IDENTIFICATION

REGION

DISTRICT

WARD

ENUMERATION AREA

NAME OF HEAD OF HOUSEHOLD

TDHS NUMBER

HOUSEHOLD NUMBER

LARGE CITY/SMALL CITY/TOWN/COUNTRYSIDE

LARGE CITIES ARE; DAR ES SALAAM AND MWANZA. SMALL CITIES ARE; ARUSHA, MOROGORO, DODOMA, MOSHI, TANGA, IRINGA MBEYA, SHINYANGA, TABORA, MJINI MAGHARIBI - ZANZIBAR. ALL OTHER URBAN AREAS ARE TOWN

NAME AND LINE NUMBER OF MAN

INTERVIEWER VISITS

FIRST VISIT (REPEAT FOR SECOND AND THIRD VISITS)
DATE
INTERVIEWER NAME
RESULT

RESULT*

NEXT VISIT
DATE
TIME

FINAL VISIT
DAY
MONTH
YEAR
INT. NUMBER
RESULT

TOTAL NUMBER OF VISITS

SURPERVISOR
NAME ___________

FIELD EDITOR
NAME ___________

OFFICE EDITOR

KEYED BY

SECTION 1. RESPONDENT'S BACKGROUND

INTRODUCTION AND CONSENT

INFORMED CONSENT
Hello. My name is _____________________________ and I am working with the National Bureau of Statistics. We are conducting a national survey about the health of men, women and children. We would very much appreciate your participation in this survey. I would like to ask you some questions related to health. This information will help the government to plan health services. The survey usually does not take too much time. Whatever information you provide will be kept strictly confidential and will not be shown to other persons.
Participation in this survey is voluntary and you can choose not to answer any individual question or all of the questions. However, we hope that you will participate in this survey since your views are important. (1)
At this time, do you want to ask me anything about the survey?
May I begin the interview now?

Signature of interviewer: ________
Date: ________

RESPONDENT AGREES TO BE INTERVIEWED 1 (GO TO 101)
RESPONDENT DOES NOT AGREE TO BE INTERVIEWED 2 (END)

101. RECORD THE TIME.

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 D'Salaam/Mwanza, Other urban area or in rural area?

103. How long have you been living continuously in (NAME OF CURRENT PLACE OF RESIDENCE)?
IF LESS THAN ONE YEAR, RECORD '00' YEARS.

104. Just before you moved here, did you live in D'Salaam/Mwanza, Other urban area or in rural area?

105. In the last 12 months, on how many separate occasions have you traveled away from your home community and slept away?

106. In the last 12 months, have you been away from your home community for more than 1 month at a time?

107. In what month and year were you born?

108. How old are you in complete years?
COMPARE AND CORRECT 107 AND/OR 108 IF INCONSISTENT.

109. Have you ever attended school?

110. What is the highest level of school you attended: primary, secondary, or higher? (2)

111. What is the highest (grade/form/year) you completed at that level? (2)

112. CHECK 110:

113. Now I would like you to read this sentence to me.
SHOW CARD TO RESPONDENT. (3)
IF RESPONDENT CANNOT READ WHOLE SENTENCE, PROBE:
Can you read any part of the sentence to me?

114. Have you ever participated in a literacy program or any other program that involves learning to read or write (not including primary school)? (4)

115. CHECK 113:

116. Do you read a newspaper or magazine almost every day, at least once a week, less than once a week or not at all?

117. Do you listen to the radio almost every day, at least once a week, less than once a week or not at all?

118. Do you watch television almost every day, at least once a week, less than once a week or not at all?

119. Are you currently working?

120. Have you done any work in the last 12 months?

121. What have you been doing for most of the time over the last 12 months?

122. What is your occupation, that is, what kind of work do you mainly do?

123. CHECK 122:

124. 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?

125. During the last 12 months, how many months did you work?

126. Are you paid in cash or kind for this work, or are you not paid at all?

127. Who mainly decides how the money you earn will be used?

128. 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?

