WOMEN'S QUESTIONNAIRE 1997
PLACE NAME ____
NAME OF HOUSEHOLD HEAD ____
CLUSTER NUMBER ____
HOUSEHOLD UNIT NUMBER ____
REGION (FARITANY) ____
RURAL 2
CITY/ADMINISTRATIVE CENTER ____
FARITANY AND ANTSIRABE ADMINISTRATIVE CENTER 2
FIVONDRONAMPOKONTANY ADMINISTRATIVE CENTER 3
FIRAISAMPOKONTANY ADMINISTRATIVE CENTER 4
RURAL 5
NAME AND LINE NO. OF FEMALE RESPONDENT ____
INTERVIEW ONE (REPEAT FOR SECOND AND THIRD INTERVIEWS)
DATE ____
INTERVIEWER'S NAME ____
NOT AT HOME 2
DEFERRED 3
REFUSED 4
PARTIALLY COMPLETED 5
INCAPACITATED 6
OTHER (SPECIFY) 7
NEXT VISIT
DATE ____
TIME ____
FINAL VISIT
DAY ____
MONTH ____
YEAR 1997
INT. NUMBER ____
RESULT ____
NOT AT HOME 2
DEFERRED 3
REFUSED 4
PARTIALLY COMPLETED 5
INCAPACITATED 6
OTHER (SPECIFY) 7
SUPERVISOR
NAME ______
DATE ______
FIELD EDITOR
NAME _____
DATE _____
OFFICE EDITOR ______
KEYED BY ______
SECTION 1. SOCIODEMOGRAPHIC CHARACTERISTICS OF THE RESPONDENTS
101. RECORD THE TIME.
MINUTES ______
To begin, I would like to ask you questions about yourself and your household.
102. Until the age of 12, did you mostly live in Antananarivo-Renivohitra, in an administrative center of Faritany, in an administrative center of Fivondrona, in an administrative center of Firaisana, in a rural setting, or out of the country?
FARITANY ADMINISTRATIVE CENTER 2
FIVONDRONANA ADMINISTRATIVE CENTER 3
FIRAISANA ADMINISTRATIVE CENTER 4
RURAL 5
ABROAD 6
103. How long have you been living continuously in (NAME OF CURRENT PLACE OF RESIDENCE)?
VISITOR 96 (GO TO 105)
104. Just before you moved here, did you live in Antananarivo-Renivohitra, in an administrative center of Faritany, in an administrative center of Fivondrona, in an administrative center of Firaisana, in a rural setting, or out of the country?
FARITANY ADMINISTRATIVE CENTER 2
FIVONDRONANA ADMINISTRATIVE CENTER 3
FIRAISANA ADMINISTRATIVE CENTER 4
RURAL 5
ABROAD 6
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. Have you ever attended school?
NO 2 (GO TO 114)
108. What is the highest level of school you attended: primary, secondary, or higher?
MIDDLE SCHOOL 2
HIGH SCHOOL 3
HIGHER 4
109. What is the highest grade you completed at that level?
25 OR MORE YEARS OF AGE (GO TO 113)
111. Do you currently attend school?
NO 2
112. What is the main reason you stopped going to school?
GOT MARRIED 02
TO WATCH YOUNGER CHILDREN 03
FAMILY NEEDED HELP IN FIELDS/AT WORK 04
COULD NOT PAY FEES 05
NEEDED TO EARN MONEY 06
SUFFICIENTLY SCHOOLED 07
FAILED AT SCHOOL 08
NO LONGER LIKED SCHOOL 09
SCHOOL INACCESSIBLE/TOO FAR 10
OTHER (SPECIFY) ______ 96
DOESN'T KNOW 98
SECONDARY OR HIGHER (GO TO 115)
114. Can you read and understand a letter or newspaper easily, with difficulty, or not at all?
WITH DIFFICULTY 2
NOT AT ALL 3 (GO TO 116)
115. Do you read a newspaper or magazine at least once a week?
NO 2
116. Do you listen to the radio at least once a day?
NO 2
117. Do you watch the television at least once a week?
NO 2
PROTESTANT 2
MUSLIM 3
TRADITIONAL 4
NOT RELIGIOUS 5
OTHER (SPECIFY) _____ 6
120. CHECK Q.4 IN THE HOUSEHOLD QUESTIONNAIRE:
RESPONDENT IS USUAL RESIDENT (GO TO 201)
Now I would like to ask you some questions about the place you usually live.
121. What is the name of your usual place of residence?
FARITANY ADMINISTRATIVE CENTER 2
FIVONDRONANA ADMINISTRATIVE CENTER 3
FIRAISANA ADMINISTRATIVE CENTER 4
RURAL 5
ABROAD 6 (GO TO 123)
122. In which Faritany is it? (The usual place)
FIANARANTSOA 2
TOAMASINA 3
MAHAJANGA 4
TOLIARY 5
ANSIRANANA 6
Now I would like to ask you some questions about the household in which you usually live.
123. What is the main source of drinking water for members of your household?
PIPED TO EXTERIOR 12
PUBLIC TAP/STANDPIPE 13
NOT EQUIPPED WITH PUMP 22 (GO TO 125)
DRAIN WELL 23 (GO TO 125)
NOT EQUIPPED WITH PUMP 25
DRAIN WELL 26
RIVER 32
POND/LAKE/DAM 33
TANKER TRUCK 51
BOTTLED WATER 61 (GO TO 125)
OTHER (SPECIFY) _____________ 96
124. How long does it take to go there, get water, and come back?
ON SITE 996
125. What kind of toilet facility is in your household?
LATRINE 22
PAIL 23
NO TOILET/OUTSIDE 31 (GO TO 19)
OTHER (SPECIFY) ________ 96 (GO TO 19)
125A. Is the toilet facility only used by your household or do you share it with other households?
SHARED USE 2
126. Does your household have:
NO 2
NO 2
NO 2
NO 2
NO 2
127. Can you describe the floor of your house?
DUNG 12
PALM/BAMBOO/MAT 22
VINYL OR ASPHALT STRIPS 32
CERAMIC TILES 33
CEMENT 34
CARPET 35
128. Does any member of this household own:
NO 2
NO 2
NO 2
NO 2
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 of 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 at birth but did not survive more than a few hours or days?
NO 2 (GO TO 208)
207. 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 227)
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 BIRTHS IN 212. RECORD TWINS ON SEPARATE LINES.
[REPEAT 212-221 FOR EACH SEPARATE BIRTH]
212. What name was given to your (first/next) baby?
213. Was (NAME) a single birth or part of a multiple birth?
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? OR: What season was (NAME) born in?
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
GO TO NEXT BIRTH.
219. IF DEAD: How old was (NAME) when he/she died?
IF '1 YEAR', PROBE: How many months was (NAME)?
RECORD DAYS IF LESS THAN 1 MONTH; MONTHS IF LESS THAN TWO YEARS; OR YEARS.
MONTHS 2 _____
YEARS 3 _____
220. SUBTRACT THE BIRTH YEAR OF (NAME) FROM THE YEAR OF THE PREVIOUS BIRTH. IS THE DIFFERENCE FOUR OR MORE YEARS?
[NOTE: ONLY FOR BIRTHS 2 AND AFTER.]
