DDI_NPL_2013-2014_ICTECD_v01_M_WB Development Economics Data Group 2020-07-17 Metadata Editor Version 01 (July 2020) NPL_2013-2014_ICTECD_v01_M The Role of Information and Cash Transfers on Early Childhood Development 2013-2014 Evidence from Nepal RICTECD 2013-2014 Gayatri Acharya Michael Levere Prashant Bharadwaj The Strategic Impact Evaluation Fund Metadata Editor Gayatri Acharya Alreena Renita Pinto Socio-Economic/Monitoring Survey [hh/sems] While substantial progress has been made in combating malnutrition at a global level, chronic maternal and child malnutrition remains a serious problem in many parts of the developing world. In this paper, using a randomized control trial design in Nepal, we evaluate a program that provided information on best practices about maternal and child health and nutrition, and cash to families in extremely poor areas with pregnant mothers and/or children below the age of 2. We find significant and sizable impacts of the information plus cash intervention on maternal knowledge, behavior, child development, and nutrition. The size of these impacts along some measures of knowledge and development are significantly different from the information only intervention group suggesting a potential role for providing a short term cash safety net along with information to tackle the problem of malnutrition. Nepal The intervention was implemented in four food insecure districts in Nepal - Sarlahi, Rautahat, Sindhuli, and Ramechaap Sample survey data [ssd] Detailed description of the experimental design is available in "The Role of Information and Cash Transfers on Early Childhood Development: Evidence from Nepal", pp4-7 Computer Assisted Personal Interview [capi] The baseline, midline, and endline surveys were nearly identical, and each included three separate modules to measure information on the household, the eligible mother, and the eligible infant. The household component of the survey was intended to be answered by either the household head or eligible mother, and measured a household’s composition, assets, annual income, monthly expenditures, and daily food intake. The mother then answered questions about herself and her children, which measured her knowledge of maternal health and nutritional best practices and her actual behaviors with her youngest child while pregnant and breastfeeding. The survey concluded with anthropometric measurements of the child and a measure of cognitive development as measured by the Ages and Stages Questionnaire (ASQ). Baseline data collection occurred in August-October 2013, prior to the start of the intervention. One fourth of counties were randomly assigned to be surveyed at midline in August-September 2014, with the remaining three-fourths surveyed at endline in November-December 2014. A total of 4,228 women and 3,695 children under two years old were surveyed at baseline. Of these, 3,152 women and 2,783 children were in the counties surveyed at endline, which will be primarily used in the analysis. After attrition and trimming outliers, the primary sample consists of 2,338 women and 1,953 children. The user of the data acknowledges that the original collector of the data, the authorized distributor of the data, and the relevant funding agency bear no responsibility for use of the data or for interpretations or inferences based upon such uses. SEC01.dta 4723 14 .dta Nepal 2013 data on survey information - Baseline data SEC02.dta 4723 25 .dta Nepal 2013 data on household identification - Baseline data SEC03.dta 36945 15 .dta Nepal 2013 household roster data - Baseline data SEC04A.dta 4723 22 .dta Nepal 2013 housing condition and physical assets data - Baseline SEC04B.dta 7516 7 .dta Nepal 2013 housing condition and physical assets data (Land) - Baseline SEC04C.dta 4723 5 .dta Nepal 2013 housing condition and physical assets data (Vegetables and Livestock) - Baseline SEC05A.dta 74458 4 .dta Nepal 2013 household expenditures data for the past 30 days - Baseline SEC05B1.dta 51213 4 .dta Nepal 2013 household income data in the past 12 months - Baseline SEC05B2.dta 4723 5 .dta Nepal 2013 household loans and borrowing data - Baseline SEC05C.dta 162789 5 .dta Nepal 2013 food consumption data - Baseline SEC05D.dta 46564 6 .dta Nepal 2013 household shocks data - Baseline SEC06A.dta 4229 5 .dta Nepal 2013 health data - Baseline SEC06B.dta 3166 8 .dta Nepal 2013 health data - Baseline SEC07A.dta 4229 5 .dta Nepal 2013 data on the knowledge on maternal and child nutrition for Baseline - nutrition for under 2 children SEC07B.dta 67664 5 .dta Nepal 2013 data on the knowledge on maternal and child nutrition for Baseline - nutrition for under 2 children SEC07C.dta 4229 11 .dta Nepal 2013 data on the knowledge on maternal and child nutrition for Baseline - nutrition for under 2 children and nutrition for women SEC07D.dta 59206 5 .dta Nepal 2013 data on the knowledge on maternal and child nutrition for Baseline - nutrition for women SEC07E.dta 33832 5 .dta Nepal 2013 data on the knowledge of maternal and child nutrition, specifically on health, tobacco and alcohol consumption - Baseline SEC07F.dta 4229 5 .dta Nepal 2013 data on the knowledge of maternal and child nutrition, specifically on health, tobacco and alcohol consumption - Baseline SEC08A.dta 4229 13 .dta Nepal 2013 maternal heatlh data - antenatal care - Baseline SEC08B.dta 17412 5 .dta Nepal 2013 maternal heatlh data - antenatal care - Baseline SEC08C.dta 4229 10 .dta Nepal 2013 maternal heatlh data - antenatal and postnatal care - Baseline SEC09A.dta 3882 7 .dta Nepal 2013 breastfeeding data - Baseline SEC09B.dta 20496 5 .dta Nepal 2013 breastfeeding data - Baseline SEC09C.dta 3882 8 .dta Nepal 2013 breastfeeding data - Baseline SEC09D.dta 1308 5 .dta Nepal 2013 breastfeeding data - Baseline SEC09E.dta 3882 4 .dta Nepal 2013 breastfeeding data - Baseline SEC09F.dta 84312 5 .dta Nepal 2013 Child Nutrition (0-24 month children) data - Baseline SEC09G.dta 3882 4 .dta Nepal 2013 Child Nutrition (0-24 month children) data - Baseline SEC09H.dta 39720 5 .dta Nepal 2013 Child Nutrition (0-24 month children) data - Baseline SEC09I.dta 3882 6 .dta Nepal 2013 Child Nutrition (0-24 month children) data - Baseline SEC10A.dta 4229 13 .dta Nepal 2013 anthropometric measures data - Baseline SEC10B.dta 4194 15 .dta Nepal 2013 anthropometric measures data - Baseline SEC11.dta 3993 165 .dta Nepal 2013 data on child's development - Baseline data SEC00.dta 4155 17 .dta Nepal 2014 Endline Wave 1 data SEC01.dta 1190 17 .dta Nepal 2014 survey information data for Endline Wave 1 SEC02.dta 1190 18 .dta Nepal 2014 household identification data for Endline Wave 1 SEC03.dta 9170 16 .dta Nepal 2014 household roster data for Endline Wave 1 SEC04A.dta 1190 23 .dta Nepal 2014 housing condition and physical assets data for Endline wave 1 SEC04B.dta 1989 8 .dta Nepal 2014 housing condition and physical assets data for Endline wave 1, specifically data on land. SEC04C.dta 1190 6 .dta Nepal 2014 housing condition and physical assets data for Endline wave 1, specifically data on vegetables and livestock SEC05A.dta 19830 5 .dta Nepal 2014 household expenditures in the past 30 days data for Endline wave 1. SEC05B1.dta 14005 5 .dta Nepal 2014 household income in the past 12 months data for Endline wave 1 SEC05B2.dta 1190 5 .dta Nepal 2014 household loans and borrowing data for Endline wave 1 SEC05C.dta 40800 6 .dta Nepal 2014 food consumption data for Endline wave 1 SEC05D.dta 11675 7 .dta Nepal 2014 data on household shocks for Endline wave 1 SEC06A.dta 1314 6 .dta Nepal 2014 health data for Endline wave 1 SEC06B.dta 1148 9 .dta Nepal 2014 health data for Endline wave 1 SEC07A.dta 1128 6 .dta Nepal 2014 knowledge on maternal and child nutrition data for Endline wave 1 - nutrition for under 2 children SEC07B.dta 18048 6 .dta Nepal 2014 knowledge on maternal and child nutrition data for Endline wave 1 - nutrition for under 2 children SEC07C.dta 1128 12 .dta Nepal 2014 knowledge on maternal and child nutrition data for Endline wave 1 - nutrition for under 2 children and nutrition for women SEC07D.dta 15792 6 .dta Nepal 2014 knowledge on maternal and child nutrition data for Endline wave 1 - nutrition for women SEC07E.dta 9024 6 .dta Nepal 2014 knowledge on maternal and child nutrition data for Endline wave 1 - health, tobacco and alcohol consumption SEC07F.dta 1128 13 .dta Nepal 2014 knowledge on maternal and child nutrition data for Endline wave 1 - health, tobacco and alcohol consumption SEC08A.dta 1128 14 .dta Nepal 2014 maternal health data for Endline wave 1 - antenatal care SEC08B.dta 6447 6 .dta Nepal 2014 maternal health data for Endline wave 1 - antenatal care SEC08C.dta 1128 11 .dta Nepal 2014 maternal health data for Endline wave 1 - antenatal and postnatal care SEC09A.dta 1106 8 .dta Nepal 2014 breastfeeding data for Endline wave 1 SEC09B.dta 2928 6 .dta Nepal 2014 breastfeeding data for Endline wave 1 SEC09C.dta 1106 9 .dta Nepal 2014 breastfeeding data for Endline wave 1 SEC09D.dta 329 6 .dta Nepal 2014 breastfeeding data for Endline wave 1 SEC09E.dta 1106 5 .dta Nepal 2014 breastfeeding data for Endline wave 1 SEC09F.dta 19320 6 .dta Nepal 2014 child nutrition data for Endline wave 1 SEC09G.dta 1106 5 .dta Nepal 2014 child nutrition data for Endline wave 1 SEC09H.dta 10245 6 .dta Nepal 2014 child nutrition data for Endline wave 1 SEC09I.dta 1106 7 .dta Nepal 2014 child nutrition data for Endline wave 1 SEC10A.dta 1314 16 .dta Nepal 2014 anthropometric measures data for Endline wave 1 SEC10B.dta 1410 16 .dta Nepal 2014 female respondent and child anthropometric measures data for Endline wave 1 SEC11.dta 1410 213 .dta Nepal 2014 data on child's development - Endline wave 1 data SEC00.dta 14577 16 .dta Endline Wave 2 data SEC01.dta 4246 17 .dta Nepal 2014 survey information data for Endline Wave 2 SEC02.dta 4246 18 .dta Nepal 2014 household identification data for Endline Wave 2 SEC03.dta 31429 16 .dta Nepal 2014 household roster data for Endline Wave 2 SEC04A.dta 4246 23 .dta Nepal 2014 housing condition and physical assets data for Endline wave 2 SEC04B.dta 7018 8 .dta Nepal 2014 housing condition and physical assets data for Endline wave 2, specifically data on land. SEC04C.dta 4246 6 .dta Nepal 2014 housing condition and physical assets data for Endline wave 2, specifically data on vegetables and livestock SEC05A.dta 69974 5 .dta Nepal 2014 household expenditures in the past 30 days data for Endline wave 2. SEC05B1.dta 49434 5 .dta Nepal 2014 household income in the past 12 months data for Endline wave 2 SEC05B2.dta 4246 5 .dta Nepal 2014 household loans and borrowing data for Endline wave 2 SEC05C.dta 143918 6 .dta Nepal 2014 food consumption data for Endline wave 2 SEC05D.dta 41218 7 .dta Nepal 2014 data on household shocks for Endline wave 2 SEC06A.dta 4668 6 .dta Nepal 2014 health data for Endline wave 2 SEC06B.dta 2483 9 .dta Nepal 2014 health data for Endline wave 2 SEC07A.dta 3907 6 .dta Nepal 2014 knowledge on maternal and child nutrition data for Endline wave 2 - nutrition for under 2 children SEC07B.dta 62512 6 .dta Nepal 2014 knowledge on maternal and child nutrition data for Endline wave 2 -nutrition for under 2 children SEC07C.dta 3907 12 .dta Nepal 2014 knowledge on maternal and child nutrition data for Endline wave 2 - nutrition for under 2 children and nutrition for women SEC07D.dta 54698 6 .dta Nepal 2014 knowledge on maternal and child nutrition data for Endline wave 2 - nutrition for women SEC07E.dta 31256 6 .dta Nepal 2014 knowledge on maternal and child nutrition data for Endline wave 2 - health, tobacco and alcohol consumption SEC07F.dta 3907 13 .dta Nepal 2014 knowledge on maternal and child nutrition data for Endline wave 2 - health, tobacco and alcohol consumption SEC08A.dta 3907 14 .dta Nepal 2014 maternal health data for Endline wave 2 - antenatal care SEC08B.dta 21315 6 .dta Nepal 2014 maternal health data for Endline wave 2 - antenatal care SEC08C.dta 3907 11 .dta Nepal 2014 maternal health data for Endline wave 2 - antenatal and postnatal care SEC09A.dta 3724 8 .dta Nepal 2014 breastfeeding data for Endline wave 2 SEC09B.dta 11196 6 .dta Nepal 2014 breastfeeding data for Endline wave 2 SEC09C.dta 3724 9 .dta Nepal 2014 breastfeeding data for Endline wave 2 SEC09D.dta 623 6 .dta Nepal 2014 breastfeeding data for Endline wave 2 SEC09E.dta 3724 5 .dta Nepal 2014 breastfeeding data for Endline wave 2 SEC09F.dta 61968 6 .dta Nepal 2014 child nutrition data for Endline wave 2 SEC09G.dta 3724 5 .dta Nepal 2014 child nutrition data for Endline wave 2 SEC09H.dta 29175 6 .dta Nepal 2014 child nutrition data for Endline wave 2 SEC09I.dta 3724 7 .dta Nepal 2014 child nutrition data for Endline wave 2 SEC10A.dta 4668 16 .dta Nepal 2014 anthropometric measures data for Endline wave 2 SEC10B.dta 4728 16 .dta Nepal 2014 female respondent and child anthropometric measures data for Endline wave 2 SEC11.dta 4728 213 .dta Nepal 2014 data on child's development - Endline wave 2 data CO code 4723 1 600 Household number Household number 4723 1 50 1 245 2 212 3 221 4 215 5 240 6 212 7 191 8 187 9 185 10 203 11 171 12 188 13 170 14 183 15 154 16 154 17 157 18 158 19 147 20 129 21 121 22 136 23 108 24 103 25 81 26 71 27 69 28 67 29 49 30 38 31 37 32 25 33 23 34 20 35 13 36 10 37 4 38 4 39 5 40 3 41 4 45 4 46 2 47 2 48 1 50 1 101. Round Number Round Number 4723 1 1 1 4723 103. CO Code No CO Code No (see the code sheet) 4723 1 600 104. House Serial No House Serial No (Copy from Q5 of Listing Form) 4723 1 50 1 245 2 212 3 221 4 215 5 240 6 212 7 191 8 187 9 185 10 203 11 171 12 188 13 170 14 183 15 154 16 154 17 157 18 158 19 147 20 129 21 121 22 136 23 108 24 103 25 81 26 71 27 69 28 67 29 49 30 38 31 37 32 25 33 23 34 20 35 13 36 10 37 4 38 4 39 5 40 3 41 4 45 4 46 2 47 2 48 1 50 1 105A. Number of eligible woman SN eligible woman (From listing form) 4723 0 7 0 10 1 4243 2 427 3 38 4 4 7 1 105B. Interviewed eligible woman Interviewed eligible woman 4723 0 4 0 741 1 3752 2 215 3 13 4 2 107. Date of Interview: DD 4723 1 31 1 146 2 164 3 201 4 207 5 171 6 240 7 209 8 263 9 239 10 207 11 220 12 253 13 130 14 147 15 164 16 146 17 113 18 126 19 118 20 96 21 108 22 100 23 85 24 113 25 133 26 139 27 91 28 115 29 95 30 82 31 102 107. Date of Interview: MM 4723 5 7 5 3593 6 1091 7 39 107. Date of Interview: YY 4723 2070 2070 2070 4723 108. Interviewer's name Name of enumerator 4723 1 49 1 50 2 35 3 42 4 36 5 43 6 44 7 49 8 59 9 59 10 31 11 28 12 27 13 69 14 75 15 70 16 73 17 61 18 72 19 113 20 96 21 106 22 128 23 103 24 121 25 112 26 113 27 124 28 119 29 113 30 105 31 92 32 60 33 83 34 75 35 69 36 173 37 40 38 231 39 204 40 118 41 144 42 157 43 163 44 131 45 158 46 149 47 131 48 137 49 132 109. Supervisor's name Name of supervisor 4723 1 47 1 125 4 125 7 168 10 86 13 214 16 203 19 319 22 459 26 357 29 310 32 286 36 651 40 583 44 432 45 5 47 400 110. Editor's name Name of Editor 4723 1 8 1 1017 2 393 3 531 4 430 5 747 6 749 7 767 8 89 111. Name of data entry operator Name of data entry operator 4723 1 9 1 651 2 715 3 626 4 508 5 654 6 290 7 669 8 378 9 232 CO code CO Code 4723 1 600 Household number Household number 4723 1 50 1 245 2 212 3 221 4 215 5 240 6 212 7 191 8 187 9 185 10 203 11 171 12 188 13 170 14 183 15 154 16 154 17 157 18 158 19 147 20 129 21 121 22 136 23 108 24 103 25 81 26 71 27 69 28 67 29 49 30 38 31 37 32 25 33 23 34 20 35 13 36 10 37 4 38 4 39 5 40 3 41 4 45 4 46 2 47 2 48 1 50 1 201. District District: 4723 1 4 1 Ramechhap 502 2 Sindhuli 848 3 Sarlahi 1302 4 Rautahat 2071 202. Is this a VDC or a Municipality? Is this a VDC or a Municipality? 4723 1 2 1 VDC 4670 2 Municipality 53 203. Code of VDC/Municipality Name and Code of VDC/Municipality (see code sheet) 4723 1 185 204. Ward Number Ward Number 4723 1 9 1 446 2 494 3 531 4 503 5 398 6 607 7 698 8 527 9 519 206A. ID code of the Main Respondent 4723 1 99 1 2827 2 1181 3 224 4 220 5 25 6 37 7 41 8 37 9 23 10 15 11 8 12 3 13 3 14 4 15 1 16 2 17 2 99 70 206B. ID code of the second Respondent 4723 0 99 0 21 1 153 2 989 3 256 4 808 5 52 6 56 7 83 8 87 9 68 10 44 11 15 12 10 13 6 14 5 15 8 16 2 18 3 19 1 22 1 98 1 99 2054 207B. ID code of the Household Head 4723 1 1 1 4723 208. Caste/ethnicity of HH head Caste/ethnicity of HH head 4723 1 103 1 Chhetri 222 2 Bhamhin - Hill 88 3 Magar 160 4 Tharu 130 5 Tamang 383 6 Newar 129 7 Muslim 553 8 Kami 120 9 Yadav 270 10 Rai 9 11 Gurung 3 12 Damai/dholi 72 13 Limbu 0 14 Thakuri 4 15 Sarki 133 16 Teli 120 17 Chamar/harijan/ram 345 18 Koiri 91 19 Kurmi 103 20 Sanyasi 19 21 Dhanuk 26 22 Musahar 156 23 Dusadh/paswan/pasi 300 24 Sherpa 8 25 Sonar 50 26 Kewat 0 27 Bramhin - Terai 30 28 Baniya 34 29 Gharti/bhujel 34 30 Mallah 173 31 Kalwar 39 32 Kumal 3 33 Hajam/thakur 51 34 Kanu 118 35 Rajbansi 3 36 Sunuwar 35 37 Sudhi 8 38 Lohar 63 39 Tatma 101 40 Khatwe 9 41 Dhobi 86 42 Majhi 60 43 Niniya 110 44 Kumhar 39 45 Danuwar 91 46 Chepang/praja 1 47 Haluwai 5 48 Rajput 5 49 Kayastha 1 50 Badhae 0 51 Marwadi 0 52 Santhal/satar 0 53 Jhangad 0 54 Bantar 0 55 Barae 18 56 Kahar 4 57 Gangai 0 58 Lodha 1 59 Rajbhar 0 60 Thami 0 61 Dhimal 0 62 Bhote 1 63 Bing/bida 69 64 Bhediyar/gaderi 2 65 Nurang 0 66 Yakha 0 67 Darai 0 68 Tajpuriya 0 69 Thakali 0 70 Chidimar 0 71 Pahari 2 72 Mali 3 73 Bangali 0 74 Chhantyal 0 75 Dom 2 76 Kamar 4 77 Bote 0 78 Baramu 0 79 Gaine 0 80 Jirel 0 81 Adibasi/janajati 0 82 Dura 0 83 Churoute 0 84 Badi 1 85 Meche 0 86 Lepcha 0 87 Halkhor 0 88 Panjabi/sikh 0 89 Kisan 0 90 Raji 0 91 Byasi 0 92 Hayu 7 93 Koche 0 94 Dhniya 1 95 Walung 0 96 Jaine 0 97 Munda 0 98 Raute 0 99 Yholmo 3 100 Pattharkatta/kuswadiya 0 101 Kusunda 0 102 Other caste 11 103 Unidentified caste 1 212. Result of Interview: A. HH Questionnaire (Section 1-5) (fill out after the interview) 4723 1 2 1 Completed 4649 2 HH head, spouse, or eligible woman or other adult not at home 74 3 Refused 0 4 Dwelling not found/family migrated 0 5 Eligible woman is sick 0 6 Eligible womwn is disabled 0 212. Result of Interview: B. Women Sections (Section 6-10) ? 1st set (fill out after the interview) 4649 74 1 5 1 Completed 3995 2 HH head, spouse, or eligible woman or other adult not at home 615 3 Refused 5 4 Dwelling not found/family migrated 2 5 Eligible woman is sick 32 6 Eligible womwn is disabled 0 Sysmiss 74 212. Result of Interview: C. Women Sections (Section 6-10) ? 2nd set (fill out after the interview) 4649 74 1 9 1 Completed 237 2 HH head, spouse, or eligible woman or other adult not at home 195 3 Refused 1 4 Dwelling not found/family migrated 1 5 Eligible woman is sick 12 6 Eligible womwn is disabled 0 9 No more set 4203 Sysmiss 74 212. Result of Interview: D. Women Sections (Section 6-10) ? 3rd set (fill out after the interview) 4649 74 1 9 1 Completed 8 2 HH head, spouse, or eligible woman or other adult not at home 16 3 Refused 1 4 Dwelling not found/family migrated 0 5 Eligible woman is sick 0 6 Eligible womwn is disabled 0 9 No more set 4624 Sysmiss 74 212. Result of Interview: E. Women Sections (Section 6-10) ? 4th set (fill out after the interview) 4649 74 1 9 1 Completed 3 2 HH head, spouse, or eligible woman or other adult not at home 3 3 Refused 0 4 Dwelling not found/family migrated 0 5 Eligible woman is sick 0 6 Eligible womwn is disabled 0 9 No more set 4643 Sysmiss 74 212. Result of Interview: F. Women Sections (Section 6-10) ? 5th set (fill out after the interview) 4649 74 1 9 1 Completed 5 2 HH head, spouse, or eligible woman or other adult not at home 2 3 Refused 0 4 Dwelling not found/family migrated 0 5 Eligible woman is sick 0 6 Eligible womwn is disabled 0 9 No more set 4642 Sysmiss 74 212. Result of Interview: G. ASQ (Woman and Child Section 11) ? 1st set (fill out after the interview) 4649 74 1 9 1 Completed 3376 2 HH head, spouse, or eligible woman or other adult not at home 529 3 Refused 5 4 Dwelling not found/family migrated 2 5 Eligible woman is sick 25 6 Eligible womwn is disabled 0 9 No more set 712 Sysmiss 74 212. Result of Interview: H. ASQ (Woman and Child Section 11) ? 2st set (fill out after the interview) 4649 74 1 9 1 Completed 239 2 HH head, spouse, or eligible woman or other adult not at home 125 3 Refused 1 4 Dwelling not found/family migrated 0 5 Eligible woman is sick 8 6 Eligible womwn is disabled 0 9 No more set 4276 Sysmiss 74 212. Result of Interview: I. ASQ (Woman and Child Section 11) ? 3rd set (fill out after the interview) 4649 74 1 9 1 Completed 14 2 HH head, spouse, or eligible woman or other adult not at home 14 3 Refused 0 4 Dwelling not found/family migrated 1 5 Eligible woman is sick 2 6 Eligible womwn is disabled 0 9 No more set 4618 Sysmiss 74 212. Result of Interview: J. ASQ (Woman and Child Section 11) ? 4th set (fill out after the interview) 4649 74 1 9 1 Completed 1 2 HH head, spouse, or eligible woman or other adult not at home 5 3 Refused 0 4 Dwelling not found/family migrated 0 5 Eligible woman is sick 0 6 Eligible womwn is disabled 1 9 No more set 4642 Sysmiss 74 212. Result of Interview: K. ASQ (Woman and Child Section 11) ? 5th set (fill out after the interview) 4649 74 2 9 1 Completed 0 2 HH head, spouse, or eligible woman or other adult not at home 1 3 Refused 0 4 Dwelling not found/family migrated 0 5 Eligible woman is sick 0 6 Eligible womwn is disabled 3 9 No more set 4645 Sysmiss 74 212. Result of Interview: L. ASQ (Woman and Child Section 11) ? 6th set (fill out after the interview) 4649 74 1 9 1 Completed 6 2 HH head, spouse, or eligible woman or other adult not at home 2 3 Refused 0 4 Dwelling not found/family migrated 0 5 Eligible woman is sick 0 6 Eligible womwn is disabled 1 9 No more set 4640 Sysmiss 74 213. Which religion do you follow mainly in your household? Which religion do you follow mainly in your household? 4649 74 1 8 1 Hindu 3642 2 Bouddha 395 3 Islam 545 4 Kirat 15 5 Jain 0 6 Christian 45 7 Shikh 3 8 Other 4 Sysmiss 74 214. Total family number Total family number 4649 74 2 32 2 9 3 64 4 297 5 583 6 800 7 750 8 589 9 432 10 339 11 226 12 172 13 122 14 73 15 51 16 46 17 29 18 20 19 10 20 17 21 6 22 3 23 3 24 3 27 1 28 3 32 1 Sysmiss 74 VDC Treatment Group VDC Treatment Group 4723 1 3 1 Control 1552 2 Info Only 1596 3 Info + Cash 1575 CO code CO Code 36945 1 600 Household number Household number 36945 1 50 1 2134 2 1743 3 1827 4 1679 5 1925 6 1659 7 1540 8 1429 9 1420 10 1531 11 1370 12 1464 13 1269 14 1385 15 1207 16 1215 17 1256 18 1208 19 1103 20 961 21 936 22 1090 23 829 24 775 25 604 26 556 27 518 28 492 29 383 30 283 31 240 32 192 33 162 34 151 35 77 36 68 37 30 38 36 39 37 40 38 41 33 45 30 46 15 47 21 48 10 50 14 ID CODE ID CODE 36871 74 1 32 1 4649 2 4649 3 4640 4 4576 5 4279 6 3696 7 2896 8 2146 9 1557 10 1125 11 786 12 560 13 388 14 266 15 193 16 142 17 96 18 67 19 47 20 37 21 20 22 14 23 11 24 8 25 5 26 5 27 5 28 4 29 1 30 1 31 1 32 1 99 SKIP 0 Sysmiss 74 302. Relationship to HH head Relationship to HH head 36871 74 1 14 1 Head 4649 2 Spouse 4171 3 Son/Daughter 14464 4 Grandchild 6962 5 Parent 852 6 Brother/Sister 494 7 Nephew/Niece 480 8 Son/Daughter-in-law 4022 9 Brother/Sister-in-law 497 10 Parent-in-law 158 11 Other relative (grandparents etc) 105 12 Domestic helper 5 13 Adopted/foster child 2 14 Other not related 10 Sysmiss 74 303. Sex Sex 36871 74 1 2 1 Male 18216 2 Female 18655 Sysmiss 74 304. Age (Completed): A. Year 36871 74 0 99 304. Age (Completed): B. Month 36871 74 0 11 0 30487 1 627 2 730 3 549 4 510 5 530 6 736 7 532 8 462 9 550 10 575 11 583 Sysmiss 74 305. Can [NAME] read and write a letter in any one language? Ask only to those who are aged 5 years and older Can [NAME] read and write a letter in any one language? 29537 7408 1 3 1 Read only 476 2 Read and write 13210 3 None 15851 Sysmiss 7408 306. Has [NAME] ever attended formal school/ college? Ask only to those who are aged 5 years and older Has [NAME] ever attended formal school/ college? 