VILLAGE/PLACE NAME______________
NAME OF HOUSEHOLD HEAD___________
MDHS CLUSTER NUMBER _____________
HOUSEHOLD NUMBER ___________
RURAL 2
NAME AND LINE NUMBER OF MAN _____________
FIRST VISIT (REPEAT FOR SECOND AND THIRD VISITS)
DATE ________
INTERVIEWER'S NAME _______
RESULT* ________
NOT AT HOME 2
POSTPONED 3
REFUSED 4
PARTLY COMPLETED 5
INCAPACITATED 6
OTHER (SPECIFY) ________________ 7
NEXT VISIT:
DATE_____
TIME________
FINAL VISIT
DAY ___
MONTH____
YEAR _____
NAME____
RESULT ____
TUMBUKA 2
OTHER (SPECIFY) ____ 3
SUPERVISOR
NAME ____
DATE ____
FIELD EDITOR
NAME ____
DATE ____
OFFICE EDITOR ____
KEYED BY ____
SECTION 1. RESPONDENT'S BACKGROUND
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 a city, in a town, or in a village?
TOWN 2
VILLAGE 3
102A. In the last 12 months, have you been away from your home community for more than 1 month at a time?
NO 2
102B. In the last 12 months, on how many separate occasions have you traveled away from your home community and slept away?
IF "NO OCCASIONS", RECORD '00'.
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 a city, in a town, or in a village?
TOWN 2
VILLAGE 3
105. In what month and year were you born?
DON'T KNOW MONTH 98
DON'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 111)
108. What is the highest level of school you attended: primary, secondary, or higher?
SECONDARY 2
HIGHER 3
109. How many years of school did you complete at that level?
SECONDARY OR HIGHER (GO TO 114)
111. 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
112. 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' CIRCLED (GO TO 115)
114. Do you read a newspaper or magazine almost every day, at least once a week, less often than that or not at all?
AT LEAST ONCE A WEEK 2
LESS OFTEN 3
NOT AT ALL 4
115. Do you listen to the radio almost every day, at least once a week, less often than that or not at all?
AT LEAST ONCE A WEEK 2
LESS OFTEN 3
NOT AT ALL 4
116. Do you watch television almost every day, at least once a week, less often than that or not at all?
AT LEAST ONCE A WEEK 2
LESS OFTEN 3
NOT AT ALL 4
CCAP 02
ANGLICAN 03
SEVENTH DAY ADVENT./BAPTIST 04
OTHER CHRISTIAN 05
MUSLIM 06
NO RELIGION 07
OTHER (SPECIFY) ____ 96
118. What is your tribe or ethnic group?
TUMBUKA 02
LOMWE 03
TONGA 04
YAO 05
SENA 06
NKONDE 07
NGONI 08
OTHER (SPECIFY) ____ 96
119. Have you heard that when a child is born in Malawi, you can register that child with the government and receive a birth certificate?
NO 2
201. Now I would like to ask about your children. I am interested only in the children that are biologically yours. Have you ever had children?
NO 2 (GO TO 206)
202. Do you have any sons or daughters 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'.
204. Do you have any sons or daughters 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'.
206. Have you ever had a boy or girl who was born alive but later died?
IF NO, PROBE: Any baby who cried or showed signs of life but survived only a few moments?
NO 2 (GO TO 208)
207. How many boys have died? And how many girls have died?
IF NONE, RECORD '00'.
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 _____ children during your life. Is that correct?
NO (PROBE AND CORRECT 201-208 AS NECESSARY).
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.
301. Which ways or methods have you heard about?
FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK: Have you ever heard of (METHOD)?
