIL.
1005. Do you do this work for a member of your family, for someone else, or are you self-employed?
FOR SOMEONE ELSE 2
SELF-EMPLOYED 3
DOES NOT WORK IN AGRICULTURE (GO TO 1008)
1007. Do you work mainly on your own land or on family land, or do you rent land, or work on someone else's land?
FAMILY LAND 2
RENTED LAND 3
SOMEONE ELSE'S LAND 4
1008. On a typical day, how many hours do you spend doing this work?
1009. Do you usually work throughout the year, or do you work seasonally, or only once in a while?
SEASONALLY/PART OF THE YEAR 2
ONCE IN A WHILE 3 (GO TO 1012)
1010. During the last 12 months, how many months did you work?
1011. (In the months you worked,) how many days a week did you usually work?
1012. During the last 12 months, approximately how many days did you work?
1013. Do you earn cash for your work? PROBE: Do you make money for working?
NO 2 (GO TO 1017)
1014. Now much do you usually earn for this work?
PROBE: Is this by the day, by the month or by the year?
PER MONTH 2 ____________
PER WEEK 3 __________
PER DAY 4 ___________
PER HOUR 5 ______
OTHER (SPECIFY) __________ 999996
CURRENTLY MARRIED: Who mainly decides how the money you earn will be used: you, your husband, you and your husband jointly, or someone else?
WIDOWED/DIVORCED: Who mainly decides how the money you earn will be used: you, someone else, or you and someone else jointly?
HUSBAND DECIDES 2
JOINTLY WITH HUSBAND 3
SOMEONE ELSE DECIDES 4
JOINTLY WITH SOMEONE ELSE 5
1016. What do you mainly do with your earnings? PROBE: Anything else?
SCHOOL/OTHER COSTS FOR CHILDREN B
PERSONAL EXPENSES C
SUPPORT OTHER RELATIVES D
SAVINGS E
OTHER (SPECIFY) _____ X
1017. Do you usually work at home or away from home?
AWAY FROM HOME 2
1018. CHECK 217 AND 218: IS A CHILD LIVING AT HOME WHO IS AGE 5 OR LESS?
NO (GO TO 1020)
1019. Who usually takes care of (NAME OF THE YOUNGEST CHILD AT HOME) while you are working?
HUSBAND 02
OLDER FEMALE CHILD 03
OLDER MALE CHILD 04
OTHER RELATIVES 05
NEIGHBORS 06
FRIENDS 07
SERVANTS/HIRED HELP 08
CHILD IS IH SCHOOL 09
INSTITUTIONAL CHILDCARE 10
HAS NOT WORKED SINCE LAST BIRTH 95
OTHER (SPECIFY) ______ 96
MINUTES ___
NO BIRTHS SINCE JANUARY 1990 (GO TO 1201)
INTERVIEWER:
IN 1102 (COLUMNS 2-4) RECORD THE LINE NUMBER FOR EACH CHILD BORN SINCE JANUARY 1990 AND STILL ALIVE. IN 1103 AND 1104 RECORD THE NAME AND BIRTH DATE FOR THE RESPONDENT AND FOR ALL LIVING CHILDREN BORN SINCE JANUARY 1990. IN 1106 AND 1108 RECORD HEIGHT AND WEIGHT OF THE RESPONDENT AND THE LIVING CHILDREN. (NOTE: ALL RESPONDENTS WITH ONE OR MORE BIRTHS SINCE JANUARY 1990 SHOULD BE WEIGHED AND MEASURED EVEN IF ALL OF THE CHILDREN HAVE DIED. IF THERE ARE MORE THAN 3 LIVING CHILDREN BORN SINCE JANUARY 1990, USE ADDITIONAL FORMS).
YOUNGEST LIVING CHILD __
NEXT-TO-YOUNGEST LIVING CHILD ___
SECOND-TO-YOUNGEST LIVING CHILD __
1103. NAME (FROM Q.212 FOR CHILDREN)
1104. DATE OF BIRTH
FROM Q.105 FOR RESPONDENT, FROM Q.215 FOR CHILDREN AND ASK FOR DAY OF BIRTH
MONTH ___
YEAR ___
1105. BCG SCAR ON TOP OF LEFT SHOULDER [ask only for children]
NO SCAR 2
1107. WAS HEIGHT/LENGTH OF CHILD MEASURED LYING DOWN OR STANDING UP?
STANDING 2
1109. DATE WEIGHED AND MEASURED
MONTH __
YEAR __
FOR RESPONDENTS
NOT PRESENT 3
REFUSED 4
OTHER (SPECIFY) _______ 6
FOR CHILD
CHILD NOT PRESENT 3
CHILD REFUSED 4
MOTHER REFUSED 5
OTHER (SPECIFY) _______ 6
1111. NAME OF MEASURER: _________ __
NAME OF ASSISTANT: ___________ ___
THANK THE RESPONDENT FOR PARTICIPATING IN THE SURVEY. COMPLETE QUESTIONS 1201-1202 AS APPROPRIATE. BE SURE TO REVIEW THE QESTIONNAIRE FOR COMPLETENESS BEFORE LEAVING THE HOUSEHOLD.
FAIR 2
GOOD 3
VERY GOOD 4
1202. INTERVIEWERIS COMMENTS: _______________________________
1203. FIELD EDITOR'S COMMENTS: _______________________________
1204. SUPERVISOR'S/ASSISTANT SUPERVISOR'S COMMENTS: ____________________
1205. OFFICE EDITOR'S COMMENTS: __________________________________________
ONLY ONE CODE SHOULD APPEAR IN ANY BOX, FOR COLUMNS 1 AND 3 ALL MONTHS SHOULD BE FILLED IN.