29537 7408 1 2 1 Yes 14094 2 No 15443 Sysmiss 7408 307. What is the highest grade [NAME] completed? Ask only to those who are aged 5 years and older What is the highest grade [NAME] completed 14094 22851 0 98 0 CLASS 1 NOT PASSED 1708 1 CLASS 1 1261 2 CLASS 2 1207 3 CLASS 3 1073 4 CLASS 4 1295 5 CLASS 5 1647 6 CLASS 6 897 7 CLASS 7 902 8 CLASS 8 1013 9 CLASS 9 611 10 CLASS 10 641 11 SLC 906 12 CLASS 11 281 13 CLASS 12 OR INTERMEDIATE 526 14 BACHELOR LEVEL 107 15 MASTER LEVEL/PH.D 17 98 DON'T KNOW 2 Sysmiss 22851 308. Marital status Ask only to those who are aged 5 years and older Marital status 29537 7408 1 6 1 Unmarried 10608 2 Currently married 17795 3 Divorced 14 4 Separated 45 5 Widowed 1052 6 Deserted 23 Sysmiss 7408 309. Occupation: A. Main occupation Ask only to those who are aged 5 years and older (Use OCCUPATION CODE) 29537 7408 1 36 1 Self-agri 4345 2 Self-livestock 559 3 Agri (other) 923 4 Self/other agri 501 5 Self-trade/service 821 6 Self-small/cottage industry 93 7 Self-middle/big industry 22 8 Self-construction 60 9 Self-transportation 46 10 Self-other 163 11 Wage-agri 1764 12 Wage-construction skill labour 513 13 Wage-construction unskilled labour 378 14 Wage-manufacturing skill labour 388 15 Wage-manufacturing unskilled labour 182 16 Wage-other skilled labour 430 17 Wage-other unskilled labour 252 18 Labour of transport sector 171 19 Goverment employee (NIJAMATI) 35 20 Security force 157 21 Employee on corporation sector 34 22 Employee on financial sector 26 23 Employee of education sector 168 24 Employee of healthe service 33 25 Lawer 10 26 Employee of NGOs/CBOs 20 27 Student 6454 28 Household duties/child care 6302 29 Retired/old age 380 30 Disable, can work 94 31 Disable, can not work 402 32 Unemployed/seeking work 269 33 Small age (too young) 1642 35 Foreign employee 1809 36 Other 91 Sysmiss 7408 309. Occupation: B. Secondary occupation Ask only to those who are aged 5 years and older (Use OCCUPATION CODE) 29537 7408 1 36 1 Self-agri 2439 2 Self-livestock 1358 3 Agri (other) 546 4 Self/other agri 219 5 Self-trade/service 189 6 Self-small/cottage industry 18 7 Self-middle/big industry 5 8 Self-construction 19 9 Self-transportation 7 10 Self-other 29 11 Wage-agri 1541 12 Wage-construction skill labour 91 13 Wage-construction unskilled labour 136 14 Wage-manufacturing skill labour 29 15 Wage-manufacturing unskilled labour 40 16 Wage-other skilled labour 138 17 Wage-other unskilled labour 122 18 Labour of transport sector 14 19 Goverment employee (NIJAMATI) 1 20 Security force 7 21 Employee on corporation sector 2 22 Employee on financial sector 3 23 Employee of education sector 17 24 Employee of healthe service 19 25 Lawer 0 26 Employee of NGOs/CBOs 11 27 Student 84 28 Household duties/child care 4039 29 Retired/old age 33 30 Disable, can work 13 31 Disable, can not work 37 32 Unemployed/seeking work 128 33 Small age (too young) 1097 34 No secondary occupation 16783 35 Foreign employee 282 36 Other 41 Sysmiss 7408 310. Is [name] currently residing in this HH? Is [name] currently residing in this HH? 36871 74 1 2 1 Yes 32619 2 No 4252 Sysmiss 74 311. Is this child or mother eligible for interview? Is this child or mother eligible for interview? 32619 4326 1 2 1 Yes 10111 2 No 22508 Sysmiss 4326 CO code CO Code 4723 1 600 Household number Household number 4723 1 50 1 245 2 212 3 221 4 215 5 240 6 212 7 191 8 187 9 185 10 203 11 171 12 188 13 170 14 183 15 154 16 154 17 157 18 158 19 147 20 129 21 121 22 136 23 108 24 103 25 81 26 71 27 69 28 67 29 49 30 38 31 37 32 25 33 23 34 20 35 13 36 10 37 4 38 4 39 5 40 3 41 4 45 4 46 2 47 2 48 1 50 1 401. Is this dwelling unit occupied by your household only? would like to know more about your housing units used by your household or currently residing. Is this dwelling unit occupied by your household only? 4649 74 1 2 1 Yes 4311 2 No 338 Sysmiss 74 402. What is the ownership status of the dwelling that your household residing? What is the ownership status of the dwelling that your household residing? 4649 74 1 5 1 Own house (Male ownership) 3272 2 Own house (Female ownership) 604 3 Own house (Joint ownership) 58 4 No ownership 709 5 Rented 6 Sysmiss 74 403. How many rooms are used by your household? How many rooms are used by your household? 4649 74 0 14 0 3 1 546 2 1450 3 1007 4 859 5 380 6 239 7 70 8 53 9 19 10 15 11 6 12 1 14 1 Sysmiss 74 404. How many stories are there in your household? How many stories are there in your household? 4649 74 0 4 0 4 1 2825 2 1592 3 217 4 11 Sysmiss 74 405. Has your household used separate room as a kitchen? Has your household used separate room as a kitchen? 4649 74 1 2 1 Yes 1879 2 No 2770 Sysmiss 74 406. What is the main flooring material of the house that your family using? What is the main flooring material of the house that your family using? 4649 74 1 5 1 Earth/mud 4463 2 Wood/Planks 25 3 Stone/Brick 12 4 Cement 147 5 Other 2 Sysmiss 74 407. What is the main construction material of the outside wall of the house? 4649 74 1 9 1 Bamboo/Wood/Cement mix (centre wall) 155 2 Cement bonded Stones/Bricks/Concrete 469 3 Mud bonded Stones/Bricks 1263 4 Wood 127 5 Unbaked Bricks 28 6 Bamboo and mud 1893 7 Clay, Husk, Mud, Straw, Hay 706 8 Other 6 9 No outside walls 2 Sysmiss 74 408. What is the main construction material of the roof of the house? What is the main construction material of the roof of the house? 4649 74 1 7 1 Hay/Straw 1067 2 Earth/Mud 18 3 Wood 16 4 Galvanized iron 261 5 Concrete/Cement 183 6 Tiles/Slates/Stone 3082 7 Other 22 Sysmiss 74 409. Does your household: A. Regular electricity 4649 74 1 2 1 Yes 3012 2 No 1637 Sysmiss 74 409. Does your household: B. Power generator 4649 74 1 2 1 Yes 32 2 No 4617 Sysmiss 74 409. Does your household: C. Solar power 4649 74 1 2 1 Yes 604 2 No 4045 Sysmiss 74 410. What is the main source of drinking water? What is the main source of drinking water? 4649 74 1 12 1 Piped water directly to the household/compound 408 2 Piped water from a public water tap 646 3 Private Hand-pump (Shallow) 1990 4 Public Hand-pump (Shallow) 717 5 Private Hand-pump (Deep) 50 6 Public Hand-pump (Deep) 51 7 Covered Well 8 8 Open Well 147 9 Stored Rain Water 2 10 Stone tape 250 11 River, Pond, Stream, or other open water bodies 67 12 Neighbour's tube-well 313 Sysmiss 74 411. How many minutes does it take to fetch water? How many minutes does it take to fetch water? (Write 000 if less than one minute) 4649 74 0 240 0 1494 1 278 2 335 3 120 4 64 5 1129 6 38 7 28 8 40 9 16 10 580 12 1 15 172 16 1 20 93 25 8 30 126 32 1 35 2 40 6 45 6 50 1 55 1 60 62 65 1 90 24 120 15 150 4 180 2 240 1 Sysmiss 74 412. Fuel used for cooking and heating - A. Main (If none of A, B, or C is 01 go to question 414) 4649 74 1 10 1 Wood 3011 2 Crop residues (Husk/Straw) 985 3 Dung cakes 578 4 Charcoal 4 5 Coal/cake 2 6 Kerosene 0 7 Electricity 0 8 Liquid Petroleum Gas 50 9 Bio Gas 13 10 Other (Specify) 6 Sysmiss 74 412. Fuel used for cooking and heating - B. Second (If none of A, B, or C is 01 go to question 414) 4649 74 1 99 1 Wood 354 2 Crop residues (Husk/Straw) 997 3 Dung cakes 1146 4 Charcoal 3 5 Coal/cake 5 6 Kerosene 4 7 Electricity 9 8 Liquid Petroleum Gas 82 9 Bio Gas 30 10 Other (Specify) 7 99 No 2nd/3rd answer 2012 Sysmiss 74 412. Fuel used for cooking and heating - C. Third (If none of A, B, or C is 01 go to question 414) 4649 74 1 99 1 Wood 242 2 Crop residues (Husk/Straw) 223 3 Dung cakes 449 4 Charcoal 4 5 Coal/cake 0 6 Kerosene 4 7 Electricity 4 8 Liquid Petroleum Gas 12 9 Bio Gas 11 10 Other (Specify) 4 99 No 2nd/3rd answer 3696 Sysmiss 74 413. How many minutes do you walk/bicycle to get one bhari of firewood? How many minutes do you walk/bicycle to get one bhari of firewood? Fill out only if one of the answers in Q412 is 01. For those using firewood but not fetching, write 99 99) 3607 1116 0 999 0 1 2 3 3 2 4 1 5 9 8 1 9 1 10 15 15 11 16 3 20 24 25 3 30 119 35 2 40 3 45 5 48 1 55 1 60 247 61 1 65 1 70 3 72 2 75 2 80 1 90 89 100 2 110 1 120 414 121 1 125 1 130 1 135 2 140 3 150 26 160 4 165 1 170 2 180 473 190 3 200 18 210 6 220 8 230 1 240 480 250 4 260 2 270 2 280 1 300 364 310 1 320 9 330 5 340 3 350 1 360 158 400 3 420 64 430 3 440 1 442 1 450 1 480 47 540 16 600 66 660 6 720 12 999 Not fetching water 839 Sysmiss 1116 414. What type of toilet does your household use? What type of toilet does your household use? 4649 74 1 6 1 Flush toilet 51 2 Covered Pit/Pan within Household Compound 1081 3 Open Pit within Household Compound 120 4 Community Latrine 18 5 Other type of Latrine (Specify) 10 6 No Toilet/Open Defecation 3369 Sysmiss 74 415. How many minutes does it take to get to the nearest market to your house? How many minutes does it take to get to the nearest market to your house? (Record in minutes even if the answer is in hours) 4649 74 0 960 416. Does your household own land? Does your household own land? If No, go to Q418 4649 74 1 2 1 Yes 4079 2 No 570 Sysmiss 74 CO code 7516 1 600 Household number Household number 7516 1 47 1 413 2 357 3 368 4 326 5 380 6 314 7 308 8 289 9 289 10 325 11 272 12 293 13 278 14 299 15 230 16 262 17 250 18 220 19 242 20 195 21 177 22 222 23 184 24 172 25 122 26 125 27 119 28 106 29 77 30 49 31 62 32 37 33 37 34 39 35 14 36 16 37 6 38 6 39 11 40 4 41 2 45 11 46 3 47 5 417. Land - A. Type Type of land 7516 1 4 1 Household land 3458 2 Farm land 2451 3 Bari/Pakho 1146 4 Baran/forest/etc. 461 99 SKIP 0 417. Land - B. Unit Units 7516 1 2 1 Ropani 2119 2 Bigha 5397 417. Land - C. Area (ropani/bigha) Area: - Ropani/ Bigha 7516 0 90 0 5467 1 616 2 371 3 279 4 178 5 118 6 106 7 59 8 57 9 27 10 45 11 7 12 33 13 22 14 21 15 27 16 12 17 5 18 1 20 23 21 1 22 3 23 1 24 3 25 6 26 2 27 1 28 3 29 2 30 8 32 1 38 1 40 5 47 1 50 1 53 1 60 1 90 1 417. Land - D. Area (aana/kattha) Area: - Ana/ Kattha 7516 0 20 0 4389 1 552 2 433 3 253 4 303 5 357 6 170 7 121 8 235 9 39 10 364 11 22 12 86 13 27 14 25 15 67 16 30 17 14 18 22 19 2 20 5 417. Land - C. Area (dhur/paisa) Area: - Paisa/ Dhur 7516 0 20 0 4784 1 80 2 179 3 227 4 275 5 390 6 199 7 170 8 140 9 67 10 573 11 41 12 86 13 34 14 50 15 106 16 49 17 30 18 26 19 9 20 1 CO code CO Code 4723 1 600 Household number Household number 4723 1 50 1 245 2 212 3 221 4 215 5 240 6 212 7 191 8 187 9 185 10 203 11 171 12 188 13 170 14 183 15 154 16 154 17 157 18 158 19 147 20 129 21 121 22 136 23 108 24 103 25 81 26 71 27 69 28 67 29 49 30 38 31 37 32 25 33 23 34 20 35 13 36 10 37 4 38 4 39 5 40 3 41 4 45 4 46 2 47 2 48 1 50 1 418. Does your household have a garden where you grow vegetables? Does your household have a garden where you grow vegetables? If No, go to 420 4649 74 1 2 1 Yes 2064 2 No 2585 Sysmiss 74 419. For what purpose, do you grow vegetables? For what purpose, do you grow vegetables? 2064 2659 1 3 1 Household consumption 1919 2 Selling 80 3 Both 65 Sysmiss 2659 420. Has your household owned any livestock? Has your household owned any livestock? 4649 74 1 2 1 Yes 3846 2 No 803 Sysmiss 74 CO code CO Code 74458 1 600 Household number Household number 74458 1 50 1 3920 2 3377 3 3521 4 3425 5 3810 6 3332 7 3056 8 2947 9 2900 10 3188 11 2721 12 2948 13 2645 14 2868 15 2419 16 2419 17 2482 18 2408 19 2322 20 1989 21 1906 22 2161 23 1698 24 1618 25 1266 26 1136 27 1089 28 1057 29 769 30 593 31 577 32 400 33 368 34 320 35 178 36 160 37 64 38 64 39 65 40 48 41 64 45 64 46 32 47 32 48 16 50 16 501. Expenditure: A. Item 74384 74 1 16 1 Fuel (Wood, Kerosene, LPG, etc.) 4649 2 Clothes, Apparel 4649 3 Personal care items (Soap, Comb, Shampoo, cosmetics, etc.) 4649 4 Transportation (Horse, Mule, Bus, Taxi, Rickshaw, etc) 4649 5 Entertainment/Excursion (Movies, picnics, melas, etc) 4649 6 Newspapers, Books, Copies, etc. 4649 7 Educational and Professional Services 4649 8 Medicines and Health Services 4649 9 Legal Expenses and Insurance 4649 10 Repair/Maintenance of House and Household Effects and electrician, plumber, etc. 4649 11 Religious, Marriage, Funeral, etc. expenses 4649 12 Donations/gifts 4649 13 Electricity, Water, etc. 4649 14 Household goods 4649 15 Agri. related goods 4649 16 Ornaments, land, livestock etc. purchase 4649 Sysmiss 74 501. Expenditure: B. Amount (NRs.) (Answer in Rupees, if there is no expenditure, write zero if there is no expenditure on the item.) 74384 74 0 400000 CO code CO Code 51213 1 600 Household number Household number 51213 1 50 1 2695 2 2322 3 2421 4 2355 5 2620 6 2292 7 2101 8 2027 9 1995 10 2193 11 1871 12 2028 13 1820 14 1973 15 1664 16 1664 17 1707 18 1658 19 1597 20 1369 21 1311 22 1486 23 1168 24 1113 25 871 26 781 27 749 28 727 29 529 30 408 31 397 32 275 33 253 34 220 35 123 36 110 37 44 38 44 39 45 40 33 41 44 45 44 46 22 47 22 48 11 50 11 502. Income: A. Particulars of Income 51139 74 1 11 1 Agriculture (Agriculture, NTFP, Livestock, etc) 4649 2 Non-Agriculture Enterprise 4649 3 From within the home town 4649 4 Inside the country 4649 5 Outside the country 4649 6 Old age pension/allowances 4649 7 Widow pension/Allowances 4649 8 Disability allowances 4649 9 Other social protection program payments 4649 10 Income from interest, bonus, profit, commission, fees, royalties, etc 4649 11 Prize 4649 Sysmiss 74 502. Income: B. Annual income (NRs.) (Answer in Rupees, write zero if there is no income from the item). 51139 74 0 2500000 CO code CO Code 4723 1 600 Household number Household number 4723 1 50 1 245 2 212 3 221 4 215 5 240 6 212 7 191 8 187 9 185 10 203 11 171 12 188 13 170 14 183 15 154 16 154 17 157 18 158 19 147 20 129 21 121 22 136 23 108 24 103 25 81 26 71 27 69 28 67 29 49 30 38 31 37 32 25 33 23 34 20 35 13 36 10 37 4 38 4 39 5 40 3 41 4 45 4 46 2 47 2 48 1 50 1 503. How many borrowed loans does your household have over the past 12 months? How many borrowed loans does your household have over the past 12 months? If None go to 505 4649 74 0 16 0 None 642 1 1100 2 1123 3 770 4 478 5 279 6 109 7 59 8 16 9 16 10 33 11 1 12 17 13 2 15 3 16 1 Sysmiss 74 504. What was or is the annual rate of interest of the most recent loan borrowed What was or is the annual rate of interest of the most recent loan borrowed? (If eight and a half percent, write 8.5) 4007 716 0 75 0 3 0.400000005960464 1 0.5 1 1 26 1.20000004768372 2 1.5 13 2 46 2.5 7 3 11 4 8 5 2 6 333 8 12 9 9 10 58 11.3999996185303 1 12 406 14 3 15 13 16 7 17 1 18 64 19 1 19.5 2 20 24 21 1 22 3 23 1 24 327 25 27 28 2 30 44 36 1440 38 2 40 7 42 5 48 536 54 2 60 541 72 14 75 1 Sysmiss 716 505. Has your household lent any loans to anyone over the past 12 months? Has your household lent any loans to anyone over the past 12 months? 4649 74 1 2 1 Yes 159 2 No 4490 Sysmiss 74 CO code CO Code 162789 1 600 Household number Household number 162789 1 50 1 8575 2 7386 3 7701 4 7491 5 8332 6 7284 7 6685 8 6443 9 6339 10 6969 11 5951 12 6444 13 5780 14 6269 15 5288 16 5288 17 5427 18 5258 19 5077 20 4345 21 4167 22 4726 23 3712 24 3537 25 2767 26 2485 27 2381 28 2311 29 1681 30 1296 31 1261 32 875 33 805 34 700 35 387 36 350 37 140 38 140 39 141 40 105 41 140 45 140 46 70 47 70 48 35 50 35 506. Consumption: A. Food item 162715 74 1 35 1 Rice 4649 2 Beaten rice 4649 3 Maize 4649 4 Wheat 4649 5 Barley/Oat/Sorghum 4649 6 Millet/ Buckwheat 4649 7 Pulses 4649 8 Gram/Pea 4649 9 Other beans 4649 10 Fish 4649 11 Meat 4649 12 Egg 4649 13 Milk 4649 14 Curd/Whey etc. 4649 15 Baby/Powder milk 4649 16 Ghee 4649 17 Honey 4649 18 Vegetable ghee 4649 19 Oil (Mustard, Soyabean, etc.) 4649 20 Potato/Colocasia 4649 21 Onion 4649 22 Green leafy vegetables 4649 23 Other vergetables (cauliflower, okra, etc) 4649 24 Fruits/nuts 4649 25 Salt 4649 26 Other Spices (scumin seed, marich, garlic, ginger, chillies, etc.) 4649 27 Sugar 4649 28 Sakhar/Gud/Khudo 4649 29 Sweets 4649 30 Tea/Coffee 4649 31 Alcoholic beverages (Jand, Wine, Beer, etc.) 4649 32 Non-alcoholic beverages (Coke, Frooti, Sarbat, etc.) 4649 33 Tobacco and tobacco products 4649 34 Noodles and Biscuits 4649 35 Other Foods 4649 Sysmiss 74 506. Consumption: B. Quantity (If none, write 0 and ➔Next item) 162715 74 0 900 506. Consumption: B. Unit (If none, write 0 and ➔Next item) 52032 110757 1 10 1 Kilogram 11875 2 Gram 11624 3 Litre 1954 4 Ml 2867 5 Pathi 89 6 Mana 2719 7 Kuruwa 56 8 Number 8913 9 Dozen 57 10 Spoons 11878 Sysmiss 110757 CO code CO Code 46564 1 600 Household number Household number 46564 1 50 1 2450 2 2111 3 2201 4 2141 5 2382 6 2084 7 1910 8 1843 9 1814 10 1994 11 1701 12 1844 13 1655 14 1794 15 1513 16 1513 17 1552 18 1508 19 1452 20 1245 21 1192 22 1351 23 1062 24 1012 25 792 26 710 27 681 28 661 29 481 30 371 31 361 32 250 33 230 34 200 35 112 36 100 37 40 38 40 39 41 40 30 41 40 45 40 46 20 47 20 48 10 50 10 507. Unexpected events - A. Type of shock 46490 74 1 10 1 Getting a new job of any kind 4649 2 Inheritance 4649 3 Death of HH member 4649 4 Accidental or Violent injury 4649 5 Loss of employment of any kind 4649 6 Failure/loss of business 4649 7 Livestock died 4649 8 Crop disease/pests 4649 9 Theft/robbery/burglary/assault 4649 10 Drought/floods 4649 Sysmiss 74 507. Unexpected events - B. Has the household experienced? No, go to Next item 46490 74 1 2 1 Yes 3480 2 No 43010 Sysmiss 74 507. Unexpected events - C. Who did this shock affect? 3480 43084 1 3 1 Just this household 2897 2 Several HHs in the village 422 3 All HHs in the village 161 Sysmiss 43084 507. Unexpected events - D. What was the strength of this shock? 3480 43084 1 5 1 Not important 115 2 Mild 707 3 Average 954 4 Quite strong 1325 5 Very strong 379 Sysmiss 43084 CO code CO Code 4229 1 600 Household number Household number 4229 1 50 1 226 2 198 3 203 4 194 5 221 6 184 7 163 8 162 9 166 10 186 11 148 12 167 13 151 14 164 15 138 16 140 17 145 18 120 19 141 20 104 21 100 22 129 23 94 24 89 25 72 26 69 27 62 28 61 29 45 30 34 31 34 32 28 33 24 34 19 35 10 36 9 37 6 38 2 39 2 40 3 41 6 45 4 46 2 47 2 48 1 50 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 4229 1 27 1 328 2 1388 3 349 4 1395 5 66 6 80 7 129 8 167 9 117 10 73 11 46 12 19 13 15 14 15 15 14 16 11 17 2 18 7 19 2 21 2 22 1 23 1 25 1 27 1 601. Were you or any of your children who are younger than 36 months sick in the Were you or any of your children who are younger than 36 months sick in the last 30 days? No, go to Section 7 4229 1 2 1 Yes 2522 2 No 1707 ***** Number person that was sick (Sec 06) Number person that was sick 2522 1707 0 3 0 4 1 1909 2 570 3 39 Sysmiss 1707 CO code CO Code 3166 1 600 Household number Household number 3166 1 50 1 181 2 135 3 140 4 148 5 157 6 134 7 133 8 135 9 124 10 140 11 105 12 126 13 111 14 125 15 95 16 106 17 104 18 82 19 115 20 87 21 91 22 105 23 78 24 56 25 47 26 51 27 47 28 42 29 32 30 23 31 31 32 23 33 15 34 13 35 6 36 7 37 2 38 1 39 2 40 2 41 4 45 1 46 1 47 1 48 1 50 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3166 1 27 1 288 2 1018 3 299 4 1008 5 54 6 62 7 84 8 117 9 74 10 67 11 23 12 14 13 9 14 10 15 12 16 6 17 3 18 8 19 3 21 2 22 3 23 1 27 1 ID Code ID CODE (Enter from section 3) 3166 1 28 1 85 2 326 3 173 4 542 5 596 6 494 7 304 8 220 9 136 10 80 11 69 12 40 13 29 14 16 15 12 16 10 17 10 18 4 19 4 20 8 21 1 22 3 23 1 24 2 28 1 99 SKIP 0 603. What type of illness does [NAME] suffer from last time during the past 30 d What type of illness does [NAME] suffer from last time during the past 30 days? 3166 1 17 1 Diarrhoea 350 2 Dysentry 33 3 Pneumonia/Cough 1238 4 Malaria 51 5 Other fever 981 6 Skin disease 124 7 TB 4 8 Measles 3 9 Jaundice 13 10 Parasites 8 11 Injury 54 12 Pregnancy related complications 136 13 Stomach-ache 153 14 STDs/STIs 1 15 Eye-ache 9 16 Head-ache 5 17 Orthopedic 3 604. Where did [NAME] go for the first consultation of the illness reported in Q Where did [NAME] go for the first consultation of the illness reported in Q.603? Not consulted → 606 3166 1 12 1 SHP 233 2 HP 357 3 PHC 73 4 Govt. hospital 160 5 Mobile clinic 13 6 Ayurvedic centre 2 7 Pharmacy/Clinic 1697 8 Pvt. hospital 271 9 Health worker's home 69 10 Traditional healer 64 11 GHUMTI SIBIR 20 12 Not consulted 207 605. Whom did [NAME] first consult with of the illness reported in Q.603? Whom did [NAME] first consult with of the illness reported in Q.603? → Go To Next Member 2959 207 1 6 1 Doctor 680 2 Paramedic (HA,SAHW, AHW, ANM) 1866 3 Kaviraj/Vaidya 5 4 Untrained Pharmacist 341 5 Traditional Healer 64 6 Other 3 Sysmiss 207 606. Why didn't you consult for the illness? Why didn't you consult for the illness? 207 2959 1 7 1 No money 54 2 Illness not serious 111 3 Health worker far 18 4 No good health worker 0 5 Treatment expensive 2 6 Don't know about health institution 7 7 Pregnant 15 Sysmiss 2959 CO code CO Code 4229 1 600 Household number Household number 4229 1 50 1 226 2 198 3 203 4 194 5 221 6 184 7 163 8 162 9 166 10 186 11 148 12 167 13 151 14 164 15 138 16 140 17 145 18 120 19 141 20 104 21 100 22 129 23 94 24 89 25 72 26 69 27 62 28 61 29 45 30 34 31 34 32 28 33 24 34 19 35 10 36 9 37 6 38 2 39 2 40 3 41 6 45 4 46 2 47 2 48 1 50 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 4229 1 27 1 328 2 1388 3 349 4 1395 5 66 6 80 7 129 8 167 9 117 10 73 11 46 12 19 13 15 14 15 15 14 16 11 17 2 18 7 19 2 21 2 22 1 23 1 25 1 27 1 701. In your opinion, what should be done with the first milk (colostrums)? Now I’d like to ask you some questions about the nutrition for under 2 children In your opinion, what should be done with the first milk (colostrums)? 4229 1 8 1 Given to baby 3171 2 Thrown away 907 3 Other 3 8 Do not know 148 702. In your opinion, for how long should a newborn infant be given nothing but In your opinion, for how long should a newborn infant be given nothing but breast milk? 4229 1 8 1 Less than 6 months 270 2 6 months 2230 3 More than 6 months 1545 8 Do not know 184 CO code CO Code 67664 1 600 Household number Household number 67664 1 50 1 3616 2 3168 3 3248 4 3104 5 3536 6 2944 7 2608 8 2592 9 2656 10 2976 11 2368 12 2672 13 2416 14 2624 15 2208 16 2240 17 2320 18 1920 19 2256 20 1664 21 1600 22 2064 23 1504 24 1424 25 1152 26 1104 27 992 28 976 29 720 30 544 31 544 32 448 33 384 34 304 35 160 36 144 37 96 38 32 39 32 40 48 41 96 45 64 46 32 47 32 48 16 50 16 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 67664 1 27 1 5248 2 22208 3 5584 4 22320 5 1056 6 1280 7 2064 8 2672 9 1872 10 1168 11 736 12 304 13 240 14 240 15 224 16 176 17 32 18 112 19 32 21 32 22 16 23 16 25 16 27 16 703. What foods are best? - A. Item (DO NOT DO NOT PROMPT THE MOTHER. CHECK ALL FOODS THE MOTHER MENTIONS UNPROMPTED) 67664 1 16 1 Porridge that is not enriched with other foods 4229 2 Porridge that is enriched with other foods/sarbottam pitho 4229 3 Yellow, orange and green vegetables 4229 4 Fruits 4229 5 Eggs 4229 6 Milk or yogurt 4229 7 Chicken or meat including liver 4229 8 Ghee, butter, or oil 4229 9 Lentils/pulses 4229 10 Biscuit 4229 11 Cerelac 4229 12 Hoslicks 4229 13 Noodles 4229 14 Vitamin 4229 15 Bread 4229 16 Others 4229 703. What foods are best? - B. Mentioned/Not Mentioned? (DO NOT DO NOT PROMPT THE MOTHER. CHECK ALL FOODS THE MOTHER MENTIONS UNPROMPTED) 67664 1 2 1 Mentioned 16920 2 Not mentioned 50744 CO code CO Code 4229 1 600 Household number Household number 4229 1 50 1 226 2 198 3 203 4 194 5 221 6 184 7 163 8 162 9 166 10 186 11 148 12 167 13 151 14 164 15 138 16 140 17 145 18 120 19 141 20 104 21 100 22 129 23 94 24 89 25 72 26 69 27 62 28 61 29 45 30 34 31 34 32 28 33 24 34 19 35 10 36 9 37 6 38 2 39 2 40 3 41 6 45 4 46 2 47 2 48 1 50 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 4229 1 27 1 328 2 1388 3 349 4 1395 5 66 6 80 7 129 8 167 9 117 10 73 11 46 12 19 13 15 14 15 15 14 16 11 17 2 18 7 19 2 21 2 22 1 23 1 25 1 27 1 704. How many times a day should a 6-11 month old baby be fed a meal in addition How many times a day should a 6-11 month old baby be fed a meal in addition to breast milk? 4229 0 98 0 1 1 8 2 130 3 821 4 805 5 443 6 340 7 226 8 209 9 159 10 182 11 53 12 128 13 53 14 91 15 121 16 70 17 44 18 63 19 9 20 57 21 4 22 16 23 7 24 7 25 9 27 2 28 2 29 1 30 2 50 2 98 Do not know 164 705. How many snacks a day should a 12-24 month old baby be given in addition to How many snacks a day should a 12-24 month old baby be given in addition to breast milk? 4229 0 98 0 4 1 2 2 94 3 672 4 1267 5 820 6 608 7 228 8 197 9 74 10 67 11 1 12 25 14 2 15 1 20 2 98 Do not know 165 706. In your opinion, should you breastfeed your baby less, the same or more tha In your opinion, should you breastfeed your baby less, the same or more than usual during an episode of diarrhea? 