NATIONAL FAMILY HEALTH SURVEY (NFHS-2)
WOMAN'S QUESTIONNAIRE
INDIA 1998-99
STATE ________
DISTRICT ________
TEHSIL/TALUK _________
CITY/TOWN/VILLAGE ________
RURAL 2
LARGE CITY/SMALL CITY/TOWN/RURAL AREA _______
SMALL CITY 2
TOWN 3
RURAL AREA 4
PSU NUMBER ________
HOUSEHOLD HUMBER ________
NAME AND LINE NUMBER OF WOMAN ________
ADDRESS OF HOUSEHOLD ________
FIRST INTERVIEW (REPEAT FOR SECOND AND THIRD INTERVIEWS)
DATE ______
INTERVIEWER'S NAME ________
RESULT _______
2 NOT AT HOME
3 POSTPONED
4 REFUSED
5 PARTLY COMPLETED
6 OTHER (SPECIFY) _______
NEXT VISIT
DATE _______
TIME _______
FINAL VISIT
DAY _______
MONTH _______
YEAR 19______
NAME CODE _______
RESULT CODE _______
TOTAL NUMBER OF VISIT ________
NATIVE LANGUAGE OF RESPONDENT ______
02 BENGALI
03 ENGLISH
04 GUJARATI
05 HINDI
06 KANNADA
07 KASHMIRI
08 MALAYALAM
09 MANIPURI
10 MARATHI
11 NEPALI
12 ORIYA
13 PUNJABI
14 KONKANI
15 SINDHI
16 TAMIL
17 TELUGU
18 URDU
19 OTHER (SPECIFY) _______
SUPERVISOR
NAME _______
DATE _______
FIELD EDITOR
NAME _______
DATE _______
OFFICE EDITOR
NAME _______
DATE ______
KEYED BY
NAME ______
DATE ______
SECTION 1. RESPONDENT'S BACKGROUND
101. RECORD THE TIME
MINUTES ______
Namaste. My name is _______ and I am working with (NAME OF ORGANIZATION). We are conducting a national survey about the health of women, men, and children. We would very much appreciate your participation in this survey.
I would like to ask you about your health (and the health of your children). This information will help the government to plan health services. The amount of time needed will be less than one hour. Participation in this survey is voluntary. If you decide to participate, you may stop answering questions at any time. Whatever information you provide will be kept strictly confidential and will not be shown to other persons.
We hope that you will participate in this survey since your views is important. Do you want to ask me anything about the survey at this time?
SIGNATURE OF INTERVIWER ________
DATE ________
RESPONDENT DOES NOT AGREE TO BE INTERVIEWED 2 (END INTERVIEW)
First I would like to ask some questions about you and your household.
102. For most of the time until you were 12 years old, did you live in a city, a town, or a village?
VILLAGE 2
103. How long have you been living continuously in (NAME OF CURRENT PLACE OF RESIDENCE)?
SINCE BIRTH 95 (GO TO 105)
VISITOR 96 (GO TO 105)
104. Just before you moved here, did you live in a city, a town, or a village?
COUNTRYSIDE 2
105. In what month and year were you born?
DOESN'T KNOW MONTH 98
DOESN'T KNOW YEAR 9998
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?
MARRIED, GAUNA NOT PERFORMED 2 (END)
SEPARATED 3 (GO TO 110)
DESERTED 4 (GO TO 110)
DIVORCED 5 (GO TO 110)
WIDOWED 6 (GO TO 110)
NEVER MARRIED 7 (END)
108. Are you living with your husband now, or is he staying elsewhere?
STAYING ELSEWHERE 2
109. For how long have you and your husband not been living together?
IF LESS THAN 1 YEAR, RECORD MONTHS; OTHERWISE RECORD COMPLETED YEARS.
YEARS 2 ____
Now I would like to ask you some questions about your marriage.
110. Have you been married only once or more than once?
MORE THAN ONCE 2
111. How old were you at the time of your first marriage?
112. How old were you when you started living with your first husband?
GAUNA HAD NOT TAKEN PLACE 96
113. How old were you when your first marriage dissolved?
114. How old were you at the time of your (current) marriage?
115. How old were you when you started living with your (current) husband?
GAUNA HAD NOT TAKEN PLACE 96 (END)
116. Have you ever attended school?
NO 2 (GO TO 119)
117. What is the highest grade you completed?
GRADE 6 AND ABOVE (GO TO 120)
NO 2 (GO TO 121)
120. Do you usually read a newspaper or magazine at least once a week?
NO 2
121. Do you usually listen to a radio at least once a week?
NO 2
122. Do you watch television at least once a week?
NO 2
123. Do you usually go to a cinema hall or theatre to see a movie at least once a month?
NO 2
124. How often do you yourself consume the following items: daily, weekly, occasionally, or never:
Milk or Curd?
Pulses or beans?
Green leafy vegetables?
Other vegetables?
Fruits?
Eggs?
Chicken, meat, or fish?
WEEKLY 2
OCCASIONALLY 3
NEVER 4
WEEKLY 2
OCCASIONALLY 3
NEVER 4
WEEKLY 2
OCCASIONALLY 3
NEVER 4
WEEKLY 2
OCCASIONALLY 3
NEVER 4
WEEKLY 2
OCCASIONALLY 3
NEVER 4
WEEKLY 2
OCCASIONALLY 3
NEVER 4
WEEKLY 2
OCCASIONALLY 3
NEVER 4
Now I would like to ask about all the births you have had during your life.
201. 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 signs of life but 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 201-208 AS NECESSARY.
NO BIRTHS (GO TO 225)
Now I would like to record the names of all your births, whether still alive or not, starting with the first one you had.
211. RECORD NAMES OF ALL THE LIVE BIRTHS IN 212. RECORD TWINS AND TRIPLETS ON SEPARATE LINES. (IF THERE ARE MORE THAN 12 BIRTHS, USE AN ADDITIONAL QUESTIONNAIRE).
212. What name was given to your (first/next) baby?
213. Were any of these births twins?
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?
YEAR ____
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
218A. IF ALIVE: RECORD HOUSEHOLD LINE NUMBER OF CHILD
RECORD '00' IF CHILD NOT LISTED IN HOUSEHOLD
219. IF DEAD: How old was (NAME) when he/she died?
IF '1 YEAR', PROBE: How many months old was (NAME)?
RECORD DAYS IF LESS THAN TWO YEARS; OR YEARS.
MONTH 2 ____
YEARS 3 ____
220. Between (NAME OF PREVIOUS BIRTH) and (NAME OF THIS BIRTH) did you have any stillbirth, spontaneous abortion, or induced abortion?
FOR FIRST CHILD ASK: Before (NAME), did you have any stillbirth, spontaneous abotion, or induce abortion?
IF NONE, RECORD '0'. FOR SECOND TWIN, RECORD '0' IN EACH BOX WITHOUT ASKING.
NUMBER OF SPON.ABORTIONS ____
NUMBER OF INDUCED ABORTIONS ____
221. After the last birth, did you have any stillbirth, spontaneous abortion, or induce abortion?
IF NONE, RECORD '0'.
NUMBER OF SPON.ABORTIONS ____
NUMBER OF INDUCED ABORTIONS ____
222. CHECK 220 AND 221:
Just to make sure that I have this right: you have had in TOTAL ____STILLBIRTHS, ____ SPONTANEOUS ABORTIONS, and ___ INDUCED ABORTIONS during your life: Is that correct?
NO, PROBE AND CORRECT 220-221 AS NECESSARY
223. COMPARE 208 WITH NUMBER OF BIRTHS IN HISTORY ABOVE AND MARK:
FOR EACH LIVING CHILD: CURRENT AGE IS RECORDED.
FOR EACH DEAD CHILD: AGE AT DEATH IS RECORDED.
FOR AGE AT DEATH 12 MONTHS: PROBE TO DETERMINE EXACT NUMBER OF MONTHS.
FOR EACH CALENDAR BIRTH INTERVAL 4 OR MORE YEARS: EXPLANATION IS GIVEN.
224. CHECK 215 AND ENTER THE NUMBER OF BIRTHS SINCE JANUARY 1995.
IF NONE, RECORD '0'.
225. Have you ever had a stillbirth?
NO 2 (GO TO 227)
226. How many stillbirths have you had?
227. Have you ever had an abortion?
PROBE FOR SPONTANEOUS AND INDUCED ABORTIONS.
NO 2 (GO TO 229)
228. Have mnay abortions have you had?
PROBE FOR NUMBER OF SPONTANEOUS AND INDUCED ABORTIONS.
IF NONE, RECORD '0'.
NO. OF INDUCED ABORTIONS ____
SEPARATED/DESERTED/DIVORCED/WIDOWED (GO TO 301)
NO 2 (GO TO 233)
UNSURE 8 (GO TO 233)
231. How many months pregnant are you?
232. 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 have any (more) children at all?
