Survey Text

Burkina Faso 2010
Cameroon 2004
Cote d'Ivoire 2011
Egypt 2005
Jordan 2007
Jordan 2012
Malawi 2004
Mali 2006
Rwanda 2005
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Burkina Faso 2010
Survey form view entire document:  text 
1321. Who has done any of these things to physically hurt you while you were pregnant?
Anyone else?
RECORD ALL MENTIONED.

MOTHER A
FATHER B
STEP-MOTHER C
STEP-FATHER/MOTHER'S PARTNER D
SISTER E
BROTHER F
DAUGHTER G
SON H
EX-HUSBAND/EX-PARTNER I
FRIEND/CURRENT SEX PARTNER J
EX-FRIEND/FORMER SEX PARTNER K
MOTHER-IN-LAW L
FATHER-IN-LAW M
OTHER FEMALE IN-LAW N
OTHER MALE IN-LAW O
FEMALE FRIEND/ACQUAINTANCE P
MALE FRIEND/ACQUAINTANCE Q
TEACHER R
EMPLOYER S
STRANGER T
OTHER (SPECIFY) _____ X

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Cameroon 2004
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1120) Has anyone ever hit, slapped, kicked or done anything else to hurt you physically while you were pregnant?

YES 1
NO 2 (GO TO 1122)

1121) How has done any of these things to physically hurt you while you were pregnant?

Anyone else?

RECORD ALL MENTIONED.

CURRENT HUSBAND/PARTNER A
MOTHER B
FATHER C
STEP-MOTHER D
STEP-FATHER E
SISTER F
BROTHER G
DAUGHTER H
SON I
LAST/EX-HUSBAND/EX-PARTNER J
CURRENT BOYFRIEND K
FORMER BOYFRIEND L
MOTHER-IN-LAW M
FATHER-IN-LAW N
OTHER FEMALE RELATIVE/IN-LAW O
OTHER MALE RELATIVE/IN-LAW P
FEMALE FRIEND/ACQUAINTANCE Q
MALE FRIEND/ACQUAINTANCE R
TEACHER S
EMPLOYER T
STRANGER U
OTHER (SPECIFY): ___ X

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Cote d'Ivoire 2011
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1221) Who has done any of these things to physically hurt you while you were pregnant?
Anyone else?
RECORD ALL MENTIONED

MOTHER A
FATHER B
STEP-MOTHER C
STEP-FATHER/MOTHER'S PARTNER D
SISTER E
BROTHER F
DAUGHTER G
SON H
EX-HUSBAND/EX-PARTNER I
FRIEND/CURRENT SEX PARTNER J
EX-FRIEND/FORMER SEX PARTNER K
MOTHER-IN-LAW L
FATHER-IN-LAW M
OTHER FEMALE IN-LAW N
OTHER MALE IN-LAW O
FEMALE FRIEND/ACQUAINTANCE P
MALE FRIEND/ACQUAINTANCE Q
TEACHER R
EMPLOYER S
STRANGER T
OTHER_______ (SPECIFY) X

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Egypt 2005
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915) Who has done any of these things to physically hurt you while you were pregnant?

Anyone else?
RECORD ALL MENTIONED.

MOTHER A
FATHER B
STEP-MOTHER C
STEP-FATHER D
SISTER E
BROTHER F
DAUGHTER G
SON H
LATE/EX-HUSBAND I
MOTHER-IN-LAW J
FATHER-IN-LAW K
OTHER FEMALE RELATIVE/IN-LAW L
OTHER MALE RELATIVE/ IN-LAW M
FEMALE FRIEND/ACQUAINTANCE N
MALE FRIEND/ACQUAINTANCE O
FEMALE TEACHER P
MALE TEACHER Q
FEMALE EMPLOYER R
MALE EMPLOYER S
STRANGER (FEMALE) T
STRANGER (MALE) U
OTHER (SPECIFY) ___________ X

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Jordan 2007
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1109) Who has hurt you in this way?

Anyone else?

RECORD ALL MENTIONED.