4229 1 8 1 Less than usual 1558 2 Same as usual 802 3 More than usual 1661 8 Do not know 208 707. In your opinion, at least how many times should a pregnant mother visit for Now I’d like to ask you some questions about the nutrition for women. In your opinion, at least how many times should a pregnant mother visit for ANC check up, 1, 2, 3, 4 or more? 4229 0 8 0 7 1 49 2 224 3 956 4 1709 5 335 6 182 7 106 8 Do not know 661 708. When should a pregnant woman start iron supplementation (in months)? When should a pregnant woman start iron supplementation (in months)? 4229 0 8 0 2 1 92 2 171 3 1085 4 1176 5 484 6 417 7 21 8 Do not know 781 709. When should a pregnant woman take deworming tablets (in months)? When should a pregnant woman take deworming tablets (in months)? 4229 0 8 0 7 1 59 2 85 3 438 4 586 5 437 6 980 7 78 8 Do not know 1559 710. When should a recently delivered woman take Vitamin A capsule (within When should a recently delivered woman take Vitamin A capsule (within days of delivery)? 4229 0 98 0 11 1 101 2 67 3 71 4 30 5 46 6 69 7 110 8 17 9 17 10 53 11 5 12 35 13 3 14 3 15 135 16 5 18 4 19 2 20 49 21 5 22 48 24 8 25 17 28 5 29 1 30 403 32 2 35 49 36 1 40 108 42 33 43 1 44 1 45 269 46 1 48 16 50 5 60 123 80 1 90 29 98 Do not know 2270 711. In your opinion, is it best for a pregnant woman to eat less food, the same In your opinion, is it best for a pregnant woman to eat less food, the same amount or more food than she ate before becoming pregnant? 4229 1 8 1 More than usual 2223 2 Same as usual 630 3 Less than usual 1272 8 Do not know 104 CO code CO Code 59206 1 600 Household number Household number 59206 1 50 1 3164 2 2772 3 2842 4 2716 5 3094 6 2576 7 2282 8 2268 9 2324 10 2604 11 2072 12 2338 13 2114 14 2296 15 1932 16 1960 17 2030 18 1680 19 1974 20 1456 21 1400 22 1806 23 1316 24 1246 25 1008 26 966 27 868 28 854 29 630 30 476 31 476 32 392 33 336 34 266 35 140 36 126 37 84 38 28 39 28 40 42 41 84 45 56 46 28 47 28 48 14 50 14 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 59206 1 27 1 4592 2 19432 3 4886 4 19530 5 924 6 1120 7 1806 8 2338 9 1638 10 1022 11 644 12 266 13 210 14 210 15 196 16 154 17 28 18 98 19 28 21 28 22 14 23 14 25 14 27 14 712. Good foods for a woman - A. Item (DO NOT PROMPT THE MOTHER. CHECK ALL FOODS THE MOTHER MENTIONS UNPROMPTED) 59206 1 14 1 Yellow, orange and green vegetables 4229 2 Fruit 4229 3 Eggs 4229 4 Milk or yogurt 4229 5 Meat 4229 6 Beans/pulses 4229 7 Rice 4229 8 Bread 4229 9 Horlicks 4229 10 Vitamin 4229 11 Noodles 4229 12 Biscuit 4229 13 HALUWA 4229 14 Others 4229 712. Good foods for a woman - B. Mentioned/Not Mentioned? (DO NOT PROMPT THE MOTHER. CHECK ALL FOODS THE MOTHER MENTIONS UNPROMPTED) 59206 1 2 1 Mentioned 15554 2 Not Mentioned 43652 CO code CO Code 33832 1 600 Household number Household number 33832 1 50 1 1808 2 1584 3 1624 4 1552 5 1768 6 1472 7 1304 8 1296 9 1328 10 1488 11 1184 12 1336 13 1208 14 1312 15 1104 16 1120 17 1160 18 960 19 1128 20 832 21 800 22 1032 23 752 24 712 25 576 26 552 27 496 28 488 29 360 30 272 31 272 32 224 33 192 34 152 35 80 36 72 37 48 38 16 39 16 40 24 41 48 45 32 46 16 47 16 48 8 50 8 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 33832 1 27 1 2624 2 11104 3 2792 4 11160 5 528 6 640 7 1032 8 1336 9 936 10 584 11 368 12 152 13 120 14 120 15 112 16 88 17 16 18 56 19 16 21 16 22 8 23 8 25 8 27 8 713. With whom do you usually seek advice? - A. People giving advice Circle all responses given, ask open-ended) 33832 1 8 1 FCHV 4229 2 AAMA Mothers group 4229 3 MCHW/VHW 4229 4 Other Health Workers 4229 5 Local private pharmacy 4229 6 Traditional healers 4229 7 Family members 4229 8 Other 4229 713. With whom do you usually seek advice? - B. Yes/No? Circle all responses given, ask open-ended) 33832 1 2 1 Yes 6868 2 No 26964 CO code CO Code 4229 1 600 Household number Household number 4229 1 50 1 226 2 198 3 203 4 194 5 221 6 184 7 163 8 162 9 166 10 186 11 148 12 167 13 151 14 164 15 138 16 140 17 145 18 120 19 141 20 104 21 100 22 129 23 94 24 89 25 72 26 69 27 62 28 61 29 45 30 34 31 34 32 28 33 24 34 19 35 10 36 9 37 6 38 2 39 2 40 3 41 6 45 4 46 2 47 2 48 1 50 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 4229 1 27 1 328 2 1388 3 349 4 1395 5 66 6 80 7 129 8 167 9 117 10 73 11 46 12 19 13 15 14 15 15 14 16 11 17 2 18 7 19 2 21 2 22 1 23 1 25 1 27 1 714. What kind of salt do you normally use in your house? What kind of salt do you normally use in your house? 4229 1 2 1 Aayunoon/Two child logo salt 3330 2 Other salt 899 715. Are you smoking, chewing tobacco and drinking alcohol regularly? Are you smoking, chewing tobacco and drinking alcohol regularly? 4229 1 4 1 Yes smoking and taking tobacco 143 2 Yes drinking alcohol 291 3 Yes taking both 92 4 No, taking nothing 3703 CO code CO Code 4229 1 600 Household number Household number 4229 1 50 1 226 2 198 3 203 4 194 5 221 6 184 7 163 8 162 9 166 10 186 11 148 12 167 13 151 14 164 15 138 16 140 17 145 18 120 19 141 20 104 21 100 22 129 23 94 24 89 25 72 26 69 27 62 28 61 29 45 30 34 31 34 32 28 33 24 34 19 35 10 36 9 37 6 38 2 39 2 40 3 41 6 45 4 46 2 47 2 48 1 50 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 4229 1 27 1 328 2 1388 3 349 4 1395 5 66 6 80 7 129 8 167 9 117 10 73 11 46 12 19 13 15 14 15 15 14 16 11 17 2 18 7 19 2 21 2 22 1 23 1 25 1 27 1 801. How old were you when you got married? How old were you when you got married? 4229 10 40 10 51 11 24 12 185 13 170 14 381 15 660 16 880 17 545 18 537 19 260 20 263 21 96 22 81 23 32 24 26 25 18 26 4 27 5 28 6 29 1 30 2 33 1 40 1 802. Was the marriage arranged? Was the marriage arranged? 4229 1 2 1 Yes 3693 2 No 536 803. Are you currently pregnant? Are you currently pregnant? No, go to 806 4229 1 2 1 Yes 1083 2 No 3146 804. How long have you been pregnant for? How long have you been pregnant for? 1083 3146 0 9 0 8 1 27 2 84 3 134 4 126 5 129 6 151 7 147 8 183 9 94 Sysmiss 3146 805. Is this your first pregnancy? Is this your first pregnancy? 1083 3146 1 3 1 Yes 325 2 No, and have kids who are alive 736 3 No, and other kid(s) died 22 Sysmiss 3146 806. During your pregnancy with your youngest child, how many times did you rece During your pregnancy with your youngest child (name:___________), how many times did you receive antenatal care? 3882 347 0 36 0 593 1 249 2 527 3 883 4 1065 5 221 6 140 7 40 8 36 9 93 10 12 11 3 12 8 13 3 15 4 16 1 18 1 36 3 Sysmiss 347 807. Did you receive TT injection at any time during this pregnancy (with name)? Did you receive TT injection at any time during this pregnancy (with name)? 3882 347 1 2 1 Yes 3392 2 No 490 Sysmiss 347 808. While pregnant with (name of youngest child), how many times did you receiv While pregnant with (name of youngest child), how many times did you receive such an injection? 3392 837 0 9 0 2 1 466 2 2217 3 627 4 61 5 16 6 2 9 1 Sysmiss 837 809. When you were pregnant with (name of youngest child), did you receive iron When you were pregnant with (name of youngest child), did you receive iron tablets? No, go to 812 3882 347 1 2 1 Yes 2902 2 No 980 Sysmiss 347 810. How many days during your pregnancy did you take the iron tablets? 2902 1327 1 540 CO code CO Code 17412 1 600 Household number Household number 17412 1 50 1 888 2 846 3 858 4 774 5 948 6 714 7 702 8 600 9 720 10 786 11 618 12 732 13 612 14 708 15 534 16 636 17 588 18 474 19 588 20 384 21 396 22 540 23 420 24 342 25 270 26 294 27 264 28 264 29 150 30 156 31 132 32 120 33 96 34 60 35 30 36 42 37 24 38 12 39 6 40 12 41 24 45 18 46 12 47 6 48 6 50 6 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Woman] Name and ID Code of Respondent -HH Roster 17412 1 27 1 1422 2 5634 3 1530 4 5718 5 258 6 270 7 558 8 708 9 516 10 306 11 138 12 72 13 48 14 54 15 54 16 48 17 12 18 30 19 12 21 12 25 6 27 6 811. From where? - A. Place where the tablets were taken 17412 1 6 1 FCHV 2902 2 Health Facility 2902 3 Clinic/pharmacy 2902 4 Hospital 2902 5 NGOs/INGOs 2902 6 Privat nursing home 2902 811. From where? - B. Yes/No? 17412 1 2 1 Yes 3296 2 No 14116 CO code CO Code 4229 1 600 Household number Household number 4229 1 50 1 226 2 198 3 203 4 194 5 221 6 184 7 163 8 162 9 166 10 186 11 148 12 167 13 151 14 164 15 138 16 140 17 145 18 120 19 141 20 104 21 100 22 129 23 94 24 89 25 72 26 69 27 62 28 61 29 45 30 34 31 34 32 28 33 24 34 19 35 10 36 9 37 6 38 2 39 2 40 3 41 6 45 4 46 2 47 2 48 1 50 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Woman] Name and ID Code of Respondent -HH Roster 4229 1 27 1 328 2 1388 3 349 4 1395 5 66 6 80 7 129 8 167 9 117 10 73 11 46 12 19 13 15 14 15 15 14 16 11 17 2 18 7 19 2 21 2 22 1 23 1 25 1 27 1 812. During your last pregnancy, (with name) did you take de-worming tablet? During your last pregnancy, (with name) did you take de-worming tablet? 3882 347 1 2 1 Yes 2397 2 No 1485 Sysmiss 347 813. Did you suffer from night blindness or ratandho in your last pregnancy? Did you suffer from night blindness or ratandho in your last pregnancy? 3882 347 1 2 1 Yes 658 2 No 3224 Sysmiss 347 814. Where did you give birth in your most recent delivery? Where did you give birth in your most recent delivery? 3882 347 1 6 1 Home 3032 2 Government hospital 455 3 PHC/HP/SHP 221 4 Private hospital/nursing home 146 5 Field/jungle 8 6 Road/Vehicle 20 Sysmiss 347 815. Who assisted with your most recent delivery? Who assisted with your most recent delivery? 3882 347 1 9 1 Doctor 353 2 Staff nurse/ANM 577 3 HA/AHW 394 4 MCHW 58 5 FCHV 319 6 TBA 255 7 Untrained household member/neighbor 1836 8 Other 28 9 No one 62 Sysmiss 347 816. In the first 42 days after delivery, did you take Vitamin A capsules? In the first 42 days after delivery, did you take Vitamin A capsules? 3882 347 1 2 1 Yes 1757 2 No 2125 Sysmiss 347 817. If yes, from where did you receive? If yes, from where did you receive? 1757 2472 1 3 1 FCHV 872 2 Health workers 843 3 Shop/Medical 42 Sysmiss 2472 818. Are you or your husband currently using any family planning method? Are you or your husband currently using any family planning method? 3882 347 1 2 1 Yes 565 2 No 3317 Sysmiss 347 CO code CO Code 3882 1 600 Household number Household number 3882 1 50 1 201 2 182 3 188 4 175 5 204 6 160 7 153 8 144 9 153 10 171 11 141 12 160 13 144 14 152 15 122 16 129 17 129 18 111 19 130 20 99 21 94 22 122 23 92 24 80 25 63 26 61 27 57 28 57 29 41 30 31 31 31 32 25 33 22 34 17 35 9 36 8 37 5 38 2 39 1 40 2 41 5 45 3 46 2 47 2 48 1 50 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3882 1 27 1 322 2 1363 3 327 4 1214 5 52 6 60 7 110 8 141 9 103 10 68 11 40 12 15 13 11 14 15 15 13 16 11 17 2 18 7 19 2 21 2 22 1 23 1 25 1 27 1 901. Did you ever breastfeed to your youngest child (name of child)? Did you ever breastfeed to your youngest child (name of child)? No, go to 904 3882 1 2 1 Yes 3844 2 No 38 902. How long after giving birth did you first put (name of child) to the breast How long after giving birth did you first put (name of child) to the breast? Hours (If less than 1 hour, record ‘00’ hours. Convert days to hours.) 3844 38 0 360 903. During the first three days after delivery, did you give (name) the liquid During the first three days after delivery, did you give (name) the liquid that came from your breasts? 3844 38 1 2 1 Yes 3129 2 No 715 Sysmiss 38 904. In the first three days after delivery, was (name) given anything to drink In the first three days after delivery, was (name) given anything to drink other than breast milk? No, go to 906 3882 1 2 1 Yes 1708 2 No 2174 CO code Code 20496 2 600 Household number Household number 20496 1 46 1 1140 2 1044 3 1056 4 996 5 1128 6 888 7 900 8 924 9 876 10 960 11 768 12 780 13 684 14 708 15 576 16 732 17 780 18 528 19 612 20 480 21 528 22 468 23 468 24 432 25 264 26 396 27 252 28 300 29 180 30 132 31 168 32 108 33 72 34 48 35 24 36 24 37 24 38 12 40 12 46 24 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Woman] Name and ID Code of Respondent -HH Roster 20496 1 25 1 1668 2 6396 3 1824 4 7092 5 240 6 252 7 660 8 684 9 612 10 432 11 180 12 36 13 60 14 60 15 84 16 60 17 24 18 60 19 12 21 24 22 12 23 12 25 12 905. What was (name) given to drink? - A. Liquid Food 20496 1 12 1 Milk (other than breast milk) 1708 2 Other mother milk 1708 3 Plain water 1708 4 Sugar or glucose water 1708 5 Gripe water 1708 6 Sugar-salt-water solution 1708 7 Fruit juice 1708 8 Infant formula 1708 9 Honey 1708 10 Ghee 1708 11 Milk pouder 1708 12 Others 1708 905. What was (name) given to drink? - B. Fed/not fed? 20496 1 2 1 Fed 2774 2 Not fed 17722 CO code CO Code 3882 1 600 Household number Household number 3882 1 50 1 201 2 182 3 188 4 175 5 204 6 160 7 153 8 144 9 153 10 171 11 141 12 160 13 144 14 152 15 122 16 129 17 129 18 111 19 130 20 99 21 94 22 122 23 92 24 80 25 63 26 61 27 57 28 57 29 41 30 31 31 31 32 25 33 22 34 17 35 9 36 8 37 5 38 2 39 1 40 2 41 5 45 3 46 2 47 2 48 1 50 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Woman] Name and ID Code of Respondent -HH Roster 3882 1 27 1 322 2 1363 3 327 4 1214 5 52 6 60 7 110 8 141 9 103 10 68 11 40 12 15 13 11 14 15 15 13 16 11 17 2 18 7 19 2 21 2 22 1 23 1 25 1 27 1 906. For how many months did you exclusively breastfeed (name)? For how many months did you exclusively breastfeed (name)? If less than one month record 00 months.) 3882 0 99 0 164 1 89 2 102 3 159 4 144 5 273 6 1180 7 368 8 204 9 149 10 33 11 13 12 118 13 3 14 4 15 1 16 2 17 1 18 4 19 2 22 1 23 1 24 2 99 Still breastfeeding 865 907. For how many months did you breastfeed (name)? For how many months did you breastfeed (name)? (If less than one month record 00 months.) 3882 0 99 0 17 1 4 2 2 3 3 4 6 5 6 6 8 7 6 8 14 9 22 10 2 11 6 12 47 13 16 14 11 15 17 16 15 17 7 18 59 19 10 20 17 21 11 22 15 23 2 24 80 25 7 26 10 27 4 28 2 29 9 30 22 31 3 32 1 33 3 34 2 36 51 37 1 38 2 39 1 40 3 42 1 44 1 46 1 48 15 60 6 99 Still breastfeeding 3334 908. ENUMERATOR: Is [name] younger than 24 months or older? ENUMERATOR: Is [name] younger than 24 months or older? Older than 24 m 30 d, go to Section 10 3882 1 2 1 Younger than 24 m 30 d 3513 2 Older than 24 m 30 d 369 909. Are you still breastfeeding (name)? Are you still breastfeeding (name)? No, go to 911 3513 369 1 2 1 Yes 3299 2 No 214 Sysmiss 369 910. How often did you breastfeed your child (name) day and night during last 24 3299 583 0 40 0 4 1 4 2 18 3 48 4 103 5 155 6 195 7 227 8 239 9 209 10 502 11 66 12 380 13 125 14 122 15 285 16 96 17 46 18 52 19 8 20 212 21 10 22 39 23 4 24 24 25 61 26 15 27 2 28 4 29 8 30 22 32 1 35 3 36 1 40 9 Sysmiss 583 CO code CO Code 1308 25 596 Household number Household number 1308 1 45 1 90 2 54 3 84 4 48 5 48 6 54 7 36 8 24 9 24 10 66 11 36 12 66 13 54 14 36 15 12 16 54 17 60 18 48 19 48 20 78 21 24 22 48 23 18 24 36 25 18 26 24 27 30 29 24 30 12 31 18 32 6 33 12 35 6 37 6 45 6 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1308 1 18 1 66 2 480 3 102 4 390 5 12 6 18 7 72 8 48 9 48 10 12 11 6 12 12 13 6 14 12 15 6 16 12 18 6 911. Why not? - A. Reasons for not breastfeeding (Circle all responses given, ask open-ended) 1308 1 6 1 No milking 218 2 Inadequacy of breastmilks 218 3 Work load/lack of time 218 4 Child ill 218 5 Pregnant 218 6 Mother is/was sick 218 911. Why not? - B. Yes/No? (Circle all responses given, ask open-ended) 1308 1 2 1 Yes 244 2 No 1064 CO code CO Code 3882 1 600 Household number Household number 3882 1 50 1 201 2 182 3 188 4 175 5 204 6 160 7 153 8 144 9 153 10 171 11 141 12 160 13 144 14 152 15 122 16 129 17 129 18 111 19 130 20 99 21 94 22 122 23 92 24 80 25 63 26 61 27 57 28 57 29 41 30 31 31 31 32 25 33 22 34 17 35 9 36 8 37 5 38 2 39 1 40 2 41 5 45 3 46 2 47 2 48 1 50 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3882 1 27 1 322 2 1363 3 327 4 1214 5 52 6 60 7 110 8 141 9 103 10 68 11 40 12 15 13 11 14 15 15 13 16 11 17 2 18 7 19 2 21 2 22 1 23 1 25 1 27 1 912. Did (name) drink anything milk or liquidy from a bottle with a nipple yeste Did (name) drink anything milk or liquidy from a bottle with a nipple yesterday or last night? 3513 369 1 8 1 Yes 1630 2 Nothing 1878 8 Do not know 5 Sysmiss 369 CO code CO Code 84312 1 600 Household number Household number 84312 1 50 1 4464 2 3936 3 4056 4 3648 5 4440 6 3528 7 3240 8 3072 9 3336 10 3624 11 3120 12 3456 13 3144 14 3288 15 2664 16 2952 17 2952 18 2304 19 2880 20 2136 21 2016 22 2712 23 1968 24 1656 25 1392 26 1320 27 1176 28 1248 29 960 30 624 31 696 32 576 33 456 34 384 35 192 36 168 37 96 38 48 39 24 40 48 41 120 45 72 46 48 47 24 48 24 50 24 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 84312 1 27 1 6984 2 28608 3 7176 4 27048 5 1200 6 1344 7 2424 8 3168 9 2160 10 1560 11 864 12 336 13 240 14 312 15 312 16 240 17 48 18 144 19 24 21 48 22 24 23 24 27 24 913. liquids or foods - A. Item 84312 1 24 1 Breast milk 3513 2 Plain water 3513 3 Milk such as commercially produced infant formula 3513 4 Any fortified, commercially available infant and young child food 3513 5 Any other porridge or gruel 3513 6 Fresh animal milk 3513 7 Yogurt or other milk products 3513 8 Rice, chapattis other foods made from grains such as millet, maize, lito 3513 9 White potatoes or other [roots] tubers 3513 10 Pupmkin, carrots, or other yellow or orange vegetables 3513 11 Ripe mangoes, papaya, or other yellow or orange fruits 3513 12 Any dark green leafy vegetables 3513 13 Other fruits such as banana, orange, apple 3513 14 Eggs 3513 15 Any meat such as goat, lamb, chicken, pork, ducks 3513 16 Any organ meat such as liver, kidney 3513 17 Fresh or dried fish or shellfish/dried meat 3513 18 Snails or other small protein foods 3513 19 Lentils, beans, peas, or nuts 3513 20 Any oils, fats or foods made with any of these foods 3513 21 Tea 3513 22 Sugary foods such as sweets, chocolate 3513 23 Processed foods such as biscuits, noodles 3513 24 Any other solid or soft foods/JAAND 3513 913. liquids or foods - B. Yes/No? 84312 1 2 1 Yes 16269 2 No 68043 CO code CO Code 3882 1 600 Household number Household number 3882 1 50 1 201 2 182 3 188 4 175 5 204 6 160 7 153 8 144 9 153 10 171 11 141 12 160 13 144 14 152 15 122 16 129 17 129 18 111 19 130 20 99 21 94 22 122 23 92 24 80 25 63 26 61 27 57 28 57 29 41 30 31 31 31 32 25 33 22 34 17 35 9 36 8 37 5 38 2 39 1 40 2 41 5 45 3 46 2 47 2 48 1 50 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3882 1 27 1 322 2 1363 3 327 4 1214 5 52 6 60 7 110 8 141 9 103 10 68 11 40 12 15 13 11 14 15 15 13 16 11 17 2 18 7 19 2 21 2 22 1 23 1 25 1 27 1 914. How many times did (name) youngest child eat solid, semi-solid, or soft foo How many times did (name) youngest child eat solid, semi-solid, or soft food other than liquids yesterday during the day or at night? 3513 369 0 98 0 987 1 51 2 288 3 594 4 661 5 312 6 331 7 81 8 93 9 30 10 24 12 11 15 2 16 1 20 1 98 Do not know 46 Sysmiss 369 CO code CO Code 39720 1 600 Household number Household number 39720 1 50 1 2130 2 1875 3 2070 4 1635 5 2085 6 1575 7 1545 8 1410 9 1575 10 1710 11 1260 12 1650 13 1560 14 1515 15 1245 16 1410 17 1350 18 1110 19 1320 20 1080 21 1020 22 1200 23 870 24 840 25 690 26 585 27 585 28 645 29 480 30 285 31 345 32 225 33 195 34 180 35 105 36 75 37 60 38 30 40 15 41 75 45 45 46 15 47 15 48 15 50 15 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 39720 1 27 1 3675 2 13725 3 3405 4 12480 5 585 6 555 7 1185 8 1380 9 930 10 690 11 330 12 180 13 90 14 150 15 105 16 120 17 15 18 60 19 15 21 15 23 15 27 15 915. Food usually given to the child - A. Type of food 39720 1 15 1 Solid (Dal Bhat Vegetable) 2648 2 Semi-solid (Jaulo/Porridge) 2648 3 Mashed/pureed 2648 4 Liquidy 2648 5 Milk 2648 6 Biscuit 2648 7 Horlicks 2648 8 Cerelac 2648 9 HALUWA 2648 10 Noodles 2648 11 Egg 2648 12 Meat 2648 13 Bread 2648 14 Fruits 2648 15 Others 2648 915. Food usually given to the child - B. Given/not given 39720 1 2 1 Given 4480 2 Not given 35240 CO code CO Code 3882 1 600 Household number Household number 3882 1 50 1 201 2 182 3 188 4 175 5 204 6 160 7 153 8 144 9 153 10 171 11 141 12 160 13 144 14 152 15 122 16 129 17 129 18 111 19 130 20 99 21 94 22 122 23 92 24 80 25 63 26 61 27 57 28 57 29 41 30 31 31 31 32 25 33 22 34 17 35 9 36 8 37 5 38 2 39 1 40 2 41 5 45 3 46 2 47 2 48 1 50 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3882 1 27 1 322 2 1363 3 327 4 1214 5 52 6 60 7 110 8 141 9 103 10 68 11 40 12 15 13 11 14 15 15 13 16 11 17 2 18 7 19 2 21 2 22 1 23 1 25 1 27 1 916. Did the child receive vitamin A capsule within the last 6 months? Did the child receive vitamin A capsule within the last 6 months? 3513 369 1 3 1 Yes 2067 2 No 867 3 Child below 6 months old 579 Sysmiss 369 917. How many hours were you away from your child due to work or other reasons d How many hours were you away from your child due to work or other reasons during the past 24 hours? (If answer is no or less than 1 hour, record 00) 3513 369 0 15 0 2498 1 109 2 275 3 239 4 171 5 71 6 71 7 26 8 22 9 9 10 8 11 2 12 8 13 1 15 3 Sysmiss 369 918. Did you say you would feed the baby later when he/she (name) expressed the Did you say you would feed the baby later when he/she (name) expressed the desire for it (within the last 24 hours)? 1015 2867 1 2 1 I did 146 2 I did not 869 Sysmiss 2867 CO code CO Code 4229 1 600 Household number Household number 4229 1 50 1 226 2 198 3 203 4 194 5 221 6 184 7 163 8 162 9 166 10 186 11 148 12 167 13 151 14 164 15 138 16 140 17 145 18 120 19 141 20 104 21 100 22 129 23 94 24 89 25 72 26 69 27 62 28 61 29 45 30 34 31 34 32 28 33 24 34 19 35 10 36 9 37 6 38 2 39 2 40 3 41 6 45 4 46 2 47 2 48 1 50 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women and Child] Name and ID Code of Respondent -HH Roster 4229 1 27 1 328 2 1388 3 349 4 1395 5 66 6 80 7 129 8 167 9 117 10 73 11 46 12 19 13 15 14 15 15 14 16 11 17 2 18 7 19 2 21 2 22 1 23 1 25 1 27 1 1001. Weight of the female respondent (in kilograms) Now, I would like to talk to you about your physical feature and request for measuring weight and height Weight of the female respondent (in kilograms) 4229 27.2000007629395 998 998 Could not weigh 1 1002. Height of the female respondent (in centimeters) Height of the female respondent (in centimeters) (Scale the height in nearest 0.5 centimeter, for example, if the height is 150.4-150.7 write 150.5, if the height is 150.8 or 150.9 write 151.0) 4229 120 998 998 Could not measure 2 1003. How many children under 3 years of age in your household from the eligible How many children under 3 years (0-36 months or up to 36 months 30 days) of age in your household from the eligible woman? [If this is 0, it is the end of the interview.] 4229 0 3 0 585 1 3105 2 528 3 11 ***** Interviewed children under 3 years of age (for Section 11)? Interviewed children under 3 years of age (for Section 11)? 3644 585 0 3 0 133 1 3039 2 462 3 10 Sysmiss 585 1004. Weight of mother holding child #1 (kilograms) 1) If child is below 24 months 30 days, ask the mother to hold the child, weigh both mother and child. 