PAKISTAN DEMOGRAPHIC AND HEALTH SURVEY 2012-13
EVER MARRIED MAN'S QUESTIONNAIRE
PROVINCE/REGION
SINDH 2
KPK 3
BALOCHISTAN 4
GB 5
ICT 6
DISTRICT
TEHSIL
CLUSTER NUMBER
HOUSEHOLD NUMBER
SMALL CITY 2
TOWN 3
RURAL 4
NAME OF HOUSEHOLD HEAD
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 ___
INT. NUMBER ___
RESULT __
NOT AT HOME 2
POSTPONED 3
REFUSED 4
PARTLY COMPLETED 5
INCAPACITATED 6
OTHER (SPECIFY) ____ 7
LANGUAGE OF QUESTIONNAIRE: ENGLISH 6
LANGUAGE OF INTERVIEWER ___
PUNJABI 2
SINDHI 3
PUSHTO 4
BALUCHI 5
ENGLISH 6
BARUHI 7
SARAIKI 8
OTHER 9 (SPECIFY) ____
LANGUAGE MAN SPEAKS AT HOME ____
PUNJABI 2
SINDHI 3
PUSHTO 4
BALUCHI 5
ENGLISH 6
BARUHI 7
SARAIKI 8
OTHER 9 (SPECIFY) ____
FIELD EDITOR
NAME ____
OFFICE EDITOR
KEYED BY
Assalamo Alaikum. My name is ___. I am working with NIPS. We are conducting a survey about health all over Pakistan. The information we collect will help the government to plan health services. Your household is selected for the survey. The questions usually take about 25 to 30 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 (END)
SECTION 1. RESPONDENT'S BACKGROUND
MINUTES ____
102) In what month and year were you born?
DON'T KNOW MONTH 98
YEAR ____
DON'T KNOW YEAR 9998
103) How old were you at your last birthday?
COMPARE AND CORRECT 102 AND/OR 103 IF INCONSISTENT.
104) What is your marital status now: are you currently married, or widowed, divorced, or separated?
WIDOWED 2 (GO TO 106A)
DIVORCED 3 (GO TO 106A)
SEPARATED 4 (GO TO 106A)
NEVER MARRIED 5 (END)
105) Is your wife living with you now or is she staying elsewhere?
STAYING ELSEWHERE 2
NO (ONLY ONE) 2 (GO TO 108)
106A) Did you have other wives?
NO (ONLY ONE) 2 (GO TO 108)
107) Altogether, how many wives do/did you have?
ONE WIFE: In what month and year did you start living with your (wife)?
MORE THAN ONE WIFE: Now I would like to ask about your first wife. In what month and year did you start living with her?
DON'T KNOW MONTH 98
YEAR ____ (GO TO 110)
DON'T KNOW YEAR 9998
109) How old were you when you first started living with her?
110) Have you ever attended school?
NO 2 (GO TO 113)
111) What is the highest class you completed?
IF COMPLETED LESS THAN CLASS ONE, WRITE '00'
IF MA, MPHIL, PHD, MBBS, OR BSC/4 YEARS, WRITE '16'
CLASS 09 OR HIGHER (GO TO 115)
113) Now I would like to read this sentence to me.
SHOW CARD TO RESPONDENT.
IF RESPONDENT CANNOT READ WHOLE SENTENCE, PROBE:
Can you read any part of the sentence to me?
ABLE TO READ ONLY PARTS OF SENTENCE 2
ABLE TO READ WHOLE SENTENCE 3
NO CARD WITH REQUIRED LANGUAGE (SPECIFY LANGUAGE) ____ 4
BLIND/VISUALLY IMPAIRED 5
CODE '1' OR '5' CIRCLED (GO TO 116)
115) Do you read a newspaper or magazine daily, at least once a week, occasionally or not at all?
AT LEAST ONCE A WEEK 2
OCCASIONALLY 3
NOT AT ALL 4
116) Do you listen to the radio daily, at least once a week, occasionally or not at all?
AT LEAST ONCE A WEEK 2
OCCASIONALLY 3
NOT AT ALL 4
117) Do you watch television daily, at least once a week, occasionally or not at all?
AT LEAST ONCE A WEEK 2
OCCASIONALLY 3
NOT AT ALL 4
118) What is your mother tongue?