LATER 2 (GO TO 301)
NO MORE 3 (GO TO 301)
233. When did your last menstrual period start?
WEEKS AGO 2 ____
MONTHS AGO 3 ____
YEARS AGO 4 ____
BEFORE LAST BIRTH 994
NEVER MENSTRUATED 995
301. During the last 12 months, has a health or family planning worker visited you at home?
NO 2 (GO TO 308)
302. How many times did a worker visit you in the last 12 months?
303. During these visits, what were the different matters talked about?
Anything else?
RECORD ALL MENTIONED.
BREASTFEEDING B
SUPPLEMENTARY FEEDING C
IMMUNIZATION D
NUTRITION E
DISEASE PREVENTION F
TREATMENT OF HEALTH PROBLEM G
ANTENATAL CARE H
DELIVERY CARE I
POSTPARTUM CARE J
CHILD CARE K
SANITATION/CLEANLINESS L
ORAL REHYDRATION M
OTHER (SPECIFY) _________ X
304. When was the last time a health or family planning worker visited you at home?
IF LESS THAN ONE MONTH, RECORD '00' MONTHS.
305. Who visited you at that time?
PUBLIC HEALTH NURSE 12
ANM/LHV 13
MALE MPW/SUPERVISOR 14
ANGANWADI WORKER 15
VILLAGE HEALTH GUIDE 16
OTHER PUBLIC SECTOR HEALTH WORKER 17
NGO WORKER 22
PRIVATE NURSE 32
COMPOUNDER 33
TRADITIONAL HEALER 34
DAI (TBA) 35
OTHER PRIVATE SECTOR HEALTH WORKER 36
305A. What type of services did you receive during this visit?
Any other service?
RECORD ALL MENTIONED.
CONDOM SUPPLY B
FOLLOW-UP FOR STERILIZATION C
FOLLOW-UP FOR IUD INSERTION D
FAMILY PLANNING ADVICE E
OTHER FAMILY PLANNING SERVICE F
IMMUNIZATION G
ANTENATAL CARE H
DELIVERY CARE I
POSTPARTUM CARE J
DISEASE PREVENTION K
MEDICAL TREATMENT FOR SELF L
TREATMENT FOR SICK CHILD M
TREATMENT FOR OTHER PERSON N
OTHER (SPECIFY) ________ X
306. Did she/he spend enough time with you?
NO 2
307. Did she/he talk to you nicely, somewhat nicely, or not nicely?
SOMEWHAT NICELY 2
NOT NICELY 3
308. Have you visited a health facility or camp for any reason for yourself (or your children) in the last 12 months?
NO 2 (GO TO 317)
309. During these visits in the last 12 months, what were the different matters talked about? Anything else?
RECORD ALL MENTIONED.
BREASTFEEDING B
SUPPLEMENTARY FEEDING C
IMMUNIZATION D
NUTRITION E
DISEASE PREVENTION F
TREATMENT OF HEALTH PROBLEM G
ANTENATAL CARE H
DELIVERY CARE I
POSTPARTUM CARE J
CHILD CARE K
SANITATION/CLEANLINESS L
ORAL REHYDRATION M
OTHER (SPECIFY) ________ X
310. What type of health facility did you visit most recently for yourself (or your children)?
GOVT. DISPENSARY 12
UHC/UHP/UFWC 13
CHC/RURAL HOSPITAL/PHC 14
SUB-CENTRE 15
GOVT. MOBILE CLINIC 16
CAMP 17
OTHER PUBLIC SECTOR HEALTH FACILITY 18
PVT. MOBILE CLINIC 32
PHARMACY/DRUGSTORE 33
OTHER PRIVATE SECTOR HEALTH FACILITY 34
311. What service did you go for?
Any other service?
RECORD ALL MENTIONED.
CONDOM SUPPLY B
IUD/LOOP INSERTION C
STERILIZATION OPERATION D
FOLLOW-UP FOR STERILIZATION E
FOLLOW-UP FOR IUD INSERTION F
FAMILY PLANNING ADVICE G
OTHER FAMILY PLANNING SERVICE H
IMMUNIZATION I
ANTENATAL CARE J
DELIVERY CARE K
POSTPARTUM CARE L
DISEASE PREVENTION M
MEDICAL TREATMENT FOR SELF N
TREATMENT FOR SICK CHILD O
TREATMENT FOR OTHER PERSON P
OTHER (SPECIFY) ________ X
311A. Did you receive the service that you went for?
NO 2
RECEIVED SERVICE:
How long did you have to wait before being served?
DID NOT RECEIVE SERVICE
How long did you have to wait before you learned that the service you went for would not be available?
HOURS 2 ____
NO WAIT AT ALL 995
OTHER (SPECIFY) ________ 996
313. During this visit did the staff spend enough time with you?
NO 2
314. Did the staff talk to you nicely, somewhat nicely, or not nicely?
SOMEWHAT NICELY 2
NOT NICELY 3
315. Did the staff respect your need for privacy?
NO 2
SAYS PRIVACY NOT NEEDED 3
316. Would you say the health facility was very clean, somewhat clean, or not clean?
SOMEWHAT CLEAN 2
NOT CLEAN 3
Now I would like to ask about all the contacts you have had with health or family planning workers at home or anywhere else in the last 12 months or ever before.
317. During any of these contacts, which methods of delaying or avoiding pregnancy were discussed, if any?
PROBE: Any other methods discussed?
RECORD ALL MENTIONED.
CONDOM/NIRODH B
IUD/LOOP C
FEMALE STERILIZATION D
MALE STERILIZATION E
RHYTHM/SAFE PERIOD F
WITHDRAWAL G
OTHER (SPECIFY) _______ X
NONE/NEVER DISCUSSED Y
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
318. For each method I mention, please tell me if you have ever heard of the method and whether you have ever used the method at any time in your life?
HAS HEARD, BUT HAS NOT USED 2
HAS NOT HEARD 3
HAS HEARD, BUT HAS NOT USED 2
HAS NOT HEARD 3
HAS HEARD, BUT HAS NOT USED 2
HAS NOT HEARD 3
HAS HEARD, BUT HAS NOT USED 2
HAS NOT HEARD 3
HAS HEARD, BUT HAS NOT USED 2
HAS NOT HEARD 3
HAS HEARD, BUT HAS NOT USED 2
HAS NOT HEARD 3
HAS HEARD, BUT HAS NOT USED 2
HAS NOT HEARD 3
LIST UP TO TWO METHODS.
HAS HEARD, BUT HAS NOT USED 2
HAS NOT HEARD 3
AT LEAST ONE CODE '1' (EVER USED) (GO TO 322)
320. Have you ever used anything or tried in any way to delay or avoid getting pregnant?
NO 2 (GO TO 356)
321. What have you used or done?
CORRECT 318 AND 319.
Now I would like to ask you about the time when you first did something or used a method to delay or avoid getting pregnant.
322. How many living children did you have at that time, if any?
IF NONE, RECORD '00'.
SEPARATED/DESERTED/DIVORCED/WIDOWED (GO TO 364)
PREGNANT (GO TO 358)
HE OR SHE STERILIZED (GO TO 327A)
326. Are you or your husband currently doing something or using any method to delay or avoid getting pregnant?
NO 2 (GO TO 355)
327. Which method are you using?
327A. CIRCLE '04' FOR FEMALE STERILIZATION.
CIRCLE '05' FOR MALE STERILIZATION.
CONDOM/NIRODH 02
IUD/LOOP 03 (GO TO 336)
FEMALE STERILIZATION 04 (GO TO 339)
MALE STERILIZATION 05 (GO TO 339)
RHYTHM/SAFE PERIOD 06 (GO TO 350)
WITHDRAWAL 07 (GO TO 350)
OTHER (SPECIFY) ________ 96 (GO TO 350)
328. For how many months have you been using pills/condoms continuously?
IF LESS THAN 1 MONTH, RECORD '00'.
8 YEARS OR LONGER 96
329. Where did you obtain the pills/condoms the last time?
IF SOURCE IS HOSPITAL OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF PLACE AND CIRCLE THE APPROPRIATE CODE.
GOVT. DISPENSARY 12 (GO TO 331)
UHC/UHP/UFWC 13 (GO TO 331)
CHC/RURAL HOSPITAL/PHC 14 (GO TO 331)
SUB-CENTRE 15 (GO TO 331)
GOVT. MOBILE CLINIC 16 (GO TO 331)
GOVT. PARAMEDIC 17 (GO TO 331)
CAMP 18 (GO TO 331)
OTHER PUBLIC SECTOR HEALTH FACILITY 19 (GO TO 331)
NGO WORKER 22 (GO TO 331)
PVT. DOCTOR 32 (GO TO 331)
PVT. MOBILE CLINIC 33 (GO TO 331)
PVT. PARAMEDIC 34 (GO TO 331)
VAIDYA/HAKIM/HOMEOPATH 35 (GO TO 331)
TRADITIONAL HEALER 36 (GO TO 331)
PHARMACY/DRUGSTORE 37 (GO TO 331)
DAI (TBA) 38 (GO TO 331)
OTHER PRIVATE SECTOR HEALTH FACILITY 39 (GO TO 331)
HUSBAND 42
FRIEND/OTHER RELATIVE 43
330. Do you know where this person obtained the pills/condoms the last time?
IF SOURCE IS HOSPITAL OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF PLACE AND CIRCLE THE APPROPRIATE CODE.