2) If the child is 25 months or older, do not fill out Q1004-1006. Weight of mother holding child #1 (kilograms) 3644 585 31.1000003814697 999 998 Could not weigh 0 999 NA (no >25 months child) 141 Sysmiss 585 1004. ID CODE OF CHILD 1 ID CODE OF CHILD 1 (HH Roster) 3503 726 3 28 3 118 4 340 5 963 6 747 7 444 8 299 9 196 10 118 11 88 12 60 13 37 14 26 15 14 16 16 17 11 18 6 19 5 20 8 21 1 22 2 23 1 24 2 28 1 Sysmiss 726 1005. Weight of mother holding child #2 (kilograms) Weight of mother holding child #2 (kilograms) 539 3690 36.0999984741211 999 998 Could not weigh 0 999 NA (no >25 months child) 307 Sysmiss 3690 1005. ID CODE OF CHILD 2 ID CODE OF CHILD 2 (HH Roster) 232 3997 3 20 3 6 4 14 5 52 6 51 7 40 8 25 9 12 10 15 11 3 12 3 13 5 14 1 15 2 16 1 19 1 20 1 Sysmiss 3997 1006. Weight of mother holding child #3 (kilograms) Weight of mother holding child #3 (kilograms) 11 4218 41.7999992370605 999 41.7999992370605 2 48.7000007629395 1 52.5 1 998 Could not weigh 0 999 NA (no >25 months child) 7 Sysmiss 4218 1006. ID CODE OF CHILD 3 ID CODE OF CHILD 3 (HH Roster) 4 4225 7 11 7 1 9 1 11 2 Sysmiss 4225 CO code CO Code 4194 1 600 Household number Household number 4194 1 50 1 227 2 189 3 199 4 183 5 220 6 166 7 170 8 163 9 164 10 173 11 160 12 173 13 149 14 164 15 131 16 148 17 141 18 122 19 144 20 103 21 104 22 131 23 101 24 81 25 70 26 68 27 61 28 59 29 49 30 34 31 35 32 28 33 24 34 18 35 9 36 10 37 4 38 2 39 1 40 2 41 6 45 3 46 2 47 1 48 1 50 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 4194 1 27 1 343 2 1436 3 347 4 1351 5 58 6 64 7 119 8 153 9 113 10 76 11 48 12 15 13 14 14 14 15 13 16 11 17 4 18 7 19 2 21 2 22 2 23 1 27 1 ID Code of child ID CODE of Children According to Q1003, ask the following questions about children under 3 years (0-36 months) of age and measure weight and height of those children. If the child is below 24 m 30 d ask the mother to hold the child and take measurements of both together, and then calculate the child’s weight deducting that of the mother’s. 4194 3 28 3 153 4 409 5 1156 6 885 7 529 8 351 9 230 10 144 11 107 12 72 13 49 14 32 15 18 16 17 17 11 18 6 19 7 20 10 21 1 22 2 23 2 24 2 28 1 1007. Date of Birth of Child - DD According to Q1003, ask the following questions about children under 3 years (0-36 months) of age and measure weight and height of those children. If the child is below 24 m 30 d ask the mother to hold the child and take measurements of both together, and then calculate the child’s weight deducting that of the mother’s. 4194 1 32 1 215 2 192 3 157 4 194 5 227 6 168 7 180 8 155 9 111 10 231 11 108 12 144 13 110 14 134 15 218 16 118 17 116 18 108 19 97 20 198 21 75 22 110 23 81 24 83 25 167 26 89 27 107 28 106 29 116 30 59 31 17 32 3 1007. Date of Birth of Child - MM According to Q1003, ask the following questions about children under 3 years (0-36 months) of age and measure weight and height of those children. If the child is below 24 m 30 d ask the mother to hold the child and take measurements of both together, and then calculate the child’s weight deducting that of the mother’s. 4194 1 12 1 277 2 297 3 313 4 406 5 507 6 430 7 422 8 350 9 289 10 341 11 335 12 227 1007. Date of Birth of Child - YY According to Q1003, ask the following questions about children under 3 years (0-36 months) of age and measure weight and height of those children. If the child is below 24 m 30 d ask the mother to hold the child and take measurements of both together, and then calculate the child’s weight deducting that of the mother’s. 4194 2067 2070 2067 331 2068 1455 2069 1740 2070 668 1008. Was there any problem at delivery of this child (delivery complications)? Was there any problem at delivery of this child (delivery complications)? According to Q1003, ask the following questions about children under 3 years (0-36 months) of age and measure weight and height of those children. If the child is below 24 m 30 d ask the mother to hold the child and take measurements of both together, and then calculate the child’s weight deducting that of the mother’s. 4194 1 2 1 Yes 808 2 No 3386 1009. How long was the child breastfed? 4194 0 99 0 Not breastfed 36 1 9 2 13 3 7 4 13 5 8 6 27 7 13 8 26 9 39 10 20 11 14 12 142 13 40 14 33 15 40 16 25 17 20 18 119 19 12 20 22 21 15 22 17 23 6 24 73 25 8 26 8 27 10 28 3 29 5 30 10 31 2 32 2 33 1 34 1 99 Currently breastfeeding 3355 1010. Has child been occulated? Has child been occulated? According to Q1003, ask the following questions about children under 3 years (0-36 months) of age and measure weight and height of those children. If the child is below 24 m 30 d ask the mother to hold the child and take measurements of both together, and then calculate the child’s weight deducting that of the mother’s. 4194 1 3 1 Fully occulated 2404 2 Being fully occulated 1443 3 Not occulated 347 1011. Height of Child Height of Child (to nearest 0.5 cm) According to Q1003, ask the following questions about children under 3 years (0-36 months) of age and measure weight and height of those children. If the child is below 24 m 30 d ask the mother to hold the child and take measurements of both together, and then calculate the child’s weight deducting that of the mother’s. 4194 37 999 999 Not measured 88 1012. Height is measured laying or standing Height is measured laying or standing According to Q1003, ask the following questions about children under 3 years (0-36 months) of age and measure weight and height of those children. If the child is below 24 m 30 d ask the mother to hold the child and take measurements of both together, and then calculate the child’s weight deducting that of the mother’s. 4106 88 1 2 1 Laying 2960 2 Standing 1146 Sysmiss 88 1013. Weight of Child Weight of Child If weight not measured record 999 and go to Q1015 1) According to Q1003, ask the following questions about children under 3 years (0-36 months) of age and measure weight and height of those children. If the child is below 24 m 30 d ask the mother to hold the child and take measurements of both together, and then calculate the child’s weight deducting that of the mother’s. 4194 1.5 999 999 Not measured 49 1014. Was child weighed with the mother or alone? Was child weighed with the mother or alone? With mon → Go To Next Member According to Q1003, ask the following questions about children under 3 years (0-36 months) of age and measure weight and height of those children. If the child is below 24 m 30 d ask the mother to hold the child and take measurements of both together, and then calculate the child’s weight deducting that of the mother’s. 4145 49 1 2 1 Alone 501 2 With mum 3644 Sysmiss 49 1015. Reason for not taking Height/Weight Reason for not taking Height/Weight (If you filled out 999 for question 1011 or 1013) According to Q1003, ask the following questions about children under 3 years (0-36 months) of age and measure weight and height of those children. If the child is below 24 m 30 d ask the mother to hold the child and take measurements of both together, and then calculate the child’s weight deducting that of the mother’s. 49 4145 1 4 1 Child not at home 29 2 Child was sick 8 3 Not allowed to take Height/Weight 10 4 Refused to measure 2 Sysmiss 4145 CO code 3993 1 600 Household number 3993 1 50 1 216 2 181 3 192 4 169 5 213 6 154 7 167 8 158 9 157 10 171 11 150 12 163 13 138 14 156 15 123 16 142 17 135 18 114 19 140 20 99 21 101 22 121 23 95 24 76 25 67 26 64 27 57 28 56 29 48 30 34 31 33 32 24 33 22 34 17 35 9 36 9 37 4 38 2 40 2 41 6 45 3 46 2 47 1 48 1 50 1 ID Code of Eligible Woman/respondent (Sec 06) 3993 1 27 1 331 2 1374 3 329 4 1285 5 54 6 61 7 111 8 142 9 111 10 71 11 41 12 14 13 13 14 13 15 13 16 11 17 4 18 7 19 2 21 2 22 2 23 1 27 1 ID Code of child 3993 3 28 3 147 4 396 5 1105 6 844 7 500 8 337 9 213 10 137 11 101 12 63 13 46 14 29 15 17 16 16 17 11 18 6 19 7 20 10 21 1 22 2 23 2 24 2 28 1 Age of chid (month) 3993 1 36 1 135 2 118 3 126 4 118 5 114 6 129 7 142 8 125 9 142 10 169 11 187 12 189 13 165 14 120 15 119 16 119 17 127 18 168 19 147 20 121 21 191 22 201 23 184 24 148 25 51 26 40 27 39 28 32 29 44 30 40 31 40 32 39 33 37 34 48 35 46 36 33 1101A. COMMUNICATION: 01. Does your baby sometimes make throaty or gurgling soun Does your baby sometimes make throaty or gurgling sounds? 253 3740 1 2 1 Yes 191 2 No 62 Sysmiss 3740 1101A. COMMUNICATION: 02. Does your baby make cooing sounds such as ?ooo,? ?gah, Does your baby make cooing sounds such as “ooo,” “gah,” and “aah”? 253 3740 1 2 1 Yes 169 2 No 84 Sysmiss 3740 1101A. COMMUNICATION: 03. When you speak to your baby, does she make sounds back When you speak to your baby, does she make sounds back to you? 253 3740 1 2 1 Yes 150 2 No 103 Sysmiss 3740 1101A. COMMUNICATION: 04. Does your baby smile when you talk to him? Does your baby smile when you talk to him? 497 3496 1 2 1 Yes 432 2 No 65 Sysmiss 3496 1101A. COMMUNICATION: 05. Does your baby chuckle softly? Does your baby chuckle softly? 497 3496 1 2 1 Yes 324 2 No 173 Sysmiss 3496 1101A. COMMUNICATION: 06. After you have been out of sight, does your baby smile After you have been out of sight, does your baby smile or get excited when she sees you? 497 3496 1 2 1 Yes 345 2 No 152 Sysmiss 3496 1101A. COMMUNICATION: 07. Does your baby make high-pitched squeals? Does your baby make high-pitched squeals? 487 3506 1 2 1 Yes 431 2 No 56 Sysmiss 3506 1101A. COMMUNICATION: 08. Does your baby make sounds when looking at toys or peo Does your baby make sounds when looking at toys or people? 754 3239 1 2 1 Yes 604 2 No 150 Sysmiss 3239 1101A. COMMUNICATION: 09. If you call your baby when you are out of sight, does If you call your baby when you are out of sight, does she look in the direction of your voice? 754 3239 1 2 1 Yes 657 2 No 97 Sysmiss 3239 1101A. COMMUNICATION: 10. When a loud noise occurs, does your baby turn to see w When a loud noise occurs, does your baby turn to see where the sound came from? 510 3483 1 2 1 Yes 436 2 No 74 Sysmiss 3483 1101A. COMMUNICATION: 11. If you copy the sounds your baby makes, does your baby If you copy the sounds your baby makes, does your baby repeat the same sounds back to you? 821 3172 1 2 1 Yes 427 2 No 394 Sysmiss 3172 1101A. COMMUNICATION: 12. Does your baby respond to the tone of your voice and s Does your baby respond to the tone of your voice and stop his activity at least briefly when you say “no-no” to him? 821 3172 1 2 1 Yes 317 2 No 504 Sysmiss 3172 1101A. COMMUNICATION: 13. Does your baby make two similar sounds like ?ba-ba,? ? Does your baby make two similar sounds like “ba-ba,” “da-da,” or “ga-ga”? (The sounds do not need to mean anything.) 954 3039 1 2 1 Yes 848 2 No 106 Sysmiss 3039 1101A. COMMUNICATION: 14. If you ask your baby to, does he play at least one nur If you ask your baby to, does he play at least one nursery game even if you don’t show him the activity yourself (such as “bye-bye,” “Peeka- boo,” “clap your hands,” “So Big”)? 687 3306 1 2 1 Yes 411 2 No 276 Sysmiss 3306 1101A. COMMUNICATION: 15. Does your baby follow one simple command, such as ?Com Does your baby follow one simple command, such as “Come here,” “Give it to me,” or “Put it back,” without your using gestures? 972 3021 1 2 1 Yes 570 2 No 402 Sysmiss 3021 1101A. COMMUNICATION: 16. Does your baby say three words, such as ?Mama,? ?Dada, Does your baby say three words, such as “Mama,” “Dada,” and “Baba”? (A “word” is a sound or sounds your baby says consistently to mean someone or something.) 687 3306 1 2 1 Yes 515 2 No 172 Sysmiss 3306 1101A. COMMUNICATION: 17. When your baby wants something, does he tell you by po When your baby wants something, does he tell you by pointing to it? 1194 2799 1 2 1 Yes 1018 2 No 176 Sysmiss 2799 1101A. COMMUNICATION: 18. Does your baby shake his head when he means ?no? or ?y Does your baby shake his head when he means “no” or “yes”? 661 3332 1 2 1 Yes 372 2 No 289 Sysmiss 3332 1101A. COMMUNICATION: 19. Does your baby point to, pat, or try to pick up pictur Does your baby point to, pat, or try to pick up pictures in a book? 523 3470 1 2 1 Yes 423 2 No 100 Sysmiss 3470 1101A. COMMUNICATION: 20. Does your baby say four or more words in addition to ? Does your baby say four or more words in addition to “Mama” and “Dada”? 818 3175 1 2 1 Yes 586 2 No 232 Sysmiss 3175 1101A. COMMUNICATION: 21. When you ask her to, does your baby go into another ro When you ask her to, does your baby go into another room to find a fa- miliar toy or object? (You might ask, “Where is your ball?” or say, “Bring me your coat,” or “Go get your blanket.”) 818 3175 1 2 1 Yes 597 2 No 221 Sysmiss 3175 1101A. COMMUNICATION: 22. Does your child imitate a two-word sentence? For examp Does your child imitate a two-word sentence? For example, when you say a two-word phrase, such as “Mama eat,” “Daddy play,” “Go home,” or “What’s this?” does your child say both words back to you? (Mark “yes” even if her words are difficult to understand.) 801 3192 1 2 1 Yes 322 2 No 479 Sysmiss 3192 1101A. COMMUNICATION: 23. Without your showing him, does your child point to the Without your showing him, does your child point to the correct picture when you say, “Show me the kitty,” or ask, “Where is the dog?” (He needs to identify only one picture correctly.) 1525 2468 1 2 1 Yes 802 2 No 723 Sysmiss 2468 1101A. COMMUNICATION: 24. Does your child say two or three words that represent Does your child say two or three words that represent different ideas together, such as “See dog,” “Mommy come home,” or “Kitty gone”? (Don’t count word combinations that express one idea, such as “bye- bye,” “all gone,” “all right,” and “What’s that?”) 1287 2706 1 2 1 Yes 707 2 No 580 Sysmiss 2706 1101A. COMMUNICATION: 25. If you point to a picture of a ball (kitty, cup, hat, If you point to a picture of a ball (kitty, cup, hat, etc.) and ask your child, “What is this?” does your child correctly name at least one picture? 1122 2871 1 2 1 Yes 563 2 No 559 Sysmiss 2871 1101A. COMMUNICATION: 26. Without your giving him clues by pointing or using ges 1481 2512 1 2 1 Yes 1359 2 No 122 Sysmiss 2512 1101A. COMMUNICATION: 27. When you ask your child to point to her nose, eyes, ha When you ask your child to point to her nose, eyes, hair, feet, ears, and so forth, does she correctly point to at least seven body parts? (She can point to parts of herself, you, or a doll. Mark “sometimes” if she cor- rectly points to at least three different body parts.) 1481 2512 1 2 1 Yes 1091 2 No 390 Sysmiss 2512 1101A. COMMUNICATION: 28. Does your child correctly use at least two words like Does your child correctly use at least two words like “me,” “I,” “mine,” and “you”? 854 3139 1 2 1 Yes 551 2 No 303 Sysmiss 3139 1101A. COMMUNICATION: 29. Does your child make sentences that are three or four Does your child make sentences that are three or four words long? Please give an example: 489 3504 1 2 1 Yes 397 2 No 92 Sysmiss 3504 1101A. COMMUNICATION: 30. Without giving your child help by pointing or using ge Without giving your child help by pointing or using gestures, ask him to “put the book on the table” and “put the shoe under the chair.” Does your child carry out both of these directions correctly? 489 3504 1 2 1 Yes 412 2 No 77 Sysmiss 3504 1101A. COMMUNICATION: 31. When looking at a picture book, does your child tell y When looking at a picture book, does your child tell you what is hap- pening or what action is taking place in the picture (for example, “bark- ing,” “running,” “eating,” or “crying”)? You may ask, “What is the dog (or boy) doing?” 359 3634 1 2 1 Yes 221 2 No 138 Sysmiss 3634 1101A. COMMUNICATION: 32. When you ask, ?What is your name?? does your child say When you ask, “What is your name?” does your child say his first name or nickname? 359 3634 1 2 1 Yes 260 2 No 99 Sysmiss 3634 1101B. GROSS MOTOR: 01. While your baby is on his back, does he wave his arms an Fill the code in the blank cell: YES=1; NO = 2] While your baby is on his back, does he wave his arms and legs, wiggle, and squirm? 253 3740 1 2 1 Yes 237 2 No 16 Sysmiss 3740 1101B. GROSS MOTOR: 02. When your baby is on her tummy does she turn her head to When your baby is on her tummy does she turn her head to the side? 253 3740 1 2 1 Yes 138 2 No 115 Sysmiss 3740 1101B. GROSS MOTOR: 03. When your baby is on his tummy, does he hold his head up 253 3740 1 2 1 Yes 68 2 No 185 Sysmiss 3740 1101B. GROSS MOTOR: 04. When your baby is on her back, does she kick her legs? When your baby is on her back, does she kick her legs? 497 3496 1 2 1 Yes 427 2 No 70 Sysmiss 3496 1101B. GROSS MOTOR: 05. After holding her head up while on her tummy does your b After holding her head up while on her tummy does your baby lay her head down on the floor, rather than let it drop or fall forward? 497 3496 1 2 1 Yes 202 2 No 295 Sysmiss 3496 1101B. GROSS MOTOR: 06. When your baby is on his tummy, does he hold his head up When your baby is on his tummy, does he hold his head up so that his chin is about 3 inches from the floor for at least 15 seconds? 497 3496 1 2 1 Yes 165 2 No 332 Sysmiss 3496 1101B. GROSS MOTOR: 07. When your baby is on her tummy, does she hold her head s When your baby is on her tummy, does she hold her head straight up, looking around? 244 3749 1 2 1 Yes 103 2 No 141 Sysmiss 3749 1101B. GROSS MOTOR: 08. When you hold him in a sitting position, does your baby When you hold him in a sitting position, does your baby hold his head steady? 487 3506 1 2 1 Yes 312 2 No 175 Sysmiss 3506 1101B. GROSS MOTOR: 09. While your baby is on his back, does your baby lift his 487 3506 1 2 1 Yes 393 2 No 94 Sysmiss 3506 1101B. GROSS MOTOR: 10. Does your baby roll from his back to his tummy, getting 510 3483 1 2 1 Yes 462 2 No 48 Sysmiss 3483 1101B. GROSS MOTOR: 11. When you put your baby on the floor, does she lean on he When you put your baby on the floor, does she lean on her hands while sitting? (If she already sits up straight without leaning on her hands, mark “yes” for this item.) 510 3483 1 2 1 Yes 359 2 No 151 Sysmiss 3483 1101B. GROSS MOTOR: 12. If you hold both hands just to balance your baby, does h If you hold both hands just to balance your baby, does he support his own weight while standing? 821 3172 1 2 1 Yes 603 2 No 218 Sysmiss 3172 1101B. GROSS MOTOR: 13. Does your baby get into a crawling position by getting u Does your baby get into a crawling position by getting up on her hands and knees? 821 3172 1 2 1 Yes 580 2 No 241 Sysmiss 3172 1101B. GROSS MOTOR: 14. When sitting on the floor, does your baby sit up straigh When sitting on the floor, does your baby sit up straight for several minutes without using her hands for support? 578 3415 1 2 1 Yes 445 2 No 133 Sysmiss 3415 1101B. GROSS MOTOR: 15. When you stand your baby next to furniture or the crib r When you stand your baby next to furniture or the crib rail, does he hold on without leaning his chest against the furniture for support? 954 3039 1 2 1 Yes 699 2 No 255 Sysmiss 3039 1101B. GROSS MOTOR: 16. Does your baby walk beside furniture while holding on wi Does your baby walk beside furniture while holding on with only one hand? 687 3306 1 2 1 Yes 408 2 No 279 Sysmiss 3306 1101B. GROSS MOTOR: 17. If you hold both hands just to balance your baby, does h If you hold both hands just to balance your baby, does he take several steps without tripping or falling? (If your baby already walks alone, mark “yes” for this item.) 972 3021 1 2 1 Yes 572 2 No 400 Sysmiss 3021 1101B. GROSS MOTOR: 18. When you hold one hand just to balance your baby, does s When you hold one hand just to balance your baby, does she take several steps forward? (If your baby already walks alone, mark “yes” for this item.) 661 3332 1 2 1 Yes 443 2 No 218 Sysmiss 3332 1101B. GROSS MOTOR: 19. Does your baby stand up in the middle of the floor by hi 899 3094 1 2 1 Yes 412 2 No 487 Sysmiss 3094 1101B. GROSS MOTOR: 20. Does your baby bend over or squat to pick up an object f 899 3094 1 2 1 Yes 461 2 No 438 Sysmiss 3094 1101B. GROSS MOTOR: 21. Does your baby move around by walking, rather than by cr 818 3175 1 2 1 Yes 605 2 No 213 Sysmiss 3175 1101B. GROSS MOTOR: 22. Does your child walk well and seldom fall? 801 3192 1 2 1 Yes 592 2 No 209 Sysmiss 3192 1101B. GROSS MOTOR: 23. Does your child climb on an object such as a chair to re 1086 2907 1 2 1 Yes 606 2 No 480 Sysmiss 2907 1101B. GROSS MOTOR: 24. Does your child walk down stairs if you hold onto one of 1193 2800 1 2 1 Yes 793 2 No 400 Sysmiss 2800 1101B. GROSS MOTOR: 25. When you show your child how to kick a large ball, does 1287 2706 1 2 1 Yes 1035 2 No 252 Sysmiss 2706 1101B. GROSS MOTOR: 26. Does your child run fairly well, stopping herself withou 1649 2344 1 2 1 Yes 1292 2 No 357 Sysmiss 2344 1101B. GROSS MOTOR: 27. Does your child walk either up or down at least two step 1238 2755 1 2 1 Yes 908 2 No 330 Sysmiss 2755 1101B. GROSS MOTOR: 28. Does your child jump with both feet leaving the floor at Does your child jump with both feet leaving the floor at the same time? 1213 2780 1 2 1 Yes 731 2 No 482 Sysmiss 2780 1101B. GROSS MOTOR: 29. Without holding onto anything for support, does your chi Without holding onto anything for support, does your child kick a ball by swinging his leg forward? 1213 2780 1 2 1 Yes 1002 2 No 211 Sysmiss 2780 1101B. GROSS MOTOR: 30. Does your child walk up stairs, using only one foot on e Does your child walk up stairs, using only one foot on each stair? (The left foot is on one step, and the right foot is on the next.) She may hold onto the railing or wall. 821 3172 1 2 1 Yes 527 2 No 294 Sysmiss 3172 1101B. GROSS MOTOR: 31. Does your child stand on one foot for about 1 second wit Does your child stand on one foot for about 1 second without holding onto anything? 489 3504 1 2 1 Yes 349 2 No 140 Sysmiss 3504 1101B. GROSS MOTOR: 32. While standing, does your child throw a ball overhand by While standing, does your child throw a ball overhand by raising his arm to shoulder height and throwing the ball forward? (Dropping the ball or throwing the ball underhand should be scored as “not yet.”) 243 3750 1 2 1 Yes 227 2 No 16 Sysmiss 3750 1101B. GROSS MOTOR: 33. Does your child jump forward at least 6 inches with both Does your child jump forward at least 6 inches with both feet leaving the ground at the same time? 127 3866 1 2 1 Yes 81 2 No 46 Sysmiss 3866 1101C. FINE MOTOR : 01. Does your baby grasp your finger if you touch the palm o Does your baby grasp your finger if you touch the palm of her hand? 253 3740 1 2 1 Yes 178 2 No 75 Sysmiss 3740 1101C. FINE MOTOR : 02. When you put a toy in his hand, does your baby hold it i When you put a toy in his hand, does your baby hold it in his hand briefly? 497 3496 1 2 1 Yes 279 2 No 218 Sysmiss 3496 1101C. FINE MOTOR : 03. Does your baby touch her face with her hands? 253 3740 1 2 1 Yes 186 2 No 67 Sysmiss 3740 1101C. FINE MOTOR : 04. Does your baby hold his hands open or partly open when h 253 3740 1 2 1 Yes 178 2 No 75 Sysmiss 3740 1101C. FINE MOTOR : 05. Does your baby grab or scratch at her clothes? Does your baby grab or scratch at her clothes? 497 3496 1 2 1 Yes 350 2 No 147 Sysmiss 3496 1101C. FINE MOTOR : 06. When you put a toy in her hand, does your baby wave it a 497 3496 1 2 1 Yes 207 2 No 290 Sysmiss 3496 1101C. FINE MOTOR : 07. When you put a toy in her hand, does your baby hold onto When you put a toy in her hand, does your baby hold onto it for about 1 minute while looking at it, waving it about, or trying to chew it? 244 3749 1 2 1 Yes 128 2 No 116 Sysmiss 3749 1101C. FINE MOTOR : 08. When you hold your baby in a sitting position, does she 487 3506 1 2 1 Yes 353 2 No 134 Sysmiss 3506 1101C. FINE MOTOR : 09. Does your baby grab a toy you offer and look at it, wave 487 3506 1 2 1 Yes 285 2 No 202 Sysmiss 3506 1101C. FINE MOTOR : 10. Does your baby reach for or grasp a toy using both hands 510 3483 1 2 1 Yes 415 2 No 95 Sysmiss 3483 1101C. FINE MOTOR : 11. Does your baby reach for a crumb or Cheerio and touch it Does your baby reach for a crumb or Cheerio and touch it with his finger or hand? (If he already picks up a small object the size of a pea, mark “yes” for this item.) 510 3483 1 2 1 Yes 385 2 No 125 Sysmiss 3483 1101C. FINE MOTOR : 12. Does your baby pick up a small toy, holding it in the ce Does your baby pick up a small toy, holding it in the center of her hand with her fingers around it? 510 3483 1 2 1 Yes 441 2 No 69 Sysmiss 3483 1101C. FINE MOTOR : 13. Does your baby pick up a small toy with only one hand? Does your baby pick up a small toy with only one hand? 821 3172 1 2 1 Yes 593 2 No 228 Sysmiss 3172 1101C. FINE MOTOR : 14. Does your baby successfully pick up a crumb or Cheerio b Does your baby successfully pick up a crumb or Cheerio by using his thumb and all of his fingers in a raking motion? (If he already picks up a crumb or Cheerio, mark “yes” for this item.) 578 3415 1 2 1 Yes 400 2 No 178 Sysmiss 3415 1101C. FINE MOTOR : 15. After one or two tries, does your baby pick up a piece o After one or two tries, does your baby pick up a piece of string with her first finger and thumb? (The string may be attached to a toy.) 954 3039 1 2 1 Yes 446 2 No 508 Sysmiss 3039 1101C. FINE MOTOR : 16. Does your baby put a small toy down, without dropping it Does your baby put a small toy down, without dropping it, and then take her hand off the toy? 972 3021 1 2 1 Yes 543 2 No 429 Sysmiss 3021 1101C. FINE MOTOR : 17. Does your baby help turn the pages of a book? Does your baby help turn the pages of a book? (You may lift a page for him to grasp.) 