LESOTHO DEMOGRAPHIC AND HEALTH SURVEY
MAN'S QUESTIONNAIRE
IDENTIFICATION
PLACE NAME ___________________
NAME OF HOUSEHOLD HEAD ______________
EA NUMBER
HOUSEHOLD NUMBER
FOOTHILLS 2
MOUNTAINS 3
SENQU RIVER VALLEY 4
DISTRICT
URBAN/RURAL
RURAL 2
HOUSEHOLD SELECTED FOR MALE SURVEY
NO 2
INTERVIEWER VISITS
INTERVIEWER VISIT 1
DATE __________
INTERVIEWER'S NAME __________
RESULT* ________
NEXT VISIT:
DATE _______
TIME _______
INTERVIEWER VISIT 2
DATE __________
INTERVIEWER'S NAME __________
RESULT* ________
NEXT VISIT:
DATE _______
TIME _______
INTERVIEWER VISIT 3
DATE __________
INTERVIEWER'S NAME __________
RESULT* ________
FINAL VISIT
DAY _____
MONTH _____
YEAR _____
INT. NUMBER ______
RESULT _____
TOTAL NUMBER OF VISITS _____
TOTAL PERSONS IN HOUSEHOLD ______
TOTAL ELIGIBLE WOMEN _____
TOTAL ELIGIBLE MEN _____
LINE NO. OF RESPONDENT TO HOUSEHOLD QUESTIONNAIRE _____
*RESULT CODES:
COMPLETED 1
NO HOUSEHOLD MEMBER AT HOME OR NO COMPETENT RESPONDENT AT HOME AT TIME OF VISIT 2
ENTIRE HOUSEHOLD ABSENT FOR EXTENDED PERIOD OF TIME 3
POSTPONED 4
REFUSED 5
DWELLING VACANT OR ADDRESS NOT A DWELLING 6
DWELLING DESTROYED 7
DWELLING NOT FOUND 8
OTHER (SPECIFY) ________ 9
SUPERVISOR
NAME _______
DATE _______
FIELD EDITOR
NAME _______
DATE _______
OFFICE EDITOR ___ ___
KEYD BY ___ ___
01=BUTHA-BUTHE; 02=LERIBE; 03=BEREA; 04=MASERU; 05=MAFETENG; 06=MOHALE'S HOEK; 07=QUTHING; 08=QASHA'S NEK; 09=MOKHOTLONG; 10=THABA-TSEKA
SECTION 1. RESPONDENT'S BACKGROUND
INTRODUCTION AND CONSENT
INFORMED CONSENT
Hello. My name is __________________ and I am working with the Ministry of Health and Social Welfare. We are conducting a national survey about the health of men, women and children. We would very much appreciate your participation in this survey. I would like to ask you about your health. This information will help the government to plan health services. The survey usually takes between 20 and 45 minutes to complete. Whatever information you provide will be kept strictly confidential and will not be shown to other persons.
At this time, do you want to ask me anything about the survey?
May I begin the interview now?
Signature of interviewer:________________________
Date:____________________________________________
RESPONDENT AGREES TO BE INTERVIEWED 1 GO TO
RESPONDENT DOES NOT AGREE TO BE INTERVIEWED 2 GO TO END
MINUTES ___ ___
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 an urban or in a rural area?
RURAL 2
103 How long have you been living continuously in (NAME OF CURRENT PLACE OF RESIDENCE)?
IF LESS THAN ONE YEAR, RECORD '00' YEARS.
ALWAYS 95 GO TO 105
VISITOR 96 GO TO 105
104 Just before you moved here, did you live in an urban or in a rural area?
RURAL 2
105 In the last 12 months, on how many separate occasions have you traveled away from this household and slept away?
NONE 00 GO TO 107
106 In the last 12 months, have you been away from your home community for more than 1 month at a time?
NO 2
107 In what month and year were you born?
DON'T KNOW MONTH 98
YEAR ___ ___ ___ ___
DON'T KNOW YEAR 9998
108 How old were you at your last birthday?
AGE IN COMPLETED YEARS ___ ___
109 Have you ever attended school?
NO 2 GO TO 116
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP
110 What is the highest level of school you attended?
VOCAT/TECHN. TRAINING AFTER PRIMARY 2
SECONDARY/HIGH 3
VOCAT/TECHN. TRAINING AFTER SECONDARY/HIGH 4
COLLEGE 5
GRADUATE/POST GRADUATE 6
111 What is the highest (standard/form/year) you completed at that level?
AGE 25 OR ABOVE GO TO 115
113 Are you currently attending school?
NO 2 GO TO 115
114 What is the main reason you are not attending school?
CARE FOR YOUNGER CHILDREN 02
FAMILY NEEDED HELP ON FARM OR IN BUSINESS 03
COULD NOT PAY SCHOOL FEES 04
NEEDED TO WORK FOR MONEY 05
GRADUATED 06
DID NOT PASS ENTRANCE EXAMS 07
DID NOT LIKE SCHOOL 08
SCHOOL NOT ACCESSIBLE/ TOO FAR 09
OTHER __________(SPECIFY) 96
DON'T KNOW 98
SECONDARY OR HIGHER GO TO 119
116 Now I would like you to read this sentence to me.
SHOW CARD TO RESPONDENT.
IF RESPONDENT CANNOT READ WHOLE SENTENCE, PROBE:
Can you read any part of the sentence to me?
ABLE TO READ ONLY PARTS OF SENTENCE 2
ABLE TO READ WHOLE SENTENCE 3
NO CARD WITH REQUIRED LANGUAGE _________ (SPECIFY LANGUAGE) 4
BLIND/VISUALLY IMPAIRED 5
117 Have you ever participated in a literacy program or any other program that involves learning to read or write (not including primary school)?
NO 2
CODE '1' OR '5' CIRCLED GO TO 120
119 Do you read a newspaper or magazine almost every day, at least once a week, less than once a week or not at all?
AT LEAST ONCE A WEEK 2
LESS THAN ONCE A WEEK 3
NOT AT ALL 4 GO TO 120
119A What kind of newspapers or magazines do you read: Lesotho newspapers/magazines, RSA newspapers/magazines, or any other?
RECORD ALL MENTIONED.
RSA NEWSPAPER/MAGAZINE B
OTHER _______________(SPECIFY) X
120 Do you listen to the radio almost every day, at least once a week, less than once a week or not at all?
AT LEAST ONCE A WEEK 2
LESS THAN ONCE A WEEK 3
NOT AT ALL 4 GO TO 121
120A What kind of radio do you listen to: Lesotho radio, RSA radio, or any other?
RECORD ALL MENTIONED.
RSA RADIO B
OTHER _________________ (SPECIFY) X
121 Do you watch television almost every day, at least once a week, less than once a week or not at all?
AT LEAST ONCE A WEEK 2
LESS THAN ONCE A WEEK 3
NOT AT ALL 4 GO TO 122
121A What kind of TV do you watch: Lesotho TV, RSA TV, or any other?
RECORD ALL MENTIONED.
RSA TV B
OTHER ________________ (SPECIFY) X
122 Are you currently working?
NO 2 GO TO 125
123 Have you done any work in the last 12 months?
NO 2 GO TO 125
124 What have you been doing for most of the time over the last 12 months?
LOOKING FOR WORK 2
RETIRED 3
UNABLE TO WORK,
ILL/HANDICAPPED 4
HOUSEWORK/CHILDCARE 5
OTHER _______________ (SPECIFY) 6
ALL GO TO 132
125 What is your occupation, that is, what kind of work do you mainly do?
__________________ ____ ____
DOES NOT WORK IN AGRICULTURE GO TO 128
127 Do you work mainly on your own land or on family land, or do you work on land that you rent from someone else, or do you work on someone else's land?
