REPUBLIC OF SENEGAL DEMOGRAPHIC AND HEALTH SURVEY (EDSIII) - 1997 - MAN'S QUESTIONNAIRE
PLACE NAME (COMMUNE/VILLAGE) _____
NAME OF HEAD OF HOUSEHOLD_____
CLUSTER NUMBER_____
HOUSEHOLD NUMBER_____
REGION_____
RURAL 2
DAKAR/REGIONAL CAPITAL/OTHER CITY/RURAL?
REGIONAL CAPITAL (THIES, KAOLACK, ZIGUINCHOR, ST. LOUIS, DIOURBEL) 2
OTHER CITY 3
RURAL 4
NAME/LINE NUMBER OF THE HUSBAND:
LINE NUMBER(S) OF ELIGIBLE WIFE/WIVES:
FIRST INTERVIEW (REPEAT FOR SECOND AND THIRD INTERVIEWS)
DATE_____
INTERVIEWER NAME_____
RESULT___
2 NOT AT HOME
3 POSTPONED
4 REFUSED
5 PARTIALLY FILLED OUT
6 ILL/INCAPACITATED
7 OTHER (SPECIFY) ______
NEXT VISIT (FOR INTERVIEWERS 1 AND 2)
DATE_____
TIME_____
FINAL VISIT
DAY_____
MONTH_____
YEAR _____
INTERVIEWER_____
RESULT_____
NO 2
P 2
SR 3
M 4
D 5
SM 6
ALN 7
F 8
AL 9
SUPERVISOR
NAME_____
DATE_____
FIELD EDITOR
NAME_____
DATE_____
KEYED BY_____
CODE _____
SECTION 1: SOCIO-DEMOGRAPHIC CHARACTERISTICS OF THE RESPONDENT
102. In which month and in which year were you born?
DOESN'T KNOW MONTH 98
DOESN'T KNOW YEAR 98
103. How old are you currently?
COMPARE AND CORRECT 102 AND/OR 103 IS INCONSISTENT
NO 2 (GO TO 108)
105. What is the highest level of school you attended: primary, secondary or superior?
SECONDARY 2
SUPERIOR 3
106. What is the last (year/grade) that you achieved at this level?
SECONDARY OR MORE (GO TO 110)
108. Can you read and understand a letter or a newspaper easily, with difficulty or not at all?
WITH DIFFICULTY 2
NOT AT ALL 3
NO 2 (GO TO 112)
POULAR 02
SERER 03
MANDINGUE/SOCE/MALINKE 04
DIOLA 05
SOLINKE/SARAKOLE 06
BAMBARA 07
MANJAAK 08
MANCAGNE 09
BALANT 10
OTHER (SPECIFY) ______11
112. What is your occupation?
That is, what kind of work do you do?
113. Are you currently married?
NO 2
114. Are you celibate, widowed, divorced or separated or do you live in a union with someone?
WIDOWED 2 (GO TO 116)
DIVORCED 3 (GO TO 116)
SEPARATED 4 (GO TO 116)
CELIBATE 5 (GO TO 118A)
115. How many wives/partners do you currently have?
FIVE OR MORE 5
116. Do you intend to take another (other) wife (wives) in the future?
NO 2
117. In which month and in which year were you married for the first time?
DOESN'T KNOW MONTH 98
DOESN'T KNOW YEAR 98
118. How old were you when you were married/began living with someone for the first time?
DOESN'T KNOW AGE 98 (GO TO 118B)
IF NEVER IN UNION OR FIRST UNION NOT CONSUMMATED:
118A. Have you ever had sexual intercourse?
NO 2 (GO TO 201)
118B. How old were you when you first had sexual intercourse?
FIRST TIME WHEN MARRIED 96
201. Now I would like to talk to you about family planning - the various ways or methods that a couple can use to delay or avoid a pregnancy. What methods or ways have you heard of?
CIRCLE CODE '1' ON LINE 202 FOR EACH METHOD MENTIONED SPONTANEOUSLY. THEN CONTINUE DOWN THE COLUMN READING THE NAME AND DESCRIPTION OF EACH METHOD NOT MENTIONED SPONTANEOUSLY. CIRCLE CODE '2' IF THE METHOD IS RECOGNIZED AND CODE '3' IF NOT RECOGNIZED. THEN, FOR EACH METHOD WITH CODE '1' OR '2' CIRCLED IN 202, ASK 203-203A BEFORE GOING ON TO THE NEXT QUESTION.