PUNJABI 02
SINDHI 03
PUSHTO 04
BALOCHI 05
ENGLISH 06
BARAUHI 07
SIRAIKI 08
HINDKO 09
KASHMIRI 10
SHINA 11
BRUSHASKI 12
WAKHI 13
CHITRALI/KHWAR 14
BALTI 15
PAHARI 16
POTOWARI 17
MARWARI 18
FARSI 19
OTHER 96
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.
Do you have any 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'
DAUGHTERS AT HOME __
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'
DAUGHTERS ELSEWHERE __
206) Do you have a son or daughter who was born alive but later died?
IF NO, PROBE: Any baby who cried or showed signs of life but did not survive?
NO 2 (GO TO 208)
DON'T KNOW 8 (GO TO 208)
207) How many boys have died? And how many girls have died?
IF NONE, RECORD '00'
GIRLS DEAD __
208) SUM ANSWERS TO 203, 205, AND 207, AND ENTER TOTAL
IF NONE, RECORD '00'
HAS ONLY HAD ONE CHILD 2 (GO TO 212)
HAS NOT HAD ANY CHILDREN 3 (GO TO 301)
210) Did all of your children have the same biological mother?
NO 2
211) In all, how many wives have you fathered children with?
212) How old were you when your (first) child was born?
NO LIVING CHILDREN (GO TO 301)
214) How old is your (youngest) child?
IF LESS THAN ONE YEAR, RECORD '00'
OTHER __ (GO TO 301)
216) What is the name of your (youngest) child?
______
[IF NOT LISTED IN THE HOUSEHOLD ROSTER, ENTER '00']
LINE NUMBER ___
217) When (NAME)'s mother was pregnant with (NAME), did she have any antenatal check-ups?
NO 2 (GO TO 219)
DON'T KNOW 8 (GO TO 219)
218) Were you ever present during any of those antenatal checkups or did you just accompanied your wife to any of those antenatal checkups?
ONLY ACCOMPANY 2
NOT ACCOMPANY 3
219) Was (NAME) born in a hospital or health facility?
OTHER 2
220) 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)?
PROCEED DOWN COLUMN 301, READING THE NAME AND DESCRIPTION OF EACH METHOD. 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.
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
SPECIFY _____
302) Have you or your wife/wives 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
SPECIFY _____
303) In the last few months have you:
NO 2
NO 2
NO 2
NOT HEARD/WATCH/READ ABOUT MESSAGE __ (GO TO 304C)
304A) What messages did it convey to you? Anything else?
[CIRCLE ALL MENTIONED]
HIGHER AGE AT MARRIAGE B
SPACING OF CHILDREN C
USE ON CONTRACEPTIVES D
WELFARE OF FAMILY E
MATERNAL AND CHILD HEALTH F
LESS CHILDREN MEAN PROSPEROUS LIFE G
MORE CHILDREN MEAN POVERTY AND STARVATION H
IMPORTANCE OF BREASTFEEDING I
OTHER-1 (SPECIFY) X
OTHER-2 (SPECIFY) Y
DON'T KNOW/NOT REMEMBER Z
304B) Do you think that the message you heard or watch or read was effective or not effective in persuading couples to use family planning?
NOT EFFECTIVE 2
DON'T KNOW 8
WIDOWED/DIVORCED OR SEPARATED __ (GO TO 307)
MAN STERILIZED __ (GO TO 307)
306) In the last few months, have you discussed family planning with a health worker or health professional?
NO 2
307) 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 309)
DON'T KNOW 8 (GO TO 309)
308) 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
309) 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
310) CHECK 301 (07): KNOWS CONDOM
NO __ (GO TO 401)
311) Do you know of a place where a person can get condoms?
NO 2 (GO TO 401)
312) Where is that? Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
RURAL HEALTH CENTRE B
FAMILY WELFARE CENTRE C
MCH D
DISPENSORY E
MOBILE SERVICE CAMP F
LADY HEALTH WORKER G
LH VISITOR H
BASIC HEALTH UNIT I
MALE MOBILIZER J
OTHER PUBLIC (SPECIFY) ___ K
PHARMACY, CHEMISTS M
PRIVATE DOCTOR N
HOMEOPATH O
DISPENSER/COMPOUNDER .P
OTHER PRIVATE MEDICAL (SPECIFY) ____ Q
FRIEND/RELATIVE S
HAKIM T
DAI, TRAD. BIRTH ATTENDANT U
OTHER (SPECIFY) ___ X
313) If you wanted to, could you yourself get a condom?