129. What is your religion?

1 Wording of this paragraph should be modified in countries where participation is legally required.
2 Revise according to the local education system.
3 Each card should have four simple sentences appropriate to the country (e.g., "Parents love their children", "Farming is hard work",
"The child is reading a book", "Children work hard at school"). Cards should be prepared for every language in which respondents are likely to be literate.
4 In countries with an interest in measuring participation across a number of literacy programs, an additional multiple-response question may be included for men who participated in a literacy program (for example, "What type of literacy programs have you participated in? PROBE: Any other programs?")

SECTION 2. REPRODUCTION

201. Now I would like to ask about any children you have had during your life. I am interested only in the children that are biologically yours. Have you ever fathered any children with any woman?

202. Do you have any sons or daughters that you have fathered who are now living with you?

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 that you have fathered who are alive but do not live with you?

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 fathered a son or a daughter who was born alive but later died?
IF NO, PROBE: Any baby who cried or showed signs of life but did not survive?

207. How many boys have died? And how many girls have died?
IF NONE, RECORD '00'.

208. (In addition to the children that you have just told me about), do you have:
a) any other living sons or daughters who are biologically your children but who are not legally yours or do not have your last name?
b) any other sons or daughters who died who were biologically your children but who were not legally yours or did not have your last name?

209. SUM ANSWERS TO 203, 205, AND 207, AND ENTER TOTAL.
IF NONE, RECORD '00'.

210. CHECK 209:

211. Do the children that you have fathered all have the same biological mother?

212. In all, how many women have you fathered children with?

213. How old were you when your (first) child was born?

SECTION 3. CONTRACEPTION

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 IF APPLICABLE.

301. Which ways or methods have you heard about? FOR METHODS NOT MENTIONED SPONTANEOUSLY, ASK: Have you ever heard of (METHOD)?

302. Have you ever used (METHOD)?

303. 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 if she has sexual relations?

304. Is this time just before her period begins, during her period, right after her period has ended, or halfway between two periods?

305. Do you think that a woman who is breastfeeding her baby can become pregnant?

306. I will now read you some statements about contraception. Please tell me if you agree or disagree with each one.

307. CHECK 301(02) AND 302(02):
KNOWLEDGE AND USE OF MALE STERILIZATION (1)

308. Once you have had all the children you want, would you yourself ever consider getting sterilized? (1)

309. Why would you never consider getting sterilized? (1)
PROBE: Any other reasons?
RECORD ALL REASONS MENTIONED.

1 Question may be deleted in countries where male sterilization is not widely known, used, or promoted.

SECTION 4. MARRIAGE AND SEXUAL ACTIVITY (1)

401. Are you currently married or living with a woman as if married?

401A. Is your wife/partner living with you now or is she staying elsewhere?

401B. CHECK 401:

402. Do you have one wife or more than one wife?
IF ONLY ONE WIFE, RECORD '01'. IF MORE THAN ONE, ASK: How many wives do you currently have?

403. Are there any other women with whom you live as if married?

404. Are you living with one (other) woman or more than one (other) woman as if married?
IF ONLY ONE LIVE-IN PARTNER, RECORD '01'. IF MORE THAN ONE, ASK: How many women are you living with as if married?

405. Apart from the woman/women you have already mentioned, do you currently have any other regular or occasional sexual partners?
IF 'YES', PROBE TO IDENTIFY TYPE OF PARTNER.

406. Do you currently have any regular sexual partners, occasional sexual partners, or do you have no sexual partner at all?
IF 'YES', PROBE TO IDENTIFY TYPE OF PARTNER.

407. Have you ever been married or lived with a woman?

408. What is your marital status now: are you widowed, divorced, or separated?

409. WRITE THE LINE NUMBERS FROM THE HOUSEHOLD QUESTIONNAIRE FOR EACH WIFE/PARTNER REPORTED IN QUESTIONS 402 AND 404 ONLY. IF A WIFE/PARTNER IS NOT LISTED IN THE HOUSEHOLD SCHEDULE, RECORD '00' IN THE LINE NUMBER BOXES. THE NUMBER OF LINES FILLED IN MUST BE EQUAL TO THE NUMBER OF WIVES AND PARTNERS. (IF RESPONDENT HAS MORE THAN FIVE WIVES/PARTNERS USE ADDITIONAL QUESTIONNAIRE(S).)