1210 2783 1 2 1 Yes 542 2 No 668 Sysmiss 2783 1101C. FINE MOTOR : 18. Does your baby throw a small ball with a forward arm mot Does your baby throw a small ball with a forward arm motion? (If he simply drops the ball, mark “not yet” for this item.) 1505 2488 1 2 1 Yes 989 2 No 516 Sysmiss 2488 1101C. FINE MOTOR : 19. Does your baby stack a small block or toy on top of anot Does your baby stack a small block or toy on top of another one? (You could also use spools of thread, small boxes, or toys that are about 1 inch in size.) 1854 2139 1 2 1 Yes 790 2 No 1064 Sysmiss 2139 1101C. FINE MOTOR : 20. Does your baby make a mark on the paper with the tip of Does your baby make a mark on the paper with the tip of a crayon (or pencil or pen) when trying to draw? 2186 1807 1 2 1 Yes 1046 2 No 1140 Sysmiss 1807 1101C. FINE MOTOR : 21. Does your child turn the pages of a book by himself? Does your child turn the pages of a book by himself? (He may turn more than one page at a time.) 1940 2053 1 2 1 Yes 1320 2 No 620 Sysmiss 2053 1101C. FINE MOTOR : 22. Does your child get a spoon into her mouth right side up Does your child get a spoon into her mouth right side up so that the food usually doesn’t spill? 1655 2338 1 2 1 Yes 1144 2 No 511 Sysmiss 2338 1101C. FINE MOTOR : 23. Does your child use a turning motion with her hand while Does your child use a turning motion with her hand while trying to turn doorknobs, wind up toys, twist tops, or screw lids on and off jars? 1533 2460 1 2 1 Yes 1123 2 No 410 Sysmiss 2460 1101C. FINE MOTOR : 24. Can your child string small items such as beads, macaron Can your child string small items such as beads, macaroni, or pasta “wagon wheels” onto a string or shoelace? 1481 2512 1 2 1 Yes 399 2 No 1082 Sysmiss 2512 1101C. FINE MOTOR : 25. Does your child copy you by drawing a single line in a v After your child watches you draw a line from the top of the paper to the bottom with a pencil, crayon, or pen, ask him to make a line like yours. Do not let your child trace your line. Does your child copy you by drawing a single line in a vertical direction? 821 3172 1 2 1 Yes 301 2 No 520 Sysmiss 3172 1101C. FINE MOTOR : 26. Does your child copy you by drawing a single line in a h After your child watches you draw a line from one side of the paper to the other side, ask her to make a line like yours. Do not let your child trace your line. Does your child copy you by drawing a single line in a horizontal direction? 489 3504 1 2 1 Yes 184 2 No 305 Sysmiss 3504 1101C. FINE MOTOR : 27. Do not let him trace your circle. Does your child copy y After your child watches you draw a single circle, ask him to make a circle like yours. Do not let him trace your circle. Does your child copy you by drawing a circle? 359 3634 1 2 1 Yes 149 2 No 210 Sysmiss 3634 1101C. FINE MOTOR : 28. Does your child turn pages in a book, one page at a time Does your child turn pages in a book, one page at a time? 359 3634 1 2 1 Yes 247 2 No 112 Sysmiss 3634 1101C. FINE MOTOR : 29. When drawing, does your child hold a pencil, crayon, or When drawing, does your child hold a pencil, crayon, or pen between her fingers and thumb like an adult does? 243 3750 1 2 1 Yes 144 2 No 99 Sysmiss 3750 1101D. PROBLEM SOLVING : 01. Does your baby look at objects that are 8?10 inches Fill the code in the blank cell: YES=1; NO = 2] Does your baby look at objects that are 8–10 inches away? 253 3740 1 2 1 Yes 163 2 No 90 Sysmiss 3740 1101D. PROBLEM SOLVING : 02. When you move around, does your baby follow you wit 253 3740 1 2 1 Yes 165 2 No 88 Sysmiss 3740 1101D. PROBLEM SOLVING : 03. When you move a toy slowly from side to side in fro When you move a toy slowly from side to side in front of your baby’s face (about 10 inches away), does your baby follow the toy with her eyes, sometimes turning her head? 497 3496 1 2 1 Yes 274 2 No 223 Sysmiss 3496 1101D. PROBLEM SOLVING : 04. When you move a small toy up and down slowly in fro 497 3496 1 2 1 Yes 274 2 No 223 Sysmiss 3496 1101D. PROBLEM SOLVING : 05. When you hold your baby in a sitting position, does When you hold your baby in a sitting position, does she look at a toy (about the size of a cup or rattle) that you place on the table or floor in front of her? 497 3496 1 2 1 Yes 324 2 No 173 Sysmiss 3496 1101D. PROBLEM SOLVING : 06. When you dangle a toy above your baby while he is l When you dangle a toy above your baby while he is lying on his back, does he wave his arms toward the toy? 497 3496 1 2 1 Yes 195 2 No 302 Sysmiss 3496 1101D. PROBLEM SOLVING : 07. When you put a toy in her hand, does your baby look When you put a toy in her hand, does your baby look at it? 244 3749 1 2 1 Yes 196 2 No 48 Sysmiss 3749 1101D. PROBLEM SOLVING : 08. When you put a toy in his hand, does your baby put When you put a toy in his hand, does your baby put the toy in his mouth? 487 3506 1 2 1 Yes 396 2 No 91 Sysmiss 3506 1101D. PROBLEM SOLVING : 09. When a toy is in front of your baby, does she reach When a toy is in front of your baby, does she reach for it with both hands? 243 3750 1 2 1 Yes 199 2 No 44 Sysmiss 3750 1101D. PROBLEM SOLVING : 10. When your baby is on her back, does she try to get When your baby is on her back, does she try to get a toy she has dropped if she can see it? 510 3483 1 2 1 Yes 433 2 No 77 Sysmiss 3483 1101D. PROBLEM SOLVING : 11. Does your baby pick up a toy and put it in his mout Does your baby pick up a toy and put it in his mouth? 510 3483 1 2 1 Yes 467 2 No 43 Sysmiss 3483 1101D. PROBLEM SOLVING : 12. Does your baby play by banging a toy up and down on Does your baby play by banging a toy up and down on the floor or table? 821 3172 1 2 1 Yes 554 2 No 267 Sysmiss 3172 1101D. PROBLEM SOLVING : 13.Does your baby pick up two small toys, one in each h Does your baby pick up two small toys, one in each hand, and hold onto them for about 1 minute? 821 3172 1 2 1 Yes 451 2 No 370 Sysmiss 3172 1101D. PROBLEM SOLVING : 14. When holding a toy in his hand, does your baby bang When holding a toy in his hand, does your baby bang it against another toy on the table? 954 3039 1 2 1 Yes 690 2 No 264 Sysmiss 3039 1101D. PROBLEM SOLVING : 15. While holding a small toy in each hand, does your b While holding a small toy in each hand, does your baby clap the toys together (like “Pat-a-cake”)? 954 3039 1 2 1 Yes 682 2 No 272 Sysmiss 3039 1101D. PROBLEM SOLVING : 16. After watching you hide a small toy under a piece o After watching you hide a small toy under a piece of paper or cloth, does your baby find it? (Be sure the toy is completely hidden.) 972 3021 1 2 1 Yes 532 2 No 440 Sysmiss 3021 1101D. PROBLEM SOLVING : 17. If you put a small toy into a bowl or box, does you If you put a small toy into a bowl or box, does your baby copy you by putting in a toy, although she may not let go of it? (If she already lets go of the toy into a bowl or box, mark “yes” for this item.) 972 3021 1 2 1 Yes 527 2 No 445 Sysmiss 3021 1101D. PROBLEM SOLVING : 18. After you scribble back and forth on paper with a c After you scribble back and forth on paper with a crayon (or a pencil or pen), does your baby copy you by scribbling? (If she already scribbles on her own, mark “yes” for this item.) 899 3094 1 2 1 Yes 385 2 No 514 Sysmiss 3094 1101D. PROBLEM SOLVING : 19. Does your baby drop two small toys, one after the o Does your baby drop two small toys, one after the other, into a container like a bowl or box? (You may show him how to do it.) 1194 2799 1 2 1 Yes 759 2 No 435 Sysmiss 2799 1101D. PROBLEM SOLVING : 20. After you have shown your baby how, does he try to After you have shown your baby how, does he try to get a small toy that is slightly out of reach by using a spoon, stick, or similar tool? 1086 2907 1 2 1 Yes 503 2 No 583 Sysmiss 2907 1101D. PROBLEM SOLVING : 21. Without your showing him how, does your child scrib Without your showing him how, does your child scribble back and forth when you give him a crayon (or pencil or pen)? 1478 2515 1 2 1 Yes 842 2 No 636 Sysmiss 2515 1101D. PROBLEM SOLVING : 22. After a crumb or Cheerio is dropped into a small, c After a crumb or Cheerio is dropped into a small, clear bottle, does your child turn the bottle upside down to dump it out? (You may show her how.) (You can use a soda-pop bottle or a baby bottle.) 533 3460 1 2 1 Yes 357 2 No 176 Sysmiss 3460 1101D. PROBLEM SOLVING : 23. Does your child copy you by drawing a single line o After watching you draw a line from the top of the paper to the bottom with a crayon (or pencil or pen), does your child copy you by drawing a single line on the paper in any direction? (Mark “not yet” if your child scribbles back and forth.) 1525 2468 1 2 1 Yes 298 2 No 1227 Sysmiss 2468 1101D. PROBLEM SOLVING : 24. If you give your child a bottle, spoon, or pencil u If you give your child a bottle, spoon, or pencil upside down, does she turn it right side up so that she can use it properly? 1287 2706 1 2 1 Yes 742 2 No 545 Sysmiss 2706 1101D. PROBLEM SOLVING : 25. If your child wants something he cannot reach, does 1122 2871 1 2 1 Yes 788 2 No 334 Sysmiss 2871 1101D. PROBLEM SOLVING : 26. Does your child pretend objects are something else? Does your child pretend objects are something else? For example, does your child hold a cup to his ear, pretending it is a telephone? Does he put a box on his head, pretending it is a hat? Does he use a block or small toy to stir food? 1354 2639 1 2 1 Yes 1144 2 No 210 Sysmiss 2639 1101D. PROBLEM SOLVING : 27. Does your child put things away where they belong? Does your child put things away where they belong? For example, does he know his toys belong on the toy shelf, his blanket goes on his bed, and dishes go in the kitchen? 1213 2780 1 2 1 Yes 775 2 No 438 Sysmiss 2780 1101D. PROBLEM SOLVING : 28. When looking in the mirror, ask ?Where is _______?? When looking in the mirror, ask “Where is _______?” (Use your child’s name.) Does your child point to his image in the mirror? 821 3172 1 2 1 Yes 633 2 No 188 Sysmiss 3172 1101D. PROBLEM SOLVING : 29. When you point to the figure and ask your child, ?W When you point to the figure and ask your child, “What is this?” does your child say a word that means a person or something similar? (Mark “yes” for responses like “snowman,” “boy,” “man,” “girl,” “Daddy,” “spaceman,” and “monkey.”) Please write your child’s response here:_______________ 489 3504 1 2 1 Yes 251 2 No 238 Sysmiss 3504 1101D. PROBLEM SOLVING : 30. When you say, ?Say ?seven three,?? does your child When you say, “Say ‘seven three,’” does your child repeat just the two numbers in the same order? Do not repeat the numbers. If necessary, try another pair of numbers and say, “Say ‘eight two.’” Your child must repeat just one series of two numbers for you to answer “yes” to this question 489 3504 1 2 1 Yes 248 2 No 241 Sysmiss 3504 1101D. PROBLEM SOLVING : 31. After your child draws a ?picture,? even a simple s After your child draws a “picture,” even a simple scribble, does she tell you what she drew? (You may say, “Tell me about your picture,” or ask, “What is this?” to prompt her.) 359 3634 1 2 1 Yes 120 2 No 239 Sysmiss 3634 1101D. PROBLEM SOLVING : 32. When you say, ?Say ?five eight three,?? does your c When you say, “Say ‘five eight three,’” does your child repeat just the three numbers in the same order? Do not repeat the numbers. If neces- sary, try another series of numbers and say, “Say ‘six nine two.’” (Your child must repeat just one series of three numbers for you to answer “yes” to this question.) 127 3866 1 2 1 Yes 55 2 No 72 Sysmiss 3866 1101E. PERSONAL SOCIAL : 01. Does your baby cry when he is hungry, wet, tired, o Fill the code in the blank cell: YES=1; NO = 2] Does your baby cry when he is hungry, wet, tired, or wants to be held? 253 3740 1 2 1 Yes 217 2 No 36 Sysmiss 3740 1101E. PERSONAL SOCIAL : 02. When you smile at your baby, does she smile back? When you smile at your baby, does she smile back? 253 3740 1 2 1 Yes 166 2 No 87 Sysmiss 3740 1101E. PERSONAL SOCIAL : 03. Does your baby watch his hands? Does your baby watch his hands? 253 3740 1 2 1 Yes 109 2 No 144 Sysmiss 3740 1101E. PERSONAL SOCIAL : 04. When your baby sees the breast or bottle, does she When your baby sees the breast or bottle, does she seem to know she is about to be fed? 497 3496 1 2 1 Yes 301 2 No 196 Sysmiss 3496 1101E. PERSONAL SOCIAL : 05. When your baby has her hands together, does she pla When your baby has her hands together, does she play with her fingers? 497 3496 1 2 1 Yes 348 2 No 149 Sysmiss 3496 1101E. PERSONAL SOCIAL : 06. Does your baby help hold the bottle with both hands Does your baby help hold the bottle with both hands at once, or when nursing, does she hold the breast with her free hand? 497 3496 1 2 1 Yes 267 2 No 230 Sysmiss 3496 1101E. PERSONAL SOCIAL : 07. When in front of a large mirror, does your baby smi When in front of a large mirror, does your baby smile or coo at herself? 487 3506 1 2 1 Yes 218 2 No 269 Sysmiss 3506 1101E. PERSONAL SOCIAL : 08. Does your baby act differently toward strangers tha Does your baby act differently toward strangers than he does with you and other familiar people? (Reactions to strangers may include staring, frowning, withdrawing, or crying.) 487 3506 1 2 1 Yes 240 2 No 247 Sysmiss 3506 1101E. PERSONAL SOCIAL : 09. While lying on her back, does your baby play by gra While lying on her back, does your baby play by grab- bing her foot? 754 3239 1 2 1 Yes 574 2 No 180 Sysmiss 3239 1101E. PERSONAL SOCIAL : 10. When in front of a large mirror, does your baby rea When in front of a large mirror, does your baby reach out to pat the mirror? 510 3483 1 2 1 Yes 242 2 No 268 Sysmiss 3483 1101E. PERSONAL SOCIAL : 11. Does your baby try to get a toy that is out of reac Does your baby try to get a toy that is out of reach? (She may roll, pivot on her tummy, or crawl to get it.) 510 3483 1 2 1 Yes 344 2 No 166 Sysmiss 3483 1101E. PERSONAL SOCIAL : 12. Does your baby drink water, juice, or formula from Does your baby drink water, juice, or formula from a cup while you hold it? 821 3172 1 2 1 Yes 542 2 No 279 Sysmiss 3172 1101E. PERSONAL SOCIAL : 13. Does your baby feed himself a cracker or a cookie? Does your baby feed himself a cracker or a cookie? 578 3415 1 2 1 Yes 491 2 No 87 Sysmiss 3415 1101E. PERSONAL SOCIAL : 14. When you hold out your hand and ask for her toy, do When you hold out your hand and ask for her toy, does your baby offer it to you even if she doesn’t let go of it? (If she already lets go of the toy into your hand, mark “yes” for this item.) 954 3039 1 2 1 Yes 601 2 No 353 Sysmiss 3039 1101E. PERSONAL SOCIAL : 15. When you hold out your hand and ask for her toy, do When you hold out your hand and ask for her toy, does your baby let go of it into your hand? 687 3306 1 2 1 Yes 407 2 No 280 Sysmiss 3306 1101E. PERSONAL SOCIAL : 16. When you dress your baby, does she lift her foot fo When you dress your baby, does she lift her foot for her shoe, sock, or pant leg? 687 3306 1 2 1 Yes 256 2 No 431 Sysmiss 3306 1101E. PERSONAL SOCIAL : 17. When you dress your baby, does he push his arm thro When you dress your baby, does he push his arm through a sleeve once his arm is started in the hole of the sleeve? 972 3021 1 2 1 Yes 321 2 No 651 Sysmiss 3021 1101E. PERSONAL SOCIAL : 18. Does your baby roll or throw a ball back to you so Does your baby roll or throw a ball back to you so that you can return it to him? 661 3332 1 2 1 Yes 270 2 No 391 Sysmiss 3332 1101E. PERSONAL SOCIAL : 19. Does your baby play with a doll or stuffed animal b Does your baby play with a doll or stuffed animal by hugging it? 899 3094 1 2 1 Yes 693 2 No 206 Sysmiss 3094 1101E. PERSONAL SOCIAL : 20. Does your baby help undress himself by taking off c Does your baby help undress himself by taking off clothes like socks, hat, shoes, or mittens? 1086 2907 1 2 1 Yes 664 2 No 422 Sysmiss 2907 1101E. PERSONAL SOCIAL : 21. Does your baby get your attention or try to show yo Does your baby get your attention or try to show you something by pulling on your hand or clothes? 818 3175 1 2 1 Yes 740 2 No 78 Sysmiss 3175 1101E. PERSONAL SOCIAL : 22. While looking at himself in the mirror, does your c While looking at himself in the mirror, does your child offer a toy to his own image? 533 3460 1 2 1 Yes 318 2 No 215 Sysmiss 3460 1101E. PERSONAL SOCIAL : 23. Does your child come to you when she needs help, su Does your child come to you when she needs help, such as with wind- ing up a toy or unscrewing a lid from a jar? 1478 2515 1 2 1 Yes 1245 2 No 233 Sysmiss 2515 1101E. PERSONAL SOCIAL : 24. Does your child drink from a cup or glass, putting Does your child drink from a cup or glass, putting it down again with little spilling? 1193 2800 1 2 1 Yes 873 2 No 320 Sysmiss 2800 1101E. PERSONAL SOCIAL : 25. Does your child copy the activities you do, such as Does your child copy the activities you do, such as wipe up a spill, sweep, shave, or comb hair? 1287 2706 1 2 1 Yes 1047 2 No 240 Sysmiss 2706 1101E. PERSONAL SOCIAL : 26. Does your child eat (with a fork) well? Does your child eat (with a fork) well? 1481 2512 1 2 1 Yes 1293 2 No 188 Sysmiss 2512 1101E. PERSONAL SOCIAL : 27. If you do any of the following gestures, does your 1481 2512 1 2 1 Yes 1348 2 No 133 Sysmiss 2512 1101E. PERSONAL SOCIAL : 28. Does your child push a little wagon, stroller, or o Does your child push a little wagon, stroller, or other toy on wheels, steering it around objects and backing out of corners if she cannot turn? 854 3139 1 2 1 Yes 590 2 No 264 Sysmiss 3139 1101E. PERSONAL SOCIAL : 29. Does your child call herself ?I? or ?me? more often Does your child call herself “I” or “me” more often than her own name? For example, “I do it,” more often than “Juanita do it.” 578 3415 1 2 1 Yes 395 2 No 183 Sysmiss 3415 1101E. PERSONAL SOCIAL : 30. Does your child put on a coat, jacket, or shirt by Does your child put on a coat, jacket, or shirt by himself? 821 3172 1 2 1 Yes 309 2 No 512 Sysmiss 3172 1101E. PERSONAL SOCIAL : 31. After you put on loose-fitting pants around her fee After you put on loose-fitting pants around her feet, does your child pull them completely up to her waist? 362 3631 1 2 1 Yes 293 2 No 69 Sysmiss 3631 1101E. PERSONAL SOCIAL : 32. When your child is looking in a mirror and you ask, When your child is looking in a mirror and you ask, “Who is in the mir- ror?” does he say either “me” or his own name? 359 3634 1 2 1 Yes 272 2 No 87 Sysmiss 3634 1101E. PERSONAL SOCIAL : 33. Using these exact words, ask your child, ?Are you a Using these exact words, ask your child, “Are you a girl or a boy?” Does your child answer correctly? 243 3750 1 2 1 Yes 153 2 No 90 Sysmiss 3750 1101E. PERSONAL SOCIAL : 34. Does your child take turns by waiting while another Does your child take turns by waiting while another child or adult takes a turn? 127 3866 1 2 1 Yes 51 2 No 76 Sysmiss 3866 CO code CO Code 4155 1 600 Household number Household number 4155 1 46 1 239 2 185 3 212 4 192 5 216 6 202 7 207 8 186 9 203 10 189 11 140 12 167 13 139 14 177 15 144 16 118 17 132 18 151 19 105 20 89 21 88 22 126 23 73 24 70 25 57 26 56 27 59 28 42 29 39 30 41 31 27 32 22 33 16 34 15 35 3 36 7 37 3 39 3 41 9 45 3 46 3 Household sub-number (if separated) Household sub-number (if separated) 4155 0 3 0 4105 1 23 2 24 3 3 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 4130 25 1 99 1 143 2 369 3 202 4 598 5 455 6 340 7 254 8 183 9 129 10 91 11 62 12 38 13 29 14 25 15 16 16 15 17 7 18 4 19 2 21 1 22 1 23 1 99 1165 Sysmiss 25 ID Code of child ID Code of Child (See HH Roster) 2965 1190 1 99 1 76 2 322 3 116 4 398 5 264 6 211 7 147 8 107 9 71 10 43 11 29 12 15 13 15 14 7 15 5 16 6 17 5 19 1 20 1 21 1 22 1 27 1 28 1 99 1122 Sysmiss 1190 02. Women or children? 02. Women or children? 2959 1196 1 2 1 Women 1321 2 Children 1638 Sysmiss 1196 03. If women, is she new? 03. If women, is she new? 1321 2834 1 2 1 Yes 54 2 No 1267 Sysmiss 2834 04. Current status 04. Current status 1321 2834 1 2 1 Pregnant 37 2 Mother 1284 Sysmiss 2834 05. ID code of mother ID code of mother 1638 2517 1 21 1 184 2 466 3 129 4 564 5 20 6 27 7 41 8 59 9 45 10 45 11 14 12 14 13 4 14 9 15 11 16 3 18 1 21 2 Sysmiss 2517 06A. Date of birth: YY 1638 2517 2067 2071 2067 119 2068 383 2069 502 2070 513 2071 121 Sysmiss 2517 06A. Date of birth: MM 1638 2517 1 12 1 101 2 109 3 103 4 153 5 213 6 151 7 177 8 128 9 118 10 145 11 143 12 97 Sysmiss 2517 06A. Date of birth: DD 1638 2517 1 32 1 81 2 79 3 58 4 84 5 86 6 58 7 74 8 42 9 52 10 97 11 48 12 68 13 39 14 43 15 92 16 48 17 43 18 40 19 32 20 85 21 24 22 44 23 29 24 38 25 71 26 40 27 36 28 41 29 42 30 21 31 1 32 2 Sysmiss 2517 06B. Age: Year Age: Year 1638 2517 0 5 0 411 1 496 2 509 3 196 4 25 5 1 Sysmiss 2517 06B. Age: Month Age: Month 1638 2517 0 11 0 210 1 153 2 111 3 107 4 94 5 109 6 132 7 146 8 111 9 134 10 173 11 158 Sysmiss 2517 06B. Age: Day Age: Day 1638 2517 0 30 0 71 1 72 2 77 3 60 4 48 5 46 6 38 7 49 8 52 9 40 10 58 11 60 12 50 13 41 14 46 15 53 16 44 17 63 18 57 19 64 20 56 21 62 22 45 23 58 24 57 25 48 26 47 27 64 28 51 29 57 30 4 Sysmiss 2517 07. Interview result (of eligible women/children) 07. Interview result (of eligible women/children) 2959 1196 1 7 1 Completed 2538 3 Separated 6 4 Out of home 373 5 Dead 6 6 Refused to answer 0 7 Other 36 Sysmiss 1196 4155 1 3 1 master only (1) 2 2 using only (2) 3217 3 matched (3) 936 4 missing updated (4) 0 5 nonmissing conflict (5) 0 CO code CO Code 1190 1 600 Household number Household number 1190 1 46 1 69 2 49 3 60 4 53 5 63 6 60 7 57 8 54 9 59 10 56 11 40 12 50 13 40 14 49 15 40 16 34 17 39 18 41 19 30 20 27 21 24 22 35 23 20 24 23 25 18 26 16 27 17 28 12 29 12 30 11 31 8 32 6 33 4 34 4 35 1 36 2 37 1 39 1 41 3 45 1 46 1 Household sub-number (if separated) Household sub-number (if separated) 1190 0 3 0 1175 1 7 2 7 3 1 101. Round Number Round Number 1190 2 2 2 1190 103. CO Code No CO Code No (see the code sheet) 1190 1 600 104. House Serial No House Serial No (Copy from Q5 of Listing Form) 1190 1 46 1 69 2 49 3 60 4 53 5 63 6 60 7 57 8 54 9 59 10 56 11 40 12 50 13 40 14 49 15 40 16 34 17 39 18 41 19 30 20 27 21 24 22 35 23 20 24 23 25 18 26 16 27 17 28 12 29 12 30 11 31 8 32 6 33 4 34 4 35 1 36 2 37 1 39 1 41 3 45 1 46 1 104. Household sub-number (if separated) House Serial No (Copy from Q5 of Listing Form) - sub-number (if any) 1190 0 3 0 1175 1 7 2 7 3 1 105A. Number of eligible woman 1190 0 4 0 4 1 1043 2 129 3 12 4 2 105B. Interviewed eligible woman 1190 0 4 0 6 1 1046 2 125 3 11 4 2 106B. Is this hh in baseline? Name of CO Member in Selected HH - Is this household in baseline? 1190 1 1 1 Yes 1190 2 No 0 107. Date of Interview: DD 1190 1 31 1 79 2 88 3 81 4 86 5 76 6 41 7 54 8 17 9 12 10 4 25 49 26 112 27 88 28 88 29 91 30 115 31 109 107. Date of Interview: MM 1190 5 6 5 648 6 542 107. Date of Interview: YY 1190 2071 2071 2071 1190 108. Interviewer's name Name of enumerator 1190 1 71 1 17 2 23 3 24 4 18 5 22 6 23 7 21 8 25 9 24 10 31 11 29 12 25 13 33 14 37 15 31 16 37 17 36 18 34 19 34 20 28 21 38 22 37 23 41 24 35 25 32 26 37 27 37 28 40 29 38 30 41 31 34 32 34 33 32 34 42 35 38 36 38 37 40 71 4 109. Supervisor's name Name of supervisor 1190 0 36 0 2 1 64 4 63 5 1 6 1 7 65 9 1 10 83 13 102 16 105 17 2 19 100 22 131 23 6 24 9 26 116 28 1 29 113 32 109 34 1 35 114 36 1 110. Editor's name Name of Editor 1190 0 24 0 2 1 641 2 258 3 145 4 63 5 78 22 2 24 1 111. Name of data entry operator Name of data entry operator 1190 2 0 7 1 446 10 2 100 1 2 125 3 101 4 59 5 75 6 347 69 1 7 21 a 1 p 1 q 1 CO code CO Code 1190 1 600 Household number Household number 1190 1 46 1 69 2 49 3 60 4 53 5 63 6 60 7 57 8 54 9 59 10 56 11 40 12 50 13 40 14 49 15 40 16 34 17 39 18 41 19 30 20 27 21 24 22 35 23 20 24 23 25 18 26 16 27 17 28 12 29 12 30 11 31 8 32 6 33 4 34 4 35 1 36 2 37 1 39 1 41 3 45 1 46 1 201. District District 1190 1 4 1 Ramechhap 118 2 Sindhuli 174 3 Sarlahi 309 4 Rautahat 589 202. Is this a VDC or a Municipality? Is this a VDC or a Municipality? 