NO 2 (GO TO NEXT BIRTH)
221. Were there any other live births between (NAME OF PREVIOUS BIRTH) and (NAME)?
[ONLY FOR BIRTHS 2 AND AFTER]
NO 2
[GO BACK AND REPEAT 212-221 FOR EACH ADDITIONAL BIRTH]
222. SUBTRACT THE BIRTH YEAR OF THE LAST CHILD FROM THE YEAR OF THE INTERVIEW. IS THE DIFFERENCE FOUR OR MORE YEARS?
NO 2 (GO TO 224)
223. Have you had any live births since the birth of (NAME OF LAST BIRTH)?
NO 2
224. COMPARE 208 WITH NUMBER OF BIRTHS REGISTERED IN TABLE ABOVE AND MARK:
NUMBERS ARE DIFFERENT (PROBE AND RECONCILE)
FOR EACH LIVING CHILD: CURRENT AGE IS RECORDED. ____
FOR EACH DEAD CHILD: AGE AT DEATH IS RECORDED. ____
FOR AGE AT DEATH 12 MONTHS OR 1 YEAR: PROBE TO DETERMINE EXACT NUMBER OF MONTHS. ____
225. CHECK 215 AND ENTER THE NUMBER OF BIRTHS SINCE JANUARY 1994.
IF NONE, RECORD '00'.
NO 2 (GO TO 236)
UNSURE 8 (GO TO 236)
228. How many months pregnant are you?
RECORD NUMBER OF COMPLETED MONTHS.
229. 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
NOT AT ALL 3
230. Do you have difficulty seeing at nightfall?
NO 2 (GO TO 236)
231. Do you have difficulty seeing during the day as well?
NO 2
232. Did you have difficulty seeing at nightfall when you weren't pregnant?
NO 2
236. When did your last menstrual period start?
RECORD THE DATE IF IT IS GIVEN.
NUMBER OF WEEKS 2 _____
NUMBER OF MONTHS 3 _____
NUMBER OF YEARS 4 _____
BEFORE LAST BIRTH 995
NEVER HAD PERIOD 996
237. 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 (GO TO 239)
DOESN'T KNOW 8 (GO TO 239)
238. At what point in her menstrual cycle is a woman most likely to become pregnant?
RIGHT AFTER HER PERIOD HAS ENDED 02
MIDDLE OF HER CYCLE 03
JUST BEFORE HER PERIOD BEGINS 04
OTHER (SPECIFY) __________ 96
DOESN'T KNOW 98
239. Have you ever had an intentional abortion?
NO 2 (GO TO 301)
240. The last time that you had an intentional abortion, did you suffer any after-effects to your health following the procedure?
NO 2 (GO TO 301)
241. Were you obligated to ask a doctor or nurse for help because of these after-effects?
NO 2
Now I would like to talk about family planning and the various ways or methods that a couple can use to delay or avoid a pregnancy.
CIRCLE CODE 1 FOR EACH METHOD MENTIONED SPONTANEOUSLY. THEN PROCEED DOWN COLUMN 302, READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE 2 IF METHOD IS RECOGNIZED, AND CODE 3 IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE 1 OR 2 CIRCLED IN 301 OR 302, ASK 303.
301. What are the ways or methods that have you heard about?
302. Have you ever heard of (METHOD)?
YES DESCRIPTION 2
NO 3
YES DESCRIPTION 2
NO 3
YES DESCRIPTION 2
NO 3
YES DESCRIPTION 2
NO 3
YES DESCRIPTION 2
NO 3
YES DESCRIPTION 2
NO 3
YES DESCRIPTION 2
NO 3
YES DESCRIPTION 2
NO 3
YES DESCRIPTION 2
NO 3
YES DESCRIPTION 2
NO 3
NO 2
303. Have you ever used (METHOD)?
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
AT LEAST ONE "YES" (EVER USED) (GO TO 309)
305. Have you ever used anything or tried in any way to delay or avoid getting pregnant?
NO 2 (GO TO 331)
307. What have you used or done?
CORRECT 303 AND 304 (AND 302 IF NECESSARY).
Now I would like to ask you about the first time that you did something or used a method to avoid getting pregnant.
309. How many living children did you have at that time?
IF NONE, RECORD '00'.
309A. In what month and what year did you first use a contraceptive method to avoid getting pregnant?
310. The first time you used family planning, was it because you wanted another child, but not until later, or was it because you didn't want any more children at all?
DIDN'T WANT CHILD AT ALL 2
OTHER (SPECIFY) _____ 6
WOMAN STERILIZED (GO TO 314A)
PREGNANT (GO TO 332)
313. Are you currently doing something or using any method to delay or avoid getting pregnant?
NO 2 (GO TO 331)
314. Which method are you currently using?
IUD 02 (GO TO 326)
INJECTABLES 03 (GO TO 326)
IMPLANTS 04 (GO TO 326)
DIAPHRAGM/FOAM/JELLY 05 (GO TO 326)
CONDOM 06 (GO TO 326)
FEMALE STERILIZATION 07 (GO TO 318)
MALE STERILIZATION 08 (GO TO 318)
RHYTHM METHOD 09 (GO TO 323)
WITHDRAWAL 10 (GO TO 326)
OTHER (SPECIFY) _______ 96 (GO TO 326)
314A. CIRCLE '07' FOR FEMALE STERILIZATION.
315. May I see the package of pills you are currently using?
NOTE THE NAME OF THE BRAND IF THE PACKAGE IS SHOWN.
BRAND ________ (GO TO 317)
316. Do you know the brand name of the pills you are currently using?
NOTE THE NAME OF THE BRAND
DOESN'T KNOW NAME 98
317. How much does one box (cycle) of pills cost you?
RECORD IN 1000 MADAGASCAR FRANCS.
DOESN'T KNOW 998 (GO TO 326)
317A. How many packets are in a box?
THREE 2
DOESN'T KNOW 8
318. Where did the sterilization take place?
IF IT IS A PUBLIC HOSPITAL OR A PRIVATE HOSPITAL OR CLINIC, WRITE THE NAME OF THE ESTABLISHMENT. PROBE TO DETERMINE THE PROPER TYPE OF SECTOR AND CIRCLE THE APPROPRIATE CODE.
HEALTH CENTER 12
DISPENSARY 13
MEDICAL POST 14
OTHER PUBLIC (SPECIFY) ______ 16
PRIVATE DOCTOR 23
OTHER PRIVATE MEDICAL (SPECIFY) ______ 26
DOESN'T KNOW 98
319. Do you (or your husband) regret having an operation in order to have no more children?
NO 2 (GO TO 321)
320. Why do you (does he) regret the operation?
HUSBAND/PARTNER WANTS ANOTHER CHILD 02
SIDE EFFECTS 03
CHILD DIED 04
OTHER (SPECIFY) ______ 96
321. In what month and year was the sterilization performed?
DOESN'T KNOW YEAR 9998 (GO TO 333A)
323. How do you determine which days in your menstrual cycle you should not have sexual intercourse?
BASED ON BODY TEMPERATURE (OGINO METHOD) 02
BASED ON CERVICAL MUCUS (BILLINGS METHOD) 03
BASED ON BODY TEMP AND CERVICAL MUCUS 04
NO SPECIFIC SYSTEM 05
OTHER (SPECIFY) ______ 96
326. For how many months have you been continuously using (METHOD)?
IF LESS THAN 1 MONTH, NOTE '00'.