410. CHECK: 402 AND 404
SUM OF 402 AND 404 = 1
Please tell me the name of your wife/partner.

SUM OF 402 AND 404 > 1
Please tell me the name of each (wife/partner that you live with as if married), starting with the one you lived with first.

LINE NUMBER IN HHOLD. QUEST.

STATUS:

410A. How old was your wife/partner on her last birthday?

410B. CHECK 410:

411. Have you been married or lived with a woman only once or more than once?

412. Have you ever been married to or lived as if married to any woman other than those you have just mentioned?

413. In total, how many women have you been married to or lived with as if married in your whole life?

414. CHECK 410 AND 411:

ONLY ONE WIFE/PARTNER AND 411=1: In what month and year did you start living with your wife/partner?

OTHER: Now we will talk about your first wife/partner. In what month and year did you start living with her?

415. How old were you when you started living with her?

416. 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?

416A. Do you intend to wait until you get married to have sexual intercourse for the first time?

416B. CHECK 108:

416C. The first time you had sexual intercourse, was a condom used? (1)

416D. How old was the person you first had sexual intercourse with?

417. When was the last time you had sexual intercourse?
RECORD 'YEARS AGO' ONLY IF LAST INTERCOURSE WAS ONE OR MORE YEARS AGO. IF 12 MONTHS OR MORE, ANSWER MUST BE RECORDED IN YEARS.

418. The last time you had sexual intercourse with this (second/third) person, was a condom used? (2)

419. What was the main reason you used a condom on that occasion?

420. Did you use a condom every time you had sexual intercourse with this person in the last 12 months?

421. CHECK 302(2):

422. The last time you had sexual intercourse with this person, did you or she do something else or use any other method besides a condom to avoid a pregnancy?

423. What method was used?

425. What is the main reason a method was not used?

426. The last time you had sexual intercourse with this (second/third) person, did you or this person drink alcohol?

427. Were you or your partner drunk at that time?
IF YES: Who was drunk?

428. What was your relationship to this person with whom you had sexual intercourse?
IF GIRLFRIEND: Were you living together as if married?
IF YES, CIRCLE '02'
IF NO, CIRCLE '03'

429. For how long (have you had/did you have) sexual relations with this person?

431. How old is this person?

434. Apart from [this person/these two people], have you had sexual intercourse with any other person in the last 12 months?

435. In total, with how many different people have you had sex in the last 12 months?
IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE.
IF NUMBER OF PARTNERS IS GREATER THAN 95, WRITE '95.'

436A. In the last 12 months, did you pay anyone in exchange for sex?

436B. The last time you paid for someone in exchange for sex, was a condom used?

436C. Did you use a condom every time you paid someone to have sexual intercourse in the last 12 months?

437A. Have you ever paid for sex?

437B. How long ago was the last time you paid for sex?

437C. The last time that you paid for sex, was a condom used on that occasion?

438. In total, with how many different people have you had sex in your lifetime?
IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE.
IF NUMBER OF PARTNERS IS GREATER THAN 95, WRITE '95.'

440. If someone needs a condom, where can they get it?
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.
PROBE: Any other place?
RECORD ALL PLACES MENTIONED.

441. If you wanted to, could you yourself get a condom?

442. CHECK 302(07), 416C, 418, AND 436B:
USE OF CONDOMS

443. How old were you when you used a condom for the first time?

444. Why did you use a condom that first time?
PROBE: Any other reason?
RECORD ALL REASONS MENTIONED.

445. Have you ever experienced any problems with using condoms?
IF YES: What problems have you experienced?
PROBE: Any other problems?
RECORD ALL PROBLEMS MENTIONED.

447. I will now read you some statements about condom use. Please tell me if you agree or disagree with each.

449. If someone needs a female condom, where can they get it?
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.
PROBE: Any other place?
RECORD ALL PLACES MENTIONED.

