DDI_IRQ_2006_MICS_v01_M Croft, Trevor James, Rhiannon 2008-03 NADA Version 01 - Slightly edited version of UNICEF's DDI ref. DDI-UNICEF-MICS2006-V0.1 Multiple Indicator Cluster Survey 2006 MICS 2006 IRQ_2006_MICS_v01_M Central Organization for Statistics and Information Technology Kurdistan Region Statistics Office Suleimaniya Statistical Directorate Ministry of Health UNICEF, Iraq Country Office Strategic Information Section, Division of Policy and Planning, UNICEF NYHQ The Pan Arab Project for Family Health Measure DHS/ORC MACRO Government Steering Commitee UN Steering Commitee NADA United Nations Children's Fund Canadian International Development Agency Central Organization for Statistics and Information Technology Kurdistan Region Statistics Office General Inquiries MICS Programme Manager Multiple Indicator Cluster Survey - Round 3 [hh/mics-3] The Multiple Indicator Cluster Survey, Round 3 (MICS3) is the third round of MICS surveys, previously conducted around 1995 (MICS1) and 2000 (MICS2). Many questions and indicators are consistent and compatible with the prior round of MICS (MICS2) but less so with MICS1, although there have been a number of changes in definition of indicators between rounds. Details can be found by reviewing the indicator definitions. Version 1.0: Edited data used for final report Household members Education Water and sanitation Household characteristics Child labour Child discipline Disability Salt iodization Women's background Marriage and union Child mortality Birth History Tetanus toxoid Maternal and newborn health Contraception and unmet need Attitudes towards domestic violence HIV/AIDS Children's background Birth registration Early learning Vitamin A Breastfeeding Care of illness Immunization Anthropometry The Multiple Indicator Cluster Survey (MICS) is a household survey programme developed by UNICEF to assist countries in filling data gaps for monitoring human development in general and the situation of children and women in particular. MICS is capable of producing statistically sound, internationally comparable estimates of social indicators. The current round of MICS is focused on providing a monitoring tool for the Millennium Development Goals (MDGs), the World Fit for Children (WFFC), as well as for other major international commitments, such as the United Nations General Assembly Special Session (UNGASS) on HIV/AIDS and the Abuja targets for malaria. The 2006 Iraq Multiple Indicator Cluster Survey has as its primary objectives: - To provide up-to-date information for assessing the situation of children and women in Iraq; - To furnish data needed for monitoring progress toward goals established by the Millennium Development Goals and the goals of A World Fit For Children (WFFC) as a basis for future action; - To contribute to the improvement of data and monitoring systems in Iraq and to strengthen technical expertise in the design, implementation and analysis of such systems. Survey Content MICS questionnaires are designed in a modular fashion that was customized to the needs of the country. They consist of a household questionnaire, a questionnaire for women aged 15-49 and a questionnaire for children under the age of five (to be administered to the mother or caretaker). Other than a set of core modules, countries can select which modules they want to include in each questionnaire. Survey Implementation The survey was implemented by the Central Organization for Statistics and Information Technology (COSIT), the Kurdistan Region Statistics Office (KRSO) and Suleimaniya Statistical Directorate (SSD), in partnership with the Ministry of Health (MOH). The survey also received support and assistance of UNICEF and other partners. Technical assistance and training for the surveys was provided through a series of regional workshops, covering questionnaire content, sampling and survey implementation; data processing; data quality and data analysis; report writing and dissemination. Iraq The survey is nationally representative and covers the whole of Iraq. Households (defined as a group of persons who usually live and eat together) De jure household members (defined as memers of the household who usually live in the household, which may include people who did not sleep in the household the previous night, but does not include visitors who slept in the household the previous night but do not usually live in the household) Women aged 15-49 Children aged 0-4 The survey covered all de jure household members (usual residents), all women aged 15-49 years resident in the household, and all children aged 0-4 years (under age 5) resident in the household. The survey also includes a full birth history listing all chuldren ever born to ever-married women age 15-49 years. Sample survey data [ssd] The Iraq Multiple Indicator Cluster Survey included the following modules in the questionnaires: HOUSEHOLD QUESTIONNAIRE : Household Listing, Education, Water and Sanitation, Household Characteristics, Child Labour, Child Discipline, Disability, Salt Iodization WOMEN'S QUESTIONNAIRE: Marriage, Child Mortality, Birth History, Tetanus Toxoid, Maternal and Newborn Health, Contraception and Unmet Need, Attitude Towards Domestic Violence, HIV/AIDS CHILDREN'S QUESTIONNAIRE: Birth Registration and Early Learning, Vitamin A, Breastfeeding, Care of Illness, Immunization, Anthropometry The sample for the Iraq Multiple Indicator Cluster Survey was designed to provide estimates on a large number of indicators on the situation of children and women at the national level; for areas of residence of Iraq represented by rural and urban (metropolitan and other urban) areas; for the18 governorates of Iraq; and also for metropolitan, other urban, and rural areas for each governorate. Thus, in total, the sample consists of 56 different sampling domains, that includes 3 sampling domains in each of the 17 governorates outside the capital city Baghdad (namely, a metropolitan area domain representing the governorate city centre, an other urban area domain representing the urban area outside the governorate city centre, and a rural area domain) and 5 sampling domains in Baghdad (namely, 3 metropolitan areas representing Sadir City, Resafa side, and Kurkh side, an other urban area sampling domain representing the urban area outside the three Baghdad governorate city centres, and a sampling domain comprising the rural area of Baghdad). The sample was selected in two stages. Within each of the 56 sampling domains, 54 PSUs were selected with linear systematic probability proportional to size (PPS). \After mapping and listing of households were carried out within the selected PSU or segment of the PSU, linear systematic samples of six households were drawn. Cluster sizes of 6 households were selected to accommodate the current security conditions in the country to allow the surveys team to complete a full cluster in a minimal time. The total sample size for the survey is 18144 households. The sample is not self-weighting. For reporting national level results, sample weights are used. The sampling procedures are more fully described in the sampling appendix of the final report and can also be found in the list of technical documents within this archive. (Extracted from the final report: Central Organisation for Statistics & Information Technology and Kurdistan Statistics Office. 2007. Iraq Multiple Indicator Cluster Survey 2006, Final Report. Iraq.) No major deviations from the original sample design were made. One cluster of the 3024 clusters selected was not completed all othe clusters were accessed. Face-to-face [f2f] The questionnaires were based on the third round of the Multiple Indicator Cluster survey model questionnaires. From the MICS-3 model English version, the questionnaires were revised and customized to suit local conditions and translated into Arabic and Kurdish languages. The Arabic language version of the questionnaire was pre-tested during January 2006 while the Kurdish language version was pre-tested during March 2006. Based on the results of the pre-test, modifications were made to the wording and translation of the questionnaires. In addition to the administration of questionnaires, fieldwork teams tested the salt used for cooking in the households for iodine content, and measured the weights and heights of children age under-5 years. In the South/Centre governorates, groups of three teams were supervised by a local supervisor from the statistical office of each governorate. A central supervisor from the steering committee members and MOH was assigned to each governorate. In Kurdistan Region, groups of three teams were supervised by two local supervisors (one from KRSO/SSD and one from MOH). Two central supervisors from KRSO/SSD and MOH were also assigned to each governorate. A high committee, consisting of members from KRSO/SSD and MOH was also assigned for overall supervision of the survey in Kurdistan. Vehicles were rented by all fieldwork teams (including local, central supervisors and steering committee members) to transport them to the selected clusters. Fieldwork began in the South/Centre governorates of Iraq in February 2006 and concluded in March 2006. In the Kurdistan Region, fieldwork began in Suleimaniya governorate in April 2006 and was completed in April 2006 while fieldwork was initiated in May 2006 in Erbil/Dohuk governorates and concluded in June 2006. The Iraq Multiple Indicator Cluster Survey sample is not self-weighted. Essentially, by allocating equal numbers of households to each of the sampling domains, different sampling fractions were used in each sampling domain since the size of the sampling domains varied. For this reason, sample weights were calculated and these were used in the subsequent analyses of the survey data. The major component of the weight is the reciprocal of the sampling fraction employed in selecting the number of sample households in that particular sampling domain: Wh = 1 / fh The term fh, the sampling fraction at the h-th stratum, is the product of probabilities of selection at every stage in each sampling domain: fh = P1h * P2h * P3h where Pih is the probability of selection of the sampling unit in the i-th stage for the h-th sampling domain. Since the estimated numbers of households per enumeration area prior to the first stage selection (selection of primary sampling units) and the updated number of households per enumeration area were different, individual sampling fractions for households in each enumeration area (cluster) were calculated. The sampling fractions for households in each enumeration area (cluster) therefore included the probability of selection of the enumeration area in that particular sampling domain and the probability of selection of a household in the sample enumeration area (cluster). A second component which has to be taken into account in the calculation of sample weights is the level of non-response for the household and individual interviews. The adjustment for household non-response is equal to the inverse value of: RR = Number of interviewed households / Number of occupied households listed After the completion of fieldwork, response rates were calculated for each sampling domain. These were used to adjust the sample weights calculated for each cluster. Similarly, the adjustment for non-response at the individual level (women and under-5 children) is equal to the inverse value of: RR = Completed women's (or under-5's) questionnaires / Eligible women (or under-5s) Numbers of eligible women and under-5 children were obtained from the household listing in the Household Questionnaire in households where interviews were completed. The unadjusted weights for the households were calculated by multiplying the above factors for each enumeration area. These weights were then standardized (or normalized), one purpose of which is to make the sum of the interviewed sample units equal the total sample size at the national level. Normalization is performed by multiplying the aforementioned unadjusted weights by the ratio of the number of completed households to the total unadjusted weighted number of households. A similar standardization procedure was followed in obtaining standardized weights for the women's and under-5's questionnaires. Adjusted (normalized) weights varied between 0.110 and 3.721 in the 56 sampling domains. Sample weights (Table SD.4) were appended to all data sets and analyses were performed by weighting each household, woman or under-5 with these sample weights. (Extracted from the final report Appendix A: Central Organisation for Statistics & Information Technology and Kurdistan Statistics Office. 2007. Iraq Multiple Indicator Cluster Survey 2006, Final Report. Iraq.) Data were processed in clusters, with each cluster being processed as a complete unit through each stage of data processing. Each cluster goes through the following steps: 1) Questionnaire reception 2) Office editing and coding 3) Data entry 4) Structure and completeness checking 5) Verification entry 6) Comparison of verification data 7) Back up of raw data 8) Secondary editing 9) Edited data back up After all clusters are processed, all data is concatenated together and then the following steps are completed for all data files: 10) Export to SPSS in 5 files (hh - household, hl - household members, wm - women age 15-49, ch - children under 5 bh - women age 15-49) 11) Recoding of variables needed for analysis 12) Adding of sample weights 13) Calculation of wealth quintiles and merging into data 14) Structural checking of SPSS files 15) Data quality tabulations 16) Production of analysis tabulations Detailed documentation of the editing of data can be found in the data processing guidelines in the MICS Manual (http://www.childinfo.org/mics/mics3/manual.php) Data entry was conducted by 12 data entry operators in tow shifts, supervised by 2 data entry supervisors, using a total of 7 computers (6 data entry computers plus one supervisors computer). All data entry was conducted at the GenCenStat head office using manual data entry. For data entry, CSPro version 2.6.007 was used with a highly structured data entry program, using system controlled approach, that controlled entry of each variable. All range checks and skips were controlled by the program and operators could not override these. A limited set of consistency checks were also included inthe data entry program. In addition, the calculation of anthropometric Z-scores was also included in the data entry programs for use during analysis. Open-ended responses ("Other" answers) were not entered or coded, except in rare circumstances where the response matched an existing code in the questionnaire. Structure and completeness checking ensured that all questionnaires for the cluster had been entered, were structurally sound, and that women's and children's questionnaires existed for each eligible woman and child. 100% verification of all variables was performed using independent verification, i.e. double entry of data, with separate comparison of data followed by modification of one or both datasets to correct keying errors by original operators who first keyed the files. After completion of all processing in CSPro, all individual cluster files were backed up before concatenating data together using the CSPro file concatenate utility. Data editing took place at a number of stages throughout the processing (see Other processing), including: a) Office editing and coding b) During data entry c) Structure checking and completeness d) Secondary editing e) Structural checking of SPSS data files Detailed documentation of the editing of data can be found in the data processing guidelines in the MICS Manual (http://www.childinfo.org/mics/mics3/manual.php) Of the 18144 households selected for the sample, 18123 were found to be occupied. Of these, 17873 were successfully interviewed for a household response rate of 98.6 percent. In the interviewed households, 27564 women (age 15-49 years) were identified. Of these, 27186 were successfully interviewed, yielding a response rate of 98.6 percent. In addition, 16570 children under age five were listed in the household questionnaire. Of these, questionnaires were completed for 16469 which correspond to a response rate of 99.4 percent. Overall response rates of 97.3 and 98.0 are calculated for the women's and under-5's interviews respectively. Estimates from a sample survey are affected by two types of errors: 1) non-sampling errors and 2) sampling errors. Non-sampling errors are the results of mistakes made in the implementation of data collection and data processing. Numerous efforts were made during implementation of the 2005-2006 MICS to minimize this type of error, however, non-sampling errors are impossible to avoid and difficult to evaluate statistically. Sampling errors can be evaluated statistically. The sample of respondents to the 2005-2006 MICS is only one of many possible samples that could have been selected from the same population, using the same design and expected size. Each of these samples would yield results that differe somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability in the results of the survey between all possible samples, and, although, the degree of variability is not known exactly, it can be estimated from the survey results. The sampling erros are measured in terms of the standard error for a particular statistic (mean or percentage), which is the square root of the variance. Confidence intervals are calculated for each statistic within which the true value for the population can be assumed to fall. Plus or minus two standard errors of the statistic is used for key statistics presented in MICS, equivalent to a 95 percent confidence interval. If the sample of respondents had been a simple random sample, it would have been possible to use straightforward formulae for calculating sampling errors. However, the 2005-2006 MICS sample is the result of a multi-stage stratified design, and consequently needs to use more complex formulae. The SPSS complex samples module has been used to calculate sampling errors for the 2005-2006 MICS. This module uses the Taylor linearization method of variance estimation for survey estimates that are means or proportions. This method is documented in the SPSS file CSDescriptives.pdf found under the Help, Algorithms options in SPSS. Sampling errors have been calculated for a select set of statistics (all of which are proportions due to the limitations of the Taylor linearization method) for the national sample, urban and rural areas, and for each of the five regions. For each statistic, the estimate, its standard error, the coefficient of variation (or relative error -- the ratio between the standard error and the estimate), the design effect, and the square root design effect (DEFT -- the ratio between the standard error using the given sample design and the standard error that would result if a simple random sample had been used), as well as the 95 percent confidence intervals (+/-2 standard errors). Details of the sampling errors are presented in the sampling errors appendix to the report and in the tables folder. A series of data quality tables and graphs are available to review the quality of the data and include the following: Age distribution of the household population Age distribution of eligible women and interviewed women Age distribution of eligible children and children for whom the mother or caretaker was interviewed Age distribution of children under age 5 by 3 month groups Age and period ratios at boundaries of eligibility Percent of observations with missing information on selected variables Presence of mother inthe household and person interviewed for the under 5 questionnaire School attendance by single year age Sex ratio at birth among children ever born, surviving and dead by age of respondent Distribution of women by time since last birth Scatterplot of weight by height, weight by age and height by age Graph of male and female population by single years of age Population pyramid The results of each of these data quality tables is shown in the appendix of the final report and is also given in the external resources section. The general rule for presentation of missing data in the final report tabulations is that a column is presented for missing data if the percentage of cases with missing data is 1% or more. Cases with missing data on the background characteristics (e.g. education) are included in the tables, but the missing data rows are suppressed and noted at the bottom of the tables in the report (not in the SPSS output, however). Users of the data agree to keep confidential all data contained in these datasets and to make no attempt to identify, trace or contact any individual whose data is included in these datasets. The Central Organization for Statistics and Information Technology /The Kurdistan Region Statistics Office, Iraq Multiple Indicator Cluster Survey: Household , household listing, women and children's files, 2005-2006 [Computer file]. Iraq: The Central Organization for Statistics and Information Technology /The Kurdistan Region Statistics Office [producer], 2006. Iraq The Central Organization for Statistics and Information Technology /The Kurdistan Region Statistics Office and New York: Strategic Information Section, Dvision of Policy and Planning, UNICEF [distributors], 2006. Survey datasets are distributed at no cost for legitimate research, with the condition that we receive a description of theresearch objectives that will be using the data prior to authorizing their distribution. Copies of all reports and publications based on the requested data must be sent to COSIT, KRSO and UNICEF. Ministry of Planning / Central Organization for Statistics and Information Technology (COSIT) Dr. Mehdi Alalak Head of COSIT alalak_mm@yahoo.com Ministry of Planning / Kurdistan Regional Statistics Office (KRSO) Dr. Jamal Ameen Head of KRSO jrmameen@glam.ac.uk UNICEF, Iraq Support Centre in Amman Mary-Louise Eagleton Chief, Planning, Monitoring & Evaluation meagleton@unicef.org Requests for access to the datasets may be made through the website www.childinfo.org. COSIT, KRSO and UNICEF provide these data to external users without any warranty or responsibility implied. COSIT, KRSO and UNICEF accept no responsibility for the results and/or implications of any actions resulting from the use of these data. hh Data collected at the household level (MICS Household questionnaire: modules Household information panel, Water and sanitation, Household characteristics, Child discipline, Salt iodization) 0 89 hl Data collected at the household member's level (MICS Household questionnaire modules:Household listing, Child labour and Disability) 0 114 wm Data collected at the women's level (MICS Women's questionnaire: modules Women's Information Panel, Child mortality, Tetanus toxoid, Maternal and newborn health, Marriage/union, Contraception (and unmet need), HIV/AIDS, Female genital mutiliation/cutting, Sexual behaviour, Attitudes towards domestic violence) 0 259 ch Data collected at mother's or primary caretaker's level (MICS Child questionnaire: modules Birth Registration and Early Learning, Vitamin A, Breastfeeding, Care of Illness, Malaria, Immunization and Anthropometry) ) 0 261 bh Data collected at the women's level (MICS Women's questionnaire: modules Birth History) 0 266 Cluster number Cluster number Cluster number Cluster number Cluster number We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. During this time I would like to speak with the household head and all mothers or others who take care of children in the household. May I start now? If permission is given, begin the interview. Cluster number: Enter the cluster number as instructed by your supervisor. Households Unique identifier for the cluster in which the household exists Household number Household number Household number Household number Household number Household number: Enter the household number as instructed by your supervisor. Households Interviewer number Interviewer number Interviewer number Interviewer number Interviewer number Interviewer name and number: Enter your own name and identification number provided to you at the time of training. Households Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor name and number: Enter your supervisor's name and identification number. You will be provided with your supervisor's identification number as soon as you know who you will be working with. Households Day of interview Day of interview Day of interview Day of interview Day of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Month of interview Month of interview Month of interview Month of interview Month of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Year of interview Year of interview Year of interview Year of interview Year of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Area Area Area Area Area Circle the code for area of residence as instructed by your supervisor. This will have been pre-determined; you will not be required to assess whether the household is in an urban or rural area. Households 1 Urban 2 Rural Muhafaza Muhafaza Muhafaza Muhafaza Muhafaza Region: Circle the code for zone. Households 11 Duhuk 12 Nainwa 13 Sulimania 14 Kakuk 15 Arbil 21 Diala 22 Anbar 23 Baghdad 24 Babil 25 Karbala 26 Wasit 27 Salahaladin 28 Najaf 31 Qadisya 32 Almuthana 33 Thiqar 34 Misan 35 Albasrah Governate/Region Qadha Qadha Qadha Qadha Qadha Recoded variable Household District Result of HH interview Result of HH interview Result of HH interview Result of HH interview Result of HH interview After all questionnaires for the household have been completed, fill in the following information: Result of HH interview: If the Household Questionnaire is completed, circle '1' for 'Completed'. If you have not been able to contact the household after repeated visits, circle '2' for 'Not at home'. If the household refuses to be interviewed, circle '3' for 'Refused'. If you are unable to locate the household or if the dwelling is destroyed, circle '4' for 'HH not found/destroyed'. If you have not been able to complete the Household Questionnaire for another reason, you should circle '6' for 'Other' and specify the reason in the space provided. Some examples of 'Other' codes might be: the household respondent is incapacitated; the questionnaire is partly completed; adult household members were not found at home after repeated visits. Households 1 Completed 2 Not at home 3 Refused 4 HH not found/destroyed 6 Other Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent to HH questionnaire: Enter the name and line number (from the Household Listing, columns HL1 and HL2) of the respondent to the Household Questionnaire. Households 99 Missing Number of household members Number of household members Number of household members Number of household members Number of household members Total number of household members: Count the number of household members recorded in column HL1 of the Household Listing and enter the total here. Households Total eligible women Total eligible women Total eligible women Total eligible women Total eligible women No.of women eligible for interview: Enter the total number of women eligible for interview for the Questionnaire for Individual Women - you will copy this from the row for totals at the bottom of the Household Listing, for HL6. Households Women interviews completed Women interviews completed Women interviews completed Women interviews completed Women interviews completed No.of women questionnaires completed: Once all of the Questionnaires for Individual Women have been completed for a particular household, enter the number completed here. Households Total children under 5 Total children under 5 Total children under 5 Total children under 5 Total children under 5 No.of children under age 5: Enter the total number of children under five eligible for inclusion in the survey from the row for totals at the bottom of the Household Listing, for HL8. You will be using the Questionnaire for Children Under Five to interview the mothers or primary caretakers of these children. Households Child interviews completed Child interviews completed Child interviews completed Child interviews completed Child interviews completed No.of under-5 questionnaires completed: Once all of the Questionnaires for Children Under Five have been completed for a particular household, enter the number completed here. Households Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk: Leave this space blank. The data clerk will enter his/her number in the space provided. Households Total number of Women 15-49 Total number of Women 15-49 Total number of Women 15-49 Total number of Women 15-49 Total number of Women 15-49 Are there any other persons living here - even if they are not members of your family or do not have parents living in this household? Including children at work or at school? If yes, insert child's name and complete form. Then, complete the totals below. Households Total number of Children 5-14 Total number of Children 5-14 Total number of Children 5-14 Total number of Children 5-14 Total number of Children 5-14 Households Total number of children Under 5 years Total number of children Under 5 years Total number of children Under 5 years Total number of children Under 5 years Total number of children Under 5 years Households Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water What is the main source of drinking water for members of your household? The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): · '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. · '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. · '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. · '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. · '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. · '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. · '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. · '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). · '52' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof and stored in a container, tank or cistern until used. · '53' Berkad · '54' Rain water catchment (Balli) · '61' - A tanker-truck water source transports and sells water by means of a tanker truck. · '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. · '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. · '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. Households 11 Piped into dwelling 12 Piped into yard or plot 13 Public tap/standpipe 21 Tubewell/borehole 31 Protected well 32 Unprotected well 41 Protected spring 42 Unprotected spring 51 Rainwater collection 62 Tanker-truck 71 Cart with small tank/drum 81 Surface water 91 Bottled water 96 Other 99 Missing Main source of water used for other purposes (if bottled wat Main source of water used for other purposes (if bottled wat Main source of water used for other purposes (if bottled wat Main source of water used for other purposes (if bottled wat Main source of water used for other purposes (if bottled wat What is the main source of water used by your household for other purposes such as cooking and handwashing? The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): · '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. · '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. · '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. · '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. · '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. · '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. · '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. · '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). · '52' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof and stored in a container, tank or cistern until used. · '53' Berkad · '54' Rain water catchment (Balli) · '61' - A tanker-truck water source transports and sells water by means of a tanker truck. · '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. · '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. · '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. Households 11 Piped into dwelling 12 Piped into yard or plot 13 Public tap/standpipe 21 Tubewell/borehole 31 Protected well 32 Unprotected well 41 Protected spring 42 Unprotected spring 51 Rainwater collection 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 96 Other 99 Missing Time to get water and come back Time to get water and come back Time to get water and come back Time to get water and come back Time to get water and come back How long does it take to go there, get water, and come back? This question is used to find out how convenient the source of water is to the dwelling. Note that the question is asked for water sources coded as '13-81' and '96' in WS1, or water sources coded as '13-96' in WS2. Fill in the estimated time (in minutes, converting from hours, if necessary) it takes by the usual mode of transport to get to the water source, wait to get water, and get back to the dwelling. Use zero(s) preceding the number if less than 100 minutes (for example, '060' or '005'). Then continue to the next question. If the water source is on the dwelling premises or if water is delivered to the dwelling by a vendor, circle '995' for 'Water on premises' and skip to WS5. If the respondent does not know how long it takes, circle '998' and continue on to the next question. Households 995 On premises 998 DK 999 Missing Person fetching water Person fetching water Person fetching water Person fetching water Person fetching water Who usually goes to this source to fetch the water for your household? Probe: Is this person under age 15? What sex? Circle code that best describes this person. The purpose of this question is to find out the age and gender of the person who usually performs the task of hauling water. This will provide an understanding of whether water hauling responsibilities are given to members of a particular sex or age group. Probe: "IS THIS PERSON UNDER AGE 15? WHAT SEX IS THIS PERSON?" Circle the code that corresponds with the response or '8' if the respondent does not know. Adult refers to anyone age 15 or over, regardless of whether he/she is a household member. Child refers to anyone under the age of 15, regardless of whether he/she is a household member. Households 1 Adult woman 2 Adult man 3 Female child (under 15) 4 Male child (under 15) 8 DK 9 Missing Treat water to make safer for drinking Treat water to make safer for drinking Treat water to make safer for drinking Treat water to make safer for drinking Treat water to make safer for drinking Do you treat your water in any way to make it safer to drink? The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle '1' if 'Yes', and continue to the next question. If 'No' or 'DK' (Doesn't know'), circle '2' or '8', respectively, and skip to WS7. Households 1 Yes 2 No 8 DK 9 Missing Boil Boil Boil Boil Boil What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing A Boil Add bleach/chlorine Add bleach/chlorine Add bleach/chlorine Add bleach/chlorine Add bleach/chlorine What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing B Add bleach/chlorine Strain it through a cloth Strain it through a cloth Strain it through a cloth Strain it through a cloth Strain it through a cloth What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing C Strain it through a cloth Use water filter Use water filter Use water filter Use water filter Use water filter What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing D Use water filter Solar disinfection Solar disinfection Solar disinfection Solar disinfection Solar disinfection What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing E Solar disinfection Let it stand and settle Let it stand and settle Let it stand and settle Let it stand and settle Let it stand and settle What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing F Let it stand and settle Other Other Other Other Other What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing X Other DK DK DK DK DK What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing Z DK Main dirinking water source give reliable supply Main dirinking water source give reliable supply Main dirinking water source give reliable supply Main dirinking water source give reliable supply Main dirinking water source give reliable supply Does your main drinking water source give you a reliable supply, i mean daily, weekly, or less than weekly problems or almost no problems? 1 Yes 2 Problems, but less than weekly 3 Weekly 4 Daily 5 Not Applic 8 DK 9 Missing secondary source of dirinking water secondary source of dirinking water secondary source of dirinking water secondary source of dirinking water secondary source of dirinking water If your main source of drinking water supply fails, what is your secondary source of drinking water? 11 Piped into dwelling 12 Piped into yard or plot 13 Public tap/standpipe 21 Tubewell/borehole 31 Protected well 32 Unprotected well 41 Protected spring 42 Unprotected spring 51 Rainwater collection 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 82 Bottle 96 Other 99 Missing Kind of toilet facility Kind of toilet facility Kind of toilet facility Kind of toilet facility Kind of toilet facility What kind of toilet facility do members of your household usually use? If "flush" or "pour flush", probe: Where does it flush to? If necessary, ask permission to observe the facility. Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of this question is to obtain a measure of the cleanliness of the sanitary facility used by the household members. It may be necessary to observe the facility. If so, ask permission to do so. If the respondent answers or it is observed that the household members have no facilities or use the bush or field, enter '95' for 'No facilities or bush or field' and skip to the next module. If any of the flush or pour flush responses (11-15) are given, probe: "WHERE DOES IT FLUSH TO?" Circle the code corresponding to the response given. Definitions of various types of toilet facilities are as follows: A flush toilet uses a cistern or holding tank for flushing water and has a water seal, which is a U-shaped pipe, below the seat or squatting pan that prevents the passage of flies and odours. A pour flush toilet uses a water seal, but unlike a flush toilet, a pour flush toilet uses water poured by hand for flushing (no cistern is used). . '11' - A piped sewer system is a system of sewer pipes, also called sewerage, that is designed to collect human excreta (faeces and urine) and wastewater and remove them from the household environment. Sewerage systems consist of facilities for collection, pumping, treating and disposing of human excreta and wastewater. . '12' - A septic tank is an excreta collection device and is a water-tight settling tank normally located underground, away from the house or toilet. . '13' - A flush/pour flush to pit latrine refers to a system that flushes excreta to a hole in the ground. . '14' - A flush/pour flush to somewhere else refers to excreta being deposited in or nearby the household environment (not into pit, septic tank or sewer); excreta may be flushed to the street, yard/plot, drainage way or other location. . '15' - Flush to unknown place/not sure/DK where should be coded in cases when the respondent knows that the toilet facility is a flush toilet, but does not know where it flushes to. '21' - A ventilated improved pit latrine or VIP is a type of pit latrine that is ventilated by a pipe extending above the latrine roof. The open end of the vent pipe is covered with gauze mesh or fly-proof netting and the inside of the superstructure is kept dark. '22' - A pit latrine with slab uses a hole in the ground for excreta collection and has a squatting slab, platform or seat that is firmly supported on all sides, easy to clean and raised above the surrounding ground level to prevent surface water from entering the pit. '23' - A pit latrine without slab uses a hole in the ground for excreta collection and does not have a squatting slab, platform or seat. An open pit is a rudimentary hole in the ground where excreta is collected. '31' - A composting toilet is a toilet into which excreta and carbon-rich material are added (vegetable wastes, straw, grass, sawdust, ash) and special conditions maintained to produce inoffensive compost. '41' - Bucket refers to the use of a bucket or other container for the retention of faeces (and sometimes urine and anal cleaning material), which is periodically removed for treatment or disposal. '51' - A hanging toilet or hanging latrine is a toilet built over the sea, a river, or other body of water into which excreta drops directly. '95' - No facilities or bush or field includes excreta wrapped and thrown with garbage, the 'cat' method of burying excreta in dirt, defecation in the bush or field or ditch, and defecation into surface water (drainage channel, beach, river, stream or sea). Households 11 Flush to piped sewer system 12 Flush to septic tank 13 Flush to pit (latrine) 14 Flush to somewhere else 15 Flush to unknown place/not sure/DK where 21 Ventilated Improved Pit latrine (VIP) 22 Pit latrine with slab 23 Pit latrine without slab/open pit 31 Composting toilet 41 Bucket 51 Hanging toilet/hanging latrine 95 No facilities or bush or field 96 Other 99 Missing Toilet/sewage system working properly Toilet/sewage system working properly Toilet/sewage system working properly Toilet/sewage system working properly Toilet/sewage system working properly Is your toilet working properly, or there are daily, weekly or less than weekly problems? If the respondent replies 'no' try to assess how often they encounter problems. If they encounter problems occasionally such as a few times a month circle '2', if a few times a week circle '3' for daily problems circle '4'. If the household complains that it is only at certain times of year they do not have a reliable supply then circle 5'. If the household does not know circle '8'. Household 1 Yes 2 Occasional problems 3 Weekly problems 4 Daily problems 5 Not Applic 8 DK 9 Missing Is your toilet working properly Is your toilet working properly Is your toilet working properly Is your toilet working properly Is your toilet working properly Is the sewage system around your house working properly or there are daily, weekly or less than weekly problems? 1 Yes 2 Occasional problems 3 Weekly problems 4 Daily problems 5 Not Applic 8 DK 9 Missing Toilet facility shared Toilet facility shared Toilet facility shared Toilet facility shared Toilet facility shared Do you share this facility with other households? Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of the following two questions is to determine whether the household shares their sanitation facility with other households. The shared status of a sanitation facility is important because shared facilities can be less hygienic than facilities used by only a single household. Unhygienic conditions (faeces on the floor, seat or wall and flies) may discourage use of the facility. --- Circle the code corresponding to the response given. If 'No', go to the next module. Households 1 Yes 2 No 9 Missing Households using this toilet facility Households using this toilet facility Households using this toilet facility Households using this toilet facility Households using this toilet facility How many households in total use this toilet facility? Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of the following two questions is to determine whether the household shares their sanitation facility with other households. The shared status of a sanitation facility is important because shared facilities can be less hygienic than facilities used by only a single household. Unhygienic conditions (faeces on the floor, seat or wall and flies) may discourage use of the facility. --- The total number of households using this facility should include the household being interviewed. If less than ten households use this toilet facility, enter the number of households on the line provided. Circle '10' if ten or more households use this toilet facility. Note that '01' is not a valid response (since it means that this is the only this household that uses the facility; if that is the case, you should go back to WS8 and correct the response there). Circle '98' for 'DK' ('Doesn't know'). Households 10 Ten or more households 98 DK 99 Missing solid waste dispose solid waste dispose solid waste dispose solid waste dispose solid waste dispose How do you dispose your solid waste/ Garbage? 1 House to house collection 2 Street containers-open 3 Street containers-closed 4 Dump to open area 5 Burn 6 Compost 7 Bury 96 Other 99 Missing frequency of collection/emptying of streert containers frequency of collection/emptying of streert containers frequency of collection/emptying of streert containers frequency of collection/emptying of streert containers frequency of collection/emptying of streert containers What is the frequency of collection/ emptying of street containers? 1 Less than once in 2 weeks 2 Once in 2 weeks 3 Once a week 4 Twice a week or more 9 Missing Number of rooms for sleeping Number of rooms for sleeping Number of rooms for sleeping Number of rooms for sleeping Number of rooms for sleeping How many rooms in this household are used for sleeping? This information provides a measure of how crowded the house is, and reflects the socio-economic condition of the household. A room in this case refers to a special area with a permanent partition that is used for sleeping. It is not necessarily the number of rooms in the household that are called 'bedrooms', but rather how many rooms get used for sleeping on a regular basis. Exclude rooms that are used only for sleeping by visitors to the household, but include those rooms that may not be regular 'bedrooms' but may be regularly used by one or more of the household members for sleeping. Enter the number of rooms in this household that are used for sleeping. Households 99 Missing Main material of floor Main material of floor Main material of floor Main material of floor Main material of floor Main material of the dwelling floor: Record observation. Circle the correct code for the material of the dwelling floor based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the floor, record the main flooring material (the material that covers the largest amount of floor space). Households 11 Earth/sand 12 Dung 21 Wood planks 22 Palm/bamboo 23 Reeds 32 Vinyl or asphalt strips 33 Ceramic tiles 34 Cement 35 Carpet 96 Other 99 Missing Main material of roof Main material of roof Main material of roof Main material of roof Main material of roof Main material of the roof. Record observation. Circle the correct code for the material of the dwelling roof, based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the roof, record the main roofing material (the material that covers the largest amount of roof). Households 11 No roof 12 Thatch/palm leaf 13 Sod 21 Rustic mat 22 Palm/bamboo 23 Reeds 24 Wood Planks 31 Metal 32 Wood 33 Calamine/cement fiber 34 Ceramic tiles 35 Cement 36 Roofing shingles 96 Other 99 Missing Main material of wall Main material of wall Main material of wall Main material of wall Main material of wall Main material of the walls. Record observation. Circle the correct code for the material of the dwelling walls, based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the walls, record the main wall material (the material that covers the largest amount of wall space). Households 11 No walls 12 Cane/palm/trunks 13 Dirt 21 Bambo with mud 22 Stone with mud 23 Uncovered adobe 24 Plywood 25 Carton 26 Reused wood 27 Reeds 31 Cement 32 Stone with lime/cement 33 Bricks 34 Cement blocks 35 Covered adobe 36 Wood planks/shingles 37 Chinku tin 96 Other 99 Missing Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking What type of fuel does your household mainly use for cooking? Information on the type of fuel used for cooking is collected as another measure of the socio-economic status of the household. The use of some cooking fuels can also have adverse health consequences. Circle the code corresponding to the answer given. Remember that this question asks about fuel for cooking, not fuel for heating or lighting. If the household uses more than one fuel for cooking, find out which type of fuel is used most often. If electricity, liquid propane gas (LPG), natural gas, or biogas is mainly used, circle '01', '02', '03', or '04', respectively, and skip to HC8. If any fuel other than the pre-coded ones is reported as being the main fuel used for cooking, circle '96' and specify the type of fuel on the line provided. Definitions of some of the types of fuel are as follows: 'Biogas' includes gases produced by fermenting manure in an enclosed pit. 