GOVT. DISPENSARY 12
UHC/UHP/UFWC 13
CHC/RURAL HOSPITAL/PHC 14
SUB-CENTRE 15
GOVT. MOBILE CLINIC 16
GOVT. PARAMEDIC 17
CAMP 18
OTHER PUBLIC SECTOR HEALTH FACILITY 19
NGO WORKER 22
PVT. DOCTOR 32
PVT. MOBILE CLINIC 33
PVT. PARAMEDIC 34
VAIDYA/HAKIM/HOMEOPATH 35
TRADITIONAL HEALER 36
PHARMACY/DRUGSTORE 37
DAI (TBA) 38
OTHER PRIVATE SECTOR HEALTH FACILITY 39
DOESN'T KNOW 98
331. May I see the packet of pills/condoms you are using now?
IF PACKET SEEN, RECORD BRAND NAME.
332. Do you know the brand name of the pills/condoms you are using now?
DOESN'T KNOW 998
333. How much does one packet of pills/condoms cost you?
DOESN'T KNOW 998 (GO TO 335)
334. For that cost how many condoms/pill cycles do you get?
335. Have you been able to get the supply of pills/condoms whenever you need them?
NO 2 (GO TO 344)
336. For how many months have you been using the IUD/LOOP continuously?
IF LESS THAN 1 MONTH, RECORD '00'.
8 YEARS OR LONGER 96
337. Who inserted the IUD/LOOP?
GOVERNMENT NURSE/PARAMEDIC 02
NGO DOCTOR 03
NGO NURSE/PARAMEDIC 04
PRIVATE DOCTOR 05
PRIVATE NURSE/PARAMEDIC 06
OTHER (SPECIFY) ________ 96
338. Where did you go to get the IUD/LOOP inserted?
GOVT. DISPENSARY 12
UHC/UHP/UFWC 13
CHC/RURAL HOSPITAL/PHC 14
SUB-CENTRE 15
GOVT. MOBILE CLINIC 16
CAMP 17
OTHER PUBLIC SECTOR HEALTH FACILITY 18
PVT. DOCTOR 32
PVT. MOBILE CLINIC 33
OTHER PRIVATE SECTOR HEALTH FACILITY 34
338A. How much did the IUD/LOOP insertion cost you?
IF NO CHARGE, RECORD `0000'.
DOESN'T KNOW 9998 (GO TO 342)
339. In what month and year was your/your husband's sterilization operation performed?
YEAR ____
340. Where did you/your husband get sterilized?
UHC/UHP/UFWC 12
CHC/RURAL HOSPITAL/PHC 13
GOVT. MOBILE CLINIC 14
CAMP 15
OTHER PUBLIC SECTOR HEALTH FACILITY 16
PVT. DOCTOR 32
PVT. MOBILE CLINIC 33
OTHER PRIVATE SECTOR HEALTH FACILITY 34
341. How much did the operation cost you?
IF NO CHARGE, RECORD '0000'.
DOESN'T KNOW 9998
342. How would you rate the care you/your husband received during or immediately after the operation/IUD insertion: very good, all right, not so good, or bad?
ALL RIGHT 2
NOT SO GOOD 3
BAD 4
343. What improvements would you suggest in the care you/your husband received during or immediately after the operation/IUD insertion? Anything else?
RECORD ALL MENTIONED.
MORE PRIVACY B
BETTER CARE BY THE DOCTOR C
BETTER CARE BY THE OTHER STAFF D
SHORTER WAITING TIME E
LOWER COST F
OTHER (SPECIFY) _______X
NONE Y
344. Who mainly motivated you to use (CURRENT METHOD)?
PUBLIC HEALTH NURSE 2
ANM/LHV 03
MALE MPW/SUPERVISOR 04
ANGANWADI WORKER 05
OTHER GOVT. HEALTH WORKER 06
NGO WORKER 07
PRIVATE DOCTOR 08
PRIVATE PARAMEDIC 09
DAI (TBA) 10
TEACHER 11
RELIGIOUS LEADER 12
POLITICAL LEADER 13
HUSBAND 14
MOTHER/MOTHER-IN-LAW 15
OTHER RELATIVE/FRIEND 16
NO ONE/SELF 17 (GO TO 347)
OTHER (SPECIFY) _______ 96
345. Did he/she tell you about any other methods that you might use?
NO 2 (GO TO 347)
346. Which other methods were you told about?
RECORD ALL MENTIONED.
CONDOM/NIRODH B
IUD/LOOP C
FEMALE STERILIZATION D
MALE STERILIZATION E
RHYTHM/SAFE PERIOD F
WITHDRAWAL G
OTHER (SPECIFY) _______ X
347. At the time when you accepted the (CURRENT METHOD) did any health or family planning worker tell you about side effects or other problems you might have using the (CURRENT METHOD)?
NO 2
348. Were you told what to do in case you experienced problems with the method?
NO 2
349. Did you receive any follow-up, either at home or in a health facility, after you accepted the (CURRENT METHOD)?
PROBE FOR TYPE OF VISIT.
IN A FACILITY ONLY 2 (GO TO 351)
BOTH 3 (GO TO 351)
NEITHER 4 (GO TO 351)
350. For how long have you been using this method continuously?
IF LESS THAN 1 MONTH, RECORD '00'.
8 YEARS OR LONGER 96
351. Have you had any problems related to the use of (CURRENT METHOD)?
NO 2 (GO TO 362)
352. What problems have you had related to the use of (CURRENT METHOD)?
PROBE: Any other problems?
RECORD ALL MENTIONED.
WEIGHT LOSS B
TOO MUCH BLEEDING C
HYPERTENSION D
HEADACHE/BODYACHE/BACKACHE E
NAUSEA/VOMITING F
NO MENSTRUATION G
WEAKNESS/TIREDNESS H
DIZZINESS I
FEVER J
CRAMPS K
SPOTTING L
INCONVENIENT TO USE M
ABDOMINAL PAIN N
WHITE DISCHARGE O
IRREGULAR PERIODS P
BREAST TENDERNESS Q
ALLERGY R
EXPULSION S
REDUCED SEXUAL SATISFACTION T
OTHER (SPECIFY) ________ X
353. When you first started having these problems, did you talk to anyone about these problems?
NO 2 (GO TO 362)
354. Who did you talk to about these problems?
Any other person?
RECORD ALL PERSONS TALKED TO.
PUBLIC HEALTH NURSE B (GO TO 362)
ANM/LHV C (GO TO 362)
ANGANWADI WORKER D (GO TO 362)
OTHER GOVT. HEALTH WORKER E (GO TO 362)
NGO DOCTOR F (GO TO 362)
NGO WORKER G (GO TO 362)
PRIVATE DOCTOR H (GO TO 362)
PRIVATE PARAMEDIC I (GO TO 362)
COMPOUNDER/PHARMACIST J (GO TO 362)
TRADITIONAL HEALER K (GO TO 362)
HUSBAND L (GO TO 362)
FRIEND/OTHER RELATIVE M (GO TO 362)
OTHER (SPECIFY) ________ X (GO TO 362)
355. What is the main reason you stopped using family planning?
LACK OF SEXUAL SATISFACTION 02 (GO TO 358)
CREATED MENSTRUAL PROBLEM 03 (GO TO 358)
CREATED HEALTH PROBLEM 04 (GO TO 358)
INCONVENIENT TO USE 05 (GO TO 358)
HARD TO GET METHOD 06 (GO TO 358)
PUT ON WEIGHT 07 (GO TO 358)
DID NOT LIKE THE METHOD 08 (GO TO 358)
WANTED TO HAVE A CHILD 09 (GO TO 358)
WANTED TO REPLACE DEAD CHILD 10 (GO TO 358)
LACK OF PRIVACY FOR USE 11 (GO TO 358)
HUSBAND AWAY 12 (GO TO 358)
COST TOO MUCH 13 (GO TO 358)
OTHER (SPECIFY) ________ 96 (GO TO 358)
SEPARATED/DESERTED/DIVORCED/WIDOWED (GO TO 364)
PREGNANT (GO TO 358)
357. What is the main reason you are not using a method of contraception to delay or avoid pregnancy?
INFREQUENT SEX 22
MENOPAUSAL/HAD HYSTERECTOMY 23 (GO TO 362)