8 YEARS OR MORE 96
327. CHECK 314: CIRCLE THE CODE OF THE METHOD USED.
IUD 02
INJECTABLES 03
IMPLANTS 04
DIAPHRAGM/FOAM/JELLY 05
CONDOM 06
FEMALE STERILIZATION 07 (GO TO 329A)
MALE STERILIZATION 08 (GO TO 329A)
RHYTHM METHOD 09 (GO TO 332)
WITHDRAWAL 10 (GO TO 332)
OTHER 96 (GO TO 332)
328. Where did you last obtain (METHOD)?
IF IT IS A PUBLIC HOSPITAL OR A PRIVATE HOSPITAL OR CLINIC, WRITE THE NAME OF THE ESTABLISHMENT. PROBE TO DETERMINE THE PROPER TYPE OF SECTOR AND CIRCLE THE APPROPRIATE CODE.
HEALTH CENTER 12
DISPENSARY 13
MEDICAL POST 14
OTHER PUBLIC (SPECIFY) ______ 16
PHARMACY 22
DOCTOR 23
PF/FISA CENTER 24
OTHER PRIVATE (SPECIFY) ______ 26
RELIGIOUS CENTER 32
RELATIVES 33
FRIENDS 34
OTHER (SPECIFY) ______ 36
329. Do you know of another place you could have gone last time to procure (METHOD)?
NO 2 (GO TO 333A)
329A. At the time of your sterilization, did you know of another place where you could have had the same operation?
NO 2 (GO TO 333A)
330. People choose where they go for family planning services for different reasons. What is the main reason why you went to (NAME OF PLACE IN 328 OR 318) rather than the other place you know of?
RECORD THE RESPONSE AND CIRCLE THE CODE.
CLOSE TO MARKET/WORK 12 (GO TO 333A)
TRANSPORTATION AVAILABLE 13 (GO TO 333A)
CLEANER 22 (GO TO 333A)
MORE PRIVACY 23 (GO TO 333A)
SHORTER WAIT 24 (GO TO 333A)
OPEN LONGER HOURS 25 (GO TO 333A)
USES OTHER SERVICES IN THE SAME ESTABLISHMENT 26 (GO TO 333A)
WANTS ANONYMITY 41 (GO TO 333A)
OTHER (SPECIFY) _______ 96 (GO TO 333A)
DOESN'T KNOW 98 (GO TO 333A)
331. What is the main reason that you are not currently using a contraceptive method?
INFREQUENT SEX 22
MENOPAUSAL/HYSTERECTOMY 23
SUBFECOND/INFECUND 24
POSTPARTUM/BREASTFEEDING 25
WANTS (OTHER) CHILDREN 26
PREGNANT 27
HUSBAND/PARTNER OPPOSED 32
OTHERS OPPOSED 33
RELIGIOUS PROHIBITION 34
KNOWS NO SOURCE 42
FEAR OF SIDE EFFECTS 52
LACK OF ACCESS/TOO FAR 53
COSTS TOO MUCH 54
INCONVENIENT TO USE 55
INTERFERES WITH BODY'S NORMAL PROCESSES 56
DOESN'T KNOW 98
332. Do you know of a place where you can get contraception?
NO 2 (GO TO 334)
IF IT IS A PUBLIC HOSPITAL OR A PRIVATE HOSPITAL OR CLINIC, WRITE THE NAME OF THE ESTABLISHMENT. PROBE TO DETERMINE THE PROPER TYPE OF SECTOR AND CIRCLE THE APPROPRIATE CODE.
HEALTH CENTER B
DISPENSARY C
MEDICAL POST D
OTHER PUBLIC (SPECIFY) ______ X
PHARMACY F
DOCTOR G
PF/FISA CENTER H
OTHER PRIVATE (SPECIFY) ______ Y
RELIGIOUS CENTER J
RELATIVES K
FRIENDS L
NO, SHE HAS NEVER HEARD OF CONDOMS ____ (GO TO 334)
333B. What brands of condoms do you know?
PANTHER B
PROFILTEX C
SULTAN D
STIMULEV E
COREEN (VIOLETTE) F
OTHER (SPECIFY) _____ X
DOESN'T KNOW Y
333C. Have you ever heard of the brand of condom called Protector?
NO 2 (GO TO 334)
333D.Where have you heard of this brand?
TELEVISION B
POSTERS C
PACKAGES FOR SALE D
RELATIVES E
FRIENDS F
OTHER (SPECIFY) _____ X
334. In the last 12 months, were you visited by a family planning agent?
NO 2
335. In the last 12 months, have you visited a health facility for any reason?
NO 2 (GO TO 337)
336. Did any staff member at the health facility speak to you about family planning methods?
NO 2
337. Do you think that breastfeeding can influence a women's ability to become pregnant?
NO 2 (GO TO 401)
DOESN'T KNOW 8
338. Do you think that breastfeeding increases or decreases a woman's chance of becoming pregnant?
DECREASES 2
IT DEPENDS 3
DOESN'T KNOW 8
NO BIRTHS (GO TO 401)
340. Have you previously relied on breastfeeding as a way to avoid becoming pregnant?
NO 2 (GO TO 401)
PREGNANT OR STERILIZED (GO TO 401)
342. Are you currently relying on breastfeeding in order to avoid getting pregnant?
NO 2
SECTION 4A. PREGNANCY AND BREASTFEEDING
401. CHECK 225:
NO BIRTHS SINCE JANUARY 1994 (GO TO 465)
402. ENTER THE LINE NUMBER, NAME, AND SURVIVAL STATUS FOR EACH BIRTH SINCE JANUARY 1994 IN THE REPRODUCTION TABLE. ASK THE QUESTIONS FOR ALL BIRTHS BEGINNING WITH THE LAST BIRTH. (IF THERE ARE MORE THAN 2 BIRTHS, USE LAST COLUMN OF ADDITIONAL QUESTIONNAIRES.)
[403-439 ARE REPEATED FOR EACH BIRTH, BEGINNING WITH THE MOST RECENT BIRTH. IF MORE THAN 2 BIRTHS, USE LAST COLUMN OF ADDITIONAL QUESTIONNAIRES.]
Now I would like to ask you some questions about the health of all your children born in the last three years. We will only talk about one child at a time.
403. LINE NUMBER FROM 212:
DEAD ____
405. At the time you became pregnant with (NAME), did you want to become pregnant then, did you want to wait until later, or did you not want to have any (more) children at all?
LATER 2
NOT AT ALL 3 (GO TO 407)
406. How much longer would you have liked to wait?
YEARS 2 ____
407. Did you see anyone for antenatal care for this pregnancy?
IF YES: Whom did you see? Anyone else?