NO 2 (GO TO NEXT METHOD)
NO 2 (GO TO NEXT METHOD)
NO 2 (GO TO NEXT METHOD)
NO 2 (GO TO NEXT METHOD)
NO 2 (GO TO NEXT METHOD)
NO 2 (GO TO NEXT METHOD)
NO 2 (GO TO NEXT METHOD)
NO 2 (GO TO NEXT METHOD)
NO 2 (GO TO NEXT METHOD)
NO 2 (GO TO NEXT METHOD)
NO 2 (GO TO NEXT METHOD)
NO 2 (GO TO NEXT METHOD)
NO 2 (GO TO NEXT METHOD)
NO 2 (GO TO NEXT METHOD)
NO 2
302. Have you ever used (METHOD)?
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
AT LEAST ONE "YES" (EVER USED) (GO TO 325A)
304. Have you or any of your partners ever used anything or tried in any way to delay or avoid getting pregnant?
NO 2 (GO TO 325A)
306. What have you used or done?
CORRECT 302 AND 303 (AND 301 IF NECESSARY).
325A. Were you ever told by a health or family planning worker about methods of family planning which you could use?
NO 2
328. Do you know of a place where you can obtain a method of family planning?
NO 2 (GO TO 492)
329. Where is that? Any other place?
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.
RECORD ALL MENTIONED.
GOVERNMENT HEALTH CENTER B
FAMILY PLANNING CLINIC C
MOBILE CLINIC D
CBDA/FIELD WORKER E
OTHER PUBLIC (SPECIFY) _____ F
HEALTH CENTER H
MOBILE CLINIC I
PHARMACY K
PRIVATE DOCTOR L
MOBILE CLINIC M
CBDA/FIELD WORKER N
OTHER PRIVATE MEDICAL (SPECIFY)_____ O
CHURCH R
FRIEND/RELATIVE S
492. Do you currently smoke cigarettes or tobacco?
IF YES: What type of tobacco do you smoke?
RECORD ALL MENTIONED.
YES, PIPE B
YES, OTHER TOBACCO C
NO Y
CODE 'A' NOT CIRCLED (GO TO 493A)
493. In the last 24 hours, how many cigarettes did you smoke?
493A. Have you ever drank an alcohol-containing beverage?
NO 2 (GO TO 493F)
493B. Have you ever gotten "drunk" from drinking an alcohol-containing beverage?
NO 2
493C. In the last 3 months, on how many days did you drink an alcohol-containing beverage?
NONE/NEVER 97 (GO TO 493F)
NO (GO TO 493F)
493E. In the last 3 months, on how many occasions did you get "drunk"?
NONE/NEVER 97
493F. Have you had any kind of injection in the last 3 months?
NO 2 (GO TO 494G)
493G. How many times did you have an injection in the last 3 months?
EVERY DAY 96
493H. The last time you had an injection, who was the person who gave you the injection?
PHARMACIST 2
TRADITIONAL HEALER 3
FRIEND/RELATIVE 4
SELF 5
OTHER (SPECIFY) ____ 6
494G. Did you have a fever at any time in the last two weeks?
NO 2 (GO TO 494K)
494H. Did you take any medicine for the fever?
NO 2 (GO TO 494K)
494I. Which medicines did you take?
ASK TO SEE MEDICINE(S). IF NOT SEEN, SHOW MEDICINE(S) TO RESPONDENT.
FOR EACH ANTI-MALARIAL MEDICINE: How long after the fever started did you start taking the medicine?
RECORD ALL MENTIONED.
TYPE OF DRUG:
QUININE B
CHLOROQUINE C
AMODIAQUINE D
HALAFAN E
PANADOL G
UNKNOWN Z
WHEN ANTI-MALARIAL WAS GIVEN:
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3
NEXT DAY AFTER THE FEVER 1
TWO DAYS AFTER THE FEVER 2
THREE OR MORE DAYS AFTER THE FEVER 3
494J. How many occasions did you take this medicine(s)?
494K. Did you sleep under a mosquito net last night?
NO 2 (GO TO 501)
494L. Where was the mosquito net you slept under bought or obtained?
VENDOR 2
NGO OR OTHER ORGANIZATION 3
OTHER (SPECIFY) ______ 6
DON'T KNOW 8
494M. How long ago was the mosquito net bought or obtained?
WRITE THE ANSWER IN MONTHS (LESS THAN 1 MONTH = 00)
IF MORE THAN 84 MONTHS, WRITE 95.
DON'T KNOW 8
494N. Since you got the mosquito net, was it ever soaked or dipped in an insecticide to repel mosquitoes or bugs?