NO 2
SECTION 4. FERTILITY PREFERENCES
WIDOWED/DIVORCED OR SEPARATED __ (GO TO 409)
MAN STERILIZED __ (GO TO 409)
403) Is your wife/are any of your (wives) currently pregnant?
NO 2 (GO TO 405)
DON'T KNOW 8 (GO TO 405)
404) Now I have some questions about the future. After the (child/children) you and your (wife/wives) 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 409)
UNDECIDED/DON'T KNOW 8 (GO TO 409)
405) 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?
NO MORE/NONE 2 (GO TO 409)
SAYS WIFE (WIVES) CAN'T GET PREGNANT 3 (GO TO 409)
WIFE (WIVES) STERILIZED 4 (GO TO 409)
HE/ALL HIS WIVES/ ARE INFECUND 5 (GO TO 409)
UNDECIDED/DON'T KNOW 8 (GO TO 409)
MORE THAN ONE WIFE __ (GO TO 408)
WIFE NOT PREGNANT OR DON'T KNOW __
How long would you like to wait from now before the birth of (a/another) child?
WIFE 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 __
SOON/NOW 993
COUPLE INFECUND 994
OTHER (SPECIFY) ___ 996
DON'T KNOW 998
408) How long would you like to wait from now before the birth of (a/another) child?
YEARS 2 __
SOON/NOW 993
COUPLE INFECUND 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 children 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?
NUMBER __
OTHER (SPECIFY) ___ 96 (GO TO 501)
410) 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 __
NUMBER OF EITHER __
OTHER (SPECIFY) ___ 96
SECTION 5. EMPLOYMENT AND GENDER ROLES
501) Have you done any work in the last seven days?
NO 2
502) 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
503) Have you done any work in the last 12 months?
NO 2 (GO TO 507)
504) What is your occupation, that is, what kind of work do you mainly do?
505) 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
506) Are you paid in cash or cash and kind both or kind only for this work or are you not paid at all?
CASH AND KIND 2
IN KIND ONLY 3
NOT PAID 4
WIDOWED/DIVORCED OR SEPARATED __ (GO TO 512)
OTHER __ (GO TO 510)
509) Who usually decides how the money you earn will be used: you, your wife, or you and your wife jointly or someone else?
WIFE 2
RESPONDENT AND WIFE JOINTLY 3
FAMILY ELDERS 4
SOMEONE ELSE 6
510) Who usually make decisions about health care for yourself: you, your wife, you are your wife jointly or someone else?
WIFE 2
RESPONDENT AND WIFE JOINTLY 3
FAMILY ELDERS 4
SOMEONE ELSE 6
511) Who usually makes decisions about making major household purchases: you, your wife, you and your wife jointly or someone else?
WIFE 2
RESPONDENT AND WIFE JOINTLY 3
FAMILY ELDERS 4
SOMEONE ELSE 6
512) 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
513) Do you own any land either alone or jointly with someone else?
JOINTLY ONLY 2
BOTH ALONE AND JOINTLY 3
DOES NOT OWN 4
514) 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
NO 2
DON'T KNOW 8
601) Now I would like to talk about something else. Have you ever heard of an illness called AIDS?
NO 2 (GO TO 617)
602) Can people reduce their chance of getting the AIDS virus by having just one uninfected sex partner who has no other sex partners?
NO 2
DON'T KNOW 8
603) Can people get the AIDS virus from mosquito bites?
NO 2
DON'T KNOW 8
604) Can people reduce their chance of getting the AIDS virus by using a condom every time they have sex?
NO 2
DON'T KNOW 8
605) Can people get the AIDS virus by sharing food with someone who has AIDS?
NO 2
DON'T KNOW 8
606) Can people get the AIDS virus because of witchcraft or other supernatural means?
NO 2
DON'T KNOW 8
607) Is it possible for a healthy-looking person to have the AIDS virus?
NO 2
DON'T KNOW 8
608) Can the virus that causes AIDS 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 611)
610) Are there any special drugs that a doctor or a nurse can give to a women infected with the AIDS virus to reduce the risk of transmission to the baby?
NO 2
DON'T KNOW 8
611) Do you know of a place where people can go to get tested for the AIDS virus?