FAMILY LAND 2
RENTED LAND 3
SOMEONE ELSE'S LAND 4
128 During the last 12 months, how many months did you work?
129 Are/were you paid in cash or kind for this work, or are you not paid at Are/were you paid in cash or kind for this work, or are you not paid at all?
CASH AND KIND 2
IN KIND ONLY 3 GO TO 132
NOT PAID 4 GO TO 132
130 Who mainly decides how the money you earn will be used?
WIFE/PARTNER 2
RESPONDENT AND WIFE/PARTNER JOINTLY 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE JOINTLY 5
131 On average, how much of your household's expenditures do your earnings pay for: 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
NONE, HIS INCOME IS ALL SAVED 6
132 What religion do you belong to?
IF CHRISTIAN: What church do you belong to?
LESOTHO EVANGELICAL CHURCH 02
METHODIST 03
ANGLICAN CHURCH 04
SEVENTH DAY ADVENTIST 05
PENTECOSTAL 06
OTHER CHRISTIAN 07
NONE 08
OTHER RELIGION _________________ (SPECIFY) 96
1. Parents love their children.
2. Farming is hard work.
3. Birds fly in the sky.
4. Children work hard at school.
Appendix E | 375
201 Now I would like to ask about any children you have had during your life. I am interested only in the children that are biologically yours.
Have you ever fathered any children with any woman?
NO 2
DON'T KNOW 8 GO TO 206
202 Do you have any sons or daughters that you have fathered 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 you have fathered 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 fathered a son or a daughter who was born alive but later died?
IF NO, PROBE: Any baby who cried or showed signs of life but did not survive?
NO 2 GO TO 208
DON'T KNOW 8 GO TO 208
207 How many boys have died? And how many girls have died?
IF NONE, RECORD '00'.
GIRLS DEAD ___ ___
208 (In addition to the children that you have just told me about), do you have:
a) any other living sons or daughters who are biologically your children but who are not legally yours or do not have your last name?
b) any other sons or daughters who died who were biologically your children but who were not legally yours or did not have your last name?
YES TO EITHER PROBE AND EITHER 201-207 AS NECESSARY.
209 SUM ANSWERS TO 203, 205, AND 207, AND ENTER TOTAL.
IF NONE, RECORD '00'.
HAD HAD ONLY ONE CHILD GO TO 213
HAS OT HAD ANY CHLDREN GO TO 301
211 Do the children that you have fathered all have the same biological mother?
NO 2 GO TO 213
212 In all, how many women have you fathered children with?
213 How old were you when your (first) child was born?
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.
CIRCLE CODE 1 IN 301 FOR EACH METHOD MENTIONED SPONTANEOUSLY. THEN PROCEED DOWN COLUMN 301, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 1 IF METHOD IS RECOGNIZED,
AND CODE 2 IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE 1 CIRCLED IN 301, ASK 302 IF APPLICABLE.
301 Which ways or methods have you heard about?
FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK:
NO 2
NO 2 (GO TO NEXT)
NO 2
NO 2
NO 2
NO 2
NO 2 (GO TO NEXT)
NO 2
NO 2
NO 2 (GO TO NEXT)
NO 2
NO 2 (GO TO NEXT)
NO 2 (GO TO NEXT)
NO 2
NO 2
____________________(SPECIFY)
NO 2
302 Have you (or your partner) ever used (METHOD)?
Have you ever had an operation to avoid having any more children?
NO
NO 2
NO 2
NO 2
DON'T KNOW 8
NO 2 GO TO NEXT
NO 2
____________________(SPECIFY)
NO 2
303 Now I would like to ask you about a woman's risk of pregnancy.
From one menstrual period to the next, are there certain days when a woman is more likely to become pregnant if she has sexual relations?
NO 2
DON'T KNOW 8 GO TO 305
304 Is this time just before her period begins, during her period, right after her period has ended, or halfway between two periods?
DURING HER PERIOD 2
RIGHT AFTER HER PERIOD
HAS ENDED 3
HALFWAY BETWEEN TWO PERIODS 4
OTHER _______________(SPECIFY) 6
DON'T KNOW 8
305 Do you think that a woman who is breastfeeding her baby can become pregnant?
NO 2
DEPENDS 3
DON'T KNOW 8
306 I would like to ask you about the first time that you or your partner did something or used a method to avoid pregnancy.
How many living children did you have at that time, if any?
DON'T KNOW 98
307 How old were you when you first started using something to avoid impregnating someone?
308 I will now read you some statements about contraception. Please tell me if you agree or disagree with each one.
a) Contraception is women's business and a man should not have to worry about it.
DISAGREE 2
DK 8
b) Women who use contraception may become promiscuous.
DISAGREE 2
DK 8
c) A woman is the one who gets pregnant so she should be the one to use contraception.
DISAGREE 2
DK 8
d) A woman who uses contraceptives might have a problem getting pregnant.
DISAGREE 2
DK 8
309 CHECK 301(02) AND 302(02): KNOWLEDGE AND USE OF MALE STERILIZATION
OTHER GO TO 401
310 Once you have had all the children you want, would you yourself ever consider getting sterilized?
WOULD NOT CONSIDER 2
UNSURE/DEPENDS 3 GO TO 401
WIFE ALREADY STERILIZED 4 GO TO 401
311 Why would you never consider getting sterilized?
PROBE: Any other reasons?
RECORD ALL REASONS MENTIONED.
BAD FOR MAN'S HEALTH B
OPERATION NOT SAFE C
LESS INTRUSIVE WAYS AVAILABLE D
MAY WANT MORE CHILDREN /MAY WANT TO REPLACE CHILD WHO DIED E
MAY REMARRY SOME DAY F
LOSS OF WAGES G
LOSS OF SEXUAL FUNCTION H
LOSS OF MANLINESS I
OTHER ______________(SPECIFY) X
SECTION 4. MARRIAGE, SEXUAL ACTIVITY AND CONTRACEPTIVE USE
401 Are you currently married or living with a partner?
NOTE TO INTERVIEWER: 'MARRIED' MEANS HAVING GOTTEN MARRIED THROUGH TRADITIONAL, CIVIL AND/OR RELIGIOUS CEREMONY.
YES, LIVING WITH A WOMAN 2 GO TO 404
NO, NOT IN UNION 3 GO TO 405
402 Do you have one wife or more than one wife?
IF ONLY ONE WIFE, ENTER '01'.
IF MORE THAN ONE, ASK: How many wives do you currently have?
403 Are there any other women with whom you live as if married?
NO 2 GO TO 405
404 Are you living with one (other) woman or more than one (other) woman as if married?
IF ONE LIVE-IN PARTNER, ENTER '01'.
IF MORE THAN ONE, ASK: How many women are you living with as if married?
405 Apart from the woman/women you have already mentioned, do you currently have any other regular or occasional sexual partners?
OCCASIONAL PARTNER(S) ONLY 2
REGULAR AND OCCASIONAL PARTNERS 3
NO SEXUAL PARTNER 4
ALL GO TO 409
406 Do you currently have any regular sexual partners, occasional sexual partners, or do you have no sexual partner at all?