NO 2 (GO TO 501)
DON'T KNOW 8 (GO TO 501)
494O. How long ago was the mosquito net last soaked or dipped?
WRITE THE ANSWER IN MONTHS (LESS THAN 1 MONTH = 00)
IF MORE THAN 84 MONTHS, WRITE 95.
DON'T KNOW 98
SECTION 5. MARRIAGE AND SEXUAL ACTIVITY
501. Are you currently married or living with a woman?
YES, LIVING WITH A WOMAN 2
NO, NOT IN UNION 3 (GO TO 504)
502. Do you have more than one wife or live-in partner?
IF YES: How many wives or live-in partners do you have?
NUMBER OF WIVES/PARTNERS (GO TO 506A)
504. Have you ever been married or lived with a woman?
YES, LIVED WITH A WOMAN 2
NO 3 (GO TO 514)
505. What is your marital status now: are you widowed, divorced, or separated?
DIVORCED 2 (GO TO 507)
SEPARATED 3 (GO TO 507)
506. What is your wife's/partner's name?
506A. Which of your current wives did you marry first?
Which of your current wives did you marry second?
FIRST RECORD ALL OF THE WIVES'/PARTNERS' NAMES AND THEN CHECK IN THE HOUSEHOLD SCHEDULE AND RECORD THE NUMBER FROM THE HOUSEHOLD SCHEDULE FOR EACH WIFE/PARTNER MENTIONED. IF SHE IS NOT LISTED IN THE HOUSEHOLD, RECORD '00'.
CHECK THAT THE NUMBER OF WIVES LISTED IS EQUAL TO THE NUMBER IN 502
507. Have you been married or lived with a woman only once, or more than once?
MORE THAN ONCE 2
MARRIED/LIVED WITH A WOMAN ONCE: In what month and year did you start living with your wife/partner?
MARRIED/LIVED WITH A WOMAN MORE THAN ONCE: 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
DON'T KNOW YEAR 9998
509. How old were you when you started living with her?
514. Now I need to ask you some questions about sexual activity in order to gain a better understanding of some family life issues.
How old were you when you first had sexual intercourse (if ever)?
AGE IN YEARS ___
FIRST TIME WHEN YOU STARTED LIVING WITH (FIRST) WIFE/PARTNER 96
515. When was the last time you had sexual intercourse?
RECORD 'YEARS AGO' ONLY IF LAST INTERCOURSE WAS ONE OR MORE YEARS AGO
WEEKS AGO 2 ___
MONTHS AGO 3 ___
YEARS AGO 4 ___ (GO TO 524)
516. The last time you had sexual intercourse, was a condom used?
NO 2 (GO TO 516C)
516A. What was the main reason you used a condom on that occasion?
OWN CONCERN TO PREVENT PREGNANCY 2
OWN CONCERN TO PREVENT BOTH STD/HIV AND PREGNANCY 3
DID NOT TRUST PARTNER/FEELS PARTNER HAS OTHER PARTNERS 4
PARTNER INSISTED 5
DON'T KNOW 6
OTHER (SPECIFY) ____ 7
516B. On that occasion, in addition to the condom, did you or your partner do something or use any other method to avoid pregnancy?
NO 2 (GO TO 516DY)
516C. On that occasion, did you or your partner do something or use anything to avoid pregnancy?
NO 2 (GO TO 517)
516D. Which method did you or your partner use?
516DX. CIRCLE 'G', THEN ASK:
In addition to the condom, which method did you or your partner use?
516DY. CIRCLE 'G', THEN CONTINUE TO 516E
MALE STERILIZATION B
PILL C
IUD D
INJECTIONS E
IMPLANTS F
CONDOM G
FEMALE CONDOM H
DIAPHRAGM I
FOAM/JELLY J
LACTATIONAL AMENORRHEA METHOD K (GO TO 517)
PERIODIC ABSTINENCE L (GO TO 517)
WITHDRAWAL M (GO TO 517)
OTHER (SPECIFY) ____ X (GO TO 517)
516E. Where did you or your partner obtain (HIGHEST METHOD: 516D) the last time?
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.
