MALAWI
PLACE NAME:
NAME OF HOUSEHOLD HEAD:
CLUSTER NUMBER:
HOUSEHOLD NUMBER:
NAME AND LINE NUMBER OF MAN:
FIRST VISIT
DATE
INTERVIEWER'S NAME
RESULT
NOT AT HOME 2
POSTPONED 3
REFUSED 4
PARTLY COMPLETED 5
INCAPACITATED 6
OTHER (SPECIFY) 7
SECOND VISIT
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
THIRD VISIT
DATE
INTERVIEWER'S NAME
RESULT
NOT AT HOME 2
POSTPONED 3
REFUSED 4
PARTLY COMPLETED 5
INCAPACITATED 6
OTHER (SPECIFY) 7
FINAL VISIT
DAY
MONTHS
YEAR
INTERVIEWER'S NUMBER
RESULT
NOT AT HOME 2
POSTPONED 3
REFUSED 4
PARTLY COMPLETED 5
INCAPACITATED 6
OTHER (SPECIFY) 7
TOTAL NUMBER OF VISITS
CHICHEWA 02
TUMBUKA 03
OTHER (SPECIFY) 09
LANGUAGE OF INTERVIEW
CHICHEWA 02
TUMBUKA 03
OTHER (SPECIFY) 09
CHICHEWA 02
TUMBUKA 03
OTHER (SPECIFY) 09
NO 2
OFFICE EDITOR
NUMBER
KEYED BY
NUMBER
Hello. My name is ___. I am working with The National Statistical Office. We are conducting a survey about health and other topics all over Malawi. The information we collect will help the government to plan health services. Your household was selected for the survey. The questions usually take about 20 minutes. All of the answers you give will be confidential and will not be shared with anyone other than members of our survey team. You don't have to be in the survey, but we hope you will agree to answer the questions since your views are important. If I ask you any question you don't want to answer, just let me know and I will go on to the next question or you can stop the interview at any time.
In case you need more information about the survey, you may contact the person listed on the card that has already been given to your household.
Do you have any questions?
May I begin the interview now?
SIGNATURE OF INTERVIEWER ___
DATE ___
RESPONDENT DOES NOT AGREE TO BE INTERVIEWED 2 (GO TO END)
SECTION 1 RESPONDENT'S BACKGROUND
101. RECORD THE TIME.
MINUTES ___
102. How long have you been living continuously in (NAME OF CURRENT CITY, TOWN OR VILLAGE OF RESIDENCE)?
IF LESS THAN ONE YEAR, RECORD '00' YEARS.
ALWAYS 95 (GO TO 105)
VISITOR 96 (GO TO 105)
103. Just before you moved here, did you live in a city, in a town, or in a rural area?
TOWN 2
RURAL AREA 3
104. Before you moved here, which REGION did you live in?
CENTRAL 02
SOUTHERN 03
OUTSIDE OF MALAWI 96
105. In what month and year were you born?
DON'T KNOW MONTH 98
YEAR ___
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. What is the highest (FORM/YEAR) you completed at that level?
IF COMPLETED LESS THAN ONE YEAR AT THAT LEVEL, RECORD '00'.
HIGHER (GO TO 113)
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 PART OF THE SENTENCE 2
ABLE TO READ WHOLE SENTENCE 3
NO CARD WITH REQUIRED LANGUAGE (SPECIFY LANGUAGE) 4
BLIND/VISUALLY IMPAIRED 5
CODE '1' OR '5' CIRCLED (GO TO 114)
113. Do you read a newspaper or magazine at least once a week, less than once a week or not at all?
LESS THAN ONCE A WEEK 2
NOT AT ALL 3
114. Do you listen to the radio at least once a week, less than once a week or not at all?
LESS THAN ONCE A WEEK 2
NOT AT ALL 3
115. Do you watch television at least once a week, less than once a week or not at all?
LESS THAN ONCE A WEEK 2
NOT AT ALL 3
116. Do you own a mobile telephone?
NO 2 (GO TO 118)
117. Do you use your mobile phone for any financial transactions?
NO 2
118. Do you have an account in a bank or other financial institution that you yourself use?
NO 2
119. Have you ever used the internet?
IF NECESSARY, PROBE FOR USE FROM ANY LOCATION WITH ANY DEVICE.