202. Have you ever heard of (METHOD)?
YES DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
YES DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
YES DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
YES DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
YES DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
YES DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
YES DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
YES DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
YES DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
YES DESCRIPTION 2
NO 3 (GO TO NEXT METHOD)
NO 3
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
NO 2
203A. What are the advantages of (METHOD)?
EASY TO USE B
EASY ACCESS C
WITHOUT SECONDARY EFFECTS D
INEXPENSIVE/FREE E
EFFICIENT F
CONTROLE/APPROVS. INFREQUENT G
FORGETTING IS NOT A PROBLEM H
DOESN'T KNOW I
OTHER J (SPECIFY) _____
EASY TO USE B
EASY ACCESS C
WITHOUT SECONDARY EFFECTS D
INEXPENSIVE/FREE E
EFFICIENT F
CONTROLE/APPROVS. INFREQUENT G
FORGETTING IS NOT A PROBLEM H
DOESN'T KNOW I
OTHER J (SPECIFY) _____
EASY TO USE B
EASY ACCESS C
WITHOUT SECONDARY EFFECTS D
INEXPENSIVE/FREE E
EFFICIENT F
CONTROLE/APPROVS. INFREQUENT G
FORGETTING IS NOT A PROBLEM H
DOESN'T KNOW I
OTHER J (SPECIFY) _____
EASY TO USE B
EASY ACCESS C
WITHOUT SECONDARY EFFECTS D
INEXPENSIVE/FREE E
EFFICIENT F
CONTROLE/APPROVS. INFREQUENT G
FORGETTING IS NOT A PROBLEM H
DOESN'T KNOW I
OTHER J (SPECIFY) _____
EASY TO USE B
EASY ACCESS C
WITHOUT SECONDARY EFFECTS D
INEXPENSIVE/FREE E
EFFICIENT F
CONTROLE/APPROVS. INFREQUENT G
FORGETTING IS NOT A PROBLEM H
DOESN'T KNOW I
OTHER J (SPECIFY) _____
EASY TO USE B
EASY ACCESS C
WITHOUT SECONDARY EFFECTS D
INEXPENSIVE/FREE E
EFFICIENT F
CONTROLE/APPROVS. INFREQUENT G
FORGETTING IS NOT A PROBLEM H
DOESN'T KNOW I
OTHER J (SPECIFY) _____
EASY TO USE B
EASY ACCESS C
WITHOUT SECONDARY EFFECTS D
INEXPENSIVE/FREE E
EFFICIENT F
CONTROLE/APPROVS. INFREQUENT G
FORGETTING IS NOT A PROBLEM H
DOESN'T KNOW I
OTHER J (SPECIFY) _____
EASY TO USE B
EASY ACCESS C
WITHOUT SECONDARY EFFECTS D
INEXPENSIVE/FREE E
EFFICIENT F
CONTROLE/APPROVS. INFREQUENT G
FORGETTING IS NOT A PROBLEM H
DOESN'T KNOW I
OTHER J (SPECIFY) _____
EASY TO USE B
EASY ACCESS C
WITHOUT SECONDARY EFFECTS D
INEXPENSIVE/FREE E
EFFICIENT F
CONTROLE/APPROVS. INFREQUENT G
FORGETTING IS NOT A PROBLEM H
DOESN'T KNOW I
OTHER J (SPECIFY) _____
EASY TO USE B
EASY ACCESS C
WITHOUT SECONDARY EFFECTS D
INEXPENSIVE/FREE E
EFFICIENT F
CONTROLE/APPROVS. INFREQUENT G
FORGETTING IS NOT A PROBLEM H
DOESN'T KNOW I
OTHER J (SPECIFY) _____
AT LEAST ONE "YES" (EVER USED) (GO TO 207)
205. Have you ever used anything or tried in any way to delay or avoid pregnancy?
NO 2 (GO TO 209)
206. What did you do or use?
CORRECT 203-203A (AND 202 IF NECESSARY). (GO TO 207)