PROBE TO IDENTIFY EACH TYPE OF PERSON AND RECORD ALL MENTIONED.
NURSE B
MIDWIFE C
NO ONE Y (GO TO 410)
408. How many months pregnant were you when you first received antenatal care for this pregnancy?
DOESN'T KNOW 98
409. How many times did you receive antenatal care during this pregnancy?
DOESN'T KNOW 98
410. During this pregnancy, were you given an injection in the arm to prevent the baby from getting tetanus, that is, convulsions after birth?
NO 2 (GO TO 412)
DOESN'T KNOW 8 (GO TO 412)
411. During this pregnancy, how many times did you get this tetanus injection?
DOESN'T KNOW 8
412. Where did you give birth to (NAME)?
OTHER HOME 12
HEALTH CENTER 22
LOCAL HEALTH POST 23
OTHER PUBLIC (SPECIFY) ______ 26
OTHER PRIVATE MEDICAL (SPECIFY) ______ 36
413. Who assisted you with the delivery of (NAME)? Anyone else?
PROBE FOR THE TYPE(S) OF PERSON(S) AND RECORD ALL MENTIONED.
NURSE B
MIDWIFE C
RELATIVE/FRIEND E
NO ONE Y
414. When (NAME) was born, did you have any of the following problems:
NO 2
NO 2
NO 2
NO 2
415. Was (NAME) delivered by caesarean section?
NO 2
416. When (NAME) was born, was he/she very large, larger than average, average, smaller than average average, or very small?
LARGER THAN AVERAGE 2
AVERAGE 3
SMALLER THAN AVERAGE 4
VERY SMALL 5
DOESN'T KNOW 8
417. Was (NAME) weighed at birth?
NO 2 (GO TO 419)
418. How much did (NAME) weigh?
RECORD WEIGHT FROM HEALTH CARD, IF AVAILABLE.
GRAMS FROM MEMORY 2 __________
DOESN'T KNOW 99998
419. Has your period come back since the birth of (NAME)?
[ONLY ASK FOR MOST RECENT BIRTH]
NO 2 (GO TO 422)
420. Did your period come back between the birth of (NAME) and your next birth?
[ASK FOR ALL BUT MOST RECENT BIRTH]
NO 2 (GO TO 424)
421. For how many months after the birth of (NAME) did you not have your period?
DOESN'T KNOW 98
422. CHECK 227:
IS RESPONDENT PREGNANT?
[ONLY ASK FOR MOST RECENT BIRTH]
PREGNANT OR UNSURE (GO TO 424)
423. Have you begun to have sexual intercourse again since the birth of (NAME)?
[ONLY ASK FOR MOST RECENT BIRTH]
NO 2 (GO TO 425)
424. For how long after the birth of (NAME) did you not have sexual intercourse?
DOESN'T KNOW 998
425. Did you breastfeed (NAME)?
NO 2 (GO TO 431)
426. 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 _____
DECEASED (GO TO 429)
428. Are you still breastfeeding (NAME)?
NO 2
429. For how many months did you breastfeed (NAME)?
DOESN'T KNOW 98
430. Why did you stop breastfeeding (NAME)?
CHILD SICK/WEAK 02
CHILD DIED 03
PROBLEMS WITH BREASTS 04
INSUFFICIENT MILK 05
MOTHER WORKS 06
CHILD REFUSED 07
WEANING AGE 08
BECAME PREGNANT 09
BEGAN USING CONTRACEPTION 10
OTHER (SPECIFY) ______ 96
DECEASED (GO TO 405 IN THE NEXT COLUMN OR, IF NO MORE BIRTHS, GO TO 440)
432. How many times did you breastfeed last night between sunset and sunrise?
IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE ANSWER.
433. How many times did you breastfeed yesterday during the daylight hours?
IF ANSWER IS NOT NUMERIC, PROBE FOR APPROXIMATE ANSWER.
434. Did (NAME) drink anything from a bottle yesterday or last night?
NO 2
DOESN'T KNOW 8
435. Did (NAME) receive, at any moment yesterday or last night, any of the following:
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
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
NO 2
DOESN'T KNOW 8
435A. Was oil or grease used in the preparation of one of (NAME'S) meals yesterday or last night?
NO 2
DOESN'T KNOW 8
436. CHECK 435: FOOD OR LIQUID GIVEN YESTERDAY
"NO/DOESN'T KNOW" FOR ALL (GO TO 438)
437. Besides breast milk, how many times did (NAME) eat yesterday, including meals and snacks?
IF 7 TIMES OR MORE, RECORD '7'.
DOESN'T KNOW 8
438. How many days out of the last 7 days did (NAME) receive one of the following liquids or foods?
RECORD THE NUMBER OF DAYS.
DOESN'T KNOW 8
DOESN'T KNOW 8
DOESN'T KNOW 8
DOESN'T KNOW 8
DOESN'T KNOW 8
DOESN'T KNOW 8
DOESN'T KNOW 8
DOESN'T KNOW 8
DOESN'T KNOW 8
DOESN'T KNOW 8
439. RETURN TO 405 IN THE NEXT COLUMN; OR IF NO MORE BIRTHS, GO TO 440.
SECTION 4B. VACCINATION AND HEALTH
440. WRITE THE LINE NUMBER, NAME, AND SURVIVAL STATUS OF EACH BIRTH SINCE JANUARY 1994 RECORDED IN THE REPRODUCTION TABLE. ASK THE QUESTIONS FOR EACH BIRTH STARTING WITH THE MOST RECENT. (IF THERE ARE MORE THAN 2 BIRTHS, USE AN ADDITIONAL QUESTIONNAIRE.)
[441-465 ARE REPEATED FOR EACH BIRTH, BEGINNING WITH THE MOST RECENT BIRTH. IF MORE THAN 2 BIRTHS, USE LAST COLUMN OF ADDITIONAL QUESTIONNAIRES.]
DEAD ____ (GO TO 442 IN NEXT COLUMN OR, IF NO MORE BIRTHS, GO TO 465)
443. Do you have a card where (NAME'S) vaccinations are written down?
IF YES: May I see it please?
YES, NOT SEEN 3 (GO TO 447)
NO CARD 4
444. Did you ever have a vaccination card for (NAME)?
NO 2 (GO TO 447)
445. (1) COPY VACCINATION DATE 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 ____
446. 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 VACCINES.
DOESN'T KNOW 8 (GO TO 449)
447. Did (NAME) ever receive any vaccinations to prevent him/her from getting diseases?
NO 2 (GO TO 449)
DOESN'T KNOW 8 (GO TO 449)
448. Please tell me if (NAME) received any of the following vaccinations:
448A. A BCG vaccination against tuberculosis, that is, an injection in the left arm or shoulder that causes a scar?
NO 2
DOESN'T KNOW 8
448B. Polio vaccine, that is, drops in the mouth?
NO 2 (GO TO 448E)
DOESN'T KNOW 8 (GO TO 448E)
448D. When was the first polio vaccine received, just after birth or later?