INFORMATION TO BE CODED FOR EACH COLUMN
COL.1: Births, Pregnancies, Contraceptive Use
B BIRTHS
P PREGNANCIES
M MISCARRIAGE
A ABORTION
S STILLBIRTH
0 NOT USING METHOD
1 PILL
2 IUD
3 INJECTABLES
4 NORPLANT
5 DIAPHRAGM/ FOAM/JELLY
6 CONDOM
7 FEMALE STERILIZATION
8 MALE STERILIZATION
9 PERIODIC ABSTINENCE
L WTHDRAWAL
G PROLONGED BREASTFEEDING
X OTHER (SPECIFY) ________
COL.2: Discontinuation of Contraceptive
I BECAME PREGNANT WHILE USING
2 WANTED TO BECOME PREGNANT
3 HUSBAND DISAPPROVED
4 WANTED MORE EFFECTIVE METHOD
5 HEALTH CONCERNS
6 SIDE EFFECTS
7 LACK OF ACCESS/TOO FAR
8 COST TOO MUCH
9 INCONVENIENT TO USE
F FATALISTIC
U UNABLE TO GET PREGNANT/MENOPAUSE
D MARITAL DISSOLUTION/SEPARATION
I INFREQUENT SEX/HUSBAND AWAY
X OTHER (SPECIFY) _________
Z DON'T KNOW
COL.3: Marriage
X MARRIED
O NOT MARRIED
1 2 3
FEB 01 _____ _____ ______ 01 FEB
JAN 02 _____ _____ ______ 02 JAN
1995 1 2 3
DEC 03 _____ _____ ______03 DEC
NOV 04 _____ _____ ______04 NOV
OCT 05 _____ _____ ______ 05 OCT
SEP 06 _____ _____ ______ 06 SEP
AUG 07 _____ _____ ______ 07 AUG
JUL 08 _____ _____ ______08 JUL
JUN 09 _____ _____ ______ 09 JUN
MAY 10 _____ _____ ______ 10 MAY
APR 11 _____ _____ ______ 11 APR
MAR 12 _____ _____ ______ 12 MAR
FEB 13 _____ _____ ______ 13 FEB
JAN 14 _____ _____ ______ 14 JAN
1994 1 2 3
DEC 15 _____ _____ ______15 DEC
NOV 16 _____ _____ ______16 NOV
OCT 17 _____ _____ ______ 17 OCT
SEP 18 _____ _____ ______ 18 SEP
AUG 19 _____ _____ ______ 19 AUG
JUL 20 _____ _____ ______20 JUL
JUN 21 _____ _____ ______ 21 JUN
MAY 22 _____ _____ ______ 22 MAY
APR 23 _____ _____ ______ 23 APR
MAR 24 _____ _____ ______ 24 MAR
FEB 25 _____ _____ ______ 25 FEB
JAN 26 _____ _____ ______ 26 JAN
1993 1 2 3
DEC 27 _____ _____ ______27 DEC
NOV 28 _____ _____ ______28 NOV
OCT 29 _____ _____ ______ 29 OCT
SEP 30 _____ _____ ______ 30 SEP
AUG 31 _____ _____ ______ 31 AUG
JUL 32 _____ _____ ______32 JUL
JUN 33 _____ _____ ______ 33 JUN
MAY 34 _____ _____ ______ 34 MAY
APR 35 _____ _____ ______ 35 APR
MAR 36 _____ _____ ______ 36 MAR
FEB 37 _____ _____ ______ 37 FEB
JAN 38 _____ _____ ______ 38 JAN
1992 1 2 3
DEC 39 _____ _____ ______39 DEC
NOV 40 _____ _____ ______40 NOV
OCT 41 _____ _____ ______ 41 OCT
SEP 42 _____ _____ ______ 42 SEP
AUG 43 _____ _____ ______ 43 AUG
JUL 44 _____ _____ ______44 JUL
JUN 45 _____ _____ ______ 45 JUN
MAY 46 _____ _____ ______ 46 MAY
APR 47 _____ _____ ______ 47 APR
MAR 48 _____ _____ ______ 48 MAR
FEB 49 _____ _____ ______ 49 FEB
JAN 50 _____ _____ ______ 50 JAN
1991 1 2 3
DEC 51 _____ _____ ______51 DEC
NOV 52 _____ _____ ______52 NOV
OCT 53 _____ _____ ______ 53 OCT
SEP 54 _____ _____ ______ 54 SEP
AUG 55 _____ _____ ______ 55 AUG
JUL 56 _____ _____ ______56 JUL
JUN 57 _____ _____ ______ 57 JUN
MAY 58 _____ _____ ______ 58 MAY
APR 59 _____ _____ ______ 59 APR
MAR 60 _____ _____ ______ 60 MAR
FEB 61 _____ _____ ______ 61 FEB
JAN 62 _____ _____ ______ 62 JAN
1990 1 2 3
DEC 63 _____ _____ ______63 DEC
NOV 64 _____ _____ ______64 NOV
OCT 65 _____ _____ ______ 65 OCT
SEP 66 _____ _____ ______ 66 SEP
AUG 67 _____ _____ ______ 67 AUG
JUL 68 _____ _____ ______68 JUL
JUN 69 _____ _____ ______ 69 JUN
MAY 70 _____ _____ ______ 70 MAY
APR 71 _____ _____ ______ 71 APR
MAR 72 _____ _____ ______ 72 MAR
FEB 73 _____ _____ ______ 73 FEB
JAN 74 _____ _____ ______ 74 JAN
IDENTIFICATION
GOVERNORATE __________
PSU/SEGMENT NO. _____________
KISM/MARKAZ __________
BUILDING NO. ________________
SHIAKHA/VILLAGE __________
HOUSE NO.___________
HOUSEHOLD NO. ___________
LARGE CITY 1
SMALL CITY 2
TOWN 3
VILLAGE 4
NAME OF HOUSEHOLD HEAD _______________
ADDRESS IN DETAIL ______________
LINE NUMBER OF WOMAN ______________
INTERVIEWER VISITS
DATE _____
TEAM _____
INTERVIWER _____
SUPERVISOR _____
ASSISTANT SUPERVISOR _____
RESULT ______
NEXT VISIT:
DATE _____
TIME ________
FINAL VISIT
DAY ____
MONTH ____
YEAR ____
TEAM ____
INTERVIWER _____
SUPERVISOR _____
ASSISTANT SUPERVISOR _____
RESULT _____
TOTAL VISITS __
2 NOT AT HOME
3 POSTPONED
4 REFUSED
5 PARTLY COMPLETED
6 INCAPACITATED
7 OTHER (SPECIFY) _______
NO 2
FIELD EDITOR
NAME _______
DATE _______
SIGNATURE _______
OFFICE EDITOR
NAME _______
DATE _______
SIGNATURE _______
CODER
NAME _______
DATE _______
SIGNATURE _______
KEYER
NAME _______
DATE _______
SIGNATURE _______
SECTION 0. INFORMATION FROM THE MAIN DHS SURVEY
BEFORE BEGINNING THE INTERVIEW FILL IN THE INFORMATION BELOW USING THE MAIN DHS SURVEY FOR THE RESPONDENT.
001. CHECK Q.106 IN THE MAIN SURVEY QUESTIONNAIRE AND RECORD THE WOMAN'S AGE.
002. CHECK Q.107 IN THE MAIN SURVEY QUESTIONNAIRE AND RECORD THE WOMAN'S CURRENT MARTIAL STATUS.
WIDOWED 2
DIVORCED 3
003. CHECK Q.901 IN THE MAIN SURVEY QUESTIONNAIRE AND RECORD THE NUMBER OF TIMES MARRIED.
004. CHECK Q.108, Q.109 AND Q.112 IN THE MAIN SURVEY QUESTIONNAIRE AND RECORD THE WOMAN'S SCHOOLING STATUS.
ATTENDED SCHOOL IN THE PAST 2
NEVER ATTENDED SCHOOL 3
005. CHECK Q.1001 IN THE MAIN SURVEY QUESTIONNAIRE AND RECORD WHETHER THE WOMAN WORKED BEFORE MARRIAGE.
DID NOT WORK BEFORE MARRIAGE 2
006. CHECK Q.1002 AND Q.1003 IN THE MAIN SURVEY QUESTIONNAIRE AND RECORD WOMAN'S EMPLOYMENT STATUS
WORKED IN PAST 12 MONTHS 2
NOT CURRENTLY WORKING AND NOT WORKED IN PAST 12 MONTHS 3
007. CHECK Q.208 IN THE MAIN SURVEY QUESTIONNAIRE AND RECORD WHETHER WOMAN HAS HAD ANY BIRTHS. THEN IF WOMAN HAS NO BIRTHS: CHECK Q.227 IN THE MAIN SURVEY QUESTIONNAIRE AND RECORD WHETHER SHE IS CURRENTLY PREGNANT.