OCCASIONAL PARTNER(S) ONLY 2
REGULAR AND OCCASIONAL PARTNERS 3
NO SEXUAL PARTNER 4
407 Have you ever been married or lived with a woman?
YES, LIVED WITH A WOMAN ONLY 2 GO TO 411
YES, BOTH 3
NO 4 GO TO 416
408 What is your marital status now: are you widowed, divorced, or separated?
DIVORCED 2
SEPARATED 3
COHABITING 4
ALL GO TO 411
409 WRITE THE LINE NUMBERS FROM THE HOUSEHOLD QUESTIONNAIRE FOR EACH WIFE/PARTNER REPORTED IN QUESTIONS 402 AND 404 ONLY. IF A WIFE/PARTNER IS NOT LISTED IN THE HOUSEHOLD
SCHEDULE, ENTER '00' IN THE LINE NUMBER BOXES. THE NUMBER OF LINES FILLED IN MUST BE EQUAL TO THE NUMBER OF WIVES AND PARTNERS. (IF RESPONDENT HAS MORE THAN FIVE WIVES/PARTNERS
USE ADDITIONAL QUESTIONNAIRE(S).
CHECK: 402 AND 404
SUM OF 402 AND 404 = 1
Please tell me the name of your wife/partner.
SUM OF 402 AND 404 > 1
Please tell me the name of each wife/partner that you live with, starting with the one you lived with first.
WIFE/PARTNER NUMBER/ LINE NUMBER IN HOUSEHOLD QUESTIONNAIRE
1 ____________________________________________________ ___ ___
2 ____________________________________________________ ___ ___
3 ____________________________________________________ ___ ___
4 ____________________________________________________ ___ ___
5 ____________________________________________________ ___ ___
6_____________________________________________________ ___ ___
7 ____________________________________________________ ___ ___
8 ____________________________________________________ ___ ___
9 ____________________________________________________ ___ ___
10____________________________________________________ ___ ___
MORE THAN ONE WIFE/PARNTER GO TO 412
411 Have you been married or lived with a woman only once or more than once?
MORE THAN ONCE 2 GO TO 413
412 Have you ever been married to or lived as if married to any woman other than those you have just mentioned?
NO 2 GO TO 414
413 In total, how many women have you been married to or lived with as if married in your whole life?
414 CHECK 409 AND 411:
ONLY ONE WIFE/PARNTER AND 411=1
In what month and year did you start living with your wife/partner?
OTHER
Now we will talk about your first wife/partner. In what month and year did you start living with her?
DON'T KNOW MONTH 98
YEAR ___ ___ ___ ___ GO TO 418
DON'T KNOW YEAR 9998
415 How old were you when you started living with her?
416 Now I need to ask you some questions about sexual activity in order to gain a better understanding of some health issues.
How old were you when you first had sexual intercourse with a woman (if ever)?
AGE IN YEARS ___ ___
FIRST TIME WHEN STARTED LIVING WITH (FIRST) WIFE/PARTNER 95
25-59 YEARS OLD GO TO 417
416B The first time you had sexual intercourse, was a male or female condom used?
YES, FEMALE CONDOM 2
NO 3
417 When was the last time you had sexual intercourse with a woman?
RECORD 'YEARS AGO' ONLY IF LAST INTERCOURSE WAS ONE OR MORE YEARS AGO.IF 12 MONTHS OR MORE, ANSWER MUST BE
RECORDED IN YEARS.
WEEKS AGO 2___ ___
MONTHS AGO 3___ ___
YEARS AGO 4 ___ ___ GO TO 445
418 The last time you had sexual intercourse, did you or your partner use any contraception/protection?
NO 2 GO TO 420
DON'T KNOW/UNSURE 8 GO TO 423A
419 What method of contraception/protection was used the last time you had sex?
IF MORE THAN ONE METHOD USED, RECORD THE HIGHEST METHOD ON THE LIST.
MALE STERILIZATION 02
PILL 03
IUCD 04
INJECTABLES 05
IMPLANTS 06
MALE CONDOM 07
FEMALE CONDOM 08
DIAPHRAGM 09
FOAM/JELLY 10
LACTATIONAL AMEN. METHOD 11
PERIODIC ABSTINENCE 12
WITHDRAWAL 13
LOCAL TRADITIONAL METHOD 14
OTHER ________________(SPECIFY) 96
ALL GO TO 421
420 What is the reason a method was not used? Any other reasons?
RECORD ALL MENTIONED.
CONTRACEPTION WOMEN'S BUSINESS B
FERTILITY-RELATED REASONS
COUPLE SUBFECUND/INFECUND D
WIFE/PARTNER WAS PREGNANT E
WIFE/PARTNER WAS POSTPARTUM AMENORRHEIC F
WIFE/PARTNER WAS BREASTFEEDING G
WANTED (MORE) CHILDREN H
WIFE/PARTNER OPPOSED J
OTHERS OPPOSED K
RELIGIOUS PROHIBITION L
KNOWS NO SOURCE N
FEAR OF SIDE EFFECTS P
LACK OF ACCESS/TOO FAR Q
COST TOO MUCH R
INCONVENIENT TO USE S
INTERFERES WITH BODY'S NORMAL PROCESSES T
DON'T KNOW Z
ALL GO TO 423A
OTHER METHOD USED ALL GO TO 423
422 What was the main reason you used a condom on that occasion?
RESPONDENT WANTED TO PREVENT PREGNANCY 02
RESPONDENT WANTED TO PREVENT BOTH STD/HIV AND PREGNANCY 03
DID NOT TRUST PARTNER/FELT PARTNER HAD OTHER PARTNERS 04
PARTNER REQUESTED/INSISTED 05
OTHER ___________________ (SPECIFY) 96
DON'T KNOW 98
ALL GO TO 423A
423 What is main reason you did not use a condom that time?
COST TOO MUCH 02
USED FAMILY PLANNING METHOD 03
CONDOMS TRANSMIT HIV 04
CONDOMS HAVE WORMS 05
TRUSTED PARTNER 06
PARTNER WAS NEGATIVE/NO RISK 07
RESPONDENT DOESN'T LIKE 08
PARTNER REFUSED/OBJECTED 09
PARTNER DRUNK/ON DRUGS 10
RESPONDENT DRUNK/ON DRUGS 11
PARTNER WANTED TO GET PREGNANT 12
OTHER _______________ (SPECIFY) 96
423A The last time you had sexual intercourse with this person, did you or this person drink alcohol?
NO 2 GO TO 424
423B Were you or your partner drunk at that time?
IF YES: Who was drunk?
PARTNER ONLY 2
BOTH RESPONDENT AND PARTNER 3
NEITHER 4
424 What is your relationship to this woman?
IF WOMAN IS "GIRLFRIEND" OR "FIANCÉE", ASK:
Was your girlfriend/fiancé living with you when you last had sex with her?
IF YES, CIRCLE '01'.
IF NO, CIRCLE '02'.
WOMAN IS GIRLFRIEND/FIANCÉE 02
OTHER FRIEND 03
CASUAL ACQUAINTANCE 04
RELATIVE 05
WOMAN IS PROSTITUTE 06
OTHER ____________ (SPECIFY) 96
425 For how long (have you had/did you have) sexual relations with this woman?
IF ONLY HAD SEXUAL RELATIONS WITH THIS WOMAN ONCE, RECORD '01' DAYS.
WEEKS 2 ___ ___
MONTHS 3 ___ ___
YEARS 4 ___ ___ ___ ___
426 Have you had sex with any other woman in the last 12 months?
NO 2 GO TO 445
427 The last time you had sexual intercourse with this second woman, did you or your partner use any contraception/protection ?
NO 2 GO TO 429
DON'T KNOW/UNSURE 8 GO TO 432A
428 What method of contraception/protection was used the last time you had sex?
IF MORE THAN ONE METHOD USED, RECORD THE HIGHEST METHOD ON THE LIST.