LATER 2
448E. A DPT vaccination, that is, an injection given at the same time as polio drops?
NO 2 (GO TO 448G)
DOESN'T KNOW 8 (GO TO 448G)
448F. How many times was a DPT vaccination received?
NO 2
DOESN'T KNOW 8
449. Has (NAME) been ill with a fever at any time in the last 2 weeks?
NO 2
DOESN'T KNOW 8
450. Has (NAME) has an illness with a cough at any time in the last 2 weeks?
NO 2 (GO TO 453A)
DOESN'T KNOW 8 (GO TO 453A)
451. When (NAME) had an illness with a cough, did he/she breathe faster than usual with short, rapid breaths or have difficulty breathing?
NO 2
DOESN'T KNOW 8
452. Did you seek advice or treatment for the cough?
NO 2 (GO TO 453A)
453. Where did you seek advice or treatment?
Anywhere else?
RECORD ALL MENTIONED.
HEALTH CENTER B
DISPENSARY C
LOCAL HEALTH POST D
OTHER PUBLIC (SPECIFY) ________ E
PHARMACY H
DOCTOR I
OTHER PRIVATE MEDICAL (SPECIFY) ________ L
TRADITIONAL HEALER N
453A. Does (NAME) have difficulty seeing at nightfall?
NO 2 (GO TO 453C)
DOESN'T KNOW 8 (GO TO 453C)
453B. Does (NAME) have difficulty seeing during the day as well?
NO 2
DOESN'T KNOW 8
453C. Has (NAME) ever received a vitamin A dose like this one?
SHOW VITAMIN A PILL.
NO 2 (GO TO 454)
DOESN'T KNOW 8 (GO TO 454)
453D. How long has it been since the last time (NAME) received a vitamin A pill?
454. Has (NAME) had diarrhea in the last 2 weeks?
NO 2 (GO TO 464)
DOESN'T KNOW 8 (GO TO 464)
455. Was there blood in the stool?
NO 2
DOESN'T KNOW 8
456. The worst day of the diarrhea, how many stools did he/she have?
DOESN'T KNOW 98
457. Did (NAME) receive about the same amount of liquid as before the diarrhea?
MORE 2
LESS 3
DOESN'T KNOW 8
458. Did (NAME) receive about the same amount of food as before the diarrhea?
MORE 2
LESS 3
DOESN'T KNOW 8
NO LONGER BREASTFED (GO TO 459)
458B. Did you breastfeed about the same number of times as before the diarrhea?
MORE 2
LESS 3
459. When (NAME) had diarrhea, was he/she given one of the following things to drink:
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
NO 2
DOESN'T KNOW 8
NO 2
DOESN'T KNOW 8
460. Was anything (else) given to (NAME) to treat the diarrhea?
NO 2 (GO TO 462)
DOESN'T KNOW 8 (GO TO 462)
461. What (else) was given to treat the diarrhea?
Anything else?
RECORD ALL TREATMENTS GIVEN.
PILL OR SYRUP B
INJECTION C
(IV) INTRAVENOUS D
HOME REMEDY/HERBAL/TRADITIONAL MEDICINE E
OTHER (SPECIFY) ________ X
462. Did you seek advice or treatment for the diarrhea?
NO 2 (GO TO 464)
463. Where did you seek advice or treatment?
Anywhere else?
RECORD ALL MENTIONED.
HEALTH CENTER B
DISPENSARY C
LOCAL HEALTH POST D
OTHER PUBLIC (SPECIFY) ________ E
PHARMACY H
DOCTOR I
OTHER PRIVATE MEDICAL (SPECIFY) ________ L
TRADITIONAL HEALER N
464. RETURN TO 442 IN THE NEXT COLUMN OR, IF NO MORE BIRTHS, GO TO 465.
465. When a child has diarrhea, should he/she be given less than usual to drink, about the same amount as usual, or more than usual?
ABOUT THE SAME 2
MORE TO DRINK 3
DOESN'T KNOW 8
466. When a child has diarrhea, should he/she be given less than usual to eat, about the same amount as usual, or more than usual?
ABOUT THE SAME 2
MORE TO EAT 3
DOESN'T KNOW 8
467. When a child suffers from diarrhea, what are the signs/symptoms that let you know he/she should be brought to a health center or a health care professional?
RECORD ALL MENTIONED.
LIQUID STOOLS B
REPEATED VOMITING C
VOMITING D
BLOOD IN STOOL E
FEVER F
PRONOUNCED THIRST G
DOESN'T EAT/DRINK WELL H
BECOMES MORE SICK/VERY SICK I
DOESN'T GET BETTER J
OTHER (SPECIFY) ______ X
DOESN'T KNOW Z
468. When a child suffers from a cough, what are the signs/symptoms that let you know he/she should be brought to a health center or a health care professional?
RECORD ALL MENTIONED.
DIFFICULTY BREATHING B
NOISY BREATHING C
FEVER D
UNABLE TO DRINK E
DOESN'T EAT/DRINK WELL H
BECOMES MORE SICK/VERY SICK I
DOESN'T GET BETTER J
OTHER (SPECIFY) ______ X
DOESN'T KNOW Z
ANY CHILD RECEIVED ORS PACKET ____ (GO TO 501)
470. Have you ever heard of a product called ORS/OVIDA you can get for the treatment of diarrhea?
NO 2
SECTION 5. MARRIAGE AND SEXUAL ACTIVITY
501. PRESENCE OF OTHERS AT THIS POINT:
NO 2
NO 2
NO 2
NO 2
502. Are you currently married or living with a man as if married?
YES, LIVING WITH A MAN 2 (GO TO 507)
NO, NOT IN UNION 3
503. Do you currently have a regular sexual partner, an occasional sexual partner, or no sexual partner at all?
OCCASIONAL SEXUAL PARTNER 2
NO SEXUAL PARTNER 3
504. Have you ever been married or lived with a man as if married?
YES, LIVED WITH A MAN 2 (GO TO 511)
NO 3 (GO TO 515)
506. What is your marital status now: are you widowed, divorced, or separated?
DIVORCED 2 (GO TO 511)
SEPARATED 3 (GO TO 511)
507. Is your husband/partner living with you now or is he staying elsewhere?
STAYING ELSEWHERE 2
508. Does your husband/partner have any wives or partners other than you?
NO 2 (GO TO 511)
509. How many other wives or partners does your husband have?
DOESN'T KNOW 98 (GO TO 511)
510. Are you the first, second, ... wife?
511. Have you been married or lived with a man only once or more than once?
MORE THAN ONCE 2
MARRIED/LIVED WITH A MAN ONLY ONCE In what month and year did you start living with your husband/partner?
MARRIED/LIVED WITH A MAN MORE THAN ONCE Now we are going to talk about your first husband/partner. In what month and year did you start living with him?
DOESN'T KNOW MONTH 98
DOESN'T KNOW YEAR 9998
513. How old were you when you first started living with him?
Now I would like to ask you some questions about your sexual activity in order to gain a better understanding of certain problems related to family planning.