NO 2 (GO TO 122)
120. In the last 12 months, have you used the internet?
IF NECESSARY, PROBE FOR USE FROM ANY LOCATION, WITH ANY DEVICE.
NO 2 (GO TO 122)
121. During the last one month, how often did you use the internet: almost every day, at least once a week, less than once a week, or not at all?
AT LEAST ONCE WEEK 2
LESS THAN ONCE A WEEK 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
123. What is your tribe or ethnic group?
TUMBUKA 02
LOMWE 03
TONGA 04
YAO 05
SENA 06
NKHONDE 07
NGONI 08
OTHER (SPECIFY) 96
124. In the last 12 months, how many times have you been away from home for one or more nights?
NONE 00 (GO TO 201)
125. In the last 12 months, have you been away from home for more than one month at a time?
NO 2
201. Now I would like to ask about any children you have had during your life. I am interested in all of the children that are biologically yours, even if they are not legally yours or do not have your last name. Have you ever fathered any children with any woman?
NO 2 (GO TO 206)
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 that 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, who made any movement, sound, or effort to breathe, or who showed any other signs of life even if for a very short time?
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. SUM ANSWERS TO 203, 205, AND 207, AND ENTER TOTAL. IF NONE, RECORD '00'.
HAS HAD ONLY ONE CHILD (GO TO 211)
HAS NOT HAD ANY CHILDREN (GO TO 301)
210. Did all the children you have fathered have the same biological mother?
NO 2
HAS HAD MORE THAN ONCE CHILD: How old were you when your first child was born?
HAS HAD ONLY ONE CHILD: How old were you when your child was born?
NO LIVING CHILDREN (GO TO 301)
MORE THAN ONE LIVING CHILD: How old is your youngest child?
ONLY ONE LIVING CHILD: How old is your child?
(YOUNGEST) CHILD IS AGE 3 YEARS OR OLDER (GO TO 301)
MORE THAN ONE LIVING CHILD: What is the name of your youngest child?
ONLY ONE LIVING CHILD: What is the name of your child?
216. When (NAME)'s mother was pregnant with (NAME), did she have any antenatal check-ups?
NO 2 (GO TO 218)
DON'T KNOW 8 (GO TO 218)
217. Were you ever present during any of those antenatal check-ups?
NOT PRESENT 2 (GO TO 218)
217A. Were you offered a test for HIV by the health provider during any of the antenatal check-ups?
NO 2 (GO TO 218)
217B. I don't want to know the results, but were you tested for HIV at that time?
NO 2
218. Was (NAME) born in a hospital or health facility?
OTHER 2
219. When a child has diarrhea, how much should he or she be given to drink: more than usual, about the same as usual, less than usual, or nothing to drink at all?
ABOUT THE SAME 2
LESS THAN USUAL 3
NOTHING TO DRINK 4
DON'T KNOW 8
301. Now I would like to talk about family planning - the various ways or methods that a couple can use to delay or avoid a pregnancy. Have you ever heard of (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
YES, TRADITIONAL METHOD (SPECIFY) 2
NO 3
302. In the last few months have you:
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
303. In the last few months, have you discussed family planning with a health worker or health professional?
NO 2
304. 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 when she has sexual relations?
NO 2 (GO TO 306)
DON'T KNOW 8 (GO TO 306)
305. 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
306. After the birth of a child, can a woman become pregnant before her menstrual period has returned?
NO 2
DON'T KNOW 8
307. I will now read you some statements about contraception. Please tell me if you agree or disagree with each one.
DISAGREE 2
DON'T KNOW 8
DISAGREE 2
DON'T KNOW 8
SECTION 4. MARRIAGE AND SEXUAL ACTIVITY
401. Are you currently married or living together with a woman as if married?
YES, LIVING WITH A WOMAN 2 (GO TO 404)