460. If you wanted to, could you yourself get a female condom? (3)

1 In countries with an active female condom program, a question should be added on use of a female condom.
2 Coding categories to be developed locally and revised based on the pretest; however, the broad categories must be maintained.
3 Question may be deleted in countries where female condoms are not actively promoted.

SECTION 5. FERTILITY PREFERENCES

501. CHECK 410:

502. (Is your wife/partner/Are any of your wives/partners) currently pregnant?

503. CHECK 502:

YES, WIFE/WIVES/PREGNANT: Now I have some questions about the future. After the child(ren) your wife/wives/ partner(s) is/are expecting now, would you like to have another child or would you prefer not to have any more children at all?

NO WIFE/PARTNER PREGNANT OR UNSURE: Now I have some questions the future. Would you like to have (a/another) child, or would you prefer not to have any (more) children at all?

504. How long would you like to wait from now before the birth of (a/another) child?

505. CHECK 203 AND 205:

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?

506. 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?

507. Would you say that you approve or disapprove of couples using a contraceptive method to avoid getting pregnant?

508. Is it acceptable or not acceptable to you for information on family planning to be provided:

a) On the radio?
b) On the television?
c) In a newspaper or magazine?

508A. In the last six months have you heard about family planning:

a) On the radio?
b) On the television?
c) In a newspaper or magazine?
d) From a poster?
e) From billboards?
f) At community events?
g) From live drama?
h) From a doctor or nurse?
i) From a community health worker?

509. In the past six months, what drama series have you listened to on the radio?
CIRCLE THE SERIES MENTIONED SPONTANEOUSLY. FOR SERIES NOT MENTIONED, ASK: YES In the last 6 months, have you listened to:

a) Zinduka?
b) Twende na Wakati?
c) Other?

509A. CHECK 509:

509B. How often do you listen to Zinduka?

509C. As a result of listening to Zinduka, did you do anything or take any action related to family planning?

509D. What did you do as a result of listening to Zinduka?

509E. CHECK 509:

509F. How often do you listen to Twenda na Wakati?

510. In the last few months, have you discussed the practice of family planning with your friends, neighbors, or relatives?

511. With whom? Anyone else?
RECORD ALL PERSONS MENTIONED.

512. In the last few months, have you discussed the practice of family planning with a health worker or health professional?

SECTION 6. PARTICIPATION IN HEALTH CARE

601. CHECK 209:

602. Please tell me the name and sex of your child (who was born most recently).

603. In what month and year was (NAME OF CHILD) born?

604. Is (NAME OF CHILD) still living?

605. How old was (NAME OF CHILD) when he/she died?
IF '1 YEAR', PROBE: How many months old was (NAME)?
RECORD DAYS IF LESS THAN 1 MONTH; MONTHS IF LESS THAN TWO YEARS; OR YEARS.

606. What is the name of (NAME OF CHILD)'s mother?
WRITE THE CHILD'S MOTHER'S NAME AND HER LINE NUMBER FROM THE HOUSEHOLD QUESTIONNAIRE. IF THE MOTHER IS NOT LISTED IN THE HOUSEHOLD SCHEDULE RECORD '00'
NAME OF CHILD'S MOTHER

607. CHECK 603:

608. CHECK 606:

609. What is your relationship with (NAME OF CHILD)'s mother?

610. ASK QUESTIONS 610-612 FIRST FOR PREGNANCY, THEN FOR DELIVERY, AND THEN FOR THE SIX WEEKS AFTER DELIVERY. ALL QUESTIONS REFER TO THE LAST BIRTH.

Now, think back to the time when (NAME OF CHILD'S MOTHER) was pregnant with (NAME OF CHILD).

PREGNANCY
610A: Did (NAME OF CHILD'S MOTHER) receive any antenatal care from a doctor or any health care provider when she was pregnant with (NAME OF CHILD)?

DELIVERY
610B: Did a doctor or any health care provider assist with the delivery of (NAME OF CHILD)?