515. How long has it been since the last time you had sexual intercourse (if you've ever had it)?
WEEKS AGO 2 _______
MONTHS AGO 3 _______
YEARS AGO 4 ______
YES, SHE HAS HEARD OF CONDOMS. Did you use a condom during your last sexual encounter?
NO, SHE HAS NEVER HEARD OF CONDOMS. Certain men use a condom, that is, they put a rubber sheath on their penis before having sexual intercourse. Did you use a condom during your last sexual encounter?
NO 2 (GO TO 517)
DOESN'T KNOW 8 (GO TO 517)
516A. Do you know the brand of condom your partner used the last time you had sexual intercourse? IF YES: Which one was it?
PANTHER 2
PROFILTEX 3
SULTAN 4
STIMULEV 5
COREEN (VIOLETTE) 6
OTHER (SPECIFY) _____ 7
DOESN'T KNOW 8
517. Do you know of a place where you can get condoms?
NO 2 (GO TO 519)
IF IT IS A PUBLIC HOSPITAL OR A PRIVATE HOSPITAL OR CLINIC, WRITE THE NAME OF THE ESTABLISHMENT. PROBE TO DETERMINE THE PROPER TYPE OF SECTOR AND CIRCLE THE APPROPRIATE CODE.
HEALTH CENTER B
DISPENSARY C
OTHER PUBLIC (SPECIFY) __________ X
PHARMACY F
DOCTOR G
PF/FISA CENTER H
OTHER PRIVATE (SPECIFY) ______ Y
RELIGIOUS CENTER J
RELATIVES K
FRIENDS L
519. What age were you when you had your first sexual encounter?
FIRST TIME WHILE MARRIED 96
12 MONTHS OR MORE SINCE LAST HAD SEXUAL INTERCOURSE ____ (GO TO 601)
521. With how many different people have you had sexual intercourse in the last 12 months?
DOESN'T KNOW 96
SECTION 6. FERTILITY PREFERENCES
601. CHECK 314:
HE OR SHE STERILIZED (GO TO 612)
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 now, would you like to have another child, or would you prefer not to have any more children?
NO MORE/NONE 2 (GO TO 604)
SAYS SHE CAN'T GET PREGNANT 3 (GO TO 606)
UNDECIDED/DOESN'T KNOW 8 (GO TO 604)
NOT PREGNANT OR UNSURE How long would you like to wait from now before the birth of (a/another) child?
PREGNANT After the birth of the child you are expecting now, how long would you like to wait before the birth of another child?
YEARS 2 ____
SAYS SHE CAN'T GET PREGNANT 994 (GO TO 606)
AFTER MARRIAGE 995 (GO TO 606)
OTHER (SPECIFY) _______ 996
DOESN'T KNOW 998
PREGNANT (GO TO 607)
605. If you were to become pregnant in the next several weeks, would you be happy, not happy, or indifferent?
NOT HAPPY 2
INDIFFERENT 3
606. CHECK 313:
USING A METHOD?
NOT CURRENTLY USING
CURRENTLY USING (GO TO 612)
607. Do you think you will use a contraceptive method to delay or avoid pregnancy at any time in the next 12 months?
NO 2
DOESN'T KNOW 8
608. Do you think you will use a contraceptive method to delay or avoid pregnancy at any time in the future?
NO 2 (GO TO 610)
DOESN'T KNOW 8 (GO TO 610)
609. Which contraceptive method would you prefer to use?
IUD 02 (GO TO 612)
INJECTABLES 03 (GO TO 612)
IMPLANTS 04 (GO TO 612)
DIAPHRAGM/FOAM/JELLY 05 (GO TO 612)
CONDOM 06 (GO TO 612)
FEMALE STERILIZATION 07 (GO TO 612)
MALE STERILIZATION 08 (GO TO 612)
RHYTHM METHOD 09 (GO TO 612)
WITHDRAWAL 10 (GO TO 612)
OTHER (SPECIFY) ____ 96 (GO TO 612)
DOESN'T KNOW 98
610. What is the main reason that you think you will never use a contraceptive method?
INFREQUENT SEX/NO SEX 22 (GO TO 612)
MENOPAUSAL/HYSTERECTOMY 23 (GO TO 612)
SUBFECOND/INFECUND 24 (GO TO 612)
POSTPARTUM CARE/BREASTFEEDING 25 (GO TO 612)
WANT (OTHER) CHILDREN 26 (GO TO 612)
HUSBAND/PARTNER OPPOSED 32 (GO TO 612)
OTHERS OPPOSED 33 (GO TO 612)
RELIGIOUS PROHIBITION 34 (GO TO 612)
KNOWS NO SOURCE 42 (GO TO 612)
FEAR OF SIDE EFFECTS 52 (GO TO 612)
LACK OF ACCESS/TOO FAR 53 (GO TO 612)
COSTS TOO MUCH 54 (GO TO 612)
INCONVENIENT TO USE 55 (GO TO 612)
INTERFERES WITH BODY'S NORMAL PROCESSES 56 (GO TO 612)
DOESN'T KNOW 98 (GO TO 612)
611. Would you ever use a contraceptive method if you were married?
NO 2
DOESN'T KNOW 8
HAS LIVING CHILDREN. If you could go back to the time you did not have any children and could choose exactly the number of children to have in your whole life, how many would that be?
PROBE FOR A NUMERIC RESPONSE.
NO LIVING CHILDREN. If you could choose exactly the number of children to have in your whole life, how many would that be?
PROBE FOR A NUMERIC RESPONSE.
OTHER (SPECIFY) ________ 96 (GO TO 614)
613. 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?
OTHER (SPECIFY) ______ 96
OTHER (SPECIFY) ______ 96
OTHER (SPECIFY) ______ 96
614. In general, do you approve or disapprove of couples that use a method to avoid becoming pregnant?
DISAPPROVE 2
NO OPINION 3
615. In your opinion, is it appropriate or inappropriate to speak of family planning:
INAPPROPRIATE 2
DOESN'T KNOW 8
INAPPROPRIATE 2
DOESN'T KNOW 8
616. Over the last few months, have you heard or read messages about family planning:
NO 2
NO 2
NO 2
NO 2
NO 2
617. Over the last several months, have you listened to a radio program called Sarivolana?
NO 2 (GO TO 618)
617A. How many times over the last 12 months have you listened to this program?
BETWEEN FIVE AND TEN TIMES 2
MORE THAN TEN TIMES 3
DOESN'T KNOW 8
618. Over the last several months, have you discussed family planning with your friends, neighbors, or relatives?
NO 2 (GO TO 620)
619. With whom did you discuss it?
Anyone else?
RECORD ALL PERSONS MENTIONED.
MOTHER B
FATHER C
SISTER(S) D
BROTHER(S) E
DAUGHTER F
MOTHER-IN-LAW G
FRIEND(S)/NEIGHBOR(S) H
OTHER (SPECIFY) ______ X
YES, LIVING WITH A MAN
NO, NOT IN UNION (GO TO 701)
Spouses don't always agree on everything. Now I would like to ask you some questions about your husband's/partner's opinions on family planning.