NO, NOT IN UNION 3
402. Have you ever been married or lived together with a woman as if married?
YES, LIVED WITH A WOMAN 2
NO 3 (GO TO 413)
403. What is your marital status now: are you widowed, divorced or separated?
DIVORCED 2 (GO TO 410)
SEPARATED 3 (GO TO 410)
404. Is your (wife/partner) living with you now or is she staying elsewhere?
STAYING ELSEWHERE 2
405. Do you have other wives or do you live with other women as if married?
NO (ONLY ONE WIFE) 2 (GO TO 407)
406. Altogether, how many wives or live-in partners do you have?
ONE WIFE/PARTNER: Please tell me the name of (your wife/the woman you are living with as if married).
MORE THAN ONE WIFE/PARTNER: Please tell me the name of each of your wives or each woman you are living with as if married.
RECORD THE NAME AND THE LINE NUMBER FROM THE HOUSEHOLD QUESTIONNAIRE FOR EACH WIFE AND LIVE-IN PARTNER.
IF WOMAN IS NOT LISTED IN THE HOUSEHOLD, RECORD '00'.
LINE NUMBER ___
408. ASK FOR EACH PERSON IN 407: How old was (NAME) on her last birthday?
MORE THAN ONE WIFE/PARTNER (GO TO 411)
410. Have you been married or lived with a woman only once or more than once?
ONLY ONCE 2
BOTH ARE CODE '2': In what month and year did you start living with your (wife/partner)?
OTHER: Now I would like to ask about your first (wife/partner). In what month and year did you start living with her?
DON'T KNOW MONTH 98
YEAR ___
DON'T KNOW YEAR 9998
412. How old were you when you first started living with her?
413. CHECK FOR PRESENCE OF OTHERS. BEFORE CONTINUING, MAKE EVERY EFFORT TO ENSURE PRIVACY.
414. I would like to ask some questions about sexual activity in order to gain a better understanding of some important life issues. Let me assure you again that your answers are completely confidential and will not be told to anyone. If we should come to any question that you don't want to answer, just let me know and we will go to the next question. How old were you when you had sexual intercourse for the very first time?
AGE IN YEARS ___
415. Now I would like to ask you about your recent sexual activity. When was the last time you had sexual intercourse?
IF LESS THAN 12 MONTHS, ANSWER MUST BE RECORDED IN DAYS, WEEKS, OR MONTHS. IF 12 MONTHS (ONE YEAR) OR MORE, ANSWER MUST BE RECORDED IN YEARS.
WEEKS AGO 2 ___ (GO TO 417)
MONTHS AGO 3 ___ (GO TO 417)
YEARS AGO 4 ___ (GO TO 427)
416. When was the last time you had sexual intercourse with this person?
WEEKS AGO 2 ___
MONTHS AGO 3 ___
417. The last time you had sexual intercourse with this person, was a condom used?
NO 2 (GO TO 419)
418. Was a male or female condom used every time you had sexual intercourse with this person in the last 12 months?
NO 2
419. What was your relationship to this person with whom you had sexual intercourse?
IF GIRLFRIEND: Were you living together as if married?
IF YES, RECORD '2'.
IF NO, RECORD '3'.
LIVE-IN PARTNER 2
GIRLFRIEND NOT LIVING WITH RESPONDENT 3
CASUAL ACQUAINTANCE 4
CLIENT/SEX WORKER 5
OTHER (SPECIFY) 6
420. How long ago did you first have sexual intercourse with this person?
WEEKS AGO 2 ___
MONTHS AGO 3 ___
YEARS AGO 4 ___
421. How many times during the last 12 months did you have sexual intercourse with this person?
IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE. IF NUMBER OF TIMES IS 95 OR MORE, RECORD '95'.
DON'T KNOW 98
423. Apart from this person, have you had sexual intercourse with any other person in the last 12 months?
NO 2 (GO TO 425)
424. In total, with how many different people have you had sexual intercourse in the last 12 months?
IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE. IF NUMBER OF PARTNERS IS 95 OR MORE, RECORD '95'.