MALE STERILIZATION 02
PILL 03
IUCD 04
INJECTABLES 05
IMPLANTS 06
MALE CONDOM 07
FEMALE CONDOM 08
DIAPHRAGM 09
FOAM/JELLY 10
LACTATIONAL AMEN. METHOD 11
PERIODIC ABSTINENCE 12
WITHDRAWAL 13
LOCAL TRADITIONAL METHOD 14
OTHER ____________(SPECIFY) 96
429 What is the reason a method was not used? Any other reasons?
RECORD ALL MENTIONED.
CONTRACEPTION WOMEN'S BUSINESS B
FERTILITY-RELATED REASONS
COUPLE SUBFECUND/INFECUND D
WIFE/PARTNER WAS PREGNANT E
WIFE/PARTNER WAS POSTPARTUM AMENORRHEIC F
WIFE/PARTNER WAS BREASTFEEDING G
WANTED (MORE) CHILDREN H
WIFE/PARTNER OPPOSED J
OTHERS OPPOSED K
RELIGIOUS PROHIBITION L
KNOWS NO SOURCE N
FEAR OF SIDE EFFECTS P
LACK OF ACCESS/TOO FAR Q
COST TOO MUCH R
INCONVENIENT TO USE S
INTERFERES WITH BODY'S NORMAL PROCESSES T
DON'T KNOW Z
ALL GO TO 432A
OTHER METHOD USED GO TO 432
431 What was the main reason you used a condom on that occasion?
RESPONDENT WANTED TO PREVENT PREGNANCY 02
RESPONDENT WANTED TO PREVENT BOTH STD/HIV AND PREGNANCY 03
DID NOT TRUST PARTNER/FELT PARTNER HAD OTHER PARTNERS 04
PARTNER REQUESTED/INSISTED 05
OTHER __________________(SPECIFY) 96
DON'T KNOW 98
ALL GO TO 432A
432 What is the main reason you did not use a condom that time?
COST TOO MUCH 02
USED FAMILY PLANNING METHOD 03
CONDOMS TRANSMIT HIV 04
CONDOMS HAVE WORMS 05
TRUSTED PARTNER 06
PARTNER WAS NEGATIVE/NO RISK 07
RESPONDENT DOESN'T LIKE 08
PARTNER REFUSED/OBJECTED 09
PARTNER DRUNK/ON DRUGS 10
RESPONDENT DRUNK/ON DRUGS 11
PARTNER WANTED TO GET PREGNANT 12
OTHER _________________(SPECIFY) 96
432A The last time you had sexual intercourse with this second person, did you or this person drink alcohol?
NO 2 GO TO 433
432B Were you or your partner drunk at that time?
IF YES: Who was drunk?
PARTNER ONLY 2
BOTH RESPONDENT AND PARTNER 3
NEITHER 4
433 What is your relationship to this woman?
IF WOMAN IS "GIRLFRIEND" OR "FIANCÉE", ASK:
Was your girlfriend/fiancé living with you when you last had sex with her?
IF YES, CIRCLE '01'.
IF NO, CIRCLE '02'.
WOMAN IS GIRLFRIEND/FIANCÉE 02
OTHER FRIEND 03
CASUAL ACQUAINTANCE 04
RELATIVE 05
WOMAN IS PROSTITUTE 06
OTHER ________(SPECIFY) 96
434 For how long (have you had/did you have) sexual relations with this woman?
IF ONLY HAD SEXUAL RELATIONS WITH THIS WOMAN ONCE, RECORD '01' DAYS.
WEEKS 2___ ___
MONTHS 3___ ___
YEARS 4___ ___
435 Other than these two women, have you had sex with any other woman in the last 12 months?
NO 2 GO TO 445
436 The last time you had sexual intercourse with this third woman, did you or your partner use any contraception/ protection?
NO 2 GO TO 438
DON'T KNOW/UNSURE 8 GO TO 441A
437 What method of contraception/protection was used the last time you had sex?
IF MORE THAN ONE METHOD USED, RECORD THE HIGHEST METHOD ON THE LIST.
MALE STERILIZATION 02
PILL 03
IUCD 04
INJECTABLES 05
IMPLANTS 06
MALE CONDOM 07
FEMALE CONDOM 08
DIAPHRAGM 09
FOAM/JELLY 10
LACTATIONAL AMEN. METHOD 11
PERIODIC ABSTINENCE 12
WITHDRAWAL 13
LOCAL TRADITIONAL METHOD 14
OTHER _____________ (SPECIFY) 96
ALL GO TO 439
438 What is the reason a method was not used? Any other reasons?
RECORD ALL MENTIONED.
CONTRACEPTION WOMEN'S BUSINESS B
FERTILITY-RELATED REASONS
COUPLE SUBFECUND/INFECUND D
WIFE/PARTNER WAS PREGNANT E
WIFE/PARTNER WAS POSTPARTUM AMENORRHEIC F
WIFE/PARTNER WAS BREASTFEEDING G
WANTED (MORE) CHILDREN H
WIFE/PARTNER OPPOSED J
OTHERS OPPOSED K
RELIGIOUS PROHIBITION L
KNOWS NO SOURCE N
FEAR OF SIDE EFFECTS P
LACK OF ACCESS/TOO FAR Q
COST TOO MUCH R
INCONVENIENT TO USE S
INTERFERES WITH BODY'S NORMAL PROCESSES T
DON'T KNOW Z
ALL GO TO 441A
OTHER METHOD USED GO TO 441
440 What was the main reason you used a condom on that occasion?
RESPONDENT WANTED TO PREVENT PREGNANCY 02
RESPONDENT WANTED TO PREVENT BOTH STD/HIV AND PREGNANCY 03
DID NOT TRUST PARTNER/FELT PARTNER HAD OTHER PARTNERS 04
PARTNER REQUESTED/INSISTED 05
OTHER ______________ (SPECIFY) 96
DON'T KNOW 98
ALL GO TO 441A
441 What is the main reason you did not use a condom that time?
COST TOO MUCH 02
USED FAMILY PLANNING METHOD 03
CONDOMS TRANSMIT HIV 04
CONDOMS HAVE WORMS 05
TRUSTED PARTNER 06
PARTNER WAS NEGATIVE/NO RISK 07
RESPONDENT DOESN'T LIKE 08
PARTNER REFUSED/OBJECTED 09
PARTNER DRUNK/ON DRUGS 10
RESPONDENT DRUNK/ON DRUGS 11
PARTNER WANTED TO GET PREGNANT 12
OTHER _________________(SPECIFY) 96
441A The last time you had sexual intercourse with this third person, did you or this person drink alcohol?
NO 2 GO TO 442
441B Were you or your partner drunk at that time?
PARTNER ONLY 2
BOTH RESPONDENT AND PARTNER 3
NEITHER 4
442 What is your relationship to this woman?
IF WOMAN IS "GIRLFRIEND" OR "FIANCÉE", ASK:
Was your girlfriend/fiancé living with you when you last had sex with her?
IF YES, CIRCLE '01'.
IF NO, CIRCLE '02'.
WOMAN IS GIRLFRIEND/FIANCÉE 02
OTHER FRIEND 03
CASUAL ACQUAINTANCE 04
RELATIVE 05
WOMAN IS PROSTITUTE 06
OTHER ___________(SPECIFY) 96
443 For how long (have you had/did you have) sexual relations with this woman?
IF ONLY HAD SEXUAL RELATIONS WITH THIS WOMAN ONCE, RECORD '01' DAYS.