WOHAN HAS NO BIRTH BUT IS CURRENTLY PREGNANT 2
WOMAN HAS NO BIRTHS AND IS NOT CURRENTLY PREGNANT 3
MINUTES ___
102. CHECK 004: SCHOOL ATTENDANCE
CURRENTLY ATTENDING /NEVER ATTENDED (GO TO 104)
103. We are interested in some details regarding your schooling and that of your parents. How old were you when you stopped attending school? RECORD AGE IN COMPLETED YEARS
DON'T KNOW 98
104. Could (can) your father read a newspaper or letter?
NO 2
DIDN'T SEE/KNOW FATHER 3 (GO TO 106)
DON'T KNOW 8
105. What was (is) your father's occupation, that is, what kind of work did(does) he mainly do?
106. Could (can) your mother read a newspaper or letter?
NO 2
DIDN'T SEE/KNOW MOTHER 3 (GO TO 110)
DON'T KNOW 8
107. At any time before you were first married did your mother work at a job for which she earned cash?
NO 2 (GO TO 110)
DON'T KNOW 8 (GO TO 110)
108. Did she do this work throughout the year, or seasonally or only once in a while?
SEASONALLY/PART OF THE YEAR 2
ONCE IN A WHILE 3
DON'T KNOW 8
109. What was your mother's main occupation, that is, what work did she mainly do?
110. How much education parents give their children depends on many factors in addition to the cost of education.
In your opinion, in deciding how many years of schooling a daughter should have:
Which of the following factors is the most important:
Which is the least important?
NOT MOST/LEAST 2
LEAST 3
NOT MOST/LEAST 2
LEAST 3
NOT MOST/LEAST 2
LEAST 3
111. And in deciding how many years of schooling a son have:
Which of the same factors is the most important:
Which is the least important?
NOT MOST/LEAST 2
LEAST 3
NOT MOST/LEAST 2
LEAST 3
NOT MOST/LEAST 2
LEAST 3
112. In your opinion is it important for a woman to marry a man who has more education than her?
NOT IMPORTANT 2
DON'T KNOW 8
201. CHECK CURRENT MARITAL STATUS IN 002.
WIDOWED 2 (GO TO 206)
DIVORCED 3 (GO TO 205)
202. Is your husband with you, or is he travelling, or does he live elsewhere?
TRAVELLING 2
LIVES ELSEWHERE 3
203. Has your husband been away for less than one month or has he been gone longer than that?
AWAY ONE MONTH OR MORE 2
OTHER (SPECIFY) _________ 6
204. In your husband's absence, who mainly makes the day to day financial decisions of your household?
SON 2 (GO TO 206)
OTHER MALE RELATIVE 3 (GO TO 206)
OTHER FEMALE RELATIVE 4 (GO TO 206)
OTHER (SPECIFY) _________ 6 (GO TO 206)
205. Was the divorce initiated by you, by your husband, or did you both decide that you should divorce?
HUSBAND 2
BOTH 3
206. Now I will be asking some questions about your husband and your marriage.
FOR WOMEN WHO HAVE BEEN MARRIED ONLY ONCE: (COMPLETE COL. 1 ONLY)
IF CURRENTLY MARRIED: ASK ABOUT HER CURRENT HUSBAND AND MARRIAGE (COMPLETE COL. 1 ONLY)
IF WIDOWED OR DIVORCED: ASK ABOUT HER LAST HUSBAND AND MARRIAGE (COMPLETE COL. 1 ONLY)
FOR WOMEN MARRIED MORE THAN ONCE: ASK FIRST QUESTIONS ABOUT HER MOST RECENT HUSBAND AND MARRIAGE (CURRENT/LAST). THEN ASK HER ABOUT HER FIRST HUSBAND AND MARRIAGE (COMPLETE COL. 1 AND COL. 2).
207. What is (was) the first name of your (last) husband?
208. CHECK NUMBER OF TIMES MARRIED IN 003.
MARRIED MORE THAN ONCE 2
209. In what month and year did you first enter into a marriage contract with (NAME OF CURRENT/LAST HUSBAND)?
DON'T KNOW MONTH 98
DON'T KNOW YEAR 98
210. How old were you when you signed this marriage contract?
DON'T KNOW 98
211. In what month and year did you start living with (NAME OF CURRENT/LAST HUSBAND)?
DON'T KNOW MONTH 98
DON'T KNOW YEAR 98
212. How old were you when you started living with your husband?
DON'T KNOW 98 (GO TO 224)
213. Now I would like to ask questions about your first husband. What was the name of your first husband?
214. How old was (NAME OF FIRST HUSBAND) when your marriage contract was signed?
DON'T KNOW 98
215. In what month and year was your first husband born?
DON'T KNOW MONTH 98
DON'T KNOW YEAR 98
216. Before you got married, was your first husband related to you in anyway?
NO 2 (GO TO 218)
217. What type of relationship was it?
FIRST COUSIN ON MOTHER'S SIDE 2
SECOND COUSIN ON FATHER'S SIDE 3
SECOND COUSIN ON MOTHER'S SIOE 4
OTHER BLOOD RELATIVE 5
OTHER RELATIVE BY MARRIAGE 6
218. Did your first husband ever attend school?
NO 2 (GO TO 221)
219 What was the highest level of school he attended?
PREPARATORY 2
SECONDARY 3
UPPER INTERMEDIATE 4
UNIVERSITY 5
MORE THAN UNIVERSITY 6
DON'T KNOW 8 (GO TO 221)
220. What was the highest grade which he completed at that level?
DON'T KNOW 8
221. What kind of work did your first husband mainly do? RECORD ANSWER IN DETAIL.
222. Did he earn a regular wage or salary?
NO 2
DON'T KNOW 8
223. Did this marriage end in a divorce or were you widowed?
WIDOWED 2
OTHER (SPECIFY) ________ 6
224. I will now like to ask some questions about how you met your (last/first) husband. Before you got married, did yourself know your (last/first) husband well, a little, or not at all?