621. Do you think that your husband/partner approves or disapproves of couples that use a method to avoid a pregnancy?
DISAPPROVES 2
DOESN'T KNOW 8
622. How many times over the last 12 months have you discussed family planning with your husband/partner?
ONE OR TWO TIMES 2
MORE OFTEN 3
623. Do you think that your husband/partner wants the same number of children that you want, or does he want more or fewer than you want?
MORE CHILDREN 2
FEWER CHILDREN 3
DOESN'T KNOW 8
SECTION 7. HUSBAND'S BACKGROUND AND WOMAN'S WORK
701. CHECK 502 AND 504:
FORMERLY MARRIED/LIVING WITH A MAN (GO TO 703)
NEVER MARRIED AND NEVER LIVED WITH A MAN (GO TO 709)
702. How old was your husband/partner on his last birthday?
703. Did your (last) husband/partner ever attend school?
NO 2 (GO TO 706)
704. What was the highest level of school he attended: primary, secondary or higher?
SECONDARY 1 2
SECONDARY 2 3
HIGHER 4 (GO TO 706)
705. What was the highest grade he completed at that level?
DOESN'T KNOW 98
706. What is (was) your husband's/partner's occupation? That is, what kind of work does (did) he mainly do?
DOES/DID NOT WORK IN AGRICULTURE ____ (GO TO 709)
708. Did/Does your husband/partner work mainly on his own land or on family land, or does/did he work on land that he rents/rented from someone else, or does/did he work on someone else's land?
FAMILY LAND 2
RENTED LAND 3
SOMEONE ELSE'S LAND 4
709. Aside from your own housework, have you done any work in the last seven days?
NO 2
710. As you know, some women take up jobs for which they are paid in cash or kind. Some have a small business or work on the family farm or in the family business. In the last seven days, have you done any of these things or any other work?
NO 2 (GO TO 712)
711. Have you done any work in the last 12 months?
NO 2 (GO TO 801)
712. What is your occupation, that is, what kind of work do you mainly do?
DOES/DID NOT WORK IN AGRICULTURE (GO TO 715)
714. 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
715. Do you do this work for a member of your family, for someone else, or are you self-employed?
FOR SOMEONE ELSE 2
SELF-EMPLOYED 3
716. Do you usually work throughout the year, or do you work seasonally, or only once in a while?
SEASONALLY/PART OF THE YEAR 2
ONCE IN A WHILE 3 (GO TO 719)
717. Out of the last 12 months, how many months did you work?
718. Over the last 12 months, about how many days per week did you generally work?
719. Over the last 12 months, about how many days did you work?
720. Do you earn a salary for this work?
INSIST: Do you earn money for doing this work?
NO 2 (GO TO 723)
721. How much do you usually earn for this work?
INSIST: Is it by day, by week or by month?
RECORD IN MGF X 1,000.
BY DAY 2 _____
BY WEEK 3 _____
BY MONTH 4 _____
BY YEAR 5 _____
OTHER (SPECIFY) ______ 999996
YES, CURRENTLY MARRIED OR LIVING WITH A MAN. Who principally decides how the money you earn will be used?
NO, NOT IN UNION. Who principally decides how the money you earn will be used? ('HUSBAND/PARTNER' OMITTED IN RESPONSE SET)
HUSBAND/PARTNER 2
RESPONDENT AND HUSBAND/PARTNER JOINTLY 3
SOMEONE ELSE 4
SOMEONE ELSE AND RESPONDENT TOGETHER 5
723. Do you usually work in the home or outside the home?
OUTSIDE THE HOME 2
724. CHECK 217 AND 218:
HAS A CHILD UNDER SIX YEARS OLD LIVING WITH HER?
NO (GO TO 801A)
725. Who usually takes care of (NAME OF YOUNGEST CHILD IN HOUSEHOLD) while you are working?
HUSBAND/PARTNER 2
OLDER FEMALE CHILD 3
OLDER MALE CHILD 4
OTHER RELATIVES 5
COUSINS 6
FRIENDS 7
NANNY/HIRED PERSON 8
CHILD GOES TO SCHOOL 9
DAYCARE/KINDERGARTEN 10
HASN'T WORKED SINCE LAST BIRTH 95
OTHER (SPECIFY) _______ 96
SECTION 8. AIDS AND OTHER SEXUALLY TRANSMITTED INFECTIONS
801A. Have you ever heard about infections that can be transmitted through sexual contact?
NO 2 (GO TO 801L)
801B. Which ones do you know of?
RECORD ALL MENTIONED.
GONORRHEA B
AIDS C
CONDYLOMA (GENITAL WARTS) D
OTHER (SPECIFY) _____ W
OTHER (SPECIFY) _____ X
DOESN'T KNOW Z
HAS NOT HAD SEXUAL INTERCOURSE (GO TO 801L)
801D. In the last 12 months, have you had one of these infections?
NO 2 (GO TO 801F)
DOESN'T KNOW 8 (GO TO 801F)
801E. Which infections did you have?
RECORD ALL MENTIONED.
GONORRHEA B
AIDS C
CONDYLOMA (GENITAL WARTS) D
OTHER (SPECIFY) _____ W
OTHER (SPECIFY) _____ X
DOESN'T KNOW Z
801F. In the last 12 months, have you had any vaginal or anal releasing/discharge?
NO 2 (GO TO 801L)
801G. The last time you had this infection (these infections), did you seek advice or treatment, treat yourself at home, or do nothing?
TREATED HERSELF 2 (GO TO 801I)
NOTHING 3 (GO TO 801I)
801H. Where did you seek advice or treatment?
RECORD ALL MENTIONED.
HEALTH CENTER B
DISPENSARY C
LOCAL HEALTH POST D
OTHER PUBLIC (SPECIFY) __________ X
PHARMACY F
DOCTOR G
OTHER PRIVATE (SPECIFY) ______ Y
RELIGIOUS CENTER J
RELATIVES K
FRIENDS L
HEALER M
801I. When you had (INFECTION(S) FROM 801E), did you inform your sexual partner(s)?
NO 2
801J. When you had (INFECTION(S) FROM 801E), did you do anything to avoid infecting your sexual partner(s)?
NO 2 (GO TO 801L)
PARTNER ALREADY INFECTED 8 (GO TO 801L)
USED CONDOMS B
TOOK MEDICATION C
OTHER (SPECIFY) ______ X
MENTIONED AIDS (GO TO 802)
801M. Have you ever heard of an illness called AIDS?
NO 2 (GO TO 811C)
802. From which sources of information have you learned the most about AIDS?
Are there other sources?
RECORD ALL MENTIONED.
TELEVISION B
NEWSPAPERS/MAGAZINES C
POSTERS D
HEALTH AGENTS E
CHURCH/MOSQUE F
SCHOOL/TEACHERS G
NEIGHBORHOOD PRESENTATIONS H
RELATIVES I
FRIENDS J
WORK PLACE K
MOVIE CLUBS L
OTHER (SPECIFY) ____ X
802A. In your opinion, does AIDS exist in Madagascar?