SUBFECUND/INFECUND 24
POSTPARTUM/BREASTFEEDING 25
WANTS MORE CHILDREN 26
HUSBAND OPPOSED 32
OTHER PEOPLE OPPOSED 33
AGAINST RELIGION 34
KNOWS NO SOURCE 42
WORRY ABOUT SIDE EFFECTS 52
HARD TO GET METHOD 53
COSTS TOO MUCH 54
INCONVENIENT 55
AFRAID OF STERILIZATION 56
DON'T LIKE EXISTING METHODS 57
DOESN'T KNOW 98
358. Do you think you will use a method to delay or avoid pregnancy within the next 12 months?
NO 2
DOESN'T KNOW 8
359. Do you think you will use a method to delay or avoid pregnancy at any time in the future?
NO 2 (GO TO 361)
DOESN'T KNOW 8 (GO TO 361)
360. Which method would you prefer to use?
CONDOM/NIRODH 02 (GO TO 362)
IUD/LOOP 03 (GO TO 362)
FEMALE STERILIZATION 04 (GO TO 362)
MALE STERILIZATION 05 (GO TO 362)
RHYTHM/SAFE PERIOD 06 (GO TO 362)
WITHDRAWAL 07 (GO TO 362)
OTHER (SPECIFY) ________ 96 (GO TO 362)
DOESN'T KNOW/UNSURE 98 (GO TO 362)
361. What is the main reason that you think you will not use a family planning method at any time in the future?
INFREQUENT SEX 12
MENOPAUSAL/HAD HYSTERECTOMY 13
SUBFECUND/INFECUND 14
WANTS AS MANY CHILDREN AS POSSIBLE 15
HUSBAND OPPOSED 22
OTHER PEOPLE OPPOSED 23
AGAINST RELIGION 24
KNOWS NO SOURCE 32
WORRY ABOUT SIDE EFFECTS 42
HARD TO GET METHOD 43
COSTS TOO MUCH 44
INCONVENIENT 45
AFRAID OF STERILIZATION 46
DOESN'T LIKE EXISTING METHODS 47
DOESN'T KNOW 98
362. In the last few months, have you discussed the practice of family planning with your husband, friends, neighbors, or relatives?
NO 2 (GO TO 364)
363. With whom?
Anyone else?
RECORD ALL MENTIONED.
MOTHER B
SISTER(S) C
DAUGHTER D
MOTHER-IN-LAW E
SISTER-IN-LAW F
FRIEND/NEIGHBOUR G
OTHER (SPECIFY) ______ X
364. In the last few months, have you heard or seen any message about family planning:
on radio?
on television?
in a cinema or film show?
in a newspaper or magazine?
on a wall painting or hoarding?
in a drama, folk dance, or street play?
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
SECTION 4A. ANTENATAL, NATAL, AND POSTNATAL CARE
401. CHECK 224:
NO BIRTHS SINCE JAN. 1995 (GO TO 486)
402. ENTER THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF LAST TWO BIRTHS SINCE JANUARY 1995 IN THE TABLE. ASK THE QUESTIONS ABOUT THESE TWO BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 2 BIRTHS, RECORD ONLY LAST TWO BIRTHS.)
Now I would like to ask you some questions about the health of your children born since January 1995. (We will talk about one child at a time.)
LINE NUMBER FROM QUESTION 212:
FROM QUESTIONS 212 AND 216:
DEAD (GO TO 403)
403. 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 want no (more) children at all?
LATER 2
NO MORE 3 (GO TO 405)
404. How much longer would you like to have waited?
YEARS 2 ___
DOESN'T KNOW 998
405. When you were pregnant with (NAME), did you go for an antenatal check-up?
NO 2 (GO TO 407)
406. Whom did you see?
Anyone?
RECORD ALL PERSONS SEEN.
ANM/NURSE/MIDWIFE/LHV B
OTHER HEALTH PROFESSIONAL C
OTHER (SPECIFY) ________ X
407. When you were pregnant with (NAME), did any health worker visit you at home for an antenatal check-up?
NO 2
NO IN BOTH (GO TO 413)
409. How many months pregnant were you when you first received an antenatal check-up?
410. How many times did you receive antenatal check-ups during this pregnancy?
411. Did you have the following performed at least once during any of your antenatal check-ups for this pregnancy:
Weight measured?
Height measured?
Blood pressure checked?
Blood?
Urine?
Abdomen examined?
Internal exam?
X-ray?
Sonogram or ultrasound?
Amniocentesis?
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
412. Did you receive advice on any of the following during at least one of your antenatal check-ups for this pregnancy:
Diet?
Danger signs of pregnancy?
Delivery care?
Newborn care?
Family planning?
NO 2
NO 2
NO 2
NO 2
NO 2 (GO TO 414)
413. What is the main reason you did not receive an antenatal check-up?
NOT CUSTOMARY 02
COST TOO MUCH 03
TOO FAR/NO TRANSPORT 04
POOR QUALITY SERVICE 05
NO TIME TO GO 06
FAMILY DID NOT ALLOW 07
LACK OF KNOWLEDGE 08
NO HEALTH WORKER VISITED 09
OTHER (SPECIFY) ________ 96
414. When you were pregnant with (NAME), did you experience any of the following problems at any time:
Night blindness? (USE LOCAL TERM)
Blurred vision?
Convulsions not from fever?
Swelling of the legs, body, or face?
Excessive fatigue?
Anemia?
Any vaginal bleeding?
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
415. When you were pregnant with (NAME), were you given any iron folic tablets or syrup?
NO 2 (GO TO 418)
416. Did you receive enough iron folic tablets or syrup to last about three months or longer?
NO 2
DOESN'T KNOW 8
417. Did you consume all the iron folic tablets or syrup you were given ?
NO 2
418. When you were pregnant with (NAME), were you given an injection in the arm to prevent you and the baby from getting tetanus (USE LOCAL TERM FOR TETANUS)?
NO 2 (GO TO 420)
DOESN'T KNOW 8 (GO TO 420)
419. During this pregnancy, how many times did you get this injection?
DOESN'T KNOW 8
420. Where did you give birth to (NAME)?
PARENTS' HOME 12
OTHER HOME 13
GOVT. DISPENSARY 22 (GO TO 422)
UHC/UHP/UFWC 23 (GO TO 422)
CHC/RURAL HOSPITAL/PHC 24 (GO TO 422)
SUB-CENTRE 25 (GO TO 422)
OTHER PUBLIC SECTOR HEALTH FACILITY 26 (GO TO 422)
OTHER PRIVATE SECTOR HEALTH FACILITY 42 (GO TO 422)
421. What is the main reason you did not go to a health facility for delivery?
NOT CUSTOMARY 02
COST TOO MUCH 03
TOO FAR/NO TRANSPORT 04
POOR QUALITY SERVICE 05
NO TIME TO GO 06
FAMILY DID NOT ALLOW 07
BETTER CARE AT HOME 08
LACK OF KNOWLEDGE 09
OTHER (SPECIFY) ______ 96
422. Who assisted with the delivery of (NAME)? Anyone else?
PROBE FOR THE TYPE OF PERSON AND RECORD ALL PERSONS ASSISTING.
ANM/NURSE/MIDWIFE/LHV B
OTHER HEALTH PROFESSIONAL C
FRIEND/RELATIVE E
NO ONE Y
NO CODE A, B, OR C (GO TO 424)
424. What is the main reason you did not receive an antenatal check-up?
NOT CUSTOMARY 02 (GO TO 426)
COST TOO MUCH 03 (GO TO 426)
TOO FAR/NO TRANSPORT 04 (GO TO 426)
PROFESSIONAL NOT AVAILABLE 05 (GO TO 426)
NO CONFIDENCE IN AVAILABLE PROFFESIONAL 06 (GO TO 426)
NO TIME TO GET HELP 07 (GO TO 426)
FAMILY DID NOT ALLOW 08 (GO TO 426)
OTHER (SPECIFY) _______ 96 (GO TO 426)
425. Was (NAME) delivered by caesarian section?
NO 2
426. When (NAME) was born, was he/she: large, average, small, or very small?
AVERAGE 2
SMALL 3
VERY SMALL 4
427. Was (NAME) weighted at birth?
NO 2 (GO TO 429)
428. How much did (NAME) weigh?
DOESN'T KNOW 9998
Now I would like to ask you about the 2-month period after the delivery of (NAME).
429. During that period, did a doctor or other health professional check your health or the health of your baby?
NO 2 (GO TO 433)
430. How soon after the birth of (NAME) did you first get a check-up?
WEEKS 2 ____
431. Where did you get the check-up?
GOVT.DISPENSARY 22
UHC/UHP/UFWC 23
CHC/RURAL HOSPITAL/PHC 24
SUB-CENTER 25
OTHER PUBLIC SECTOR HEALTH FACILITY 26
OTHER PRIVATE SECTOR HEALTH FACILITY 42
432. Did any of the following happen when you had the check-up:
Was your abdomen examined?
Did you receive advice on family planning?
Did you receive advice on breastfeeding?
Did you receive advice on baby care?
NO 2
NO 2
NO 2
NO 2
433. At any time during the two months after the delivery of (NAME), did you have any of the following: Massive vaginal bleeding? Very high fever?
NO 2
NO 2
434. Has your period returned since the birth of (NAME)?
[ASK FOR MOST RECENT BIRTH ONLY]
NO 2 (GO TO 437)
435. Did your period return between the birth of (NAME) and your next pregnancy?
[ASK FOR SECOND-TO-LAST BIRTH ONLY]
NO 2 (GO TO 439)
436. For how many months after the birth of (NAME) did you not have a period?
DOESN'T KNOW 98
437. CHECK 230:
RESPONDENT PREGNANT?