KNEW A LITTLE 2
DID NOT KNOW 3 (GO TO 229)
225. How long had you yourself known him before your marriage?
1 MONTH TO 1 YEAR 2
MORE THAN 1 YEAR 3
ALWAYS KNOWN HIM 4
226. Did you yourself choose your (last/first) husband or did your family choose or someone else choose?
FAMILY CHOSE 2 (GO TO 229)
OTHER RELATIVES CHOSE 3
OTHER (SPECIFY) ______ 6 (GO TO 229)
227. How did you yourself first meet your (last/first) husband?
THROUGH FRIENDS 2
HUSBAND IS RELATIVE 3
MET AT WORK 4
HUSBAND WAS NEIGHBOR 5
OTHER (SPECIFY) ______ 6
228. Did your family approve of your choice of husband from the very beginning, or only later, or did they never approve?
YES, BUT LATER 2 (GO TO 235)
NO, NEVER 3 (GO TO 235)
229. Had you yourself ever met and spoken to your (last/first) husband before you were married to him?
NO 2 (GO TO 231)
230. Had you yourself met and spoken to him before your engagement to him?
NO 2
231. Were you consulted when your (last/first) husband was being chosen for you, that is, were you asked whether you wanted to marry (NAME OF HUSBAND)?
NO 2
232. If you had not approved of (NAME OF CURRENT/LAST/FIRST HUSBAND) would your family have insisted that you marry him anyway?
NO 2
DON'T KNOW 8
233. Do you think that your (last/first) husband had a say in choosing you for his wife?
NO 2
DON'T KNOW 8 (GO TO 235)
234. If he had not approved of you, do you think his family would have made him marry you anyway?
NO 2
DON'T KNOW 8
235. Now I would like to ask same questions about expenses related to your marriage to your (last/first) husband. Would you tell me if these expenses were paid by you or your family or by your husband and his family or by both sides:
HUSB/ HUSB FAM. 2
BOTH 3
NO EXPENSE 4
HUSB/ HUSB FAM. 2
BOTH 3
NO EXPENSE 4
HUSB/ HUSB FAM. 2
BOTH 3
NO EXPENSE 4
HUSB/ HUSB FAM. 2
BOTH 3
NO EXPENSE 4
HUSB/ HUSB FAM. 2
BOTH 3
NO EXPENSE 4
HUSB/ HUSB FAM. 2
BOTH 3
NO EXPENSE 4
HUSB/ HUSB FAM. 2
BOTH 3
NO EXPENSE 4
HUSB/ HUSB FAM. 2
BOTH 3
NO EXPENSE 4
HUSB/ HUSB FAM. 2
BOTH 3
NO EXPENSE 4
HUSB/ HUSB FAM. 2
BOTH 3
NO EXPENSE 4
HUSB/ HUSB FAM. 2
BOTH 3
NO EXPENSE 4
236. If all the costs of the engagement and marriage are taken into consideration, approximately how much did you or your family spend on your (last/first) marriage?
DON'T KNOW 999998
237. As compared to your family's total expenditures on everything related to your engagement and marriage, did your (last/first) husband's family spend more, less, or about equal?
LESS 2
EQUAL 3
DON'T KNOW 8
238. Now I would like to talk about your living arrangements when you married your (last/first) husband. When you and your (first) husband started living together, did you live with your family, your husband's family, with someone else or by yourselves?
HUSBAND'S FAMILY 2
SOMEONE ELSE 3
OURSELVES ONLY 4 (GO TO 240)
239. Approximately how many years did you all live together then?
STILL TOGETHER 97
240. At that time were you living in Cairo, Giza, Alexandria, another city, or town or village or outside Egypt?
ALEXANDRIA 2
OTHER CITY/TOWN 3
VILLAGE 4
OUTSIDE EGYPT 5
LIVED WITH OWN FAMILY (GO TO 244 FOR COL.1; TO 245 FOR COL.2)
242. At that time were you able to meet any of your own family members often, only sometimes, or not at all?
SOMETIMES 2
NOT AT ALL 3
243. What was the main reason why you did not meet any member of your own family often?
244. CHECK NUMBER OF TIMES MARRIED IN Q.003.
MARRIED MORE THAN ONCE (GO TO 213 FOR FIRST HUSBAND)
245. In general, are the financial coats today of rearing and marrying off children greater for sons or for daughters?
DAUGHTERS 2
BOTH EQUALLY COSTLY 3
DON'T KNOW 8
SECTION 3. INTRAHOUSEHOLD RELATIONS
301. PRESENCE OF OTHERS AT THIS POINT
PRESENT/NOT LISTENING 2
NOT PRESENT 3
PRESENT/NOT LISTENING 2
NOT PRESENT 3
PRESENT/NOT LISTENING 2
NOT PRESENT 3
PRESENT/NOT LISTENING 2
NOT PRESENT 3
302. CHECK 002: MARITAL STATUS
DIVORCED/WIDOWED (GO TO 305)
303. Does your husband discuss any of the following topics with you regularly, only sometimes, or never?
SOMETIMES 2
NEVER 3
NA 5
SOMETIMES 2
NEVER 3
NA 5
SOMETIMES 2
NEVER 3
NA 5
SOMETIMES 2
NEVER 3
NA 5
SOMETIMES 2
NEVER 3
NA 5
304. Who has the final say in your family on the following---you or your husband, both you and your husband, or someone else?
IF SOMEONE ELSE: Who? (SPECIFY)
HUSB 2
BOTH 3
ELSE (Who?) ___________ 4
NA 5
HUSB 2
BOTH 3
ELSE (Who?) ___________ 4
NA 5
HUSB 2
BOTH 3
ELSE (Who?) ___________ 4
NA 5
HUSB 2
BOTH 3
ELSE (Who?) ___________ 4
NA 5
HUSB 2
BOTH 3
ELSE (Who?) ___________ 4
NA 5
HUSB 2
BOTH 3
ELSE (Who?) ___________ 4
NA 5
HUSB 2
BOTH 3
ELSE (Who?) ___________ 4
NA 5
HUSB 2
BOTH 3
ELSE (Who?) ___________ 4
NA 5
305. Now I would like to get your opinion on some aspects of family life. Please tell me if you agree or disagree with each statement.
DISAGREE 2
DK 8
DISAGREE 2
DK 8
DISAGREE 2
DK 8
DISAGREE 2
DK 8
DISAGREE 2
DK 8
DISAGREE 2
DK 8
DISAGREE 2
DK 8
DISAGREE 2
DK 8
306. In the past year, have you had an illness or any health problem for which you saw or should have seen a doctor?
NO 2 (GO TO 312)
307. If you wanted to see the doctor, did you first have to ask someone's permission?
NO 2 (GO TO 310)
308. Whose permission did you need to ask?
MOTHER-IN-LAW 2
OTHER MALE RELATIVE 3
OTHER FEMALE RELATIVE 4
OTHER (SPECIFY) _______ 6
309. Were you given permission to go see the doctor?
NO 2
NEVER ASKED PERNISSION 3
310. Did you see the doctor (anyway)?
NO 2
311. Why did you not see the doctor?
FELT ALL RIGHT AGAIN 02 (GO TO 314)
NOT SERIOUS ENOUGH 03 (GO TO 314)
TOO SHY 04 (GO TO 314)
TOO AFRAID OF DOCTOR 05 (GO TO 314)
DOCTOR NOT AVAILABLE/NO DOCTOR 06 (GO TO 314)
DID NOT HAVE MONEY 07 (GO TO 314)
DOCTOR TOO EXPENSIVE 08 (GO TO 314)
OTHER (SPECIFY) _______ 96 (GO TO 314)
312. If you are ill and need to see a doctor do you first have to ask someone's permission?
NO 2 (GO TO 314)
313. Whose permission did you need?
MOTHER-IN-LAW 2
OTHER MALE RELATIVE 3
OTHER FEMALE RELATIVE 4
OTHER (SPECIFY) _____ 6
314. Are you usually allowed to go to the following places on your own, only with children, only with another adult, or not at all?