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14
FIELD WORKER 15
OTHER PUBLIC (SPECIFY) _____ 16
HEALTH CENTER 22
MOBILE CLINIC 23
PHARMACY 32
PRIVATE DOCTOR 33
MOBILE CLINIC 34
FIELD WORKER 35
OTHER PRIVATE MEDICAL (SPECIFY)_____ 36
CHURCH 52
FRIEND/RELATIVE 53
DON'T KNOW 98
517. What is your relationship to the woman with whom you last had sex?
IF "GIRLFRIEND" OR "FIANCEE", ASK: Was your girlfriend/fiancé living with you when you last had sex?
IF 'YES' RECORD '1'
IF 'NO' RECORD '2'
GIRLFRIEND/FIANCE 02
OTHER FRIEND 03
CASUAL ACQUAINTANCE 04
RELATIVE 05
COMMERCIAL SEX WORKER 06
OTHER (SPECIFY) ____ 96
518. For how long have you had sexual relations with this woman?
WEEKS 2 __
MONTHS 3 ___
YEARS 4 ___
519. Have you had sex with any other woman in the last 12 months?
NO 2 (GO TO 523A)
520. The last time you had sexual intercourse with this other woman, was a condom used?
NO 2 (GO TO 521)
520A. What was the main reason you used a condom on that occasion?
OWN CONCERN TO PREVENT PREGNANCY 2
OWN CONCERN TO PREVENT BOTH STD/HIV AND PREGNANCY 3
DID NOT TRUST PARTNER/FEELS PARTNER HAS OTHER PARTNERS 4
PARTNER INSISTED 5
DON'T KNOW 6
OTHER (SPECIFY) _____ 7
521. What is your relationship to this woman?
IF "GIRLFRIEND" OR "FIANCEE", ASK: Was your girlfriend/fiancée living with you when you last had sex?
IF 'YES' RECORD '1'
IF 'NO' RECORD '2'
GIRLFRIEND/FIANCEE 02
OTHER FRIEND 03
CASUAL ACQUAINTANCE 04
RELATIVE 05
COMMERCIAL SEX WORKER 06
OTHER (SPECIFY) ____ 96
522. For how long have you had sexual relations with this woman?
WEEKS 2 ___
MONTHS 3 ___
YEARS 4 ___
522A. Other than these two women, have you had sex with anyone else in the last 12 months?
NO 2 (GO TO 523A)
522B. The last time you had sexual intercourse with this other woman, was a condom used?
NO 2 (GO TO 522D)
522C. What was the main reason you used a condom on that occasion?
OWN CONCERN TO PREVENT PREGNANCY 2
OWN CONCERN TO PREVENT BOTH STD/HIV AND PREGNANCY 3
DID NOT TRUST PARTNER/FEELS PARTNER HAS OTHER PARTNERS 4
PARTNER INSISTED 5
DON'T KNOW 6
OTHER (SPECIFY) _____ 7
522D. What is your relationship to this woman?
IF "GIRLFRIEND" OR "FIANCEE", ASK: Was your girlfriend/fiancée living with you when you last had sex?
IF 'YES' RECORD '1'
IF 'NO' RECORD '2'
GIRLFRIEND/FIANCEE 02
OTHER FRIEND 03
CASUAL ACQUAINTANCE 04
RELATIVE 05
COMMERCIAL SEX WORKER 06
OTHER (SPECIFY) ____ 96
522E. For how long have you had a sexual relationship with this woman?
WEEKS 2 ___
MONTHS 3 ___
YEARS 4 ___
523. Altogether, with how many different women have you had sex in the last 12 months?
523A. Have you ever paid for sex?
NO 2 (GO TO 524)
523B. How long ago was the last time you paid for sex?
WEEKS AGO 2 ___
MONTHS AGO 3 ___
YEARS AGO 4 ___
523C. The last time that you paid for sex, was a condom used on that occasion?
NO 2
524. Do you know of a place where one can get condoms?
NO 2 (GO TO 530)
525. Where is that?
RECORD FIRST RESPONSE ONLY.
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.