DON'T KNOW 98
NO PARTNERS ARE SEX WORKERS (GO TO 427)
426. CHECK 419 AND 417 (ALL COLUMNS):
OTHER (GO TO 431)
427. In the last 12 months, did you pay anyone in exchange for having sexual intercourse?
NO 2
428. Have you ever paid anyone in exchange for having sexual intercourse?
NO 2 (GO TO 431)
429. The last time you paid someone in exchange for having sexual intercourse, was a condom used?
NO 2 (GO TO 431)
430. Was a condom used during sexual intercourse every time you paid someone in exchange for having sexual intercourse in the last 12 months?
NO 2
DON'T KNOW 8
431. In the past 12 months have you given any gifts or other goods in order to have sex or to become sexually involved with anyone?
NO 2
432. Have you ever given any gifts or other goods in order to have sex or to become sexually involved with anyone?
NO 2
433. In total, with how many different people have you had sexual intercourse in your lifetime?
IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE. IF NUMBER OF PARTNERS IS 95 OR MORE, RECORD '95'.
DON'T KNOW 98
434. CHECK 417: MOST RECENT PARTNER (FIRST COLUMN)
NO CONDOM USED (GO TO 438)
NOT ASKED (GO TO 438)
435. You told me that a condom was used the last time you had sex. What is the brand name of the condom used at that time?
IF BRAND NOT KNOWN, ASK TO SEE THE PACKAGE.
MANYUCHI 02
SILVERTOUCH 03
CARE (FEMALE CONDOM) 04
PUBLIC SECTOR CONDOMS 05
OTHER (SPECIFY) 96
DON'T KNOW 98
436. From where did you obtain the condom the last time?
PROBE TO IDENTIFY TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
GOVERNMENT HEALTH CENTER 12
GOVERNMENT HEALTH POST/OUTREACH 13
MOBILE CLINIC 14
HSA 15
CBDA/DOOR TO DOOR 16
OTHER PUBLIC SECTOR (SPECIFY) 17
HEALTH CENTER 22
MOBILE CLINIC 23
DOOR TO DOOR 24
PHARMACY 32
PRIVATE DOCTOR 33
MOBILE CLINIC 34
CBDA/DOOR TO DOOR 35
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) 36
MACRO 51
YOUTH DROP IN CENTRE 61
CHURCH 72
FRIEND OR RELATIVE 73
CONDOMISED CAMPAIGNS 74
DON'T KNOW 98
437. The last time you had sex did you or your partner use any method other than a condom to avoid or prevent a pregnancy?
NO 2 (GO TO 440)
DON'T KNOW 8 (GO TO 440)
438. The last time you had sex did you or your partner use any method to avoid or prevent a pregnancy?
NO 2 (GO TO 440)
DON'T KNOW 8 (GO TO 440)
439. What method did you or your partner use?
PROBE: Did you or your partner use any other method to prevent pregnancy?
RECORD ALL MENTIONED.
MALE STERILIZATION B (GO TO 501)
IUD C (GO TO 501)
INJECTABLES D (GO TO 501)
IMPLANTS E (GO TO 501)
PILL F (GO TO 501)
CONDOM G (GO TO 501)
FEMALE CONDOM H (GO TO 501)
EMERGENCY CONTRACEPTION I (GO TO 501)
STANDARD DAYS METHOD J (GO TO 501)
LACTATIONAL AMENORRHEA METHOD K (GO TO 501)
RHYTHM METHOD L (GO TO 501)
WITHDRAWAL M (GO TO 501)
OTHER MODERN METHOD X (GO TO 501)
OTHER TRADITIONAL METHOD Y (GO TO 501)
440. Do you know of a place where you can obtain a method of family planning?
NO 2
SECTION 5. FERTILITY PREFERENCES
501. CHECK 401:
NOT CURRENTLY MARRIED AND NOT LIVING WITH A PARTNER (GO TO 514)
MAN STERILIZED (GO TO 514)
MORE THAN ONE WIFE/PARTNER (GO TO 509)
504. Is your (wife/partner) currently pregnant?
NO 2 (GO TO 507)
DON'T KNOW 8 (GO TO 507)
505. Now I have some questions about the future. After the child you and your (wife/partner) are expecting now, would you like to have another child, or would you prefer not to have any more children?