CHILD 2
ADULT 3
NEVER 5
CHILD 2
ADULT 3
NEVER 5
CHILD 2
ADULT 3
NEVER 5
CHILD 2
ADULT 3
NEVER 5
CHILD 2
ADULT 3
NEVER 5
315. Do you watch on television or listen on radio to women's programs such as Woman Journal and For You and Your Family on television and To Housewife and For Women Only on radio?
LISTENS ON RADIO B
DOES NOT WATCH OR LISTEN TO WOMEN'S PROGRAMS C (GO TO 317)
316. Do you watch or listen to these programs regularly, or only once in a while?
ONCE IN A WHILE 2
317. In your opinion would a wife have good reason for seeking divorce if:
NO 2
DK 8
NO 2
DK 8
NO 2
DK 8
NO 2
DK 8
NO 2
DK 8
NO 2
DK 8
NO 2
DK 8
318. And what about a husband? Would a husband have good reason for seeking divorce if:
NO 2
DK 8
NO 2
DK 8
NO 2
DK 8
NO 2
DK 8
NO 2
DK 8
NO 2
DK 8
NO 2
DK 8
SECTION 4. HOUSEHOLD MEMBERS, WOMEN'S WORKLOAD AND EATING PRACTICES
401. CHECK 002: MARTIAL STATUS
CURRENTLY DIVORCED (GO TO 403)
402. Which of your husband's relatives usually lives with you? RECORD ALL MENTIONED. PROBE: Any other husband's relatives?
HIS MOTHER B
HIS BROTHER C
HIS SISTER D
HIS BROTHER'S WIFE E
HIS SISTER'S HUSBAND F
OTHER (SPECIFY) ______ X
NO ONE Y
403. Which of your own relatives usually lives with you? RECORD ALL MENTIONED. PROBE: Any other relatives of your own?
OWR MOTHER B
BROTHER C
SISTER D
BROTHER'S WIFE E
SISTER'S HUSBAND F
OTHER (SPECIFY) X
NO ONE Y
404. Now I would like to know who does what household tasks in your home. First tell me which persons do each of these tasks and then tell me who is the main person responsible for the task.
HUSB B
SON C
DAUG D
OTHER MALE E
OTHER FEMALE F
SERV/MAID G
NA X
MAIN ___
HUSB B
SON C
DAUG D
OTHER MALE E
OTHER FEMALE F
SERV/MAID G
NA X
MAIN ___
HUSB B
SON C
DAUG D
OTHER MALE E
OTHER FEMALE F
SERV/MAID G
NA X
MAIN ___
HUSB B
SON C
DAUG D
OTHER MALE E
OTHER FEMALE F
SERV/MAID G
NA X
MAIN ___
HUSB B
SON C
DAUG D
OTHER MALE E
OTHER FEMALE F
SERV/MAID G
NA X
MAIN ___
HUSB B
SON C
DAUG D
OTHER MALE E
OTHER FEMALE F
SERV/MAID G
NA X
MAIN ___
405. And now tell me which persons in your household do each of these tasks. Again please tell me who is the main person responsible for the task.
HUSB B
SON C
DAUG D
OTHER MALE E
OTHER FEMALE F
SERV/MAID G
NA X
MAIN ___
HUSB B
SON C
DAUG D
OTHER MALE E
OTHER FEMALE F
SERV/MAID G
NA X
MAIN ___
HUSB B
SON C
DAUG D
OTHER MALE E
OTHER FEMALE F
SERV/MAID G
NA X
MAIN ___
HUSB B
SON C
DAUG D
OTHER MALE E
OTHER FEMALE F
SERV/MAID G
NA X
MAIN ___
HUSB B
SON C
DAUG D
OTHER MALE E
OTHER FEMALE F
SERV/MAID G
NA X
MAIN ___
406. Finally, tell me which persons in your household do the following tasks related to children. Again please tell me who is the main person responsible for the tasks.
HUSB B
SON C
DAUG D
OTHER MALE E
OTHER FEMALE F
SERV/MAID G
NA X
MAIN ___
HUSB B
SON C
DAUG D
OTHER MALE E
OTHER FEMALE F
SERV/MAID G
NA X
MAIN ___
HUSB B
SON C
DAUG D
OTHER MALE E
OTHER FEMALE F
SERV/MAID G
NA X
MAIN ___
407. Are there any elderly or disabled persons who are dependent on you for care?
NO 2 (GO TO 409)
408. How many such persons are usually in your care?
409. At the time of the main meal do all members of your household, including you, usually eat together or do some eat separately?
SEPARATELY 2
410. Who is in the group that eats first? RECORD ALL MENTIONED.
HUSBAND B
SONS C
FATHER-IN-LAW D
OWN FATHER E
OTHER MALE RELATIVES F
MOTHER-IN-LAW G
OWN MOTHER H
DAUGHTERS I
OTHER FEMALE RELATIVES J
OTHER (SPECIFY) _________ X
411. Who usually eats with you when you eat?
RECORD ALL MENTIONED.
SONS B
FATHER-IN-LAW C
OWN FATHER D
OTHER MALE RELATIVES E
MOTHER-IN-LAW F
OWN MOTHER G
DAUGHTERS H
OTHER FEMALE RELATIVES I
OTHER (SPECIFY) _________ X
EATS ALONE Y
412. In your old age do you expect to live with a son, a daughter, with both at same time, or with neither?
DAUGHTER(S) 2 (GO TO 414)
BOTH 3 (GO TO 414)
NEITHER 4
DOES NOT HAVE SONS OR DAUG 5
413. With whom do you expect to live then?
WITH OTHER FAMILY 2
OTHER (SPECIFY) ______ 6
414. When you are old what do you expect to be your major sources of financial support? RECORD ALL MENTIONED.
PENSIONS/SAVINGS B
INCOME FROM LAND/INVESTMENTS C
GOVT AID D
SUPPORT FROM SON(S) E
SUPPORT FROM DAUGHTER(S) F
SUPPORT FROM OTHER RELATIVE(S) G
OTHER (SPECIFY) ______ X
READ TO ALL RESPONDENTS
You have already been asked some questions by the earlier interviewer about your current employment. I have a few more questions that I would like you to answer.