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14
FIELD WORKER 15
OTHER PUBLIC (SPECIFY) _____ 16
HEALTH CENTER 22
MOBILE CLINIC 23
PHARMACY 32
PRIVATE DOCTOR 33
MOBILE CLINIC 34
FIELD WORKER 35
OTHER PRIVATE MEDICAL (SPECIFY)_____ 36
CHURCH 52
FRIEND/RELATIVE 53
526. If you wanted to, could you yourself get a condom?
NO 2
DON'T KNOW/UNSURE 8
530. Have you heard of a condom called "Chishango"?
NO 2
DON'T KNOW/UNSURE 8
SECTION 6. FERTILITY PREFERENCES
STERILIZED (GO TO 614)
NOT CURRENTLY IN UNION CODE '3' CIRCLED (GO TO 614)
601C. Is your wife or one of your wives or partners pregnant now?
NO 2
UNSURE 3
NONE OF WIVES/PARTNERS 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?
ONE OF WIVES/PARTNERS PREGNANT: Now I have some questions about the future. After the child your wife/partner is 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 614)
SAYS HIS WIFE/PARTNER CAN'T GET PREGNANT 3 (GO TO 614)
UNDECIDED/DON'T KNOW 4 (GO TO 614)
NONE OF WIVES/PARTNERS PREGNANT OR UNSURE: How long would you like to wait from now before the birth of (a/another) child?
ONE OF WIVES/PARTNERS PREGNANT: After the birth of the child your wife/partner is expecting now, how long would you like to wait before the birth of another child?
YEARS 2 __
SOON/NOW 993
SAYS HIS WIFE/PARTNER CAN'T GET PREGNANT 994
AFTER MARRIAGE 995
OTHER (SPECIFY) ____ 996
DON'T KNOW 998
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 would that be?
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 616)
615. 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
616. Would you say that you approve or disapprove of couples using a method to avoid getting pregnant?
DISAPPROVE 2
DON'T KNOW/UNSURE 3
617. In the last few months have you seen or heard about family planning:
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
618. In the last few months, have you listened to any of the following program series about family planning or health on the radio?
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
619. In the last few months, have you discussed the practice of family planning with your friends, neighbors, or relatives?
NO 2 (GO TO 621)
620. With whom? Anyone else?
RECORD ALL MENTIONED.
MOTHER B
FATHER C
SISTER(S) D
BROTHER(S) E
DAUGHTER F
SON G
MOTHER-IN-LAW H
FRIENDS/NEIGHBORS I
OTHER (SPECIFY) ____ X
YES, LIVING WITH A WOMAN (GO TO 621A)
NO, NOT IN UNION (GO TO 624A)
NO CODE CIRCLED (GO TO 622)
621B. You told me that you used a contraceptive method the last time you had sex. Would you say that using contraception was mainly your decision, mainly your wife's/partner's decision or did you both decide together?
MAINLY WIFE/PARTNER 2
JOINT DECISION 3
OTHER (SPECIFY) ____ 6
622. Now I want to ask you about your (last) wife's/partner's views on family planning.
Do you think that your wife/partner approves or disapproves of couples using a method to avoid pregnancy?
DISAPPROVES 2
DON'T KNOW 8
623. How often have you talked to your (last) wife/partner about family planning in the past year?
ONCE OR TWICE 2
MORE OFTEN 3
STERILIZED (GO TO 624A)
624. Do you think your wife/partner wants the same number of children that you want, or does she want more or fewer than you want?
MORE CHILDREN 2
FEWER CHILDREN 3
DON'T KNOW 8
NEVER IN UNION CODE '3' CIRCLED IN 501 OR 504 (GO TO 707)
625. 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 when:
NO 2
DON'T KNOW 8
NO 2
DON'T KNOW 8
NO 2
DON'T KNOW 8
NO 2
DON'T KNOW 8
SECTION 7. WORK AND HOUSEHOLD DECISIONS
707. Are you currently working?
NO 2
709. Have you done any work in the last 12 months?
NO 2 (GO TO 719)
710. What is your occupation, that is, what kind of work do you mainly do?
DOES NOT WORK IN FARMING (GO TO 713)
712. 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
713. 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
713A. Do you usually work at home or away from home?