'Lignite' is a derivative of coal that produces more smoke when burned but produces less heat than coal. Households 1 Electricity 2 Liquid propane gas (LPG) 5 Kerosene 6 Coal/lignite 8 Wood 9 Straw/shrubs/grass 10 Animal dung 11 Agricultural crop residue 96 Other 99 Missing Cooking location Cooking location Cooking location Cooking location Cooking location Is the cooking usually done in the house, in a separate building, or outdoors? Circle the code corresponding to the response given. If a response is given other than the pre-coded ones, circle '6' and specify on the line provided. Households 1 In the house 2 In a separate bulding 3 Outdoors 6 Other 9 Missing Electricity Electricity Electricity Electricity Electricity Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR? Households 1 Yes 2 No 9 Missing Network Electric Network Electric Network Electric Network Electric Network Electric Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR? Households 1 Yes 2 No 9 Missing generator generator generator generator generator Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR? Households 1 Yes 2 No 9 Missing Radio Radio Radio Radio Radio Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR, VCD/DVD PLAYER, FAN? Households 1 Yes 2 No 9 Missing Television Television Television Television Television Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR? Households 1 Yes 2 No 9 Missing Mobile Phone Mobile Phone Mobile Phone Mobile Phone Mobile Phone Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Phone Phone Phone Phone Phone Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR? Households 1 Yes 2 No 9 Missing Satellite dish Satellite dish Satellite dish Satellite dish Satellite dish Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Refregerator Refregerator Refregerator Refregerator Refregerator Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Watch Watch Watch Watch Watch Does your household have: This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR. Households 1 Yes 2 No 9 Missing Bicycle Bicycle Bicycle Bicycle Bicycle Does your household have: This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR. Households 1 Yes 2 No 9 Missing Motorcycle or scooter Motorcycle or scooter Motorcycle or scooter Motorcycle or scooter Motorcycle or scooter Does your household have: 1 Yes 2 No 9 Missing Animal-drawn cart Animal-drawn cart Animal-drawn cart Animal-drawn cart Animal-drawn cart Does your household have: This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR. Households 1 Yes 2 No 9 Missing Car or truck Car or truck Car or truck Car or truck Car or truck Does your household have: This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR. Households 1 Yes 2 No 9 Missing Boat with motor Boat with motor Boat with motor Boat with motor Boat with motor Does your household have: 1 Yes 2 No 9 Missing Total children aged 2-14 years Total children aged 2-14 years Total children aged 2-14 years Total children aged 2-14 years Total children aged 2-14 years Rank number of child (from response box) Rank number of child (from response box) Rank number of child (from response box) Rank number of child (from response box) Rank number of child (from response box) Child line number Child line number Child line number Child line number Child line number Identify eligible child aged 2 to 14 in the household using the tables on the preceding page, according to your instructions. Ask to interview the mother or primary caretaker of the selected child (identified by the line number in CD6). mother/caretaker of a 2-14 year old 97 Inconsistent Took away privileges Took away privileges Took away privileges Took away privileges Took away privileges All adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month. Took away privileges, forbade something (name) liked or did not allow him/her to leave house). mother/caretaker of a 2-14 year old 1 Yes 2 No 9 Missing Explaned why something was wrong Explaned why something was wrong Explaned why something was wrong Explaned why something was wrong Explaned why something was wrong All adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month. Explained why something (the behavior) was wrong. mother/caretaker of a 2-14 year old 1 Yes 2 No 9 Missing Shook him/her Shook him/her Shook him/her Shook him/her Shook him/her All adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month. Shook him/her. mother/caretaker of a 2-14 year old 1 Yes 2 No 9 Missing Shouted yelled at or screamed at him/her Shouted yelled at or screamed at him/her Shouted yelled at or screamed at him/her Shouted yelled at or screamed at him/her Shouted yelled at or screamed at him/her All adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month. Shouted, yelled at or screamed at him/her. mother/caretaker of a 2-14 year old 1 Yes 2 No 9 Missing Gave him/hersomething else to do Gave him/hersomething else to do Gave him/hersomething else to do Gave him/hersomething else to do Gave him/hersomething else to do All adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month. Gave him/her something else to do. mother/caretaker of a 2-14 year old 1 Yes 2 No 9 Missing Spanked, hit or slapped him/her with bare hand Spanked, hit or slapped him/her with bare hand Spanked, hit or slapped him/her with bare hand Spanked, hit or slapped him/her with bare hand Spanked, hit or slapped him/her with bare hand All adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month. Spanked, hit or slapped him/her on the bottom with bare hand. mother/caretaker of a 2-14 year old 1 Yes 2 No 9 Missing Hit him/her on the bottom with or elsewhere with a belt Hit him/her on the bottom with or elsewhere with a belt Hit him/her on the bottom with or elsewhere with a belt Hit him/her on the bottom with or elsewhere with a belt Hit him/her on the bottom with or elsewhere with a belt All adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month. Hit him/her on the bottom or elsewhere on the body with something like a belt, hairbrush, stick or other hard object. mother/caretaker of a 2-14 year old 1 Yes 2 No 9 Missing Called him/her dumb, lazy Called him/her dumb, lazy Called him/her dumb, lazy Called him/her dumb, lazy Called him/her dumb, lazy All adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month. Called him/her dumb, lazy, or another name like that. mother/caretaker of a 2-14 year old 1 Yes 2 No 9 Missing Hit or slapped him/her on the face Hit or slapped him/her on the face Hit or slapped him/her on the face Hit or slapped him/her on the face Hit or slapped him/her on the face All adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month. Hit or slapped him/her on the face, head or ears. mother/caretaker of a 2-14 year old 1 Yes 2 No 9 Missing Hit or slapped him/her on the hand Hit or slapped him/her on the hand Hit or slapped him/her on the hand Hit or slapped him/her on the hand Hit or slapped him/her on the hand All adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month. Hit or slapped him/her on the hand, arm, or leg. mother/caretaker of a 2-14 year old 1 Yes 2 No 9 Missing Beat him/her up with an implement Beat him/her up with an implement Beat him/her up with an implement Beat him/her up with an implement Beat him/her up with an implement All adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month. Beat him/her up with an implement (hit over and over as hard as one could). mother/caretaker of a 2-14 year old 1 Yes 2 No 9 Missing burn him/her with a heated metal burn him/her with a heated metal burn him/her with a heated metal burn him/her with a heated metal burn him/her with a heated metal All adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month. Burn him/her with a heated metal mother/caretaker of a 2-14 year old 1 Yes 2 No 9 Missing bite him/her bite him/her bite him/her bite him/her bite him/her All adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month. Bite him/her mother/caretaker of a 2-14 year old 1 Yes 2 No 9 Missing Do you believe to bring up you nedd to punish him/her Do you believe to bring up you nedd to punish him/her Do you believe to bring up you nedd to punish him/her Do you believe to bring up you nedd to punish him/her Do you believe to bring up you nedd to punish him/her All adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month. Do you believe that in order to bring up (raise, educate) (name) properly, you need to physically punish him/her? mother/caretaker of a 2-14 year old 1 Yes 2 No 8 Don't know/no opinion 9 Missing Salt iodization test outcome Salt iodization test outcome Salt iodization test outcome Salt iodization test outcome Salt iodization test outcome We would like to check whether the salt used in your household is iodized. May i see a sample of the salt used to cook the main meal eaten by members of your household last night? Once you have examined the salt, circle number that corresponds to test outcome. After you have completed all modules of the Household Questionnaire, administer the module on Salt Iodization. Note that in this module, you will most probably perform a test on a sample of salt provided by the respondent. This item is used to record the type of salt used to prepare the family's main meal the day before the questionnaire is administered, and the outcome of the test for salt iodization. Once you have a sample of salt, perform the test and circle the code that corresponds to the test outcome. Circle '1' if the test is negative (0 parts per million/no colour - not iodized). Circle '2' if the test shows less than 15 parts per million iodine (weak colour). Circle '3' if the test is positive (15 parts per million or more, strong colour). Circle '6' if there is 'No salt in home'. Circle '7' if the salt was present, but not tested for any reason. If the respondent indicates that no salt was used to cook the main meal last night, or that no meal was cooked, ask for a sample of the salt usually used for cooking in the household, and perform the test on this sample of salt. Households 1 Not iodized 0 PPM (no colour) 2 Less than 15 PPM (weak colour) 3 15 PPM or more (strong colour) 6 No salt in home 7 Salt not tested 9 Missing Area Area Area Area Area 1 Metrob1 2 Metrob2 3 Metro 4 Urban-other 5 Rural Area Area Area Area Area 1 Metropolitan 2 Urban-other 3 Rural Region Region Region Region Region 1 North 2 South/center Governorate Governorate Governorate Governorate Governorate 1 Dohuk 2 Nainwa 3 Sulimania 4 Karkuk 5 Erbil 6 Diala 7 Anbar 8 Babil 9 Karbala 10 Wasit 11 Salahaladin 12 Najaf 13 Qadisya 14 Almuthana 15 Thiqar 16 Misan 17 Albasrah 18 Baghdad Households sample weights Households sample weights Households sample weights Households sample weights Households sample weights Recoded variable Households Education of household head Education of household head Education of household head Education of household head Education of household head Recoded variable Households 1 None 2 Primary 3 Secondary + 4 Non-standard curriculum 9 Missing/DK Sex of household head Sex of household head Sex of household head Sex of household head Sex of household head Recoded variable Households 1 Male 2 Female 9 Missing/DK Cluster number Cluster number Cluster number Cluster number Cluster number We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. During this time I would like to speak with the household head and all mothers or others who take care of children in the household. May I start now? If permission is given, begin the interview. Cluster number: Enter the cluster number as instructed by your supervisor. Households Unique identifier for the cluster in which the household exists Household number Household number Household number Household number Household number Household number: Enter the household number as instructed by your supervisor. Households Line number Line number Line number Line number Line number Line number Line number Line number Line number Line number Women aged 15-49 Relationship to the head Relationship to the head Relationship to the head Relationship to the head Relationship to the head What is the relationship of (name) to the head of the household? Enter the code corresponding to how the person listed is related to the head of the household. Use the codes at the bottom of the Household Listing. Be particularly careful in doing this if the respondent is not the head of the household. Make sure that you record the relationship of each person to the household head, not the relationship to the respondent. For example, if the respondent is the wife of the head of the household and she says that Sola is her brother, then Sola should be coded as '09' ('Brother or sister-in-law'), not as '08' ('Brother or sister'), because Sola is a brother-in-law of the head of the household. Be very careful in obtaining this information correctly, since respondents tend to provide the relationship of the person to themselves, rather than to the head of the household. If the head of the household is married to a woman who has a child from a previous marriage, that child's relationship to the head of the household should be coded as '14' ('Adopted/foster/stepchild'). If a household member is not related to the head of household, such as a friend who lives with the household, enter '15' ('Not related'). Enter '98' if the respondent doesn't know the relationship of a household member to the head of household. De jure household members (usual residents) 1 Head 2 Wife or Husband 3 Son or Daughter 4 Son/Daughter in law 5 Grandchild 6 Parent 7 Brother or Sister 8 Other Relative 9 Not related 98 DK 99 Missing Sex Sex Sex Sex Sex Children aged 0-4 1 Male 2 Female 9 Missing Age Age Age Age Age How old is (name)? How old was (name) on his/her last birthday? Record in completed years 98=DK* * See instructions: to be used only for elderly household members (code meaning "do not know/over age 50"). Enter each person's age in completed years, that is, his/her age at his/her last birthday. Completed age is also defined as 'the number of completed solar years since birth'. With this definition, since a 6-month-old baby has not completed a full solar year, his/her age will be entered as '00'. Note that you will be obtaining more accurate estimates of children's ages later. This column should never be left blank. If you have difficulty obtaining the ages of very elderly members of the household, you may enter the code '98', meaning 'Doesn't know/over age 50'. For household members younger than 50, completed ages must be entered. De jure household members (usual residents) 97 97+ 98 DK 99 Missing Line number of eligible women Line number of eligible women Line number of eligible women Line number of eligible women Line number of eligible women Circle Line no. if woman is age 15-49 Circle the line number in this column if the household member is a woman 15-49 years of age (this includes those age 15 and age 49). You will not ask this question to the respondent. De jure household members (usual residents) Not eligible Line number of mother/caretaker for child labor module Line number of mother/caretaker for child labor module Line number of mother/caretaker for child labor module Line number of mother/caretaker for child labor module Line number of mother/caretaker for child labor module For each child age 5-14: Who is the mother or primary caretaker of this child? Record Line no. of mother/caretaker If the household member is a child between 5 and 14 years of age (this includes those age 5 and age 14), record the line number of his/her mother or primary caretaker in this column. Ask this question to the respondent if necessary. De jure household members (usual residents) Not eligible Line number of mother/caretaker for child health module Line number of mother/caretaker for child health module Line number of mother/caretaker for child health module Line number of mother/caretaker for child health module Line number of mother/caretaker for child health module For each child under 5: Who is the mother or primary caretaker of this child? Record Line no. of mother/caretaker If the household member is a child under the age of five (this includes those just born and those age 4, but not children who have completed 5 years of age), record the line number of his/her mother or primary caretaker in this column. Ask this question to the respondent if necessary. De jure household members (usual residents) Not eligible Mother alive Mother alive Mother alive Mother alive Mother alive For children age 0-17 years ask HL9-HL12 Is (name's) natural mother alive? For all children under age 18, we want to know whether either of their own (natural) parents is listed in the Household Listing, and their survival status. This information can be used to measure the prevalence of orphanhood and child fostering in the population. For everyone age 18 and older, HL9-12 will be left blank. --- By 'natural' we mean the biological mother. In many cultures, people consider other people's children whom they are raising as their own, especially children of their husband or sisters, etc. You should be certain that the respondent understands that you are asking about the woman who gave birth to the child. Record whether or not the child's natural mother is still alive by circling the code corresponding to the response given. If the child's natural mother is not alive or if the respondent does not know, skip to HL11. Otherwise, continue to the question in the next column. De jure household members (usual residents) aged 0-17 (under 18) 1 Yes 2 No 8 DK 9 Missing Mother line number in HH Mother line number in HH Mother line number in HH Mother line number in HH Mother line number in HH For children age 0-17 years ask HL9-HL12 If alive: Does (name's) natural mother live in this household? Record Line no. of mother or 00 for 'No' For all children under age 18, we want to know whether either of their own (natural) parents is listed in the Household Listing, and their survival status. This information can be used to measure the prevalence of orphanhood and child fostering in the population. For everyone age 18 and older, HL9-12 will be left blank. --- If the natural mother is still alive, we want to know whether she lives in the household. If the mother does live in the household, ask who she is (she should be listed in the Household Listing if she lives in the household) and record her line number in the space provided. If the mother is not a member of the household (not listed in the Household Listing), record '00'. De jure household members (usual residents) aged 0-17 (under 18) 97 Inconsistent 99 Missing Father alive Father alive Father alive Father alive Father alive For children age 0-17 years ask HL9-HL12 If alive: Is (name's) natural father alive? For all children under age 18, we want to know whether either of their own (natural) parents is listed in the Household Listing, and their survival status. This information can be used to measure the prevalence of orphanhood and child fostering in the population. For everyone age 18 and older, HL9-12 will be left blank. --- Fill in these questions in exactly the same way as HL9 and HL10. This time, make sure to record the survival status and the line number of the natural (biological) fathers. If the father of the household member is not alive or his survival status is now known by the respondent, move to the next person on the list. De jure household members (usual residents) aged 0-17 (under 18) 1 Yes 2 No 8 DK 9 Missing Father line number in HH Father line number in HH Father line number in HH Father line number in HH Father line number in HH For children age 0-17 years ask HL9-HL12 Does (name's) natural father live in this household? Record Line no. of father or 00 for 'No' For all children under age 18, we want to know whether either of their own (natural) parents is listed in the Household Listing, and their survival status. This information can be used to measure the prevalence of orphanhood and child fostering in the population. For everyone age 18 and older, HL9-12 will be left blank. --- Fill in these questions in exactly the same way as HL9 and HL10. This time, make sure to record the survival status and the line number of the natural (biological) fathers. If the father of the household member is not alive or his survival status is now known by the respondent, move to the next person on the list. --- When you have completed the listing of all household members and all questions in the Household Listing, probe to see if there are any other household members you have not included in the list: "ARE THERE ANY OTHER PERSONS LIVING HERE - EVEN IF THEY ARE NOT MEMBERS OF YOUR FAMILY OR DO NOT HAVE PARENTS LIVING IN THIS HOUSEHOLD? INCLUDING CHILDREN AT WORK OR AT SCHOOL?" If yes, insert child's name and complete the form. After you have made sure that there are no other household members to be included in the list, complete the row at the bottom of the household list, 'Totals'. Calculate the number of eligible women in the household and record the number under 'Women 15-49', calculate the number of children aged 5-14 years in the household and record the number under 'Children 5-14' and, finally, calculate the number of children under five, and record the number under 'Under-5s'. The numbers recorded here for the women 15-49 and under-5s will indicate to you the number of individual women's and under-five questionnaires you should have in the household (see below). You will also record these numbers in HH12 and HH14 in the Household Information Panel. When you have completed the Household Listing Form for all household members, prepare the individual questionnaire forms for this household: . For each woman age 15-49 years, write her name and line number in the spaces provided (WM3 and WM4) at the top of her Questionnaire for Individual Women. . For each child under age five, write his/her name and line number and the name and line number of his/her mother or caretaker in the spaces provided (UF3-6) at the top of the Questionnaire for Children Under Five. You should now have a separate questionnaire for each eligible woman and child under five in the household, ready for use when you administer the questionnaires later on. De jure household members (usual residents) aged 0-17 (under 18) 97 Inconsistent 99 Missing Line number Line number Line number Line number Line number For household members age 5 and above Continue line by line, asking the questions for each household member who is eligible (age five or older), as you did when completing the Household Listing Form. Note that the lines corresponding to household members under five should remain blank. This is the number assigned to each person on the Household Listing Form. You do not need to fill in or do anything in this column since the numbers are already provided. Copy the names of each person age five and older from the Household Listing Form (HL2) to their corresponding line numbers. De jure household members (usual residents) Ever attended school Ever attended school Ever attended school Ever attended school Ever attended school For household members age 5 and above Has (name) ever attended school or preschool? For each household member age five or older, ask ED2 and ED3. These questions ask about educational attainment for all household members in this age group. (If children younger than five attend school or pre-school, this information will be recorded in the Questionnaire for Children Under Five.) Any adult member of the household may provide this information for those not present. --- Circle '1' if the answer is 'Yes'. If the answer is 'No', circle '2' and go to the household member on the next line. The term 'school' includes primary, secondary and post-secondary schooling, as well as any other intermediate levels of schooling in the formal school system. It also includes technical or vocational training beyond the primary-school level, such as long-term courses in mechanics or secretarial work. Schools that carry out non-standard curriculum are also included here. Ensure that respondents understand what is meant by 'non-standard curriculum'. A non-standard curriculum includes religious schools, such as Koranic schools, that do not teach a full, standard school curriculum. If a school teaches religious courses but also includes the standard curriculum - such as many Catholic schools - it would be coded as a standard school. 'Pre-school' is listed for children who do not attend grade 1 at age 5, but do attend some form of organized learning or early childhood education programme, whether or not such a programme is considered part of the school system. The definition of organized early learning programme does not refer to programmes offering only babysitting or child-minding. De jure household members (usual residents) 1 Yes 2 No 9 Missing Highest level of school attended Highest level of school attended Highest level of school attended Highest level of school attended Highest level of school attended What is the highest level of school (name) attended? Children aged 0-4 Preschool/kindergarten 1 Primary 2 Secondary 3 Intermediat 4 Diplome 5 Bsc 6 Higher 7 Non-standard curriculum 8 DK 9 Missing Highest grade at level Highest grade at level Highest grade at level Highest grade at level Highest grade at level For household members age 5 and above What is the highest grade (name) completed at this level? For each household member age five or older, ask ED2 and ED3. These questions ask about educational attainment for all household members in this age group. (If children younger than five attend school or pre-school, this information will be recorded in the Questionnaire for Children Under Five.) Any adult member of the household may provide this information for those not present. --- If the person has been to school, record the highest level of schooling attended by circling the code for the response. You may need to probe for the type of school attended. Circle '8' if the respondent 'Doesn't know'. Then ask, "WHAT IS THE HIGHEST GRADE (name) COMPLETED AT THIS LEVEL?" Enter the highest grade completed or '98' for 'DK' ('Doesn't know'). If less than one grade, enter '00'. For instance, if a person has attended primary school but did not complete the first grade, then the level for this person will be circled as '1', and the grade will be entered as '00'. Similarly, for a child who is attending grade 5 in primary school at the time of the interview, the level will be coded as '1' and the grade as '4', since this person has not yet completed grade 5. De jure household members (usual residents) 97 Inconsistent 98 DK 99 Missing Currently attending school during the school year (2004-2005) Currently attending school during the school year (2004-2005) Currently attending school during the school year (2004-2005) Currently attending school during the school year (2004-2005) Currently attending school during the school year (2004-2005) For household members age 5-24 years During the (2004-2005) school year, did (name) attend school or preschool at any time? For each household member 5-24 years of age (this includes those age 5 and age 24), ask questions ED4-ED8, which inquire about school attendance. While the ideal respondent for these questions would be the mother or primary caretaker, any adult member of the household may provide the information. Since questions from ED4 to ED8 refer to school attendance, they will have to be adapted to the situation at the time of the interview. All questions should be retained. However, the wording and coding will have to be changed. The objective of these questions is to capture the school attendance of household members in two consecutive school years. In the explanations below, information is provided on how this can be tackled. --- Circle the code corresponding to the answer given. If 'Yes', continue to the next question. If 'No', skip to ED7. If the interview is carried out during the school year, then the question should be worded to refer to the current school year. If the interview is carried out between school years, then the question should refer to the last school year that has ended. Take the example of a country where the school year ends in June and the new school year begins in September: If the interview is carried out in July 2005 (between school years), then the question should refer to the 2004-2005 school year; if the interview is carried out in October 2005 (during the new school year), then the question should refer to the 2005-2006 school year. De jure household members (usual residents) aged 5-24 1 Yes 2 No 9 Missing Days attended school in last week Days attended school in last week Days attended school in last week Days attended school in last week Days attended school in last week Since last (day of the week), how many days did (name) attend school? Insert number of days in space below. Insert (9) If last week was a holiday 8 Interview during school holidays 9 Missing Level of education attended Level of education attended Level of education attended Level of education attended Level of education attended For household members age 5-24 years During this/that school year, which level and grade is/was (name) attending? For each household member 5-24 years of age (this includes those age 5 and age 24), ask questions ED4-ED8, which inquire about school attendance. While the ideal respondent for these questions would be the mother or primary caretaker, any adult member of the household may provide the information. Since questions from ED4 to ED8 refer to school attendance, they will have to be adapted to the situation at the time of the interview. All questions should be retained. However, the wording and coding will have to be changed. The objective of these questions is to capture the school attendance of household members in two consecutive school years. In the explanations below, information is provided on how this can be tackled. --- Circle the code for the level of school, and enter the household member's current grade. If it applies, circle '8' for 'DK' ('Doesn't know'). Probe to determine the type of school, particularly to make sure if it is a standard or non-standard curriculum. Then enter the highest grade number completed using '01', '02', etc. If a child is in pre-school or kindergarten, and grades are not used, omit the grade. If less than one grade was completed, enter '00'. Enter '98' for 'DK'. If the interview is conducted during the time between two school years, the question should refer to the school year that has ended, and you should use 'THAT' and 'WAS' in the question. If the interview is conducted during the school year, the question should refer to the current school year. Note that these questions should capture children who may have been attending at the beginning of the school year, but have dropped out since then. If necessary, past tense could be used to make sure that you obtain information on the level and grade of children who may have dropped out from school during the course of the school year. Questions ED4, ED5 and ED6 collect information on the school attendance of household members during the current school year (if the interview is conducted when schools are open) or the last school year that has ended (if the interview is conducted between school years). Questions ED7 and ED8 collect information on the school attendance of household members during the previous school year. De jure household members (usual residents) aged 5-24 Preschool/kindergarten 1 Primary 2 Secondary 3 Intermediat 4 Diplome 5 Bsc 6 Higher 7 Non-standard curriculum 8 DK 9 Missing Grade of education attended Grade of education attended Grade of education attended Grade of education attended Grade of education attended For household members age 5-24 years During this/that school year, which level and grade is/was (name) attending? For each household member 5-24 years of age (this includes those age 5 and age 24), ask questions ED4-ED8, which inquire about school attendance. While the ideal respondent for these questions would be the mother or primary caretaker, any adult member of the household may provide the information. Since questions from ED4 to ED8 refer to school attendance, they will have to be adapted to the situation at the time of the interview. All questions should be retained. However, the wording and coding will have to be changed. The objective of these questions is to capture the school attendance of household members in two consecutive school years. In the explanations below, information is provided on how this can be tackled. --- Circle the code for the level of school, and enter the household member's current grade. If it applies, circle '8' for 'DK' ('Doesn't know'). Probe to determine the type of school, particularly to make sure if it is a standard or non-standard curriculum. Then enter the highest grade number completed using '01', '02', etc. If a child is in pre-school or kindergarten, and grades are not used, omit the grade. If less than one grade was completed, enter '00'. Enter '98' for 'DK'. If the interview is conducted during the time between two school years, the question should refer to the school year that has ended, and you should use 'THAT' and 'WAS' in the question. If the interview is conducted during the school year, the question should refer to the current school year. Note that these questions should capture children who may have been attending at the beginning of the school year, but have dropped out since then. If necessary, past tense could be used to make sure that you obtain information on the level and grade of children who may have dropped out from school during the course of the school year. Questions ED4, ED5 and ED6 collect information on the school attendance of household members during the current school year (if the interview is conducted when schools are open) or the last school year that has ended (if the interview is conducted between school years). Questions ED7 and ED8 collect information on the school attendance of household members during the previous school year. De jure household members (usual residents) aged 5-24 97 Inconsistent 98 DK 99 Missing Attended school last year (2003-2004) Attended school last year (2003-2004) Attended school last year (2003-2004) Attended school last year (2003-2004) Attended school last year (2003-2004) For household members age 5-24 years Did (name) attend school or preschool at any time during the previous school year, that is (2003-2004)? For each household member 5-24 years of age (this includes those age 5 and age 24), ask questions ED4-ED8, which inquire about school attendance. While the ideal respondent for these questions would be the mother or primary caretaker, any adult member of the household may provide the information. Since questions from ED4 to ED8 refer to school attendance, they will have to be adapted to the situation at the time of the interview. All questions should be retained. However, the wording and coding will have to be changed. The objective of these questions is to capture the school attendance of household members in two consecutive school years. In the explanations below, information is provided on how this can be tackled. --- If the child attended school at any time during the last school year, circle '1'. If the answer is 'No' or 'DK', circle the appropriate code and go to the household member on the next line. De jure household members (usual residents) aged 5-24 1 Yes 2 No 8 DK 9 Missing Level of education attended last year Level of education attended last year Level of education attended last year Level of education attended last year Level of education attended last year For household members age 5-24 years During that previous school year, which level and grade did (name) attend? For each household member 5-24 years of age (this includes those age 5 and age 24), ask questions ED4-ED8, which inquire about school attendance. While the ideal respondent for these questions would be the mother or primary caretaker, any adult member of the household may provide the information. Since questions from ED4 to ED8 refer to school attendance, they will have to be adapted to the situation at the time of the interview. All questions should be retained. However, the wording and coding will have to be changed. The objective of these questions is to capture the school attendance of household members in two consecutive school years. In the explanations below, information is provided on how this can be tackled. --- Circle the code for the level of school attended and fill in the child's grade or enter '8' if the respondent doesn't know the level and/or '98' if the respondent doesn't know the grade. If the child was in pre-school or kindergarten, and grades are not used, omit the grade. De jure household members (usual residents) aged 5-24 Preschool/kindergarten 1 Primary 2 Secondary 3 Intermediat 4 Diplome 5 Bsc 6 Higher 7 Non-standard curriculum 8 DK 9 Missing Grade of education attended last year Grade of education attended last year Grade of education attended last year Grade of education attended last year Grade of education attended last year For household members age 5-24 years During that previous school year, which level and grade did (name) attend? For each household member 5-24 years of age (this includes those age 5 and age 24), ask questions ED4-ED8, which inquire about school attendance. While the ideal respondent for these questions would be the mother or primary caretaker, any adult member of the household may provide the information. Since questions from ED4 to ED8 refer to school attendance, they will have to be adapted to the situation at the time of the interview. All questions should be retained. However, the wording and coding will have to be changed. The objective of these questions is to capture the school attendance of household members in two consecutive school years. In the explanations below, information is provided on how this can be tackled. --- Circle the code for the level of school attended and fill in the child's grade or enter '8' if the respondent doesn't know the level and/or '98' if the respondent doesn't know the grade. If the child was in pre-school or kindergarten, and grades are not used, omit the grade. De jure household members (usual residents) aged 5-24 97 Inconsistent 98 DK 99 Missing Line number Line number Line number Line number Line number To be administered to mother/caretaker of each child in the household age 5 through 14 years. For household members below age 5 or above age 14, leave rows blank. Now I would like to ask about any work children in this household may do. This module is to be administered to the mother or primary caretaker of each child resident in the household aged 5 through 14 years (this includes those age 5 and age 14). For household members younger than five or older than 14, rows should be left blank. --- This is the number assigned to each person on the Household Listing Form. You do not need to fill in or do anything in this column since the numbers are already provided. Explain, "NOW I WOULD LIKE TO ASK ABOUT ANY WORK CHILDREN IN THIS HOUSEHOLD MAY DO." Insert the child's name, copying from the Household Listing, column HL2. This is done to prevent confusion during the interview. Children aged 5-14 Worked in past week Worked in past week Worked in past week Worked in past week Worked in past week During the past week, did (name) do any kind of work for someone who is not a member of this household? If yes: For pay in cash or kind? 'Pay' refers to any compensation for work, including cash or goods or services provided to the child or his family. 'The past week' refers to the 7 days preceding the interview day. Note that the person indicated - someone who is not a member of this household - may be a relative or a family member who lives in a different household. If the answer is 'Yes', ask if the work was done for pay in cash or kind. Circle '1' if work was done for pay in cash or kind. Circle '2' if work was not done for any form of pay. If '1' or '2' is circled, continue to the next question. If no work was done by that child in the past week, circle '3' and skip to CL5. Children aged 5-14 1 Yes, paid 2 Yes, unpaid 3 No 9 Missing Hours worked in past week Hours worked in past week Hours worked in past week Hours worked in past week Hours worked in past week If yes: Since last (day of the week), about how many hours did he/she do this work for someone who is not a member of this household? If more than one job, include all hours at all jobs. Record the estimated number of hours the child spent doing work in the past 7 days and skip to CL6. Make sure the mother or primary caretaker understands what you mean by "SINCE LAST (day of the week)" - specify the name of today's weekday, as you did in the Education Module. If the child works more than one such job, include the total hours spent doing such work in all jobs. Children aged 5-14 98 DK 99 Missing Worked in past year Worked in past year Worked in past year Worked in past year Worked in past year At any time during the past year, did (name) do any kind of work for someone who is not a member of this household? If yes: For pay in cash or kind? CL5 is essentially the same question as CL3; this time the reference period is 1 year rather than the last 1 week. Continue with the next question after you have circled the response to this question. Children aged 5-14 1 Yes, paid 2 Yes, unpaid 3 No 9 Missing Helped with household chores in past week Helped with household chores in past week Helped with household chores in past week Helped with household chores in past week Helped with household chores in past week During the past week, did (name) help with household chores such as shopping, collecting firewood, cleaning, fetching water, or caring for children? As was explained in CL3, 'the past week' refers to the 7 days preceding the interview day. Circle '1' if 'Yes', and continue to the next question. If 'No', circle '2' and skip to CL8. Children aged 5-14 1 Yes, paid 2 Yes, unpaid 3 No 9 Missing Hours spent on chores in past week Hours spent on chores in past week Hours spent on chores in past week Hours spent on chores in past week Hours spent on chores in past week If yes: Since last (day of the week), about how many hours did he/she spend doing these chores? Insert the estimated number of hours the child spent doing household chores in the past 7 days. Make sure the mother/primary caretaker understands what you mean by 'since last (day of the week)' - specify the name of today's weekday, just as you did for CL4. Children aged 5-14 98 DK 99 Missing Did other family work in past week Did other family work in past week Did other family work in past week Did other family work in past week Did other family work in past week During the past week, did (name) do any other family work (on the farm or in a business or selling goods in the street?) As was explained in CL6, 'the past week' refers to the 7 days preceding the interview day. 'Other family work' means any work done other than household chores/housekeeping to help with family income generation or subsistence production. This may include raising livestock belonging to the household or working in a family business. Circle '1' if 'Yes', and continue to the next question. If 'No', circle '2' and go to the next line, corresponding to the next eligible child aged 5-14 years. Children aged 5-14 1 Yes 2 No 9 Missing Hours worked on other family work Hours worked on other family work Hours worked on other family work Hours worked on other family work Hours worked on other family work If yes: Since last (day of the week), about how many hours did he/she do this work? Insert the estimated number of hours worked. Again, make sure the mother/primary caretaker understands what you mean by 'since last (day of the week)' - specify the name of today's weekday, just as you did for CL4 and CL7. Children aged 5-14 98 DK 99 Missing Line number from household listing Line number from household listing Line number from household listing Line number from household listing Line number from household listing To be administered to caretakers of all children 2 through 14 years old living in the household. For household members below age 2 or above age 14, leave rows blank Refer to table 1 in the child discipline module and list all the children in the table below using CD2 I would like to ask you if any children in this household aged 2 through 14 has any of the health conditions i am going to mention to you. Any serious delay sitting, standang or walking Any serious delay sitting, standang or walking Any serious delay sitting, standang or walking Any serious delay sitting, standang or walking Any serious delay sitting, standang or walking Compared with other children, does or did (name) have any serious delay in sitting, standing, or walking? Children age 2-14 1 Yes 2 No 9 Missing Does he have difficulty seeing in daytime or nightime Does he have difficulty seeing in daytime or nightime Does he have difficulty seeing in daytime or nightime Does he have difficulty seeing in daytime or nightime Does he have difficulty seeing in daytime or nightime Compared with other children, does (name) have difficulty seeing, either in the daytime or at night? Compared with other children, does (name) have difficulty seeing, either in the daytime or at night? Children age 2-14 1 Yes 2 No 9 Missing Does he apear to have difficulty hearing Does he apear to have difficulty hearing Does he apear to have difficulty hearing Does he apear to have difficulty hearing Does he apear to have difficulty hearing Does (name) appear to have difficulty hearing? (uses hearing aid, hears with difficulty, completely deaf?) Does (name) appear to have difficulty hearing? (uses hearing aid, hears with difficulty, completely deaf?) Children age 2-14 1 Yes 2 No 9 Missing When you ask him to do something, does he understand what y When you ask him to do something, does he understand what y When you ask him to do something, does he understand what y When you ask him to do something, does he understand what y When you ask him to do something, does he understand what y When you tell (name) to do something, does he/she seem to understand what you are saying? Children age 2-14 1 Yes 2 No 9 Missing Does he have difficulty walking or moving Does he have difficulty walking or moving Does he have difficulty walking or moving Does he have difficulty walking or moving Does he have difficulty walking or moving Does (name) have difficulty in walking or moving his/her arms or does he/she have weakness and/or stiffness in the arms or legs? Children age 2-14 1 Yes 2 No 9 Missing Does he have fits, become rigid or los consciousnes Does he have fits, become rigid or los consciousnes Does he have fits, become rigid or los consciousnes Does he have fits, become rigid or los consciousnes Does he have fits, become rigid or los consciousnes Does (name) sometimes have fits, become rigid, or lose consc-iousness? Children age 2-14 1 Yes 2 No 9 Missing Does he learn to do thing like other Does he learn to do thing like other Does he learn to do thing like other Does he learn to do thing like other Does he learn to do thing like other Does (name) learn to do things like other children his/her age? Children age 2-14 1 Yes 2 No 9 Missing Can says recognizable words Can says recognizable words Can says recognizable words Can says recognizable words Can says recognizable words Does (name) speak at all (can he/she make him or herself understood in words; can say any recognizable words)? Children age 2-14 1 Yes 2 No 9 Missing Speech in any way different from normal Speech in any way different from normal Speech in any way different from normal Speech in any way different from normal Speech in any way different from normal Is (name)'s speech in any way different from normal (not clear enough to be understood by people other than the immediate family)? (For 3-14 year olds): Children aged 3-14 1 Yes 2 No 9 Missing Can he name at least one object Can he name at least one object Can he name at least one object Can he name at least one object Can he name at least one object Can (name) name at least one object (for example, an animal, a toy, a cup, a spoon)? (For 2-year-olds): Children aged 2 1 Yes 2 No 9 Missing Compared to other children does he appear mentally backward, Compared to other children does he appear mentally backward, Compared to other children does he appear mentally backward, Compared to other children does he appear mentally backward, Compared to other children does he appear mentally backward, Compared with other children of the same age, does (name) appear in any way mentally backward, dull or slow? Compared with other children of the same age, does (name) appear in any way mentally backward, dull or slow? 1 Yes 2 No 9 Missing Interviewer number Interviewer number Interviewer number Interviewer number Interviewer number Interviewer name and number: Enter your own name and identification number provided to you at the time of training. Households Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor name and number: Enter your supervisor's name and identification number. You will be provided with your supervisor's identification number as soon as you know who you will be working with. Households Day of interview Day of interview Day of interview Day of interview Day of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Month of interview Month of interview Month of interview Month of interview Month of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Year of interview Year of interview Year of interview Year of interview Year of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Area Area Area Area Area Circle the code for area of residence as instructed by your supervisor. This will have been pre-determined; you will not be required to assess whether the household is in an urban or rural area. Households 1 Urban 2 Rural Muhafaza Muhafaza Muhafaza Muhafaza Muhafaza Region: Circle the code for zone. Households 11 Duhuk 12 Nainwa 13 Sulimania 14 Kakuk 15 Arbil 21 Diala 22 Anbar 23 Baghdad 24 Babil 25 Karbala 26 Wasit 27 Salahaladin 28 Najaf 31 Qadisya 32 Almuthana 33 Thiqar 34 Misan 35 Albasrah Governate/Region Qadha Qadha Qadha Qadha Qadha Recoded variable Household District Result of HH interview Result of HH interview Result of HH interview Result of HH interview Result of HH interview After all questionnaires for the household have been completed, fill in the following information: Result of HH interview: If the Household Questionnaire is completed, circle '1' for 'Completed'. If you have not been able to contact the household after repeated visits, circle '2' for 'Not at home'. If the household refuses to be interviewed, circle '3' for 'Refused'. If you are unable to locate the household or if the dwelling is destroyed, circle '4' for 'HH not found/destroyed'. If you have not been able to complete the Household Questionnaire for another reason, you should circle '6' for 'Other' and specify the reason in the space provided. Some examples of 'Other' codes might be: the household respondent is incapacitated; the questionnaire is partly completed; adult household members were not found at home after repeated visits. Households 1 Completed 2 Not at home 3 Refused 4 HH not found/destroyed 6 Other Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent to HH questionnaire: Enter the name and line number (from the Household Listing, columns HL1 and HL2) of the respondent to the Household Questionnaire. Households 99 Missing Number of household members Number of household members Number of household members Number of household members Number of household members Total number of household members: Count the number of household members recorded in column HL1 of the Household Listing and enter the total here. Households Total eligible women Total eligible women Total eligible women Total eligible women Total eligible women No.of women eligible for interview: Enter the total number of women eligible for interview for the Questionnaire for Individual Women - you will copy this from the row for totals at the bottom of the Household Listing, for HL6. Households Women interviews completed Women interviews completed Women interviews completed Women interviews completed Women interviews completed No.of women questionnaires completed: Once all of the Questionnaires for Individual Women have been completed for a particular household, enter the number completed here. Households Total children under 5 Total children under 5 Total children under 5 Total children under 5 Total children under 5 No.of children under age 5: Enter the total number of children under five eligible for inclusion in the survey from the row for totals at the bottom of the Household Listing, for HL8. You will be using the Questionnaire for Children Under Five to interview the mothers or primary caretakers of these children. Households Child interviews completed Child interviews completed Child interviews completed Child interviews completed Child interviews completed No.of under-5 questionnaires completed: Once all of the Questionnaires for Children Under Five have been completed for a particular household, enter the number completed here. Households Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk: Leave this space blank. The data clerk will enter his/her number in the space provided. Households Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water What is the main source of drinking water for members of your household? The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): · '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. · '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. · '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. · '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. · '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. · '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. · '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. · '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). · '52' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof and stored in a container, tank or cistern until used. · '53' Berkad · '54' Rain water catchment (Balli) · '61' - A tanker-truck water source transports and sells water by means of a tanker truck. · '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. · '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. · '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. Households 11 Piped into dwelling 12 Piped into yard or plot 13 Public tap/standpipe 21 Tubewell/borehole 31 Protected well 32 Unprotected well 41 Protected spring 42 Unprotected spring 51 Rainwater collection 62 Tanker-truck 71 Cart with small tank/drum 81 Surface water 91 Bottled water 96 Other 99 Missing Main source of water used for other purposes (if bottled wat Main source of water used for other purposes (if bottled wat Main source of water used for other purposes (if bottled wat Main source of water used for other purposes (if bottled wat Main source of water used for other purposes (if bottled wat What is the main source of water used by your household for other purposes such as cooking and handwashing? The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): · '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. · '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. · '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. · '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. · '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. · '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. · '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. · '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). · '52' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof and stored in a container, tank or cistern until used. · '53' Berkad · '54' Rain water catchment (Balli) · '61' - A tanker-truck water source transports and sells water by means of a tanker truck. · '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. · '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. · '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. Households 11 Piped into dwelling 12 Piped into yard or plot 13 Public tap/standpipe 21 Tubewell/borehole 31 Protected well 32 Unprotected well 41 Protected spring 42 Unprotected spring 51 Rainwater collection 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 96 Other 99 Missing Time to get water and come back Time to get water and come back Time to get water and come back Time to get water and come back Time to get water and come back How long does it take to go there, get water, and come back? This question is used to find out how convenient the source of water is to the dwelling. Note that the question is asked for water sources coded as '13-81' and '96' in WS1, or water sources coded as '13-96' in WS2. Fill in the estimated time (in minutes, converting from hours, if necessary) it takes by the usual mode of transport to get to the water source, wait to get water, and get back to the dwelling. Use zero(s) preceding the number if less than 100 minutes (for example, '060' or '005'). Then continue to the next question. If the water source is on the dwelling premises or if water is delivered to the dwelling by a vendor, circle '995' for 'Water on premises' and skip to WS5. If the respondent does not know how long it takes, circle '998' and continue on to the next question. Households 995 On premises 998 DK 999 Missing Person fetching water Person fetching water Person fetching water Person fetching water Person fetching water Who usually goes to this source to fetch the water for your household? Probe: Is this person under age 15? What sex? Circle code that best describes this person. The purpose of this question is to find out the age and gender of the person who usually performs the task of hauling water. This will provide an understanding of whether water hauling responsibilities are given to members of a particular sex or age group. Probe: "IS THIS PERSON UNDER AGE 15? WHAT SEX IS THIS PERSON?" Circle the code that corresponds with the response or '8' if the respondent does not know. Adult refers to anyone age 15 or over, regardless of whether he/she is a household member. Child refers to anyone under the age of 15, regardless of whether he/she is a household member. Households 1 Adult woman 2 Adult man 3 Female child (under 15) 4 Male child (under 15) 8 DK 9 Missing Treat water to make safer for drinking Treat water to make safer for drinking Treat water to make safer for drinking Treat water to make safer for drinking Treat water to make safer for drinking Do you treat your water in any way to make it safer to drink? The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle '1' if 'Yes', and continue to the next question. If 'No' or 'DK' (Doesn't know'), circle '2' or '8', respectively, and skip to WS7. Households 1 Yes 2 No 8 DK 9 Missing Boil Boil Boil Boil Boil What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing A Boil Add bleach/chlorine Add bleach/chlorine Add bleach/chlorine Add bleach/chlorine Add bleach/chlorine What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing B Add bleach/chlorine Strain it through a cloth Strain it through a cloth Strain it through a cloth Strain it through a cloth Strain it through a cloth What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing C Strain it through a cloth Use water filter Use water filter Use water filter Use water filter Use water filter What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing D Use water filter Solar disinfection Solar disinfection Solar disinfection Solar disinfection Solar disinfection What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing E Solar disinfection Let it stand and settle Let it stand and settle Let it stand and settle Let it stand and settle Let it stand and settle What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing F Let it stand and settle Other Other Other Other Other What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing X Other DK DK DK DK DK What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing Z DK Main dirinking water source give reliable supply Main dirinking water source give reliable supply Main dirinking water source give reliable supply Main dirinking water source give reliable supply Main dirinking water source give reliable supply Does your main drinking water source give you a reliable supply, i mean daily, weekly, or less than weekly problems or almost no problems? 