NO MORE 2 (GO TO 514)
UNDECIDED/DON'T KNOW 8 (GO TO 514)
506. 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 ___ (GO TO 514)
SOON/NOW 993 (GO TO 514)
OTHER (SPECIFY) 996 (GO TO 514)
DON'T KNOW 998 (GO TO 514)
HAS FATHERED CHILDREN: Now I have some questions about the future. Would you like to have another child, or would you prefer not to have any more children?
HAS NOT FATHERED CHILDREN: Now I have some questions about the future. Would you like to have a child, or would you prefer not to have any children?
NO MORE/NONE 2 (GO TO 514)
SAYS COUPLE CAN'T GET PREGNANT 3 (GO TO 514)
WIFE/PARTNER STERILIZED 4 (GO TO 514)
UNDECIDED/DON'T KNOW 8 (GO TO 514)
HAS FATHERED CHILDREN: How long would you like to wait from now before the birth of another child?
HAS NOT FATHER CHILDREN: How long would you like to wait from now before the birth of a child?
YEARS 2 ___ (GO TO 514)
SOON/NOW 993 (GO TO 514)
SAYS COUPLE CAN'T GET PREGNANT 994 (GO TO 514)
OTHER (SPECIFY) 996 (GO TO 514)
DON'T KNOW 998 (GO TO 514)
509. Are any of your (wives/partners) currently pregnant?
NO 2 (GO TO 512)
DON'T KNOW (GO TO 512)
510. Now I have some questions about the future. After the (child/children) you and your (wives/partners) are expecting now, would you like to have another child, or would you prefer not to have any more children?
NO MORE 2 (GO TO 514)
UNDECIDED/DON'T KNOW 8 (GO TO 514)
511. 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 ___ (GO TO 514)
SOON/NOW 993 (GO TO 514)
OTHER (SPECIFY) 996 (GO TO 514)
DON'T KNOW 998 (GO TO 514)
HAS FATHERED CHILDREN: Now I have some questions about the future. Would you like to have another child, or would you prefer not to have any more children?
HAS NOT FATHERED CHILDREN: Now I have some questions about the future. Would you like to have a child, or would you prefer not to have any children?
NO MORE/NONE 2 (GO TO 514)
SAYS COUPLE CAN'T GET PREGNANT 3 (GO TO 514)
(WIFE/WIVES/PARTNER(S)) STERILIZED 4 (GO TO 514)
UNDECIDED/DON'T KNOW 8 (GO TO 514)
HAS FATHERED CHILDREN: How long would you like to wait from now before the birth of another child?
HAS NOT FATHER CHILDREN: How long would you like to wait from now before the birth of a child?
YEARS 2 ___
SOON/NOW 993
SAYS COUPLE CAN'T GET PREGNANT 994
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 child to have in your whole life, how many 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.
NUMBER ___
OTHER (SPECIFY) 96 (GO TO 601)
515. How many of these children would you like to be boys, how many would you like to be girls and for how many would it not matter if it's a boy or a girl?
NUMBER OF GIRLS ___
EITHER ___
OTHER (SPECIFY) 96
SECTION 6. EMPLOYMENT AND GENDER ROLES
601. Have you done any work in the last seven days?
NO 2
602. Although you did not work in the last seven days, do you have any job or business from which you were absent for leave, illness, vacation, or any other such reason?
NO 2
603. Have you done any work in the last 12 months?
NO 2 (GO TO 607)
604. What is your occupation? That is, what kind of work do you mainly do?
605. 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
606. Are you paid in cash or kind for this work or are you not paid at all?
CASH AND KIND 2
IN KIND ONLY 3
NOT PAID 4
NOT CURRENTLY MARRIED AND NOT LIVING WITH A PARTNER (GO TO 612)
OTHER (GO TO 610)
609. Who usually decides how the money you earn will used: you, your (wife/partner), or you and your (wife/partner) jointly?