AWAY 2
714. 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
715. Are you paid or do you earn in cash or kind for this work or are you not paid at all?
CASH AND KIND 2
IN KIND ONLY 3 (GO TO 719)
NOT PAID 4 (GO TO 719)
716. 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
717. 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
719. Who in your family usually has the final say on the following decisions:
WIFE/PARTNER 2
RESPONDENT AND WIFE/PARTNER JOINTLY 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE JOINTLY 5
DECISION NOT MADE/NOT APPLICABLE 6
WIFE/PARTNER 2
RESPONDENT AND WIFE/PARTNER JOINTLY 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE JOINTLY 5
DECISION NOT MADE/NOT APPLICABLE 6
WIFE/PARTNER 2
RESPONDENT AND WIFE/PARTNER JOINTLY 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE JOINTLY 5
DECISION NOT MADE/NOT APPLICABLE 6
WIFE/PARTNER 2
RESPONDENT AND WIFE/PARTNER JOINTLY 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE JOINTLY 5
DECISION NOT MADE/NOT APPLICABLE 6
WIFE/PARTNER 2
RESPONDENT AND WIFE/PARTNER JOINTLY 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE JOINTLY 5
DECISION NOT MADE/NOT APPLICABLE 6
WIFE/PARTNER 2
RESPONDENT AND WIFE/PARTNER JOINTLY 3
SOMEONE ELSE 4
RESPONDENT AND SOMEONE ELSE JOINTLY 5
DECISION NOT MADE/NOT APPLICABLE 6
720. PRESENCE OF OTHERS AT THIS POINT (PRESENT AND LISTENING, PRESENT BUT NOT LISTENING OR NOT PRESENT)
PRESENT BUT NOT LISTENING 2
NOT PRESENT 8
PRESENT BUT NOT LISTENING 2
NOT PRESENT 8
PRESENT BUT NOT LISTENING 2
NOT PRESENT 8
PRESENT BUT NOT LISTENING 2
NOT PRESENT 8
721. Sometimes a husband is annoyed or angered by things which his wife does. In your opinion, is a husband justified in hitting or beating his wife in the following situations:
NO 2
DON'T KNOW 8
NO 2
DON'T KNOW 8
NO 2
DON'T KNOW 8
NO 2
DON'T KNOW 8
NO 2
DON'T KNOW 8
SECTION 8: AIDS AND OTHER SEXUALLY TRANSMITTED DISEASES
801. Now I would like to talk about something else. Have you ever heard of an illness called AIDS?
NO 2 (GO TO 818)
802. Is there anything a person can do to avoid getting AIDS or the virus that causes AIDS?
NO 2 (GO TO 809)
DON'T KNOW 8 (GO TO 809)
803. What can a person do? Anything else?
RECORD ALL 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 KISSING K
AVOID MOSQUITO BITES L
SEEK PROTECTION FROM TRADITIONAL HEALER M
AVOID SHARING RAZORS, BLADES N
OTHER (SPECIFY) ____ W
OTHER (SPECIFY) ____ X
DON'T KNOW Z
804. Can people protect themselves from getting the AIDS virus by having just one uninfected sex partner who has no other partners?
NO 2
DON'T KNOW 8
805. Can a person get the AIDS virus from mosquito bites?
NO 2
DON'T KNOW 8
806. Can people protect themselves from getting the AIDS virus by using a condom every time they have sex?
NO 2
DON'T KNOW 8
807. Can a person get the AIDS virus from sharing food with a person who has AIDS?
NO 2
DON'T KNOW 8
808. Can people protect themselves from getting the AIDS virus by not having sex at all?
NO 2
DON'T KNOW 8
809. Is it possible for a healthy-looking person to have the AIDS virus?
NO 2
DON'T KNOW 8
811. Do you know someone personally who has the virus that causes AIDS or someone who died from AIDS?
NO 2
812. Can the virus that causes AIDS be transmitted from a mother to a child?
NO 2 (GO TO 814)
DON'T KNOW 8 (GO TO 814)
813. Can the virus that causes AIDS be transmitted from a mother to a child:
NO 2
DON'T KNOW 8
NO 2
DON'T KNOW 8
NO 2
DON'T KNOW 8
NO, NOT IN UNION (GO TO 815A)
815. 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
815A. In your opinion, is it acceptable or unacceptable for AIDS to be discussed:
NOT ACCEPTABLE 2
NOT ACCEPTABLE 2
NOT ACCEPTABLE 2
816. If a person learns that he/she is infected with the virus that causes AIDS, should the person be allowed to keep this fact private or should this information be available to the community?