CURRENTLY WORKING (GO TO 504)
502. I believe that you are not (currently) working. What is the main reason why you are not currently working?
CHILDREN 02
HOUSEHOLD CARE 03
ILL OR DISABLED 04
CAN'T FIND/WAITING FOR WORK 05
HUSBAND/ELDERS OPPOSED 06
NO NEED TO WORK 07
DON'T WANT TO WORK ANY MORE 08
NO SKILLS/NO EDUCATION 09
GOT FIRED 10
OTHER (SPECIFY) ____ 96
NOT CURRENTLY WORKING AND DID NOT WORK LAST 12 MONTHS (GO TO 521)
504. For how many years have(had) you been working at your current/most recent job? ROUND TO THE NEAREST FULL YEAR.
505. When working do (did) you interact with only women, only men, or both women and men?
MEN ONLY 2
WOMEN AND MEN 3
MEETS NO ONE 4 (GO TO 507)
506. When working, do (did) you interact with mainly relatives, non-relatives, or with both?
ONLY NON-RELATIVES 2
BOTH 3
507. Have you had any special training for the work that you do (did)?
NO 2 (GO TO 509)
508. What training did you receive?
509. What is your main reason for working?
FINANCIAL INDEPENDENCE 02
TO PURSUE PROFESSION 03
USE EDUCATICATIONAL SKILLS 04
HELP WITH FAMILY BUSINESS/FARM 05
MAKE USE OF FREE TIME 06
TO GET SOCIAL STATUS 07
TO BE HERSELF/FIND HERSELF 08
OTHER (SPECIFY) _______ 96
510. In your current/most recent job are(were) you paid cash or kind or both, or are(were) you not paid at in all?
BOTH CASH AND KIND 2
ONLY KIND 3 (GO TO 518)
NOT PAID 4 (GO TO 521)
511. Do you use your own earnings to meet your personal needs or does your husband(someone else) give you money to cover your needs?
HUSBAND GIVES MONEY 2
USES OWN AND HUSBAND'S MONEY 3
OTHER (SPECIFY) ____ 6
512. When you earn, do you give all your earnings to your husband or family, or do you keep part and give the rest, or do you keep all of your earnings?
KEPT PART FOR SELF 2
KEPT ALL FOR SELF 3 (GO TO 516)
513. Do you give less than half, about half, or more than half to your husband or family?
HALF 2
MORE THAN HALF 3
514. Do you have the main control, some control, or no control over how the earnings you give to your husband or family are used?
SOME CONTROL 2
NO CONTROL 3
ALL EARNINGS GIVEN TO HUSBAND OR FAMILY (GO TO 517)
516. Do you have to account to anyone for what you do with the earnings that you keep?
IF YES: Who do you account to?
HUSBAND 1
FATHER/MOTHER 2
FATHER-IN-LAW/MOTHER-IN-LAW 3
OTHER (SPECIFY) ________ 6
DOES NOT ACCOUNT TO ANYONE 7
517. On average, when you work(ed) what is(was) the share of your family's expenditures that are(were) met by the income or goods that you earn(ed): all, more than half, about half, less than half, or almost nothing?
MORE THAN HALF 2
ABOUT HALF 3
LESS THAN HALF 4
ALMOST ZERO 5
DON'T KNOW 8
518. In addition to the work you described for which you are (were) paid in cash or kind, are(were) you also doing any other work for which you are(were) NOT paid in cash or kind? PROBE: Any work in a family business or family farm?
NO 2 (GO TO 521)
519. What is the work that you are (were) doing? RECORD RESPONSE IN FULL.
520. Approximately how many hours per week do (did) you spend doing this work?
WORKS ONLY IRREGULARLY 95
DID NOT WORK BEFORE (FIRST) MARRIAGE (GO TO 540)
522. I believe that you worked before (first) marriage. What was your last occupation before marriage, that is what work did you mainly do? RECORD RESPONSE 1N FULL.
523. Were you paid in cash or in kind or both for this work or were you not paid at all?
BOTH CASH AND KIND 2
ONLY KIND 3 (GO TO 525)
NOT PAID 4 (GO TO 525)
524. Did you have the main control, same control, or no control over how the income that you earned at this time was spent?
SOME CONTROL 2
NO CONTROL 3
525. Were you still working at the time of your marriage?
NO 2 (GO TO 540)
526. Did you continue this work even after your marriage, or did you do some other work, or did you stop then?
YES, DIFFERENT WORK 2
NO 3 (GO TO 540)
527. What was your new occupation? RECORD RESPONSE IN FULL.
528. Were you paid in cash or in kind or both for this work or were you not paid at all?
BOTH CASH AND KIND 2
ONLY KIND 3 (GO TO 530)
NOT PAID 4 (GO TO 530)
529. After marriage, did you have the main control, some control, or no control over how the income that you earned at that time was spent?
SOME CONTROL 2
NO CONTROL 3
530. For how many years did you continue to do this work since you first began? ROUND TO THE NEAREST FULL YEAR.
STILL WORKING 94 (GO TO 548)
531. What was the main reason you stopped working then?
HOUSEHOLD CARE 02
ILL OR DISABLED 03
COULDN'T FIND WORK 04
MIGRATED 05
HUSBAND/ELDERS OPPOSED 06
DIDN'T NEED TO WORK 07
DIDN'T WANT TO WORK 08
DID UNPAID WORK 09
WAS FIRED 10
OTHER (SPECIFY) ______ 96
CURRENTLY WORKING OR DID WORK LAST 12 MONTHS (GO TO 548)
533. Was this the last time that you worked after your marriage?
NO 2
534. The last time that you worked, what was your occupation, that is, what work did you mainly do? RECORD RESPONSE IN FULL.
535. Were you paid in cash or in kind or both for this work or were you not paid at all?
BOTH CASH ANO KIND 2
ONLY KIND 3 (GO TO 537)
NOT PAID 4 (GO TO 537)
536. Did you have the main control, some control, or no control over how the income that you earned at that time was spent?
SOME CONTROL 2
NO CONTROL 3
537. For how many years did you work then? ROUND TO THE NEAREST FULL YEAR.
538. In which year did you last stop working?
539. What was the main reason you stopped working then?
HOUSEHOLD CARE 02 (GO TO 548)
ILL OR DISABLED 03 (GO TO 548)
COULDN'T FIND WORK 04 (GO TO 548)
MIGRATED 05 (GO TO 548)
HUSBAND/ELDERS OPPOSED 06 (GO TO 548)
DIDN'T NEED TO WORK 07 (GO TO 548)
DIDN'T WANT TO WORK 08 (GO TO 548)
DID UNPAID WORK 09 (GO TO 548)
WAS FIRED 10 (GO TO 548)
OTHER (SPECIFY) ______ 96 (GO TO 548)
CURRENTLY WORKING OR DID WORK LAST 12 MONTHS (GO TO 548)
541. Did you ever work after your (first) marriage?
NO 2 (GO TO 548)
542. What was your (last) occupation, that is, what work did you mainly do? RECORD RESPONSE IN FULL.
543. Were you paid in cash or kind or both for this work or were you not paid at all?
BOTH CASH AND KIND 2
ONLY KIND 3 (GO TO 545)
NOT PAID 4 (GO TO 545)
544. Did you have the main control, some control, or no control over how the income that you earned at that time was spent?