WEEKS 2 ___ ___
MONTHS 3 ___ ___
YEARS 4 ___ ___
444 In total, how many different women have you had sexual intercourse with in the last 12 months?
IF NON-NUMERIC, PROBE TO GET AN ESTIMATE. IF NUMBER OF PARTNERS IS GREATER THAN 95, WRITE '95'.
DON'T KNOW 98
445 In total, how many different women have you had sexual intercourse with in your lifetime?
IF NON-NUMERIC, PROBE TO GET AN ESTIMATE. IF NUMBER OF PARTNERS IS GREATER THAN 95, WRITE '95'.
DON'T KNOW 98
446 If you needed or wanted to, could you yourself get a male condom easily?
SOMEWHAT DIFFICULT 2
VERY DIFFICULT/IMPOSSIBLE 3
DON'T KNOW/UNSURE 8
447 CHECK 302(07), 416B, 419, 428, 437 EVER USED A MALE OR FEMALE CONDOM?
NEVER USED A CONDOM GO TO 449
448 How old were you when you used a male/female condom for the first time?
DON'T REMEMBER 98
449 Have you ever paid for sex?
NO 2 GO TO 452
450 How long ago was the last time you paid for sex?
WEEKS AGO 2 ___ ___
MONTHS AGO 3 ___ ___
YEARS AGO 4 ___ ___
451 The last time that you paid for sex, was a male or female condom used on that occasion?
YES, FEMALE CONDOM 2
NO 3
452 Do you know of a place where a person can get male or female condoms?
NO 2 GO TO 454
453 Where is that? Any other place?
RECORD ALL MENTIONED.
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
OTHER PUBLIC _____________(SPECIFY) D
PHARMACY F
PRIVATE DOCTOR G
OTHER PRIVATE MEDICAL _____________(SPECIFY) H
CHAL HEALTH CENTER J
COMMUNITY HEALTH WORKER L
SUPPORT GROUPS M
OTHER SOURCE
CHURCH O
PEER EDUCATORS P
FRIENDS/RELATIVES Q
454 Have you ever experienced any problems with using condoms?
IF YES: What problems have you experienced?
PROBE: Any other problems?
RECORD ALL PROBLEMS MENTIONED.
DIFFICULT TO PUT ON/TAKE OFF B
SPOILS THE MOOD C
DIMINISHES PLEASURE D
WIFE PARTNER OBJECTS/DOES NOT LIKE E
WIFE/PARTNER GOT PREGNANT F
INCONVENIENT TO USE/MESSY G
CONDOM BROKE H
OTHER _______________(SPECIFY) X
NO PROBLEM Y
455 I will now read you some statements about male condom use. Please tell me if you agree or disagree with each.
a) Male condoms diminish a man's sexual pleasure.
DISAGREE 2
DK 8
b) A male condom is very inconvenient to use.
DISAGREE 2
DK 8
c) A male condom can be reused.
DISAGREE 2
DK 8
d) A male condom protects against sexually transmitted infection.
DISAGREE 2
DK 8
e) Buying male condoms is embarrassing.
DISAGREE 2
DK 8
f) A woman has no right to ask a man to use a male condom.
DISAGREE 2
DK 8
g) A male condom has the AIDS virus
DISAGREE 2
DK 8
h) A male condom is the best way to prevent unwanted pregnancy
DISAGREE 2
DK 8
i) People who use the male condom are not faithful since they might have the AIDS virus or other sexually transmitted infections.
DISAGREE 2
DK 8
SECTION 5. FERTILITY PREFERENCES
501 CHECK 409:
HAS MORE THAN ONE/WIFE PARTNER GO TO ENXT
QUESTION SKIPPED GO TO 505
502 (Is your wife/partner/Are any of your wives/partners) currently pregnant?
NO 2
UNSURE 3
503 CHECK 502:
YES, WIFE/WIVES/ PARTNER(S) PREGNANT (CODE '1')
Now I have some questions about the future. After the child(ren) you wife/wives/partner(s) is/are expecting now, would you like to have another child or would you prefer not to have any more children at all?
NO WIFE/PARTNER PREGNANT OR UNSURE (CODE '2' OR '3')
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 at all?
NO MORE/NONE 2 GO TO 505
WIFE/WIVES INFECUND/STERILIZED 3 GO TO 505
UNDECIDED/DON'T KNOW 8 GO TO 505
504 How long would you like to wait from now before the birth of (a/another) child?
YEARS 2 ___ ___
SOON/NOW 993
AFTER MARRIAGE 995
OTHER ___________(SPECIFY) 996
DON'T KNOW 998
505 CHECK 203 AND 205:
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 that be?
NO LIVING CHILDREN
If you could choose exactly the number of children to have in your whole life, how many would life, how many would that be?
PROBE FOR A NUMERIC RESPONSE.
NUMBER ___ ___
OTHER _________(SPECIFY) 96 GO TO 507
506 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?
BOYS ___ ___
GIRS ___ ___
ETHER ___ ___
OTHER ________________ (SPECIFY) 96
507 Would you say that you approve or disapprove of couples using a contraceptive method to avoid getting pregnant?
DISAPPROVE 2
DON'T KNOW/UNSURE 8
508 In the last few months have you heard about family planning:
On the radio?
NO 2
On the television?
NO 2
In a newspaper or magazine?
NO 2
509 In the last 3 months, have you discussed the practice of family planning with your friends, neighbors, or relatives?
NO 2 GO TO 511
510 With whom? Anyone else?
RECORD ALL PERSONS MENTIONED.
MOTHER B
FATHER C
SISTER(S) D
BROTHER(S) E
DAUGHTER F
SON G
MOTHER-IN-LAW H
FRIENDS/NEIGHBORS I
TEACHERS J
CHIEFS K
FATHER-IN-LAW L
OTHER _____________ (SPECIFY) X
511 In the last 3 months, have you discussed the practice of family planning with a health worker or health professional?
NO 2
SECTION 6. PARTICIPATION IN HEALTH CARE
601 CHECK 209:
HAS NOT HAD ANY CHILDREN GO TO 617
602 Please tell me the name and sex of your child (who was born most recently).
________________________ (NAME OF CHILD)
GIRL 2
603 In what month and year was (NAME OF CHILD) born?
YEAR ___ ___ ___ ___
604 Is (NAME OF CHILD) still living?
NO 2
DON'T KNOW 8 GO TO 606
605 How old was (NAME OF CHILD) when he/she died?
IF '1 YEAR', 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 ___ ___
DON'T KNOW 998
606 What is the name of (NAME OF CHILD)'s mother?
WRITE THE CHILD'S MOTHER'S NAME AND HER LINE NUMBER FROM THE HOUSEHOLD QUESTIONNAIRE.
IF THE MOTHER IS NOT LISTED IN THE HOUSEHOLD SCHEDULE RECORD '00'
NAME OF CHILD'S MOTHER
________________________
LINE NUMBER IN HHD QRE. ___ ___
(LAST) CHILD BORN IN 1998 OR EARLIER GO TO 617
OTHER LINE NUMBER GO TO 610
609 What is your relationship with (NAME OF CHILD'S MOTHER)?
FORMER SPOUSE 02
CURRENT LIVE-INPARTNER 03
FORMER LIVE-IN PARTNER 04
REGULAR SEXUALPARTNER 05
WOMAN IS GIRLFRIEND/FIANCÉE 06
OCCASIONAL SEXUAL PARTNER 07
FRIEND/ACQUAINTANCE 08
OTHER __________ (SPECIFY) 96
FOR THE SIX WEEKS AFTER DELIVERY. ALL QUESTIONS REFER TO THE LAST BIRTH.