[ASK FOR MOST RECENT BIRTH ONLY]
PREGNANT OR UNSURE (GO TO 439)
438. Have you resumed sexual relations since the birth of (NAME)?
[ASK FOR MOST RECENT BIRTH ONLY]
NO 2 (GO TO 440)
439. For how many months after the birth of (NAME) did you not have sexual relations?
DOESN'T KNOW 98
440. Did you ever breastfeed (NAME)?
NO 2
441. Why did you not breastfeed (NAME)?
CHILD ILL/WEAK 02 (GO TO 448)
CHILD DIED 03 (GO TO 448)
NIPPLE/BREAST PROBLEM 04 (GO TO 448)
INSUFFICIENT MILK 05 (GO TO 448)
MOTHER WORKING 06 (GO TO 448)
CHILD REFUSED 07 (GO TO 448)
OTHER (SPECIFY) ________ 96 (GO TO 448)
442. How long after birth did you first put (NAME) to the breast?
IF LESS THAN 1 HOUR, RECORD '00' HOURS. IF LESS THAN 24 HOURS, RECORD HOURS. OTHERWISE, RECORD DAYS.
HOURS 1 ____
DAYS 2 ____
443. Did you squeeze out the milk from the breast before you first put (NAME) to the breast?
NO 2
DEAD (GO TO 446)
445. Are you still breastfeeding (NAME)?
NO 2
446. For how many months did you breastfeed (NAME)?
UNTIL DIED 96 (GO TO 452)
447. Why did you stop breastfeeding (NAME)?
CHILD ILL/WEAK 02
CHILD DIED 03
NIPPLE/BREAST PROBLEM 04
INSUFFICIENT MILK 05
MOTHER WORKING 06
CHILD REFUSED 07
WEANING AGE 08
BECAME PREGNANT 09
STARTED USING CONTRACEPTION 10
OTHER (SPECIFY) ______ 96
DEAD (GO TO 452)
449. Did (NAME) drink anything from a bottle with a nipple yesterday or last night?
NO 2
DOESN'T KNOW 8
450. At any time yesterday or last night, was (NAME) given any of the following:
Plain water?
Powdered milk?
Any other milk (other than breast milk)?
Any other liquid?
Green, leafy vegetables?
Fruits?
Any other solid or mushy food?
NO 2
DOESN'T KNOW 8
NO 2
DOESN'T KNOW 8
NO 2
DOESN'T KNOW 8
NO 2
DOESN'T KNOW 8
NO 2
DOESN'T KNOW 8
NO 2
DOESN'T KNOW 8
NO 2
DOESN'T KNOW 8
451. How often during the last seven days was (NAME) given any of the following:
Plain water?
Powdered milk?
Any other milk (other than breast milk)?
Any other liquid?
Green, leafy vegetables?
Fruits?
Any other solid or mushy food?
2 SOME DAYS
3 NOT AT ALL
8 DOESN'T KNOW
2 SOME DAYS
3 NOT AT ALL
8 DOESN'T KNOW
2 SOME DAYS
3 NOT AT ALL
8 DOESN'T KNOW
2 SOME DAYS
3 NOT AT ALL
8 DOESN'T KNOW
2 SOME DAYS
3 NOT AT ALL
8 DOESN'T KNOW
2 SOME DAYS
3 NOT AT ALL
8 DOESN'T KNOW
2 SOME DAYS
3 NOT AT ALL
8 DOESN'T KNOW
452. FOR THE MOST RECENT BIRTH: GO BACK TO 403 IN NEXT COLUMN; OR, IF NO MORE BIRTHS, GO TO 453 FOR THE SECOND-TO-LAST BIRTH: GO TO 453
SECTION 4B. IMMUNIZATION AND HEALTH
453. ENTER THE LINE NUMBER AND NAME OF LAST TWO BIRTHS SINCE JANUARY 1995 IN THE TABLE. ASK THE QUESTIONS ABOUT THESE TWO BIRTHS. BEGIN WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 2 BIRTHS, RECORD ONLY LAST TWO BIRTHS.)
LINE NUMBER FROM QUESTION 212:
FROM QUESTIONS 212 AND 216:
DEAD (GO TO NEXT COLUMN/BIRTH OR, IF NO MORE BIRTHS, GO TO 481)
454. Do you have a card where (NAME'S) vaccinations are written down?
IF YES: May I see it please?
YES, NOT SEEN 2 (GO TO 458)
NO CARD 3
455. Did you ever have a vaccination card for (NAME)?
NO 2 (GO TO 458)
456. (1) COPY VACCINATION DATES FOR EACH VACCINE FROM THE CARD.
(2) WRITE '44' IN 'DAY' COLUMN IF CARD SHOWS THAT A VACCINATION WAS GIVEN, BUT NO DATE IS RECORDED.
MONTH _____
YEAR ____
MONTH _____
YEAR ____
MONTH _____
YEAR ____
MONTH _____
YEAR ____
MONTH _____
YEAR ____
MONTH _____
YEAR ____
MONTH _____
YEAR ____
MONTH _____
YEAR ____
MONTH _____
YEAR ____
457. Has (NAME) received any vaccinations that are not recorded on this card?
RECORD 'YES' ONLY IF RESPONDENT MENTIONS BCG, POLIO 0-3, DPT 1-3, AND/OR MEASLES VACCINE(S).
NO 2 (GO TO 460)
DOESN'T KNOW 8 (GO TO 460)
458. Did (NAME) ever receive any vaccinations to prevent him/her from getting diseases?
NO 2 (GO TO 462)
DOESN'T KNOW 8 (GO TO 462)
459. Please tell me if (NAME) received any of the following vaccinations:
459A. A BCG vaccination against tuberculosis, that is, an injection in the arm or shoulder that usually causes a scar?
NO 2
DOESN'T KNOW 8
459B. A DPT vaccination against diphtheria, whooping cough, and tetanus given as an injection?
NO 2 (GO TO 459D)
DOESN'T KNOW 8 (GO TO 459D)
459D. Polio vaccine, that is, drops in the mouth?
NO 2 (GO TO 459G)
DOESN'T KNOW 8 (GO TO 459G)
459F. When was the first polio vaccine given just after birth or later?
LATER 2
459G. An injection against measles?
NO 2 (GO TO 461)
DOESN'T KNOW 8 (GO TO 461)
460. CHECK 456:
ANY VACCINATIONS RECEIVED?
NO 2 (GO TO 462)
461. Where did (NAME) receive most of his/her vaccinations?
GOVT. DISPENSARY 12
UHC/UHP/UFWC 13
CHC/RUR. HOSP/PHC 14
SUB-CENTRE 15
GOVT. MOBILE CLINIC 16
CAMP 17
PULSE POLIO LOCATION 18
OTHER PUBLIC SECTOR HEALTH FACILITY 19
PVT. DOCTOR 32
PVT. MOBILE CLINIC 33
VAIDYA/HAKIM/HOMEOPATH 34
PHARMACY/DRUGSTORE 35
OTHER PRIVATE SECTOR HEALTH FACILITY 36
462. Was a dose of vitamin A liquid or capsule ever given to (NAME) to protect him/her from night blindness (USE LOCAL TERM)?
NO 2 (GO TO 464)
DOESN'T KNOW 8 (GO TO 464)
463. How many months ago did (NAME) receive the last dose of Vitamin A?
464. Has (NAME) been ill with a fever at any time in the last 2 weeks?
NO 2
DOESN'T KNOW 8
465. Has (NAME) been ill with a cough at any time in the last 2 weeks?
NO 2 (GO TO 469)
DOESN'T KNOW 8 (GO TO 469)
466. When (NAME) was ill with a cough, did he/she breathe faster than usual with short, rapid breaths?
NO 2
DOESN'T KNOW 8
467. Did you seek advice or treatment for the cough?
NO 2 (GO TO 469)
468. Where did you seek advice or treatment?
Anywhere else?
RECORD ALL MENTIONED.
GOVT. DISPENSARY B
UHC/UHP/UFWC C
CHC/RURAL HOSPITAL/PHC D
SUB-CENTRE E
GOVT. MOBILE CLINIC F
GOVT. PARAMEDIC G
CAMP H
OTHER PUBLIC SECTOR HEALTH FACILITY I
NGO WORKER K
PVT. DOCTOR M
PVT. MOBILE CLINIC N
PVT. PARAMEDIC O
VAIDYA/HAKIM/HOMEOPATH P
TRADITIONAL HEALER Q
PHARMACY/DRUGSTORE R
OTHER PRIVATE HEALTH FACILITY S
FRIEND/RELATIVE U
469. Has (NAME) had diarrhoea in the last two weeks?
NO 2 (GO TO 480)
DOESN'T KNOW 8 (GO TO 480)
470. Was there any blood in the stools?
NO 2
471. (Including breast milk) Was he/she given the same amount to drink as before the diarrhoea, or more, or less?