207. At this time, are you or your wife/wives/partner(s) doing something or using a method to delay or avoid pregnancy?
NO 2 (GO TO 209)
208. What method are you using?
IUD 02 (GO TO 301)
INJECTIONS 03 (GO TO 301)
IMPLANTS 04 (GO TO 301)
DIAPHRAGM/FOAM/JELLY 05(GO TO 301)
CONDOM 06 (GO TO 301)
FEMALE STERILIZATION 07 (GO TO 301)
MALE STERILIZATION 08 (GO TO 301)
RHYTHM METHOD 09 (GO TO 301)
WITHDRAWAL 10 (GO TO 301)
OTHER (SPECIFY) _____11 (GO TO 301)
DOESN'T KNOW 98
209. Do you or your wife/wives/partner(s) intend to use, in the future, a family planning method to delay or avoid becoming pregnant?
NO 2
DOESN'T KNOW 8 (GO TO 301)
210. What is the main reason you do not intend to use a method?
RECORD ALL THE REASONS MENTIONED.
LACK OF INFORMATION 02 (GO TO 301)
PARTNER DISAPPROVES 03 (GO TO 301)
TOO EXPENSIVE 04 (GO TO 301)
SECONDARY EFFECTS 05 (GO TO 301)
HEALTH PROBLEMS 06 (GO TO 301)
HARD TO GET 07 (GO TO 301)
RELIGION 08 (GO TO 301)
OPPOSED TO FAMILY PLANNING 09 (GO TO 301)
FATALISTIC 10 (GO TO 301)
OTHER PEOPLE DISAPPROVE 11 (GO TO 301)
INFREQUENT SEX 12 (GO TO 301)
WOMAN HAS DIFFICULTY GETTING PREGNANT 13 (GO TO 301)
WOMAN IN MENOPAUSE/HYSTERECTOMY 14 (GO TO 301)
INCONVENIENT TO USE 15 (GO TO 301)
NOT MARRIED 16 (GO TO 301)
OTHER (SPECIFY) ______17 (GO TO 301)
DOESN'T KNOW 98 (GO TO 301)
211. Do you intend to use, in the next 12 months, a family planning method?
NO 2
DOESN'T KNOW 8
212. When you would use a method, what method would you prefer to use?
IUD 02
INJECTIONS 03
IMPLANTS 04
DIAPHRAGM/FOAM/JELLY 05
CONDOM 06
FEMALE STERILIZATION 07
MALE STERILIZATION 08
RHYTHM METHOD 09
WITHDRAWAL 10
OTHER (SPECIFY) _____11
DOESN'T KNOW 98
SECTION 3. FERTILITY PREFERENCES
301. Do you have living biological children?
NO 2 (GO TO 303)
302. How many boys do you have?
How many girls do you have?
HE OR SHE STERILIZED (GO TO 306)
NOT MARRIED/NOT IN UNION (GO TO 310)
305. Would you like to have (a/another) child, or would you prefer not to have (other) children at all?
NO MORE/NONE 2
SAYS HIS WIFE CANNOT GET PREGNANT 3
SAYS HE CANNOT HAVE ANY MORE CHILDREN 4
NOT DECIDED/DOESN'T KNOW 8
306. Do you think that your wife/wives/partner(s) approve(s) or disapprove(s) of couples who use a method to avoid getting pregnant?
DISAPPROVE(S) 2
DOESN'T KNOW 8
307. How many times have you talked about family planning with your wife/wives/partner(s) during the last twelve months?
ONCE OR TWICE 2
MORE OFTEN 3
308. Have you ever discussed with your wife/wives/partner(s) the number of children you would like to have?
NO 2
309. Do you think that your wife/wives/partner(s) would like to have the same number of children as you would like to have?
MORE CHILDREN 2
FEWER CHILDREN 3
DOESN'T KNOW 8
310. Do you approve or disapprove of information about family planning being discussed on television or radio?
DISAPPROVES 2
NO OPINION 8
311. In general, do you approve or disapprove of couples who use a method to avoid getting pregnant?
DISAPPROVES 2
NO OPINION 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?
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 RESPONSE (SPECIFY) _____96
401. Have you ever heard of an illness that can be transmitted sexually?
NO 2 (GO TO 407B)
402. Which sexually transmitted diseases do you know of?
CIRCLE THE CODES CORRESPONDING TO ALL MENTIONED.