610 Now, think back to the time when (NAME OF CHILD'S MOTHER) was pregnant with (NAME OF CHILD).
PREGNANCY DELIVERY
610A: Did (NAME OF CHILD'S MOTHER) receive any antenatal care from a doctor or any health care provider when she was pregnant with (NAME OF CHILD)?
NO 2 (SKIP TO 612)
DK 8 (GO TO 610B IN NEXT COLUMN)
SIX WEEKS AFTER
610B: Did a doctor or any health care provider assist with the delivery of (NAME OF CHILD)?
NO 2(SKIP TO 612)
DK 8 (GO TO 610C IN NEXT COLUMN)
DELIVERY
610C: Did (NAME OF CHILD'S MOTHER) receive any care for herself from a doctor or any health care provider during the six weeks after this delivery?
NO 2 (SKIP TO 612)
DK 8 (SKIP TO 613)
611 Who mainly provided the money or goods or services to pay for this care?
PREGNANCY DELIVERY
INSURANCE 02
RESPONDENT 03
CHILD'S MOTHER 04
RESPONDENT AND CHILD'S MOTHER 05o
RESPONDENT'S FAMILY 06
CHILD'S MOTHER'S FAMILY 07
OTHER __________(SPECIFY) 96
ALL GO TO 610B IN NEXT COLUMN
DELIVERY
INSURANCE 02
RESPONDENT 03
CHILD'S MOTHER 04
RESPONDENT AND CHILD'S MOTHER 05o
RESPONDENT'S FAMILY 06
CHILD'S MOTHER'S FAMILY 07
OTHER __________(SPECIFY) 96
ALL GO TO 610B IN NEXT COLUMN
SIX WEEKS AFTER DELIVERY
INSURANCE 02
RESPONDENT 03
CHILD'S MOTHER 04
RESPONDENT AND CHILD'S MOTHER 05o
RESPONDENT'S FAMILY 06
CHILD'S MOTHER'S FAMILY 07
OTHER __________(SPECIFY) 96
ALL GO TO 610B IN NEXT COLUMN
612 What was the main reason (NAME OF CHILD'S MOTHER) did not receive any advice or care from a doctor or other health care provider during (pregnancy/ delivery/the six weeks after delivery)?
PREGNANCY
NOT CUSTOMARY 02
RESPONDENT DIDN'T ALLOW 03
TOO COSTLY 04
TOO FAR/NO TRANSPORT 05
POOR SERVICE 06
LACK OF KNOWLEDGE 07
OTHER _________(SPECIFY) 96
ALL GO TO 610B IN NEXT COLUMN
DELIVERY
NOT CUSTOMARY 02
RESPONDENT DIDN'T ALLOW 03
TOO COSTLY 04
TOO FAR/NO TRANSPORT 05
POOR SERVICE 06
LACK OF KNOWLEDGE 07
OTHER _________(SPECIFY) 96
ALL GO TO 610B IN NEXT COLUMN
SIX WEEKS AFTER DELIVERY
NOT CUSTOMARY 02
RESPONDENT DIDN'T ALLOW 03
TOO COSTLY 04
TOO FAR/NO TRANSPORT 05
POOR SERVICE 06
LACK OF KNOWLEDGE 07
OTHER _________(SPECIFY) 96
ALL GO TO 610B IN NEXT COLUMN
613 At any time while (NAME OF CHILD'S MOTHER) was pregnant with (NAME OF CHILD), did you yourself talk with a doctor or any other health care provider about the health of the mother or of the pregnancy?
NO 2
614 CHECK 602 AND 604:
NAME OF (LAST) CHILD _____________________
(LAST) CHILD NOT LIVING OR DON'T KNOW GO TO 617
615 Does (NAME OF CHILD) live with you in your household?
NO 2 GO TO 617
616 In your household who usually decides what to do if (NAME OF CHILD) is ill?
RECORD ALL PERSONS MENTIONED.
CHILD'S MOTHER B
WIFE/PARTNER WHO IS NOT CHILD'S MOTHER C
FEMALE RELATIVE D
MALE RELATIVE E
OTHER ______________ (SPECIFY) X
CHILD HAS NEVER BEEN ILL Y
617 Now, I want to talk to you about pregnancy and the health of children.
Sometimes a pregnancy can have complications that lead to miscarriage or even death. What are some of the signs and symptoms that indicate that a pregnancy may be in danger?
PROBE: Any other signs or symptoms?
RECORD ALL SIGNS AND SYMPTOMS MENTIONED.
HIGH FEVER B
ABDOMINAL PAIN C
SWELLING OF HANDS AND FEET D
DIFFICULT LABOR FOR MORE THAN 12 HRS E
CONVULSIONS F
OTHER ____________ (SPECIFY) X
DON'T KNOW ANY SIGNS OR SYMPTOMS Z
618 When a child has diarrhea, should he/she be given less to drink than usual, about the same amount, or more than usual?
ABOUT THE SAME 2
MORE 3
DON'T KNOW 8
619 Have you ever heard of a special product called [MOTSOAKO] you can get for the treatment of diarrhea?
NO 2
620 Now, please tell me about yourself. Do you currently smoke cigarettes or tobacco?
IF YES: What type of tobacco do you smoke?
RECORD ALL TYPES MENTIONED.
YES, PIPE B
YES, SNUFF C
YES, OTHER TOBACCO D
NO Y
CODE 'A' NOT CIRCLED GO TO 623
622 In the last 24 hours, how many cigarettes did you smoke?
623 Have you ever drunk an alcohol-containing beverage?
NO 2 GO TO 628A
624 In the last 3 months, on how many days did you drink an alcohol-containing beverage?
IF EVERY DAY, RECORD '90'.
NONE 95
625 Have you ever gotten drunk from drinking an alcohol-containing beverage?
NO 2 GO TO 628A
NONE GO TO 628A
627 In the last 3 months, on how many occasions did you get drunk?
NONE 95
628A Have you had an injection for any reason in the last three months?
IF YES: How many injections did you have?
IF DAILY INJECTIONS FOR 3 MONTHS, ASK: Are you diabetic?
IF YES, CIRLCE CODE '95'.
IF NUMBER OF INJECTIONS IS GREATER THAN 90, OR DAILY FOR 3 MONTHS AND NOT DIABETIC, RECORD '90'.
IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE.
DIABETIC 95 GO TO 628C
NONE 00 GO TO 629A
628B Among these injections, how many were administered by a doctor, a nurse, a pharmacist, a dentist, or any other health workers?
IF NUMBER OF INJECTIONS IS GREATER THAN 90, OR DAILY
FOR 3 MONTHS OR MORE, RECORD '90'.
IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE.
NONE 00
628C The last time you had an injection, did [You/The person who gave you the injection] take the syringe and the needle from a new, unopened package?
NO 2
DON'T KNOW 8
629A Do you have a Health Card/Bukana?
NO 2 GO TO 701
629B Have you ever used another person's Health Card/Bukana?
NO 2
SECTION 7. HIV AND AIDS, OTHER SEXUALLY TRANSMITTED INFECTIONS, AND TUBERCULOSIS
701 Now I would like to talk about something else.
Have you ever heard of an illness called AIDS?
NO 2 GO TO 734
702 Can people reduce their chances of getting the AIDS virus by having just one sex partner who is not infected and who has no other partners?