1 Yes 2 Problems, but less than weekly 3 Weekly 4 Daily 5 Not Applic 8 DK 9 Missing secondary source of dirinking water secondary source of dirinking water secondary source of dirinking water secondary source of dirinking water secondary source of dirinking water If your main source of drinking water supply fails, what is your secondary source of drinking water? 11 Piped into dwelling 12 Piped into yard or plot 13 Public tap/standpipe 21 Tubewell/borehole 31 Protected well 32 Unprotected well 41 Protected spring 42 Unprotected spring 51 Rainwater collection 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 82 Bottle 96 Other 99 Missing Kind of toilet facility Kind of toilet facility Kind of toilet facility Kind of toilet facility Kind of toilet facility What kind of toilet facility do members of your household usually use? If "flush" or "pour flush", probe: Where does it flush to? If necessary, ask permission to observe the facility. Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of this question is to obtain a measure of the cleanliness of the sanitary facility used by the household members. It may be necessary to observe the facility. If so, ask permission to do so. If the respondent answers or it is observed that the household members have no facilities or use the bush or field, enter '95' for 'No facilities or bush or field' and skip to the next module. If any of the flush or pour flush responses (11-15) are given, probe: "WHERE DOES IT FLUSH TO?" Circle the code corresponding to the response given. Definitions of various types of toilet facilities are as follows: A flush toilet uses a cistern or holding tank for flushing water and has a water seal, which is a U-shaped pipe, below the seat or squatting pan that prevents the passage of flies and odours. A pour flush toilet uses a water seal, but unlike a flush toilet, a pour flush toilet uses water poured by hand for flushing (no cistern is used). . '11' - A piped sewer system is a system of sewer pipes, also called sewerage, that is designed to collect human excreta (faeces and urine) and wastewater and remove them from the household environment. Sewerage systems consist of facilities for collection, pumping, treating and disposing of human excreta and wastewater. . '12' - A septic tank is an excreta collection device and is a water-tight settling tank normally located underground, away from the house or toilet. . '13' - A flush/pour flush to pit latrine refers to a system that flushes excreta to a hole in the ground. . '14' - A flush/pour flush to somewhere else refers to excreta being deposited in or nearby the household environment (not into pit, septic tank or sewer); excreta may be flushed to the street, yard/plot, drainage way or other location. . '15' - Flush to unknown place/not sure/DK where should be coded in cases when the respondent knows that the toilet facility is a flush toilet, but does not know where it flushes to. '21' - A ventilated improved pit latrine or VIP is a type of pit latrine that is ventilated by a pipe extending above the latrine roof. The open end of the vent pipe is covered with gauze mesh or fly-proof netting and the inside of the superstructure is kept dark. '22' - A pit latrine with slab uses a hole in the ground for excreta collection and has a squatting slab, platform or seat that is firmly supported on all sides, easy to clean and raised above the surrounding ground level to prevent surface water from entering the pit. '23' - A pit latrine without slab uses a hole in the ground for excreta collection and does not have a squatting slab, platform or seat. An open pit is a rudimentary hole in the ground where excreta is collected. '31' - A composting toilet is a toilet into which excreta and carbon-rich material are added (vegetable wastes, straw, grass, sawdust, ash) and special conditions maintained to produce inoffensive compost. '41' - Bucket refers to the use of a bucket or other container for the retention of faeces (and sometimes urine and anal cleaning material), which is periodically removed for treatment or disposal. '51' - A hanging toilet or hanging latrine is a toilet built over the sea, a river, or other body of water into which excreta drops directly. '95' - No facilities or bush or field includes excreta wrapped and thrown with garbage, the 'cat' method of burying excreta in dirt, defecation in the bush or field or ditch, and defecation into surface water (drainage channel, beach, river, stream or sea). Households 11 Flush to piped sewer system 12 Flush to septic tank 13 Flush to pit (latrine) 14 Flush to somewhere else 15 Flush to unknown place/not sure/DK where 21 Ventilated Improved Pit latrine (VIP) 22 Pit latrine with slab 23 Pit latrine without slab/open pit 31 Composting toilet 41 Bucket 51 Hanging toilet/hanging latrine 95 No facilities or bush or field 96 Other 99 Missing Toilet/sewage system working properly Toilet/sewage system working properly Toilet/sewage system working properly Toilet/sewage system working properly Toilet/sewage system working properly Is your toilet working properly, or there are daily, weekly or less than weekly problems? If the respondent replies 'no' try to assess how often they encounter problems. If they encounter problems occasionally such as a few times a month circle '2', if a few times a week circle '3' for daily problems circle '4'. If the household complains that it is only at certain times of year they do not have a reliable supply then circle 5'. If the household does not know circle '8'. Household 1 Yes 2 Occasional problems 3 Weekly problems 4 Daily problems 5 Not Applic 8 DK 9 Missing Is your toilet working properly Is your toilet working properly Is your toilet working properly Is your toilet working properly Is your toilet working properly Is the sewage system around your house working properly or there are daily, weekly or less than weekly problems? 1 Yes 2 Occasional problems 3 Weekly problems 4 Daily problems 5 Not Applic 8 DK 9 Missing Toilet facility shared Toilet facility shared Toilet facility shared Toilet facility shared Toilet facility shared Do you share this facility with other households? Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of the following two questions is to determine whether the household shares their sanitation facility with other households. The shared status of a sanitation facility is important because shared facilities can be less hygienic than facilities used by only a single household. Unhygienic conditions (faeces on the floor, seat or wall and flies) may discourage use of the facility. --- Circle the code corresponding to the response given. If 'No', go to the next module. Households 1 Yes 2 No 9 Missing Households using this toilet facility Households using this toilet facility Households using this toilet facility Households using this toilet facility Households using this toilet facility How many households in total use this toilet facility? Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of the following two questions is to determine whether the household shares their sanitation facility with other households. The shared status of a sanitation facility is important because shared facilities can be less hygienic than facilities used by only a single household. Unhygienic conditions (faeces on the floor, seat or wall and flies) may discourage use of the facility. --- The total number of households using this facility should include the household being interviewed. If less than ten households use this toilet facility, enter the number of households on the line provided. Circle '10' if ten or more households use this toilet facility. Note that '01' is not a valid response (since it means that this is the only this household that uses the facility; if that is the case, you should go back to WS8 and correct the response there). Circle '98' for 'DK' ('Doesn't know'). Households 10 Ten or more households 98 DK 99 Missing solid waste dispose solid waste dispose solid waste dispose solid waste dispose solid waste dispose How do you dispose your solid waste/ Garbage? 1 House to house collection 2 Street containers-open 3 Street containers-closed 4 Dump to open area 5 Burn 6 Compost 7 Bury 96 Other 99 Missing frequency of collection/emptying of streert containers frequency of collection/emptying of streert containers frequency of collection/emptying of streert containers frequency of collection/emptying of streert containers frequency of collection/emptying of streert containers What is the frequency of collection/ emptying of street containers? 1 Less than once in 2 weeks 2 Once in 2 weeks 3 Once a week 4 Twice a week or more 9 Missing Number of rooms for sleeping Number of rooms for sleeping Number of rooms for sleeping Number of rooms for sleeping Number of rooms for sleeping How many rooms in this household are used for sleeping? This information provides a measure of how crowded the house is, and reflects the socio-economic condition of the household. A room in this case refers to a special area with a permanent partition that is used for sleeping. It is not necessarily the number of rooms in the household that are called 'bedrooms', but rather how many rooms get used for sleeping on a regular basis. Exclude rooms that are used only for sleeping by visitors to the household, but include those rooms that may not be regular 'bedrooms' but may be regularly used by one or more of the household members for sleeping. Enter the number of rooms in this household that are used for sleeping. Households 99 Missing Main material of floor Main material of floor Main material of floor Main material of floor Main material of floor Main material of the dwelling floor: Record observation. Circle the correct code for the material of the dwelling floor based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the floor, record the main flooring material (the material that covers the largest amount of floor space). Households 11 Earth/sand 12 Dung 21 Wood planks 22 Palm/bamboo 23 Reeds 32 Vinyl or asphalt strips 33 Ceramic tiles 34 Cement 35 Carpet 96 Other 99 Missing Main material of roof Main material of roof Main material of roof Main material of roof Main material of roof Main material of the roof. Record observation. Circle the correct code for the material of the dwelling roof, based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the roof, record the main roofing material (the material that covers the largest amount of roof). Households 11 No roof 12 Thatch/palm leaf 13 Sod 21 Rustic mat 22 Palm/bamboo 23 Reeds 24 Wood Planks 31 Metal 32 Wood 33 Calamine/cement fiber 34 Ceramic tiles 35 Cement 36 Roofing shingles 96 Other 99 Missing Main material of wall Main material of wall Main material of wall Main material of wall Main material of wall Main material of the walls. Record observation. Circle the correct code for the material of the dwelling walls, based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the walls, record the main wall material (the material that covers the largest amount of wall space). Households 11 No walls 12 Cane/palm/trunks 13 Dirt 21 Bambo with mud 22 Stone with mud 23 Uncovered adobe 24 Plywood 25 Carton 26 Reused wood 27 Reeds 31 Cement 32 Stone with lime/cement 33 Bricks 34 Cement blocks 35 Covered adobe 36 Wood planks/shingles 37 Chinku tin 96 Other 99 Missing Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking What type of fuel does your household mainly use for cooking? Information on the type of fuel used for cooking is collected as another measure of the socio-economic status of the household. The use of some cooking fuels can also have adverse health consequences. Circle the code corresponding to the answer given. Remember that this question asks about fuel for cooking, not fuel for heating or lighting. If the household uses more than one fuel for cooking, find out which type of fuel is used most often. If electricity, liquid propane gas (LPG), natural gas, or biogas is mainly used, circle '01', '02', '03', or '04', respectively, and skip to HC8. If any fuel other than the pre-coded ones is reported as being the main fuel used for cooking, circle '96' and specify the type of fuel on the line provided. Definitions of some of the types of fuel are as follows: 'Biogas' includes gases produced by fermenting manure in an enclosed pit. 'Lignite' is a derivative of coal that produces more smoke when burned but produces less heat than coal. Households 1 Electricity 2 Liquid propane gas (LPG) 5 Kerosene 6 Coal/lignite 8 Wood 9 Straw/shrubs/grass 10 Animal dung 11 Agricultural crop residue 96 Other 99 Missing Cooking location Cooking location Cooking location Cooking location Cooking location Is the cooking usually done in the house, in a separate building, or outdoors? Circle the code corresponding to the response given. If a response is given other than the pre-coded ones, circle '6' and specify on the line provided. Households 1 In the house 2 In a separate bulding 3 Outdoors 6 Other 9 Missing Electricity Electricity Electricity Electricity Electricity Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR? Households 1 Yes 2 No 9 Missing Network Electric Network Electric Network Electric Network Electric Network Electric Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR? Households 1 Yes 2 No 9 Missing generator generator generator generator generator Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR? Households 1 Yes 2 No 9 Missing Radio Radio Radio Radio Radio Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR, VCD/DVD PLAYER, FAN? Households 1 Yes 2 No 9 Missing Televesion Televesion Televesion Televesion Televesion Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR? Households 1 Yes 2 No 9 Missing Mobile Phone Mobile Phone Mobile Phone Mobile Phone Mobile Phone Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Phone Phone Phone Phone Phone Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR? Households 1 Yes 2 No 9 Missing satellite dish satellite dish satellite dish satellite dish satellite dish Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Refregerator Refregerator Refregerator Refregerator Refregerator Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Watch Watch Watch Watch Watch Does your household have: This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR. Households 1 Yes 2 No 9 Missing Bicycle Bicycle Bicycle Bicycle Bicycle Does your household have: This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR. Households 1 Yes 2 No 9 Missing Motorcycle or scooter Motorcycle or scooter Motorcycle or scooter Motorcycle or scooter Motorcycle or scooter Does your household have: 1 Yes 2 No 9 Missing Animal-drawn cart Animal-drawn cart Animal-drawn cart Animal-drawn cart Animal-drawn cart Does your household have: This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR. Households 1 Yes 2 No 9 Missing Car or truck Car or truck Car or truck Car or truck Car or truck Does your household have: This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR. Households 1 Yes 2 No 9 Missing Boat with motor Boat with motor Boat with motor Boat with motor Boat with motor Does your household have: 1 Yes 2 No 9 Missing Area Area Area Area Area 1 Metrob1 2 Metrob2 3 Metro 4 Urban-other 5 Rural Area Area Area Area Area 1 Metropolitan 2 Urban-other 3 Rural Region Region Region Region Region 1 North 2 South/center Governorate Governorate Governorate Governorate Governorate 1 Dohuk 2 Nainwa 3 Sulimania 4 Karkuk 5 Erbil 6 Diala 7 Anbar 8 Babil 9 Karbala 10 Wasit 11 Salahaladin 12 Najaf 13 Qadisya 14 Almuthana 15 Thiqar 16 Misan 17 Albasrah 18 Baghdad Households sample weight Households sample weight Households sample weight Households sample weight Households sample weight Recoded variable Households Mother's line number Mother's line number Mother's line number Mother's line number Mother's line number Recoded variable De jure household members (usual residents) Mother's education Mother's education Mother's education Mother's education Mother's education Recoded Variable Women age 15-49 1 None 2 Primary 3 Secondary + 4 Non-standard curriculum 5 Mother not in household 9 Missing/DK Father's line number Father's line number Father's line number Father's line number Father's line number Recoded variable De jure household members (usual residents) Father's education Father's education Father's education Father's education Father's education Recoded variable De jure household members (usual residents) 1 None 2 Primary 3 Secondary + 4 Non-standard curriculum 5 Father not in household 9 Missing/DK Education of household head Education of household head Education of household head Education of household head Education of household head Recoded variable Households 1 None 2 Primary 3 Secondary + 4 Non-standard curriculum 9 Missing/DK Cluster number Cluster number Cluster number Cluster number Cluster number We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. During this time I would like to speak with the household head and all mothers or others who take care of children in the household. May I start now? If permission is given, begin the interview. Cluster number: Enter the cluster number as instructed by your supervisor. Households Unique identifier for the cluster in which the household exists Household number Household number Household number Household number Household number Household number: Enter the household number as instructed by your supervisor. Households Line number Line number Line number Line number Line number Women aged 15-49 Cluster number Cluster number Cluster number Cluster number Cluster number Ever married women age 15-49 who have given birth Household number Household number Household number Household number Household number Ever married women age 15-49 who have given birth Woman's line number Woman's line number Woman's line number Woman's line number Woman's line number Ever married women age 15-49 who have given birth Interviewer number Interviewer number Interviewer number Interviewer number Interviewer number Day of interview Day of interview Day of interview Day of interview Day of interview Month of interview Month of interview Month of interview Month of interview Month of interview Year of interview Year of interview Year of interview Year of interview Year of interview Result of women 's interview Result of women 's interview Result of women 's interview Result of women 's interview Result of women 's interview 1 Completed 2 Not at home 3 Refused 4 Partly completed 5 Incapacitated 6 Other Month of birth of woman Month of birth of woman Month of birth of woman Month of birth of woman Month of birth of woman In what month and year were you born? 97 Inconsistent 98 DK 99 Missing Year of birth of woman Year of birth of woman Year of birth of woman Year of birth of woman Year of birth of woman In what month and year were you born? Women age 15-49 9997 Inconsistent 9998 DK 9999 Missing Age of woman Age of woman Age of woman Age of woman Age of woman How old were you at your last birthday? Women age 15-49 Currently working Currently working Currently working Currently working Currently working Beside your house work, are you currently working? If yes, ask: do you work in the governoment or privatly? 1 Gov. office work 2 Gov. labor/physical work 3 Private. office work 4 Private. labor/physical work 5 Home based work 6 Other 7 DK 9 missing Have you ever attended school Have you ever attended school Have you ever attended school Have you ever attended school Have you ever attended school Have you ever attended school? Women age 15-49 1 Yes 2 No 9 Missing What is the highest level of school you attended What is the highest level of school you attended What is the highest level of school you attended What is the highest level of school you attended What is the highest level of school you attended What is the highest level of school you've reached? Women age 15-49 Preschool/kindergarten 1 Primary 2 Secondary 3 Intermediat 4 Diplome 5 Bsc 6 Higher 7 Non-standard curriculum 8 DK 9 Missing What is the highest grade completed at that level What is the highest grade completed at that level What is the highest grade completed at that level What is the highest grade completed at that level What is the highest grade completed at that level What is the highest grade you completed at that level? Women age 15-49 97 Inconsistent 98 DK 99 Missing Can read part of the sentence Can read part of the sentence Can read part of the sentence Can read part of the sentence Can read part of the sentence Now I would like you to read this sentence to me. Show sentences to respondent. If respondent cannot read whole sentence, probe: Can you read part of the sentence to me? Women age 15-49 1 Cannot read at all 2 Able to read only parts of sentence 3 Able to read whole sentence 4 Required language 5 Blind/visually impaired 9 Missing Currently married Currently married Currently married Currently married Currently married Are you currently married or living together with a man as if married? Women age 15-49 1 Yes, currently married 2 No,not married Age of husband/partner Age of husband/partner Age of husband/partner Age of husband/partner Age of husband/partner How old was your husband/partner on his last birthday? Ever married women age 15-49 98 DK 99 Missing Ever married Ever married Ever married Ever married Ever married Have you ever been married or lived together with a man? Women age 15-49 1 Yes, formerly married 2 No Marital status Marital status Marital status Marital status Marital status What is your marital status now: are you widowed, divorced or separated? Women age 15-49 1 Widowed 2 Divorced 3 Separated Married once or more than once Married once or more than once Married once or more than once Married once or more than once Married once or more than once Have you been married or lived with a man only once or more than once? Ever married women age 15-49 1 Only once 2 More than once 9 Missing Month of first union Month of first union Month of first union Month of first union Month of first union In what month and year did you first marry or start living with a man as if married? Ever married women age 15-49 97 Inconsistent 98 DK 99 Missing Year of first union Year of first union Year of first union Year of first union Year of first union In what month and year did you first marry or start living with a man as if married? Ever married women age 15-49 9997 Inconsistent 9998 DK 9999 Missing Age at first marraige Age at first marraige Age at first marraige Age at first marraige Age at first marraige How old were you when you started living with your first husband/partner? Ever married women age 15-49 97 Inconsistent 98 DK 99 Missing Was first husband a relative Was first husband a relative Was first husband a relative Was first husband a relative Was first husband a relative Before you got married, was your (first) husband related to you in any way? 1 Yes 2 No 9 Missing Kind of relation Kind of relation Kind of relation Kind of relation Kind of relation What type of relationship was it? 1 First cousin on father side 2 First cousin on mother side 3 Second cousin 4 Other blood relative 5 Relative by marriage Ever given birth Ever given birth Ever given birth Ever given birth Ever given birth Now i would like to ask about all the births you have had during your life. Have you ever given birth? If "No" probe by asking: I mean, to a child who ever breathed or cried or showed other signs of life - even if he or she lived only a few minutes or hours? Ever married women age 15-49 1 Yes 2 No Any sons or daughters living with you Any sons or daughters living with you Any sons or daughters living with you Any sons or daughters living with you Any sons or daughters living with you Do you have any sons or daughters to whom you have given birth who are now living with you? Ever married women age 15-49 1 Yes 2 No Sons living with you Sons living with you Sons living with you Sons living with you Sons living with you How many sons live with you? Ever married women age 15-49 Daughters living with you Daughters living with you Daughters living with you Daughters living with you Daughters living with you How many daughters live with you? Ever married women age 15-49 Any sons or daughters not living with you Any sons or daughters not living with you Any sons or daughters not living with you Any sons or daughters not living with you Any sons or daughters not living with you Do you have any sons or daughters to whom you have given birth who are alive but do not live with you? Ever married women age 15-49 1 Yes 2 No Sons not living with you Sons not living with you Sons not living with you Sons not living with you Sons not living with you How many sons are alive but do not live with you? Ever married women age 15-49 Daughters not living with you Daughters not living with you Daughters not living with you Daughters not living with you Daughters not living with you How many daughters are alive but do not live with you? Ever married women age 15-49 Ever had child who later died Ever had child who later died Ever had child who later died Ever had child who later died Ever had child who later died Have you ever given birth to a boy or girl who was born alive but later died? Ever married women age 15-49 1 Yes 2 No Boys dead Boys dead Boys dead Boys dead Boys dead How many boys have died? Ever married women age 15-49 Girls dead Girls dead Girls dead Girls dead Girls dead How many girls have died? Add the numbers of births reported in CM4, CM6 and CM8 and write the sum here, then check: If she says it is correct, check the box marked 'Yes' and continue to the next question. If she says 'No', first check your addition and then go back through the list to check with the respondent whether you have obtained the information correctly. For example, starting with CM4, you would ask: "YOU HAVE TWO SONS AND ONE DAUGHTER LIVING WITH YOU, IS THAT CORRECT?" Do the same for CM6 and CM8. Correct the answers and the sum mentioned in CM9 and then continue to the next question. Make sure to cancel the 'No' in CM10 and check 'Yes' after you have made the corrections. Ever married women age 15-49 Children ever born Children ever born Children ever born Children ever born Children ever born If the respondent's last birth occurred in the last 2 years, enter the name of the child on the line provided and check the box marked 'Yes'. Then continue with CM13. If the respondent's last birth did not occur in the last 2 years, check the box marked 'No' and go to the Marriage/Union module. Ever married women age 15-49 Any live births since last birth listed in birth history Any live births since last birth listed in birth history Any live births since last birth listed in birth history Any live births since last birth listed in birth history Any live births since last birth listed in birth history Have you had any live births since the birth of (Name of last birth)? Ever married women age 15-49 who have given birth 1 yes 2 no 9 missing Any pregnancies ended before term Any pregnancies ended before term Any pregnancies ended before term Any pregnancies ended before term Any pregnancies ended before term Some pregnancies end before full term as a miscarriage, while others may result in a stillbirth. have you had a miscarriage? This purpose of this question is to find out about miscarriages (not still births), therefore care should be taken to make sure the women understands that a miscarriage occurs before the baby is due i.e. before the full 9 months. If the woman reports she has never had a miscarriage proceed to BH15. Ever married women age 15-49 who have given birth 1 yes 2 no 9 missing Number of miscarriage/abortions Number of miscarriage/abortions Number of miscarriage/abortions Number of miscarriage/abortions Number of miscarriage/abortions In all how many pregnancies did you have that ended in a miscarriage? Ever married women age 15-49 who have given birth 98 dk 99 missing Ever had a still birth Ever had a still birth Ever had a still birth Ever had a still birth Ever had a still birth Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? Ever married women age 15-49 who have given birth 1 yes 2 no 9 missing Number of stillbirths Number of stillbirths Number of stillbirths Number of stillbirths Number of stillbirths Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? Ever married women age 15-49 who have given birth 98 DK 99 mising Live birth in last two years Live birth in last two years Live birth in last two years Live birth in last two years Live birth in last two years Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? Check BH4 of last birth: Did the woman's last birth occur within the last 2 years, that is, since (month of interview in 2004)? If child has died, take special care when referring to this child by name in the following modules. No live birth in last 2 years go to contraception and unmet needs module. Yes, live birth in last 2 years continue with CM13 Before last pregnancy, desired time to become pregnant Before last pregnancy, desired time to become pregnant Before last pregnancy, desired time to become pregnant Before last pregnancy, desired time to become pregnant Before last pregnancy, desired time to become pregnant Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? 1 Then 2 Later 3 No more 9 Missing Has immunization card Has immunization card Has immunization card Has immunization card Has immunization card Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? If a card is presented, use it to assist with answers to the following questions. 1 Yes (card seen) 2 Yes (card not seen) 3 No 8 DK 9 Missing Any tetanus toxoid injection during last pregnancy Any tetanus toxoid injection during last pregnancy Any tetanus toxoid injection during last pregnancy Any tetanus toxoid injection during last pregnancy Any tetanus toxoid injection during last pregnancy Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? 1 Yes 2 No 8 DK 9 Missing Doses of tetanus toxoid during last pregnancy Doses of tetanus toxoid during last pregnancy Doses of tetanus toxoid during last pregnancy Doses of tetanus toxoid during last pregnancy Doses of tetanus toxoid during last pregnancy Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? 98 DK 99 Missing Any tetanus toxoid injection before last pregnancy Any tetanus toxoid injection before last pregnancy Any tetanus toxoid injection before last pregnancy Any tetanus toxoid injection before last pregnancy Any tetanus toxoid injection before last pregnancy Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? 1 Yes 2 No 8 DK 9 Missing Doses of tetanus toxoid before last pregnancy Doses of tetanus toxoid before last pregnancy Doses of tetanus toxoid before last pregnancy Doses of tetanus toxoid before last pregnancy Doses of tetanus toxoid before last pregnancy Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? 98 DK 99 Missing Month last tetanus toxoid received Month last tetanus toxoid received Month last tetanus toxoid received Month last tetanus toxoid received Month last tetanus toxoid received Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? 97 Inconsistent 98 DK 99 Missing Year last tetanus toxoid received Year last tetanus toxoid received Year last tetanus toxoid received Year last tetanus toxoid received Year last tetanus toxoid received Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? Skip to next module only if year of injection is given. Otherwise, continue with TT8. 9997 Inconsistent 9998 DK 9999 Missing Years ago last tetanus toxoid received Years ago last tetanus toxoid received Years ago last tetanus toxoid received Years ago last tetanus toxoid received Years ago last tetanus toxoid received Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? 98 DK 99 Missing Antenatal care: Govt doctor Antenatal care: Govt doctor Antenatal care: Govt doctor Antenatal care: Govt doctor Antenatal care: Govt doctor Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? ? Missing A Govt doctor Antenatal care: Private doctor Antenatal care: Private doctor Antenatal care: Private doctor Antenatal care: Private doctor Antenatal care: Private doctor Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? ? Missing B Private doctor Antenatal care: Nursing Antenatal care: Nursing Antenatal care: Nursing Antenatal care: Nursing Antenatal care: Nursing Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? ? Missing C Nurse Antenatal care: Licensed Antenatal care: Licensed Antenatal care: Licensed Antenatal care: Licensed Antenatal care: Licensed Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? ? Missing D Licensed Antenatal care:Not licensed Antenatal care:Not licensed Antenatal care:Not licensed Antenatal care:Not licensed Antenatal care:Not licensed Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? ? Missing E Not licensed Antenatal care: Traditional birth attendant Antenatal care: Traditional birth attendant Antenatal care: Traditional birth attendant Antenatal care: Traditional birth attendant Antenatal care: Traditional birth attendant Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? ? Missing F Traditional birth attendance Antenatal care: RelativeLfriend Antenatal care: RelativeLfriend Antenatal care: RelativeLfriend Antenatal care: RelativeLfriend Antenatal care: RelativeLfriend Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? ? Missing G Relative/friend Antenatal care: Other Antenatal care: Other Antenatal care: Other Antenatal care: Other Antenatal care: Other Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? ? Missing X Other Antenatal care:No one Antenatal care:No one Antenatal care:No one Antenatal care:No one Antenatal care:No one Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? ? Missing Y No one How many months pregnant were you when you first How many months pregnant were you when you first How many months pregnant were you when you first How many months pregnant were you when you first How many months pregnant were you when you first How many months pregnant were you when you first received antenatal care for this pregnancy? 98 DK 99 Missing How many times did you receive care How many times did you receive care How many times did you receive care How many times did you receive care How many times did you receive care How manytimes did you receive antenatal care for this pregnancy? 98 DK 99 Missing Did you go mainly to a public facility Did you go mainly to a public facility Did you go mainly to a public facility Did you go mainly to a public facility Did you go mainly to a public facility Did you go mainly to a public or private facility to receive antenatal care? 1 Yes,public facility 2 Yes,Private facility 3 No 9 Missing Reason for choosing facility Reason for choosing facility Reason for choosing facility Reason for choosing facility Reason for choosing facility What is the reason you chose the facility that you mainly go to? 1 Proximitly 2 Familitariy 3 Cost 4 Safety 5 Told to do so 6 Referred for special care 7 Do not know of another 96 OTHER 99 Missing Were needs addressed Were needs addressed Were needs addressed Were needs addressed Were needs addressed When you last went to this facility, were you medical needs addressed or not? 1 needs addressed 2 needs not addressed 9 missing How many months pregnant when last received ANC How many months pregnant when last received ANC How many months pregnant when last received ANC How many months pregnant when last received ANC How many months pregnant when last received ANC How many months pregnant were you when you last received antenatal care for this pregnancy? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. 98 DK 99 Missing Weighed Weighed Weighed Weighed Weighed As part of your antenatal care, were any of the following done at least once? Were you weighed? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. 1 Yes 2 No 9 Missing Blood pressure measured Blood pressure measured Blood pressure measured Blood pressure measured Blood pressure measured As part of your antenatal care, were any of the following done at least once? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. 1 Yes 2 No 9 Missing Urine sample Urine sample Urine sample Urine sample Urine sample As part of your antenatal care, were any of the following done at least once? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. 1 Yes 2 No 9 Missing Blood sample Blood sample Blood sample Blood sample Blood sample As part of your antenatal care, were any of the following done at least once? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. 1 Yes 2 No 9 Missing Did not feel the need to see anyone Did not feel the need to see anyone Did not feel the need to see anyone Did not feel the need to see anyone Did not feel the need to see anyone What are the reasons for not seeing anyone? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing A Did not feel the need to see anyone Not convinced by the asistance Not convinced by the asistance Not convinced by the asistance Not convinced by the asistance Not convinced by the asistance What are the reasons for not seeing anyone? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing B Not convinced by the assistance Financial not capable to see anyone Financial not capable to see anyone Financial not capable to see anyone Financial not capable to see anyone Financial not capable to see anyone What are the reasons for not seeing anyone? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing C Financially not capable to see anyone Difficulty in reaching the ANC center Difficulty in reaching the ANC center Difficulty in reaching the ANC center Difficulty in reaching the ANC center Difficulty in reaching the ANC center What are the reasons for not seeing anyone? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing D Diffculty in reaching the ANC center Non-availabilty of medicaments Non-availabilty of medicaments Non-availabilty of medicaments Non-availabilty of medicaments Non-availabilty of medicaments What are the reasons for not seeing anyone? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing E None-availability of medicaments Other (specify) Other (specify) Other (specify) Other (specify) Other (specify) What are the reasons for not seeing anyone? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing X Other DK DK DK DK DK What are the reasons for not seeing anyone? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing z DK Assistance at delivery:Gov't Doctor Assistance at delivery:Gov't Doctor Assistance at delivery:Gov't Doctor Assistance at delivery:Gov't Doctor Assistance at delivery:Gov't Doctor Who assisted with the delivery of your last child (name)? Anyone else? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing A Doctor Assistance at delivery:Private doctor Assistance at delivery:Private doctor Assistance at delivery:Private doctor Assistance at delivery:Private doctor Assistance at delivery:Private doctor Who assisted with the delivery of your last child (name)? Anyone else? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing B Private Doctor Assistance at delivery: Nurse/midwife Assistance at delivery: Nurse/midwife Assistance at delivery: Nurse/midwife Assistance at delivery: Nurse/midwife Assistance at delivery: Nurse/midwife Who assisted with the delivery of your last child (name)? Anyone else? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing C Nurse Assistance at delivery: Licensed Assistance at delivery: Licensed Assistance at delivery: Licensed Assistance at delivery: Licensed Assistance at delivery: Licensed Who assisted with the delivery of your last child (name)? Anyone else? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing D Licensed Assistance at delivery:Not licensed Assistance at delivery:Not licensed Assistance at delivery:Not licensed Assistance at delivery:Not licensed Assistance at delivery:Not licensed Who assisted with the delivery of your last child (name)? Anyone else? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing E Not licensed midwife Assistance at delivery: Traditional birth attendant Assistance at delivery: Traditional birth attendant Assistance at delivery: Traditional birth attendant Assistance at delivery: Traditional birth attendant Assistance at delivery: Traditional birth attendant Who assisted with the delivery of your last child (name)? Anyone else? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing F Traditional birth attendance Assistance at delivery: Relative/friend Assistance at delivery: Relative/friend Assistance at delivery: Relative/friend Assistance at delivery: Relative/friend Assistance at delivery: Relative/friend Who assisted with the delivery of your last child (name)? Anyone else? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing G Relative/friend Assistance at delivery: Other Assistance at delivery: Other Assistance at delivery: Other Assistance at delivery: Other Assistance at delivery: Other Who assisted with the delivery of your last child (name)? Anyone else? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing X Other Assistance at delivery: No one Assistance at delivery: No one Assistance at delivery: No one Assistance at delivery: No one Assistance at delivery: No one Who assisted with the delivery of your last child (name)? Anyone else? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing Y No one Place of delivery Place of delivery Place of delivery Place of delivery Place of delivery Where did you give birth to (NAME)? The intent of this question is to identify births delivered in a health facility. If the woman gave birth in a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the place is in the public (run by the government) or private sector. If the place is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle '26'. Similarly, if the place is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle '36'. If the respondent answers that she delivered in another place not listed, write the description of the place in the space provided for 'Other' and circle '96'. Then write the name of the place in the space provided on the questionnaire 'Name of place' and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response. Places that are not health facilities, other than home, should also be coded as 'Other' and described. 11 Your home 12 Midwifes home 13 Other home 21 Government hospital 22 Government clinic/health center 26 Other public 31 Private hospital 32 Private clinic 36 Other private medical 96 Other 99 Missing Kind of delivery Kind of delivery Kind of delivery Kind of delivery Kind of delivery Was (name) delivered by caesarian section? 1 Yes 2 No 9 Missing Size of child at birth Size of child at birth Size of child at birth Size of child at birth Size of child at birth When your last child (name) was born, was he/she very large, larger than average, average, smaller than average, or very small? 1 Very large 2 Larger than average 3 Average 4 Smaller than average 5 Very small 8 DK 9 Missing Child weighed at birth Child weighed at birth Child weighed at birth Child weighed at birth Child weighed at birth Was (name) weighed at birth? 1 Yes 2 No 8 DK 9 Missing Weight from card or recall Weight from card or recall Weight from card or recall Weight from card or recall Weight from card or recall How much did (name) weigh? 1 Card 2 Recall 7 Inconsistent 9 Missing Weight at birth (Kilograms) Weight at birth (Kilograms) Weight at birth (Kilograms) Weight at birth (Kilograms) Weight at birth (Kilograms) How much did (name) weigh? 9.998 DK 9.999 Missing Gov doctor Gov doctor Gov doctor Gov doctor Gov doctor Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? ? Missing A Govt doctor Privat doctor Privat doctor Privat doctor Privat doctor Privat doctor Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? ? Missing B Private doctor Nurse Nurse Nurse Nurse Nurse Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? ? Missing C Nurse Licensed Licensed Licensed Licensed Licensed Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? ? Missing D Midwife licensed Not licensed Not licensed Not licensed Not licensed Not licensed Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? ? Missing E Midwife not licensed Traditional birth attendant Traditional birth attendant Traditional birth attendant Traditional birth attendant Traditional birth attendant Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? ? Missing F Traditional birth attendant Community health worker Community health worker Community health worker Community health worker Community health worker Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? ? Missing G Community health worker Others Others Others Others Others Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? ? Missing X Other No one No one No one No one No one Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? ? Missing Y No one Attended a public or private facility Attended a public or private facility Attended a public or private facility Attended a public or private facility Attended a public or private facility Did you go to a public or private facility to receive post-natal checkup? 1 Yes,public facility 2 Yes,Private facility 3 No 9 Missing Prescribed a family planning method Prescribed a family planning method Prescribed a family planning method Prescribed a family planning method Prescribed a family planning method Where you prescribed a family planning method in the facility? 1 Yes 2 No 9 Missing Able to get prescription Able to get prescription Able to get prescription Able to get prescription Able to get prescription Were you able to get your presecription medicine at the same facility? 1 Yes 2 No 9 Missing Reason for no post natal check Reason for no post natal check Reason for no post natal check Reason for no post natal check Reason for no post natal check What was the main reason for not recieveing a post-natal checkup? 1 No complication 2 Able to manage 3 Unaware of importantance 4 Srevice not available 5 Costs too much 6 Too busy 7 Husband too busy 96 Other 99 Missing Did you receive a Vitamin A Did you receive a Vitamin A Did you receive a Vitamin A Did you receive a Vitamin A Did you receive a Vitamin A In the first 40 days after your last birth [the birth of name], did you receive a Vitamin A dose like this? 1 Yes 2 No 8 DK 9 Missing Ever breastfeed Ever breastfeed Ever breastfeed Ever breastfeed Ever breastfeed Did you ever breastfeed (name)? 1 Yes 2 No 9 Missing Time baby put to breast (unit) Time baby put to breast (unit) Time baby put to breast (unit) Time baby put to breast (unit) Time baby put to breast (unit) How long after birth did you first put (name) to the breast? Immediately 1 Hours 2 Days 9 Missing Time baby put to breast (number) Time baby put to breast (number) Time baby put to breast (number) Time baby put to breast (number) Time baby put to breast (number) How long after birth did you first put (name) to the breast? 98 DK 99 Missing Did you have fever Did you have fever Did you have fever Did you have fever Did you have fever Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you have 1 Yes 2 No 9 Missing Did you have trouble controlling urine Did you have trouble controlling urine Did you have trouble controlling urine Did you have trouble controlling urine Did you have trouble controlling urine Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you have 1 Yes 2 No 9 Missing Did you suffer from urinary tract infection Did you suffer from urinary tract infection Did you suffer from urinary tract infection Did you suffer from urinary tract infection Did you suffer from urinary tract infection Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you have 1 Yes 2 No 9 Missing Did you suffer from mastitis Did you suffer from mastitis Did you suffer from mastitis Did you suffer from mastitis Did you suffer from mastitis Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you have 1 Yes 2 No 9 Missing Did you suffer from offensive discharge Did you suffer from offensive discharge Did you suffer from offensive discharge Did you suffer from offensive discharge Did you suffer from offensive discharge Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you have 1 Yes 2 No 9 Missing Did you suffer from wound infection Did you suffer from wound infection Did you suffer from wound infection Did you suffer from wound infection Did you suffer from wound infection Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you have 1 Yes 2 No 9 Missing Did you suffer from hemorrhage Did you suffer from hemorrhage Did you suffer from hemorrhage Did you suffer from hemorrhage Did you suffer from hemorrhage Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you have 1 Yes 2 No 9 Missing Did you suffer from tear Did you suffer from tear Did you suffer from tear Did you suffer from tear Did you suffer from tear Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you have 1 Yes 2 No 9 Missing Did you suffer from post delivery depression Did you suffer from post delivery depression Did you suffer from post delivery depression Did you suffer from post delivery depression Did you suffer from post delivery depression Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you have 1 Yes 2 No 9 Missing Did you suffer from any other problems Did you suffer from any other problems Did you suffer from any other problems Did you suffer from any other problems Did you suffer from any other problems Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you have 1 Yes 2 No 9 Missing Currently pregnant Currently pregnant Currently pregnant Currently pregnant Currently pregnant Are you pregnant now? 1 Yes, currently pregnant 2 No 8 Unsure or DK 9 Missing Did you want to wait later or not want any more children Did you want to wait later or not want any more children Did you want to wait later or not want any more children Did you want to wait later or not want any more children Did you want to wait later or not want any more children At the time you became pregnant did you want to become pregnant then, did you want to wait until later, or did you not want to have any more children? 