AVAILABLE TO COMMUNITY 2
DON'T KNOW/NOT SURE 8
817. If a relative of yours became sick with AIDS, would you be willing to care for her or him in your own household?
NO 2
DON'T KNOW/NOT SURE/DEPENDS 8
817A. Should persons with the AIDS virus who work with other persons such as in a shop, office, or farm be allowed to continue their work or not?
SHOULD NOT CONTINUE WORK 2
DON'T KNOW/NOT SURE/DEPENDS 8
817B. Should children aged 12-14 be taught about using a condom to avoid AIDS?
NO 2
DON'T KNOW/NOT SURE/DEPENDS 8
817BX. Do you think that condoms are safe to use?
NO 2
DON'T KNOW/NOT SURE/DEPENDS 8
817BY. Do you think that men and women who intend to marry should be tested for the AIDS virus before marriage?
NO 2
DON'T KNOW/NOT SURE/DEPENDS 8
817C. Have you ever been tested to see if you have the AIDS virus?
NO 2
817D. Would you want to be tested for the AIDS virus?
NO 2
DON'T KNOW/NOT SURE/DEPENDS 8
817E. Do you know a place where you could go to get an AIDS test?
NO 2 (GO TO 818)
817F. Where can you go for the test?
817FX. 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.
GOVERNMENT HEALTH CENTER 12
FAMILY PLANNING CLINIC 13
MOBILE CLINIC 14
OTHER PUBLIC (SPECIFY) _____ 16
HEALTH CENTER 22
MOBILE CLINIC 23
PRIVATE DOCTOR 32
MOBILE CLINIC 33
OTHER PRIVATE MEDICAL (SPECIFY) ____ 36
MACRO 51
OTHER (SPECIFY) _____ 96
818. Apart from AIDS, have you heard about other infections that can be transmitted through sexual contact?
NO 2 (GO TO 820C)
HAS NOT HAD SEXUAL INTERCOURSE (GO TO 821)
820B. 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 disease?
NO 2
DON'T KNOW 8
820C. Sometimes, men experience a discharge from their penis. During the last 12 months, have you had a discharge from your penis?
NO 2
DON'T KNOW 8
820D. Sometimes, men experience a sore or ulcer 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 (GO TO 821)
820F. The last time you had (INFECTION FROM 820B/820C/820D), did you seek any kind of advice or treatment?
NO 2 (GO TO 820H)
820G. The last time you had (INFECTION FROM 820B/820C/820D) did you do any of the following? Did you....
NO 2
NO 2
NO 2
NO 2
820H. When you had (INFECTION FROM 820B/820C/820D), did you inform the persons with whom you were having sex?
NO 2
SOME/NOT ALL 3
820I. When you had (INFECTION FROM 820B/820C/820D) did you do something to avoid infecting your sexual partner(s)?
NO 2 (GO TO 821)
PARTNER ALREADY INFECTED 3 (GO TO 821)
820J. What did you do to avoid infecting your partner(s)? Did you....
NO 2
NO 2
NO 2
821. RECORD THE TIME.
MINUTES ___
TO BE FILLED IN AFTER COMPLETING INTERVIEW
COMMENTS ABOUT RESPONDENT:________________________________
COMMENTS ON SPECIFIC QUESTIONS:_______________________________
ANY OTHER COMMENTS:________________________________
SIGNATURE OF THE INTERVIEWER: ________________________
DATE: __________
SUPERVISOR'S OBSERVATIONS:________________________________
NAME OF THE SUPERVISOR: _______________________________
DATE: ___________
EDITOR'S OBSERVATIONS:________________________________
NAME OF EDITOR: _________________________________________
DATE: ___________