NO 2
DOESN'T KNOW 8
802B. In your opinion, can someone get AIDS:
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
NO 2
DOESN'T KNOW 8
803. Is there something people can do to avoid contracting AIDS?
NO 2 (GO TO 807)
DOESN'T KNOW 8 (GO TO 807)
804. What can one do?
Anything else?
RECORD ALL MENTIONED.
USE CONDOMS B
ONLY HAVE ONE PARTNER C
AVOID PROSTITUTES D
AVOID HOMOSEXUAL RELATIONS E
AVOID BLOOD TRANSFUSIONS F
AVOID INJECTIONS G
AVOID KISSING H
AVOID MOSQUITO BITES I
SEEK PROTECTION FROM TRADITIONAL HEALERS J
SEEK PROTECTION FROM ANCESTORS K
OTHER (SPECIFY) _____ W
OTHER (SPECIFY) _____ X
DOESN'T KNOW Z
807. Is it possible for a healthy-looking person to have AIDS?
NO 2
DOESN'T KNOW 8
808. Do you think that a person with AIDS almost never dies from it, sometimes dies from it, or almost always dies from it?
SOMETIMES 2
ALMOST ALWAYS 3
DOESN'T KNOW 8
808A. Do you think AIDS can be cured?
NO 2
DOESN'T KNOW 8
808B. Can AIDS be passed from mother to child?
NO 2
DOESN'T KNOW 8
808C. Do you personally know anyone who has the AIDS or has died of AIDS?
NO 2
DOESN'T KNOW 8
809. Do you think your risk of getting AIDS is small, moderate, significant, or do you think you run no risk at all in contracting AIDS?
MODERATE 2 (GO TO 809B)
SIGNIFICANT 3 (GO TO 809B)
NO RISK AT ALL 4
HAS AIDS 5 (GO TO 811A)
DOESN'T KNOW 8 (GO TO 811A)
809A. Why do you think your risk of getting AIDS is small?
Why do you think you run no risk of getting AIDS?
Are there other reasons?
RECORD ALL MENTIONED.
USES CONDOMS B (GO TO 811A)
ONLY HAS SEX WITH ONE PARTNER C (GO TO 811A)
LIMITS NUMBER OF SEXUAL PARTNERS D (GO TO 811A)
PARTNER IS FAITHFUL E (GO TO 811A)
AVOIDS BLOOD TRANSFUSIONS G (GO TO 811A)
AVOIDS INJECTIONS H (GO TO 811A)
OTHER (SPECIFY) _____ X (GO TO 811A)
809B. Why do you think your risk of getting AIDS is moderate?
Why do you think your risk of getting AIDS is significant?
Are there other reasons?
RECORD ALL MENTIONED.
HAS MORE THAN ONE PARTNER C
HAS NUMEROUS PARTNERS D
PARTNER IS UNFAITHFUL E
AVOIDS BLOOD TRANSFUSIONS G
AVOIDS INJECTIONS H
OTHER (SPECIFY) _____ X
811A. Since you've heard about AIDS, have you changed your behavior in order to avoid getting the illness?
IF YES, INSIST: What have you done? Anything else?
RECORD ALL MENTIONED.
STOPPED HAVING SEX B
STARTED TO USE CONDOMS C (GO TO 901)
HAS ONE PARTNER D
REDUCED NUMBER OF PARTNERS E
OTHER (SPECIFY) ____ X
CHANGED NOTHING ABOUT SEXUAL BEHAVIOR Y
DOESN'T KNOW Z
811B. Some people use a condom during sexual intercourse to protect themselves from AIDS and other sexually transmitted infections. Have you already heard of this?
NO 2 (GO TO 901)
HAS NOT HAD SEXUAL INTERCOURSE (GO TO 901)
811D. Have you ever used a condom to protect yourself from illnesses such as AIDS?
NO 2
Now, I would like to ask you some questions about your brothers and sisters, that is, all of the children born to your natural mother including those that live with you, those that live elsewhere, and those that are deceased.
901. To how many children did your mother give birth in total, including yourself?
ONLY ONE BIRTH (RESPONDENT) (GO TO 916)
903. How many of these births did your mother have before you were born?
904. What was the name given to your oldest (next oldest) brother or sister?
905. Is (NAME) male or female?
FEMALE 2
NO 2 (GO TO 908)
DOESN'T KNOW 8 (GO TO NEXT COLUMN)
908. In what year did (NAME) die?
DOESN'T KNOW 9998
909. How many years ago did (NAME) die?
910. How old was (NAME) when he/she died?
IF MALE, OR IF FEMALE AND DIED BEFORE 12 YEARS OF AGE, GO TO NEXT COLUMN.
911. Was (NAME) pregnant when she died?
NO 2
912. Did (NAME) die during childbirth?
NO 2
DOESN'T KNOW 8
913. Did (NAME) die within two months after the end of a pregnancy or childbirth?
NO 2
DOESN'T KNOW 8
914. Did (NAME) die due to complications from pregnancy or childbirth?
NO 2
DOESN'T KNOW 8
915. How many children did (NAME) give birth to?
[GO TO NEXT COLUMN. IF NO MORE BROTHERS OR SISTERS, GO TO 916]
916. RECORD THE TIME.
MINUTES ____
1001. CHECK 215:
NO BIRTHS SINCE JANUARY 1994 (END OF SURVEY)
1002. LINE NUMBER ACCORDING TO 212.
[FOR CHILDREN ONLY]
1004. BIRTH DATE (ACCORDING TO 215, ASK FOR DATE OF BIRTH)
[FOR CHILDREN ONLY]
MONTH ____
YEAR _____
1005. TB VACCINE SCAR ON THE TOP OF LEFT SHOULDER.
[FOR CHILDREN ONLY]
SCAR NOT SEEN 2
1007. Was the child measured lying down or standing up?
[FOR CHILDREN ONLY]
STANDING UP 2
1008A. FOLLOWING THE INSTRUCTIONS IN THE MANUAL, INFORM THE WOMAN OF THE BLOOD DRAW PROCEDURE THAT YOU WILL PERFORM, AND THAT SHE HAS THE RIGHT TO REFUSE IF SHE DOES NOT WANT TO HAVE THIS PROCEDURE DONE.
1008B. LEVEL SHOWN BY THE HEMOGLOBINOMETER (IN GRAMS PER DECILITER):
1009. DATE OF HEIGHT AND WEIGHT MEASUREMENT:
MONTH ____
YEAR ____
ABSENT 3
REFUSED 4
OTHER (SPECIFY) ____ 6
RESULT FOR CHILDREN
CHILD SICK 2
CHILD ABSENT 3
CHILD REFUSED 4
MOTHER REFUSED 5
OTHER (SPECIFY) ____ 6
1011. NAME OF OPERATOR: _________
NAME OF ASSISTANT: ___________
TO BE FILLED IN AFTER COMPLETING INTERVIEW:
COMMENTS ABOUT RESPONDENT ____
COMMENTS ON SPECIFIC QUESTIONS ____
ANY OTHER COMMENTS ____
SUPERVISOR'S OBSERVATIONS ____
NAME OF SUPERVISOR ____
DATE____
EDITOR'S OBSERVATIONS ____
NAME OF EDITOR ____
DATE ____