NO 2
DON'T KNOW 8
703 Can a person get the AIDS virus from mosquito bites?
NO 2
DON'T KNOW 8
704 Can a person get the AIDS virus from kissing another person?
NO 2
DON'T KNOW 8
705 Can people reduce their chances of getting the AIDS virus by using a condom every time they have sex?
NO 2
DON'T KNOW 8
706 Can people get the AIDS virus by sharing food with a person who has AIDS?
NO 2
DON'T KNOW 8
707 Can people get the AIDS virus by using the same eating utensils as a person who has AIDS?
NO 2
DON'T KNOW . 8
708 Can people reduce their chance of getting the AIDS virus by not having sex at all?
NO 2
DON'T KNOW 8
709 Can people get the AIDS virus because of witchcraft or other supernatural means?
NO 2
DON'T KNOW 8
710 Is there anything a person can do to avoid getting AIDS or the virus that causes AIDS?
NO 2 GO TO 712
DON'T KNOW 8 GO TO 712
711 What can a person do? Anything else?
RECORD ALL WAYS MENTIONED.
USE CONDOMS B
LIMIT SEX TO ONE PARTNER/STAY FAITHFUL TO ONE PARTNER C
LIMIT NUMBER OF SEXUAL PARTNERS D
AVOID SEX WITH PROSTITUTES E
AVOID SEX WITH PERSONS WHO HAVE MANY PARTNERS F
AVOID SEX WITH HOMOSEXUALS G
AVOID SEX WITH PERSONS WHO INJECT DRUGS INTRAVENOUSLY H
AVOID BLOOD TRANSFUSIONS I
AVOID INJECTIONS J
AVOID SHARING RAZORS/BLADES K
AVOID KISSING L
AVOID MOSQUITO BITES M
SEEK PROTECTION FROM TRADITIONAL PRACTITIONER N
OTHER __________ (SPECIFY) W
OTHER (SPECIFY) ____________ X
DON'T KNOW Z
712 Is it possible for a healthy-looking person to have the AIDS virus?
NO 2
DON'T KNOW 8
713 Do you know someone personally who has the virus that causes AIDS or someone who died from AIDS?
NO 2
714 Can the virus that causes AIDS be transmitted from a mother to her baby:
During pregnancy?
NO 2
DK 8
During delivery?
NO 2
DK 8
By breastfeeding?
NO 2
DK 8
715 Are there any special medications that a doctor or a nurse can give to a pregnant woman infected with the AIDS virus can take to reduce the risk of transmission to the baby?
NO 2
DON'T KNOW 8
716 Is there any special medication that people infected with the AIDS virus can get from a doctor or a nurse?
NO 2
DON'T KNOW 8
717 I don't want to know the results, but have you ever been tested to see if you have the AIDS virus?
NO 2 GO TO 721
718 When was the last time you were tested?
12-23 MONTHS 2
2 YEARS OR MORE 3
719 The last time you had the test, did you yourself ask for the test, was it offered to you and you accepted, or was it required?
OFFERED AND ACCEPTED 2
REQUIRED 3
720 I don't want to know the results, but did you get the results of the test?
NO 2 GO TO 723A
721 Would you want to be tested for the AIDS virus?
NO 2
DON'T KNOW/UNSURE 8
722 Do you know a place where you could go to get an AIDS test?
NO 2 GO TO 724
723 Where can you go for the test?
RECORD ONLY FIRST RESPONSE GIVEN.
723A Where did you go for the test?
IF SOURCE IS HOSPITAL, HEALTH CENTER, OR CLINIC, WRITE THE NAME OF THE PLACE. PROBE TO IDENTIFY THE TYPE OF SOURCE AND CIRCLE THE APPROPRIATE CODE.
_________________________________________ (NAME OF PLACE)
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
OTHER PUBLIC ______________ (SPECIFY) 16
PHARMACY 22
PRIVATE DOCTOR 23
OTHER PRIVATE MEDICAL ___________( SPECIFY) 26
CHAL HEALTH CENTER 32
COMMUNITY HEALTH WORKER 42
SUPPORT GROUPS 43
OTHER SOURCE
CHURCH 52
FRIENDS/RELATIVES 53
NO, NOT IN UNION GO TO 726
725 Have you ever talked about ways to prevent getting the virus that causes AIDS with (your wife/the woman you are living with)?
NO 2
726 In your opinion, is it acceptable or unacceptable for AIDS to be discussed:
On the radio?
NOT ACCEPTABLE 2
On the TV?
NOT ACCEPTABLE 2
In newspapers?
NOT ACCEPTABLE 2
727 Would you buy fresh vegetables from a vendor who has the AIDS virus?
NO 2
DK/NOT SURE 8
728 If a member of your family got infected with the virus that causes AIDS, would you want it to remain a secret or not?
NO 2
DK/NOT SURE 8
729 If a relative of yours became sick with the virus that causes AIDS, would you be willing to care for her or him in your own household?
NO 2
DK/NOT SURE 8
730A If a female teacher has the AIDS virus, should she be allowed to continue teaching in the school?
SHOULD NOT CONTINUE 2
DK/NOT SURE 8
730B If a male teacher has the AIDS virus, should she be allowed to continue teaching in the school?
SHOULD NOT CONTINUE 2
DK/NOT SURE 8
731 Should children age 12-14 be taught about using a condom to avoid AIDS?
NO 2
DK/NOT SURE 8
732 Have you ever been taught how to use a condom?
NO 2 GO TO 734
733 Where/who taught you how to use a condom? Anywhere/anybody else?
RECORD ALL MENTIONED.
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
OTHER PUBLIC ____________(SPECIFY) D
PHARMACY F
PRIVATE DOCTOR G
OTHER PRIVATE MEDICAL ________ (SPECIFY) H
CHAL HEALTH CENTER J
COMMUNITY HEALTH WORKER L
SUPPORT GROUPS M
OTHER SOURCE
PEER EDUCATORS O
SHOP P
CHURCH Q
FRIENDS/RELATIVES R
734 (Apart from AIDS), have you heard about other infections that can be transmitted through sexual contact?
NO 2 GO TO 737
735 If a man has a sexually transmitted infection, what symptoms might he have? Any others?
RECORD ALL SYMPTOMS MENTIONED.
GENITAL DISCHARGE/DRIPPING B
FOUL SMELLING DISCHARGE C
BURNING PAIN ON URINATION D
REDNESS/INFLAMMATION IN GENITAL AREA E
SWELLING IN GENITAL AREA F
GENITAL SORES/ULCERS G
GENITAL WARTS H
GENITAL ITCHING I
BLOOD IN URINE J
LOSS OF WEIGHT K
IMPOTENCE L
OTHER _______________(SPECIFY) W
OTHER _______________(SPECIFY) X
NO SYMPTOMS Y
DON'T KNOW Z
736 If a woman has a sexually transmitted infection, what symptoms might she have? Any others?
RECORD ALL SYMPTOMS MENTIONED.
GENITAL DISCHARGE B
FOUL SMELLING DISCHARGE C
BURNING PAIN ON URINATION D
REDNESS/INFLAMMATION IN GENITAL AREA E
SWELLING IN GENITAL AREA F
GENITAL SORES/ULCERS G
GENITAL WARTS H
GENITAL ITCHING I
BLOOD IN URINE J
LOSS OF WEIGHT K
HARD TO GET PREGNANT/HAVE A CHILD L
OTHER __________________(SPECIFY) W
OTHER __________________(SPECIFY) X
NO SYMPTOMS Y
DON'T KNOW Z
HAS NOT HAD SEXUAL INTERCOURSE GO TO 748
DOES NOT KNOW STIP TO 740
739 Now I would like to ask you some questions about your health in the last 12 months. During the last 12 months, have you had a sexually-transmitted infection?
NO 2
DON'T KNOW 8
740 Sometimes, men experience an abnormal discharge from their penis. During the last 12 months, have you had an abnormal discharge from your penis?