WIFE/PARTNER 2
RESPONDENT AND WIFE/PARTNER JOINTLY 3
OTHER (SPECIFY) 6
610. Who usually makes decisions about health care for yourself: you, your (wife/partner), you and your (wife/partner) jointly, or someone else?
WIFE/PARTNER 2
RESPONDENT AND WIFE/PARTNER JOINTLY 3
SOMEONE ELSE 4
OTHER (SPECIFY) 6
611. Who usually makes decisions about making major household purchases?
WIFE/PARTNER 2
RESPONDENT AND WIFE/PARTNER JOINTLY 3
SOMEONE ELSE 4
OTHER (SPECIFY) 6
612. Do you own this or any other house either alone or jointly with someone else?
JOINTLY ONLY 2
BOTH ALONE AND JOINTLY 3
DOES NOT OWN 4 (GO TO 615)
613. Do you have a title deed for any house you own?
NO 2 (GO TO 615)
DON'T KNOW 8 (GO TO 615)
614. Is your name on the title deed?
NO 2
DON'T KNOW 8
615. Do you own any agricultural or non-agricultural land either alone or jointly with someone else?
JOINTLY ONLY 2
BOTH ALONE AND JOINTLY 3
DOES NOT OWN 4 (GO TO 618)
616. Do you have a title deed for any land you own?
NO 2 (GO TO 618)
DON'T KNOW 8 (GO TO 618)
617. Is your name on the title deed?
NO 2
DON'T KNOW 8
618. 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
701. Now I would like to talk about something else. Have you ever heard of HIV or AIDS?
NO 2 (GO TO 727)
702. HIV is the virus than can lead to AIDS. Can people reduce their chance of getting HIV by having just one uninfected sex partner who has no other sex partners?
NO 2
DON'T KNOW 8
703. Can people get HIV from mosquito bites?
NO 2
DON'T KNOW 8
704. Can people reduce their chance of getting HIV by using a condom every time they have sex?
NO 2
DON'T KNOW 8
704A. Can people reduce their chance of getting the AIDS virus by not having sexual intercourse at all?
NO 2
DON'T KNOW 8
705. Can people get HIV by sharing food with a person who has HIV?
NO 2
DON'T KNOW 8
706. Can people get HIV because of witchcraft or other supernatural means?
NO 2
DON'T KNOW 8
707. Is it possible for a healthy-looking person to have HIV?
NO 2
DON'T KNOW 8
708. Can HIV be transmitted from a mother to her baby:
NO 2
DON'T KNOW 8
NO 2
DON'T KNOW 8
NO 2
DON'T KNOW 8
OTHER (GO TO 711)
710. Are there any special drugs that a doctor or a nurse can give to a woman infected with HIV to reduce the risk of transmission to the baby?
NO 2
DON'T KNOW 8
711. CHECK FOR PRESENCE OF OTHERS. BEFORE CONTINUING, MAKE EVERY EFFORT TO ENSURE PRIVACY.
712. I don't want to know the results, but have you ever been tested for HIV?
NO 2 (GO TO 716)
713. How many months ago was your most recent HIV test?
TWO OR MORE YEARS 95
714. I don't want to know the results, but did you get the results of the test?
NO 2
714A. 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 by the health provider?
TEST OFFERED BY THE HEALTH PROVIDER 2
TEST REQUIRED BY THE HEALTH PROVIDER 3
PROBE TO IDENTIFY TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
GOVERNMENT HEALTH CENTER 12 (GO TO 718)
GOVERNMENT HEALTH POST/OUTREACH 13 (GO TO 718)
HSA 14 (GO TO 718)
CBDA/DOOR TO DOOR 15 (GO TO 718)
OTHER PUBLIC SECTOR (SPECIFY) 16 (GO TO 718)
HEALTH CENTER 22 (GO TO 718)
MOBILE CLINIC 23 (GO TO 718)
DOOR TO DOOR 24 (GO TO 718)
PHARMACY 32 (GO TO 718)
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) 36 (GO TO 718)
MACRO 51 (GO TO 718)
WORKPLACE 62 (GO TO 718)
CORRECTIONAL FACILITY 63 (GO TO 718)