GONORRHEA B
AIDS C
CONDYLOMA/HOT URINE D
OTHER (SPECIFY) _____E
DOESN'T KNOW F
HAS NEVER HAD SEXUAL INTERCOURSE (GO TO 407A)
404. During the last twelve months, have you had any of these illnesses?
NO 2 (GO TO 407A)
DOESN'T KNOW 8 (GO TO 407A)
405. Among these illnesses, which have you had?
GONORRHEA B
AIDS C
CONDYLOMA/HOT URINE D
OTHER (SPECIFY) _____E
DOESN'T KNOW F
406. The last time you had one of these illnesses (NAME OF ILLNESSES), did you seek advice or treatment?
NO 2 (GO TO 407A)
407. Where did you seek advice or treatment?
CIRCLE THE CODES CORRESPONDING TO RESPONSES GIVEN.
HEALTH CENTER B
HEALTH POST/ PMI (Protection Maternelle et Infantile) C
PHARMACY E
PRIVATE DOCTOR F
PRIVATE NURSE/CONFES G
TRADITIONAL HEALER I
CHURCH J
FRIEND/RELATIVE K
AUXILIARY L
OTHER (SPECIFY) _____ M
MENTIONED 'AIDS' (GO TO 408)
407B. Do you know or have you ever heard of a disease called AIDS?
NO 2 (GO TO 415)
408. How can a person get AIDS?
CIRCLE THE CORRESPONDING CODES TO THE RESPONSES GIVEN.
SEXUAL INTERCOURSE WITH AN UNKNOWN PERSON B
SEXUAL INTERCOURSE WITH PROSTITUTES C
NOT USING A CONDOM D
INTERCOURSE WITH HOMOSEXUALS E
BLOOD TRANSFUSION F
INJECTION G
BY KISSES H
BLADE/RAZOR I
BY MOSQUITOS J
OTHER (SPECIFY) ______K
DOESN'T KNOW L
409. In your opinion, is there something a person can do to avoid getting an STD, AIDS or the virus that causes AIDS?
NO 2 (GO TO 411)
DOESN'T KNOW 8 (GO TO 411)
410. In your opinion, what can a person do?
CIRCLE THE CORRESPONDING CODES TO THE RESPONSES GIVEN.
LOYALTY TO PARTNERS B
USE A CONDOM C
ABSTINENCE D
NO SEXUAL INTERCOURSE WITH PROSTITUTES E
NO SEXUAL INTERCOURSE WITH HOMOSEXUALS F
NO SEXUAL INTERCOURSE WITH MULTIPLE PARTNERS G
NO BLOOD TRANSFUSION H
NO INJECTIONS I
NO KISSES J`
NO MOSQUITO BITES K
SEEK PROTECTION FROM A HEALER/TRADITIONAL WITCH DOCTOR L
OTHER (SPECIFY) _____M
OTHER (SPECIFY) _____N
DOESN'T KNOW O
411. Is it possible that someone who appears to be in good health actually has AIDS?
NO 2
DOESN'T KNOW 8
412. Some people use condoms during sexual intercourse to avoid getting AIDS or other sexually transmitted illnesses. Have you ever heard of this?
NO 2
DOESN'T KNOW 8
413. Do you know of a place where you can get condoms?
NO 2 (GO TO 415)
414 .Which place(s) do you know of?
CIRCLE THE CODES CORRESPONDING TO RESPONSES GIVEN.
HEALTH CENTER B
HEALTH POST/ PMI (Protection Maternelle et Infantile) C
PHARMACY E
PRIVATE DOCTOR F
PRIVATE NURSE/CONFES G
TRADITIONAL HEALER I
CHURCH J
FRIEND/RELATIVE K
AUXILIARY L
OTHER (SPECIFY) _____M
TO BE FILLED OUT AFTER HAVING ENDED THE INTERVIEW.
COMMENTS ABOUT THE RESPONDENT _____
COMMENTS ON PARTICULAR QUESTIONS _____
OTHER COMMENTS _____
SUPERVISOR'S OBSERVATIONS _____
NAME_____
DATE_____
OTHER OBSERVATIONS _____