NO 2 (GO TO 613)
612) Where is that? Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
GOVT. HEALTH CENTER B
STAND-ALONE VCT CENTER C
OTHER PUBLIC SECTOR (SPECIFY) ____ G
STAND-ALONE VCT CENTER I
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ____ M
613) Would you buy fresh vegetables from a shopkeeper or vendor if you knew that this person had the AIDS virus?
NO 2
DON'T KNOW 8
614) If a member of your family got infected with the AIDS virus, would you want it to remain a secret or not?
NO 2
DON'T KNOW/NOT SURE/DEPENDS 8
615) If a member of your family 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
616) In your opinion, if a female teacher has the AIDS virus but is not sick, should she be allowed to continue teaching in the school?
SHOULD NOT BE ALLOWED 2
DON'T KNOW/NOT SURE/DEPENDS 8
HEARD ABOUT AIDS:
Apart from AIDS, have you heard about other infections that can be transmitted through sexual contact?
NOT HEARD ABOUT AIDS:
Have you heard about infections that can be transmitted through sexual contact?
NO 2 (GO TO 701)
618) 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 got through sexual contact?
NO 2 (GO TO 701)
DON'T KNOW 8 (GO TO 701)
619) The last time you has problems, did you seek any kind of advice or treatment?
NO 2 (GO TO 701)
620) Where did you go? Any other place?
PROBE TO IDENTIFY EACH TYPE OF SOURCE.
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE SECTOR, WRITE THE NAME OF THE PLACE.
GOVT. HEALTH CENTER B
STAND-ALONE VCT CENTER C
FAMILY PLANNING CLINIC D
MOBILE CLINIC E
FIELDWORKER F
OTHER PUBLIC SECTOR (SPECIFY) ____ G
STAND-ALONE VCT CENTER I
PHARMACY J
MOBILE CLINIC K
FIELDWORKER L
OTHER PRIVATE MEDICAL SECTOR (SPECIFY) ____ M
OTHER (SPECIFY) ____ X
SECTION 7. OTHER HEALTH ISSUES
701) Have you ever heard of an illness called tuberculosis or TB?
NO 2 (GO TO 706)
702) How does tuberculosis spread from one person to another?
PROBE: Any other ways?
[CIRCLE ALL MENTIONED]
BY SHARING UTENSILS B
BY TOUCHING A PERSON WITH TB C
THROUGH SHARING FOOD D
THROUGH SEXUAL CONTACT E
THROUGH MOSQUITO BITES F
OTHER (SPECIFY) ___ X
DON'T KNOW Z
703) Can tuberculosis be cured?
NO 2 (GO TO 705)
DON'T KNOW 8 (GO TO 705)
704) What is the duration of treatment of TB now a days?
[IF MORE THAN 7 MONTHS, RECORD 7]
DON'T KNOW 8
705) Have you ever been told by a doctor or nurse or LHV that Gos forbid you have/had tuberculosis?
NO 2
DON'T KNOW 8
706) Have you ever heard of an illness called Hepatitis B or C?
NO 2 (GO TO 709)
DON'T KNOW 8 (GO TO 709)
707) Is there anything a person can do to avoid getting Hepatitis B or C?
NO 2 (GO TO 709)
DON'T KNOW 8 (GO TO 709)
708) What can a person do to avoid getting Hepatitis B or C?
PROBE: Any other ways?
[CIRCLE ALL MENTIONED]
SAFE BLOOD TRANSFUSION B
USE OF DISPOSABLE SYRINGE C
AVOID CONTAMINATED FOOD/WATER D
AVOID CONTACT WITH INFECTED PERSON E
MAKING SURE THAT THE INSTRUMENTS OF DENTISTS ARE PROPERLY STERILIZED F
OTHER (SPECIFY) ___ X
NO RESPONSE Y
DON'T KNOW Z
709) 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 712)
710) 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 712)
711) The last time you got an injection from a health worker, did he/she take the syringe and needle from a new, unopened package?
NO 2
DON'T KNOW 8
712) Do you presently smoke cigarettes?
NO 2 (GO TO 714)
713) In the last 24 hours, how many cigarettes did you smoke?
714) Do you currently smoke or use any other type of tobacco?
NO 2 (GO TO 716)
715) What (other) type of tobacco do you currently smoke or use?
[CIRCLE ALL MENTIONED]
CHEWING TOBACCO/NUSWAR B
SNUFF C
HUKAA/SHEESHA D
OTHER (SPECIFY) ____ X
MINUTES __