1190 1 1 1 VDC 1190 2 Municipality 0 203. Code of VDC/Municipality Name and Code of VDC/Municipality (see code sheet) 1190 1 179 1 37 7 15 9 12 10 21 11 22 15 19 19 11 32 14 37 8 38 14 42 22 51 36 53 31 60 6 62 44 67 10 69 50 70 12 71 32 74 23 75 40 79 16 85 10 88 17 89 19 97 22 107 34 113 29 114 17 115 32 119 13 126 17 135 17 139 47 141 47 148 15 155 39 161 18 163 25 166 65 172 36 174 25 176 22 177 39 178 38 179 52 1190 0 1 0 783 1 407 1190 0 1 0 770 1 420 1190 0 1 0 827 1 363 Household sub-number (if separated) Household sub-number (if separated) 1190 0 3 0 1175 1 7 2 7 3 1 204. Ward Number Ward Number 1190 1 9 1 90 2 29 3 181 4 177 5 100 6 189 7 123 8 182 9 119 206A. ID code of the Main Respondent 1190 1 99 1 642 2 353 3 47 4 97 5 8 6 10 7 8 8 5 9 6 10 2 11 1 12 2 13 1 14 1 15 2 99 5 206B. ID code of the second Respondent 1190 0 99 0 1 1 66 2 217 3 69 4 217 5 9 6 15 7 12 8 23 9 16 10 11 11 6 12 2 14 1 15 1 16 2 99 522 207B. ID code of the Household Head 1190 1 1 1 1190 208. Caste/ethnicity of HH head Caste/ethnicity of HH head 1190 1 99 1 Chhetri 60 2 Bhamhin - Hill 14 3 Magar 30 4 Tharu 12 5 Tamang 120 6 Newar 41 7 Muslim 210 8 Kami 18 9 Yadav 22 10 Rai 0 11 Gurung 0 12 Damai/dholi 10 13 Limbu 0 14 Thakuri 3 15 Sarki 19 16 Teli 29 17 Chamar/harijan/ram 73 18 Koiri 36 19 Kurmi 25 20 Sanyasi 9 21 Dhanuk 11 22 Musahar 34 23 Dusadh/paswan/pasi 88 24 Sherpa 7 25 Sonar 14 26 Kewat 1 27 Bramhin - Terai 10 28 Baniya 11 29 Gharti/bhujel 8 30 Mallah 67 31 Kalwar 15 32 Kumal 4 33 Hajam/thakur 9 34 Kanu 24 35 Rajbansi 0 36 Sunuwar 5 37 Sudhi 1 38 Lohar 10 39 Tatma 18 40 Khatwe 2 41 Dhobi 26 42 Majhi 5 43 Niniya 62 44 Kumhar 0 45 Danuwar 8 46 Chepang/praja 1 47 Haluwai 1 48 Rajput 1 49 Kayastha 0 50 Badhae 0 51 Marwadi 0 52 Santhal/satar 0 53 Jhangad 0 54 Bantar 0 55 Barae 2 56 Kahar 2 57 Gangai 0 58 Lodha 0 59 Rajbhar 0 60 Thami 0 61 Dhimal 0 62 Bhote 0 63 Bing/bida 8 64 Bhediyar/gaderi 1 65 Nurang 0 66 Yakha 0 67 Darai 0 68 Tajpuriya 0 69 Thakali 0 70 Chidimar 0 71 Pahari 0 72 Mali 1 73 Bangali 0 74 Chhantyal 0 75 Dom 0 76 Kamar 0 77 Bote 0 78 Baramu 0 79 Gaine 0 80 Jirel 0 81 Adibasi/janajati 0 82 Dura 0 83 Churoute 0 84 Badi 0 85 Meche 0 86 Lepcha 0 87 Halkhor 0 88 Panjabi/sikh 0 89 Kisan 0 90 Raji 0 91 Byasi 0 92 Hayu 0 93 Koche 0 94 Dhniya 0 95 Walung 0 96 Jaine 0 97 Munda 0 98 Raute 1 99 Yholmo 1 100 Pattharkatta/kuswadiya 0 101 Kusunda 0 102 Other caste 0 103 Unidentified caste 0 212. Result of Interview Result of Interview: (fill out after the interview) 1190 1 2 1 Completed 1165 2 Not completed 25 3 MIgrated 0 213. Which religion do you follow mainly in your household? Which religion do you follow mainly in your household? 1165 25 1 8 1 Hindu 849 2 Bouddha 110 3 Islam 199 4 Kirat 1 5 Jain 0 6 Christian 5 7 Shikh 0 8 Other 1 Sysmiss 25 214. Total family number Total family number 1165 25 3 23 3 29 4 76 5 146 6 202 7 181 8 154 9 111 10 72 11 60 12 36 13 23 14 21 15 15 16 9 17 14 18 9 19 4 20 1 21 1 23 1 Sysmiss 25 1190 1 3 1 Control 407 2 Info Only 420 3 Info + Cash 363 CO code CO Code 9170 1 600 Household number Household number 9170 1 46 1 571 2 407 3 515 4 402 5 490 6 408 7 443 8 408 9 435 10 420 11 297 12 381 13 287 14 400 15 299 16 269 17 294 18 369 19 237 20 191 21 193 22 290 23 158 24 150 25 116 26 107 27 120 28 87 29 109 30 91 31 51 32 42 33 30 34 43 35 6 36 15 37 4 39 10 41 11 45 6 46 8 Household sub-number (if separated) Household sub-number (if separated) 9170 0 3 0 9093 1 39 2 35 3 3 ID CODE ID Code 9145 25 1 23 1 1165 2 1165 3 1165 4 1136 5 1060 6 914 7 712 8 531 9 377 10 266 11 194 12 134 13 98 14 75 15 54 16 39 17 30 18 16 19 7 20 3 21 2 22 1 23 1 99 SKIP 0 Sysmiss 25 302. Relationship to HH head Relationship to HH head 9145 25 1 14 1 Head 1165 2 Spouse 1056 3 Son/Daughter 3585 4 Grandchild 1761 5 Parent 192 6 Brother/Sister 103 7 Nephew/Niece 136 8 Son/Daughter-in-law 936 9 Brother/Sister-in-law 117 10 Parent-in-law 72 11 Other relative (grandparents etc) 20 12 Domestic helper 0 13 Adopted/foster child 1 14 Other not related 1 Sysmiss 25 303. Sex Sex 9145 25 1 2 1 Male 4526 2 Female 4619 Sysmiss 25 304. Age (Completed): A. Year 9145 25 0 99 304. Age (Completed): B. Month 9145 25 0 11 0 7572 1 167 2 134 3 126 4 100 5 125 6 161 7 153 8 122 9 142 10 179 11 164 Sysmiss 25 305. Can [NAME] read and write a letter in any one language? Ask only to those who are aged 5 years and older Can [NAME] read and write a letter in any one language? 7350 1820 1 2 1 Can read/write 2967 2 Can't read/write 4383 Sysmiss 1820 306. Has [NAME] ever attended formal school/ college? Ask only to those who are aged 5 years and older Has [NAME] ever attended formal school/ college? No, go to Q308 7350 1820 1 2 1 Yes 3337 2 No 4013 Sysmiss 1820 307. What is the highest grade [NAME] completed? Ask only to those who are aged 5 years and older What is the highest grade [NAME] completed Use EDUCATION CODE) 3337 5833 0 98 0 CLASS 1 NOT PASSED 429 1 CLASS 1 303 2 CLASS 2 317 3 CLASS 3 280 4 CLASS 4 322 5 CLASS 5 400 6 CLASS 6 230 7 CLASS 7 200 8 CLASS 8 210 9 CLASS 9 126 10 CLASS 10 127 11 SLC 188 12 CLASS 11 67 13 CLASS 12 OR INTERMEDIATE 105 14 BACHELOR LEVEL 28 15 MASTER LEVEL/PH.D 4 98 DON'T KNOW 1 Sysmiss 5833 308. Marital status Ask only to those who are aged 5 years and older Marital status 7350 1820 1 4 1 Unmarried 2712 2 Married 4342 3 Divorced/separated 23 4 Widow/er 273 Sysmiss 1820 309. Occupation: A. Main occupation Ask only to those who are aged 5 years and older (Use OCCUPATION CODE) 7350 1820 1 36 1 Self-agri 1032 2 Self-livestock 62 3 Agri (other) 220 4 Self/other agri 109 5 Self-trade/service 207 6 Self-small/cottage industry 19 7 Self-middle/big industry 10 8 Self-construction 11 9 Self-transportation 10 10 Self-other 38 11 Wage-agri 360 12 Wage-construction skill labour 87 13 Wage-construction unskilled labour 161 14 Wage-manufacturing skill labour 50 15 Wage-manufacturing unskilled labour 45 16 Wage-other skilled labour 65 17 Wage-other unskilled labour 92 18 Labour of transport sector 46 19 Goverment employee (NIJAMATI) 9 20 Security force 21 21 Employee on corporation sector 4 22 Employee on financial sector 2 23 Employee of education sector 31 24 Employee of healthe service 9 25 Lawer 3 26 Employee of NGOs/CBOs 3 27 Student 1536 28 Household duties/child care 1442 29 Retired/old age 161 30 Disable, can work 26 31 Disable, can not work 115 32 Unemployed/seeking work 101 33 Small age (too young) 644 35 Foreign employee 617 36 Other 2 Sysmiss 1820 309. Occupation: B. Secondary occupation Ask only to those who are aged 5 years and older (Use OCCUPATION CODE) 7350 1820 1 36 1 Self-agri 461 2 Self-livestock 182 3 Agri (other) 96 4 Self/other agri 55 5 Self-trade/service 36 6 Self-small/cottage industry 5 7 Self-middle/big industry 1 8 Self-construction 3 9 Self-transportation 0 10 Self-other 10 11 Wage-agri 216 12 Wage-construction skill labour 17 13 Wage-construction unskilled labour 51 14 Wage-manufacturing skill labour 3 15 Wage-manufacturing unskilled labour 5 16 Wage-other skilled labour 7 17 Wage-other unskilled labour 26 18 Labour of transport sector 2 19 Goverment employee (NIJAMATI) 0 20 Security force 0 21 Employee on corporation sector 1 22 Employee on financial sector 1 23 Employee of education sector 1 24 Employee of healthe service 5 25 Lawer 0 26 Employee of NGOs/CBOs 0 27 Student 15 28 Household duties/child care 740 29 Retired/old age 15 30 Disable, can work 3 31 Disable, can not work 12 32 Unemployed/seeking work 62 33 Small age (too young) 488 34 No secondary occupation 4805 35 Foreign employee 22 36 Other 4 Sysmiss 1820 310. Is [name] currently residing in this HH? Is [name] currently residing in this HH? No, go to another 9145 25 1 2 1 Yes 8057 2 No 1088 Sysmiss 25 311. Is this child or mother eligible for interview? Is this child or mother eligible for interview? 8057 1113 1 2 1 Yes 2959 2 No 5098 Sysmiss 1113 CO code CO Code 1190 1 600 Household number Household number 1190 1 46 1 69 2 49 3 60 4 53 5 63 6 60 7 57 8 54 9 59 10 56 11 40 12 50 13 40 14 49 15 40 16 34 17 39 18 41 19 30 20 27 21 24 22 35 23 20 24 23 25 18 26 16 27 17 28 12 29 12 30 11 31 8 32 6 33 4 34 4 35 1 36 2 37 1 39 1 41 3 45 1 46 1 Household sub-number (if separated) Household sub-number (if separated) 1190 0 3 0 1175 1 7 2 7 3 1 401. Is this dwelling unit occupied by your household only? I would like to know more about your housing units used by your household or currently residing. Is this dwelling unit occupied by your household only? 1165 25 1 2 1 Yes 1110 2 No 55 Sysmiss 25 402. What is the ownership status of the dwelling that your household residing? What is the ownership status of the dwelling that your household residing? 1165 25 1 5 1 Own house (Male ownership) 868 2 Own house (Female ownership) 148 3 Own house (Joint ownership) 2 4 No ownership 144 5 Rented 3 Sysmiss 25 403. How many rooms are used by your household? How many rooms are used by your household? 1165 25 0 10 0 2 1 155 2 385 3 272 4 212 5 62 6 52 7 10 8 11 9 2 10 2 Sysmiss 25 404. How many stories are there in your household? How many stories are there in your household? 1165 25 0 10 0 18 1 766 2 323 3 53 4 2 6 1 10 2 Sysmiss 25 405. Has your household used separate room as a kitchen? Has your household used separate room as a kitchen? 1165 25 1 2 1 Yes 476 2 No 689 Sysmiss 25 406. What is the main flooring material of the house that your family using? What is the main flooring material of the house that your family using? 1165 25 1 4 1 Earth/mud 1071 2 Wood/Planks 19 3 Stone/Brick 29 4 Cement 46 5 Other 0 Sysmiss 25 407. What is the main construction material of the outside wall of the house? 1165 25 1 9 1 Bamboo/Wood/Cement mix (centre wall) 85 2 Cement bonded Stones/Bricks/Concrete 145 3 Mud bonded Stones/Bricks 359 4 Wood 15 5 Unbaked Bricks 8 6 Bamboo and mud 319 7 Clay, Husk, Mud, Straw, Hay 233 8 Other 0 9 No outside walls 1 Sysmiss 25 408. What is the main construction material of the roof of the house? What is the main construction material of the roof of the house? 1165 25 1 7 1 Hay/Straw 285 2 Earth/Mud 7 3 Wood 11 4 Galvanized iron 58 5 Concrete/Cement 56 6 Tiles/Slates/Stone 746 7 Other 2 Sysmiss 25 409. Does your household: A. Regular electricity 1165 25 1 2 1 Yes 779 2 No 386 Sysmiss 25 409. Does your household: B. Power generator 1165 25 1 2 1 Yes 12 2 No 1153 Sysmiss 25 409. Does your household: C. Solar power 1165 25 1 2 1 Yes 217 2 No 948 Sysmiss 25 410. What is the main source of drinking water? What is the main source of drinking water? 1165 25 1 12 1 Piped water directly to the household/compound 124 2 Piped water from a public water tap 117 3 Private Hand-pump (Shallow) 544 4 Public Hand-pump (Shallow) 178 5 Private Hand-pump (Deep) 16 6 Public Hand-pump (Deep) 13 7 Covered Well 1 8 Open Well 36 9 Stored Rain Water 1 10 Stone tape 44 11 River, Pond, Stream, or other open water bodies 15 12 Neighbour's tube-well 76 13 Other 0 Sysmiss 25 411. How many minutes does it take to fetch water? How many minutes does it take to fetch water? (Write 000 if less than one minute) 1165 25 0 240 0 550 1 26 2 39 3 28 4 6 5 183 6 4 7 6 8 10 10 164 12 2 15 73 16 2 20 19 25 4 30 32 60 12 90 1 115 1 120 2 240 1 Sysmiss 25 412. Fuel used for cooking and heating - A. Main (If none of A, B, or C is 01 go to question 414) 1165 25 1 10 1 Wood 759 2 Crop residues (Husk/Straw) 241 3 Dung cakes 133 4 Charcoal 4 5 Coal/cake 0 6 Kerosene 0 7 Electricity 0 8 Liquid Petroleum Gas 21 9 Bio Gas 6 10 Other (Specify) 1 Sysmiss 25 412. Fuel used for cooking and heating - B. Second (If none of A, B, or C is 01 go to question 414) 1165 25 1 99 1 Wood 82 2 Crop residues (Husk/Straw) 201 3 Dung cakes 237 4 Charcoal 0 5 Coal/cake 0 6 Kerosene 5 7 Electricity 5 8 Liquid Petroleum Gas 36 9 Bio Gas 6 10 Other (Specify) 0 99 No 2nd/3rd answer 593 Sysmiss 25 412. Fuel used for cooking and heating - C. Third (If none of A, B, or C is 01 go to question 414) 1165 25 1 99 1 Wood 32 2 Crop residues (Husk/Straw) 36 3 Dung cakes 72 4 Charcoal 0 5 Coal/cake 2 6 Kerosene 3 7 Electricity 2 8 Liquid Petroleum Gas 5 9 Bio Gas 0 10 Other (Specify) 0 99 No 2nd/3rd answer 1013 Sysmiss 25 413. How many minutes do you walk/bicycle to get one bhari of firewood? How many minutes do you walk/bicycle to get one bhari of firewood? 873 317 0 999 0 1 2 1 4 1 5 2 8 2 9 1 10 3 12 2 15 2 20 5 30 28 40 5 45 1 50 2 60 74 65 1 75 1 90 27 95 1 108 1 118 1 120 123 125 2 140 1 150 9 160 6 170 1 180 124 190 1 192 1 200 1 210 1 220 2 240 79 245 1 280 2 300 51 310 1 320 3 350 1 360 32 420 5 480 5 540 6 660 1 720 3 999 Not fetching water 249 Sysmiss 317 414. What type of toilet does your household use? What type of toilet does your household use? 1165 25 1 6 1 Flush toilet 50 2 Covered Pit/Pan within Household Compound 301 3 Open Pit within Household Compound 26 4 Community Latrine 2 5 Other type of Latrine (Specify) 1 6 No Toilet/Open Defecation 785 Sysmiss 25 415. How many minutes does it take to get to the nearest market to your house? How many minutes does it take to get to the nearest market to your house? (Record in minutes even if the answer is in hours) 1165 25 0 480 0 5 1 3 2 3 3 1 5 40 7 1 10 64 12 2 15 51 20 118 25 43 30 303 35 27 38 1 40 44 45 20 50 10 60 186 65 2 70 5 75 3 80 9 90 43 120 105 130 1 150 7 160 2 180 43 200 1 210 1 240 14 300 2 360 3 420 1 480 1 Sysmiss 25 416. Does your household own land? Does your household own land? No, go to Q418 1165 25 1 2 1 Yes 1028 2 No 137 Sysmiss 25 CO code CO Code 1989 1 600 Household number Household number 1989 1 46 1 123 2 75 3 107 4 79 5 100 6 87 7 93 8 75 9 103 10 102 11 62 12 87 13 74 14 79 15 66 16 66 17 57 18 68 19 60 20 41 21 31 22 64 23 37 24 40 25 29 26 27 27 31 28 18 29 24 30 15 31 17 32 13 33 8 34 10 35 2 36 4 37 3 39 4 41 2 45 3 46 3 Household sub-number (if separated) Household sub-number (if separated) 1989 0 2 0 1977 1 4 2 8 417. Land - A. Type Type of land 1989 1 4 1 Household land 1009 2 Farm land 597 3 Bari/Pakho 274 4 Baran/forest/etc. 109 99 SKIP 0 417. Land - B. Unit Units 1989 1 2 1 Ropani 502 2 Bigha 1487 417. Land - C. Area (ropani/bigha) 1989 0 75 0 1584 1 126 2 88 3 48 4 33 5 23 6 11 7 14 8 13 9 6 10 14 11 1 12 5 13 3 15 4 16 3 17 1 18 1 19 1 20 3 22 1 25 1 40 1 50 1 58 1 74 1 75 1 417. Land - D. Area (aana/kattha) 1989 0 18 0 1062 1 147 2 116 3 84 4 106 5 115 6 39 7 32 8 83 9 13 10 114 11 2 12 31 13 5 14 3 15 23 16 8 18 6 417. Land - C. Area (dhur/paisa) 1989 0 20 0 1193 1 10 2 53 3 115 4 78 5 113 6 37 7 48 8 41 9 19 10 175 11 13 12 25 13 16 14 11 15 21 16 15 18 4 19 1 20 1 CO code CO Code 1190 1 600 Household number Household number 1190 1 46 1 69 2 49 3 60 4 53 5 63 6 60 7 57 8 54 9 59 10 56 11 40 12 50 13 40 14 49 15 40 16 34 17 39 18 41 19 30 20 27 21 24 22 35 23 20 24 23 25 18 26 16 27 17 28 12 29 12 30 11 31 8 32 6 33 4 34 4 35 1 36 2 37 1 39 1 41 3 45 1 46 1 Household sub-number (if separated) Household sub-number (if separated) 1190 0 3 0 1175 1 7 2 7 3 1 418. Does your household have a garden where you grow vegetables? Does your household have a garden where you grow vegetables? No, go to 420 1165 25 1 2 1 Yes 473 2 No 692 Sysmiss 25 419. For what purpose, do you grow vegetables? For what purpose, do you grow vegetables? 473 717 1 3 1 Household consumption 427 2 Selling 9 3 Both 37 Sysmiss 717 420. Has your household owned any livestock? Has your household owned any livestock? 1165 25 1 2 1 Yes 907 2 No 258 Sysmiss 25 CO code CO Code 19830 1 600 Household number Household number 19830 1 46 1 1157 2 833 3 1020 4 885 5 1071 6 988 7 953 8 870 9 987 10 936 11 632 12 802 13 680 14 817 15 664 16 562 17 647 18 697 19 478 20 459 21 408 22 579 23 340 24 391 25 290 26 272 27 289 28 188 29 204 30 187 31 136 32 102 33 68 34 68 35 17 36 34 37 17 39 17 41 51 45 17 46 17 Household sub-number (if separated) Household sub-number (if separated) 19830 0 3 0 19575 1 119 2 119 3 17 501. Expenditure: A. Item 19805 25 1 17 1 Fuel (Wood, Kerosene, LPG, etc.) 1165 2 Clothes, Apparel 1165 3 Personal care items (Soap, Comb, Shampoo, cosmetics, etc.) 1165 4 Transportation (Horse, Mule, Bus, Taxi, Rickshaw, etc) 1165 5 Entertainment/Excursion (Movies, picnics, melas, etc) 1165 6 Newspapers, Books, Copies, etc. 1165 7 Educational and Professional Services 1165 8 Medicines and Health Services 1165 9 Legal Expenses and Insurance 1165 10 Repair/Maintenance of House and Household Effects and electrician, plumber, etc. 1165 11 Religious, Marriage, Funeral, etc. expenses 1165 12 Donations/gifts 1165 13 Electricity, Water, etc. 1165 14 Household goods 1165 15 Agri. related goods 1165 16 Ornaments, land, livestock etc. purchase 1165 17 Other 1165 Sysmiss 25 501. Expenditure: B. Amount (NRs.) (Answer in Rupees, if there is no expenditure, write zero if there is no expenditure on the item.) 19805 25 0 600000 CO code CO Code 14005 1 600 Household number Household number 14005 1 46 1 817 2 588 3 720 4 625 5 756 6 698 7 673 8 615 9 697 10 661 11 447 12 567 13 480 14 577 15 469 16 397 17 457 18 492 19 338 20 324 21 288 22 409 23 240 24 276 25 205 26 192 27 204 28 133 29 144 30 132 31 96 32 72 33 48 34 48 35 12 36 24 37 12 39 12 41 36 45 12 46 12 Household sub-number (if separated) Household sub-number (if separated) 14005 0 3 0 13825 1 84 2 84 3 12 502. Income: A. Particulars of Income (Answer in Rupees, write zero if there is no income from the item) 13980 25 1 12 1 Agriculture (Agriculture, NTFP, Livestock, etc) 1165 2 Non-Agriculture Enterprise 1165 3 From within the home town 1165 4 Inside the country 1165 5 Outside the country 1165 6 Old age pension/allowances 1165 7 Widow pension/Allowances 1165 8 Disability allowances 1165 9 Other social protection program payments 1165 10 Income from interest, bonus, profit, commission, fees, royalties, etc 1165 11 Prize 1165 12 Other 1165 Sysmiss 25 502. Income: B. Annual income (NRs.) (Answer in Rupees, write zero if there is no income from the item) 13980 25 0 1800000 CO code CO Code 1190 1 600 352.824369747899 164.694447295456 Household number Household number 1190 1 46 12.4260504201681 8.42914326683102 1 69 2 49 3 60 4 53 5 63 6 60 7 57 8 54 9 59 10 56 11 40 12 50 13 40 14 49 15 40 16 34 17 39 18 41 19 30 20 27 21 24 22 35 23 20 24 23 25 18 26 16 27 17 28 12 29 12 30 11 31 8 32 6 33 4 34 4 35 1 36 2 37 1 39 1 41 3 45 1 46 1 Household sub-number (if separated) Household sub-number (if separated) 1190 0 3 0.0201680672268908 0.191308113444256 0 1175 1 7 2 7 3 1 503. How many borrowed loans does your household have over the past 12 months? How many borrowed loans does your household have over the past 12 months? None ➔ 505 1165 25 0 12 2.01030042918455 1.73697321239926 0 None 210 1 310 2 273 3 181 4 115 5 37 6 17 7 7 8 4 9 1 10 7 12 3 Sysmiss 25 504. What was or is the annual rate of interest of the most recent loan borrowed What was or is the annual rate of interest of the most recent loan borrowed? (If eight and a half percent, write 8.5) 955 235 0 96 32.2376963350785 14.7681431936373 0 1 4 1 5 4 6 40 7.5 1 8 1 9 1 10 4 12 108 12.5 1 15 7 16 2 17 1 18 27 20 5 24 165 25 2 30 6 34 2 36 390 46 1 48 95 50 1 56 1 60 80 72 7 96 1 Sysmiss 235 CO code CO Code 40800 1 600 Household number Household number 40800 1 46 1 2381 2 1715 3 2100 4 1821 5 2205 6 2032 7 1961 8 1788 9 2031 10 1926 11 1298 12 1648 13 1400 14 1681 15 1366 16 1156 17 1331 18 1435 19 982 20 945 21 840 22 1191 23 700 24 805 25 596 26 560 27 595 28 386 29 420 30 385 31 280 32 210 33 140 34 140 35 35 36 70 37 35 39 35 41 105 45 35 46 35 Household sub-number (if separated) Household sub-number (if separated) 40800 0 3 0 40275 1 245 2 245 3 35 506. Consumption: A. Food item 40775 25 1 35 1 Rice 1165 2 Beaten rice 1165 3 Maize 1165 4 Wheat 1165 5 Barley/Oat/Sorghum 1165 6 Millet/ Buckwheat 1165 7 Pulses 1165 8 Gram/Pea 1165 9 Other beans 1165 10 Fish 1165 11 Meat 1165 12 Egg 1165 13 Milk 1165 14 Curd/Whey etc. 1165 15 Baby/Powder milk 1165 16 Ghee 1165 17 Honey 1165 18 Vegetable ghee 1165 19 Oil (Mustard, Soyabean, etc.) 1165 20 Potato/Colocasia 1165 21 Onion 1165 22 Green leafy vegetables 1165 23 Other vergetables (cauliflower, okra, etc) 1165 24 Fruits/nuts 1165 25 Salt 1165 26 Other Spices (scumin seed, marich, garlic, ginger, chillies, etc.) 1165 27 Sugar 1165 28 Sakhar/Gud/Khudo 1165 29 Sweets 1165 30 Tea/Coffee 1165 31 Alcoholic beverages (Jand, Wine, Beer, etc.) 1165 32 Non-alcoholic beverages (Coke, Frooti, Sarbat, etc.) 1165 33 Tobacco and tobacco products 1165 34 Noodles and Biscuits 1165 35 Other Foods 1165 Sysmiss 25 506. Consumption: B. Quantity (If none, write 0 and ➔Next item) 40775 25 0 800 506. Consumption: B. Unit (If none, write 0 and ➔Next item) 14182 26618 1 10 1 Kilogram 3229 2 Gram 3031 3 Litre 621 4 Ml 874 5 Pathi 27 6 Mana 610 7 Kuruwa 11 8 Number 2475 9 Dozen 9 10 Spoons 3295 Sysmiss 26618 CO code CO Code 11675 1 600 Household number Household number 11675 1 46 1 681 2 490 3 600 4 521 5 630 6 582 7 561 8 513 9 581 10 551 11 373 12 473 13 400 14 481 15 391 16 331 17 381 18 410 19 282 20 270 21 240 22 341 23 200 24 230 25 171 26 160 27 170 28 111 29 120 30 110 31 80 32 60 33 40 34 40 35 10 36 20 37 10 39 10 41 30 45 10 46 10 Household sub-number (if separated) Household sub-number (if separated) 11675 0 3 0 11525 1 70 2 70 3 10 507. Unexpected events - A. Type of shock 11650 25 1 10 1 Getting a new job of any kind 1165 2 Inheritance 1165 3 Death of HH member 1165 4 Accidental or Violent injury 1165 5 Loss of employment of any kind 1165 6 Failure/loss of business 1165 7 Livestock died 1165 8 Crop disease/pests 1165 9 Theft/robbery/burglary/assault 1165 10 Drought/floods 1165 Sysmiss 25 507. Unexpected events - B. Has the household experienced? No, go to Next item 11650 25 1 2 1 Yes 970 2 No 10680 Sysmiss 25 507. Unexpected events - C. Who did this shock affect? 970 10705 1 3 1 Just this household 687 2 Several HHs in the village 151 3 All HHs in the village 132 Sysmiss 10705 507. Unexpected events - D. What was the strength of this shock? 