MORE 2
LESS 3
DOESN'T KNOW 8
472. Was he/she given the same amount of food as before the diarrhoea, or more, or less?
MORE 2
LESS 3
STOPPED COMPLETELY 4
DOESN'T KNOW 8
473. Did you seek advice or treatment for the diarrhoea?
NO 2 (GO TO 475)
474. Where did you seek advice or treatment?
Anywhere else?
RECORD ALL MENTIONED.
GOVT. DISPENSARY B
UHC/UHP/UFWC C
CHC/RURAL HOSPITAL/PHC D
SUB-CENTRE E
GOVT. MOBILE CLINIC F
GOVT. PARAMEDIC G
CAMP H
OTHER PUBLIC SECTOR HEALTH FACILITY I
NGO WORKER K
PVT. DOCTOR M
PVT. MOBILE CLINIC N
PVT. PARAMEDIC O
VAIDYA/HAKIM/HOMEOPATH P
TRADITIONAL HEALER Q
PHARMACY/DRUGSTORE R
OTHER PRIVATE HEALTH FACILITY S
FRIEND/RELATIVE U
475. When (NAME) had diarrhoea, was he/she given any of the following to drink:
A fluid made from a special packet called [LOCAL NAME]?
Gruel made from rice [OR OTHER LOCAL GRAIN, TUBER, OR PLANTAIN]?
NO 2
DOESN'T KNOW 8
NO 2
DOESN'T KNOW 8
476. CHECK 475:
FLUID FROM ORS PACKET GIVEN?
NO OR DOESN'T KNOW (GO TO 478)
477. Where did you obtain the ORS packet?
GOVT. DISPENSARY 12
UHC/UHP/UFWC 13
CHC/RURAL HOSPITAL/PHC 14
SUB-CENTRE 15
GOVT. MOBILE CLINIC 16
GOVT. PARAMEDIC 17
OTHER PUBLIC SECTOR HEALTH FACILITY 18
NGO WORKER 22
PVT. DOCTOR 32
PVT. MOBILE CLINIC 33
VAIDYA/HAKIM/HOMEOPATH 34
PVT. PARAMEDIC 35
PHARMACY/DRUGSTORE 36
DAI(TBA) 37
OTHER PRIVATE SECTOR HEALTH FACILITY 38
HUSBAND 42
FRIEND/OTHER RELATIVE 43
478. Was anything (else) given to treat the diarrhoea?
NO 2 (GO TO 480)
DOESN'T KNOW 8 (GO TO 480)
479. What was given to treat the diarrhoea?
Anything else?
RECORD ALL MENTIONED.
INJECTION B
INTRAVENOUS (I.V./DRIP/BOTTLE) C
HOMEMADE SUGAR-SALT-WATER SOLUTION D
HOME REMEDY/HERBAL MEDICINE E
OTHER (SPECIFY) ______ X
480. FOR THE LAST BIRTH, GO BACK TO 454 IN NEXT COLUMN; OR, IF NO MORE BIRTHS, GO TO 481. FOR THE NEXT-TO-LAST BIRTH, GO TO 481.
ORS FLUID FROM PACKET NOT GIVEN TO ANY CHILD OR 475 NOT ASKED (GO TO 482)
482. Have you ever heard of a special product called (LOCAL TERM FOR ORS) you can get for the treatment of diarrhoea?
IF SHE NEVER HEARD OF ORS, SHOW GOVERNMENT AND COMMERCIAL ORS PACKETS AND ASK: Have you ever seen a packet like one of these before?
YES, AFTER SHOWING PACKETS 2
NO 3
483. When a child has diarrhoea, 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
DOESN'T KNOW 8
484. When a child is sick with diarrhoea, what signs of illness would tell you that he or she should be taken to a health facility or health worker? Any other signs?
RECORD ALL MENTIONED.
ANY WATERY STOOLS B
REPEATED VOMITING C
ANY VOMITING D
BLOOD IN STOOLS E
FEVER F
MARKED THIRST G
NOT EATING/NOT DRINKING WELL H
GETTING SICKER/VERY SICK I
NOT GETTING BETTER J
OTHER (SPECIFY) _______ X
DOESN'T KNOW Z
485. 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?
Any other signs?
RECORD ALL MENTIONED.
DIFFICULT BREATHING B
NOISY BREATHING C
FEVER D
UNABLE TO DRINK E
NOT EATING/NOT DRINKING WELL F
GETTING SICKER/VERY SICK G
NOT GETTING BETTER H
OTHER (SPECIFY) _______ X
DOESN'T KNOW Z
Now I would like to ask you about some health symptoms you yourself may have.
486. During the past three months, have you had any of the following problems with your vaginal discharge:
Any itching or irritation in vaginal area with the discharge?
A bad odour along with the discharge?
Severe lower abdominal pain with the discharge, not related with menstruation?
A fever along with the discharge?
Any other problem with the discharge?
NO 2
NO 2
NO 2
NO 2
NO 2
487. During the past three months have you had a problem with pain or burning while urinating, or have you had more frequent or difficult urination?
NO 2
SEPARATED/DESERTED/DIVORCED/WIDOWED (GO TO 491)
489. Another problem some women have is feeling pain in their abdomen or vagina during intercourse. Do you often experience this kind of pain?
NO 2
490. Do you ever see blood after having sex, at times when you are not menstruating?
NO 2
491. CHECK 486, 487, 489 AND 490:
OTHER (GO TO 501)
492. Have you seen anyone for advice or treatment to help you with (this problem/these problems)?
IF YES, ASK: Whom did you see? Anyone else?
RECORD ALL PERSONS SEEN.
PUBLIC HEALTH NURSE B
ANM/LHV C
MALE MPW/SUPERVISOR D
ANGANWADI WORKER E
VILLAGE HEALTH GUIDE F
OTHER PUBLIC SECTOR HEALTH WORKER G
PRIVATE NURSE J
COMPOUNDER/PHARMACIST K
VAID/HAKIM/HOMEOPATH L
DAI(TBA) M
TRADITIONAL HEALER N
OTHER PRIVATE SECTOR HEALTH WORKER O
NO, NOBODY SEEN Y
SECTION 5A. FERTILITY PREFERENCES
501. CHECK 107:
SEPARATED/DESERTED/DIVORCED/WIDOWED (GO TO 507)
HE OR SHE STERILIZED (GO TO 507)
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 506)
SAYS SHE CAN'T GET PREGNANT 3 (GO TO 507)
UP TO GOD 4 (GO TO 506)
UNDECIDED/DOESN'T KNOW 8 (GO TO 506)
504. Would you prefer your next child to be a boy or a girl or doesn't it matter?
GIRL 2
DOESN'T MATTER 3
UP TO GOD 4
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 993
OTHER (SPECIFY) _______ 996
DOESN'T KNOW 998
NOT PREGNANT OR UNSURE
Do you think your husband would like to have (a/another) child or do you think he would prefer not have any (more) children?
PREGNANT
After the child you are expecting, do you think your husband would like to have another child or do you think he would prefer not have any more children?
NO MORE/NONE 2
UP TO GOD 3
UNDECIDED 4
DOESN'T KNOW 8
HAS LIVING CHILD(REN)
If you could go back to the time you did not have any children and could choose exactly the number of children to have in your whole life, how many would that be?
NO LIVING CHILDREN
If you could choose exactly the number of to have in exactly the number of children to have in your whole life, how many would that be?
RECORD SINGLE NUMBER OR OTHER ANSWER.
OTHER ANSWER (SPECIFY) _______96 (GO TO 509)
508. How many of these children would you like to be boys, how many would you like to be girls, and for how many would the sex not matter?
GIRLS _____
EITHER _____
509. In your opinion, how much education should be given to girls these days?
LESS THAN PRIMARY 02
PRIMARY 03
MIDDLE 04
HIGH SCHOOL 05
HIGHER SECONDARY 06
GRADUATE AND ABOVE 07
PROFESSIONAL DEGREE 08
AS MUCH AS SHE DESIRES 09
DEPENDS 10
DOESN'T KNOW 98
510. In your opinion, how much education should be given to boys these days?
LESS THAN PRIMARY 02
PRIMARY 03
MIDDLE 04
HIGH SCHOOL 05
HIGHER SECONDARY 06
GRADUATE AND ABOVE 07
PROFESSIONAL DEGREE 08
AS MUCH AS HE DESIRES 09
DEPENDS 10
DOESN'T KNOW 98
511. Who makes the following decisions in your household:
What items to cook?
Obtaining health care for yourself?
Purchasing jewellery or other major household items?
Your going and staying with parents or siblings?