SIX WEEKS AFTER DELIVERY
610C: Did (NAME OF CHILD'S MOTHER) receive any care for herself from a doctor or any health care provider during the six weeks after this delivery?

611. Who mainly provided the money or goods or services to pay for this care?

612. What was the main reason (NAME OF CHILD'S MOTHER) did not receive any advice or care from a doctor or other health care provider during (pregnancy/delivery/the six weeks after delivery)?

613. At any time while (NAME OF CHILD'S MOTHER) was pregnant with (NAME OF CHILD), did you yourself talk with a doctor or any other health care provider about the health of the mother or of the pregnancy?

614. CHECK 602 AND 604:

615. Does (NAME OF CHILD) live with you in your household?

616. In your household who usually decides what to do if the (NAME OF CHILD) is ill?
RECORD ALL PERSONS MENTIONED.

617. Now, I want to talk to you about pregnancy and the health of children. Sometimes a pregnancy can have complications that lead to miscarriage or even death. What are some of the signs and symptoms that indicate that a pregnancy may be in danger?
PROBE: Any other signs or symptoms?
RECORD ALL SIGNS AND SYMPTOMS MENTIONED.

618. When a child has diarrhea, should he/she be given less to drink than usual, about the same amount, or more than usual?

619. Have you ever heard of a special product called [LOCAL NAME FOR ORS PACKET] you can get for the treatment of diarrhea?

619A. Have you ever heard of female circumcision?

619B. In a number of countries, there is a practice in which a girl may have part of her genitals cut. Have you heard about this practice?

619C. Do you think that this practice should be continued, or should it be discontinued?

620. Now, please tell me about yourself. Do you currently smoke cigarettes or tobacco? (3)
IF YES: What type of tobacco do you smoke?
RECORD ALL TYPES MENTIONED.

621. CHECK 620:

622. In the last 24 hours, how many cigarettes did you smoke?

623. Have you had an injection for any reason in the last six months?
IF YES: How many injections did you have?
IF NUMBER OF INJECTIONS IS GREATER THAN 94,
OR DAILY FOR 3 MONTHS OR MORE, RECORD '95'.
IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE.

624. Among these injections, how many were administered by a doctor, a nurse, a pharmacist, a dentist, or any other health workers?
IF NUMBER OF INJECTIONS IS GREATER THAN 94,
OR DAILY FOR 3 MONTHS OR MORE, RECORD '95'.
IF NON-NUMERIC ANSWER, PROBE TO GET AN ESTIMATE.

625. The last time you had an injection, where did you go for the injection to be given?

626. The last time you had an injection, did the person who gave you the injection take the syringe and needle from a new, unopened package?

627. Some ethnic groups circumcise their males and some ethnic groups do not. Are you circumcised?

SECTION 7. HIV/AIDS AND OTHER SEXUALLY TRANSMITTED INFECTIONS

701. Now I would like to talk about something else. Have you ever heard of an illness called AIDS?

702. Can people reduce their chances of getting the AIDS virus by having just one uninfected sex partner who has no other sex partners?

703. (1) Can people get the AIDS virus from mosquito bites?

704. By using condoms each time they have sex, can people reduce their chances of being infected with the AIDS virus?

705. (1) Can people be infected with the AIDS virus by eating from the same plate as someone who is sick with AIDS?

706. Can people reduce their chances of being infected with the AIDS virus if they stop having sex altogether?

707. (1) Can people get the AIDS virus because of witchcraft or other supernatural means?

708. What else can a person do in order to avoid or reduce their chances of being infected by the AIDS virus?
Anything else?
RECORD ALL WAYS MENTIONED.

710. Is it possible for a healthy-looking person to have the AIDS virus?

711. Is it possible for a child to be infected by the AIDS virus:

During pregnancy?
During delivery?
By breastfeeding?

712. CHECK 711:

713. Are there any special medications that a doctor or a nurse can give to a woman infected with the AIDS virus to reduce the risk of transmission to the baby?

714. Is there any special medication that people infected with the AIDS virus can get from a doctor or a nurse?

724. I don't want to know the results, but have you ever been tested to see if you have the AIDS virus?

725. When was the last time you were tested?

726. 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?