970 10705 1 5 1 Not important 50 2 Mild 225 3 Average 189 4 Quite strong 390 5 Very strong 116 Sysmiss 10705 CO code CO Code 1314 1 600 Household number Household number 1314 1 46 1 76 2 60 3 66 4 58 5 74 6 61 7 67 8 57 9 64 10 61 11 42 12 51 13 45 14 57 15 46 16 34 17 42 18 48 19 34 20 29 21 27 22 41 23 23 24 23 25 17 26 17 27 19 28 14 29 12 30 13 31 9 32 7 33 5 34 5 35 1 36 2 37 1 39 1 41 3 45 1 46 1 Household sub-number (if separated) Household sub-number (if separated) 1314 0 3 0 1298 1 7 2 8 3 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1314 1 21 1 143 2 368 3 106 4 446 5 17 6 25 7 36 8 51 9 38 10 35 11 13 12 11 13 3 14 7 15 9 16 3 18 2 21 1 601. Were you or any of your children who are younger than 60 months sick in the Were you or any of your children who are younger than 36 months sick in the last 30 days? No, go to Section 7 1314 1 2 1 Yes 847 2 No 467 ***** CHECK: Number person that was sick (Sec 06) CHECK: Number person that was sick (Sec 06) 847 467 0 4 0 34 1 515 2 263 3 33 4 2 Sysmiss 467 CO code CO Code 1148 1 600 Household number Household number 1148 1 46 1 74 2 64 3 65 4 54 5 64 6 57 7 48 8 57 9 57 10 53 11 40 12 45 13 41 14 47 15 41 16 29 17 34 18 34 19 29 20 21 21 26 22 38 23 20 24 14 25 16 26 19 27 9 28 7 29 10 30 8 31 7 32 6 33 3 34 2 35 1 36 3 37 1 41 2 45 1 46 1 Household sub-number (if separated) Household sub-number (if separated) 1148 0 3 0 1132 1 8 2 7 3 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1148 1 21 1 150 2 365 3 78 4 375 5 10 6 26 7 18 8 34 9 34 10 17 11 6 12 8 13 2 14 9 15 11 16 3 18 1 21 1 ID Code ID CODE (Enter from section 3) 1148 1 21 1 40 2 110 3 74 4 179 5 238 6 173 7 111 8 66 9 47 10 33 11 19 12 15 13 10 14 9 15 7 16 7 17 5 18 3 19 1 21 1 99 SKIP 0 603. What type of illness does [NAME] suffer from last time during the past 30 d What type of illness does [NAME] suffer from last time during the past 30 days? 1148 1 18 1 Diarrhoea 122 2 Dysentry 8 3 Pneumonia/Cough 328 4 Malaria 15 5 Other fever 441 6 Skin disease 47 7 TB 1 8 Measles 4 9 Jaundice 15 10 Parasites 1 11 Injury 16 12 Pregnancy related complications 12 13 Stomach-ache 47 14 STDs/STIs 3 15 Eye-ache 10 16 Head-ache 33 17 Orthopedic 20 18 Other 25 604. Where did [NAME] go for the first consultation of the illness reported in Q Where did [NAME] go for the first consultation of the illness reported in Q.603? Not consulted, go to 606 1148 1 12 1 SHP 47 2 HP 175 3 PHC 27 4 Govt. hospital 66 5 Mobile clinic 4 6 Ayurvedic centre 0 7 Pharmacy/Clinic 436 8 Pvt. hospital 248 9 Health worker's home 54 10 Traditional healer 2 11 GHUMTI SIBIR 1 12 Not consulted 88 605. Whom did [NAME] first consult with of the illness reported in Q.603? Whom did [NAME] first consult with of the illness reported in Q.603? → Go To Next Member 1060 88 1 5 1 Doctor 371 2 Paramedic (HA,SAHW, AHW, ANM) 580 3 Kaviraj/Vaidya 1 4 Untrained Pharmacist 106 5 Traditional Healer 2 6 Other 0 Sysmiss 88 606. Why didn't you consult for the illness? Why didn't you consult for the illness? 88 1060 1 7 1 No money 20 2 Illness not serious 51 3 Health worker far 12 4 No good health worker 0 5 Treatment expensive 1 6 Don't know about health institution 0 7 Pregnant 4 Sysmiss 1060 CO code CO Code 1128 1 600 Household number Household number 1128 1 46 1 66 2 58 3 60 4 51 5 64 6 50 7 54 8 53 9 57 10 55 11 35 12 40 13 34 14 46 15 42 16 29 17 35 18 36 19 30 20 25 21 24 22 37 23 20 24 20 25 16 26 16 27 12 28 9 29 11 30 10 31 8 32 6 33 5 34 4 35 1 36 2 37 1 39 1 41 3 45 1 46 1 Household sub-number (if separated) Household sub-number (if separated) 1128 0 3 0 1112 1 7 2 8 3 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1128 1 21 1 140 2 350 3 87 4 368 5 12 6 21 7 22 8 39 9 29 10 24 11 11 12 8 13 2 14 4 15 6 16 3 18 1 21 1 701. In your opinion, what should be done with the first milk (colostrums)? Now I’d like to ask you some questions about the nutrition for under 2 children. In your opinion, what should be done with the first milk (colostrums)? 1128 1 8 1 Given to baby 998 2 Thrown away 119 3 Other 0 8 Do not know 11 702. In your opinion, for how long should a newborn infant be given nothing but In your opinion, for how long should a newborn infant be given nothing but breast milk? 1128 1 8 1 Less than 6 months 86 2 6 months 738 3 More than 6 months 276 8 Do not know 28 CO code CO Code 18048 1 600 Household number Household number 18048 1 46 1 1056 2 928 3 960 4 816 5 1024 6 800 7 864 8 848 9 912 10 880 11 560 12 640 13 544 14 736 15 672 16 464 17 560 18 576 19 480 20 400 21 384 22 592 23 320 24 320 25 256 26 256 27 192 28 144 29 176 30 160 31 128 32 96 33 80 34 64 35 16 36 32 37 16 39 16 41 48 45 16 46 16 Household sub-number (if separated) Household sub-number (if separated) 18048 0 3 0 17792 1 112 2 128 3 16 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 18048 1 21 1 2240 2 5600 3 1392 4 5888 5 192 6 336 7 352 8 624 9 464 10 384 11 176 12 128 13 32 14 64 15 96 16 48 18 16 21 16 703. What foods are best? - A. Item (DO NOT PROMPT THE MOTHER. CHECK ALL FOODS THE MOTHER MENTIONS UNPROMPTED) 18048 1 16 1 Porridge that is not enriched with other foods 1128 2 Porridge that is enriched with other foods/sarbottam pitho 1128 3 Yellow, orange and green vegetables 1128 4 Fruits 1128 5 Eggs 1128 6 Milk or yogurt 1128 7 Chicken or meat including liver 1128 8 Ghee, butter, or oil 1128 9 Lentils/pulses 1128 10 Biscuit 1128 11 Cerelac 1128 12 Horlicks 1128 13 Noodles 1128 14 Vitamin 1128 15 Bread 1128 16 Others 1128 703. What foods are best? - B. Mentioned/Not Mentioned? (DO NOT PROMPT THE MOTHER. CHECK ALL FOODS THE MOTHER MENTIONS UNPROMPTED) 18048 1 2 1 Mentioned 6025 2 Not mentioned 12023 CO code CO Code 1128 1 600 Household number Household number 1128 1 46 1 66 2 58 3 60 4 51 5 64 6 50 7 54 8 53 9 57 10 55 11 35 12 40 13 34 14 46 15 42 16 29 17 35 18 36 19 30 20 25 21 24 22 37 23 20 24 20 25 16 26 16 27 12 28 9 29 11 30 10 31 8 32 6 33 5 34 4 35 1 36 2 37 1 39 1 41 3 45 1 46 1 Household sub-number (if separated) Household sub-number (if separated) 1128 0 3 0 1112 1 7 2 8 3 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1128 1 21 1 140 2 350 3 87 4 368 5 12 6 21 7 22 8 39 9 29 10 24 11 11 12 8 13 2 14 4 15 6 16 3 18 1 21 1 704. How many times a day should a 6-11 month old baby be fed a meal in addition How many times a day should a 6-11 month old baby be fed a meal in addition to breast milk? 1128 1 98 1 1 2 23 3 172 4 238 5 125 6 94 7 62 8 94 9 41 10 80 11 18 12 52 13 16 14 30 15 31 16 15 17 2 18 5 19 1 25 2 98 Do not know 26 705. How many snacks a day should a 12-24 month old baby be given in addition to How many snacks a day should a 12-24 month old baby be given in addition to breast milk? 1128 2 98 2 18 3 120 4 361 5 260 6 174 7 57 8 45 9 13 10 34 11 1 12 10 14 1 15 1 16 3 20 2 98 Do not know 28 706. In your opinion, should you breastfeed your baby less, the same or more tha In your opinion, should you breastfeed your baby less, the same or more than usual during an episode of diarrhea? 1128 1 8 1 Less than usual 279 2 Same as usual 149 3 More than usual 671 8 Do not know 29 707. In your opinion, at least how many times should a pregnant mother visit for Now I’d like to ask you some questions about the nutrition for women. In your opinion, at least how many times should a pregnant mother visit for ANC check up, 1, 2, 3, 4 or more? 1128 0 98 0 1 1 19 2 71 3 258 4 559 5 64 6 37 7 12 8 9 9 25 10 1 98 Do not know 72 708. When should a pregnant woman start iron supplementation (in months)? When should a pregnant woman start iron supplementation (in months)? 1128 1 98 1 27 2 38 3 294 4 336 5 126 6 172 7 9 8 8 98 Do not know 118 709. When should a pregnant woman take deworming tablets (in months)? When should a pregnant woman take deworming tablets (in months)? 1128 0 98 0 1 1 32 2 28 3 164 4 197 5 105 6 332 7 26 8 16 9 5 98 Do not know 222 710. When should a recently delivered woman take Vitamin A capsule (within When should a recently delivered woman take Vitamin A capsule (within days of delivery)? 1128 1 98 1 41 2 30 3 33 4 27 5 26 6 35 7 19 8 3 9 5 10 14 12 8 13 1 15 14 17 1 20 7 21 3 22 17 25 5 27 1 30 138 35 13 36 1 40 23 42 31 45 92 50 1 60 19 90 13 98 Do not know 507 711. In your opinion, is it best for a pregnant woman to eat less food, the same In your opinion, is it best for a pregnant woman to eat less food, the same amount or more food than she ate before becoming pregnant? 1128 1 8 1 More than usual 712 2 Same as usual 109 3 Less than usual 292 8 Do not know 15 CO code CO Code 15792 1 600 Household number Household number 15792 1 46 1 924 2 812 3 840 4 714 5 896 6 700 7 756 8 742 9 798 10 770 11 490 12 560 13 476 14 644 15 588 16 406 17 490 18 504 19 420 20 350 21 336 22 518 23 280 24 280 25 224 26 224 27 168 28 126 29 154 30 140 31 112 32 84 33 70 34 56 35 14 36 28 37 14 39 14 41 42 45 14 46 14 Household sub-number (if separated) Household sub-number (if separated) 15792 0 3 0 15568 1 98 2 112 3 14 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 15792 1 21 1 1960 2 4900 3 1218 4 5152 5 168 6 294 7 308 8 546 9 406 10 336 11 154 12 112 13 28 14 56 15 84 16 42 18 14 21 14 712. Good foods for a woman - A. Item (DO NOT PROMPT THE MOTHER. CHECK ALL FOODS THE MOTHER MENTIONS UNPROMPTED) 15792 1 14 1 Yellow, orange and green vegetables 1128 2 Fruit 1128 3 Eggs 1128 4 Milk or yogurt 1128 5 Meat 1128 6 Beans/pulses 1128 7 Rice 1128 8 Bread 1128 9 Horlicks 1128 10 Vitamin 1128 11 Noodles 1128 12 Biscuit 1128 13 HALUWA 1128 14 Others 1128 712. Good foods for a woman - B. Mentioned/Not Mentioned? (DO NOT PROMPT THE MOTHER. CHECK ALL FOODS THE MOTHER MENTIONS UNPROMPTED) 15792 1 2 1 Mentioned 5806 2 Not Mentioned 9986 CO code CO Code 9024 1 600 Household number Household number 9024 1 46 1 528 2 464 3 480 4 408 5 512 6 400 7 432 8 424 9 456 10 440 11 280 12 320 13 272 14 368 15 336 16 232 17 280 18 288 19 240 20 200 21 192 22 296 23 160 24 160 25 128 26 128 27 96 28 72 29 88 30 80 31 64 32 48 33 40 34 32 35 8 36 16 37 8 39 8 41 24 45 8 46 8 Household sub-number (if separated) Household sub-number (if separated) 9024 0 3 0 8896 1 56 2 64 3 8 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 9024 1 21 1 1120 2 2800 3 696 4 2944 5 96 6 168 7 176 8 312 9 232 10 192 11 88 12 64 13 16 14 32 15 48 16 24 18 8 21 8 713. With whom do you usually seek advice? - A. People giving advice Now I would like to ask you about health, tobacco and alcohol consumption (Circle all responses given, ask open-ended) 9024 1 8 1 FCHV 1128 2 AAMA Mothers group 1128 3 MCHW/VHW 1128 4 Other Health Workers 1128 5 Local private pharmacy 1128 6 Traditional healers 1128 7 Family members 1128 8 Other 1128 713. With whom do you usually seek advice? - B. Yes/No? 9024 1 2 1 Yes 1837 2 No 7187 CO code CO Code 1128 1 600 Household number Household number 1128 1 46 1 66 2 58 3 60 4 51 5 64 6 50 7 54 8 53 9 57 10 55 11 35 12 40 13 34 14 46 15 42 16 29 17 35 18 36 19 30 20 25 21 24 22 37 23 20 24 20 25 16 26 16 27 12 28 9 29 11 30 10 31 8 32 6 33 5 34 4 35 1 36 2 37 1 39 1 41 3 45 1 46 1 Household sub-number (if separated) Household sub-number (if separated) 1128 0 3 0 1112 1 7 2 8 3 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1128 1 21 1 140 2 350 3 87 4 368 5 12 6 21 7 22 8 39 9 29 10 24 11 11 12 8 13 2 14 4 15 6 16 3 18 1 21 1 714. What kind of salt do you normally use in your house? What kind of salt do you normally use in your house? 1128 1 2 1 Aayunoon/Two child logo salt 982 2 Other salt 146 715. Are you smoking, chewing tobacco and drinking alcohol regularly? Are you smoking, chewing tobacco and drinking alcohol regularly? 1128 1 4 1 Yes smoking and taking tobacco 31 2 Yes drinking alcohol 71 3 Yes taking both 57 4 No, taking nothing 969 716. Rank the most important: A. Health 1128 1 4 1 287 2 462 3 254 4 125 716. Rank the most important: B. Food 1128 1 4 1 631 2 338 3 130 4 29 716. Rank the most important: C. Education 1128 1 4 1 144 2 224 3 501 4 259 716. Rank the most important: D. Security 1128 1 4 1 66 2 104 3 243 4 715 717. What is the highest level of education that you think your child will obtai What is the highest level of education that you think your child will obtain? 1128 0 98 0 CLASS 1 NOT PASSED 19 1 CLASS 1 1 2 CLASS 2 3 3 CLASS 3 1 4 CLASS 4 4 5 CLASS 5 47 6 CLASS 6 18 7 CLASS 7 13 8 CLASS 8 47 9 CLASS 9 31 10 CLASS 10 263 11 SLC 310 12 CLASS 11 90 13 CLASS 12 OR INTERMEDIATE 102 14 BACHELOR LEVEL 35 15 MASTER LEVEL/PH.D 86 98 DON'T KNOW 58 718. In the past month, have you been to a CO meeting? In the past month, have you been to a CO meeting? 1128 1 2 1 Yes 460 2 No 668 719. Do you think your child will work in agriculture or industry? Do you think your child will work in agriculture or industry? 1128 1 5 1 Agriculture 272 2 Industry 226 3 Foreign employee 68 4 Service 333 5 Other 229 CO code CO Code 1128 1 600 Household number Household number 1128 1 46 1 66 2 58 3 60 4 51 5 64 6 50 7 54 8 53 9 57 10 55 11 35 12 40 13 34 14 46 15 42 16 29 17 35 18 36 19 30 20 25 21 24 22 37 23 20 24 20 25 16 26 16 27 12 28 9 29 11 30 10 31 8 32 6 33 5 34 4 35 1 36 2 37 1 39 1 41 3 45 1 46 1 Household sub-number (if separated) Household sub-number (if separated) 1128 0 3 0 1112 1 7 2 8 3 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1128 1 21 1 140 2 350 3 87 4 368 5 12 6 21 7 22 8 39 9 29 10 24 11 11 12 8 13 2 14 4 15 6 16 3 18 1 21 1 801. How old were you when you got married? How old were you when you got married? 1128 10 30 10 16 11 3 12 37 13 44 14 124 15 212 16 218 17 117 18 165 19 55 20 71 21 22 22 20 23 8 24 3 25 5 27 1 28 1 29 1 30 5 802. Was the marriage arranged? Was the marriage arranged? 1128 1 2 1 Yes 1018 2 No 110 803. Are you currently pregnant? Are you currently pregnant? No, go to 806 1128 1 2 1 Yes 151 2 No 977 804. How long have you been pregnant for? How long have you been pregnant for? (Write 0 if less than 1 month) 151 977 0 9 0 2 1 2 2 24 3 19 4 18 5 9 6 21 7 22 8 22 9 12 Sysmiss 977 805. Is this your first pregnancy? Is this your first pregnancy? 151 977 1 3 1 Yes 20 2 No, and have kids who are alive 129 3 No, and other kid(s) died 2 Sysmiss 977 806. During your pregnancy with your youngest child, how many times did you rece During your pregnancy with your youngest child (name:___________), how many times did you receive antenatal care? 1106 22 0 15 0 92 1 52 2 118 3 258 4 432 5 68 6 44 7 15 8 10 9 15 10 1 15 1 Sysmiss 22 807. Did you receive TT injection at any time during this pregnancy (with name)? Did you receive TT injection at any time during this pregnancy (with name)? No, go to 809 1106 22 1 2 1 Yes 1012 2 No 94 Sysmiss 22 808. While pregnant with (name of youngest child), how many times did you receiv While pregnant with (name of youngest child), how many times did you receive such an injection? 1012 116 1 9 1 140 2 602 3 229 4 34 5 6 9 1 Sysmiss 116 809. When you were pregnant with (name of youngest child), did you receive iron When you were pregnant with (name of youngest child), did you receive iron tablets? No, go to 812 1106 22 1 2 1 Yes 921 2 No 185 Sysmiss 22 810. How many days during your pregnancy did you take the iron tablets? How many days during your pregnancy did you take the iron tablets? 921 207 1 999 CO code CO Code 6447 1 600 Household number Household number 6447 1 46 1 364 2 378 3 343 4 322 5 357 6 287 7 322 8 280 9 315 10 287 11 189 12 231 13 217 14 252 15 259 16 175 17 224 18 196 19 168 20 126 21 133 22 196 23 126 24 105 25 84 26 112 27 42 28 42 29 70 30 56 31 49 32 42 33 35 34 7 36 7 37 7 39 7 41 21 45 7 46 7 Household sub-number (if separated) Household sub-number (if separated) 6447 0 3 0 6342 1 49 2 49 3 7 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 6447 1 21 1 735 2 2079 3 525 4 2114 5 77 6 112 7 126 8 196 9 168 10 133 11 49 12 35 13 14 14 28 15 35 16 14 21 7 811. From where? - A. Place where the tablets were taken (Choose all that apply, ask open-ended) 6447 1 7 1 FCHV 921 2 Health Facility 921 3 Clinic/pharmacy 921 4 Hospital 921 5 NGOs/INGOs 921 6 Privat nursing home 921 7 Other 921 811. From where? - B. Yes/No? 6447 1 2 1 Yes 1173 2 No 5274 CO code CO Code 1128 1 600 Household number Household number 1128 1 46 1 66 2 58 3 60 4 51 5 64 6 50 7 54 8 53 9 57 10 55 11 35 12 40 13 34 14 46 15 42 16 29 17 35 18 36 19 30 20 25 21 24 22 37 23 20 24 20 25 16 26 16 27 12 28 9 29 11 30 10 31 8 32 6 33 5 34 4 35 1 36 2 37 1 39 1 41 3 45 1 46 1 Household sub-number (if separated) Household sub-number (if separated) 1128 0 3 0 1112 1 7 2 8 3 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1128 1 21 1 140 2 350 3 87 4 368 5 12 6 21 7 22 8 39 9 29 10 24 11 11 12 8 13 2 14 4 15 6 16 3 18 1 21 1 812. During your last pregnancy, (with name) did you take de-worming tablet? During your last pregnancy, (with name) did you take de-worming tablet? 1106 22 1 2 1 Yes 875 2 No 231 Sysmiss 22 813. Did you suffer from night blindness or ratandho in your last pregnancy? Did you suffer from night blindness or ratandho in your last pregnancy? 1106 22 1 2 1 Yes 165 2 No 941 Sysmiss 22 814. Where did you give birth in your most recent delivery? Where did you give birth in your most recent delivery? 1106 22 1 6 1 Home 812 2 Government hospital 123 3 PHC/HP/SHP 107 4 Private hospital/nursing home 51 5 Field/jungle 8 6 Road/Vehicle 5 Sysmiss 22 815. Who assisted with your most recent delivery? Who assisted with your most recent delivery? 1106 22 1 9 1 Doctor 105 2 Staff nurse/ANM 186 3 HA/AHW 120 4 MCHW 29 5 FCHV 72 6 TBA 89 7 Untrained household member/neighbor 492 8 Other 2 9 No one 11 Sysmiss 22 816. In the first 42 days after delivery, did you take Vitamin A capsules? In the first 42 days after delivery, did you take Vitamin A capsules? No, go to 818 1106 22 1 2 1 Yes 642 2 No 464 Sysmiss 22 817. If yes, from where did you receive? If yes, from where did you receive? 642 486 1 3 1 FCHV 322 2 Health workers 265 3 Shop/Medical 55 4 Other 0 Sysmiss 486 818. Are you or your husband currently using any family planning method? Are you or your husband currently using any family planning method? 1106 22 1 2 1 Yes 201 2 No 905 Sysmiss 22 CO code CO Code 1106 1 600 Household number Household number 1106 1 46 1 64 2 57 3 59 4 50 5 60 6 50 7 52 8 51 9 56 10 55 11 35 12 40 13 34 14 44 15 42 16 29 17 35 18 35 19 29 20 25 21 24 22 36 23 20 24 20 25 15 26 16 27 11 28 8 29 11 30 10 31 8 32 6 33 5 34 4 35 1 36 2 37 1 39 1 41 3 45 1 46 1 Household sub-number (if separated) Household sub-number (if separated) 1106 0 3 0 1091 1 7 2 7 3 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1106 1 21 1 140 2 348 3 87 4 363 5 12 6 21 7 19 8 36 9 27 10 22 11 9 12 7 13 2 14 4 15 6 16 2 21 1 901. Did you ever breastfeed to your youngest child (name of child)? Did you ever breastfeed to your youngest child (name of child)? 1106 1 2 1 Yes 1096 2 No 10 902. How long after giving birth did you first put (name of child) to the breast How long after giving birth did you first put (name of child) to the breast? 1096 10 0 720 0 516 1 193 2 101 3 45 4 23 5 8 6 7 7 3 8 2 9 4 10 5 12 12 15 3 16 1 20 1 23 1 24 37 30 13 35 1 36 10 48 47 50 4 52 1 55 1 60 27 70 1 72 19 90 4 96 1 120 1 130 1 144 1 240 1 720 1 Sysmiss 10 903. During the first three days after delivery, did you give (name) the liquid During the first three days after delivery, did you give (name) the liquid that came from your breasts? 1096 10 1 2 1 Yes 967 2 No 129 Sysmiss 10 904. In the first three days after delivery, was (name) given anything to drink In the first three days after delivery, was (name) given anything to drink other than breast milk? No, go to 906 1106 1 2 1 Yes 244 2 No 862 CO code CO Code 2928 6 600 Household number Household number 2928 1 46 1 216 2 192 3 156 4 180 5 108 6 180 7 108 8 168 9 144 10 108 11 72 12 48 13 108 14 108 15 120 16 72 17 60 18 144 19 60 20 60 21 72 22 72 23 48 24 84 25 24 26 60 27 36 28 48 29 24 30 12 32 12 35 12 46 12 Household sub-number (if separated) Household sub-number (if separated) 2928 0 2 0 2892 1 12 2 24 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 2928 1 15 1 276 2 876 3 216 4 1056 5 48 6 60 7 36 8 108 9 84 10 84 12 24 13 12 14 24 15 24 905. What was (name) given to drink? - A. Liquid Food (Circle all responses given) 2928 1 12 1 Milk (other than breast milk) 244 2 Other mother milk 244 3 Plain water 244 4 Sugar or glucose water 244 5 Gripe water 244 6 Sugar-salt-water solution 244 7 Fruit juice 244 8 Infant formula 244 9 Honey 244 10 Ghee 244 11 Milk pouder 244 12 Others 244 905. What was (name) given to drink? - B. Fed/not fed? 2928 1 2 1 Fed 379 2 Not fed 2549 CO code CO Code 1106 1 600 Household number Household number 1106 1 46 1 64 2 57 3 59 4 50 5 60 6 50 7 52 8 51 9 56 10 55 11 35 12 40 13 34 14 44 15 42 16 29 17 35 18 35 19 29 20 25 21 24 22 36 23 20 24 20 25 15 26 16 27 11 28 8 29 11 30 10 31 8 32 6 33 5 34 4 35 1 36 2 37 1 39 1 41 3 45 1 46 1 Household sub-number (if separated) Household sub-number (if separated) 1106 0 3 0 1091 1 7 2 7 3 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1106 1 21 1 140 2 348 3 87 4 363 5 12 6 21 7 19 8 36 9 27 10 22 11 9 12 7 13 2 14 4 15 6 16 2 21 1 906. For how many months did you exclusively breastfeed (name)? For how many months did you exclusively breastfeed (name)? (If less than one month record 00 months.) 1106 0 99 0 54 1 19 2 15 3 37 4 44 5 56 6 553 7 68 8 42 9 34 10 9 11 7 12 24 13 1 14 1 15 4 16 1 17 2 18 4 19 2 24 3 25 1 99 Still breastfeeding 125 907. For how many months did you breastfeed (name)? For how many months did you breastfeed (name)? (If less than one month record 00 months.) 1106 0 99 0 4 3 1 4 1 6 4 7 2 8 1 9 2 10 2 11 1 12 8 14 3 15 3 16 3 17 3 18 25 20 3 22 3 24 47 25 3 26 3 28 2 30 5 34 2 35 1 36 2 48 1 52 1 99 Still breastfeeding 970 908. ENUMERATOR: Is [name] younger than 24 months or older? ENUMERATOR: Is [name] younger than 24 months or older? Older than 24 m 30 d, go to Section 10 1106 1 3 1 Younger than 24 m 30 d 805 2 Older than 24 m 30 d 300 3 Child dead 1 909. Are you still breastfeeding (name)? Are you still breastfeeding (name)? No, go to 911 805 301 1 2 1 Yes 760 2 No 45 Sysmiss 301 910. How often did you breastfeed your child (name) day and night during last 24 How often did you breastfeed your child (name) day and night during last 24 hours? Go to Q911 if answer is 0, if more than that go to Q912 760 346 0 35 0 2 1 1 2 5 3 11 4 24 5 44 6 68 7 43 8 64 9 31 10 119 11 27 12 102 13 9 14 22 15 70 16 9 17 4 18 15 19 2 20 49 21 2 22 3 23 1 24 4 25 16 26 1 28 3 30 7 35 2 Sysmiss 346 CO code CO Code 329 25 596 25 7 34 7 163 14 179 14 204 7 210 7 239 7 253 14 256 7 262 7 287 7 345 7 408 7 420 7 422 14 427 7 461 21 462 7 463 21 464 7 465 7 472 14 474 14 475 7 503 14 507 14 512 14 514 7 582 7 584 7 595 14 596 14 Household number Household number 329 1 30 1 42 2 14 3 28 4 7 5 35 6 14 7 21 8 21 9 7 10 7 11 7 12 21 13 14 14 14 15 7 16 7 18 7 19 7 20 21 24 14 29 7 30 7 Household sub-number (if separated) Household sub-number (if separated) 329 0 2 0 322 2 7 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 329 1 14 1 35 2 70 3 21 4 161 6 14 7 7 8 7 9 7 14 7 911. Why not? - A. Reasons for not breastfeeding (Circle all responses given, ask open-ended) 329 1 7 1 No milking 47 2 Inadequacy of breastmilks 47 3 Work load/lack of time 47 4 Child ill 47 5 Pregnant 47 6 Mother is/was sick 47 7 Other 47 911. Why not? - B. Yes/No? (Circle all responses given, ask open-ended) 329 1 2 1 Yes 53 2 No 276 CO code CO Code 1106 1 600 Household number Household number 1106 1 46 1 64 2 57 3 59 4 50 5 60 6 50 7 52 8 51 9 56 10 55 11 35 12 40 13 34 14 44 15 42 16 29 17 35 18 35 19 29 20 25 21 24 22 36 23 20 24 20 25 15 26 16 27 11 28 8 29 11 30 10 31 8 32 6 33 5 34 4 35 1 36 2 37 1 39 1 41 3 45 1 46 1 Household sub-number (if separated) Household sub-number (if separated) 1106 0 3 0 1091 1 7 2 7 3 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1106 1 21 1 140 2 348 3 87 4 363 5 12 6 21 7 19 8 36 9 27 10 22 11 9 12 7 13 2 14 4 15 6 16 2 21 1 912. Did (name) drink anything milk or liquidy from a bottle with a nipple yeste Did (name) drink anything milk or liquidy from a bottle with a nipple yesterday or last night? 805 301 1 8 1 Yes 588 2 Nothing 211 8 Do not know 6 Sysmiss 301 CO code CO Code 19320 2 600 Household number Household number 19320 1 46 1 1248 2 1056 3 912 4 888 5 1008 6 888 7 936 8 816 9 1080 10 936 11 624 12 696 13 600 14 816 15 816 16 504 17 600 18 672 19 504 20 432 21 336 22 576 23 312 24 288 25 240 26 264 27 192 28 168 29 96 30 240 31 144 32 120 33 96 34 96 36 24 37 24 39 24 41 24 46 24 Household sub-number (if separated) Household sub-number (if separated) 19320 0 3 0 19056 1 96 2 144 3 24 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 19320 1 21 1 2160 2 5664 3 1368 4 6528 5 288 6 456 7 408 8 768 9 552 10 480 11 192 12 144 13 48 14 96 15 120 16 24 21 24 913. liquids or foods - A. Item 19320 1 24 1 Breast milk 805 2 Plain water 805 3 Milk such as commercially produced infant formula 805 4 Any fortified, commercially available infant and young child food 805 5 Any other porridge or gruel 805 6 Fresh animal milk 805 7 Yogurt or other milk products 805 8 Rice, chapattis other foods made from grains such as millet, maize, lito 805 9 White potatoes or other [roots] tubers 805 10 Pupmkin, carrots, or other yellow or orange vegetables 805 11 Ripe mangoes, papaya, or other yellow or orange fruits 805 12 Any dark green leafy vegetables 805 13 Other fruits such as banana, orange, apple 805 14 Eggs 805 15 Any meat such as goat, lamb, chicken, pork, ducks 805 16 Any organ meat such as liver, kidney 805 17 Fresh or dried fish or shellfish/dried meat 805 18 Snails or other small protein foods 805 19 Lentils, beans, peas, or nuts 805 20 Any oils, fats or foods made with any of these foods 805 21 Tea 805 22 Sugary foods such as sweets, chocolate 805 23 Processed foods such as biscuits, noodles 805 24 Any other solid or soft foods/JAAND 805 913. liquids or foods - B. Yes/No? 19320 1 2 1 Yes 4503 2 No 14817 CO code CO Code 1106 1 600 Household number Household number 1106 1 46 1 64 2 57 3 59 4 50 5 60 6 50 7 52 8 51 9 56 10 55 11 35 12 40 13 34 14 44 15 42 16 29 17 35 18 35 19 29 20 25 21 24 22 36 23 20 24 20 25 15 26 16 27 11 28 8 29 11 30 10 31 8 32 6 33 5 34 4 35 1 36 2 37 1 39 1 41 3 45 1 46 1 Household sub-number (if separated) Household sub-number (if separated) 1106 0 3 0 1091 1 7 2 7 3 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1106 1 21 1 140 2 348 3 87 4 363 5 12 6 21 7 19 8 36 9 27 10 22 11 9 12 7 13 2 14 4 15 6 16 2 21 1 914. How many times did (name) youngest child eat solid, semi-solid, or soft foo How many times did (name) youngest child eat solid, semi-solid, or soft food other than liquids yesterday during the day or at night? 