2 HUSBAND
3 JOINTLY WITH HUSBAND
4 OTHERS IN HOUSEHOLD
5 JOINTLY WITH OTHERS IN HOUSEHOLD
2 HUSBAND
3 JOINTLY WITH HUSBAND
4 OTHERS IN HOUSEHOLD
5 JOINTLY WITH OTHERS IN HOUSEHOLD
2 HUSBAND
3 JOINTLY WITH HUSBAND
4 OTHERS IN HOUSEHOLD
5 JOINTLY WITH OTHERS IN HOUSEHOLD
2 HUSBAND
3 JOINTLY WITH HUSBAND
4 OTHERS IN HOUSEHOLD
5 JOINTLY WITH OTHERS IN HOUSEHOLD
512. Do you need permission to: go to the market? To visit relatives or friends?
NO 2
NOT ALLOWED TO GO 3
NO 2
NOT ALLOWED TO GO 3
513. Are you allowed to have some money set aside that you can use as you wish?
NO 2
514. Sometimes a wife can do things that bother her husband. Please tell me if you think that a husband is justified in beating his wife in each of the following situations:
If he suspects her of being unfaithful?
If her natal family does not give expected money, jewellery, or other items?
If she shows disrespect for in-laws?
If she goes out without telling him?
If she neglects the house or children?
If she doesn't cook food properly?
NO 2
DOESN'T KNOW 8
NO 2
DOESN'T KNOW 8
NO 2
DOESN'T KNOW 8
NO 2
DOESN'T KNOW 8
NO 2
DOESN'T KNOW 8
NO 2
DOESN'T KNOW 8
515. Since you completed 15 years of age, have you been beaten or mistreated physically by any person?
NO 2 (GO TO 601)
516. Who has beaten you or mistreated you physically?
Anyone else?
RECORD ALL PERSONS MENTIONED.
FATHER B
STEP MOTHER C
STEP FATHER D
SON E
DAUGHTER F
BROTHER/SISTER G
BOYFRIEND H
HUSBAND I
EX-HUSBAND J
SON-IN-LAW K
DAUGHTER-IN-LAW L
MOTHER-IN-LAW M
FATHER-IN-LAW N
BROTHER-IN-LAW O
SISTER-IN-LAW P
OTHER RELATIVE Q
FRIEND/ACQUAINTANCE R
TEACHER S
EMPLOYER T
STRANGER U
OTHER (SPECIFY) ______ X
517. How often have you been beaten or mistreated physically in the last 12 months: once, a few times, many times, or not at all?
A FEW TIMES 2
MANY TIMES 3
NOT BEATEN 4
SECTION 6. HUSBAND'S BACKGROUND AND WOMAN'S WORK
601. CHECK 107:
SEPARATED/DESERTED/DIVORCED/WIDOWED (GO TO 603)
602. How old was your husband on his last birthday?
603. Did your (last) husband ever attend school?
NO 2 (GO TO 606)
604. What is the highest grade he completed?
GRADE 6 AND ABOVE (GO TO 607)
606. (Can/Could) he read and write?
NO 2
607. What kind of work (does/did) your (last) husband mainly do?
DOES (DID) NOT WORK ON FARM (GO TO 610)
609. (Does/did) your husband work mainly on his own land or family land, or (does/did) he rent land, or (does/did) he work on someone else's land?
FAMILY LAND 2
RENTED LAND 3
SOMEONE ELSE'S LAND 4
610. Aside from your own housework, are you currently working?
NO 2
611. 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. Are you currently doing any of these things or any other work?
NO 2
612. Have you done any work in the last 12 months?
NO 2 (GO TO 701)
613. What is your occupation, that is, what kind of work do/did you mainly do?
614. Do you do this work for your family's farm or business, for someone else, or are you self-employed?
SOMEONE ELSE 2
SELF-EMPLOYED 3
615. 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
616. Are you paid in cash or kind for this work, or are you not paid at all?
CASH AND KIND 2
KIND ONLY 3 (GO TO 619)
NOT PAID 4 (GO TO 619)
617. Generally, how much do your earnings contribute to the total family earnings: almost none, less than half, about half, more than half, or all?
LESS THAN HALF 2
ABOUT HALF 3
MORE THAN HALF 4
ALL 5
618. Who mainly decides how the money you earn will be used?
HUSBAND DECIDES 2
JOINTLY WITH HUSBAND 3
SOMEONE ELSE DECIDES 4
JOINTLY WITH SOMEONE ELSE 5
619. Do you usually work at home or away from home?
AWAY 2
620. CHECK 215/218:
HAS CHILD BEEN BORN SINCE JAN. 1995 AND LIVING AT HOME?
NO (GO TO 701)
621. While you are working, do you usually have (NAME OF YOUNGEST CHILD AT HOME) with you, sometimes have him/her with you, or never have him/her with you?
SOMETIMES 2
NEVER 3
622. Who usually takes care of (NAME OF YOUNGEST CHILD AT HOME) while you are working?
OLDER BOYS 02
OLDER GIRLS 03
OTHER RELATIVES 04
NEIGHBOURS 05
FRIENDS 06
SERVANTS/HIRED HELP 07
CHILD IS IN SCHOOL 08
INSTITUTIONAL CHILDCARE 09
OTHER (SPECIFY) _______96
701. Have you ever heard of an illness called AIDS?
NO 2 (GO TO 705)
702. From which sources of information have you learned about AIDS?
Any other source?
RECORD ALL MENTIONED.
TELEVISION B
CINEMA C
NEWSPAPERS/MAGAZINES D
POSTERS/HOARDINGS E
EXHIBITION/MELA F
HEALTH WORKERS G
ADULT EDUCATION PROGRAMME H
RELIGIOUS LEADERS I
POLITICAL LEADERS J
SCHOOLS/TEACHERS K
COMMUNITY MEETINGS L
FRIENDS/RELATIVES M
WORK PLACE N
OTHER (SPECIFY) ______X
703. Is there anything a person can do to avoid getting AIDS?
NO 2 (GO TO 705)
DOESN'T KNOW 8 (GO TO 705)
704. What can a person do?
Any other ways?
RECORD ALL MENTIONED.
USE CONDOMS B
HAVE ONLY ONE SEX PARTNER C
AVOID SEX WITH COMMERCIAL SEX WORKERS D
AVOID SEX WITH HOMOSEXUALS E
AVOID BLOOD TRANSFUSIONS F
AVOID INJECTIONS/USE CLEAN NEEDLES G
AVOID I.V. DRUG USE H
AVOID KISSING I
AVOID HUGGING J
AVOID HAND SHAKING K
AVOID SHARING CLOTHES L
AVOID SHARING UTENSILS M
AVOID SHARING SHAVING KITS/RAZORS N
AVOID STEPPING ON URINE/STOOL O
AVOID MOSQUITO BITES P
OTHER (SPECIFY)________X
DOESN'T KNOW Z
MINUTES _____
706. PRESENCE OF OTHERS DURING MOST OF THE INTERVIEW TIME.
NO 2
NO 2
NO 2
NO 2
NO 2
FIRST VISIT (REPEAT FOR SECOND AND THIRD VISIT)
DATE _____
INVESTIGATOR'S NAME _____
RESULT _____
2 NOT AT HOME
3 POSTPONED
4 REFUSED
5 PARTLY COMPLETED
6 OTHER (SPECIFY)______
NEXT VISIT
DATE ______
TIME _____
FINAL VISIT
DAY ____
MONTH ____
YEAR 19__
NAME CODE ____
RESULT CODE ____
INTERVIEWER: IN 801 (COLUMNS 23) RECORD THE LINE NUMBER FOR EACH CHILD BORN SINCE JANUARY 1995 AND STILL ALIVE. IN 802 AND 803 RECORD THE NAME OF THE RESPONDENT AND ALL HER LIVING CHILDREN BORN SINCE JANUARY 1995, AND THE DATE OF BIRTH OF THE CHILDREN. IN 804 AND 806 RECORD THE HEIGHT AND WEIGHT OF THE RESPONDENT AND LIVING CHILDREN.
(NOTE: IF THERE ARE MORE THAN 2 LIVING CHILDREN BORN SINCE JANUARY 1995, CHECK BOX AND USE ADDITIONAL QUESTIONNAIRE)
[REPEAT QUESTIONS 801-809 FOR RESPONDENT, LAST BIRTH, AND NEXT-TO-LAST BIRTH]
801. LINE NUMBER FROM QUESTION 212
[DO NOT ASK FOR MOST RECENT BIRTH]
802. NAME FROM QUESTION 212 FOR CHILDREN
803. DATE OF BIRTH
[DO NOT ASK FOR MOST RECENT BIRTH]
FROM QUESTION 215 FOR CHILDREN, COPY MONTH AND YEAR OF BIRTH AND ASK FOR DAY OF BIRTH
MONTH_____
YEAR_____
805. WAS HEIGHT/LENGTH OF CHILD MEASURED LYING DOWN OR STANDING UP?
[DO NOT ASK FOR MOST RECENT BIRTH]
STANDING 2
807. DATE WEIGHED AND MEASURED
MONTH _____
YEAR _____
NOT PRESENT 2
REFUSED 3
OTHER (SPECIFY) ______ 6
CHILD SICK 2
CHILD NOT PRESENT 3
CHILD DID NOT ALLOW 4
MOTHER REFUSED 5
OTHER (SPECIFY) ______ 6
809. NAME OF MEASURER _______
NAME OF ASSISTANT_______
901. As a part of this survey, we are studying anaemia among women and children. We request your cooperation in this regard. This will assist the Government of India to develop programs to prevent and treat anaemia.