SOME CONTROL 2
NO CONTROL 3
545. For how many years did you work then? ROUND TO THE NEAREST FULL YEAR.
546. In which year did you last stop working?
547. What was the main reason you stopped working then?
HOUSEHOLD CARE 02
ILL OR DISABLED 03
COULDN'T FIND WORK 04
MIGRATED 05
HUSBAND/ELDERS OPPOSED 06
DIDN'T NEED TO WORK 07
DIDN'T WANT TO WORK 08
DID UNPAID WORK 09
WAS FIRED 10
OTHER (SPECIFY) ______ 96
NO 2
DON'T KNOW 8
NO 2
DON'T KNOW 8
NO 2
DON'T KNOW 8
549. What do you think is the importance of work to a woman?
FINANCIAL INDEPENDENCE 02
TO PURSUE PROFESSION 03
USE EDUCATIONAL SKILLS 04
HELP WITH FAMILY BUSINESS/FARM 05
MAKE USE OF FREE TIME 06
TO GET SOCIAL STATUS 07
TO BE HERSELF/FIND HERSELF 08
OTHER (SPECIFY) _______ 96
NO IMPORTANCE OF WORK/ WOMAN SHOULD NOT WORK 95
READ TO ALL RESPONDENTS
Now I would like to ask you some questions about financial matters. This is to try and understand more about the financial position of women.
601. Please tell me if you solely, or jointly with someone else own each of the following assets.
DOES NOT OWN 2
DOES NOT OWN 2
DOES NOT OWN 2
DOES NOT OWN 2
DOES NOT OWN 2
DOES NOT OWN 2
DOES NOT OWN 2
OWNS ONLY FURNITURE (GO TO 604)
DOES NOT OWN ANY ASSET (GO TO 605)
603. Who mainly manages each of these assets?
HUSB 2
HUSB FAM. 3
OWN FAM. 4
NON-FAM. MEMBER 5
DO NOT OWN 7
HUSB 2
HUSB FAM. 3
OWN FAM. 4
NON-FAM. MEMBER 5
DO NOT OWN 7
HUSB 2
HUSB FAM. 3
OWN FAM. 4
NON-FAM. MEMBER 5
DO NOT OWN 7
HUSB 2
HUSB FAM. 3
OWN FAM. 4
NON-FAM. MEMBER 5
DO NOT OWN 7
HUSB 2
HUSB FAM. 3
OWN FAM. 4
NON-FAM. MEMBER 5
DO NOT OWN 7
HUSB 2
HUSB FAM. 3
OWN FAM. 4
NON-FAM. MEMBER 5
DO NOT OWN 7
604. If you ever needed to, could you sell or exchange these assets without anyone else's permission, only with permission, or not at all? IF PERMISSION IS NEEDED ASK: Whose permission?
ONLY WITH PERMISSION FROM:
HUSB 2
HUSB FAM. 3
OWN FAM. 4
NON-FAM. MEMBER 5
NOT AT ALL 6
DO NOT OWN 7
ONLY WITH PERMISSION FROM:
HUSB 2
HUSB FAM. 3
OWN FAM. 4
NON-FAM. MEMBER 5
NOT AT ALL 6
DO NOT OWN 7
ONLY WITH PERMISSION FROM:
HUSB 2
HUSB FAM. 3
OWN FAM. 4
NON-FAM. MEMBER 5
NOT AT ALL 6
DO NOT OWN 7
ONLY WITH PERMISSION FROM:
HUSB 2
HUSB FAM. 3
OWN FAM. 4
NON-FAM. MEMBER 5
NOT AT ALL 6
DO NOT OWN 7
ONLY WITH PERMISSION FROM:
HUSB 2
HUSB FAM. 3
OWN FAM. 4
NON-FAM. MEMBER 5
NOT AT ALL 6
DO NOT OWN 7
ONLY WITH PERMISSION FROM:
HUSB 2
HUSB FAM. 3
OWN FAM. 4
NON-FAM. MEMBER 5
NOT AT ALL 6
DO NOT OWN 7
605. Do you know how much your family's approximate total income from all sources is?
NO 2
606. Who mainly decides how your family's income is spent?
RESPONDENT ONLY 2
BOTH HUSBAND AND RESPONDENT 3
IN-LAWS 4
PARENTS 5
OTHER (SPECIFY) ______ 6
607. Do you have a bank account or postal saving account in your name or jointly with someone else?
OTHER (SPECIFY) ______ X
608. Do you yourself operate the account, that is, sign checks or deposit money and withdraw money?
NO 2
609. Are you personally part of any other kind of saving scheme which is not with a bank, into which you regularly deposit money?
NO 2
610. Do you know of any source from which you could get a loan or credit if you needed it?
IF YES: What sources of credit do you know of? RECORD ALL SOURCES MENTIONED.
BANK B
OTHER (SPECIFY) _____ X
DOES NOT KNOW ANY SOURCE Y (GO TO 613)
611. Have you ever applied on your own or jointly with someone else for credit of any kind?
YES, JOINTLY WITH OTHERS 2
NO 3 (GO TO 613)
612. What was the credit to be used for? RECORD ALL MENTIONED.
TO BUY HOME/PROPERTY B
TO TIDE OVER BAD TIME C
TO BUY LIVESTOCK O
TO START A BUSINESS E
OTHER (SPECIFY) _______ X
613. When you have to spend money on each of the following things how do you usually get the money? ENTER RESPONSE CODE FOR EACH ITEM.
RESPONSE CODES:
01 ASKS HUSBAND
02 HUSBAND ALREADY ASSIGNED MONEY.
03 TAKES FROM HOUSEHOLD POT/ACCOUNT, WITH PERMISSION.
04 TAKES FROM HOUSEHOLD POT/ACCOUNT, WITHOUT PERMISSION.
05 HAS OWN SEPARATE MONEY.
06 HUSBAND BUYS ITEM.
94 NOT APPLICABLE.
96 OTHER (SPECIFY) __________
614. What is the main source of income from which you and your family meet most of your financial needs?
OWN AND HUSBAND'S EARNINGS 02
OWN EARNINGS 03 (GO TO 617)
HUSBAND'S FAMILY INCOME 04 (GO TO 617)
OWN FAMILY INCOME 05 (GO TO 617)
ALIMOMY/CHILD SUPPORT 06 (GO TO 617)
OWN PENSION 07 (GO TO 617)
HUSBAND'S PENSION 08 (GO TO 617)
OTHER (SPECIFY) _____ 96 (GO TO 617)
615. If for some reason your husband was not there or not able to provide for you and your family financially, would you still be able to meet your financial needs somehow?