1 Then 2 Later 3 Not want more children 9 Missing Currently using a method to avoid pregnancy Currently using a method to avoid pregnancy Currently using a method to avoid pregnancy Currently using a method to avoid pregnancy Currently using a method to avoid pregnancy Some people use various ways or methods to delay or avoid a pregnancy. Are you currently doing something or using any method to delay or avoid getting pregnant? 1 Yes 2 No 9 Missing Desire to have childern Desire to have childern Desire to have childern Desire to have childern Desire to have childern What is the reason for not doing something or using any method to delay or avoid getting pregnant? ? Missing A Desire to have children Health reason Health reason Health reason Health reason Health reason What is the reason for not doing something or using any method to delay or avoid getting pregnant? ? Missing B Health reasons Religious reasons Religious reasons Religious reasons Religious reasons Religious reasons What is the reason for not doing something or using any method to delay or avoid getting pregnant? ? Missing C Religioous causes/reasons Husband not convinced Husband not convinced Husband not convinced Husband not convinced Husband not convinced What is the reason for not doing something or using any method to delay or avoid getting pregnant? ? Missing D Husband not convinced Wife not convinced Wife not convinced Wife not convinced Wife not convinced Wife not convinced What is the reason for not doing something or using any method to delay or avoid getting pregnant? ? Missing E Wife not convinced High price of contraceptives High price of contraceptives High price of contraceptives High price of contraceptives High price of contraceptives What is the reason for not doing something or using any method to delay or avoid getting pregnant? ? Missing F High price of contraceptives Other Other Other Other Other What is the reason for not doing something or using any method to delay or avoid getting pregnant? ? Missing X Others Current method: Female sterilization Current method: Female sterilization Current method: Female sterilization Current method: Female sterilization Current method: Female sterilization Which method are currently you using? ? Missing A Female sterilization Current method: Male sterilization Current method: Male sterilization Current method: Male sterilization Current method: Male sterilization Current method: Male sterilization Which method are currently you using? ? Missing B Male sterilization Current method: Pill Current method: Pill Current method: Pill Current method: Pill Current method: Pill Which method are currently you using? ? Missing C PILL Current method: IUD Current method: IUD Current method: IUD Current method: IUD Current method: IUD Which method are currently you using? ? Missing D IUD Current method: Injections Current method: Injections Current method: Injections Current method: Injections Current method: Injections Which method are currently you using? ? Missing E Injections Current method: Implants Current method: Implants Current method: Implants Current method: Implants Current method: Implants Which method are currently you using? ? Missing F Implants Current method: Condom Current method: Condom Current method: Condom Current method: Condom Current method: Condom Which method are currently you using? ? Missing G Condom Current method: Female condom Current method: Female condom Current method: Female condom Current method: Female condom Current method: Female condom Which method are currently you using? ? Missing H Female condom Current method: Diaphragm Current method: Diaphragm Current method: Diaphragm Current method: Diaphragm Current method: Diaphragm Which method are currently you using? ? Missing I Diaphragm Current method: Foam/jelly Current method: Foam/jelly Current method: Foam/jelly Current method: Foam/jelly Current method: Foam/jelly Which method are currently you using? ? Missing J Foam/Jelly Current method: Lactational amenorrhea method Current method: Lactational amenorrhea method Current method: Lactational amenorrhea method Current method: Lactational amenorrhea method Current method: Lactational amenorrhea method Which method are currently you using? ? Missing K Lactational amenorrhoea (LAM) Current method: Periodic abstinence Current method: Periodic abstinence Current method: Periodic abstinence Current method: Periodic abstinence Current method: Periodic abstinence Which method are currently you using? ? Missing L Periodic abstinence Current method: Withdrawal Current method: Withdrawal Current method: Withdrawal Current method: Withdrawal Current method: Withdrawal Which method are currently you using? ? Missing M Withdrawal Current method: Other Current method: Other Current method: Other Current method: Other Current method: Other Which method are currently you using? ? Missing X Other Source of method Source of method Source of method Source of method Source of method Where did you obtain (Current method) the last time? If the currently used method is Lactational amenorrhoea method (LAM) or Periodic abstinence or Withdrawal or other, ask: where/who described the method for you? 11 Govt hospital 12 Govt health center 13 Family planning clinc 16 Other public 21 Private hospital/clinic 22 Private phyician 23 Private pharmacy 24 Health worker 26 Medical 31 Relative or friend 32 Shop 33 Traditional practitioner 96 Other 98 DK 99 Missing Prefer to have or not to have any more children Prefer to have or not to have any more children Prefer to have or not to have any more children Prefer to have or not to have any more children Prefer to have or not to have any more children a. Now I would like to ask some questions about the future. Would you like to have (a/another) child, or would you prefer not to have any (more) children? b. If currently pregnant: Now I would like to ask some questions about the future. After the child you are now expecting, would you like to have another child, or would you prefer not to have any (more) children? 1 Have (a/another) child 2 No more /none 3 Says she cannot get pregnant 8 Undecided/don't know 9 Missing Desired waiting time (units) Desired waiting time (units) Desired waiting time (units) Desired waiting time (units) Desired waiting time (units) How long would you like to wait before the birth of (a/another) child? 1 Months 2 Years 9 Special Desired waiting time (number) Desired waiting time (number) Desired waiting time (number) Desired waiting time (number) Desired waiting time (number) How long would you like to wait before the birth of (a/another) child? 93 Soon/now 94 Says she cannot get pregnant 95 After marriage 96 Other 98 Don't know 99 Missing Able to get pregnant Able to get pregnant Able to get pregnant Able to get pregnant Able to get pregnant Do you think you are physically able to get pregnant at this time? 1 Yes 2 No 8 Don't know 9 Missing If she goes out with out telling him If she goes out with out telling him If she goes out with out telling him If she goes out with out telling him If she goes out with out telling him If she goes out with out telling him? 1 Yes 2 No 8 DK 9 Missing If she neclects the children If she neclects the children If she neclects the children If she neclects the children If she neclects the children If she neglects the children? 1 Yes 2 No 8 DK 9 Missing If she argues with him If she argues with him If she argues with him If she argues with him If she argues with him If she argues with him? 1 Yes 2 No 8 DK 9 Missing If she refuses sex with him If she refuses sex with him If she refuses sex with him If she refuses sex with him If she refuses sex with him If she refuses sex with him? 1 Yes 2 No 8 DK 9 Missing If she burns the food If she burns the food If she burns the food If she burns the food If she burns the food If she burns the food? 1 Yes 2 No 8 DK 9 Missing Ever heard of HIV or AIDS Ever heard of HIV or AIDS Ever heard of HIV or AIDS Ever heard of HIV or AIDS Ever heard of HIV or AIDS Have you ever heard of the virus HIV or an illness called AIDS? 1 Yes 2 No 9 Missing Can avoid AIDS by having one unifected partner Can avoid AIDS by having one unifected partner Can avoid AIDS by having one unifected partner Can avoid AIDS by having one unifected partner Can avoid AIDS by having one unifected partner Can people protect themselves from getting infected with the AIDS virus by having one sex partner who is not infected and also has no other partners? 1 Yes 2 No 8 DK 9 Missing Can avoid AIDS by witch creaft Can avoid AIDS by witch creaft Can avoid AIDS by witch creaft Can avoid AIDS by witch creaft Can avoid AIDS by witch creaft Can people get infected with the AIDS virus because of witchcraft or other supernatural means? 1 Yes 2 No 8 DK 9 Missing Can avoid by using condom Can avoid by using condom Can avoid by using condom Can avoid by using condom Can avoid by using condom Can people reduce their chance of getting the AIDS virus by using a condom every time they have sex? 1 Yes 2 No 8 DK 9 Missing Can avoid AIDS from mosquito Can avoid AIDS from mosquito Can avoid AIDS from mosquito Can avoid AIDS from mosquito Can avoid AIDS from mosquito Can people get the AIDS virus from mosquito bites? 1 Yes 2 No 8 DK 9 Missing Can avoid AIDS by not having sex Can avoid AIDS by not having sex Can avoid AIDS by not having sex Can avoid AIDS by not having sex Can avoid AIDS by not having sex Can people reduce their chance of getting infected with the AIDS virus by not having sex at all? 1 Yes 2 No 8 DK 9 Missing Can avoid AIDS by sharing food Can avoid AIDS by sharing food Can avoid AIDS by sharing food Can avoid AIDS by sharing food Can avoid AIDS by sharing food Can people get the AIDS virus by sharing food with a person who has AIDS? 1 Yes 2 No 8 DK 9 Missing Can avoid AIDS by getting injection Can avoid AIDS by getting injection Can avoid AIDS by getting injection Can avoid AIDS by getting injection Can avoid AIDS by getting injection Can people get the AIDS virus by getting injections with a needle that was already used by someone else? 1 Yes 2 No 8 DK 9 Missing Is it possible the healthy person have AIDS virus Is it possible the healthy person have AIDS virus Is it possible the healthy person have AIDS virus Is it possible the healthy person have AIDS virus Is it possible the healthy person have AIDS virus Is it possible for a healthy-looking person to have the AIDS virus? 1 Yes 2 No 8 DK 9 Missing During pregnancy During pregnancy During pregnancy During pregnancy During pregnancy Can the AIDS virus be transmitted from a mother to a baby? During pregnancy? 1 Yes 2 No 8 DK 9 Missing During delivary During delivary During delivary During delivary During delivary Can the AIDS virus be transmitted from a mother to a baby? During delivery? 1 Yes 2 No 8 DK 9 Missing By breastfeeding By breastfeeding By breastfeeding By breastfeeding By breastfeeding Can the AIDS virus be transmitted from a mother to a baby? By breastfeeding? 1 Yes 2 No 8 DK 9 Missing If a female teacher has a virus If a female teacher has a virus If a female teacher has a virus If a female teacher has a virus If a female teacher has a virus If a female teacher has the AIDS virus but is not sick, should she be allowed to continue teaching in school? 1 Yes 2 No 8 DK 9 Missing Would you buy fresh vegetables Would you buy fresh vegetables Would you buy fresh vegetables Would you buy fresh vegetables Would you buy fresh vegetables Would you buy fresh vegetables from a shopkeeper or vendor if you knew that this person had the AIDS virus? 1 Yes 2 No 8 DK 9 Missing Want it to be secret Want it to be secret Want it to be secret Want it to be secret Want it to be secret If a member of your family became infected with the AIDS virus, would you want it to remain a secret? 1 Yes 2 No 8 DK 9 Missing Willing to care for him or her in your household Willing to care for him or her in your household Willing to care for him or her in your household Willing to care for him or her in your household Willing to care for him or her in your household If a member of your family became sick with the AIDS virus, would you be willing to care for him or her in your household? 1 Yes 2 No 8 DK 9 Missing I do not want to know the result I do not want to know the result I do not want to know the result I do not want to know the result I do not want to know the result I do not want to know the results, but have you ever been tested to see if you have HIV, the virus that causes AIDS? 1 Yes 2 No 8 DK 9 Missing Have you been told the result Have you been told the result Have you been told the result Have you been told the result Have you been told the result I do not want you to tell me the results of the test, but have you been told the results? 1 Yes 2 No 9 Missing Did you yourself ask for the test Did you yourself ask for the test Did you yourself ask for the test Did you yourself ask for the test Did you yourself ask for the test Did you, yourself, ask for the test, was it offered to you and you accepted, or was it required? 1 Asked for the test 2 offered and accepted 3 Required 9 Missing Know of a testing place Know of a testing place Know of a testing place Know of a testing place Know of a testing place At this time, do you know of a place where you can go to get such a test to see if you have the AIDS virus? A. If tested for HIV during antenatal care: Other than at the antenatal clinic, do you know of a place where you can go to get a test to see if you have the AIDS virus? 1 Yes 2 No 9 Missing What is the best method What is the best method What is the best method What is the best method What is the best method In your opinion, What is the best method to be used to increase public knowledge about HIV/AIDS? 11 School curriculum 12 TV messages 13 Radio messages 14 Newspapers 15 Banners 16 Healthh education 96 Others 99 Missing Partner should be examined even with no symptoms Partner should be examined even with no symptoms Partner should be examined even with no symptoms Partner should be examined even with no symptoms Partner should be examined even with no symptoms In case of someone was infected with a sexually transmitted diseases, do you think that the other partner (husband) should be tested even if he has no symptoms? 1 Yes 2 No 8 DK 9 Missing Interviewer number Interviewer number Interviewer number Interviewer number Interviewer number Interviewer name and number: Enter your own name and identification number provided to you at the time of training. Households Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor name and number: Enter your supervisor's name and identification number. You will be provided with your supervisor's identification number as soon as you know who you will be working with. Households Day of interview Day of interview Day of interview Day of interview Day of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Month of interview Month of interview Month of interview Month of interview Month of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Year of interview Year of interview Year of interview Year of interview Year of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Area Area Area Area Area Circle the code for area of residence as instructed by your supervisor. This will have been pre-determined; you will not be required to assess whether the household is in an urban or rural area. Households 1 Urban 2 Rural Muhafaza Muhafaza Muhafaza Muhafaza Muhafaza Region: Circle the code for zone. Households 11 Duhuk 12 Nainwa 13 Sulimania 14 Kakuk 15 Arbil 21 Diala 22 Anbar 23 Baghdad 24 Babil 25 Karbala 26 Wasit 27 Salahaladin 28 Najaf 31 Qadisya 32 Almuthana 33 Thiqar 34 Misan 35 Albasrah Governate/Region Qadha Qadha Qadha Qadha Qadha Recoded variable Household District Result of HH interview Result of HH interview Result of HH interview Result of HH interview Result of HH interview After all questionnaires for the household have been completed, fill in the following information: Result of HH interview: If the Household Questionnaire is completed, circle '1' for 'Completed'. If you have not been able to contact the household after repeated visits, circle '2' for 'Not at home'. If the household refuses to be interviewed, circle '3' for 'Refused'. If you are unable to locate the household or if the dwelling is destroyed, circle '4' for 'HH not found/destroyed'. If you have not been able to complete the Household Questionnaire for another reason, you should circle '6' for 'Other' and specify the reason in the space provided. Some examples of 'Other' codes might be: the household respondent is incapacitated; the questionnaire is partly completed; adult household members were not found at home after repeated visits. Households 1 Completed 2 Not at home 3 Refused 4 HH not found/destroyed 6 Other Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent to HH questionnaire: Enter the name and line number (from the Household Listing, columns HL1 and HL2) of the respondent to the Household Questionnaire. Households 99 Missing Number of household members Number of household members Number of household members Number of household members Number of household members Total number of household members: Count the number of household members recorded in column HL1 of the Household Listing and enter the total here. Households Total eligible women Total eligible women Total eligible women Total eligible women Total eligible women No.of women eligible for interview: Enter the total number of women eligible for interview for the Questionnaire for Individual Women - you will copy this from the row for totals at the bottom of the Household Listing, for HL6. Households Women interviews completed Women interviews completed Women interviews completed Women interviews completed Women interviews completed No.of women questionnaires completed: Once all of the Questionnaires for Individual Women have been completed for a particular household, enter the number completed here. Households Total children under 5 Total children under 5 Total children under 5 Total children under 5 Total children under 5 No.of children under age 5: Enter the total number of children under five eligible for inclusion in the survey from the row for totals at the bottom of the Household Listing, for HL8. You will be using the Questionnaire for Children Under Five to interview the mothers or primary caretakers of these children. Households Child interviews completed Child interviews completed Child interviews completed Child interviews completed Child interviews completed No.of under-5 questionnaires completed: Once all of the Questionnaires for Children Under Five have been completed for a particular household, enter the number completed here. Households Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk: Leave this space blank. The data clerk will enter his/her number in the space provided. Households Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water What is the main source of drinking water for members of your household? The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): · '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. · '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. · '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. · '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. · '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. · '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. · '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. · '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). · '52' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof and stored in a container, tank or cistern until used. · '53' Berkad · '54' Rain water catchment (Balli) · '61' - A tanker-truck water source transports and sells water by means of a tanker truck. · '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. · '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. · '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. Households 11 Piped into dwelling 12 Piped into yard or plot 13 Public tap/standpipe 21 Tubewell/borehole 31 Protected well 32 Unprotected well 41 Protected spring 42 Unprotected spring 51 Rainwater collection 62 Tanker-truck 71 Cart with small tank/drum 81 Surface water 91 Bottled water 96 Other 99 Missing Main source of water used for other purposes (if bottled wat Main source of water used for other purposes (if bottled wat Main source of water used for other purposes (if bottled wat Main source of water used for other purposes (if bottled wat Main source of water used for other purposes (if bottled wat What is the main source of water used by your household for other purposes such as cooking and handwashing? The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): · '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. · '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. · '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. · '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. · '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. · '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. · '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. · '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). · '52' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof and stored in a container, tank or cistern until used. · '53' Berkad · '54' Rain water catchment (Balli) · '61' - A tanker-truck water source transports and sells water by means of a tanker truck. · '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. · '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. · '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. Households 11 Piped into dwelling 12 Piped into yard or plot 13 Public tap/standpipe 21 Tubewell/borehole 31 Protected well 32 Unprotected well 41 Protected spring 42 Unprotected spring 51 Rainwater collection 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 96 Other 99 Missing Time to get water and come back Time to get water and come back Time to get water and come back Time to get water and come back Time to get water and come back How long does it take to go there, get water, and come back? This question is used to find out how convenient the source of water is to the dwelling. Note that the question is asked for water sources coded as '13-81' and '96' in WS1, or water sources coded as '13-96' in WS2. Fill in the estimated time (in minutes, converting from hours, if necessary) it takes by the usual mode of transport to get to the water source, wait to get water, and get back to the dwelling. Use zero(s) preceding the number if less than 100 minutes (for example, '060' or '005'). Then continue to the next question. If the water source is on the dwelling premises or if water is delivered to the dwelling by a vendor, circle '995' for 'Water on premises' and skip to WS5. If the respondent does not know how long it takes, circle '998' and continue on to the next question. Households 995 On premises 998 DK 999 Missing Person fetching water Person fetching water Person fetching water Person fetching water Person fetching water Who usually goes to this source to fetch the water for your household? Probe: Is this person under age 15? What sex? Circle code that best describes this person. The purpose of this question is to find out the age and gender of the person who usually performs the task of hauling water. This will provide an understanding of whether water hauling responsibilities are given to members of a particular sex or age group. Probe: "IS THIS PERSON UNDER AGE 15? WHAT SEX IS THIS PERSON?" Circle the code that corresponds with the response or '8' if the respondent does not know. Adult refers to anyone age 15 or over, regardless of whether he/she is a household member. Child refers to anyone under the age of 15, regardless of whether he/she is a household member. Households 1 Adult woman 2 Adult man 3 Female child (under 15) 4 Male child (under 15) 8 DK 9 Missing Treat water to make safer for drinking Treat water to make safer for drinking Treat water to make safer for drinking Treat water to make safer for drinking Treat water to make safer for drinking Do you treat your water in any way to make it safer to drink? The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle '1' if 'Yes', and continue to the next question. If 'No' or 'DK' (Doesn't know'), circle '2' or '8', respectively, and skip to WS7. Households 1 Yes 2 No 8 DK 9 Missing Boil Boil Boil Boil Boil What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing A Boil Add bleach/chlorine Add bleach/chlorine Add bleach/chlorine Add bleach/chlorine Add bleach/chlorine What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing B Add bleach/chlorine Strain it through a cloth Strain it through a cloth Strain it through a cloth Strain it through a cloth Strain it through a cloth What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing C Strain it through a cloth Use water filter Use water filter Use water filter Use water filter Use water filter What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing D Use water filter Solar disinfection Solar disinfection Solar disinfection Solar disinfection Solar disinfection What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing E Solar disinfection Let it stand and settle Let it stand and settle Let it stand and settle Let it stand and settle Let it stand and settle What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing F Let it stand and settle Other Other Other Other Other What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing X Other DK DK DK DK DK What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing Z DK Main dirinking water source give reliable supply Main dirinking water source give reliable supply Main dirinking water source give reliable supply Main dirinking water source give reliable supply Main dirinking water source give reliable supply Does your main drinking water source give you a reliable supply, i mean daily, weekly, or less than weekly problems or almost no problems? 1 Yes 2 Problems, but less than weekly 3 Weekly 4 Daily 5 Not Applic 8 DK 9 Missing secondary source of dirinking water secondary source of dirinking water secondary source of dirinking water secondary source of dirinking water secondary source of dirinking water If your main source of drinking water supply fails, what is your secondary source of drinking water? 11 Piped into dwelling 12 Piped into yard or plot 13 Public tap/standpipe 21 Tubewell/borehole 31 Protected well 32 Unprotected well 41 Protected spring 42 Unprotected spring 51 Rainwater collection 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 82 Bottle 96 Other 99 Missing Kind of toilet facility Kind of toilet facility Kind of toilet facility Kind of toilet facility Kind of toilet facility What kind of toilet facility do members of your household usually use? If "flush" or "pour flush", probe: Where does it flush to? If necessary, ask permission to observe the facility. Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of this question is to obtain a measure of the cleanliness of the sanitary facility used by the household members. It may be necessary to observe the facility. If so, ask permission to do so. If the respondent answers or it is observed that the household members have no facilities or use the bush or field, enter '95' for 'No facilities or bush or field' and skip to the next module. If any of the flush or pour flush responses (11-15) are given, probe: "WHERE DOES IT FLUSH TO?" Circle the code corresponding to the response given. Definitions of various types of toilet facilities are as follows: A flush toilet uses a cistern or holding tank for flushing water and has a water seal, which is a U-shaped pipe, below the seat or squatting pan that prevents the passage of flies and odours. A pour flush toilet uses a water seal, but unlike a flush toilet, a pour flush toilet uses water poured by hand for flushing (no cistern is used). . '11' - A piped sewer system is a system of sewer pipes, also called sewerage, that is designed to collect human excreta (faeces and urine) and wastewater and remove them from the household environment. Sewerage systems consist of facilities for collection, pumping, treating and disposing of human excreta and wastewater. . '12' - A septic tank is an excreta collection device and is a water-tight settling tank normally located underground, away from the house or toilet. . '13' - A flush/pour flush to pit latrine refers to a system that flushes excreta to a hole in the ground. . '14' - A flush/pour flush to somewhere else refers to excreta being deposited in or nearby the household environment (not into pit, septic tank or sewer); excreta may be flushed to the street, yard/plot, drainage way or other location. . '15' - Flush to unknown place/not sure/DK where should be coded in cases when the respondent knows that the toilet facility is a flush toilet, but does not know where it flushes to. '21' - A ventilated improved pit latrine or VIP is a type of pit latrine that is ventilated by a pipe extending above the latrine roof. The open end of the vent pipe is covered with gauze mesh or fly-proof netting and the inside of the superstructure is kept dark. '22' - A pit latrine with slab uses a hole in the ground for excreta collection and has a squatting slab, platform or seat that is firmly supported on all sides, easy to clean and raised above the surrounding ground level to prevent surface water from entering the pit. '23' - A pit latrine without slab uses a hole in the ground for excreta collection and does not have a squatting slab, platform or seat. An open pit is a rudimentary hole in the ground where excreta is collected. '31' - A composting toilet is a toilet into which excreta and carbon-rich material are added (vegetable wastes, straw, grass, sawdust, ash) and special conditions maintained to produce inoffensive compost. '41' - Bucket refers to the use of a bucket or other container for the retention of faeces (and sometimes urine and anal cleaning material), which is periodically removed for treatment or disposal. '51' - A hanging toilet or hanging latrine is a toilet built over the sea, a river, or other body of water into which excreta drops directly. '95' - No facilities or bush or field includes excreta wrapped and thrown with garbage, the 'cat' method of burying excreta in dirt, defecation in the bush or field or ditch, and defecation into surface water (drainage channel, beach, river, stream or sea). Households 11 Flush to piped sewer system 12 Flush to septic tank 13 Flush to pit (latrine) 14 Flush to somewhere else 15 Flush to unknown place/not sure/DK where 21 Ventilated Improved Pit latrine (VIP) 22 Pit latrine with slab 23 Pit latrine without slab/open pit 31 Composting toilet 41 Bucket 51 Hanging toilet/hanging latrine 95 No facilities or bush or field 96 Other 99 Missing Toilet/sewage system working properly Toilet/sewage system working properly Toilet/sewage system working properly Toilet/sewage system working properly Toilet/sewage system working properly Is your toilet working properly, or there are daily, weekly or less than weekly problems? If the respondent replies 'no' try to assess how often they encounter problems. If they encounter problems occasionally such as a few times a month circle '2', if a few times a week circle '3' for daily problems circle '4'. If the household complains that it is only at certain times of year they do not have a reliable supply then circle 5'. If the household does not know circle '8'. Household 1 Yes 2 Occasional problems 3 Weekly problems 4 Daily problems 5 Not Applic 8 DK 9 Missing Is your toilet working properly Is your toilet working properly Is your toilet working properly Is your toilet working properly Is your toilet working properly Is the sewage system around your house working properly or there are daily, weekly or less than weekly problems? 1 Yes 2 Occasional problems 3 Weekly problems 4 Daily problems 5 Not Applic 8 DK 9 Missing Toilet facility shared Toilet facility shared Toilet facility shared Toilet facility shared Toilet facility shared Do you share this facility with other households? Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of the following two questions is to determine whether the household shares their sanitation facility with other households. The shared status of a sanitation facility is important because shared facilities can be less hygienic than facilities used by only a single household. Unhygienic conditions (faeces on the floor, seat or wall and flies) may discourage use of the facility. --- Circle the code corresponding to the response given. If 'No', go to the next module. Households 1 Yes 2 No 9 Missing Households using this toilet facility Households using this toilet facility Households using this toilet facility Households using this toilet facility Households using this toilet facility How many households in total use this toilet facility? Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of the following two questions is to determine whether the household shares their sanitation facility with other households. The shared status of a sanitation facility is important because shared facilities can be less hygienic than facilities used by only a single household. Unhygienic conditions (faeces on the floor, seat or wall and flies) may discourage use of the facility. --- The total number of households using this facility should include the household being interviewed. If less than ten households use this toilet facility, enter the number of households on the line provided. Circle '10' if ten or more households use this toilet facility. Note that '01' is not a valid response (since it means that this is the only this household that uses the facility; if that is the case, you should go back to WS8 and correct the response there). Circle '98' for 'DK' ('Doesn't know'). Households 10 Ten or more households 98 DK 99 Missing solid waste dispose solid waste dispose solid waste dispose solid waste dispose solid waste dispose How do you dispose your solid waste/ Garbage? 1 House to house collection 2 Street containers-open 3 Street containers-closed 4 Dump to open area 5 Burn 6 Compost 7 Bury 96 Other 99 Missing frequency of collection/emptying of streert containers frequency of collection/emptying of streert containers frequency of collection/emptying of streert containers frequency of collection/emptying of streert containers frequency of collection/emptying of streert containers What is the frequency of collection/ emptying of street containers? 1 Less than once in 2 weeks 2 Once in 2 weeks 3 Once a week 4 Twice a week or more 9 Missing Number of rooms for sleeping Number of rooms for sleeping Number of rooms for sleeping Number of rooms for sleeping Number of rooms for sleeping How many rooms in this household are used for sleeping? This information provides a measure of how crowded the house is, and reflects the socio-economic condition of the household. A room in this case refers to a special area with a permanent partition that is used for sleeping. It is not necessarily the number of rooms in the household that are called 'bedrooms', but rather how many rooms get used for sleeping on a regular basis. Exclude rooms that are used only for sleeping by visitors to the household, but include those rooms that may not be regular 'bedrooms' but may be regularly used by one or more of the household members for sleeping. Enter the number of rooms in this household that are used for sleeping. Households 99 Missing Main material of floor Main material of floor Main material of floor Main material of floor Main material of floor Main material of the dwelling floor: Record observation. Circle the correct code for the material of the dwelling floor based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the floor, record the main flooring material (the material that covers the largest amount of floor space). Households 11 Earth/sand 12 Dung 21 Wood planks 22 Palm/bamboo 23 Reeds 32 Vinyl or asphalt strips 33 Ceramic tiles 34 Cement 35 Carpet 96 Other 99 Missing Main material of roof Main material of roof Main material of roof Main material of roof Main material of roof Main material of the roof. Record observation. Circle the correct code for the material of the dwelling roof, based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the roof, record the main roofing material (the material that covers the largest amount of roof). Households 11 No roof 12 Thatch/palm leaf 13 Sod 21 Rustic mat 22 Palm/bamboo 23 Reeds 24 Wood Planks 31 Metal 32 Wood 33 Calamine/cement fiber 34 Ceramic tiles 35 Cement 36 Roofing shingles 96 Other 99 Missing Main material of wall Main material of wall Main material of wall Main material of wall Main material of wall Main material of the walls. Record observation. Circle the correct code for the material of the dwelling walls, based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the walls, record the main wall material (the material that covers the largest amount of wall space). Households 11 No walls 12 Cane/palm/trunks 13 Dirt 21 Bambo with mud 22 Stone with mud 23 Uncovered adobe 24 Plywood 25 Carton 26 Reused wood 27 Reeds 31 Cement 32 Stone with lime/cement 33 Bricks 34 Cement blocks 35 Covered adobe 36 Wood planks/shingles 37 Chinku tin 96 Other 99 Missing Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking What type of fuel does your household mainly use for cooking? Information on the type of fuel used for cooking is collected as another measure of the socio-economic status of the household. The use of some cooking fuels can also have adverse health consequences. Circle the code corresponding to the answer given. Remember that this question asks about fuel for cooking, not fuel for heating or lighting. If the household uses more than one fuel for cooking, find out which type of fuel is used most often. If electricity, liquid propane gas (LPG), natural gas, or biogas is mainly used, circle '01', '02', '03', or '04', respectively, and skip to HC8. If any fuel other than the pre-coded ones is reported as being the main fuel used for cooking, circle '96' and specify the type of fuel on the line provided. Definitions of some of the types of fuel are as follows: 'Biogas' includes gases produced by fermenting manure in an enclosed pit. 'Lignite' is a derivative of coal that produces more smoke when burned but produces less heat than coal. Households 1 Electricity 2 Liquid propane gas (LPG) 5 Kerosene 6 Coal/lignite 8 Wood 9 Straw/shrubs/grass 10 Animal dung 11 Agricultural crop residue 96 Other 99 Missing Cooking location Cooking location Cooking location Cooking location Cooking location Is the cooking usually done in the house, in a separate building, or outdoors? Circle the code corresponding to the response given. If a response is given other than the pre-coded ones, circle '6' and specify on the line provided. Households 1 In the house 2 In a separate bulding 3 Outdoors 6 Other 9 Missing Electricity Electricity Electricity Electricity Electricity Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR? Households 1 Yes 2 No 9 Missing Network Electric Network Electric Network Electric Network Electric Network Electric Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR? Households 1 Yes 2 No 9 Missing generator generator generator generator generator Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR? Households 1 Yes 2 No 9 Missing Radio Radio Radio Radio Radio Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR, VCD/DVD PLAYER, FAN? Households 1 Yes 2 No 9 Missing Television Television Television Television Television Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR? Households 1 Yes 2 No 9 Missing Mobile Phone Mobile Phone Mobile Phone Mobile Phone Mobile Phone Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Phone Phone Phone Phone Phone Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR? Households 1 Yes 2 No 9 Missing satellite dish satellite dish satellite dish satellite dish satellite dish Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Refrigerator Refrigerator Refrigerator Refrigerator Refrigerator Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Watch Watch Watch Watch Watch Does your household have: This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR. Households 1 Yes 2 No 9 Missing Bicycle Bicycle Bicycle Bicycle Bicycle Does your household have: This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR. Households 1 Yes 2 No 9 Missing Motorcycle or scooter Motorcycle or scooter Motorcycle or scooter Motorcycle or scooter Motorcycle or scooter Does your household have: 1 Yes 2 No 9 Missing Animal-drawn cart Animal-drawn cart Animal-drawn cart Animal-drawn cart Animal-drawn cart Does your household have: This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR. Households 1 Yes 2 No 9 Missing Car or truck Car or truck Car or truck Car or truck Car or truck Does your household have: This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR. Households 1 Yes 2 No 9 Missing Boat with motor Boat with motor Boat with motor Boat with motor Boat with motor Does your household have: 1 Yes 2 No 9 Missing Area Area Area Area Area 1 Metrob1 2 Metrob2 3 Metro 4 Urban-other 5 Rural Area Area Area Area Area 1 Metropolitan 2 Urban-other 3 Rural Region Region Region Region Region 1 North 2 South/center Governorate Governorate Governorate Governorate Governorate 1 Dohuk 2 Nainwa 3 Sulimania 4 Karkuk 5 Erbil 6 Diala 7 Anbar 8 Babil 9 Karbala 10 Wasit 11 Salahaladin 12 Najaf 13 Qadisya 14 Almuthana 15 Thiqar 16 Misan 17 Albasrah 18 Baghdad Women's sample weight Women's sample weight Women's sample weight Women's sample weight Women's sample weight Recoded Variable Women age 15-49 The sample is not self weighting therefore survey sample weights have been created using urban and rural population estimates at the regional level. (See data processing folder under external documents which contains excel sheets and syntax files related to constructing and merging sample weights to file). Month of last birth Month of last birth Month of last birth Month of last birth Month of last birth Of these (total number) births you have had, when did you deliver the last one (even if he or she has died)? This question is used to ascertain the woman's eligibility for the subsequent two modules. Enter the date of the woman's most recent birth, even if the child is no longer alive, in the space provided. If the child has died, take special care when referring to this child by name in the following modules. If the woman does not remember the day of birth, you may enter '98' to the space provided for 'Day'. Note that you MUST obtain exact information on the month and year of the last birth; '98' is not allowed for month and year. Women aged 15-49 98 Don't know 99 Missing Year of last birth Year of last birth Year of last birth Year of last birth Year of last birth Of these (total number) births you have had, when did you deliver the last one (even if he or she has died)? This question is used to ascertain the woman's eligibility for the subsequent two modules. Enter the date of the woman's most recent birth, even if the child is no longer alive, in the space provided. If the child has died, take special care when referring to this child by name in the following modules. If the woman does not remember the day of birth, you may enter '98' to the space provided for 'Day'. Note that you MUST obtain exact information on the month and year of the last birth; '98' is not allowed for month and year. Women aged 15-49 CMC of date of last birth CMC of date of last birth CMC of date of last birth CMC of date of last birth CMC of date of last birth Month of first birth Month of first birth Month of first birth Month of first birth Month of first birth 98 Don't know 99 Missing Year of first birth Year of first birth Year of first birth Year of first birth Year of first birth CMC of date of first birth CMC of date of first birth CMC of date of first birth CMC of date of first birth CMC of date of first birth Date of interview women (CMC) Date of interview women (CMC) Date of interview women (CMC) Date of interview women (CMC) Date of interview women (CMC) Recoded Variable Women age 15-49 Completed years ago since first birth Completed years ago since first birth Completed years ago since first birth Completed years ago since first birth Completed years ago since first birth Date of birth (CMC) Date of birth (CMC) Date of birth (CMC) Date of birth (CMC) Date of birth (CMC) Recoded Variable Women age 15-49 Age Age Age Age Age Recoded Variable Women age 15-49 1 15-19 2 20-24 3 25-29 4 30-34 5 35-39 6 40-44 7 45-49 Age at first marriage Age at first marriage Age at first marriage Age at first marriage Age at first marriage Recoded Variable Women age 15-49 Education Education Education Education Education Recoded Variable Women age 15-49 1 None 2 Primary 3 Secondary + 4 Non-standard curriculum 9 Missing/DK Children ever born Children ever born Children ever born Children ever born Children ever born Recoded Variable Women age 15-49 Dead children Dead children Dead children Dead children Dead children Recoded Variable Women age 15-49 Number of children surviving Number of children surviving Number of children surviving Number of children surviving Number of children surviving Recoded Variable Women age 15-49 Marital status Marital status Marital status Marital status Marital status Recoded Variable Women age 15-49 1 Currently married 2 Formerly married 3 Never married Cluster number Cluster number Cluster number Cluster number Cluster number We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. During this time I would like to speak with the household head and all mothers or others who take care of children in the household. May I start now? If permission is given, begin the interview. Cluster number: Enter the cluster number as instructed by your supervisor. Households Unique identifier for the cluster in which the household exists Household number Household number Household number Household number Household number Household number: Enter the household number as instructed by your supervisor. Households Line number Line number Line number Line number Line number Women aged 15-49 Cluster number Cluster number Cluster number Cluster number Cluster number Cluster number: Enter the cluster number from the Household Questionnaire, question HH1. Children aged 0-4 Household number Household number Household number Household number Household number Household number: Enter the household number from the Household Questionnaire, question HH2. Children aged 0-4 Child's line number Child's line number Child's line number Child's line number Child's line number Child's line number: Enter the child's line number from the Household Questionnaire, column HL1 of the Household Listing. Children aged 0-4 Caretaker's line number Caretaker's line number Caretaker's line number Caretaker's line number Caretaker's line number Mother's/Caretaker's Line Number: Enter the mother's/primary caretaker's line number from the Household Questionnaire, column HL1 of the Household Listing. Children aged 0-4 Interviewer number Interviewer number Interviewer number Interviewer number Interviewer number Interviewer name and number: Enter your own name and identifying number. You will be provided with these identification numbers during training. Children aged 0-4 Day of interview Day of interview Day of interview Day of interview Day of interview Day/Month/Year of interview: Enter the date of the interview: day/month/year. If the interview is not completed on your first visit and you visit the household to interview the mother/caretaker again, revise and enter the final date of the interview. In other words, the date here should be the date when you have either completed the Questionnaire for Children Under Five, or when the interview was not conducted but when it was decided that there will be no more attempts to interview the mother or primary caretaker of the under-five child. Children aged 0-4 Month of interview Month of interview Month of interview Month of interview Month of interview Day/Month/Year of interview: Enter the date of the interview: day/month/year. If the interview is not completed on your first visit and you visit the household to interview the mother/caretaker again, revise and enter the final date of the interview. In other words, the date here should be the date when you have either completed the Questionnaire for Children Under Five, or when the interview was not conducted but when it was decided that there will be no more attempts to interview the mother or primary caretaker of the under-five child. Children aged 0-4 Year of interview Year of interview Year of interview Year of interview Year of interview Day/Month/Year of interview: Enter the date of the interview: day/month/year. If the interview is not completed on your first visit and you visit the household to interview the mother/caretaker again, revise and enter the final date of the interview. In other words, the date here should be the date when you have either completed the Questionnaire for Children Under Five, or when the interview was not conducted but when it was decided that there will be no more attempts to interview the mother or primary caretaker of the under-five child. Children aged 0-4 Result of interview for chidren under 5 Result of interview for chidren under 5 Result of interview for chidren under 5 Result of interview for chidren under 5 Result of interview for chidren under 5 Result of interview for children under 5 Complete this question once you have concluded the interview. Remember that the code refers to the mother or primary caretaker of the under-five child. Circle the code corresponding to the results of the interview. If the questionnaire is completed, circle '1' for 'Completed'. If you have not been able to contact the mother/primary caretaker after repeated visits, circle '2' for 'Not at home'. If the mother/primary caretaker refuses to be interviewed, circle '3' for 'Refused'. If you were able to only partly complete the questionnaire, circle '4' for 'Partly completed'. If the mother/primary caretaker is incapacitated, circle '5'. If you have not been able to complete this questionnaire for another reason, you should circle '6' for 'Other' and specify the reason in the space provided. Ask the mother/primary caretaker to collect all the birth certificates and health/ immunization cards she has for this child before you begin the interview. You will need these during the interview. Repeat greeting if not already read to this mother/primary caretaker: "WE ARE FROM (country-specific affiliation). WE ARE WORKING ON A PROJECT CONCERNED WITH FAMILY HEALTH AND EDUCATION. I WOULD LIKE TO TALK TO YOU ABOUT THIS. THE INTERVIEW WILL TAKE ABOUT (number) MINUTES. ALL THE INFORMATION WE OBTAIN WILL REMAIN STRICTLY CONFIDENTIAL AND YOUR ANSWERS WILL NEVER BE IDENTIFIED. ALSO, YOU ARE NOT OBLIGED TO ANSWER ANY QUESTION YOU DON'T WANT TO, AND YOU MAY WITHDRAW FROM THE INTERVIEW AT ANY TIME. MAY I START NOW?" As with