716. Do you know of a place where people can go to get an HIV test?
NO 2 (GO TO 718)
717. Where is that? Any other place?
PROBE TO IDENTIFY TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
GOVERNMENT HEALTH CENTER B
GOVERNMENT HEALTH POST/OUTREACH C
HSA D
CBDA/DOOR TO DOOR E
OTHER PUBLIC SECTOR (SPECIFY) F
HEALTH CENTER H
MOBILE CLINIC I
DOOR TO DOOR J
PHARMACY L
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) M
MACRO 51 O
WORKPLACE Q
CORRECTIONAL FACILITY R
718. Have you heard of test kits people can use to test themselves for HIV?
NO 2 (GO TO 720)
719. Have you ever tested yourself for HIV using a self-test kit?
NO 2
720. Would you buy fresh vegetables form a shopkeeper or vendor if you knew that this person had HIV?
NO 2
DON'T KNOW/NOT SURE/DEPENDS 8
721. Do you think children living with HIV should be allowed to attend school with children who do not have HIV?
NO 2
DON'T KNOW/NOT SURE/DEPENDS 8
722. Do you think people hesitate to take an HIV test because they are afraid of how other people will react if the test result is positive for HIV?
NO 2
DON'T KNOW/NOT SURE/DEPENDS 8
723. Do people talk badly about people living with HIV, or who are thought to be living with HIV?
NO 2
DON'T KNOW/NOT SURE/DEPENDS 8
724. Do people living with HIV, or thought to be living with HIV, lose respect of other people?
NO 2
DON'T KNOW/NOT SURE/DEPENDS 8
725. Do you agree or disagree with the following statement: I would be ashamed if someone in my family had HIV.
DISAGREE 2
DON'T KNOW/NOT SURE/DEPENDS 8
726. Do you fear that you could get HIV if you come into contact with the saliva of a person living with HIV?
NO 2
SAYS HE HAS HIV 3
DON'T KNOW/NOT SURE/DEPENDS 8
HEARD ABOUT HIV OR AIDS: Apart from HIV, have you heard about other infections that can be transmitted through sexual contact?
NOT HEARD ABOUT HIV OR AIDS: Have you heard about infections that can be transmitted through sexual contact?
NO 2
NEVER HAD SEXUAL INTERCOURSE (GO TO 736)
729. CHECK 727: HEARD ABOUT OTHER SEXUALLY TRANSMITTED INFECTIONS?
NO (GO TO 731)
730. 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 disease which you go through sexual contact?
NO 2
DON'T KNOW 8
731. 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
732. Sometimes men have 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 OR DOES NOT KNOW (GO TO 736)
734. The last time you had (PROBLEM IN 730/731/732), did you seek any kind of advice or treatment?
NO 2 (GO TO 736)
735. Where did you go? Any other place?
PROBE TO IDENTIFY TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
GOVERNMENT HEALTH CENTER B
GOVERNMENT HEALTH POST/OUTREACH C
HSA D
CBDA/DOOR TO DOOR E
OTHER PUBLIC SECTOR (SPECIFY) F
HEALTH CENTER H
MOBILE CLINIC I
DOOR TO DOOR J
PHARMACY L
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) M
MACRO 51 O
WORKPLACE Q
CORRECTIONAL FACILITY R
736. If a wife knows her husband has a disease that she can get during sexual intercourse, is she justified in asking that they use a condom when they have sex?
NO 2
DON'T KNOW 8
737. Is a wife justified in refusing to have sex with her husband when she knows he has sex with other women?
NO 2
DON'T KNOW 8
SECTION 8. OTHER HEALTH ISSUES
801. Some men are circumcised, that is, the foreskin is completely removed from the penis. Are you circumcised?
NO 2 (GO TO 805)
DON'T KNOW 8 (GO TO 805)
802. How old were you when you got circumcised?
DURING CHILDHOOD (LESS THAN 5 YEARS) 95
DON'T KNOW 98
803. Who did the circumcision?
HEALTH WORKER/PROFESSIONAL 2
OTHER (SPECIFY) 3
DON'T KNOW 8
HOME OF A HEALTH WORKER/PROFESSIONAL 2
CIRCUMCISION DONE AT HOME 3
INITIATION CEREMONY 4
OTHER HOME/PLACE 5
DON'T KNOW 8
805. Now I would like to ask you some other questions relating to health matters. Have you had an injection for any reason in the last 12 months?