NO 2 (GO TO 617)
616. What is the principal way by which you would try and meet your financial needs?
INCOME FROM PROPERTY 2
FAMILY HELP 3
OTHER (SPECIFY) _______ 6
617. Are you a member of any type of association, organization or club which holds meetings?
NO 2 (GO TO 701)
618. What kind of association/organization/club is it? RECORD ALL MENTIOMED.
SAVINGS CLUB B
WOMAN'S ORGANIZATION C
LABOR UNION D
OTHER (SPECIFY) ______ X
619. Are both men and women members or only women?
BOTH MEN AND WOMEN 2
620. Do you attend meetings regularly, sometimes, or never?
SOMETIMES 2
NEVER 3
NO MEETINGS 6
621. Do you hold or have you ever held any special position in the association/organization/club?
NO 2 (GO TO 701)
622. What is the most important position that you have held? RECORD IN FULL.
SECTION 7. TREATMENT OF WOMEN IN THE HOUSEHOLD
701. Sometime a wife can do things which annoy or anger her husband. Please tell me if a husband is justified in beating his wife for each of the following situations:
NO 2
DON'T KNOW 8
NO 2
DON'T KNOW 8
NO 2
DON'T KNOW 8
NO 2
DON'T KNOW 8
NO 2
DON'T KNOW 8
NO 2
DON'T KNOW 8
702. Are there any (other) situations when a husband is justified in beating his wife?
NO 2 (GO TO 704)
NEVER JUSTIFIED IN BEATING WIFE 3 (GO TO 706)
703. What would you say is another such situation?
ALL RESPONSES ARE "NO" (GO TO 706)
705. In your opinion is it alright for a husband to beat his wife in front of anyone, or only in front of his children, or should he do it only when no one else is present?
ALRIGHT IN FRONT OF ANYONE 2
ONLY WHEN NO ONE PRESENT 3
NEVER ALRIGHT 4
DON'T KNOW 8
706. Do you think that a man who beats his wife regularly to discipline her is more of a man than one who does not beat his wife?
NO 2
DON'T KNOW 8
707. From the time you were married has anyone ever beaten you?
NO 2 (GO TO 726)
NO ANSWER 8 (GO TO 726)
708. Can you tell me who has done this to you since you were married? Anyone else? RECORD ALL NENTIONED.
FORMER HUSBAND B
FATHER C
BROTHER D
SON E
MOTHER F
FATHER-IN-LAW G
MOTHER-IN-LAW H
OTHER MALE RELATIVE l
OTHER FEMALE RELATIVE J
OTHER (SPECIFY) __________ X
NO ANSWER Y
ONLY ONE PERSON MENTIONED OR NO RESPONSE (GO TO 711)
710. Who is the person who beats you most often?
FATHER 01
BROTHER 03
SON 04
MOTHER 05
FATHER-IN-LAW 06
MOTHER-IN-LAW 07
OTHER MALE RELATIVE 08
OTHER FEMALE RELATIVE 09
OTHER (SPECIFY) __________ 96
NO ANSWER 98
711. Is this person always, sometimes or never "on something" (drugs or alcohol) when he/she beats you?
SOMETIMES 2
NEVER 3
NO ANSWER 8
712. Approximately, how many times were you beaten in the past one year?
THREE TO FIVE 2
ONE TO TWO 3
NOT BEATEN IN PAST YEAR 4
ONLY ONCE OR TWICE EVER 6
DON'T KNOW 8
713. What do you generally do when you are being beaten? CIRCLE ALL MENTIONED
JUST CRY B
HIT BACK C
YELL/SCREAM AT PERSON BEATING HER D
SCREAM FOR HELP E
THROW THINGS F
BEAT CHILDREN G
OTHER (SPECIFY) __________ X
714. What is the most common reason for which you are beaten?
BEATEN FOR NO REASON/FOR ANY REASON 94
DON'T KNOW 98
715. Generally, are you hurt as a result of a beating? PROBE: Any bruises, aches, or pains?
NO 2
OTHER 6
NO BIRTHS/ CURRENTLY PREGNANT (GO TO 719)
NO BIRTHS/NOT PREGNANT (GO TO 721)
717. Have you ever been beaten when you were pregnant?
NO 2 (GO TO 721)
718. Were you beaten more often or less often when you were pregnant, as compared to when you were not pregnant?
LESS OFTEN 2 (GO TO 721)
NO DIFFERENCE 3 (GO TO 721)
NOT BEATEN BEFORE PREGNANCY 4 (GO TO 721)
719. Since you became pregnant, have you ever been beaten?
NO 2 (GO TO 721)
720. Are you beaten more often or less often now that you are pregnant as compared to when you were not pregnant?
LESS OFTEN 2
SAME 3
NOT BEATEN BEFORE PREGNANCY 4
721. Have you ever been so seriously hurt during a beating that you needed medical attention even if you did not see a doctor?
NO 2 (GO TO 723)
NO ANSWER 5 (GO TO 723)
722. How often has this happened?
TWICE 2
THRICE 3
MORE THAN THREE TIMES 4
EVERY TIME BEATEN 5
OTHER (SPECIFY) _______ 6
723. Have you ever talked to anyone about the beatings to try and get help?
NO 2 (GO TO 725)
724. Can you tell me who you sought help from? RECORD ALL MENTIONED.
MOTHER B (GO TO 726)
SISTER C (GO TO 726)
HUSBAND D (GO TO 726)
FATHER E (GO TO 726)
BROTHER F (GO TO 726)
OTHER MALE RELATIVE G (GO TO 726)
OTHER FEMALE RELATIVE H (GO TO 726)
DOCTOR/MEDICAL PERSONNEL I (GO TO 726)
OTHER (SPECIFY) ______ X (GO TO 726)
725. What is the main reason you have never sought help?
NO USE 02
PART OF LIFE 03
AFRAID OF DIVORCE 04
AFRAID OF FURTHER BEATINGS 05
AFRAID OF GETTING PERSON BEATING HER INTO TROUBLE 06
EMBARASSED 07
OTHER (SPECIFY) __________ 96
MINUTES _____
THANK THE RESPONDENT FOR PARTICIPATING IN THE SURVEY, COMPLETE QUESTIONS 801-805 AS APPROPRIATE. BE SURE TO REVIEW THE QUESTIONNAIRE FOR COMPLETENESS BEFORE LEAVING THE HOUSEHOLD.
FAIR 2
GOOD 3
VERY GOOO 4
802. INTERVIEWER'S COMMENTS:
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803. FIELD EDITOR'S COMMENTS:
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804. SUPERVISOR'S/ASSISTANT SUPERVISOR'S COMMENTS:
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805. OFFICE EDITOR'S COMMENTS:
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