similar sentences at the beginning of the Household Questionnaire and Questionnaire for Individual Women, you may change the wording of these introductory sentences as appropriate. You must make sure, however, to include the following when you are introducing yourself: The name of the implementing agency; the topic of the survey; the approximate duration of the interview; the issue of confidentiality; and with whom you would like to speak. If permission is given, begin the interview. If the respondent does not agree to continue, thank her/him and go to the next interview. Later, discuss the refusal with your supervisor; you or another person from the team may attempt to interview the respondent for a second time. This will depend on your description of the refusal. However, remember that the respondent's participation in the survey must be on a voluntary basis, and potential respondents must never be forced to participate. Children aged 0-4 1 Completed 2 Not at home 3 Refused 4 Partly completed 5 Incapacitated 6 Other Day of birth of child Day of birth of child Day of birth of child Day of birth of child Day of birth of child Repeat greeting if not already read to this respondent: We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. Also, you are not obliged to answer any question you don't want to, and you may withdraw from the interview at any time. May I start now? If permission is given, begin the interview. If the respondent does not agree to continue, thank him/her and go to the next interview. Discuss this result with your supervisor for a future revisit. Now I would like to ask you some questions about the health of each child under the age of 5 in your care, who lives with you now. Now I want to ask you about (NAME). In what month and year was (NAME) born? Probe: What is his/her birthday? If the mother/caretaker knows the exact birth date, also enter the day; otherwise, circle 98 for day. You will begin the interview with questions about the child's date of birth and age. These are two of the most important questions in the interview, since almost all analysis of the data depends on the child's exact age. While completed age in years is sufficient for women's interviews, we need to obtain accurate information on the child's age in months. This is necessary because some of the analysis of the information that you will be collecting can only be done on the basis of age in months. You will collect this information by learning the child's date of birth. It will then be possible to compare the date of interview with the date of birth of the child and, after the data is collected, calculate the child's age in months by comparing these two pieces of information. The questions on age and date of birth must be asked independently from similar questions on the Household Questionnaire and Questionnaire for Individual Women. The person you may be interviewing for this questionnaire may be the same woman you interviewed for the Questionnaire for Individual Women, and you may have obtained dates of birth of her children in that questionnaire. Also, you may have obtained the child's age in the Household Questionnaire. Even in such cases, you must ask these questions again. --- Note that you may modify the first sentence based on the number of children in the respondent's care. If this is the only child the respondent cares for, change the sentences to "NOW I WOULD LIKE TO ASK YOU SOME QUESTIONS ABOUT THE HEALTH OF (name). IN WHAT MONTH AND YEAR WAS (name) BORN?" Ask the mother or primary caretaker for the child's date of birth. Probe: "WHAT IS HIS/HER BIRTHDAY?" It is important to record the child's month and year of birth accurately. If the mother/primary caretaker knows the exact birth date, including the day, enter the day of birth. Otherwise, circle '98' for 'DK day'. You do not need to probe further for day of birth. Convert the month to a number as you have done before. Enter the number in the space provided. If the month or day contains only one digit, use a leading zero. For example, the month of March is coded as '03'. Note that you are not allowed to enter DK for month or year of birth. You have to obtain month and year of birth of the child. Since all MICS3 surveys will be conducted in 2005 or 2006, the year of birth of the child cannot be earlier than 2000 (for surveys in 2005) or 2001 (for surveys in 2006). If the mother/primary caretaker is unable to provide the date of birth information, ask whether she/he has any documentation such as an identification card, health card, horoscope, or a birth or baptismal certificate that might give the date of birth of the child. However, confirm with the respondent that the date of birth recorded on such documents is indeed correct. Children aged 0-4 97 Inconsistent 98 DK 99 Missing Month of birth of child Month of birth of child Month of birth of child Month of birth of child Month of birth of child Repeat greeting if not already read to this respondent: We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. Also, you are not obliged to answer any question you don't want to, and you may withdraw from the interview at any time. May I start now? If permission is given, begin the interview. If the respondent does not agree to continue, thank him/her and go to the next interview. Discuss this result with your supervisor for a future revisit. Now I would like to ask you some questions about the health of each child under the age of 5 in your care, who lives with you now. Now I want to ask you about (NAME). In what month and year was (NAME) born? Probe: What is his/her birthday? If the mother/caretaker knows the exact birth date, also enter the day; otherwise, circle 98 for day. You will begin the interview with questions about the child's date of birth and age. These are two of the most important questions in the interview, since almost all analysis of the data depends on the child's exact age. While completed age in years is sufficient for women's interviews, we need to obtain accurate information on the child's age in months. This is necessary because some of the analysis of the information that you will be collecting can only be done on the basis of age in months. You will collect this information by learning the child's date of birth. It will then be possible to compare the date of interview with the date of birth of the child and, after the data is collected, calculate the child's age in months by comparing these two pieces of information. The questions on age and date of birth must be asked independently from similar questions on the Household Questionnaire and Questionnaire for Individual Women. The person you may be interviewing for this questionnaire may be the same woman you interviewed for the Questionnaire for Individual Women, and you may have obtained dates of birth of her children in that questionnaire. Also, you may have obtained the child's age in the Household Questionnaire. Even in such cases, you must ask these questions again. --- Note that you may modify the first sentence based on the number of children in the respondent's care. If this is the only child the respondent cares for, change the sentences to "NOW I WOULD LIKE TO ASK YOU SOME QUESTIONS ABOUT THE HEALTH OF (name). IN WHAT MONTH AND YEAR WAS (name) BORN?" Ask the mother or primary caretaker for the child's date of birth. Probe: "WHAT IS HIS/HER BIRTHDAY?" It is important to record the child's month and year of birth accurately. If the mother/primary caretaker knows the exact birth date, including the day, enter the day of birth. Otherwise, circle '98' for 'DK day'. You do not need to probe further for day of birth. Convert the month to a number as you have done before. Enter the number in the space provided. If the month or day contains only one digit, use a leading zero. For example, the month of March is coded as '03'. Note that you are not allowed to enter DK for month or year of birth. You have to obtain month and year of birth of the child. Since all MICS3 surveys will be conducted in 2005 or 2006, the year of birth of the child cannot be earlier than 2000 (for surveys in 2005) or 2001 (for surveys in 2006). If the mother/primary caretaker is unable to provide the date of birth information, ask whether she/he has any documentation such as an identification card, health card, horoscope, or a birth or baptismal certificate that might give the date of birth of the child. However, confirm with the respondent that the date of birth recorded on such documents is indeed correct. Children aged 0-4 97 Inconsistent 98 DK 99 Missing Year of birth of child Year of birth of child Year of birth of child Year of birth of child Year of birth of child Repeat greeting if not already read to this respondent: We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. Also, you are not obliged to answer any question you don't want to, and you may withdraw from the interview at any time. May I start now? If permission is given, begin the interview. If the respondent does not agree to continue, thank him/her and go to the next interview. Discuss this result with your supervisor for a future revisit. Now I would like to ask you some questions about the health of each child under the age of 5 in your care, who lives with you now. Now I want to ask you about (NAME). In what month and year was (NAME) born? Probe: What is his/her birthday? If the mother/caretaker knows the exact birth date, also enter the day; otherwise, circle 98 for day. You will begin the interview with questions about the child's date of birth and age. These are two of the most important questions in the interview, since almost all analysis of the data depends on the child's exact age. While completed age in years is sufficient for women's interviews, we need to obtain accurate information on the child's age in months. This is necessary because some of the analysis of the information that you will be collecting can only be done on the basis of age in months. You will collect this information by learning the child's date of birth. It will then be possible to compare the date of interview with the date of birth of the child and, after the data is collected, calculate the child's age in months by comparing these two pieces of information. The questions on age and date of birth must be asked independently from similar questions on the Household Questionnaire and Questionnaire for Individual Women. The person you may be interviewing for this questionnaire may be the same woman you interviewed for the Questionnaire for Individual Women, and you may have obtained dates of birth of her children in that questionnaire. Also, you may have obtained the child's age in the Household Questionnaire. Even in such cases, you must ask these questions again. --- Note that you may modify the first sentence based on the number of children in the respondent's care. If this is the only child the respondent cares for, change the sentences to "NOW I WOULD LIKE TO ASK YOU SOME QUESTIONS ABOUT THE HEALTH OF (name). IN WHAT MONTH AND YEAR WAS (name) BORN?" Ask the mother or primary caretaker for the child's date of birth. Probe: "WHAT IS HIS/HER BIRTHDAY?" It is important to record the child's month and year of birth accurately. If the mother/primary caretaker knows the exact birth date, including the day, enter the day of birth. Otherwise, circle '98' for 'DK day'. You do not need to probe further for day of birth. Convert the month to a number as you have done before. Enter the number in the space provided. If the month or day contains only one digit, use a leading zero. For example, the month of March is coded as '03'. Note that you are not allowed to enter DK for month or year of birth. You have to obtain month and year of birth of the child. Since all MICS3 surveys will be conducted in 2005 or 2006, the year of birth of the child cannot be earlier than 2000 (for surveys in 2005) or 2001 (for surveys in 2006). If the mother/primary caretaker is unable to provide the date of birth information, ask whether she/he has any documentation such as an identification card, health card, horoscope, or a birth or baptismal certificate that might give the date of birth of the child. However, confirm with the respondent that the date of birth recorded on such documents is indeed correct. Children aged 0-4 9997 Inconsistent 9998 DK 9999 Missing Age of child Age of child Age of child Age of child Age of child How old was (NAME) at his/her last birthday? Record age in completed years. You will begin the interview with questions about the child's date of birth and age. These are two of the most important questions in the interview, since almost all analysis of the data depends on the child's exact age. While completed age in years is sufficient for women's interviews, we need to obtain accurate information on the child's age in months. This is necessary because some of the analysis of the information that you will be collecting can only be done on the basis of age in months. You will collect this information by learning the child's date of birth. It will then be possible to compare the date of interview with the date of birth of the child and, after the data is collected, calculate the child's age in months by comparing these two pieces of information. The questions on age and date of birth must be asked independently from similar questions on the Household Questionnaire and Questionnaire for Individual Women. The person you may be interviewing for this questionnaire may be the same woman you interviewed for the Questionnaire for Individual Women, and you may have obtained dates of birth of her children in that questionnaire. Also, you may have obtained the child's age in the Household Questionnaire. Even in such cases, you must ask these questions again. --- After having obtained the child's date of birth, ask the child's age in completed years, and record in the space provided. Remember, ages must refer to the last birthday. If the mother/primary caretaker does not know the current age of the child, try asking "HOW MANY YEARS AGO WAS (name) BORN?" You may help the respondent by relating the child's age to that of other children or to some important event or to the season of birth, by asking, for example, "HOW MANY WET SEASONS AGO WAS (name) BORN?" Ask UF10 and UF11 independently. Then, check for consistency between the date of birth and completed age. You have to be meticulous in checking for the consistency between the date of birth and age. You also have to be fairly quick in doing so. A good interviewer will perform the check without causing a lull in the conversation. Checking for consistency between date of birth (UF10) and completed age (UF11). After having obtained both date of birth and age, check for the consistency between the two. The child's age plus her year of birth must equal the year in which the child last had a birthday. Assuming that you were able to obtain a month and year of birth, you should check the consistency by following these steps: If the month of birth is before the month of interview (the child had his/her birthday this year), then her/his age plus her/his year of birth should equal the year of interview. . Example: A child who was born in October 2003, in a survey conducted in November 2005, should be age 2 (2003 + 2 = 2005). If the month of birth is after the month of interview (the child has not had his/her birthday this year), then her/his age plus year of birth should equal the previous year. . Example: A child who was born in December 2003, in a survey conducted in October 2005, should be age 1 (2003 + 1 = 2004). If the month of birth is the same as the month of interview, and the day of birth is not known, then a sum of either the current or the previous year is correct. . Example: A child born in November 2002, in a survey conducted in November 2005, could be age 3 or age 2. Probe further to see if the date of birth is correct and whether the child has completed age 2 or 3. If the month of birth is the same as the month of interview, and the day of birth is known, the sum of age and year of birth should equal the year of interview if the day of birth is before the day of interview, and the sum of age and year of birth should equal the previous year if the day of birth is after the day of interview. . Example: A child born on 8 February 2002, in an interview conducted on 15 February 2006, should be age four. A child born on 28 February 2002, in an interview conducted on 3 February 2006, should be age three, since this child will complete 4 full years on 28 February 2006. If you find that the date of birth and age are inconsistent, either the date of birth or the age, or both, are incorrect, and need to be corrected. Do not assume that one is more accurate than the other. Probe, using documents that may be available, dates of well-known events and ages of other children, of the respondent herself/himself, etc. Children aged 0-4 Child has birth certificate Child has birth certificate Child has birth certificate Child has birth certificate Child has birth certificate Does (name) have a birth certificate? May I see it? This question aims to provide an estimate of the extent of birth registration in your country. Respondents must be assured that the information about individual families will never be given to authorities, and that they cannot be identified in any way. Ask to see the birth certificate. Circle the appropriate corresponding code, noting whether or not the certificate was seen. If the child has a birth certificate and it was seen, circle '1' and skip to BR5. If the child does not have a birth certificate ('3'), or if the child has a birth certificate but the mother/primary caretaker is unable to show you the certificate ('2'), continue to the next question. Children aged 0-4 1 Yes, seen 2 Yes, not seen 3 No 8 DK 9 Missing Child registered Child registered Child registered Child registered Child registered BR2. Has (name's) birth been registered with the civil authorities? If no birth certificate is shown, ask: 1 Yes 2 No 8 DK 9 Missing Reason birth not registered Reason birth not registered Reason birth not registered Reason birth not registered Reason birth not registered Why is (name's) birth not registered? This question aims to elicit the reason for non-registration. Circle the code corresponding to the response. Note that although there might be more than one reason for not registering a child, we need to get only one response - the most important one according to the mother/primary caretaker. If the response is definitely not one of the pre-coded responses, circle '6' for 'Other' and specify the response in the space provided. Children aged 0-4 1 Costs too much 2 Must travel too far 3 Did not know it should be registered 4 Does not know where to register 6 Other 8 DK 9 Missing Know how to register birth Know how to register birth Know how to register birth Know how to register birth Know how to register birth . Do you know how to register your child's birth? 1 Yes 2 No 9 Missing Child attends early childhood education programme Child attends early childhood education programme Child attends early childhood education programme Child attends early childhood education programme Child attends early childhood education programme BR5. Check age of child in UF11: Child is 3 or 4 years old? Yes. Continue with BR6 No. Go to BR8 Does (name) attend any organized learning or early childhood education programme, such as a private or government facility, including kindergarten or community child care? If the child is 3 or 4 years old, check the box marked 'Yes' and continue on to BR6. If not (if the child is 0, 1 or 2 years old), check the box marked 'No' and skip to BR8. --- This question aims to find out if the child is participating in early learning activities. Baby-sitting or child-minding, even if done in a special place such as a day-care centre, does not qualify as such a programme unless it includes organized learning activities. You must ensure that the mother or primary caretaker understands the meaning of 'Early Childhood Education Programme', explaining it as instructed. Circle the appropriate code. Skip to BR8 if the answer to this question is 'No' or 'DK'. Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Hours attended education in last 7 days Hours attended education in last 7 days Hours attended education in last 7 days Hours attended education in last 7 days Hours attended education in last 7 days Within the last seven days, about how many hours did (name) attend? This question is asked if the child is attending an early childhood education programme. Record the estimated number of hours the child attended any organized learning or early childhood education programme in the last 7 days. Use a leading zero if necessary. Children aged 0-4 98 DK 99 Missing Books-Mother Books-Mother Books-Mother Books-Mother Books-Mother In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Read books or look at picture books with (name)? Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here. Children aged 0-4 ? Missing A Mother Books-Father Books-Father Books-Father Books-Father Books-Father In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Read books or look at picture books with (name)? Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here. Children aged 0-4 ? Missing B Father Books-Other Books-Other Books-Other Books-Other Books-Other In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Read books or look at picture books with (name)? Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here. Children aged 0-4 ? Missing X Other Books-No one Books-No one Books-No one Books-No one Books-No one In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Read books or look at picture books with (name)? Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here. Children aged 0-4 ? Missing Y No one Stories-Mother Stories-Mother Stories-Mother Stories-Mother Stories-Mother In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Tell stories to (name)? Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here. Children aged 0-4 ? Missing A Mother Stories-Father Stories-Father Stories-Father Stories-Father Stories-Father In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Tell stories to (name)? Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here. Children aged 0-4 ? Missing B Father Stories-Other Stories-Other Stories-Other Stories-Other Stories-Other In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Tell stories to (name)? Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here. Children aged 0-4 ? Missing X Other Stories-No one Stories-No one Stories-No one Stories-No one Stories-No one In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Tell stories to (name)? Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here. Children aged 0-4 ? Missing Y No one Songs-Mother Songs-Mother Songs-Mother Songs-Mother Songs-Mother In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Sing songs with (name)? Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here. Children aged 0-4 ? Missing A Mother Songs-Father Songs-Father Songs-Father Songs-Father Songs-Father In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Sing songs with (name)? Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here. Children aged 0-4 ? Missing B Father Songs-Other Songs-Other Songs-Other Songs-Other Songs-Other In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Sing songs with (name)? Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here. Children aged 0-4 ? Missing X Other Songs-No one Songs-No one Songs-No one Songs-No one Songs-No one In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Sing songs with (name)? Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here. Children aged 0-4 ? Missing Y No one Outside-Mother Outside-Mother Outside-Mother Outside-Mother Outside-Mother In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Take (name) outside the home, compound, yard or enclosure? Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here. Children aged 0-4 ? Missing A Mother Outside-Father Outside-Father Outside-Father Outside-Father Outside-Father In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Take (name) outside the home, compound, yard or enclosure? Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here. Children aged 0-4 ? Missing B Father Outside-Other Outside-Other Outside-Other Outside-Other Outside-Other In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Take (name) outside the home, compound, yard or enclosure? Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here. Children aged 0-4 ? Missing X Other Outside-No one Outside-No one Outside-No one Outside-No one Outside-No one In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Take (name) outside the home, compound, yard or enclosure? Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here. Children aged 0-4 ? Missing Y No one Play-Mother Play-Mother Play-Mother Play-Mother Play-Mother In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Play with (name)? Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here. Children aged 0-4 ? Missing A Mother Play-Father Play-Father Play-Father Play-Father Play-Father In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Play with (name)? Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here. Children aged 0-4 ? Missing B Father Play-Other Play-Other Play-Other Play-Other Play-Other In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Play with (name)? Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here. Children aged 0-4 ? Missing X Other Play-No one Play-No one Play-No one Play-No one Play-No one In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Play with (name)? Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here. Children aged 0-4 ? Missing Y No one Naming-Mother Naming-Mother Naming-Mother Naming-Mother Naming-Mother In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Spend time with (name) naming, counting, and/or drawing things? Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here. Children aged 0-4 ? Missing A Mother Naming-Father Naming-Father Naming-Father Naming-Father Naming-Father In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Spend time with (name) naming, counting, and/or drawing things? Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here. Children aged 0-4 ? Missing B Father Naming-Other Naming-Other Naming-Other Naming-Other Naming-Other In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Spend time with (name) naming, counting, and/or drawing things? Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here. Children aged 0-4 ? Missing X Other Naming-No one Naming-No one Naming-No one Naming-No one Naming-No one In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Spend time with (name) naming, counting, and/or drawing things? Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here. Children aged 0-4 ? Missing Y No one Recite Quran-Mother Recite Quran-Mother Recite Quran-Mother Recite Quran-Mother Recite Quran-Mother Recite religious verses? ? Missing A Mother Recite Quran-Father Recite Quran-Father Recite Quran-Father Recite Quran-Father Recite Quran-Father Recite religious verses? ? Missing B Father Recite Quran-Other Recite Quran-Other Recite Quran-Other Recite Quran-Other Recite Quran-Other Recite religious verses? ? Missing X Other Recite Quran-No one Recite Quran-No one Recite Quran-No one Recite Quran-No one Recite Quran-No one Recite religious verses? ? Missing Y No one Child ever received vitamin A Child ever received vitamin A Child ever received vitamin A Child ever received vitamin A Child ever received vitamin A Has (name) ever received a vitamin A capsule (supplement) like this one? Show capsule or dispenser for different doses - 100,000 IU for those 6-11 months old, 200,000 IU for those 12-59 months old This question asks if the child has received a vitamin A supplement. Show the capsule or dispenser you were given to help the caretaker remember. You may be instructed to show different capsules, 100,000 IU for children 6-11 months old and 200,000 IU for children 12-59 months old, asking the caretaker to identify the correct one. Circle the code corresponding to the response. If the child has never received a vitamin A supplement or the mother/caretaker does not know if he/she has ever received one, skip to the next module. Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Months ago child took last Vitamin A dose Months ago child took last Vitamin A dose Months ago child took last Vitamin A dose Months ago child took last Vitamin A dose Months ago child took last Vitamin A dose How many months ago did (name) take the last dose? If the answer to VA1 was 'Yes', record the number of months ago the last dose was given to the child. As you have done before, use a leading zero if necessary. If the child received the supplement during the 1-month period preceding the interview, record '00'. Circle '98' if the mother/primary caretaker does not know when the child took the last dose. Children aged 0-4 97 Inconsistent 98 DK 99 Missing Place child got last Vitamin A dose Place child got last Vitamin A dose Place child got last Vitamin A dose Place child got last Vitamin A dose Place child got last Vitamin A dose Where did (name) get this last dose? This question is meant to provide information for health programmes about where children are most likely to get their vitamin A dose. Circle the code corresponding to the answer given. If the dose was obtained during a routine visit to a health facility, circle '1'. If the child was taken to a health facility because she/he was sick, and the supplement was obtained during this visit, circle '2'. If vitamin A supplement was given during a National Immunization Campaign, circle '3'. If the supplement was obtained from a source not listed, write the description next to 'Other' and circle '6'. Children aged 0-4 1 On routine visit to health centre 2 Sick child visit to health centre 6 Other 8 DK 9 Missing Child ever been breastfed Child ever been breastfed Child ever been breastfed Child ever been breastfed Child ever been breastfed Has (name) ever been breastfed? This question asks if the child has ever been breastfed. It includes any breastfeeding experience of the child - not necessarily by the mother/primary caretaker. Circle the code corresponding to the response. Continue to the next question if the child was ever breastfed ('1'). If the child was never breastfed, circle 'No' and skip to BF3. Skip to BF3 in the case of a 'DK' response as well. Children aged 0-4 1 Yes 2 No 8 DK 9 Missing After how many hours after birth did statrt After how many hours after birth did statrt After how many hours after birth did statrt After how many hours after birth did statrt After how many hours after birth did statrt After how many hours after birth did breastfeeding start? 998 DK 999 Missing Did take colustrum Did take colustrum Did take colustrum Did take colustrum Did take colustrum Did (name) take colustrum? 1 Yes 2 No 8 DK 9 Missing Child still being breastfed Child still being breastfed Child still being breastfed Child still being breastfed Child still being breastfed Is he/she still being breastfed? 'Being breastfed' is defined as putting the child to the breast at least once a day. Circle the code corresponding to the response. Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Child received vitamin, mineral supplements or medicine Child received vitamin, mineral supplements or medicine Child received vitamin, mineral supplements or medicine Child received vitamin, mineral supplements or medicine Child received vitamin, mineral supplements or medicine Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Vitamin, mineral supplements or medicine? This question asks about what the child was fed in the preceding 24 hours. The purpose of this question is to determine what liquids or foods the child was given. Prompt by asking each listed item in turn, such as: "DID (name) RECEIVE VITAMIN OR MINERAL SUPPLEMENTS OR MEDICINE?" or "DID HE/SHE RECEIVE PLAIN WATER?" and so on through the list. Read each item aloud and record the response before proceeding to the next item. Use the local terms for these liquids or foods. Make sure that the respondent understands the question, particularly what is meant by 'since this time yesterday'. Specify to the mother/primary caretaker: mid-morning, mid-afternoon, etc., depending on the time of the interview. Circle the code corresponding to the response. If the mother/primary caretaker does not know the answer, repeat the question using other local words for the fluid or food. If the answer is still not known, circle '8' for 'DK' Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Child received plain water Child received plain water Child received plain water Child received plain water Child received plain water Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Plain water? This question asks about what the child was fed in the preceding 24 hours. The purpose of this question is to determine what liquids or foods the child was given. Prompt by asking each listed item in turn, such as: "DID (name) RECEIVE VITAMIN OR MINERAL SUPPLEMENTS OR MEDICINE?" or "DID HE/SHE RECEIVE PLAIN WATER?" and so on through the list. Read each item aloud and record the response before proceeding to the next item. Use the local terms for these liquids or foods. Make sure that the respondent understands the question, particularly what is meant by 'since this time yesterday'. Specify to the mother/primary caretaker: mid-morning, mid-afternoon, etc., depending on the time of the interview. Circle the code corresponding to the response. If the mother/primary caretaker does not know the answer, repeat the question using other local words for the fluid or food. If the answer is still not known, circle '8' for 'DK' Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Child received sweetened water or juice Child received sweetened water or juice Child received sweetened water or juice Child received sweetened water or juice Child received sweetened water or juice Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Sweetened, flavoured water or fruit juice or tea or infusion? This question asks about what the child was fed in the preceding 24 hours. The purpose of this question is to determine what liquids or foods the child was given. Prompt by asking each listed item in turn, such as: "DID (name) RECEIVE VITAMIN OR MINERAL SUPPLEMENTS OR MEDICINE?" or "DID HE/SHE RECEIVE PLAIN WATER?" and so on through the list. Read each item aloud and record the response before proceeding to the next item. Use the local terms for these liquids or foods. Make sure that the respondent understands the question, particularly what is meant by 'since this time yesterday'. Specify to the mother/primary caretaker: mid-morning, mid-afternoon, etc., depending on the time of the interview. Circle the code corresponding to the response. If the mother/primary caretaker does not know the answer, repeat the question using other local words for the fluid or food. If the answer is still not known, circle '8' for 'DK' Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Child received oral rehydration solution Child received oral rehydration solution Child received oral rehydration solution Child received oral rehydration solution Child received oral rehydration solution Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Oral rehydration solution (ORS)? This question asks about what the child was fed in the preceding 24 hours. The purpose of this question is to determine what liquids or foods the child was given. Prompt by asking each listed item in turn, such as: "DID (name) RECEIVE VITAMIN OR MINERAL SUPPLEMENTS OR MEDICINE?" or "DID HE/SHE RECEIVE PLAIN WATER?" and so on through the list. Read each item aloud and record the response before proceeding to the next item. Use the local terms for these liquids or foods. Make sure that the respondent understands the question, particularly what is meant by 'since this time yesterday'. Specify to the mother/primary caretaker: mid-morning, mid-afternoon, etc., depending on the time of the interview. Circle the code corresponding to the response. If the mother/primary caretaker does not know the answer, repeat the question using other local words for the fluid or food. If the answer is still not known, circle '8' for 'DK' Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Child received infant formula Child received infant formula Child received infant formula Child received infant formula Child received infant formula Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Infant formula? This question asks about what the child was fed in the preceding 24 hours. The purpose of this question is to determine what liquids or foods the child was given. Prompt by asking each listed item in turn, such as: "DID (name) RECEIVE VITAMIN OR MINERAL SUPPLEMENTS OR MEDICINE?" or "DID HE/SHE RECEIVE PLAIN WATER?" and so on through the list. Read each item aloud and record the response before proceeding to the next item. Use the local terms for these liquids or foods. Make sure that the respondent understands the question, particularly what is meant by 'since this time yesterday'. Specify to the mother/primary caretaker: mid-morning, mid-afternoon, etc., depending on the time of the interview. Circle the code corresponding to the response. If the mother/primary caretaker does not know the answer, repeat the question using other local words for the fluid or food. If the answer is still not known, circle '8' for 'DK' Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Child received milk Child received milk Child received milk Child received milk Child received milk Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Tinned, powdered or fresh milk? This question asks about what the child was fed in the preceding 24 hours. The purpose of this question is to determine what liquids or foods the child was given. Prompt by asking each listed item in turn, such as: "DID (name) RECEIVE VITAMIN OR MINERAL SUPPLEMENTS OR MEDICINE?" or "DID HE/SHE RECEIVE PLAIN WATER?" and so on through the list. Read each item aloud and record the response before proceeding to the next item. Use the local terms for these liquids or foods. Make sure that the respondent understands the question, particularly what is meant by 'since this time yesterday'. Specify to the mother/primary caretaker: mid-morning, mid-afternoon, etc., depending on the time of the interview. Circle the code corresponding to the response. If the mother/primary caretaker does not know the answer, repeat the question using other local words for the fluid or food. If the answer is still not known, circle '8' for 'DK' Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Child received other liquids Child received other liquids Child received other liquids Child received other liquids Child received other liquids Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Any other liquids? This question asks about what the child was fed in the preceding 24 hours. The purpose of this question is to determine what liquids or foods the child was given. Prompt by asking each listed item in turn, such as: "DID (name) RECEIVE VITAMIN OR MINERAL SUPPLEMENTS OR MEDICINE?" or "DID HE/SHE RECEIVE PLAIN WATER?" and so on through the list. Read each item aloud and record the response before proceeding to the next item. Use the local terms for these liquids or foods. Make sure that the respondent understands the question, particularly what is meant by 'since this time yesterday'. Specify to the mother/primary caretaker: mid-morning, mid-afternoon, etc., depending on the time of the interview. Circle the code corresponding to the response. If the mother/primary caretaker does not know the answer, repeat the question using other local words for the fluid or food. If the answer is still not known, circle '8' for 'DK' Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Child received solid or mushy food Child received solid or mushy food Child received solid or mushy food Child received solid or mushy food Child received solid or mushy food Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Solid or semi-solid (mushy) food? This question asks about what the child was fed in the preceding 24 hours. The purpose of this question is to determine what liquids or foods the child was given. Prompt by asking each listed item in turn, such as: "DID (name) RECEIVE VITAMIN OR MINERAL SUPPLEMENTS OR MEDICINE?" or "DID HE/SHE RECEIVE PLAIN WATER?" and so on through the list. Read each item aloud and record the response before proceeding to the next item. Use the local terms for these liquids or foods. Make sure that the respondent understands the question, particularly what is meant by 'since this time yesterday'. Specify to the mother/primary caretaker: mid-morning, mid-afternoon, etc., depending on the time of the interview. Circle the code corresponding to the response. If the mother/primary caretaker does not know the answer, repeat the question using other local words for the fluid or food. If the answer is still not known, circle '8' for 'DK' Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Time ate solid, semisolid or soft food other than liquids Time ate solid, semisolid or soft food other than liquids Time ate solid, semisolid or soft food other than liquids Time ate solid, semisolid or soft food other than liquids Time ate solid, semisolid or soft food other than liquids Check BF3H: Child received solid or semi-solid (mushy) food? Yes. Continue with BF5 No or DK. Go to Next Module Since this time yesterday, how many times did (NAME) eat solid, semisolid, or soft foods other than liquids? If 7 or more times, record '7'. If the child received solid or semi-solid (mushy) food (BF3H=1), check the box marked 'Yes' and continue to the next question. If 'No' or 'DK', check the corresponding box and go to the next module. --- In this question, we want to find out how many times the child was given non-liquid foods in the 24 hours prior to the interview. Record the number of times in the space provided. If the number is seven or more, record '7'. If the respondent does not know, circle '8'. Children aged 0-4 7 7+ 8 DK 9 Missing Did you recefed the infant formula Did you recefed the infant formula Did you recefed the infant formula Did you recefed the infant formula Did you recefed the infant formula Did you receive the infant formula share of your child (name) in the last month? 1 Yes 2 No 8 DK 9 Missing What do you do with infant formula What do you do with infant formula What do you do with infant formula What do you do with infant formula What do you do with infant formula What do you do with infant formulas? 1 Givet to the child 2 Givet to older children 3 Turn it into yougurt 4 Sell it 6 Other 9 Missing Do you prefered that the infant formula share Do you prefered that the infant formula share Do you prefered that the infant formula share Do you prefered that the infant formula share Do you prefered that the infant formula share Do you prefer that the infant formula share of (name) to be continued, stopped, or replaced with other food items in the monthly PDS? 1 Continue with formula 2 Stop it 3 Replace with other food 6 Other 8 DK 9 Missing Child had diarrhoea in last 2 weeks Child had diarrhoea in last 2 weeks Child had diarrhoea in last 2 weeks Child had diarrhoea in last 2 weeks Child had diarrhoea in last 2 weeks Has (name) had diarrhoea in the last two weeks, that is, since (day of the week) of the week before last? Diarrhoea is determined as perceived by mother or caretaker, or as three or more loose or watery stools per day, or blood in stool. These questions aim to find out if the child has recently had diarrhoea or any other illness and, if so, what treatments, drinks and foods the child took during the episode. Diarrhoea is determined by the perception of the mother or caretaker, or by three or more loose or watery stools per day, or by blood in stool. When asking this question, insert the name of the day of the interview. For example, if the interview is taking place on a Tuesday, ask: "HAS (name) HAD DIARRHOEA IN THE LAST TWO WEEKS, THAT IS, SINCE TUESDAY OF THE WEEK BEFORE LAST?" Record the mother's/primary caretaker's answer by circling the corresponding code. If a respondent is not sure what is meant by diarrhoea, tell her/him it means "THREE OR MORE LOOSE OR WATERY STOOLS PER DAY, OR BLOOD IN THE STOOL." Make sure the respondent understands what is meant by 'in the last 2 weeks'. If the child has not had diarrhoea in the last 2 weeks or the caretaker doesn't know, skip to CA5. Children aged 0-4 1 Yes 2 Yes without blood 3 No 8 DK 9 Missing Drank fluid made from special packet (ORS) Drank fluid made from special packet (ORS) Drank fluid made from special packet (ORS) Drank fluid made from special packet (ORS) Drank fluid made from special packet (ORS) During this last episode of diarrhoea, did (name) drink any of the following: Read each item aloud and record response before proceeding to the next item. A fluid made from a special packet called (local name for ORS packet solution)? We want to know if and what type of oral rehydration solution (ORS) the child took during the last episode of diarrhoea. Ask each question separately: "WAS (name) GIVEN A FLUID MADE FROM A SPECIAL PACKET CALLED (local name for ORS packet solution)? WAS HE/SHE GIVEN GOVERNMENT-RECOMMENDED HOMEMADE FLUID?" and so forth. Read each item aloud and circle the code corresponding to the response before proceeding to the next item. Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Plain water Plain water Plain water Plain water Plain water During this last episode of diarrhoea, did (name) drink any of the following: Read each item aloud and record response before proceeding to the next item. Plain water? We want to know if and what type of oral rehydration solution (ORS) the child took during the last episode of diarrhoea. Ask each question separately: "WAS (name) GIVEN A FLUID MADE FROM A SPECIAL PACKET CALLED (local name for ORS packet solution)? WAS HE/SHE GIVEN GOVERNMENT-RECOMMENDED HOMEMADE FLUID?" and so forth. Read each item aloud and circle the code corresponding to the response before proceeding to the next item. Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Rice water Rice water Rice water Rice water Rice water During this last episode of diarrhoea, did (name) drink any of the following: Read each item aloud and record response before proceeding to the next item. Rice water? We want to know if and what type of oral rehydration solution (ORS) the child took during the last episode of diarrhoea. Ask each question separately: "WAS (name) GIVEN A FLUID MADE FROM A SPECIAL PACKET CALLED (local name for ORS packet solution)? WAS HE/SHE GIVEN GOVERNMENT-RECOMMENDED HOMEMADE FLUID?" and so forth. Read each item aloud and circle the code corresponding to the response before proceeding to the next item. Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Vegetable soap Vegetable soap Vegetable soap Vegetable soap Vegetable soap During this last episode of diarrhoea, did (name) drink any of the following: Read each item aloud and record response before proceeding to the next item. Vegetable soup? 1 Yes 2 No 8 DK 9 Missing Yogurt drink Yogurt drink Yogurt drink Yogurt drink Yogurt drink During this last episode of diarrhoea, did (name) drink any of the following: Read each item aloud and record response before proceeding to the next item. Yoghurt drink? 1 Yes 2 No 8 DK 9 Missing Fruit juce Fruit juce Fruit juce Fruit juce Fruit juce During this last episode of diarrhoea, did (name) drink any of the following: Read each item aloud and record response before proceeding to the next item. Fruit juice? 1 Yes 2 No 8 DK 9 Missing Child drank less or more during illness Child drank less or more during illness Child drank less or more during illness Child drank less or more during illness Child drank less or more during illness During (name's) illness, did he/she drink much less, about the same, or more than usual? For those children who had diarrhoea in the past 2 weeks, 'illness' in this and the next question refers to the diarrhoea episode. Disregard any additional illness these children might have had. If dehydrated, a child may take more fluids than usual. We want to know if the pattern of fluid consumption changed during the illness. The focus in this question is on how much fluid was actually consumed by the child. Ask the question just as it is worded here. Read out the entire question and circle the appropriate code for the caretaker's response. Get the respondent's best judgement of the relative amount of total fluids actually consumed by the child. All fluids are included, not just special ones given during diarrhoea. For example, water, tea, fruit juice, breastmilk and formula are included as well as special fluids such as ORS. Try to find out what actually happened, not what the respondent thinks ought to have happened. An answer such as, "A child with diarrhoea (or 'a child who is ill') needs more fluids" is not satisfactory. You would need to ask, "BUT HOW MUCH DID YOUR CHILD ACTUALLY DRINK DURING THIS DIARRHOEA?" It may be difficult to estimate the relative amount of breastmilk taken by the child. The respondent may make an estimate based on whether the child nursed longer or more frequently. Children aged 0-4 1 Much less or none 2 About the same (or somewhat less) 3 More 8 DK 9 Missing Child ate less or more during illness Child ate less or more during illness Child ate less or more during illness Child ate less or more during illness Child ate less or more during illness During (name's) illness, did he/she eat less, about the same, or more food than usual? If "less", probe: Much less or a little less? During an episode of diarrhoea or other illness, a child may change the amount usually eaten. The focus in this question is on how much food was actually consumed by the child. Ask the question just as it is worded here. Read out the entire question and circle the code corresponding to the caretaker's response. Get the caretaker's best judgement of the relative amount of total food actually consumed by the child. Try to find out what actually happened, not what the caretaker thinks ought to have happened. An answer such as, "A child with diarrhoea (or 'a child who is ill') needs more food" is not satisfactory. You would need to ask, "BUT HOW MUCH DID YOUR CHILD ACTUALLY EAT DURING THIS DIARRHOEA?" If the caretaker replies that the child took only fluids (that is, the child did not 'eat'), circle '1' for 'None'. If the caretaker's answer is 'less than usual', probe by asking "MUCH LESS OR A LITTLE LESS?" to find out if she/he thinks the amount was 'much less' or 'somewhat less'. Then circle the appropriate code. If the mother/primary caretaker offered more food than usual, but the child ate much less, the answer is 'much less'; circle '2'. Make sure that the respondent understands that this includes breastmilk, if the child is still being breastfed. If the child is very young and the caretaker replies that he/she takes only fluids or breastmilk (that is, has not started 'eating' yet), there is no need to probe, since 'drinking' and 'eating' count as the same for this child. Circle the answer for this question (eating) that comes closest to the answer you circle for CA3 (drinking). Children aged 0-4 1 None 2 Much less 3 Somewhat less 4 About the same 5 More 8 DK 9 Missing Child ill with cough in last 2 weeks Child ill with cough in last 2 weeks Child ill with cough in last 2 weeks Child ill with cough in last 2 weeks Child ill with cough in last 2 weeks Has (name) had an illness with a cough at any time in the last two weeks, that is, since (day of the week) of the week before last? Illness with a cough means a cold or other acute respiratory illness with a cough. Circle the code corresponding to the response given. If the respondent says "He coughs all the time," or "She's been coughing for months," do not count this as an 'illness with a cough' since it is a chronic problem. If the answer is 'No' or 'DK', circle the appropriate code and go to CA12. If the symptoms started before but continued into the 2-week period, this counts as 'Yes'. Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Difficulty breathing during illness with cough Difficulty breathing during illness with cough Difficulty breathing during illness with cough Difficulty breathing during illness with cough Difficulty breathing during illness with cough When (name) had an illness with a cough, did he/she breathe faster than usual with short, quick breaths or have difficulty breathing? The question aims to find out if the child has or had an illness needing assessment by a health professional (as defined by the US Centers for Disease Control/Integrated Management of Childhood Illness programme). If the respondent asks "What do you mean by 'fast breathing'?" you may say "NOTICEABLY FASTER THAN NORMAL WHEN THE CHILD IS RESTED." If the respondent asks "What do you mean by 'difficulty breathing'?" you may say "THE CHILD SOUNDED/LOOKED AS IF HE/SHE WAS HAVING TROUBLE BREATHING." You may give other explanations that were developed and tested during the adaptation and pre-testing of the questionnaire. Circle the code corresponding to the response. If the answer is 'Yes', continue to the next question. Otherwise, skip to CA12. Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Symptoms due to problem in chest or blocked nose Symptoms due to problem in chest or blocked nose Symptoms due to problem in chest or blocked nose Symptoms due to problem in chest or blocked nose Symptoms due to problem in chest or blocked nose Were the symptoms due to a problem in the chest or a blocked nose? This question aims to find out if the problem needs assessment by a health professional, which does not include a simple cold. Circle the code corresponding to the caretaker's response. If the symptoms were from a 'Blocked nose', skip to CA12. If the symptoms were due to 'Other' reasons, write the respondent's description in the line provided, circle '6' and skip to CA12. Otherwise, continue to the next question. Children aged 0-4 1 Problem in chest 2 Blocked nose 3 Both 6 Other 8 DK 9 Missing Sought advice or teatment for illness Sought advice or teatment for illness Sought advice or teatment for illness Sought advice or teatment for illness Sought advice or teatment for illness Did you seek advice or treatment for the illness outside the home? 'Seeking care outside the home' means going outside the family or household for advice or treatment. Seeking care could include anything from asking a neighbour for advice, to holding a religious ceremony on the child's behalf, to going to a hospital. If a physician or other provider visits the household to give care, this counts as seeking care outside the home. The child may or may not have accompanied the respondent when he/she sought care. For example, going to buy medicine without the child counts as seeking care. Circle the code corresponding to the response given. If the answer is 'Yes', continue to the next question. Otherwise, skip to CA10. Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Place sought care: Govt Hospital Place sought care: Govt Hospital Place sought care: Govt Hospital Place sought care: Govt Hospital Place sought care: Govt Hospital From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response. Children aged 0-4 ? Missing A Govt. Hospital Place sought care: Govt Health centre Place sought care: Govt Health centre Place sought care: Govt Health centre Place sought care: Govt Health centre Place sought care: Govt Health centre From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response. Children aged 0-4 ? Missing B Govt. Health centre Place sought care: Govt Health post Place sought care: Govt Health post Place sought care: Govt Health post Place sought care: Govt Health post Place sought care: Govt Health post From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response. Children aged 0-4 ? Missing C Govt. health post Place sought care:Local helth care center Place sought care:Local helth care center Place sought care:Local helth care center Place sought care:Local helth care center Place sought care:Local helth care center From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response. Children aged 0-4 ? Missing D Village health worker Place sought care: Other public Place sought care: Other public Place sought care: Other public Place sought care: Other public Place sought care: Other public From where did you seek care? Anywhere else? ? Missing E Mobile/outreach clinic Place sought care: Private hospital/clinic Place sought care: Private hospital/clinic Place sought care: Private hospital/clinic Place sought care: Private hospital/clinic Place sought care: Private hospital/clinic From where did you seek care? Anywhere else? ? Missing I Private hospital/clinic Place sought care: Private physician Place sought care: Private physician Place sought care: Private physician Place sought care: Private physician Place sought care: Private physician From where did you seek care? Anywhere else? ? Missing J Private phisician Place sought care: Private pharmacy Place sought care: Private pharmacy Place sought care: Private pharmacy Place sought care: Private pharmacy Place sought care: Private pharmacy From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response. Children aged 0-4 ? Missing K Pharmacy Place sought care: Other private medical Place sought care: Other private medical Place sought care: Other private medical Place sought care: Other private medical Place sought care: Other private medical From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response. Children aged 0-4 ? Missing O Other private Place sought care: Relative or friend Place sought care: Relative or friend Place sought care: Relative or friend Place sought care: Relative or friend Place sought care: Relative or friend From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response. Children aged 0-4 ? Missing P Relative or friend Place sought care: Shop Place sought care: Shop Place sought care: Shop Place sought care: Shop Place sought care: Shop From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response. Children aged 0-4 ? Missing Q Shop Place sought care: Other Place sought care: Other Place sought care: Other Place sought care: Other Place sought care: Other From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response. Children aged 0-4 ? Missing X Other Why did you choose this facility Why did you choose this facility Why did you choose this facility Why did you choose this facility Why did you choose this facility Why did you choose the facility that you mainly go to? 1 Proximity 2 Familiarity 3 Cost 4 Safety 5 Told to do so 6 Refered for special care 7 Do not know of another 8 Do not have 9 Missing 96 other Who where your child medical needs address Who where your child medical needs address Who where your child medical needs address Who where your child medical needs address Who where your child medical needs address when you last went to thie facility that you mainly go to, were your child medical needs addressed or not? 1 Not well 2 Well 9 Missing Given medicine to treat this illness Given medicine to treat this illness Given medicine to treat this illness Given medicine to treat this illness Given medicine to treat this illness Was (name) given medicine to treat this illness? Circle the appropriate code. If the answer is 'Yes', continue to the next question. Otherwise, go to CA12. Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Antibiotic Antibiotic Antibiotic Antibiotic Antibiotic What medicine was (name) given? Circle all medicines given. This question aims to determine whether the child was given an antibiotic for the illness. More than one medicine may have been administered to the child. Circle the codes corresponding to all medicines given. If the respondent does not know the name of the medicine, ask him/her to show you the medicines. If he/she cannot show the packaged medicine, follow the guidelines provided to you during training. If the respondent names a medicine that is not listed, circle 'X' for 'Other' medicine and fill in the name of the medicine in the space provided. If you cannot determine the type of medicine given to the child with a cough, circle 'Z' for 'DK'. Children aged 0-4 ? Missing A Antibiotic Antipyretics Antipyretics Antipyretics Antipyretics Antipyretics What medicine was (name) given? ? Missing S Paracetamol/Panadol/Acetaminophen Decongestant Decongestant Decongestant Decongestant Decongestant What medicine was (name) given? ? Missing T Aspirin Antitusiv Antitusiv Antitusiv Antitusiv Antitusiv What medicine was (name) given? ? Missing U Ibuprofen Other Other Other Other Other What medicine was (name) given? Circle all medicines given. This question aims to determine whether the child was given an antibiotic for the illness. More than one medicine may have been administered to the child. Circle the codes corresponding to all medicines given. If the respondent does not know the name of the medicine, ask him/her to show you the medicines. If he/she cannot show the packaged medicine, follow the guidelines provided to you during training. If the respondent names a medicine that is not listed, circle 'X' for 'Other' medicine and fill in the name of the medicine in the space provided. If you cannot determine the type of medicine given to the child with a cough, circle 'Z' for 'DK'. Children aged 0-4 ? Missing X Other DK DK DK DK DK What medicine was (name) given? Circle all medicines given. This question aims to determine whether the child was given an antibiotic for the illness. More than one medicine may have been administered to the child. Circle the codes corresponding to all medicines given. If the respondent does not know the name of the medicine, ask him/her to show you the medicines. If he/she cannot show the packaged medicine, follow the guidelines provided to you during training. If the respondent names a medicine that is not listed, circle 'X' for 'Other' medicine and fill in the name of the medicine in the space provided. If you cannot determine the type of medicine given to the child with a cough, circle 'Z' for 'DK'. Children aged 0-4 ? Missing Z DK Where you able to get the prescription from the same facilit Where you able to get the prescription from the same facilit Where you able to get the prescription from the same facilit Where you able to get the prescription from the same facilit Where you able to get the prescription from the same facilit were you able to get all the prescriptions from the same facility? 1 Yes 2 No 9 Missing What was done to dispose of the stools What was done to dispose of the stools What was done to dispose of the stools What was done to dispose of the stools What was done to dispose of the stools Check UF11: Child aged under 3? Yes. Continue with CA13 No. Go to CA14 The last time (name) passed stools, what was done to dispose of the stools? CA13 is used to filter out children aged 3, 4 and 5 years, since the next question is to be asked only of children under age three. Check UF11; if the child is under three (he/she is 0, 1 or 2 years old), mark the box corresponding to 'Yes' and continue with the next question. If the child is not under three (she/he is 3, 4 or 5 years old), mark the box corresponding to 'No' and skip to CA14. --- The purpose of this question is to know what was done with the most recent stools passed by the child in the household. The safe disposal of children's stools is of particular importance because children's stools are the most likely cause of faecal contamination to the immediate household environment. Correct disposal of stools is linked with lower risks of diarrhoea. Respondents are asked where they usually dispose of their children's stools if the child did not use the toilet facility. Circle the most appropriate code. Children aged 0-4 1 Child used toilet/latrine 2 Put/rinsed into toilet or latrine 3 Put/rinsed into drain or ditch 4 Thrown into garbage (solid waste) 5 Buried 6 Left in the open 96 Other 98 DK 99 Missing Symptoms: Child not able to drink or breastfeed Symptoms: Child not able to drink or breastfeed Symptoms: Child not able to drink or breastfeed Symptoms: Child not able to drink or breastfeed Symptoms: Child not able to drink or breastfeed Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later. Children aged 0-4 ? Missing A Child not able to drink or breatfeed Symptoms: Child becomes sicker Symptoms: Child becomes sicker Symptoms: Child becomes sicker Symptoms: Child becomes sicker Symptoms: Child becomes sicker Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later. Children aged 0-4 ? Missing B Child becomes sicker Symptoms: Child develops a fever Symptoms: Child develops a fever Symptoms: Child develops a fever Symptoms: Child develops a fever Symptoms: Child develops a fever Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later. Children aged 0-4 ? Missing C Child develops a fever Symptoms: Child has faster breathing Symptoms: Child has faster breathing Symptoms: Child has faster breathing Symptoms: Child has faster breathing Symptoms: Child has faster breathing Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later. Children aged 0-4 ? Missing D Child has fast breathing Symptoms: Child has difficult breathing Symptoms: Child has difficult breathing Symptoms: Child has difficult breathing Symptoms: Child has difficult breathing Symptoms: Child has difficult breathing Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later. Children aged 0-4 ? Missing E Child has difficult breathing Symptoms: Child has blood in stool Symptoms: Child has blood in stool Symptoms: Child has blood in stool Symptoms: Child has blood in stool Symptoms: Child has blood in stool Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later. Children aged 0-4 ? Missing F Child has blood in stool Symptoms: Child is drinking poorly Symptoms: Child is drinking poorly Symptoms: Child is drinking poorly Symptoms: Child is drinking poorly Symptoms: Child is drinking poorly Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later. Children aged 0-4 ? Missing G Child is drinking poorly Symptoms: Child gets convulsions Symptoms: Child gets convulsions Symptoms: Child gets convulsions Symptoms: Child gets convulsions Symptoms: Child gets convulsions Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? ? Missing Symptoms: Child continuous vomiting Symptoms: Child continuous vomiting Symptoms: Child continuous vomiting Symptoms: Child continuous vomiting Symptoms: Child continuous vomiting Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? ? Missing Symptoms: Other Symptoms: Other Symptoms: Other Symptoms: Other Symptoms: Other Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later. Children aged 0-4 ? Missing X Other Symptoms: Other Symptoms: Other Symptoms: Other Symptoms: Other Symptoms: Other ? Missing Y Other Symptoms: Other Symptoms: Other Symptoms: Other Symptoms: Other Symptoms: Other Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later. Children aged 0-4 ? Missing Z Other Vaccination card for child Vaccination card for child Vaccination card for child Vaccination card for child Vaccination card for child If an immunization card is available, copy the dates in IM2-IM8 for each type of immunization or vitamin A dose recorded on the card. IM10-IM18 are for recording vaccinations that are not recorded on the card. IM10-IM18 will only be asked when a card is not available. Is there a vaccination card for (name)? If the respondent reports that there is a vaccination card for the child, ask to see it. You should have obtained vaccination cards at the beginning of the interview. If you did not already obtain the card for the child, now is the time to ask for it again. In some cases, the respondent may not be willing to take time to look for the vaccination card, thinking that you are in a hurry. Encourage the respondent to look for the vaccination card for the child. It is critical to obtain written documentation of the child's immunization history. Therefore, be patient if the respondent needs to search for the card. If the respondent does not have a vaccination card but the vaccine doses are registered in another document (for example, a booklet with records of clinic visits), ask to see it. If the card or other document is seen, circle '1' and continue to the next question. If the card or other document is not seen, circle '2' and skip to IM10 - you will be asking the respondent to recall the child's vaccinations. If the respondent does not have a vaccination card or any other document where the vaccine doses are registered for the child, circle '3' and skip to IM10. Children aged 0-4 1 Yes, seen 2 Yes, not seen 3 No 9 Missing Day of BCG immunization Day of BCG immunization Day of BCG immunization Day of BCG immunization Day of BCG immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization BCG You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 Not given 44 Marked on card - no date given 66 Reported by mother 99 Missing Month of BCG immunization Month of BCG immunization Month of BCG immunization Month of BCG immunization Month of BCG immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization BCG You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 99 Missing Year of BCG immunization Year of BCG immunization Year of BCG immunization Year of BCG immunization Year of BCG immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization BCG You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 9998 DK 9999 Missing Day of OPV0 immunization Day of OPV0 immunization Day of OPV0 immunization Day of OPV0 immunization Day of OPV0 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio at birth You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 Not given 44 Marked on card - no date given 66 Reported by mother 99 Missing Month of OPV0 immunization Month of OPV0 immunization Month of OPV0 immunization Month of OPV0 immunization Month of OPV0 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio at birth You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 99 Missing Year of OPV0 immunization Year of OPV0 immunization Year of OPV0 immunization Year of OPV0 immunization Year of OPV0 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio at birth You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 9998 DK 9999 Missing Day of OPV1 immunization Day of OPV1 immunization Day of OPV1 immunization Day of OPV1 immunization Day of OPV1 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 1 You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 Not given 44 Marked on card - no date given 66 Reported by mother 99 Missing Month of OPV1 immunization Month of OPV1 immunization Month of OPV1 immunization Month of OPV1 immunization Month of OPV1 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 1 You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 99 Missing Year of OPV1 immunization Year of OPV1 immunization Year of OPV1 immunization Year of OPV1 immunization Year of OPV1 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 1 You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 9998 DK 9999 Missing Day of OPV2 immunization Day of OPV2 immunization Day of OPV2 immunization Day of OPV2 immunization Day of OPV2 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 2 You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 Not given 44 Marked on card - no date given 66 Reported by mother 99 Missing Month of OPV2 immunization Month of OPV2 immunization Month of OPV2 immunization Month of OPV2 immunization Month of OPV2 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 2 You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 99 Missing Year of OPV2 immunization Year of OPV2 immunization Year of OPV2 immunization Year of OPV2 immunization Year of OPV2 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 2 You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 9998 DK 9999 Missing Day of OPV3 immunization Day of OPV3 immunization Day of OPV3 immunization Day of OPV3 immunization Day of OPV3 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 3 You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 Not given 44 Marked on card - no date given 66 Reported by mother 99 Missing Month of OPV3 immunization Month of OPV3 immunization Month of OPV3 immunization Month of OPV3 immunization Month of OPV3 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 3 You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 99 Missing Year of OPV3 immunization Year of OPV3 immunization Year of OPV3 immunization Year of OPV3 immunization Year of OPV3 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 3 You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 9998 DK 9999 Missing Day of DPT1 immunization Day of DPT1 immunization Day of DPT1 immunization Day of DPT1 immunization Day of DPT1 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 1 You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 Not given 44 Marked on card - no date given 66 Reported by mother 99 Missing Month of DPT1 immunization Month of DPT1 immunization Month of DPT1 immunization Month of DPT1 immunization Month of DPT1 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 1 You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 99 Missing Year of DPT1 immunization Year of DPT1 immunization Year of DPT1 immunization Year of DPT1 immunization Year of DPT1 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 1 You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 9998 DK 9999 Missing Day of DPT2 immunization Day of DPT2 immunization Day of DPT2 immunization Day of DPT2 immunization Day of DPT2 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 2 You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 Not given 44 Marked on card - no date given 66 Reported by mother 99 Missing Month of DPT2 immunization Month of DPT2 immunization Month of DPT2 immunization Month of DPT2 immunization Month of DPT2 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 2 You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 99 Missing Year of DPT2 immunization Year of DPT2 immunization Year of DPT2 immunization Year of DPT2 immunization Year of DPT2 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 2 You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 9998 DK 9999 Missing Day of DPT3 immunization Day of DPT3 immunization Day of DPT3 immunization Day of DPT3 immunization Day of DPT3 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 3 You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 Not given 44 Marked on card - no date given 66 Reported by mother 99 Missing Month of DPT3 immunization Month of DPT3 immunization Month of DPT3 immunization Month of DPT3 immunization Month of DPT3 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 3 You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 99 Missing Year of DPT3 immunization Year of DPT3 immunization Year of DPT3 immunization Year of DPT3 immunization Year of DPT3 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 3 You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 9998 DK 9999 Missing Day of HepB1 or DPTHepB1 immunization Day of HepB1 or DPTHepB1 immunization Day of HepB1 or DPTHepB1 immunization Day of HepB1 or DPTHepB1 immunization Day of HepB1 or DPTHepB1 immunization Not given 44 Marked on card - no date given 66 Reported by mother 99 Missing Month of HepB1 or DPThepB1 immunization Month of HepB1 or DPThepB1 immunization Month of HepB1 or DPThepB1 immunization Month of HepB1 or DPThepB1 immunization Month of HepB1 or DPThepB1 immunization 99 Missing Year of HepB1 or DPTHepB1 immunization Year of HepB1 or DPTHepB1 immunization Year of HepB1 or DPTHepB1 immunization Year of HepB1 or DPTHepB1 immunization Year of HepB1 or DPTHepB1 immunization 9998 DK 9999 Missing Day HepB2 or DPTHepB2 immunization Day HepB2 or DPTHepB2 immunization Day HepB2 or DPTHepB2 immunization Day HepB2 or DPTHepB2 immunization Day HepB2 or DPTHepB2 immunization Not given 44 Marked on card - no date given 66 Reported by mother 99 Missing Month of HepB2 or DPTHepB2 imunization Month of HepB2 or DPTHepB2 imunization Month of HepB2 or DPTHepB2 imunization Month of HepB2 or DPTHepB2 imunization Month of HepB2 or DPTHepB2 imunization 99 Missing Year of HepB2 or DPTHepB2 immunization Year of HepB2 or DPTHepB2 immunization Year of HepB2 or DPTHepB2 immunization Year of HepB2 or DPTHepB2 immunization Year of HepB2 or DPTHepB2 immunization 9998 DK 9999 Missing Day of DPTHepB3 or HepB3 immunization Day of DPTHepB3 or HepB3 immunization Day of DPTHepB3 or HepB3 immunization Day of DPTHepB3 or HepB3 immunization Day of DPTHepB3 or HepB3 immunization Not given 44 Marked on card - no date given 66 Reported by mother 99 Missing Month of DPTHepB3 or HepB3 ummunization Month of DPTHepB3 or HepB3 ummunization Month of DPTHepB3 or HepB3 ummunization Month of DPTHepB3 or HepB3 ummunization Month of DPTHepB3 or HepB3 ummunization 99 Missing Year of DPTHepB3 or HepB3 immunization Year of DPTHepB3 or HepB3 immunization Year of DPTHepB3 or HepB3 immunization Year of DPTHepB3 or HepB3 immunization Year of DPTHepB3 or HepB3 immunization 9998 DK 9999 Missing Day measles immunization Day measles immunization Day measles immunization Day measles immunization Day measles immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Measles (or MMR) You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 Not given 44 Marked on card - no date given 66 Reported by mother 99 Missing Month Measles immunization Month Measles immunization Month Measles immunization Month Measles immunization Month Measles immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Measles (or MMR) You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 99 Missing Year of Measles immunization Year of Measles immunization Year of Measles immunization Year of Measles immunization Year of Measles immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Measles (or MMR) You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 9998 DK 9999 Missing Day of MMR Day of MMR Day of MMR Day of MMR Day of MMR Not given 44 Marked on card - no date given 66 Reported by mother 99 Missing Month of MMR Month of MMR Month of MMR Month of MMR Month of MMR 99 Missing Year of MMR Year of MMR Year of MMR Year of MMR Year of MMR 9998 DK 9999 Missing Child received any other vaccinations Child received any other vaccinations Child received any other vaccinations Child received any other vaccinations Child received any other vaccinations In addition to the vaccinations and vitamin A capsules shown on this card, did (name) receive any other vaccinations - including vaccinations received in campaigns or immunization days? Record 'Yes' only if respondent mentions BCG, OPV 0-3, DPT 1-3, Hepatitis B 1-3, Measles, Yellow Fever vaccine(s), or Vitamin A supplements. (If yes, Probe for vaccinations and write '66' in the corresponding day column on IM2 to IM8B.) It is possible that some of the vaccinations received by the child were not recorded. For example, the respondent may have forgotten to bring the card to the health facility or the respondent may have taken (name) to a National Immunization Day. If the answer is 'Yes', circle '1' only if the respondent mentions vaccines included in the questionnaire. You can refer to the information already obtained from the vaccination card to make sure that the mother/primary caretaker is referring only to these vaccines. Write '66' in the corresponding 'Day' column for IM2-IM8B, and leave the month and year columns blank. For example, if two doses of DPT were recorded on the card, and another dose was given but not recorded, the answer to IM4C should be '66' in the 'Day' column. Do not ask the respondent to supply dates from memory. Enter a date only if the card or other document is available and lists a date for the immunization dose. Once you have probed for all vaccinations, skip to IM19. 1 Yes 2 No 8 DK 9 Missing Child ever received any vaccinations Child ever received any vaccinations Child ever received any vaccinations Child ever received any vaccinations Child ever received any vaccinations Has (name) ever received any vaccinations to prevent him/her from getting diseases, including vaccinations received in a campaign or immunization day? Questions IM10 through IM18 are asked only to mothers/primary caretakers of children who do not have vaccination cards, or those children for whom vaccination cards were not shown. --- Only ask IM10-18 to obtain the child's vaccination status if a vaccination card or other document is not available (that is, if the answer to IM1 was '2' for 'Yes, 'Not seen' or '3' for 'No'). Describe the vaccination techniques in detail to the caretaker and provide further explanations if needed. When mentioning the vaccines or the specific diseases, use local synonyms if needed. We are not interested in injections for treating a disease - antibiotics, antimalarials, etc. - but only in vaccines. Circle the code corresponding to the response. If the answer is 'Yes', continue to the next question, to start asking about each of the vaccines. If the answer is 'No' or 'DK', skip to IM19. Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Child ever given BCG vaccination Child ever given BCG vaccination Child ever given BCG vaccination Child ever given BCG vaccination Child ever given BCG vaccination Has (name) ever been given a BCG vaccination against tuberculosis - that is, an injection in the arm or shoulder that caused a scar? Questions IM10 through IM18 are asked only to mothers/primary caretakers of children who do not have vaccination cards, or those children for whom vaccination cards were not shown. --- Circle the code corresponding to the response. Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Child ever given Polio vaccination Child ever given Polio vaccination Child ever given Polio vaccination Child ever given Polio vaccination Child ever given Polio vaccination Has (name) ever been given any "vaccination drops in the mouth" to protect him/her from getting diseases - that is, polio? Questions IM10 through IM18 are asked only to mothers/primary caretakers of children who do not have vaccination cards, or those children for whom vaccination cards were not shown. --- Circle the code corresponding to the response. If the answer is 'Yes', continue to the next question. If the answer is 'No' or 'DK', skip to IM15. Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Polio first given just after birth or later Polio first given just after birth or later Polio first given just after birth or later Polio first given just after birth or later Polio first given just after birth or later How old was he/she when the first dose was given - just after birth (within two weeks) or later? Questions IM10 through IM18 are asked only to mothers/primary caretakers of children who do not have vaccination cards, or those children for whom vaccination cards were not shown. --- Ask how old the child was at first dose, prompting "JUST AFTER BIRTH OR LATER?" Circle the code corresponding to the response. Children aged 0-4 1 Just after birth (within 2 weeks) 2 Later 9 Missing Times child given Polio vaccination Times child given Polio vaccination Times child given Polio vaccination Times child given Polio vaccination Times child given Polio vaccination How many times has he/she been given these drops? Questions IM10 through IM18 are asked only to mothers/primary caretakers of children who do not have vaccination cards, or those children for whom vaccination cards were not shown. --- Fill in the number in the space provided. Children aged 0-4 98 Dk 99 Missing Child ever given DPT vaccination Child ever given DPT vaccination Child ever given DPT vaccination Child ever given DPT vaccination Child ever given DPT vaccination Has (name) ever been given "DPT vaccination injections" - that is, an injection in the thigh or buttocks - to prevent him/her from getting tetanus, whooping cough, diphtheria? (sometimes given at the same time as polio) Questions IM10 through IM18 are asked only to mothers/primary caretakers of children who do not have vaccination cards, or those children for whom vaccination cards were not shown. --- Circle the code corresponding to the response. If the answer is 'Yes', continue to the next question. If 'No' or 'DK', skip to IM17. Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Times child given DPT vaccination Times child given DPT vaccination Times child given DPT vaccination Times child given DPT vaccination Times child given DPT vaccination How many times? Questions IM10 through IM18 are asked only to mothers/primary caretakers of children who do not have vaccination cards, or those children for whom vaccination cards were not shown. --- Fill in the number in the space provided. Children aged 0-4 98 Dk 99 Missing Have ever been given Hb Have ever been given Hb Have ever been given Hb Have ever been given Hb Have ever been given Hb . Has (name) ever been given “HB vaccination injections” - that is, an injection in the thigh or buttocks - to prevent him/her from getting Hepatitis (use local term)? (sometimes given at the same time as DPT & polio) 1 Yes 2 No 8 DK 9 Missing How many times How many times How many times How many times How many times How many times? 98 Dk 99 Missing Child ever given Measles or MMR vaccination Child ever given Measles or MMR vaccination Child ever given Measles or MMR vaccination Child ever given Measles or MMR vaccination Child ever given Measles or MMR vaccination Has (name) ever been given "Measles vaccination injections" or MMR - that is, a shot in the arm at the age of 9 months or older - to prevent him/her from getting measles? Questions IM10 through IM18 are asked only to mothers/primary caretakers of children who do not have vaccination cards, or those children for whom vaccination cards were not shown. --- Circle the code corresponding to the response. If the caretaker specifically mentions measles vaccine but refers to an injection in the thigh, accept the answer as valid and circle '1' for 'Yes'. Children aged 0-4 1 Yes 2 No 8 DK 9 Missing Child participated in national immunization day A Child participated in national immunization day A Child participated in national immunization day A Child participated in national immunization day A Child participated in national immunization day A Please tell me if (name) has participated in any of the following campaigns, national immunization days and/or vitamin A or child health days: IM19a. polio campaign 19-23 june 2005 1 Yes 2 No 8 DK 9 Missing Child participated in national immunization day B Child participated in national immunization day B Child participated in national immunization day B Child participated in national immunization day B Child participated in national immunization day B Please tell me if (name) has participated in any of the following campaigns, national immunization days and/or vitamin A or child health days: IM19b. polio campaign 24-28 july 2005 1 Yes 2 No 8 DK 9 Missing Child participated in national immunization day C Child participated in national immunization day C Child participated in national immunization day C Child participated in national immunization day C Child participated in national immunization day C Please tell me if (name) has participated in any of the following campaigns, national immunization days and/or vitamin A or child health days: IM19c. MMR campaign May/april 2005 1 Yes 2 No 8 DK 9 Missing Does your child growth monitored Does your child growth monitored Does your child growth monitored Does your child growth monitored Does your child growth monitored Does your child's growth mon itored using a growth monitoring chart? MMR campaign in April or may 2005 includes children born in may 2000 to may 2004 for centre and south and children born in june 2000 to june 2004 for the north region (erbil, suleimaniyah, dohuk, kirkuk and mosul) includes children age 12 months to 5 complete years 1 Yes seen monitored in chart 2 No, not seen monitored in chart 3 Yes monitored but no card 4 No monitored but no card 8 DK 9 Missing Child weighted during the last 6 months Child weighted during the last 6 months Child weighted during the last 6 months Child weighted during the last 6 months Child weighted during the last 6 months Was your child weighted regularly at the health facility during the last 6 months? 1 Weighted reguerly 2 Weighted once ,not regularly 3 Not weighted at all 4 Did not visit a facility 8 Dk 9 Missing Child's weight (kilograms) Child's weight (kilograms) Child's weight (kilograms) Child's weight (kilograms) Child's weight (kilograms) After questionnaires for all children are complete, the measurer weighs and measures each child. Record weight and length/height below, taking care to record the measurements on the correct questionnaire for each child. Check the child's name and line number on the household listing before recording measurements. Child's weight. Weights and heights of all eligible children under five in the household will be measured after all the Questionnaires for Children Under Five are completed. However, if some respondents or children have to leave the household before all questionnaires in the household have been completed, or if a call-back has to be made to interview another respondent, it is best to complete the measurements on those children who are present. The most important thing is not to miss measuring those who are eligible. Measurement of heights and weights will normally be the responsibility of field editors. Each fieldwork team will have one set of measuring boards and weighing scales. Therefore, once you have completed the questionnaires and are ready to start anthropometric measurements, you should call upon field editors to join you in the household, together with the equipment. Although the field editor will be the main team member responsible for anthropometric measurements, you will also receive training on how to weigh and measure children. In some cases, the entrance of field editors to the household may not be possible; in such cases, you may yourself perform the measurements, with the assistance of the mother. Each child will be weighed and measured, and the results will be recorded in his/her questionnaire. Be sure the weight for each child is recorded on the correct questionnaire. Procedures for weight and height measurements are discussed in detail in Appendix Five. This section is confined to explaining how the results will be coded. --- The child should be weighed according to the instructions given during training. Record the result to the nearest tenth of a kilogram (100 grams). Place the kilograms to the left of the decimal point and grams to the right of the decimal point. Use a leading zero if the number of kilograms is one digit. Children aged 0-4 99.9 Missing Child measured lying or standing Child measured lying or standing Child measured lying or standing Child measured lying or standing Child measured lying or standing Child's length or height. Check age of child in UF11: Child under 2 years old. Measure length (lying down). Child age 2 or more years. Measure height (standing up). Weights and heights of all eligible children under five in the household will be measured after all the Questionnaires for Children Under Five are completed. However, if some respondents or children have to leave the household before all questionnaires in the household have been completed, or if a call-back has to be made to interview another respondent, it is best to complete the measurements on those children who are present. The most important thing is not to miss measuring those who are eligible. Measurement of heights and weights will normally be the responsibility of field editors. Each fieldwork team will have one set of measuring boards and weighing scales. Therefore, once you have completed the questionnaires and are ready to start anthropometric measurements, you should call upon field editors to join you in the household, together with the equipment. Although the field editor will be the main team member responsible for anthropometric measurements, you will also receive training on how to weigh and measure children. In some cases, the entrance of field editors to the household may not be possible; in such cases, you may yourself perform the measurements, with the assistance of the mother. Each child will be weighed and measured, and the results will be recorded in his/her questionnaire. Be sure the weight for each child is recorded on the correct questionnaire. Procedures for weight and height measurements are discussed in detail in Appendix Five. This section is confined to explaining how the results will be coded. --- Check the age of the child in UF11. If the child is under 2 years old, check the appropriate box, measure and record recumbent length (that is, lying down), to the nearest tenth of a centimetre. If the child is age two or older, check the corresponding box and then measure and record standing height. Write a zero first if the number of centimetres is two digits. Children aged 0-4 1 Lying down 2 Standing up 9 Missing Child's length or height Child's length or height Child's length or height Child's length or height Child's length or height Child's length or height. Check age of child in UF11: Child under 2 years old. Measure length (lying down). Child age 2 or more years. Measure height (standing up). Weights and heights of all eligible children under five in the household will be measured after all the Questionnaires for Children Under Five are completed. However, if some respondents or children have to leave the household before all questionnaires in the household have been completed, or if a call-back has to be made to interview another respondent, it is best to complete the measurements on those children who are present. The most important thing is not to miss measuring those who are eligible. Measurement of heights and weights will normally be the responsibility of field editors. Each fieldwork team will have one set of measuring boards and weighing scales. Therefore, once you have completed the questionnaires and are ready to start anthropometric measurements, you should call upon field editors to join you in the household, together with the equipment. Although the field editor will be the main team member responsible for anthropometric measurements, you will also receive training on how to weigh and measure children. In some cases, the entrance of field editors to the household may not be possible; in such cases, you may yourself perform the measurements, with the assistance of the mother. Each child will be weighed and measured, and the results will be recorded in his/her questionnaire. Be sure the weight for each child is recorded on the correct questionnaire. Procedures for weight and height measurements are discussed in detail in Appendix Five. This section is confined to explaining how the results will be coded. --- Check the age of the child in UF11. If the child is under 2 years old, check the appropriate box, measure and record recumbent length (that is, lying down), to the nearest tenth of a centimetre. If the child is age two or older, check the corresponding box and then measure and record standing height. Write a zero first if the number of centimetres is two digits. Children aged 0-4 999.9 Missing Measurer's identification code Measurer's identification code Measurer's identification code Measurer's identification code Measurer's identification code Result of measurement Result of measurement Result of measurement Result of measurement Result of measurement Result of measurement. Circle the appropriate code corresponding to the result of the measurement. If the reason is 'Other', write a description in the line provided and circle '6'. Children aged 0-4 1 Measured 2 Not present 3 Refused 6 Other 7 Inconsistent 9 Missing BCG found or not found ? BCG found or not found ? BCG found or not found ? BCG found or not found ? BCG found or not found ? Check the left shoulder (which is the normal location of the bcg injection) to identify BCG scar. 1 Yes: Seen 2 Not seen 3 No 8 Dk 9 Missing Height for age percentile Height for age percentile Height for age percentile Height for age percentile Height for age percentile Recoded variable Is (name) male or female? Children aged 0-4 Height for age z-score Height for age z-score Height for age z-score Height for age z-score Height for age z-score Recoded variable Is (name) male or female? Children aged 0-4 Height for age percent of reference median Height for age percent of reference median Height for age percent of reference median Height for age percent of reference median Height for age percent of reference median Recoded variable Is (name) male or female? Children aged 0-4 Weight for age percentile Weight for age percentile Weight for age percentile Weight for age percentile Weight for age percentile Recoded variable Is (name) male or female? Children aged 0-4 Weight for age z-score Weight for age z-score Weight for age z-score Weight for age z-score Weight for age z-score Recoded variable Is (name) male or female? Children aged 0-4 Weight for age percent of reference median Weight for age percent of reference median Weight for age percent of reference median Weight for age percent of reference median Weight for age percent of reference median Recoded variable Is (name) male or female? Children aged 0-4 Weight for height percentile Weight for height percentile Weight for height percentile Weight for height percentile Weight for height percentile Recoded variable Is (name) male or female? Children aged 0-4 Weight for height z-score Weight for height z-score Weight for height z-score Weight for height z-score Weight for height z-score Recoded variable Is (name) male or female? Children aged 0-4 Weight for height percent of reference median Weight for height percent of reference median Weight for height percent of reference median Weight for height percent of reference median Weight for height percent of reference median Recoded variable Is (name) male or female? Children aged 0-4 Flag for anthropometric indicators Flag for anthropometric indicators Flag for anthropometric indicators Flag for anthropometric indicators Flag for anthropometric indicators Recoded variable Is (name) male or female? Children aged 0-4 No flag 1 Height for age 2 Weight for height 3 Weight for height, Height for age 4 Weight for age 5 Weight for age, Height for age 6 Weight for age, Weight for height 7 Weight for age, Weight for height, Height for age Sex Sex Sex Sex Sex Children aged 0-4 1 Male 2 Female 9 Missing Highest level of school attended Highest level of school attended Highest level of school attended Highest level of school attended Highest level of school attended What is the highest level of school (name) attended? Children aged 0-4 Preschool/kindergarten 1 Primary 2 Secondary 3 Intermediat 4 Diplome 5 Bsc 6 Higher 7 Non-standard curriculum 8 DK 9 Missing Interviewer number Interviewer number Interviewer number Interviewer number Interviewer number Interviewer name and number: Enter your own name and identification number provided to you at the time of training. Households Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor name and number: Enter your supervisor's name and identification number. You will be provided with your supervisor's identification number as soon as you know who you will be working with. Households Day of interview Day of interview Day of interview Day of interview Day of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Month of interview Month of interview Month of interview Month of interview Month of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Year of interview Year of interview Year of interview Year of interview Year of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Area Area Area Area Area Circle the code for area of residence as instructed by your supervisor. This will have been pre-determined; you will not be required to assess whether the household is in an urban or rural area. Households 1 Urban 2 Rural Muhafaza Muhafaza Muhafaza Muhafaza Muhafaza Region: Circle the code for zone. Households 11 Duhuk 12 Nainwa 13 Sulimania 14 Kakuk 15 Arbil 21 Diala 22 Anbar 23 Baghdad 24 Babil 25 Karbala 26 Wasit 27 Salahaladin 28 Najaf 31 Qadisya 32 Almuthana 33 Thiqar 34 Misan 35 Albasrah Governate/Region Qadha Qadha Qadha Qadha Qadha Recoded variable Household District Result of HH interview Result of HH interview Result of HH interview Result of HH interview Result of HH interview After all questionnaires for the household have been completed, fill in the following information: Result of HH interview: If the Household Questionnaire is completed, circle '1' for 'Completed'. If you have not been able to contact the household after repeated visits, circle '2' for 'Not at home'. If the household refuses to be interviewed, circle '3' for 'Refused'. If you are unable to locate the household or if the dwelling is destroyed, circle '4' for 'HH not found/destroyed'. If you have not been able to complete the Household Questionnaire for another reason, you should circle '6' for 'Other' and specify the reason in the space provided. Some examples of 'Other' codes might be: the household respondent is incapacitated; the questionnaire is partly completed; adult household members were not found at home after repeated visits. Households 1 Completed 2 Not at home 3 Refused 4 HH not found/destroyed 6 Other Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent to HH questionnaire: Enter the name and line number (from the Household Listing, columns HL1 and HL2) of the respondent to the Household Questionnaire. Households 99 Missing Number of household members Number of household members Number of household members Number of household members Number of household members Total number of household members: Count the number of household members recorded in column HL1 of the Household Listing and enter the total here. Households Total eligible women Total eligible women Total eligible women Total eligible women Total eligible women No.of women eligible for interview: Enter the total number of women eligible for interview for the Questionnaire for Individual Women - you will copy this from the row for totals at the bottom of the Household Listing, for HL6. Households Women interviews completed Women interviews completed Women interviews completed Women interviews completed Women interviews completed No.of women questionnaires completed: Once all of the Questionnaires for Individual Women have been completed for a particular household, enter the number completed here. Households Total children under 5 Total children under 5 Total children under 5 Total children under 5 Total children under 5 No.of children under age 5: Enter the total number of children under five eligible for inclusion in the survey from the row for totals at the bottom of the Household Listing, for HL8. You will be using the Questionnaire for Children Under Five to interview the mothers or primary caretakers of these children. Households Child interviews completed Child interviews completed Child interviews completed Child interviews completed Child interviews completed No.of under-5 questionnaires completed: Once all of the Questionnaires for Children Under Five have been completed for a particular household, enter the number completed here. Households Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk: Leave this space blank. The data clerk will enter his/her number in the space provided. Households Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water What is the main source of drinking water for members of your household? The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): · '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. · '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. · '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. · '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. · '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. · '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. · '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. · '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). · '52' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof and stored in a container, tank or cistern until used. · '53' Berkad · '54' Rain water catchment (Balli) · '61' - A tanker-truck water source transports and sells water by means of a tanker truck. · '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. · '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. · '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. Households 11 Piped into dwelling 12 Piped into yard or plot 13 Public tap/standpipe 21 Tubewell/borehole 31 Protected well 32 Unprotected well 41 Protected spring 42 Unprotected spring 51 Rainwater collection 62 Tanker-truck 71 Cart with small tank/drum 81 Surface water 91 Bottled water 96 Other 99 Missing Main source of water used for other purposes (if bottled wat Main source of water used for other purposes (if bottled wat Main source of water used for other purposes (if bottled wat Main source of water used for other purposes (if bottled wat Main source of water used for other purposes (if bottled wat What is the main source of water used by your household for other purposes such as cooking and handwashing? The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): · '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. · '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. · '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. · '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. · '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. · '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. · '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. · '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). · '52' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof and stored in a container, tank or cistern until used. · '53' Berkad · '54' Rain water catchment (Balli) · '61' - A tanker-truck water source transports and sells water by means of a tanker truck. · '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. · '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. · '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. Households 11 Piped into dwelling 12 Piped into yard or plot 13 Public tap/standpipe 21 Tubewell/borehole 31 Protected well 32 Unprotected well 41 Protected spring 42 Unprotected spring 51 Rainwater collection 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 96 Other 99 Missing Time to get water and come back Time to get water and come back Time to get water and come back Time to get water and come back Time to get water and come back How long does it take to go there, get water, and come back? This question is used to find out how convenient the source of water is to the dwelling. Note that the question is asked for water sources coded as '13-81' and '96' in WS1, or water sources coded as '13-96' in WS2. Fill in the estimated time (in minutes, converting from hours, if necessary) it takes by the usual mode of transport to get to the water source, wait to get water, and get back to the dwelling. Use zero(s) preceding the number if less than 100 minutes (for example, '060' or '005'). Then continue to the next question. If the water source is on the dwelling premises or if water is delivered to the dwelling by a vendor, circle '995' for 'Water on premises' and skip to WS5. If the respondent does not know how long it takes, circle '998' and continue on to the next question. Households 995 On premises 998 DK 999 Missing Person fetching water Person fetching water Person fetching water Person fetching water Person fetching water Who usually goes to this source to fetch the water for your household? Probe: Is this person under age 15? What sex? Circle code that best describes this person. The purpose of this question is to find out the age and gender of the person who usually performs the task of hauling water. This will provide an understanding of whether water hauling responsibilities are given to members of a particular sex or age group. Probe: "IS THIS PERSON UNDER AGE 15? WHAT SEX IS THIS PERSON?" Circle the code that corresponds with the response or '8' if the respondent does not know. Adult refers to anyone age 15 or over, regardless of whether he/she is a household member. Child refers to anyone under the age of 15, regardless of whether he/she is a household member. Households 1 Adult woman 2 Adult man 3 Female child (under 15) 4 Male child (under 15) 8 DK 9 Missing Treat water to make safer for drinking Treat water to make safer for drinking Treat water to make safer for drinking Treat water to make safer for drinking Treat water to make safer for drinking Do you treat your water in any way to make it safer to drink? The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle '1' if 'Yes', and continue to the next question. If 'No' or 'DK' (Doesn't know'), circle '2' or '8', respectively, and skip to WS7. Households 1 Yes 2 No 8 DK 9 Missing Boil Boil Boil Boil Boil What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing A Boil Add bleach/chlorine Add bleach/chlorine Add bleach/chlorine Add bleach/chlorine Add bleach/chlorine What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing B Add bleach/chlorine Strain it through a cloth Strain it through a cloth Strain it through a cloth Strain it through a cloth Strain it through a cloth What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing C Strain it through a cloth Use water filter Use water filter Use water filter Use water filter Use water filter What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing D Use water filter Solar disinfection Solar disinfection Solar disinfection Solar disinfection Solar disinfection What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing E Solar disinfection Let it stand and settle Let it stand and settle Let it stand and settle Let it stand and settle Let it stand and settle What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing F Let it stand and settle Other Other Other Other Other What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing X Other DK DK DK DK DK What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing Z DK Main dirinking water source give reliable supply Main dirinking water source give reliable supply Main dirinking water source give reliable supply Main dirinking water source give reliable supply Main dirinking water source give reliable supply Does your main drinking water source give you a reliable supply, i mean daily, weekly, or less than weekly problems or almost no problems? 