NO 2
DON'T KNOW 8
741 Sometimes men have a sore or ulcer on or near their penis. During the last 12 months, have you had a sore or ulcer on or near your penis?
NO 2
DON'T KNOW 8
HAS NOT HAD AN INFECTION OR DOES NOT KNOW GO TO 748
743 The last time you had (PROBLEM FROM 739/740/741), did you seek any kind of advice or treatment?
NO 2 GO TO 745
744 Where did you go? Anywhere else?
RECORD ALL MENTIONED.
GOVT. HEALTH CENTER B
FAMILY PLANNING CLINIC C
OTHER PUBLIC _____________(SPECIFY) D
PHARMACY F
PRIVATE DOCTOR G
OTHER PRIVATE MEDICAL ____________ (SPECIFY) H
CHAL HEALTH CENTER J
COMMUNITY HEALTH WORKER L
SUPPORT GROUPS M
OTHER SOURCE
CHURCH O
FRIENDS/RELATIVES P
TRADITIONAL HEALER Q
745 When you had (PROBLEM FROM 739/740/741), did you do something to avoid infecting your sexual partner(s)?
NO 2
PARTNER ALREADY INFECTED 3 GO TO 748
746 When you had (PROBLEM FROM 739/740/741), did you inform your sexual partner(s) about it?
SOME/NOT ALL 2
NO 3
DID NOT HAVE PARTNER 4 GO TO 748
747 What did you do to avoid infecting your partner(s)? Did you
Use medicine?
NO 2
Stop having sex?
NO 2
Use a condom when having sex?
NO 2
748 Now I would like to ask you about something else. Some men in Lesotho are circumcised. Are you circumcised?
NO 2
749 Now I would like to ask you about something else. Since age 15, have you ever had the following symptoms:
a. Cough for two weeks or more?
NO 2
b. Fever for two weeks or more?
NO 2
c. Chest or back pain?
NO 2
d. Coughing up blood?
NO 2
e. Sweating at night?
NO 2
NOT A SINGLE 'YES' GO TO 758
751 Did you seek consultation or treatment for the symptom(s)?
NO 2
752 What is the main reason you did not seek consultation or treatment for the symptom(s)?
COST 2
DISTANCE 3
EMBARRASSED 4
OTHER _______________(SPECIFY) 6
ALL GO TO 758
753 The last time you had such symptoms, where did you first go for advice or treatment?
GOVT. HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
OTHER PUBLIC ___________(SPECIFY) 14
PHARMACY 22
PRIVATE DOCTOR 23
OTHER PRIVATE MEDICAL __________(SPECIFY) 24
CHAL HEALTH CENTER 32
COMMUNITY HEALTH WORKER 42
SUPPORT GROUPS 43
TRADITIONAL HEALER 51
OTHER ______________(SPECIFY) 96
754 How soon after the symptom(s) did you first seek consultation or treatment?
WEEKS 2 ___ ___
MONTHS 3 ___ ___
DON'T KNOW 998
755 During that first visit, were you told by a doctor or another health professional that you had tuberculosis?
NO 2 GO TO 758
756 Did you go anywhere else for advice or treatment after you were told that you had tuberculosis?
NO 2 GO TO 759
GOVT. HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
OTHER PUBLIC ____________(SPECIFY) 14
PHARMACY 22
PRIVATE DOCTOR 23
OTHER PRIVATE MEDICAL (SPECIFY) _______ 24
CHAL HEALTH CENTER 32
COMMUNITY HEALTH WORKER 42
SUPPORT GROUPS 43
TRADITIONAL HEALER 51
OTHER ________________(SPECIFY) 96
ALL GO TO 759
758 Have you ever heard of an illness called tuberculosis?
NO 2 GO TO 801
759 Do you think tuberculosis can be cured?
NO 2
760 Would you be willing to work with someone who has been previously treated for tuberculosis?
NO 2
DK/NOT SURE 8
761 What signs or symptoms would lead you to think that a person has tuberculosis?
PROBE: Any others?
RECORD ALL MENTIONED.
COUGHING WITH SPUTUM B
COUGHING FOR SEVERAL WEEKS C
FEVER D
BLOOD IN SPUTUM E
LOSS OF APPETITE F
NIGHT SWEATING G
PAIN IN CHEST OR BACK H
TIREDNESS/FATIGUE I
WEIGHT LOSS J
OTHER ______________(SPECIFY) X
NO SYMPTOMS Y
DON'T KNOW Z
762 What do you think is the cause of tuberculosis?
PROBE: Anything else?
RECORD ALL METIONED
INHERITED B
LIFESTYLE C
SMOKING D
ALCOHOL DRINKING E
EXPOSURE TO COLD TEMPERAT. F
DUST/POLLUTION G
OTHER ____________(SPECIFY) X
OTHER ______________(SPECIFY) Y
DON'T KNOW Z
SECTION 8. ATTITUDES TOWARDS GENDER ROLES
801 In a couple, who do you think should have the greater say in each of the following decisions: the husband, the wife or both equally:
a) making large household purchases?
WIFE 2
BOTH EQUALLY 3
DON'T KNOW/DEPENDS 8
b) making small daily household purchases?
WIFE 2
BOTH EQUALLY 3
DON'T KNOW/DEPENDS 8
c) deciding when to visit family, friends or relatives?
WIFE 2
BOTH EQUALLY 3
DON'T KNOW/DEPENDS 8
d) deciding what to do with the money she earns for her work?
WIFE 2
BOTH EQUALLY 3
DON'T KNOW/DEPENDS 8
e) deciding how many children to have and when to have them?
WIFE 2
BOTH EQUALLY 3
DON'T KNOW/DEPENDS 8
f) deciding on family planning
WIFE 2
BOTH EQUALLY 3
DON'T KNOW/DEPENDS 8
802 Sometimes a husband is annoyed or angered by things that his wife/partner does. In your opinion, is a husband justified in hitting or beating his wife in the following situations
a) If she goes out without telling him?
NO 2
DON'T KNOW/DEPENDS 8
b) If she neglects the children?
NO 2
DON'T KNOW/DEPENDS 8
c) If she argues with him?
NO 2
DON'T KNOW/DEPENDS 8
d) If she refuses to have sex with him?
NO 2
DON'T KNOW/DEPENDS 8
e) If she burns the food?
NO 2
DON'T KNOW/DEPENDS 8
f) If she is unfaithful and has sex with other men?
NO 2
DON'T KNOW/DEPENDS 8
803 When a wife knows her husband has a sexually transmitted disease, is she justified in asking that they use a condom?
NO 2
DON'T KNOW 8
804 Husbands and wives do not always agree on everything. Please tell me if you think a wife is justified in refusing to have sex with her husband if
a) She is tired and not in the mood?
NO 2
DON'T KNOW/DEPENDS 8
b) She has recently given birth?
NO 2
DON'T KNOW/DEPENDS 8
c) She knows her husband has sex with other women?
NO 2
DON'T KNOW/DEPENDS 8
d) She knows her husband has a sexually transmitted disease?
NO 2
DON'T KNOW/DEPENDS 8
805 Do you think that if a woman refuses to have sex with her husband when he wants her to, he has the right to
a) Get angry and reprimand her?
NO 2
DON'T KNOW/DEPENDS 8
b) Refuse to give her money or other means of financial support?
NO 2
DON'T KNOW/DEPENDS 8
c) Use force and have sex with her even if she doesn't want to?
NO 2
DON'T KNOW/DEPENDS 8
d) Go and have sex with another woman?
NO 2
DON'T KNOW/DEPENDS 8
MINUTES ___ ___