IF YES: How many injections have you had?
IF NUMBER OF INJECTIONS IS 90 OR MORE, OR DAILY FOR 3 MONTHS OR MORE, RECORD '90'. IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE.
NONE 00 (GO TO 808)
806. Among these injections, how many were administered by a doctor, a nurse, a pharmacist, a dentist, or any other health worker?
IF NUMBER OF INJECTIONS IS 90 OR MORE, OR DAILY FOR 3 MONTHS OR MORE, RECORD '90'. IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE.
NONE 00 (GO TO 808)
807. The last time you got an injection from a health worker, did he or she take the syringe and needle from a new unopened package?
NO 2
DON'T KNOW 8
808. Do you currently smoke tobacco every day, some days, or not at all?
SOME DAYS 2
NOT AT ALL (GO TO 810)
809. In the past, have you smoked tobacco every day?
NO 2 (GO TO 812)
810. In the past, have you ever smoked tobacco every day, some days, or not at all?
SOME DAYS 2 (GO TO 813)
NOT AT ALL 3 (GO TO 813)
811. On average, how many of the following products do you currently smoke each day? Also, let me know if you use the product, but not every day.
IF RESPONDENT REPORTS USING THE PRODUCT BUT NOT EVERY DAY, RECORD '888'. IF THE PRODUCT IS NOT USED AT ALL, RECORD '000'.
812. On average, how many of the following products do you currently smoke each week? Also, let me know if you use the product, but not every week.
IF RESPONDENT REPORTS USING THE PRODUCT BUT NOT EVERY WEEK, RECORD '888'. IF THE PRODUCT IS NOT USED AT ALL, RECORD '000'.
813. Do you currently use smokeless tobacco every day, some days, or not at all?
SOME DAYS (GO TO 815)
NOT AT ALL 3 (GO TO 816)
814. On average, how many times a day do you use the following products? Also, let me know if you use the product but not every day.
IF RESPONDENT REPORTS USING THE PRODUCT BUT NOT EVERY DAY, RECORD '888', IF THE PRODUCT IS NOT USED AT ALL, RECORD '000'.
815. On average, how many times a week do you use the following products? Also, let me know if you use the product but not every week.
IF RESPONDENT REPORTS USING THE PRODUCT BUT NOT EVERY WEEK, RECORD '888', IF THE PRODUCT IS NOT USED AT ALL, RECORD '000'.
c. Chewing tobacco?
816. Are you covered by any health insurance?
NO 2 (GO TO 818)
817. What type of health insurance are you covered by?
RECORD ALL MENTIONED.
OTHER PRIVATELY PURCHASED COMMERCIAL HEALTH INSURANCE B
OTHER (SPECIFY) X
818. Have you ever heard of an illness called tuberculosis or TB?
NO 2 (GO TO 822)
819. How does tuberculosis spread from one person to another?
PROBE: Any other ways?
RECORD ALL MENTIONED.
THROUGH SHARING UTENSILS B
THROUGH TOUCHING A PERSON WITH TB C
THROUGH FOOD D
THROUGH SEXUAL CONTACT E
THROUGH MOSQUITO BITES F
OTHER (SPECIFY) X
DON'T KNOW Z
820. Can tuberculosis be cured?
NO 2
DON'T KNOW 8
821. If a member of your family got tuberculosis, would you want it to remain a secret or not?
NO 2
DON'T KNOW/NOT SURE/DEPENDS 8
MINUTES ___
TO BE FILLED IN AFTER COMPLETING INTERVIEW
COMMENTS ABOUT INTERVIEW:
COMMENTS ON SPECIFIC QUESTIONS:
ANY OTHER COMMENTS:
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EDITOR'S OBSERVATIONS