1 Yes 2 Problems, but less than weekly 3 Weekly 4 Daily 5 Not Applic 8 DK 9 Missing secondary source of dirinking water secondary source of dirinking water secondary source of dirinking water secondary source of dirinking water secondary source of dirinking water If your main source of drinking water supply fails, what is your secondary source of drinking water? 11 Piped into dwelling 12 Piped into yard or plot 13 Public tap/standpipe 21 Tubewell/borehole 31 Protected well 32 Unprotected well 41 Protected spring 42 Unprotected spring 51 Rainwater collection 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 82 Bottle 96 Other 99 Missing Kind of toilet facility Kind of toilet facility Kind of toilet facility Kind of toilet facility Kind of toilet facility What kind of toilet facility do members of your household usually use? If "flush" or "pour flush", probe: Where does it flush to? If necessary, ask permission to observe the facility. Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of this question is to obtain a measure of the cleanliness of the sanitary facility used by the household members. It may be necessary to observe the facility. If so, ask permission to do so. If the respondent answers or it is observed that the household members have no facilities or use the bush or field, enter '95' for 'No facilities or bush or field' and skip to the next module. If any of the flush or pour flush responses (11-15) are given, probe: "WHERE DOES IT FLUSH TO?" Circle the code corresponding to the response given. Definitions of various types of toilet facilities are as follows: A flush toilet uses a cistern or holding tank for flushing water and has a water seal, which is a U-shaped pipe, below the seat or squatting pan that prevents the passage of flies and odours. A pour flush toilet uses a water seal, but unlike a flush toilet, a pour flush toilet uses water poured by hand for flushing (no cistern is used). . '11' - A piped sewer system is a system of sewer pipes, also called sewerage, that is designed to collect human excreta (faeces and urine) and wastewater and remove them from the household environment. Sewerage systems consist of facilities for collection, pumping, treating and disposing of human excreta and wastewater. . '12' - A septic tank is an excreta collection device and is a water-tight settling tank normally located underground, away from the house or toilet. . '13' - A flush/pour flush to pit latrine refers to a system that flushes excreta to a hole in the ground. . '14' - A flush/pour flush to somewhere else refers to excreta being deposited in or nearby the household environment (not into pit, septic tank or sewer); excreta may be flushed to the street, yard/plot, drainage way or other location. . '15' - Flush to unknown place/not sure/DK where should be coded in cases when the respondent knows that the toilet facility is a flush toilet, but does not know where it flushes to. '21' - A ventilated improved pit latrine or VIP is a type of pit latrine that is ventilated by a pipe extending above the latrine roof. The open end of the vent pipe is covered with gauze mesh or fly-proof netting and the inside of the superstructure is kept dark. '22' - A pit latrine with slab uses a hole in the ground for excreta collection and has a squatting slab, platform or seat that is firmly supported on all sides, easy to clean and raised above the surrounding ground level to prevent surface water from entering the pit. '23' - A pit latrine without slab uses a hole in the ground for excreta collection and does not have a squatting slab, platform or seat. An open pit is a rudimentary hole in the ground where excreta is collected. '31' - A composting toilet is a toilet into which excreta and carbon-rich material are added (vegetable wastes, straw, grass, sawdust, ash) and special conditions maintained to produce inoffensive compost. '41' - Bucket refers to the use of a bucket or other container for the retention of faeces (and sometimes urine and anal cleaning material), which is periodically removed for treatment or disposal. '51' - A hanging toilet or hanging latrine is a toilet built over the sea, a river, or other body of water into which excreta drops directly. '95' - No facilities or bush or field includes excreta wrapped and thrown with garbage, the 'cat' method of burying excreta in dirt, defecation in the bush or field or ditch, and defecation into surface water (drainage channel, beach, river, stream or sea). Households 11 Flush to piped sewer system 12 Flush to septic tank 13 Flush to pit (latrine) 14 Flush to somewhere else 15 Flush to unknown place/not sure/DK where 21 Ventilated Improved Pit latrine (VIP) 22 Pit latrine with slab 23 Pit latrine without slab/open pit 31 Composting toilet 41 Bucket 51 Hanging toilet/hanging latrine 95 No facilities or bush or field 96 Other 99 Missing Toilet/sewage system working properly Toilet/sewage system working properly Toilet/sewage system working properly Toilet/sewage system working properly Toilet/sewage system working properly Is your toilet working properly, or there are daily, weekly or less than weekly problems? If the respondent replies 'no' try to assess how often they encounter problems. If they encounter problems occasionally such as a few times a month circle '2', if a few times a week circle '3' for daily problems circle '4'. If the household complains that it is only at certain times of year they do not have a reliable supply then circle 5'. If the household does not know circle '8'. Household 1 Yes 2 Occasional problems 3 Weekly problems 4 Daily problems 5 Not Applic 8 DK 9 Missing Is your toilet working properly Is your toilet working properly Is your toilet working properly Is your toilet working properly Is your toilet working properly Is the sewage system around your house working properly or there are daily, weekly or less than weekly problems? 1 Yes 2 Occasional problems 3 Weekly problems 4 Daily problems 5 Not Applic 8 DK 9 Missing Toilet facility shared Toilet facility shared Toilet facility shared Toilet facility shared Toilet facility shared Do you share this facility with other households? Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of the following two questions is to determine whether the household shares their sanitation facility with other households. The shared status of a sanitation facility is important because shared facilities can be less hygienic than facilities used by only a single household. Unhygienic conditions (faeces on the floor, seat or wall and flies) may discourage use of the facility. --- Circle the code corresponding to the response given. If 'No', go to the next module. Households 1 Yes 2 No 9 Missing Households using this toilet facility Households using this toilet facility Households using this toilet facility Households using this toilet facility Households using this toilet facility How many households in total use this toilet facility? Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of the following two questions is to determine whether the household shares their sanitation facility with other households. The shared status of a sanitation facility is important because shared facilities can be less hygienic than facilities used by only a single household. Unhygienic conditions (faeces on the floor, seat or wall and flies) may discourage use of the facility. --- The total number of households using this facility should include the household being interviewed. If less than ten households use this toilet facility, enter the number of households on the line provided. Circle '10' if ten or more households use this toilet facility. Note that '01' is not a valid response (since it means that this is the only this household that uses the facility; if that is the case, you should go back to WS8 and correct the response there). Circle '98' for 'DK' ('Doesn't know'). Households 10 Ten or more households 98 DK 99 Missing solid waste dispose solid waste dispose solid waste dispose solid waste dispose solid waste dispose How do you dispose your solid waste/ Garbage? 1 House to house collection 2 Street containers-open 3 Street containers-closed 4 Dump to open area 5 Burn 6 Compost 7 Bury 96 Other 99 Missing frequency of collection/emptying of streert containers frequency of collection/emptying of streert containers frequency of collection/emptying of streert containers frequency of collection/emptying of streert containers frequency of collection/emptying of streert containers What is the frequency of collection/ emptying of street containers? 1 Less than once in 2 weeks 2 Once in 2 weeks 3 Once a week 4 Twice a week or more 9 Missing Number of rooms for sleeping Number of rooms for sleeping Number of rooms for sleeping Number of rooms for sleeping Number of rooms for sleeping How many rooms in this household are used for sleeping? This information provides a measure of how crowded the house is, and reflects the socio-economic condition of the household. A room in this case refers to a special area with a permanent partition that is used for sleeping. It is not necessarily the number of rooms in the household that are called 'bedrooms', but rather how many rooms get used for sleeping on a regular basis. Exclude rooms that are used only for sleeping by visitors to the household, but include those rooms that may not be regular 'bedrooms' but may be regularly used by one or more of the household members for sleeping. Enter the number of rooms in this household that are used for sleeping. Households 99 Missing Main material of floor Main material of floor Main material of floor Main material of floor Main material of floor Main material of the dwelling floor: Record observation. Circle the correct code for the material of the dwelling floor based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the floor, record the main flooring material (the material that covers the largest amount of floor space). Households 11 Earth/sand 12 Dung 21 Wood planks 22 Palm/bamboo 23 Reeds 32 Vinyl or asphalt strips 33 Ceramic tiles 34 Cement 35 Carpet 96 Other 99 Missing Main material of roof Main material of roof Main material of roof Main material of roof Main material of roof Main material of the roof. Record observation. Circle the correct code for the material of the dwelling roof, based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the roof, record the main roofing material (the material that covers the largest amount of roof). Households 11 No roof 12 Thatch/palm leaf 13 Sod 21 Rustic mat 22 Palm/bamboo 23 Reeds 24 Wood Planks 31 Metal 32 Wood 33 Calamine/cement fiber 34 Ceramic tiles 35 Cement 36 Roofing shingles 96 Other 99 Missing Main material of wall Main material of wall Main material of wall Main material of wall Main material of wall Main material of the walls. Record observation. Circle the correct code for the material of the dwelling walls, based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the walls, record the main wall material (the material that covers the largest amount of wall space). Households 11 No walls 12 Cane/palm/trunks 13 Dirt 21 Bambo with mud 22 Stone with mud 23 Uncovered adobe 24 Plywood 25 Carton 26 Reused wood 27 Reeds 31 Cement 32 Stone with lime/cement 33 Bricks 34 Cement blocks 35 Covered adobe 36 Wood planks/shingles 37 Chinku tin 96 Other 99 Missing Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking What type of fuel does your household mainly use for cooking? Information on the type of fuel used for cooking is collected as another measure of the socio-economic status of the household. The use of some cooking fuels can also have adverse health consequences. Circle the code corresponding to the answer given. Remember that this question asks about fuel for cooking, not fuel for heating or lighting. If the household uses more than one fuel for cooking, find out which type of fuel is used most often. If electricity, liquid propane gas (LPG), natural gas, or biogas is mainly used, circle '01', '02', '03', or '04', respectively, and skip to HC8. If any fuel other than the pre-coded ones is reported as being the main fuel used for cooking, circle '96' and specify the type of fuel on the line provided. Definitions of some of the types of fuel are as follows: 'Biogas' includes gases produced by fermenting manure in an enclosed pit. 'Lignite' is a derivative of coal that produces more smoke when burned but produces less heat than coal. Households 1 Electricity 2 Liquid propane gas (LPG) 5 Kerosene 6 Coal/lignite 8 Wood 9 Straw/shrubs/grass 10 Animal dung 11 Agricultural crop residue 96 Other 99 Missing Cooking location Cooking location Cooking location Cooking location Cooking location Is the cooking usually done in the house, in a separate building, or outdoors? Circle the code corresponding to the response given. If a response is given other than the pre-coded ones, circle '6' and specify on the line provided. Households 1 In the house 2 In a separate bulding 3 Outdoors 6 Other 9 Missing Electricity Electricity Electricity Electricity Electricity Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR? Households 1 Yes 2 No 9 Missing Network Electric Network Electric Network Electric Network Electric Network Electric Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR? Households 1 Yes 2 No 9 Missing generator generator generator generator generator Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR? Households 1 Yes 2 No 9 Missing Radio Radio Radio Radio Radio Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR, VCD/DVD PLAYER, FAN? Households 1 Yes 2 No 9 Missing Televesion Televesion Televesion Televesion Televesion Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR? Households 1 Yes 2 No 9 Missing Mobile Phone Mobile Phone Mobile Phone Mobile Phone Mobile Phone Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Phone Phone Phone Phone Phone Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR? Households 1 Yes 2 No 9 Missing satellite dish satellite dish satellite dish satellite dish satellite dish Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Refregerator Refregerator Refregerator Refregerator Refregerator Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Watch Watch Watch Watch Watch Does your household have: This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR. Households 1 Yes 2 No 9 Missing Bicycle Bicycle Bicycle Bicycle Bicycle Does your household have: This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR. Households 1 Yes 2 No 9 Missing Motorcycle or scooter Motorcycle or scooter Motorcycle or scooter Motorcycle or scooter Motorcycle or scooter Does your household have: 1 Yes 2 No 9 Missing Animal-drawn cart Animal-drawn cart Animal-drawn cart Animal-drawn cart Animal-drawn cart Does your household have: This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR. Households 1 Yes 2 No 9 Missing Car or truck Car or truck Car or truck Car or truck Car or truck Does your household have: This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR. Households 1 Yes 2 No 9 Missing Boat with motor Boat with motor Boat with motor Boat with motor Boat with motor Does your household have: 1 Yes 2 No 9 Missing Area Area Area Area Area 1 Metrob1 2 Metrob2 3 Metro 4 Urban-other 5 Rural Area Area Area Area Area 1 Metropolitan 2 Urban-other 3 Rural Region Region Region Region Region 1 North 2 South/center Governorate Governorate Governorate Governorate Governorate 1 Dohuk 2 Nainwa 3 Sulimania 4 Karkuk 5 Erbil 6 Diala 7 Anbar 8 Babil 9 Karbala 10 Wasit 11 Salahaladin 12 Najaf 13 Qadisya 14 Almuthana 15 Thiqar 16 Misan 17 Albasrah 18 Baghdad children's sample weight children's sample weight children's sample weight children's sample weight children's sample weight Recoded variable Children aged 0-4 Date of interview child (CMC) Date of interview child (CMC) Date of interview child (CMC) Date of interview child (CMC) Date of interview child (CMC) Recoded variable Children aged 0-4 Date of birth (CMC) Date of birth (CMC) Date of birth (CMC) Date of birth (CMC) Date of birth (CMC) Recoded variable Children aged 0-4 Age (months) Age (months) Age (months) Age (months) Age (months) Recoded variable Children aged 0-4 Age Age Age Age Age Recoded variable Children aged 0-4 1 < 6 months 2 6-11 months 3 12-23 months 4 24-35 months 5 36-47 months 6 48-59 months Age Age Age Age Age Recoded variable Children aged 0-4 1 0-11 months 2 12-23 months 3 24-35 months 4 36-47 months 5 48-59 months Mother's education Mother's education Mother's education Mother's education Mother's education Recoded Variable Women age 15-49 1 None 2 Primary 3 Secondary 4 Non-standard curriculum 9 Missing/DK Cluster number Cluster number Cluster number Cluster number Cluster number We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. During this time I would like to speak with the household head and all mothers or others who take care of children in the household. May I start now? If permission is given, begin the interview. Cluster number: Enter the cluster number as instructed by your supervisor. Households Unique identifier for the cluster in which the household exists Household number Household number Household number Household number Household number Household number: Enter the household number as instructed by your supervisor. Households Line number Line number Line number Line number Line number Women aged 15-49 Birth History line number Birth History line number Birth History line number Birth History line number Birth History line number Type of birth Type of birth Type of birth Type of birth Type of birth WERE ANY OF THESE BIRTHS TWINS? If the woman responds that (name) was part of a twin or triplets etc circle '2' for multiple birth. For all other births circle '1' for single. Ever married women age 15-49 who have given birth 1 single 2 multiple Sex of child Sex of child Sex of child Sex of child Sex of child IS (name) A BOY OR A GIRL? Circle '1' for 'Male' and '2' for 'Female'. Do not guess the sex of the child from the name provided to you. When the woman is listing each birth she may indicate the sex at the same time, by saying “My son Ahmed,” for instance. In this case, you do not need to ask the sex again, since it is already obvious that the person is a male. However, when a name is mentioned that can be used for both males and females, never use your judgement. Even in cases when you think that the name would most likely be a male's (or a female's) name, have the respondent confirm the sex. Ever married women age 15-49 who have given birth 1 Boy 2 Girl 9 Missing Month of birth Month of birth Month of birth Month of birth Month of birth n what month and year was (name) born? If the woman knows the date of birth, write it in the appropriate spaces for 'Month' and 'Year'. You will need to convert the month into numbers. For this, January is '01', February is '02', March is '03', etc. If the month contains only one digit, use a leading zero to fill in the first space. For example, the month of March is coded as '03'. If she does not know the month of birth, circle '98' for 'DK month' and ask her for the year of her birth. If she knows the year, write it in the spaces for 'Year'. Try under all circumstances to obtain at least the year of birth. Only when it is absolutely impossible to even estimate the year of birth should you circle '9998' for 'DK year'. If she does not know the probe to clues that might indicate the age. Ask how old she was when she gave birth. Try to find out how long ago she got married or had her first child. You MUST fill in this information. Do not leave this blank. Ever married women age 15-49 who have given birth 98 Don't know 99 Missing Year of birth Year of birth Year of birth Year of birth Year of birth n what month and year was (name) born? Probe: What is his/her birthday? If the woman knows the date of birth, write it in the appropriate spaces for 'Month' and 'Year'. You will need to convert the month into numbers. For this, January is '01', February is '02', March is '03', etc. If the month contains only one digit, use a leading zero to fill in the first space. For example, the month of March is coded as '03'. If she does not know the month of birth, circle '98' for 'DK month' and ask her for the year of her birth. If she knows the year, write it in the spaces for 'Year'. Try under all circumstances to obtain at least the year of birth. Only when it is absolutely impossible to even estimate the year of birth should you circle '9998' for 'DK year'. If she does not know the probe to clues that might indicate the age. Ask how old she was when she gave birth. Try to find out how long ago she got married or had her first child. You MUST fill in this information. Do not leave this blank. Ever married women age 15-49 who have given birth 9998 DK Survival status of child Survival status of child Survival status of child Survival status of child Survival status of child IS (name) STILL ALIVE? Ever married women age 15-49 who have given birth 1 Yes 2 No 9 Missing Age of child on last birthday Age of child on last birthday Age of child on last birthday Age of child on last birthday Age of child on last birthday How old was (name) at his/her last birthday? Record age in completed years Ever married women age 15-49 who have given birth 98 DK 99 Missing Does child live at home Does child live at home Does child live at home Does child live at home Does child live at home IS (name) LIVING WITH YOU? Ever married women age 15-49 who have given birth 1 Yes 2 No 9 Missing Child's household listing line number Child's household listing line number Child's household listing line number Child's household listing line number Child's household listing line number Refer back to the household listing module in the household questionnaire and observe the line number of the child. Transfer this number into the column under BH8. If the child was not on the household list check again to make sure the child does not live in the household. If the woman confirms that the child lives elsewhere record '00'. Move to the next birth. If no more births go to BH11A Ever married women age 15-49 who have given birth 99 Missing Units of age at death Units of age at death Units of age at death Units of age at death Units of age at death How old was (name) when he/she died? If '1 YR', probe: How many months old was (Name)? This information is very important but interviewers must probe gently as women may not like talking about their dead children. Do not leave this question blank. Record the information in complete years if the child died after it was 2 year old, complete months if the infant died after it was one month old but not older than 2 years and complete days if the infant died before it reached a month old. Ever married women age 15-49 who have given birth 1 Days 2 Months 3 Years 9 Missing Number of age at death Number of age at death Number of age at death Number of age at death Number of age at death How old was (name) when he/she died? If '1 YR', probe: How many months old was (Name)? Ever married women age 15-49 who have given birth 98 Dk 99 Missing Live births between this child and previous child Live births between this child and previous child Live births between this child and previous child Live births between this child and previous child Live births between this child and previous child Where there any other live births between (name of previous birth) and (name Ever married women age 15-49 who have given birth 1 Yes 2 No 9 Missing Cluster number Cluster number Cluster number Cluster number Cluster number Ever married women age 15-49 who have given birth Household number Household number Household number Household number Household number Ever married women age 15-49 who have given birth Woman's line number Woman's line number Woman's line number Woman's line number Woman's line number Ever married women age 15-49 who have given birth Interviewer number Interviewer number Interviewer number Interviewer number Interviewer number Day of interview Day of interview Day of interview Day of interview Day of interview Month of interview Month of interview Month of interview Month of interview Month of interview Year of interview Year of interview Year of interview Year of interview Year of interview Result of women 's interview Result of women 's interview Result of women 's interview Result of women 's interview Result of women 's interview 1 Completed 2 Not at home 3 Refused 4 Partly completed 5 Incapacitated 6 Other Month of birth of woman Month of birth of woman Month of birth of woman Month of birth of woman Month of birth of woman In what month and year were you born? 97 Inconsistent 98 DK 99 Missing Year of birth of woman Year of birth of woman Year of birth of woman Year of birth of woman Year of birth of woman In what month and year were you born? Women age 15-49 9997 Inconsistent 9998 DK 9999 Missing Age of woman Age of woman Age of woman Age of woman Age of woman How old were you at your last birthday? Women age 15-49 Currently working Currently working Currently working Currently working Currently working Beside your house work, are you currently working? If yes, ask: do you work in the governoment or privatly? 1 Gov. office work 2 Gov. labor/physical work 3 Private. office work 4 Private. labor/physical work 5 Home based work 6 Other 7 DK 9 missing Have you ever attended school Have you ever attended school Have you ever attended school Have you ever attended school Have you ever attended school Have you ever attended school? Women age 15-49 1 Yes 2 No 9 Missing What is the highest level of school you attended What is the highest level of school you attended What is the highest level of school you attended What is the highest level of school you attended What is the highest level of school you attended What is the highest level of school you've reached? Women age 15-49 Preschool/kindergarten 1 Primary 2 Secondary 3 Intermediat 4 Diplome 5 Bsc 6 Higher 7 Non-standard curriculum 8 DK 9 Missing What is the highest grade completed at that level What is the highest grade completed at that level What is the highest grade completed at that level What is the highest grade completed at that level What is the highest grade completed at that level What is the highest grade you completed at that level? Women age 15-49 97 Inconsistent 98 DK 99 Missing Can read part of the sentence Can read part of the sentence Can read part of the sentence Can read part of the sentence Can read part of the sentence Now I would like you to read this sentence to me. Show sentences to respondent. If respondent cannot read whole sentence, probe: Can you read part of the sentence to me? Women age 15-49 1 Cannot read at all 2 Able to read only parts of sentence 3 Able to read whole sentence 4 Required language 5 Blind/visually impaired 9 Missing Currently married Currently married Currently married Currently married Currently married Are you currently married or living together with a man as if married? Women age 15-49 1 Yes, currently married 2 No,not married Age of husband/partner Age of husband/partner Age of husband/partner Age of husband/partner Age of husband/partner How old was your husband/partner on his last birthday? Ever married women age 15-49 98 DK 99 Missing Ever married Ever married Ever married Ever married Ever married Have you ever been married or lived together with a man? Women age 15-49 1 Yes, formerly married 2 No Marital status Marital status Marital status Marital status Marital status What is your marital status now: are you widowed, divorced or separated? Women age 15-49 1 Widowed 2 Divorced 3 Separated Married once or more than once Married once or more than once Married once or more than once Married once or more than once Married once or more than once Have you been married or lived with a man only once or more than once? Ever married women age 15-49 1 Only once 2 More than once 9 Missing Month of first union Month of first union Month of first union Month of first union Month of first union In what month and year did you first marry or start living with a man as if married? Ever married women age 15-49 97 Inconsistent 98 DK 99 Missing Year of first union Year of first union Year of first union Year of first union Year of first union In what month and year did you first marry or start living with a man as if married? Ever married women age 15-49 9997 Inconsistent 9998 DK 9999 Missing Age of first marraige Age of first marraige Age of first marraige Age of first marraige Age of first marraige How old were you when you started living with your first husband/partner? Ever married women age 15-49 97 Inconsistent 98 DK 99 Missing Was first husband a relative Was first husband a relative Was first husband a relative Was first husband a relative Was first husband a relative Before you got married, was your (first) husband related to you in any way? 1 Yes 2 No 9 Missing Kind of relative Kind of relative Kind of relative Kind of relative Kind of relative What type of relationship was it? 1 First cousion on father side 2 First cousion on mother side 3 Second cousion 4 Other blood relative 5 Relative by marriage Ever given birth Ever given birth Ever given birth Ever given birth Ever given birth Now i would like to ask about all the births you have had during your life. Have you ever given birth? If "No" probe by asking: I mean, to a child who ever breathed or cried or showed other signs of life - even if he or she lived only a few minutes or hours? Ever married women age 15-49 1 Yes 2 No Any sons or daughters living with you Any sons or daughters living with you Any sons or daughters living with you Any sons or daughters living with you Any sons or daughters living with you Do you have any sons or daughters to whom you have given birth who are now living with you? Ever married women age 15-49 1 Yes 2 No Sons living with you Sons living with you Sons living with you Sons living with you Sons living with you How many sons live with you? Ever married women age 15-49 Daughters living with you Daughters living with you Daughters living with you Daughters living with you Daughters living with you How many daughters live with you? Ever married women age 15-49 Any sons or daughters not living with you Any sons or daughters not living with you Any sons or daughters not living with you Any sons or daughters not living with you Any sons or daughters not living with you Do you have any sons or daughters to whom you have given birth who are alive but do not live with you? Ever married women age 15-49 1 Yes 2 No Sons not living with you Sons not living with you Sons not living with you Sons not living with you Sons not living with you How many sons are alive but do not live with you? Ever married women age 15-49 Daughters not living with you Daughters not living with you Daughters not living with you Daughters not living with you Daughters not living with you How many daughters are alive but do not live with you? Ever married women age 15-49 Ever had child who later died Ever had child who later died Ever had child who later died Ever had child who later died Ever had child who later died Have you ever given birth to a boy or girl who was born alive but later died? Ever married women age 15-49 1 Yes 2 No Boys dead Boys dead Boys dead Boys dead Boys dead How many boys have died? Ever married women age 15-49 Girls dead Girls dead Girls dead Girls dead Girls dead How many girls have died? Add the numbers of births reported in CM4, CM6 and CM8 and write the sum here, then check: If she says it is correct, check the box marked 'Yes' and continue to the next question. If she says 'No', first check your addition and then go back through the list to check with the respondent whether you have obtained the information correctly. For example, starting with CM4, you would ask: "YOU HAVE TWO SONS AND ONE DAUGHTER LIVING WITH YOU, IS THAT CORRECT?" Do the same for CM6 and CM8. Correct the answers and the sum mentioned in CM9 and then continue to the next question. Make sure to cancel the 'No' in CM10 and check 'Yes' after you have made the corrections. Ever married women age 15-49 Children ever born Children ever born Children ever born Children ever born Children ever born If the respondent's last birth occurred in the last 2 years, enter the name of the child on the line provided and check the box marked 'Yes'. Then continue with CM13. If the respondent's last birth did not occur in the last 2 years, check the box marked 'No' and go to the Marriage/Union module. Ever married women age 15-49 Any live births since last birth listed in birth history Any live births since last birth listed in birth history Any live births since last birth listed in birth history Any live births since last birth listed in birth history Any live births since last birth listed in birth history Have you had any live births since the birth of (Name of last birth)? Ever married women age 15-49 who have given birth 1 yes 2 no 9 missing Any pregnancies ended before term Any pregnancies ended before term Any pregnancies ended before term Any pregnancies ended before term Any pregnancies ended before term Some pregnancies end before full term as a miscarriage, while others may result in a stillbirth. have you had a miscarriage? This purpose of this question is to find out about miscarriages (not still births), therefore care should be taken to make sure the women understands that a miscarriage occurs before the baby is due i.e. before the full 9 months. If the woman reports she has never had a miscarriage proceed to BH15. Ever married women age 15-49 who have given birth 1 yes 2 no 9 missing Number of miscarriage/abortions Number of miscarriage/abortions Number of miscarriage/abortions Number of miscarriage/abortions Number of miscarriage/abortions In all how many pregnancies did you have that ended in a miscarriage? Ever married women age 15-49 who have given birth 98 dk 99 missing Ever had a still birth Ever had a still birth Ever had a still birth Ever had a still birth Ever had a still birth Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? Ever married women age 15-49 who have given birth 1 yes 2 no 9 missing Number of stillbirths Number of stillbirths Number of stillbirths Number of stillbirths Number of stillbirths Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? Ever married women age 15-49 who have given birth 98 DK 99 mising Live birth in last two years Live birth in last two years Live birth in last two years Live birth in last two years Live birth in last two years Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? Check BH4 of last birth: Did the woman's last birth occur within the last 2 years, that is, since (month of interview in 2004)? If child has died, take special care when referring to this child by name in the following modules. No live birth in last 2 years go to contraception and unmet needs module. Yes, live birth in last 2 years continue with CM13 Before last pregnancy, desired time to become pregnant Before last pregnancy, desired time to become pregnant Before last pregnancy, desired time to become pregnant Before last pregnancy, desired time to become pregnant Before last pregnancy, desired time to become pregnant Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? 1 Then 2 Later 3 No more 9 Missing Has immunization card Has immunization card Has immunization card Has immunization card Has immunization card Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? If a card is presented, use it to assist with answers to the following questions. 1 Yes (card seen) 2 Yes (card not seen) 3 No 8 DK 9 Missing Any tetanus toxoid injection during last pregnancy Any tetanus toxoid injection during last pregnancy Any tetanus toxoid injection during last pregnancy Any tetanus toxoid injection during last pregnancy Any tetanus toxoid injection during last pregnancy Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? 1 Yes 2 No 8 DK 9 Missing Doses of tetanus toxoid during last pregnancy Doses of tetanus toxoid during last pregnancy Doses of tetanus toxoid during last pregnancy Doses of tetanus toxoid during last pregnancy Doses of tetanus toxoid during last pregnancy Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? 98 DK 99 Missing Any tetanus toxoid injection before last pregnancy Any tetanus toxoid injection before last pregnancy Any tetanus toxoid injection before last pregnancy Any tetanus toxoid injection before last pregnancy Any tetanus toxoid injection before last pregnancy Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? 1 Yes 2 No 8 DK 9 Missing Doses of tetanus toxoid before last pregnancy Doses of tetanus toxoid before last pregnancy Doses of tetanus toxoid before last pregnancy Doses of tetanus toxoid before last pregnancy Doses of tetanus toxoid before last pregnancy Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? 98 DK 99 Missing Month last tetanus toxoid received Month last tetanus toxoid received Month last tetanus toxoid received Month last tetanus toxoid received Month last tetanus toxoid received Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? 97 Inconsistent 98 DK 99 Missing Year last tetanus toxoid received Year last tetanus toxoid received Year last tetanus toxoid received Year last tetanus toxoid received Year last tetanus toxoid received Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? Skip to next module only if year of injection is given. Otherwise, continue with TT8. 9997 Inconsistent 9998 DK 9999 Missing Years ago last tetanus toxoid received Years ago last tetanus toxoid received Years ago last tetanus toxoid received Years ago last tetanus toxoid received Years ago last tetanus toxoid received Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? 98 DK 99 Missing Antenatal care: Govt doctor Antenatal care: Govt doctor Antenatal care: Govt doctor Antenatal care: Govt doctor Antenatal care: Govt doctor Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? ? Missing A Govt doctor Antenatal care: Private doctor Antenatal care: Private doctor Antenatal care: Private doctor Antenatal care: Private doctor Antenatal care: Private doctor Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? ? Missing B Private doctor Antenatal care: Nursing Antenatal care: Nursing Antenatal care: Nursing Antenatal care: Nursing Antenatal care: Nursing Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? ? Missing C Nurse Antenatal care: Licensed Antenatal care: Licensed Antenatal care: Licensed Antenatal care: Licensed Antenatal care: Licensed Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? ? Missing D Licensed Antenatal care:Not licensed Antenatal care:Not licensed Antenatal care:Not licensed Antenatal care:Not licensed Antenatal care:Not licensed Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? ? Missing E Not licensed Antenatal care: Traditional birth attendant Antenatal care: Traditional birth attendant Antenatal care: Traditional birth attendant Antenatal care: Traditional birth attendant Antenatal care: Traditional birth attendant Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? ? Missing F Traditional birth attendance Antenatal care: RelativeLfriend Antenatal care: RelativeLfriend Antenatal care: RelativeLfriend Antenatal care: RelativeLfriend Antenatal care: RelativeLfriend Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? ? Missing G Relative/friend Antenatal care: Other Antenatal care: Other Antenatal care: Other Antenatal care: Other Antenatal care: Other Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? ? Missing X Other Antenatal care:No one Antenatal care:No one Antenatal care:No one Antenatal care:No one Antenatal care:No one Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? ? Missing Y No one How many months pregnant were you when you first How many months pregnant were you when you first How many months pregnant were you when you first How many months pregnant were you when you first How many months pregnant were you when you first How many months pregnant were you when you first received antenatal care for this pregnancy? 98 DK 99 Missing How many time did you receive care How many time did you receive care How many time did you receive care How many time did you receive care How many time did you receive care How manytimes did you receive antenatal care for this pregnancy? 98 DK 99 Missing Did you go mainly to a public facility Did you go mainly to a public facility Did you go mainly to a public facility Did you go mainly to a public facility Did you go mainly to a public facility Did you go mainly to a public or private facility to receive antenatal care? 1 Yes,public facility 2 Yes,Private facility 3 No 9 Missing Reason for choosing facility Reason for choosing facility Reason for choosing facility Reason for choosing facility Reason for choosing facility What is the reason you chose the facility that you mainly go to? 1 Proximitly 2 Familitariy 3 Cost 4 Safety 5 Told to do so 6 Referred for special care 7 Do not know of another 96 OTHER 99 Missing Were needs addresses Were needs addresses Were needs addresses Were needs addresses Were needs addresses When you last went to this facility, were you medical needs addressed or not? 1 needs addressed 2 needs not addressed 9 missing How many mnth pregnant when last received How many mnth pregnant when last received How many mnth pregnant when last received How many mnth pregnant when last received How many mnth pregnant when last received How many months pregnant were you when you last received antenatal care for this pregnancy? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. 98 DK 99 Missing Weighed Weighed Weighed Weighed Weighed As part of your antenatal care, were any of the following done at least once? Were you weighed? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. 1 Yes 2 No 9 Missing Blood pressure measured Blood pressure measured Blood pressure measured Blood pressure measured Blood pressure measured As part of your antenatal care, were any of the following done at least once? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. 1 Yes 2 No 9 Missing Urine sample Urine sample Urine sample Urine sample Urine sample As part of your antenatal care, were any of the following done at least once? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. 1 Yes 2 No 9 Missing Blood sample Blood sample Blood sample Blood sample Blood sample As part of your antenatal care, were any of the following done at least once? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. 1 Yes 2 No 9 Missing Did not feel the need to see anyone Did not feel the need to see anyone Did not feel the need to see anyone Did not feel the need to see anyone Did not feel the need to see anyone What are the reasons for not seeing anyone? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing A Did not feel the need to see anyone Not convinced by th asistance Not convinced by th asistance Not convinced by th asistance Not convinced by th asistance Not convinced by th asistance What are the reasons for not seeing anyone? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing B Not convinced by the assistance Financial not capable to see anyone Financial not capable to see anyone Financial not capable to see anyone Financial not capable to see anyone Financial not capable to see anyone What are the reasons for not seeing anyone? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing C Financially not capable to see anyone Difficulty in reaching the ANC center Difficulty in reaching the ANC center Difficulty in reaching the ANC center Difficulty in reaching the ANC center Difficulty in reaching the ANC center What are the reasons for not seeing anyone? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing D Diffculty in reaching the ANC center Non-availabilty of medicamentsl Non-availabilty of medicamentsl Non-availabilty of medicamentsl Non-availabilty of medicamentsl Non-availabilty of medicamentsl What are the reasons for not seeing anyone? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing E None-availability of medicaments Other(pecify) Other(pecify) Other(pecify) Other(pecify) Other(pecify) What are the reasons for not seeing anyone? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing X Other DK DK DK DK DK What are the reasons for not seeing anyone? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing z DK Assistance at delivery:Gov't Doctor Assistance at delivery:Gov't Doctor Assistance at delivery:Gov't Doctor Assistance at delivery:Gov't Doctor Assistance at delivery:Gov't Doctor Who assisted with the delivery of your last child (name)? Anyone else? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing A Doctor Assistance at delivery:Privat doctor Assistance at delivery:Privat doctor Assistance at delivery:Privat doctor Assistance at delivery:Privat doctor Assistance at delivery:Privat doctor Who assisted with the delivery of your last child (name)? Anyone else? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing B Private Doctor Assistance at delivery: Nurse/midwife Assistance at delivery: Nurse/midwife Assistance at delivery: Nurse/midwife Assistance at delivery: Nurse/midwife Assistance at delivery: Nurse/midwife Who assisted with the delivery of your last child (name)? Anyone else? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing C Nurse Assistance at delivery: Licensed Assistance at delivery: Licensed Assistance at delivery: Licensed Assistance at delivery: Licensed Assistance at delivery: Licensed Who assisted with the delivery of your last child (name)? Anyone else? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing D Licensed Assistance at delivery:Not licensed Assistance at delivery:Not licensed Assistance at delivery:Not licensed Assistance at delivery:Not licensed Assistance at delivery:Not licensed Who assisted with the delivery of your last child (name)? Anyone else? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing E Not licensed midwife Assistance at delivery: Traditional birth attendant Assistance at delivery: Traditional birth attendant Assistance at delivery: Traditional birth attendant Assistance at delivery: Traditional birth attendant Assistance at delivery: Traditional birth attendant Who assisted with the delivery of your last child (name)? Anyone else? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing F Traditional birth attendance Assistance at delivery: Relative/friend Assistance at delivery: Relative/friend Assistance at delivery: Relative/friend Assistance at delivery: Relative/friend Assistance at delivery: Relative/friend Who assisted with the delivery of your last child (name)? Anyone else? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing G Relative/friend Assistance at delivery: Other Assistance at delivery: Other Assistance at delivery: Other Assistance at delivery: Other Assistance at delivery: Other Who assisted with the delivery of your last child (name)? Anyone else? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing X Other Assistance at delivery: No one Assistance at delivery: No one Assistance at delivery: No one Assistance at delivery: No one Assistance at delivery: No one Who assisted with the delivery of your last child (name)? Anyone else? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. ? Missing Y No one Place of delivery Place of delivery Place of delivery Place of delivery Place of delivery Where did you give birth to (NAME)? The intent of this question is to identify births delivered in a health facility. If the woman gave birth in a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the place is in the public (run by the government) or private sector. If the place is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle '26'. Similarly, if the place is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle '36'. If the respondent answers that she delivered in another place not listed, write the description of the place in the space provided for 'Other' and circle '96'. Then write the name of the place in the space provided on the questionnaire 'Name of place' and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response. Places that are not health facilities, other than home, should also be coded as 'Other' and described. 11 Your home 12 Midwifes home 13 Other home 21 Government hospital 22 Government clinic/health center 26 Other public 31 Private hospital 32 Private clinic 36 Other private medical 96 Other 99 Missing Kind of delivered Kind of delivered Kind of delivered Kind of delivered Kind of delivered Was (name) delivered by caesarian section? 1 Yes 2 No 9 Missing Size of child at birth Size of child at birth Size of child at birth Size of child at birth Size of child at birth When your last child (name) was born, was he/she very large, larger than average, average, smaller than average, or very small? 1 Very large 2 Larger than average 3 Average 4 Smaller than average 5 Very small 8 DK 9 Missing Child weighed at birth Child weighed at birth Child weighed at birth Child weighed at birth Child weighed at birth Was (name) weighed at birth? 1 Yes 2 No 8 DK 9 Missing Weight from card or recall Weight from card or recall Weight from card or recall Weight from card or recall Weight from card or recall How much did (name) weigh? 1 Card 2 Recall 7 Inconsistent 9 Missing Weight at birth (Kilograms) Weight at birth (Kilograms) Weight at birth (Kilograms) Weight at birth (Kilograms) Weight at birth (Kilograms) How much did (name) weigh? 9.998 DK 9.999 Missing Gov doctor Gov doctor Gov doctor Gov doctor Gov doctor Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? ? Missing A Govt doctor Privat doctor Privat doctor Privat doctor Privat doctor Privat doctor Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? ? Missing B Private doctor Nurse Nurse Nurse Nurse Nurse Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? ? Missing C Nurse licensed licensed licensed licensed licensed Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? ? Missing D Midwife licensed Not licensed Not licensed Not licensed Not licensed Not licensed Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? ? Missing E Midwife not licensed Traditional birth attendant Traditional birth attendant Traditional birth attendant Traditional birth attendant Traditional birth attendant Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? ? Missing F Traditional birth attendant Community health worker Community health worker Community health worker Community health worker Community health worker Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? ? Missing G Community health worker Others Others Others Others Others Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? ? Missing X Other No one No one No one No one No one Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? ? Missing Y No one Attended a puplic or private facility Attended a puplic or private facility Attended a puplic or private facility Attended a puplic or private facility Attended a puplic or private facility Did you go to a public or private facility to receive post-natal checkup? 1 Yes,public facility 2 Yes,Private facility 3 No 9 Missing Prescribed a family planning method Prescribed a family planning method Prescribed a family planning method Prescribed a family planning method Prescribed a family planning method Where you prescribed a family planning method in the facility? 1 Yes 2 No 9 Missing Able to get prescription Able to get prescription Able to get prescription Able to get prescription Able to get prescription Were you able to get your presecription medicine at the same facility? 1 Yes 2 No 9 Missing Reason for no psot natal check up Reason for no psot natal check up Reason for no psot natal check up Reason for no psot natal check up Reason for no psot natal check up What was the main reason for not recieveing a post-natal checkup? 1 No complication 2 Able to manage 3 Unaware of importantance 4 Srevice not available 5 Costs too much 6 Too busy 7 Husband too busy 96 Other 99 Missing Did you receive a Vitamin A Did you receive a Vitamin A Did you receive a Vitamin A Did you receive a Vitamin A Did you receive a Vitamin A In the first 40 days after your last birth [the birth of name], did you receive a Vitamin A dose like this? 1 Yes 2 No 8 DK 9 Missing Ever breastfeed Ever breastfeed Ever breastfeed Ever breastfeed Ever breastfeed Did you ever breastfeed (name)? 1 Yes 2 No 9 Missing Time baby put to breast (unit) Time baby put to breast (unit) Time baby put to breast (unit) Time baby put to breast (unit) Time baby put to breast (unit) How long after birth did you first put (name) to the breast? Immediately 1 Hours 2 Days 9 Missing Time baby put to breast (number) Time baby put to breast (number) Time baby put to breast (number) Time baby put to breast (number) Time baby put to breast (number) How long after birth did you first put (name) to the breast? 98 DK 99 Missing Did you have fever Did you have fever Did you have fever Did you have fever Did you have fever Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you have 1 Yes 2 No 9 Missing Did you have trouble controlling urine Did you have trouble controlling urine Did you have trouble controlling urine Did you have trouble controlling urine Did you have trouble controlling urine Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you have 1 Yes 2 No 9 Missing Did you suffer from you are urinary tract infection Did you suffer from you are urinary tract infection Did you suffer from you are urinary tract infection Did you suffer from you are urinary tract infection Did you suffer from you are urinary tract infection Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you have 1 Yes 2 No 9 Missing Did you suffer from mastitis Did you suffer from mastitis Did you suffer from mastitis Did you suffer from mastitis Did you suffer from mastitis Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you have 1 Yes 2 No 9 Missing Did you suffer from offensive discharge Did you suffer from offensive discharge Did you suffer from offensive discharge Did you suffer from offensive discharge Did you suffer from offensive discharge Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you have 1 Yes 2 No 9 Missing Did you suffer from wound Did you suffer from wound Did you suffer from wound Did you suffer from wound Did you suffer from wound Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you have 1 Yes 2 No 9 Missing Did you suffer from hemorrhage Did you suffer from hemorrhage Did you suffer from hemorrhage Did you suffer from hemorrhage Did you suffer from hemorrhage Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you have 1 Yes 2 No 9 Missing Did you suffer from tear Did you suffer from tear Did you suffer from tear Did you suffer from tear Did you suffer from tear Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you have 1 Yes 2 No 9 Missing Did you suffer from post delivery depression Did you suffer from post delivery depression Did you suffer from post delivery depression Did you suffer from post delivery depression Did you suffer from post delivery depression Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you have 1 Yes 2 No 9 Missing Did you suffer from any other problems Did you suffer from any other problems Did you suffer from any other problems Did you suffer from any other problems Did you suffer from any other problems Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you have 1 Yes 2 No 9 Missing Currently pregnant Currently pregnant Currently pregnant Currently pregnant Currently pregnant Are you pregnant now? 1 Yes, currently pregnant 2 No 8 Unsure or DK 9 Missing Did you want to wait later or not want any more children Did you want to wait later or not want any more children Did you want to wait later or not want any more children Did you want to wait later or not want any more children Did you want to wait later or not want any more children At the time you became pregnant did you want to become pregnant then, did you want to wait until later, or did you not want to have any more children? 1 Then 2 Later 3 Not want more children 9 Missing Currently using a method to avoid pregnancy Currently using a method to avoid pregnancy Currently using a method to avoid pregnancy Currently using a method to avoid pregnancy Currently using a method to avoid pregnancy Some people use various ways or methods to delay or avoid a pregnancy. Are you currently doing something or using any method to delay or avoid getting pregnant? 1 Yes 2 No 9 Missing Desire to have childern Desire to have childern Desire to have childern Desire to have childern Desire to have childern What is the reason for not doing something or using any method to delay or avoid getting pregnant? ? Missing A Desire to have children Health reason Health reason Health reason Health reason Health reason What is the reason for not doing something or using any method to delay or avoid getting pregnant? ? Missing B Health reasons Religious reasons Religious reasons Religious reasons Religious reasons Religious reasons What is the reason for not doing something or using any method to delay or avoid getting pregnant? ? Missing C Religioous causes/reasons Husband not convinced Husband not convinced Husband not convinced Husband not convinced Husband not convinced What is the reason for not doing something or using any method to delay or avoid getting pregnant? ? Missing D Husband not convinced Wife not convinced Wife not convinced Wife not convinced Wife not convinced Wife not convinced What is the reason for not doing something or using any method to delay or avoid getting pregnant? ? Missing E Wife not convinced High price of contraceptives High price of contraceptives High price of contraceptives High price of contraceptives High price of contraceptives What is the reason for not doing something or using any method to delay or avoid getting pregnant? ? Missing F High price of contraceptives Other Other Other Other Other What is the reason for not doing something or using any method to delay or avoid getting pregnant? ? Missing X Others Current method: Female sterilization Current method: Female sterilization Current method: Female sterilization Current method: Female sterilization Current method: Female sterilization Which method are currently you using? ? Missing A Female sterilization Current method: Male sterilization Current method: Male sterilization Current method: Male sterilization Current method: Male sterilization Current method: Male sterilization Which method are currently you using? ? Missing B Male sterilization Current method: Pill Current method: Pill Current method: Pill Current method: Pill Current method: Pill Which method are currently you using? ? Missing C PILL Current method: IUD Current method: IUD Current method: IUD Current method: IUD Current method: IUD Which method are currently you using? ? Missing D IUD Current method: Injections Current method: Injections Current method: Injections Current method: Injections Current method: Injections Which method are currently you using? ? Missing E Injections Current method: Implants Current method: Implants Current method: Implants Current method: Implants Current method: Implants Which method are currently you using? ? Missing F Implants Current method: Condom Current method: Condom Current method: Condom Current method: Condom Current method: Condom Which method are currently you using? ? Missing G Condom Current method: Female condom Current method: Female condom Current method: Female condom Current method: Female condom Current method: Female condom Which method are currently you using? ? Missing H Female condom Current method: Diaphragm Current method: Diaphragm Current method: Diaphragm Current method: Diaphragm Current method: Diaphragm Which method are currently you using? ? Missing I Diaphragm Current method: Foam/jelly Current method: Foam/jelly Current method: Foam/jelly Current method: Foam/jelly Current method: Foam/jelly Which method are currently you using? ? Missing J Foam/Jelly Current method: Lactational amenorrhea method Current method: Lactational amenorrhea method Current method: Lactational amenorrhea method Current method: Lactational amenorrhea method Current method: Lactational amenorrhea method Which method are currently you using? ? Missing K Lactational amenorrhoea (LAM) Current method: Periodic abstinence Current method: Periodic abstinence Current method: Periodic abstinence Current method: Periodic abstinence Current method: Periodic abstinence Which method are currently you using? ? Missing L Periodic abstinence Current method: Withdrawal Current method: Withdrawal Current method: Withdrawal Current method: Withdrawal Current method: Withdrawal Which method are currently you using? ? Missing M Withdrawal Current method: Other Current method: Other Current method: Other Current method: Other Current method: Other Which method are currently you using? ? Missing X Other Source of method Source of method Source of method Source of method Source of method Where did you obtain (Current method) the last time? If the currently used method is Lactational amenorrhoea method (LAM) or Periodic abstinence or Withdrawal or other, ask: where/who described the method for you? 11 Govt hospital 12 Govt health center 13 Family planning clinc 16 Other public 21 Private hospital/clinic 22 Private phyician 23 Private pharmacy 24 Health worker 26 Medical 31 Relative or friend 32 Shop 33 Traditional practitioner 96 Other 98 DK 99 Missing Prefer to have or not to have any more children Prefer to have or not to have any more children Prefer to have or not to have any more children Prefer to have or not to have any more children Prefer to have or not to have any more children a. Now I would like to ask some questions about the future. Would you like to have (a/another) child, or would you prefer not to have any (more) children? b. If currently pregnant: Now I would like to ask some questions about the future. After the child you are now expecting, would you like to have another child, or would you prefer not to have any (more) children? 1 Have (a/another) child 2 No more /none 3 Says she cannot get pregnant 8 Undecided/don't know 9 Missing Desired waiting time (units) Desired waiting time (units) Desired waiting time (units) Desired waiting time (units) Desired waiting time (units) How long would you like to wait before the birth of (a/another) child? 1 Months 2 Years 9 Special Desired waiting time (number) Desired waiting time (number) Desired waiting time (number) Desired waiting time (number) Desired waiting time (number) How long would you like to wait before the birth of (a/another) child? 93 Soon/now 94 Says she cannot get pregnant 95 After marriage 96 Other 98 Don't know 99 Missing Able to get pregnant Able to get pregnant Able to get pregnant Able to get pregnant Able to get pregnant Do you think you are physically able to get pregnant at this time? 1 Yes 2 No 8 Don't know 9 Missing If she goes out with out telling him If she goes out with out telling him If she goes out with out telling him If she goes out with out telling him If she goes out with out telling him If she goes out with out telling him? 1 Yes 2 No 8 DK 9 Missing If she neclects the children If she neclects the children If she neclects the children If she neclects the children If she neclects the children If she neglects the children? 1 Yes 2 No 8 DK 9 Missing If she argues with him If she argues with him If she argues with him If she argues with him If she argues with him If she argues with him? 1 Yes 2 No 8 DK 9 Missing If she refuses sex with him If she refuses sex with him If she refuses sex with him If she refuses sex with him If she refuses sex with him If she refuses sex with him? 1 Yes 2 No 8 DK 9 Missing If she burns the food If she burns the food If she burns the food If she burns the food If she burns the food If she burns the food? 1 Yes 2 No 8 DK 9 Missing Ever heard of HIV or AIDS Ever heard of HIV or AIDS Ever heard of HIV or AIDS Ever heard of HIV or AIDS Ever heard of HIV or AIDS Have you ever heard of the virus HIV or an illness called AIDS? 1 Yes 2 No 9 Missing Can avoid AIDS by having one unifected partner Can avoid AIDS by having one unifected partner Can avoid AIDS by having one unifected partner Can avoid AIDS by having one unifected partner Can avoid AIDS by having one unifected partner Can people protect themselves from getting infected with the AIDS virus by having one sex partner who is not infected and also has no other partners? 1 Yes 2 No 8 DK 9 Missing Can avoid AIDS by witch creaft Can avoid AIDS by witch creaft Can avoid AIDS by witch creaft Can avoid AIDS by witch creaft Can avoid AIDS by witch creaft Can people get infected with the AIDS virus because of witchcraft or other supernatural means? 1 Yes 2 No 8 DK 9 Missing Can avoid by using condom Can avoid by using condom Can avoid by using condom Can avoid by using condom Can avoid by using condom Can people reduce their chance of getting the AIDS virus by using a condom every time they have sex? 1 Yes 2 No 8 DK 9 Missing Can avoid AIDS from mosquito Can avoid AIDS from mosquito Can avoid AIDS from mosquito Can avoid AIDS from mosquito Can avoid AIDS from mosquito Can people get the AIDS virus from mosquito bites? 1 Yes 2 No 8 DK 9 Missing Can avoid AIDS by not having sex Can avoid AIDS by not having sex Can avoid AIDS by not having sex Can avoid AIDS by not having sex Can avoid AIDS by not having sex Can people reduce their chance of getting infected with the AIDS virus by not having sex at all? 1 Yes 2 No 8 DK 9 Missing Can avoid AIDS by sharing food Can avoid AIDS by sharing food Can avoid AIDS by sharing food Can avoid AIDS by sharing food Can avoid AIDS by sharing food Can people get the AIDS virus by sharing food with a person who has AIDS? 1 Yes 2 No 8 DK 9 Missing Can avoid AIDS by getting injection Can avoid AIDS by getting injection Can avoid AIDS by getting injection Can avoid AIDS by getting injection Can avoid AIDS by getting injection Can people get the AIDS virus by getting injections with a needle that was already used by someone else? 1 Yes 2 No 8 DK 9 Missing Is it possible the healthy person have AIDS virus Is it possible the healthy person have AIDS virus Is it possible the healthy person have AIDS virus Is it possible the healthy person have AIDS virus Is it possible the healthy person have AIDS virus Is it possible for a healthy-looking person to have the AIDS virus? 1 Yes 2 No 8 DK 9 Missing During pregnancy During pregnancy During pregnancy During pregnancy During pregnancy Can the AIDS virus be transmitted from a mother to a baby? During pregnancy? 1 Yes 2 No 8 DK 9 Missing During delivary During delivary During delivary During delivary During delivary Can the AIDS virus be transmitted from a mother to a baby? During delivery? 1 Yes 2 No 8 DK 9 Missing By breastfeeding By breastfeeding By breastfeeding By breastfeeding By breastfeeding Can the AIDS virus be transmitted from a mother to a baby? By breastfeeding? 1 Yes 2 No 8 DK 9 Missing If a female teacher has a virus If a female teacher has a virus If a female teacher has a virus If a female teacher has a virus If a female teacher has a virus If a female teacher has the AIDS virus but is not sick, should she be allowed to continue teaching in school? 1 Yes 2 No 8 DK 9 Missing Would you buy fresh vegetables Would you buy fresh vegetables Would you buy fresh vegetables Would you buy fresh vegetables Would you buy fresh vegetables Would you buy fresh vegetables from a shopkeeper or vendor if you knew that this person had the AIDS virus? 1 Yes 2 No 8 DK 9 Missing Want it to be secret Want it to be secret Want it to be secret Want it to be secret Want it to be secret If a member of your family became infected with the AIDS virus, would you want it to remain a secret? 1 Yes 2 No 8 DK 9 Missing Willing to care for him or her in your household Willing to care for him or her in your household Willing to care for him or her in your household Willing to care for him or her in your household Willing to care for him or her in your household If a member of your family became sick with the AIDS virus, would you be willing to care for him or her in your household? 1 Yes 2 No 8 DK 9 Missing Had HIV test Had HIV test Had HIV test Had HIV test Had HIV test I do not want to know the results, but have you ever been tested to see if you have HIV, the virus that causes AIDS? 1 Yes 2 No 8 DK 9 Missing Have you been told the result Have you been told the result Have you been told the result Have you been told the result Have you been told the result I do not want you to tell me the results of the test, but have you been told the results? 1 Yes 2 No 9 Missing Did you yourself ask for the test Did you yourself ask for the test Did you yourself ask for the test Did you yourself ask for the test Did you yourself ask for the test Did you, yourself, ask for the test, was it offered to you and you accepted, or was it required? 1 Asked for the test 2 offered and accepted 3 Required 9 Missing Know of a testing place Know of a testing place Know of a testing place Know of a testing place Know of a testing place At this time, do you know of a place where you can go to get such a test to see if you have the AIDS virus? A. If tested for HIV during antenatal care: Other than at the antenatal clinic, do you know of a place where you can go to get a test to see if you have the AIDS virus? 1 Yes 2 No 9 Missing What is the best method What is the best method What is the best method What is the best method What is the best method In your opinion, What is the best method to be used to increase public knowledge about HIV/AIDS? 11 School curriculum 12 TV messages 13 Radio messages 14 Newspapers 15 Banners 16 Healthh education 96 Others 99 Missing Partner should be examined even if he has no symptoms Partner should be examined even if he has no symptoms Partner should be examined even if he has no symptoms Partner should be examined even if he has no symptoms Partner should be examined even if he has no symptoms In case of someone was infected with a sexually transmitted diseases, do you think that the other partner (husband) should be tested even if he has no symptoms? 1 Yes 2 No 8 DK 9 Missing Interviewer number Interviewer number Interviewer number Interviewer number Interviewer number Interviewer name and number: Enter your own name and identification number provided to you at the time of training. Households Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor name and number: Enter your supervisor's name and identification number. You will be provided with your supervisor's identification number as soon as you know who you will be working with. Households Day of interview Day of interview Day of interview Day of interview Day of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Month of interview Month of interview Month of interview Month of interview Month of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Year of interview Year of interview Year of interview Year of interview Year of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Area Area Area Area Area Circle the code for area of residence as instructed by your supervisor. This will have been pre-determined; you will not be required to assess whether the household is in an urban or rural area. Households 1 Urban 2 Rural Muhafaza Muhafaza Muhafaza Muhafaza Muhafaza Region: Circle the code for zone. Households 11 Duhuk 12 Nainwa 13 Sulimania 14 Kakuk 15 Arbil 21 Diala 22 Anbar 23 Baghdad 24 Babil 25 Karbala 26 Wasit 27 Salahaladin 28 Najaf 31 Qadisya 32 Almuthana 33 Thiqar 34 Misan 35 Albasrah Governate/Region Qadha Qadha Qadha Qadha Qadha Recoded variable Household District Result of HH interview Result of HH interview Result of HH interview Result of HH interview Result of HH interview After all questionnaires for the household have been completed, fill in the following information: Result of HH interview: If the Household Questionnaire is completed, circle '1' for 'Completed'. If you have not been able to contact the household after repeated visits, circle '2' for 'Not at home'. If the household refuses to be interviewed, circle '3' for 'Refused'. If you are unable to locate the household or if the dwelling is destroyed, circle '4' for 'HH not found/destroyed'. If you have not been able to complete the Household Questionnaire for another reason, you should circle '6' for 'Other' and specify the reason in the space provided. Some examples of 'Other' codes might be: the household respondent is incapacitated; the questionnaire is partly completed; adult household members were not found at home after repeated visits. Households 1 Completed 2 Not at home 3 Refused 4 HH not found/destroyed 6 Other Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent to HH questionnaire: Enter the name and line number (from the Household Listing, columns HL1 and HL2) of the respondent to the Household Questionnaire. Households 99 Missing Number of household members Number of household members Number of household members Number of household members Number of household members Total number of household members: Count the number of household members recorded in column HL1 of the Household Listing and enter the total here. Households Total eligible women Total eligible women Total eligible women Total eligible women Total eligible women No.of women eligible for interview: Enter the total number of women eligible for interview for the Questionnaire for Individual Women - you will copy this from the row for totals at the bottom of the Household Listing, for HL6. Households Women interviews completed Women interviews completed Women interviews completed Women interviews completed Women interviews completed No.of women questionnaires completed: Once all of the Questionnaires for Individual Women have been completed for a particular household, enter the number completed here. Households Total children under 5 Total children under 5 Total children under 5 Total children under 5 Total children under 5 No.of children under age 5: Enter the total number of children under five eligible for inclusion in the survey from the row for totals at the bottom of the Household Listing, for HL8. You will be using the Questionnaire for Children Under Five to interview the mothers or primary caretakers of these children. Households Child interviews completed Child interviews completed Child interviews completed Child interviews completed Child interviews completed No.of under-5 questionnaires completed: Once all of the Questionnaires for Children Under Five have been completed for a particular household, enter the number completed here. Households Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk: Leave this space blank. The data clerk will enter his/her number in the space provided. Households Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water What is the main source of drinking water for members of your household? The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): · '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. · '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. · '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. · '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. · '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. · '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. · '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. · '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). · '52' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof and stored in a container, tank or cistern until used. · '53' Berkad · '54' Rain water catchment (Balli) · '61' - A tanker-truck water source transports and sells water by means of a tanker truck. · '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. · '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. · '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. Households 11 Piped into dwelling 12 Piped into yard or plot 13 Public tap/standpipe 21 Tubewell/borehole 31 Protected well 32 Unprotected well 41 Protected spring 42 Unprotected spring 51 Rainwater collection 62 Tanker-truck 71 Cart with small tank/drum 81 Surface water 91 Bottled water 96 Other 99 Missing Main source of water used for other purposes (if bottled wat Main source of water used for other purposes (if bottled wat Main source of water used for other purposes (if bottled wat Main source of water used for other purposes (if bottled wat Main source of water used for other purposes (if bottled wat What is the main source of water used by your household for other purposes such as cooking and handwashing? The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): · '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. · '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. · '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. · '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. · '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. · '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. · '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. · '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). · '52' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof and stored in a container, tank or cistern until used. · '53' Berkad · '54' Rain water catchment (Balli) · '61' - A tanker-truck water source transports and sells water by means of a tanker truck. · '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. · '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. · '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. Households 11 Piped into dwelling 12 Piped into yard or plot 13 Public tap/standpipe 21 Tubewell/borehole 31 Protected well 32 Unprotected well 41 Protected spring 42 Unprotected spring 51 Rainwater collection 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 96 Other 99 Missing Time to get water and come back Time to get water and come back Time to get water and come back Time to get water and come back Time to get water and come back How long does it take to go there, get water, and come back? This question is used to find out how convenient the source of water is to the dwelling. Note that the question is asked for water sources coded as '13-81' and '96' in WS1, or water sources coded as '13-96' in WS2. Fill in the estimated time (in minutes, converting from hours, if necessary) it takes by the usual mode of transport to get to the water source, wait to get water, and get back to the dwelling. Use zero(s) preceding the number if less than 100 minutes (for example, '060' or '005'). Then continue to the next question. If the water source is on the dwelling premises or if water is delivered to the dwelling by a vendor, circle '995' for 'Water on premises' and skip to WS5. If the respondent does not know how long it takes, circle '998' and continue on to the next question. Households 995 On premises 998 DK 999 Missing Person fetching water Person fetching water Person fetching water Person fetching water Person fetching water Who usually goes to this source to fetch the water for your household? Probe: Is this person under age 15? What sex? Circle code that best describes this person. The purpose of this question is to find out the age and gender of the person who usually performs the task of hauling water. This will provide an understanding of whether water hauling responsibilities are given to members of a particular sex or age group. Probe: "IS THIS PERSON UNDER AGE 15? WHAT SEX IS THIS PERSON?" Circle the code that corresponds with the response or '8' if the respondent does not know. Adult refers to anyone age 15 or over, regardless of whether he/she is a household member. Child refers to anyone under the age of 15, regardless of whether he/she is a household member. Households 1 Adult woman 2 Adult man 3 Female child (under 15) 4 Male child (under 15) 8 DK 9 Missing Treat water to make safer for drinking Treat water to make safer for drinking Treat water to make safer for drinking Treat water to make safer for drinking Treat water to make safer for drinking Do you treat your water in any way to make it safer to drink? The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle '1' if 'Yes', and continue to the next question. If 'No' or 'DK' (Doesn't know'), circle '2' or '8', respectively, and skip to WS7. Households 1 Yes 2 No 8 DK 9 Missing Boil Boil Boil Boil Boil What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing A Boil Add bleach/chlorine Add bleach/chlorine Add bleach/chlorine Add bleach/chlorine Add bleach/chlorine What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing B Add bleach/chlorine Strain it through a cloth Strain it through a cloth Strain it through a cloth Strain it through a cloth Strain it through a cloth What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing C Strain it through a cloth Use water filter Use water filter Use water filter Use water filter Use water filter What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing D Use water filter Solar disinfection Solar disinfection Solar disinfection Solar disinfection Solar disinfection What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing E Solar disinfection Let it stand and settle Let it stand and settle Let it stand and settle Let it stand and settle Let it stand and settle What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing F Let it stand and settle Other Other Other Other Other What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing X Other DK DK DK DK DK What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles. Households ? Missing Z DK Main dirinking water source give reliable supply Main dirinking water source give reliable supply Main dirinking water source give reliable supply Main dirinking water source give reliable supply Main dirinking water source give reliable supply Does your main drinking water source give you a reliable supply, i mean daily, weekly, or less than weekly problems or almost no problems? 1 Yes 2 Problems, but less than weekly 3 Weekly 4 Daily 5 Not Applic 8 DK 9 Missing secondary source of dirinking water secondary source of dirinking water secondary source of dirinking water secondary source of dirinking water secondary source of dirinking water If your main source of drinking water supply fails, what is your secondary source of drinking water? 11 Piped into dwelling 12 Piped into yard or plot 13 Public tap/standpipe 21 Tubewell/borehole 31 Protected well 32 Unprotected well 41 Protected spring 42 Unprotected spring 51 Rainwater collection 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 82 Bottle 96 Other 99 Missing Kind of toilet facility Kind of toilet facility Kind of toilet facility Kind of toilet facility Kind of toilet facility What kind of toilet facility do members of your household usually use? If "flush" or "pour flush", probe: Where does it flush to? If necessary, ask permission to observe the facility. Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of this question is to obtain a measure of the cleanliness of the sanitary facility used by the household members. It may be necessary to observe the facility. If so, ask permission to do so. If the respondent answers or it is observed that the household members have no facilities or use the bush or field, enter '95' for 'No facilities or bush or field' and skip to the next module. If any of the flush or pour flush responses (11-15) are given, probe: "WHERE DOES IT FLUSH TO?" Circle the code corresponding to the response given. Definitions of various types of toilet facilities are as follows: A flush toilet uses a cistern or holding tank for flushing water and has a water seal, which is a U-shaped pipe, below the seat or squatting pan that prevents the passage of flies and odours. A pour flush toilet uses a water seal, but unlike a flush toilet, a pour flush toilet uses water poured by hand for flushing (no cistern is used). . '11' - A piped sewer system is a system of sewer pipes, also called sewerage, that is designed to collect human excreta (faeces and urine) and wastewater and remove them from the household environment. Sewerage systems consist of facilities for collection, pumping, treating and disposing of human excreta and wastewater. . '12' - A septic tank is an excreta collection device and is a water-tight settling tank normally located underground, away from the house or toilet. . '13' - A flush/pour flush to pit latrine refers to a system that flushes excreta to a hole in the ground. . '14' - A flush/pour flush to somewhere else refers to excreta being deposited in or nearby the household environment (not into pit, septic tank or sewer); excreta may be flushed to the street, yard/plot, drainage way or other location. . '15' - Flush to unknown place/not sure/DK where should be coded in cases when the respondent knows that the toilet facility is a flush toilet, but does not know where it flushes to. '21' - A ventilated improved pit latrine or VIP is a type of pit latrine that is ventilated by a pipe extending above the latrine roof. The open end of the vent pipe is covered with gauze mesh or fly-proof netting and the inside of the superstructure is kept dark. '22' - A pit latrine with slab uses a hole in the ground for excreta collection and has a squatting slab, platform or seat that is firmly supported on all sides, easy to clean and raised above the surrounding ground level to prevent surface water from entering the pit. '23' - A pit latrine without slab uses a hole in the ground for excreta collection and does not have a squatting slab, platform or seat. An open pit is a rudimentary hole in the ground where excreta is collected. '31' - A composting toilet is a toilet into which excreta and carbon-rich material are added (vegetable wastes, straw, grass, sawdust, ash) and special conditions maintained to produce inoffensive compost. '41' - Bucket refers to the use of a bucket or other container for the retention of faeces (and sometimes urine and anal cleaning material), which is periodically removed for treatment or disposal. '51' - A hanging toilet or hanging latrine is a toilet built over the sea, a river, or other body of water into which excreta drops directly. '95' - No facilities or bush or field includes excreta wrapped and thrown with garbage, the 'cat' method of burying excreta in dirt, defecation in the bush or field or ditch, and defecation into surface water (drainage channel, beach, river, stream or sea). Households 11 Flush to piped sewer system 12 Flush to septic tank 13 Flush to pit (latrine) 14 Flush to somewhere else 15 Flush to unknown place/not sure/DK where 21 Ventilated Improved Pit latrine (VIP) 22 Pit latrine with slab 23 Pit latrine without slab/open pit 31 Composting toilet 41 Bucket 51 Hanging toilet/hanging latrine 95 No facilities or bush or field 96 Other 99 Missing Toilet/sewage system working properly Toilet/sewage system working properly Toilet/sewage system working properly Toilet/sewage system working properly Toilet/sewage system working properly Is your toilet working properly, or there are daily, weekly or less than weekly problems? If the respondent replies 'no' try to assess how often they encounter problems. If they encounter problems occasionally such as a few times a month circle '2', if a few times a week circle '3' for daily problems circle '4'. If the household complains that it is only at certain times of year they do not have a reliable supply then circle 5'. If the household does not know circle '8'. Household 1 Yes 2 Occasional problems 3 Weekly problems 4 Daily problems 5 Not Applic 8 DK 9 Missing Is your toilet working properly Is your toilet working properly Is your toilet working properly Is your toilet working properly Is your toilet working properly Is the sewage system around your house working properly or there are daily, weekly or less than weekly problems? 1 Yes 2 Occasional problems 3 Weekly problems 4 Daily problems 5 Not Applic 8 DK 9 Missing Toilet facility shared Toilet facility shared Toilet facility shared Toilet facility shared Toilet facility shared Do you share this facility with other households? Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of the following two questions is to determine whether the household shares their sanitation facility with other households. The shared status of a sanitation facility is important because shared facilities can be less hygienic than facilities used by only a single household. Unhygienic conditions (faeces on the floor, seat or wall and flies) may discourage use of the facility. --- Circle the code corresponding to the response given. If 'No', go to the next module. Households 1 Yes 2 No 9 Missing Households using this toilet facility Households using this toilet facility Households using this toilet facility Households using this toilet facility Households using this toilet facility How many households in total use this toilet facility? Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of the following two questions is to determine whether the household shares their sanitation facility with other households. The shared status of a sanitation facility is important because shared facilities can be less hygienic than facilities used by only a single household. Unhygienic conditions (faeces on the floor, seat or wall and flies) may discourage use of the facility. --- The total number of households using this facility should include the household being interviewed. If less than ten households use this toilet facility, enter the number of households on the line provided. Circle '10' if ten or more households use this toilet facility. Note that '01' is not a valid response (since it means that this is the only this household that uses the facility; if that is the case, you should go back to WS8 and correct the response there). Circle '98' for 'DK' ('Doesn't know'). Households 10 Ten or more households 98 DK 99 Missing solid waste dispose solid waste dispose solid waste dispose solid waste dispose solid waste dispose How do you dispose your solid waste/ Garbage? 1 House to house collection 2 Street containers-open 3 Street containers-closed 4 Dump to open area 5 Burn 6 Compost 7 Bury 96 Other 99 Missing frequency of collection/emptying of streert containers frequency of collection/emptying of streert containers frequency of collection/emptying of streert containers frequency of collection/emptying of streert containers frequency of collection/emptying of streert containers What is the frequency of collection/ emptying of street containers? 1 Less than once in 2 weeks 2 Once in 2 weeks 3 Once a week 4 Twice a week or more 9 Missing Number of rooms for sleeping Number of rooms for sleeping Number of rooms for sleeping Number of rooms for sleeping Number of rooms for sleeping How many rooms in this household are used for sleeping? This information provides a measure of how crowded the house is, and reflects the socio-economic condition of the household. A room in this case refers to a special area with a permanent partition that is used for sleeping. It is not necessarily the number of rooms in the household that are called 'bedrooms', but rather how many rooms get used for sleeping on a regular basis. Exclude rooms that are used only for sleeping by visitors to the household, but include those rooms that may not be regular 'bedrooms' but may be regularly used by one or more of the household members for sleeping. Enter the number of rooms in this household that are used for sleeping. Households 99 Missing Main material of floor Main material of floor Main material of floor Main material of floor Main material of floor Main material of the dwelling floor: Record observation. Circle the correct code for the material of the dwelling floor based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the floor, record the main flooring material (the material that covers the largest amount of floor space). Households 11 Earth/sand 12 Dung 21 Wood planks 22 Palm/bamboo 23 Reeds 32 Vinyl or asphalt strips 33 Ceramic tiles 34 Cement 35 Carpet 96 Other 99 Missing Main material of roof Main material of roof Main material of roof Main material of roof Main material of roof Main material of the roof. Record observation. Circle the correct code for the material of the dwelling roof, based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the roof, record the main roofing material (the material that covers the largest amount of roof). Households 11 No roof 12 Thatch/palm leaf 13 Sod 21 Rustic mat 22 Palm/bamboo 23 Reeds 24 Wood Planks 31 Metal 32 Wood 33 Calamine/cement fiber 34 Ceramic tiles 35 Cement 36 Roofing shingles 96 Other 99 Missing Main material of wall Main material of wall Main material of wall Main material of wall Main material of wall Main material of the walls. Record observation. Circle the correct code for the material of the dwelling walls, based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the walls, record the main wall material (the material that covers the largest amount of wall space). Households 11 No walls 12 Cane/palm/trunks 13 Dirt 21 Bambo with mud 22 Stone with mud 23 Uncovered adobe 24 Plywood 25 Carton 26 Reused wood 27 Reeds 31 Cement 32 Stone with lime/cement 33 Bricks 34 Cement blocks 35 Covered adobe 36 Wood planks/shingles 37 Chinku tin 96 Other 99 Missing Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking What type of fuel does your household mainly use for cooking? Information on the type of fuel used for cooking is collected as another measure of the socio-economic status of the household. The use of some cooking fuels can also have adverse health consequences. Circle the code corresponding to the answer given. Remember that this question asks about fuel for cooking, not fuel for heating or lighting. If the household uses more than one fuel for cooking, find out which type of fuel is used most often. If electricity, liquid propane gas (LPG), natural gas, or biogas is mainly used, circle '01', '02', '03', or '04', respectively, and skip to HC8. If any fuel other than the pre-coded ones is reported as being the main fuel used for cooking, circle '96' and specify the type of fuel on the line provided. Definitions of some of the types of fuel are as follows: 'Biogas' includes gases produced by fermenting manure in an enclosed pit. 'Lignite' is a derivative of coal that produces more smoke when burned but produces less heat than coal. Households 1 Electricity 2 Liquid propane gas (LPG) 5 Kerosene 6 Coal/lignite 8 Wood 9 Straw/shrubs/grass 10 Animal dung 11 Agricultural crop residue 96 Other 99 Missing Cooking location Cooking location Cooking location Cooking location Cooking location Is the cooking usually done in the house, in a separate building, or outdoors? Circle the code corresponding to the response given. If a response is given other than the pre-coded ones, circle '6' and specify on the line provided. Households 1 In the house 2 In a separate bulding 3 Outdoors 6 Other 9 Missing Electricity Electricity Electricity Electricity Electricity Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR? Households 1 Yes 2 No 9 Missing Network Electric Network Electric Network Electric Network Electric Network Electric Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR? Households 1 Yes 2 No 9 Missing generator generator generator generator generator Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR? Households 1 Yes 2 No 9 Missing Radio Radio Radio Radio Radio Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR, VCD/DVD PLAYER, FAN? Households 1 Yes 2 No 9 Missing Televesion Televesion Televesion Televesion Televesion Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR? Households 1 Yes 2 No 9 Missing Mobile Phone Mobile Phone Mobile Phone Mobile Phone Mobile Phone Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Phone Phone Phone Phone Phone Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR? Households 1 Yes 2 No 9 Missing satellite dish satellite dish satellite dish satellite dish satellite dish Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Refregerator Refregerator Refregerator Refregerator Refregerator Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Watch Watch Watch Watch Watch Does your household have: This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR. Households 1 Yes 2 No 9 Missing Bicycle Bicycle Bicycle Bicycle Bicycle Does your household have: This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR. Households 1 Yes 2 No 9 Missing Motorcycle or scooter Motorcycle or scooter Motorcycle or scooter Motorcycle or scooter Motorcycle or scooter Does your household have: 1 Yes 2 No 9 Missing Animal-drawn cart Animal-drawn cart Animal-drawn cart Animal-drawn cart Animal-drawn cart Does your household have: This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR. Households 1 Yes 2 No 9 Missing Car or truck Car or truck Car or truck Car or truck Car or truck Does your household have: This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR. Households 1 Yes 2 No 9 Missing Boat with motor Boat with motor Boat with motor Boat with motor Boat with motor Does your household have: 1 Yes 2 No 9 Missing Area Area Area Area Area 1 Metrob1 2 Metrob2 3 Metro 4 Urban-other 5 Rural Area Area Area Area Area 1 Metropolitan 2 Urban-other 3 Rural Area Area Area Area Area 1 Urban 2 Rural Region Region Region Region Region 1 North 2 South/center Governorate Governorate Governorate Governorate Governorate 1 Dohuk 2 Nainwa 3 Sulimania 4 Karkuk 5 Erbil 6 Diala 7 Anbar 8 Babil 9 Karbala 10 Wasit 11 Salahaladin 12 Najaf 13 Qadisya 14 Almuthana 15 Thiqar 16 Misan 17 Albasrah 18 Baghdad Women's sample weight Women's sample weight Women's sample weight Women's sample weight Women's sample weight Recoded Variable Women age 15-49 The sample is not self weighting therefore survey sample weights have been created using urban and rural population estimates at the regional level. (See data processing folder under external documents which contains excel sheets and syntax files related to constructing and merging sample weights to file). Date of interview women (CMC) Date of interview women (CMC) Date of interview women (CMC) Date of interview women (CMC) Date of interview women (CMC) Recoded Variable Women age 15-49 Child's date of birth (CMC) Child's date of birth (CMC) Child's date of birth (CMC) Child's date of birth (CMC) Child's date of birth (CMC) Recoded Variable Women age 15-49 Women's date of birth (CMC) Women's date of birth (CMC) Women's date of birth (CMC) Women's date of birth (CMC) Women's date of birth (CMC) Recoded Variable Women age 15-49 Women's age Women's age Women's age Women's age Women's age Recoded Variable Women age 15-49 1 15-19 2 20-24 3 25-29 4 30-34 5 35-39 6 40-44 7 45-49 Age at first marriage Age at first marriage Age at first marriage Age at first marriage Age at first marriage Recoded Variable Women age 15-49 Marital status Marital status Marital status Marital status Marital status Recoded Variable Women age 15-49 1 Currently married 2 Formerly married 3 Never married Women's education Women's education Women's education Women's education Women's education Recoded Variable Women age 15-49 1 None 2 Primary 3 Secondary + 4 Non-standard curriculum 9 Missing/DK Children ever born Children ever born Children ever born Children ever born Children ever born Recoded Variable Women age 15-49 Dead children Dead children Dead children Dead children Dead children Recoded Variable Women age 15-49 Number of children surviving Number of children surviving Number of children surviving Number of children surviving Number of children surviving Recoded Variable Women age 15-49