727. I don't want to know the results, but did you get the results of the test?

728. Where was the test done? (3)
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.

729. Do you know of a place where people can go to get tested for the virus that causes AIDS?

730. Where is that? (3)
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.
Any other place?
RECORD ALL SOURCES MENTIONED.

731. If you learn that a fresh food vendor has the AIDS virus, but is not sick, would you buy fresh food from him/her?

731A. And if she/he is sick?

732. If a member of your family has been infected with the AIDS virus, but is not sick, would you want it to remain a secret within the family, or not a secret?

733. If a relative of yours became sick with the virus that causes AIDS, would you be willing to care for her or him in your own household?

734. In your opinion, if a female teacher has been infected with the AIDS virus, but is not sick, should she continue teaching?

734A. In your opinion, if a male teacher has been infected with the AIDS virus, should he continue teaching?

735. Do you personally know someone who has been denied health services in the last 12 months because he or she is suspected to have the AIDS virus or has the AIDS virus?

736. Do you personally know someone who has been denied involvement in social events, religious services, or community events in the last 12 months because he or she is suspected to have the AIDS virus or has the AIDS virus?

737. Do you personally know someone who has been verbally abused or teased in the last 12 months because he or she is suspected to have the AIDS virus or has the AIDS virus?

738. CHECK 735, 736, AND 737:

739. Do you personally know someone who is suspected to have the AIDS virus or who has the AIDS virus?

740. Do you agree or disagree with the following statement: People with the AIDS virus should be ashamed of themselves.

741. Do you agree or disagree with the following statement:
People with the AIDS virus should be blamed for bringing the disease into the community.

742. Should children age 12-14 be taught about using a condom to avoid AIDS?

743. Should children age 12-14 be taught to wait until they get married to have sexual intercourse in order to avoid AIDS?

744. Do you believe that young men should wait until they are married to have sexual intercourse?

745. Do you believe that young women should wait until they are married to have sexual intercourse?

746. Do you believe that married men should only have sex with their wives?

747. Do you think that most men you know have sex only with their wives?

747. Do you believe that married women should only have sex with their husbands?

749. Do you think that most women you know have sex only with their husbands?

750. CHECK 701:

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?

751. If a man has a sexually transmitted disease, what symptoms might he have? Any others?
RECORD ALL SYMPTOMS MENTIONED.

752. If a woman has a sexually transmitted disease, what symptoms might she have? Any others?
RECORD ALL SYMPTOMS MENTIONED.

753. CHECK 416:

754. CHECK 750:

755. 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?

756. Sometimes men experience an abnormal discharge from their penis. During the last 12 months, have you had an abnormal discharge from your penis?

757. Sometimes men have a sore or ulcer on or near their penis. During the last 12 months, have you had a sore or ulcer on or near your penis?

758. CHECK 755, 756, AND 757:

759. The last time you had (PROBLEM FROM 755/756/757), did you seek any kind of advice or treatment?

760. Where did you go? Any other place?
RECORD ALL SOURCES MENTIONED.

(1) If 703, 705 and/or 707 do not apply to the local context, replace the question using a specific local misconception. At least two questions related to misconceptions are needed.
(2) For fieldwork in 2005 and 2006, the year should be 2003 and 2004, respectively.
(3) Coding categories to be developed locally and revised based on the pretest; however, the broad categories must be maintained.

SECTION 8. ATTITUDES TOWARDS GENDER ROLES

801. In a couple, who do you think should have the greater say in BOTH DON'T each of the following decisions: the husband, the wife or both equally:

802. Sometimes a husband is annoyed or angered by things that his wife/partner does. In your opinion, is a husband justified in hitting or beating his wife in the following situations...

803. When a wife knows her husband has a sexually transmitted disease, is she justified in asking that they use a condom?

804. 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 if...

805. Do you think that if a woman refuses to have sex with her husband when he wants her to, he has the right to...

806. RECORD THE TIME.

1 In polygynous societies, the phrase 'other women' should be replaced by the phrase 'women other than his wives.'