Anaemia is a serious health problem in India, which results from poor nutrition. However, if a person is found to have anaemia, the person can be given iron folic tablets to cure the disease.
[We are also doing research on lead poisoning among children and we request your cooperation in this regard. This will assist the Government of India to develop programs to prevent and treat lead poisoning. The benefit to you is that you will learn whether your child has a high lead exposure that needs to be addressed. If children are exposed to too much lead from the environment around them, it can harm their intelligence, growth and hearing and can contribute to anaemia. However, it is possible to take steps to decrease the amount of lead that a child is exposed to. Children with severe lead poisoning can get medical treatment.]
If you decide to be tested for anaemia, we will request that you give a drop of blood from your finger for the test. (Also, if you have a child under 3 years old, please allow me to take a (few) drop(s) of blood from him/her for anaemia [and lead] testing). We will use disposable sterile instruments that are clean and completely safe. Your child will feel a slight pinch when the blood is drawn. There is essentially no risk to your child from this procedure. The blood will be analyzed with new equipment provided by the United Nations. The result(s) of the test(s) will be given to you right after the blood is taken. The results of the tests will be kept confidential and will not be shown to other persons. Are there any questions about the blood testing that you would like to ask me now?
May I ask you now to give your consent to have the test(s) done. If you decide not to have the test(s), it is your right, and we will respect your decision. Now please tell me whether you agree to have the test(s) (and allow me to test your child).
AFTER EXPLAINING THE ABOVE, I HAVE FOUND THAT (NAME OF RESPONDENT) AGREED TO GIVE A (FEW) DROP(S) OF BLOOD FOR HERSELF [AND FOR HER CHILD (REN) NAMED (NAME OF CHILD(REN))]
SIGNATURE OF INTERVIEWER ________
DATE ________
RESPONDENT DOES NOT AGREE TO TESTING 2 (GO TO 914)
SIGNATURE OF WITNESS ________
DATE ________
(STATEMENTS ABOUT IN SQUARE BRACKETS WERE ADDED ONLY FOR USE IN DELHI AND MUMBAI)
902. RESPONDENT'S HAEMOGLOBIN LEVEL (G/DL)
REFUSED 2
OTHER (SPECIFY) _______6
NO LIVING CHILDREN BORN SINCE JANUARY 1995 (GO TO 910)
[IN 905 RECORD THE LINE NUMBER FOR EACH CHILD BORN SINCE JANUARY 1995 AND STILL ALIVE. IN 906 RECORD THE NAMES OF THE LIVING CHILDREN. IN 907 RECORD THE HAEMOGLOBIN LEVEL IN THE BLOOD OF THE LIVING CHILDREN.
(NOTE:IF THERE ARE MORE THAN 2 LIVING CHILDREN BORN SINCE JANUARY 1995, CHECK BOX AND USE ADDITIONAL QUESTIONNAIRE)]
905. LINE NUMBER FROM QUESTION 212
907. HAEMOGLOBIN LEVEL IN THE BLOOD (G/DL)
907A. CHECK SAMPLE:
IS PSU IN LEAD TESTING SAMPLE?
NO 2 (GO TO 908)
907B. LEAD LEVEL IN THE BLOOD (µg/dL)
CHILD SICK 2
CHILD NOT PRESENT 3
CHILD DID NOT ALLOW 4
MOTHER REFUSED 5
OTHER (SPECIFY) _______ 6
909. NAME OF MEASURER ________
ANY VALUE BELOW 7 G/DL FOR MOTHER AND/OR CHILD(REN), GIVE MOTHER RESULT OF HAEMOGLOBIN MEASUREMENT (GO TO 911)
911. CHECK COLUMN (5) OF HOUSEHOLD SCHEDULE:
RESPONDENT IS VISITOR (END INTERVIEW)
912. We detected a low level of haemoglobin in your (your child's) blood. This indicates you (your child) have developed severe anaemia, which is a serious health problem. We would like to inform the doctor at _______ about your (your child's) condition. This will assist you to obtain appropriate treatment of your (your child's) condition.
Do you agree that the information about the level of haemoglobin in your (your child's) blood may be given to the doctor.
AFTER EXPLAINING THE ABOVE, I HAVE FOUND THAT (NAME OF RESPONDENT)
AGREED FOR REFERRAL FOR HERSELF [AND FOR HER CHILD(REN), (NAME OF CHILD(REN))]
SIGNATURE OF INTERVIEWER ________
DATE ________
RESPONDENT DOES NOT AGREE FOR REFERRAL 2 (GO TO 913A)
913. RECORD NAMES OF WOMAN AND CHILD (REN) WITH HAEMOGLOBIN LEVEL LESS THAN 7 G/DL ON REFERRAL FORM.
913A. CHECK 907B:
NO VALUES OF 45 µg/dL OR ABOVE, GIVE MOTHER RESULT OF LEAD MEASUREMENT (GO TO 914)
ANY VALUE OF 45 µg/dL OR ABOVE, GIVE MOTHER RESULT OF LEAD MEASUREMENT (GO TO 913B)
913B. We detected a high level of lead in your child's blood. This indicates your child has developed lead poisoning, which is a serious health problem. We would like to inform the doctor at________ about your child's condition. This will assist you to obtain appropriate treatment of your child's condition.
Do you agree that the information about the level of lead in your child's blood may be given to the doctor?
AFTER EXPLAINING THE ABOVE, I HAVE FOUND THAT (NAME OF RESPONDENT)
AGREED FOR REFERRAL FOR HER CHILD(REN), (NAME OF CHILD(REN)).
SIGNATURE OF INVESTIGATOR________
DATE ________
RESPONDENT DOES NOT AGREE TO REFERRAL 2 (GO TO 914)
SIGNATURE OF WITNESS _______
DATE ________
DELHI, MAHARASHTRA, AND TAMIL NADU ONLY:
914. Would you mind if we come again for a similar study at some future date after a year or so?
DOES NOT AGREE TO REVISIT 2
INTERVIEWER'S OBSERVATIONS
(TO BE FILLED OUT AFTER COMPLETING INTERVIEW)
COMMENTS ABOUT RESPONDENT _______
COMMENTS ON SPECIFIC QUESTIONS _______
ANY OTHER COMMENTS ______
SUPERVISOR'S OBSERVATIONS/COMMENTS _______
NAME OF SUPERVISOR _______
DATE ______
EDITOR'S OBSERVATIONS/COMMENTS _______
NAME OF EDITOR _______
DATE ______
RESULTS OF HAEMOGLOBIN MEASUREMENT IN THE BLOOD
DATE _______
HAEMOGLOBIN LEVEL IN THE BLOOD (G/DL):
G/DL ________
G/DL ________
G/DL ________
WHO CLASSIFICATION OF ANAEMIA:
- NORMAL LEVEL: HB LEVEL ABOVE 11 G/DL
- MILD ANAEMIA: HB (10-10.9 G/DL)
- MODERATE ANAEMIA: HB (7-9.9 G/DL)
- SEVERE ANAEMIA HB (LESS THAN 7 G/DL)
MILD ANAEMIA
MODERATE ANAEMIA
SEVERE ANAEMIA
MILD ANAEMIA
MODERATE ANAEMIA
SEVERE ANAEMIA
MILD ANAEMIA
MODERATE ANAEMIA
SEVERE ANAEMIA
In case of severe anaemia (Hb less than 7 G/DL), we recommend that you immediately contact your doctor.
DELHI AND MAHARASHTRA ONLY: RESULTS OF LEAD MEASUREMENT IN THE BLOOD
DATE _______
LEAD LEVEL IN THE BLOOD (µg/dL):
µg/dL ________
µg/dL ________
CLASSIFICATION OF LEAD LEVELS:
(BASED ON CLASSIFICATION SYSTEM OF CENTRE FOR DISEASE CONTROL AND PREVENTION OF THE UNITED STATES)
- CLASS I: PB LEVEL BELOW 10 µg/DL
- CLASS II: PB LEVEL 10-19 µg/DL
- CLASS III: PB LEVEL 20-44 µg/DL
- CLASS IV: PB LEVEL 45-65 µg/DL
- CLASS V: PB LEVEL ABOVE 65 µg/DL
CLASS II
CLASS III
CLASS IV
CLASS V
CLASS II
CLASS III
CLASS IV
CLASS V
CLASS I indicates no exposure to lead or exposure below the level of concern.
CLASS II and CLASS III indicate some exposure to lead has occurred. Families should attempt to minimize exposure to lead.
CLASS IV and CLASS V indicate children should be referred to a clinician for confirmation of blood lead level, medical evaluation and treatment.
In case of severe lead poisoning (Pb above 65 µg/DL, CLASS V), we recommend that you contact your doctor for immediate treatment.