MOTHER A
FATHER B
STEP-MOTHER C
STEP-FATHER D
BROTHER E
SISTER F
SON G
DAUGHTER H
EX-HUSBAND I
MOTHER-IN-LAW J
FATHER-IN-LAW K
OTHER FEMALE RELATIVE/IN-LAW L
OTHER MALE RELATIVE/ IN-LAW M
FEMALE FRIEND/ACQUAINTANCE N
MALE FRIEND/ACQUAINTANCE O
FEMALE TEACHER P
MALE TEACHER Q
FEMALE EMPLOYER R
MALE EMPLOYER S
FEMALE STRANGER T
MALE STRANGER U
POLICE/SOLDIER V
OTHER (SPECIFY)_______ X

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Jordan 2012
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1217. Who has hurt you in this way?
Anyone else?
RECORD ALL MENTIONED.

MOTHER A
FATHER B
STEP-MOTHER C
STEP-FATHER D
BROTHER E
SISTER F
SON G
DAUGHTER H
MOTHER-IN-LAW J
FATHER-IN-LAW K
OTHER FEMALE RELATIVE/IN-LAW L
OTHER MALE RELATIVE/IN-LAW M
FEMALE FRIEND/ACQUAINTANCE N
MALE FRIEND/ACQUAINTANCE O
FEMALE TEACHER P
MALE TEACHER Q
FEMALE EMPLOYER R
MALE EMPLOYER S
FEMALE STRANGER T
MALE STRANGER U
POLICE/SOLDIER V
OTHER (SPECIFY) _____ X

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Malawi 2004
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DV21. Who has done any of these things to physically hurt you while you were pregnant? Anyone else?
RECORD ALL MENTIONED.

CURRENT HUSBAND/PARTNER A
MOTHER B
FATHER C
STEP-MOTHER D
STEP-FATHER E
SISTER F
BROTHER G
DAUGHTER H
SON I
LATE/EX-HUSBAND/EX-PARTNER J
CURRENT BOYFRIEND K
FORMER BOYFRIEND L
MOTHER-IN-LAW M
FATHER-IN-LAW N
OTHER FEMALE RELATIVE/IN-LAW O
OTHER MALE RELATIVE/ IN-LAW P
FEMALE FRIEND/ACQUAINTANCE Q
MALE FRIEND/ACQUAINTANCE R
TEACHER S
EMPLOYER T
STRANGER U
OTHER (SPECIFY) ________ X

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Mali 2006
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1021. Who physically attacked you during a pregnancy?
Someone else?
CIRCLE ALL MENTIONED.

MOTHER A
FATHER B
FATHER'S NEW WIFE C
MOTHER'S NEW HUSBAND/PARTNER D
SISTER E
BROTHER F
DAUGHTER G
SON H
EX-HUSBAND/EX -PARTNER I
CURRENT FRIEND/ SEXUAL PARTNER J
FORMER FRIEND/SEXUAL PARTNER K
MOTHER-IN-LAW L
FATHER-IN-LAW M
OTHER FEMALE RELATIVES IN LAW N
OTHER MALE RELATIVES IN LAW O
FEMALE FRIENDS P
MALE FRIENDS Q
INSTRUCTOR R
EMPLOYER S
STRANGER T
OTHERS (SPECIFY) __X

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Rwanda 2005
Survey form view entire document:  text 
1021. Who has done any of these things to physically hurt you while you were pregnant? Anyone else?
RECORD ALL MENTIONED.

CURRENT HUSBAND/PARTNER A
MOTHER B
FATHER C
STEP-MOTHER D
STEP-FATHER E
SISTER F
BROTHER G
DAUGHTER H
SON I
LATE/EX-HUSBAND/EX-PARTNER J
CURRENT BOYFRIEND K
MOTHER-IN-LAW M
FATHER-IN-LAW N
OTHER FEMALE RELATIVE/IN-LAW O
OTHER MALE RELATIVE/IN-LAW P
FEMALE FRIEND/ACQUAINTANCE Q
MALE FRIEND/ACQUAINTANCE R
TEACHER S
EMPLOYER T
STRANGER U
OTHER (SPECIFY)_____ X