805 301 0 98 0 144 1 9 2 50 3 137 4 218 5 94 6 70 7 26 8 17 9 3 10 8 12 3 14 1 15 2 98 Do not know 23 Sysmiss 301 CO code CO Code 10245 2 600 361.803806734993 161.120547094923 Household number Household number 10245 1 46 12.1244509516837 8.35951693187491 1 660 2 570 3 465 4 420 5 600 6 480 7 420 8 450 9 570 10 465 11 330 12 345 13 360 14 420 15 480 16 285 17 285 18 405 19 255 20 255 21 210 22 300 23 180 24 180 25 105 26 105 27 90 28 75 29 45 30 135 31 75 32 60 33 30 34 60 36 15 37 15 39 15 41 15 46 15 Household sub-number (if separated) Household sub-number (if separated) 10245 0 3 0.0248901903367496 0.218406470417431 0 10095 1 60 2 75 3 15 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 10245 1 16 3.76573938506589 2.67491883932387 1 1200 2 3090 3 750 4 3465 5 135 6 285 7 165 8 375 9 225 10 240 11 75 12 75 13 15 14 60 15 75 16 15 915. Food usually given to the child - A. Type of food 10245 1 15 8 4.32070467302899 1 Solid (Dal Bhat Vegetable) 683 2 Semi-solid (Jaulo/Porridge) 683 3 Mashed/pureed 683 4 Liquidy 683 5 Milk 683 6 Biscuit 683 7 Horlicks 683 8 Cerelac 683 9 HALUWA 683 10 Noodles 683 11 Egg 683 12 Meat 683 13 Bread 683 14 Fruits 683 15 Others 683 915. Food usually given to the child - B. Given/not given 10245 1 2 1.67847730600293 0.467083660846072 1 Given 3294 2 Not given 6951 CO code CO Code 1106 1 600 Household number Household number 1106 1 46 1 64 2 57 3 59 4 50 5 60 6 50 7 52 8 51 9 56 10 55 11 35 12 40 13 34 14 44 15 42 16 29 17 35 18 35 19 29 20 25 21 24 22 36 23 20 24 20 25 15 26 16 27 11 28 8 29 11 30 10 31 8 32 6 33 5 34 4 35 1 36 2 37 1 39 1 41 3 45 1 46 1 Household sub-number (if separated) Household sub-number (if separated) 1106 0 3 0 1091 1 7 2 7 3 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1106 1 21 1 140 2 348 3 87 4 363 5 12 6 21 7 19 8 36 9 27 10 22 11 9 12 7 13 2 14 4 15 6 16 2 21 1 916. Did the child receive vitamin A capsule within the last 6 months? Did the child receive vitamin A capsule within the last 6 months? 805 301 1 3 1 Yes 528 2 No 210 3 Child below 6 months old 67 Sysmiss 301 917. How many hours were you away from your child due to work or other reasons d How many hours were you away from your child due to work or other reasons during the past 24 hours? (If answer is no or less than 1 hour, record 00) 805 301 0 10 0 618 1 27 2 50 3 44 4 21 5 16 6 16 7 2 8 6 9 3 10 2 Sysmiss 301 918. Did you say you would feed the baby later when he/she (name) expressed the Did you say you would feed the baby later when he/she (name) expressed the desire for it (within the last 24 hours)? 187 919 1 2 1 I did 17 2 I did not 170 Sysmiss 919 CO code CO Code 1314 1 600 Household number Household number 1314 1 46 1 76 2 60 3 66 4 58 5 74 6 61 7 67 8 57 9 64 10 61 11 42 12 51 13 45 14 57 15 46 16 34 17 42 18 48 19 34 20 29 21 27 22 41 23 23 24 23 25 17 26 17 27 19 28 14 29 12 30 13 31 9 32 7 33 5 34 5 35 1 36 2 37 1 39 1 41 3 45 1 46 1 Household sub-number (if separated) Household sub-number (if separated) 1314 0 3 0 1298 1 7 2 8 3 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women and Child] Name and ID Code of Eligible Woman -HH Roster 1314 1 21 1 143 2 368 3 106 4 446 5 17 6 25 7 36 8 51 9 38 10 35 11 13 12 11 13 3 14 7 15 9 16 3 18 2 21 1 1001. Weight of the female respondent (in kilograms) Now, I would like to talk to you about your physical feature and request for measuring weight and height Weight of the female respondent (in kilograms) 1128 186 27.1000003814697 86 998 Could not weigh 0 Sysmiss 186 1002. Height of the female respondent (in centimeters) Height of the female respondent (in centimeters) (Scale the height in nearest 0.5 centimeter, for example, if the height is 150.4-150.7 write 150.5, if the height is 150.8 or 150.9 write 151.0) 1128 186 130.5 170 998 Could not measure 0 Sysmiss 186 1003A. How many children under 5 years of age in your household from the eligibl How many children under 3 years (0-36 months or up to 36 months 30 days) of age in your household from the eligible woman? [If this is 0, it is the end of the interview.] 1314 0 4 0 52 1 909 2 336 3 15 4 2 1003B. Interviewed children under 5 years of age (for Section 11)? 1262 52 0 4 0 158 1 813 2 278 3 11 4 2 Sysmiss 52 1004. Weight of mother holding child #1 (kilograms) Weight of mother holding child #1 (kilograms) According to Q1003, ask the following questions about children under 3 years (0-36 months) of age and measure weight and height of those children. If the child is below 24 m 30 d ask the mother to hold the child and take measurements of both together, and then calculate the child’s weight deducting that of the mother’s. 1262 52 30.5 999 998 Could not weigh 2 999 NA (>=25 months child) 478 Sysmiss 52 1004. ID CODE OF CHILD #1 ID CODE OF CHILD 1 (HH Roster) 784 530 3 22 3 49 4 64 5 220 6 146 7 100 8 59 9 49 10 30 11 21 12 12 13 12 14 10 15 3 16 2 17 4 18 1 19 1 22 1 Sysmiss 530 1005. Weight of mother holding child #2 (kilograms) Weight of mother holding child #2 (kilograms) According to Q1003, ask the following questions about children under 3 years (0-36 months) of age and measure weight and height of those children. If the child is below 24 m 30 d ask the mother to hold the child and take measurements of both together, and then calculate the child’s weight deducting that of the mother’s. 353 961 33.5999984741211 999 33.5999984741211 1 40.9000015258789 2 41 1 41.5999984741211 1 42 1 42.0999984741211 1 43 2 43.2999992370605 1 43.5 1 44.0999984741211 2 44.2999992370605 1 44.7000007629395 1 45 1 45.5999984741211 1 46.7000007629395 2 48 1 48.2000007629395 1 48.2999992370605 1 48.4000015258789 1 48.5 1 48.5999984741211 1 49 3 49.0999984741211 1 49.5 1 49.7999992370605 2 50 1 51 2 51.5999984741211 1 51.7999992370605 1 52 2 52.5 1 52.5999984741211 1 52.7999992370605 1 52.9000015258789 1 53 1 53.4000015258789 1 54 1 54.7999992370605 1 54.9000015258789 1 55 2 55.5 1 55.7999992370605 1 57.7999992370605 1 58.2000007629395 1 58.5 4 58.7000007629395 1 60.7000007629395 1 63 1 998 Could not weigh 2 999 NA (>=25 months child) 290 Sysmiss 961 1005. ID CODE OF CHILD #2 ID CODE OF CHILD 2 (HH Roster) 63 1251 4 23 4 6 5 9 6 20 7 11 8 8 9 1 10 3 11 2 13 1 15 1 23 1 Sysmiss 1251 1006. Weight of mother holding child #3 (kilograms) Weight of mother holding child #3 (kilograms) According to Q1003, ask the following questions about children under 3 years (0-36 months) of age and measure weight and height of those children. If the child is below 24 m 30 d ask the mother to hold the child and take measurements of both together, and then calculate the child’s weight deducting that of the mother’s. 17 1297 42.5 999 42.5 1 49.4000015258789 1 50 1 998 Could not weigh 0 999 NA (>=25 months child) 14 Sysmiss 1297 1006. ID CODE OF CHILD #3 ID CODE OF CHILD 3 (HH Roster) 3 1311 5 9 5 1 8 1 9 1 Sysmiss 1311 1006A. Weight of mother holding child #4 (kilograms) Weight of mother holding child #4 (kilograms) According to Q1003, ask the following questions about children under 3 years (0-36 months) of age and measure weight and height of those children. If the child is below 24 m 30 d ask the mother to hold the child and take measurements of both together, and then calculate the child’s weight deducting that of the mother’s. 5 1309 999 999 998 Could not weigh 0 999 NA (>=25 months child) 5 Sysmiss 1309 1006A. ID CODE OF CHILD #4 ID CODE OF CHILD 4 (HH Roster) 1314 * Sysmiss 1314 CO code CO Code 1410 1 600 Household number Household number 1410 1 46 1 82 2 73 3 76 4 69 5 69 6 66 7 64 8 70 9 73 10 65 11 50 12 54 13 43 14 58 15 51 16 42 17 42 18 45 19 35 20 28 21 31 22 45 23 27 24 23 25 19 26 22 27 15 28 9 29 13 30 13 31 9 32 8 33 6 34 4 35 1 36 3 37 1 39 1 41 3 45 1 46 1 Household sub-number (if separated) Household sub-number (if separated) 1410 0 3 0 1391 1 9 2 9 3 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1410 1 21 1 177 2 443 3 106 4 472 5 16 6 22 7 23 8 43 9 36 10 30 11 10 12 10 13 3 14 6 15 8 16 3 21 2 ID Code of child ID CODE of Children 1410 3 23 3 88 4 137 5 387 6 274 7 190 8 110 9 70 10 42 11 38 12 22 13 18 14 12 15 4 16 7 17 6 18 2 19 1 22 1 23 1 1007. Date of Birth of Child - DD 1410 1 32 1 71 2 68 3 47 4 78 5 72 6 52 7 61 8 34 9 39 10 87 11 40 12 61 13 30 14 39 15 80 16 39 17 38 18 37 19 30 20 70 21 19 22 40 23 25 24 34 25 63 26 32 27 33 28 35 29 37 30 17 31 1 32 1 1007. Date of Birth of Child - MM 1410 1 12 1 87 2 96 3 90 4 133 5 159 6 128 7 157 8 119 9 104 10 127 11 125 12 85 1007. Date of Birth of Child - YY 1410 2067 2071 2067 110 2068 338 2069 439 2070 449 2071 74 1008. Was there any problem at delivery of this child (delivery complications)? Was there any problem at delivery of this child (delivery complications)? 1410 1 2 1 Yes 399 2 No 1011 1009. How long was the child breastfed? How long was the child breastfed? Specify breastfed period in months. If not breastfed, write 00. If currently breastfeeding, write 99) 1410 0 99 0 Not breastfed 15 1 2 2 2 3 3 4 4 6 38 7 8 8 9 9 8 10 10 11 6 12 51 13 7 14 7 15 19 16 10 17 6 18 86 19 7 20 11 22 3 23 1 24 115 25 10 26 4 27 2 28 2 30 10 34 2 36 5 99 Currently breastfeeding 947 1010. Has child been occulated? Has child been occulated? 1410 1 3 1 Fully occulated 1030 2 Being fully occulated 350 3 Not occulated 30 1011. Height of Child Height of Child If height not measured record 999 and go to Q1013 (to nearest 0.5 cm) 1410 40 999 999 Not measured 29 1012. Height is measured laying or standing Height is measured laying or standing 1381 29 1 2 1 Laying 670 2 Standing 711 Sysmiss 29 1013. Weight of Child Weight of Child If weight not measured record 999 and go to Q1015 1410 1.89999997615814 999 999 Not measured 22 1014. Was child weighed with the mother or alone? Was child weighed with the mother or alone? → Go To Next Member 1388 22 1 2 1 Alone 575 2 With mum 813 Sysmiss 22 1015. Reason for not taking Height/Weight Reason for not taking Height/Weight (If you filled out 999 for question 1011 or 1013) 22 1388 1 3 1 Child not at home 13 2 Child was sick 6 3 Not allowed to take Height/Weight 3 Sysmiss 1388 CO code CO Code 1410 1 600 Household number Household number 1410 1 46 1 82 2 73 3 76 4 69 5 69 6 66 7 64 8 70 9 73 10 65 11 50 12 54 13 43 14 58 15 51 16 42 17 42 18 45 19 35 20 28 21 31 22 45 23 27 24 23 25 19 26 22 27 15 28 9 29 13 30 13 31 9 32 8 33 6 34 4 35 1 36 3 37 1 39 1 41 3 45 1 46 1 Household sub-number (if separated) Household sub-number (if separated) 1410 0 3 0 1391 1 9 2 9 3 1 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women and Child] Name and ID Code of Respondent -HH Roster 1410 1 21 1 177 2 443 3 106 4 472 5 16 6 22 7 23 8 43 9 36 10 30 11 10 12 10 13 3 14 6 15 8 16 3 21 2 ID Code of child ID Code of Child (See HH Roster) 1410 3 23 3 88 4 137 5 387 6 274 7 190 8 110 9 70 10 42 11 38 12 22 13 18 14 12 15 4 16 7 17 6 18 2 19 1 22 1 23 1 Age of chid (month) Age of Child 1410 1 52 1101A. COMMUNICATION: 01. Does your baby sometimes make throaty or gurgling soun Does your baby sometimes make throaty or gurgling sounds? 45 1365 1 2 1 Yes 37 2 No 8 Sysmiss 1365 1101A. COMMUNICATION: 02. Does your baby make cooing sounds such as ?ooo,? ?gah, Does your baby make cooing sounds such as “ooo,” “gah,” and “aah”? 45 1365 1 2 1 Yes 31 2 No 14 Sysmiss 1365 1101A. COMMUNICATION: 03. When you speak to your baby, does she make sounds back When you speak to your baby, does she make sounds back to you? 45 1365 1 2 1 Yes 24 2 No 21 Sysmiss 1365 1101A. COMMUNICATION: 04. Does your baby smile when you talk to him? 72 1338 1 2 1 Yes 64 2 No 8 Sysmiss 1338 1101A. COMMUNICATION: 05. Does your baby chuckle softly? 72 1338 1 2 1 Yes 50 2 No 22 Sysmiss 1338 1101A. COMMUNICATION: 06. After you have been out of sight, does your baby smile After you have been out of sight, does your baby smile or get excited when she sees you? 72 1338 1 2 1 Yes 50 2 No 22 Sysmiss 1338 1101A. COMMUNICATION: 07. Does your baby make high-pitched squeals? Does your baby make high-pitched squeals? 85 1325 1 2 1 Yes 80 2 No 5 Sysmiss 1325 1101A. COMMUNICATION: 08. Does your baby make sounds when looking at toys or peo Does your baby make sounds when looking at toys or people? 149 1261 1 2 1 Yes 126 2 No 23 Sysmiss 1261 1101A. COMMUNICATION: 09. If you call your baby when you are out of sight, does If you call your baby when you are out of sight, does she look in the direction of your voice? 149 1261 1 2 1 Yes 135 2 No 14 Sysmiss 1261 1101A. COMMUNICATION: 10. When a loud noise occurs, does your baby turn to see w When a loud noise occurs, does your baby turn to see where the sound came from? 122 1288 1 2 1 Yes 100 2 No 22 Sysmiss 1288 1101A. COMMUNICATION: 11. If you copy the sounds your baby makes, does your baby 221 1189 1 2 1 Yes 132 2 No 89 Sysmiss 1189 1101A. COMMUNICATION: 12. Does your baby respond to the tone of your voice and s Does your baby respond to the tone of your voice and stop his activity at least briefly when you say “no-no” to him? 221 1189 1 2 1 Yes 86 2 No 135 Sysmiss 1189 1101A. COMMUNICATION: 13. Does your baby make two similar sounds like ?ba-ba,? ? Does your baby make two similar sounds like “ba-ba,” “da-da,” or “ga-ga”? (The sounds do not need to mean anything.) 247 1163 1 2 1 Yes 219 2 No 28 Sysmiss 1163 1101A. COMMUNICATION: 14. If you ask your baby to, does he play at least one nur If you ask your baby to, does he play at least one nursery game even if you don’t show him the activity yourself (such as “bye-bye,” “Peeka- boo,” “clap your hands,” “So Big”)? 183 1227 1 2 1 Yes 114 2 No 69 Sysmiss 1227 1101A. COMMUNICATION: 15. Does your baby follow one simple command, such as ?Com Does your baby follow one simple command, such as “Come here,” “Give it to me,” or “Put it back,” without your using gestures? 267 1143 1 2 1 Yes 139 2 No 128 Sysmiss 1143 1101A. COMMUNICATION: 16. Does your baby say three words, such as ?Mama,? ?Dada, Does your baby say three words, such as “Mama,” “Dada,” and “Baba”? (A “word” is a sound or sounds your baby says consistently to mean someone or something.) 183 1227 1 2 1 Yes 131 2 No 52 Sysmiss 1227 1101A. COMMUNICATION: 17. When your baby wants something, does he tell you by po When your baby wants something, does he tell you by pointing to it? 278 1132 1 2 1 Yes 238 2 No 40 Sysmiss 1132 1101A. COMMUNICATION: 18. Does your baby shake his head when he means ?no? or ?y Does your baby shake his head when he means “no” or “yes”? 168 1242 1 2 1 Yes 87 2 No 81 Sysmiss 1242 1101A. COMMUNICATION: 19. Does your baby point to, pat, or try to pick up pictur Does your baby point to, pat, or try to pick up pictures in a book? 138 1272 1 2 1 Yes 121 2 No 17 Sysmiss 1272 1101A. COMMUNICATION: 20. Does your baby say four or more words in addition to ? Does your baby say four or more words in addition to “Mama” and “Dada”? 194 1216 1 2 1 Yes 124 2 No 70 Sysmiss 1216 1101A. COMMUNICATION: 21. When you ask her to, does your baby go into another ro When you ask her to, does your baby go into another room to find a fa- miliar toy or object? (You might ask, “Where is your ball?” or say, “Bring me your coat,” or “Go get your blanket.”) 194 1216 1 2 1 Yes 140 2 No 54 Sysmiss 1216 1101A. COMMUNICATION: 22. Does your child imitate a two-word sentence? For examp Does your child imitate a two-word sentence? For example, when you say a two-word phrase, such as “Mama eat,” “Daddy play,” “Go home,” or “What’s this?” does your child say both words back to you? (Mark “yes” even if her words are difficult to understand.) 178 1232 1 2 1 Yes 66 2 No 112 Sysmiss 1232 1101A. COMMUNICATION: 23. Without your showing him, does your child point to the Without your showing him, does your child point to the correct picture when you say, “Show me the kitty,” or ask, “Where is the dog?” (He needs to identify only one picture correctly.) 351 1059 1 2 1 Yes 204 2 No 147 Sysmiss 1059 1101A. COMMUNICATION: 24. Does your child say two or three words that represent Does your child say two or three words that represent different ideas together, such as “See dog,” “Mommy come home,” or “Kitty gone”? (Don’t count word combinations that express one idea, such as “bye- bye,” “all gone,” “all right,” and “What’s that?”) 297 1113 1 2 1 Yes 176 2 No 121 Sysmiss 1113 1101A. COMMUNICATION: 25. If you point to a picture of a ball (kitty, cup, hat, If you point to a picture of a ball (kitty, cup, hat, etc.) and ask your child, “What is this?” does your child correctly name at least one picture? 345 1065 1 2 1 Yes 188 2 No 157 Sysmiss 1065 1101A. COMMUNICATION: 26. Without your giving him clues by pointing or using ges 678 732 1 2 1 Yes 579 2 No 99 Sysmiss 732 1101A. COMMUNICATION: 27. When you ask your child to point to her nose, eyes, ha When you ask your child to point to her nose, eyes, hair, feet, ears, and so forth, does she correctly point to at least seven body parts? (She can point to parts of herself, you, or a doll. Mark “sometimes” if she cor- rectly points to at least three different body parts.) 678 732 1 2 1 Yes 534 2 No 144 Sysmiss 732 1101A. COMMUNICATION: 28. Does your child correctly use at least two words like 277 1133 1 2 1 Yes 183 2 No 94 Sysmiss 1133 1101A. COMMUNICATION: 29. Does your child make sentences that are three or four 437 973 1 2 1 Yes 359 2 No 78 Sysmiss 973 1101A. COMMUNICATION: 30. Without giving your child help by pointing or using ge Without giving your child help by pointing or using gestures, ask him to “put the book on the table” and “put the shoe under the chair.” Does your child carry out both of these directions correctly? 437 973 1 2 1 Yes 356 2 No 81 Sysmiss 973 1101A. COMMUNICATION: 31. When looking at a picture book, does your child tell y When looking at a picture book, does your child tell you what is hap- pening or what action is taking place in the picture (for example, “bark- ing,” “running,” “eating,” or “crying”)? You may ask, “What is the dog (or boy) doing?” 333 1077 1 2 1 Yes 227 2 No 106 Sysmiss 1077 1101A. COMMUNICATION: 32. When you ask, ?What is your name?? does your child say When you ask, “What is your name?” does your child say his first name or nickname? 333 1077 1 2 1 Yes 264 2 No 69 Sysmiss 1077 1101A. COMMUNICATION: 33. Without your giving help by pointing or repeating dire Without your giving help by pointing or repeating directions, does your child follow three directions that are unrelated to one another? Give all three directions before your child starts. For example, you may ask your child, “Clap your hands, walk to the door, and sit down,” or “Give me the pen, open the book, and stand up.” 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101A. COMMUNICATION: 34. Does your child use all of the words in a sentence to Does your child use all of the words in a sentence (for example, “a,” “the,” “am,” “is,” and “are”) to make complete sentences, such as “I am going to the park,” or “Is there a toy to play with?” or “Are you coming, too?” 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101A. COMMUNICATION: 35. Does your child name at least three items from a commo Does your child name at least three items from a common category? For example, if you say to your child, “Tell me some things that you can eat,” does your child answer with something like “cookies, eggs, and cereal”? Or if you say, “Tell me the names of some animals,” does your child answer with something like “cow, dog, and elephant”? 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101A. COMMUNICATION: 36. Does your child answer the following questions? - 1. ? 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101A. COMMUNICATION: 37. Does your child tell you at least two things about com Does your child tell you at least two things about common objects? For example, if you say to your child, “Tell me about your ball,” does she say something like, “It’s round. I throw it. It’s big”? 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101A. COMMUNICATION: 38. Does your child use endings of words, such as ?-s,? ?- Does your child use endings of words, such as “-s,” “-ed,” and “-ing”? For example, does your child say things like, “I see two cats,” “I am playing,” or “I kicked the ball”? 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101A. COMMUNICATION: 39. Does your child use four- and five-word sentences? For Does your child use four- and five-word sentences? For example, does your child say, “I want the car”? 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101A. COMMUNICATION: 40. When talking about something that already happened, do 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101A. COMMUNICATION: 41. Does your child use comparison words, such as ?heavier Does your child use comparison words, such as “heavier,” “stronger,” or “shorter”? Ask your child questions, such as “A car is big, but a bus is _____” (bigger); “A cat is heavy, but a man is _____” (heavier); “A TV is small, but a book is _____” (smaller). 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101A. COMMUNICATION: 42. Does your child repeat the sentences shown below back 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101B. GROSS MOTOR: 01. While your baby is on his back, does he wave his arms an While your baby is on his back, does he wave his arms and legs, wiggle, and squirm? 45 1365 1 2 1 Yes 37 2 No 8 Sysmiss 1365 1101B. GROSS MOTOR: 02. When your baby is on her tummy does she turn her head to When your baby is on her tummy does she turn her head to the side? 45 1365 1 2 1 Yes 28 2 No 17 Sysmiss 1365 1101B. GROSS MOTOR: 03. When your baby is on his tummy, does he hold his head up When your baby is on his tummy, does he hold his head up longer than a few seconds? 45 1365 1 2 1 Yes 15 2 No 30 Sysmiss 1365 1101B. GROSS MOTOR: 04. When your baby is on her back, does she kick her legs? When your baby is on her back, does she kick her legs? 72 1338 1 2 1 Yes 59 2 No 13 Sysmiss 1338 1101B. GROSS MOTOR: 05. After holding her head up while on her tummy does your b 72 1338 1 2 1 Yes 26 2 No 46 Sysmiss 1338 1101B. GROSS MOTOR: 06. When your baby is on his tummy, does he hold his head up When your baby is on his tummy, does he hold his head up so that his chin is about 3 inches from the floor for at least 15 seconds? 72 1338 1 2 1 Yes 24 2 No 48 Sysmiss 1338 1101B. GROSS MOTOR: 07. When your baby is on her tummy, does she hold her head s When your baby is on her tummy, does she hold her head straight up, looking around? 27 1383 1 2 1 Yes 14 2 No 13 Sysmiss 1383 1101B. GROSS MOTOR: 08. When you hold him in a sitting position, does your baby When you hold him in a sitting position, does your baby hold his head steady? 85 1325 1 2 1 Yes 47 2 No 38 Sysmiss 1325 1101B. GROSS MOTOR: 09. While your baby is on his back, does your baby lift his While your baby is on his back, does your baby lift his legs high enough to see his feet? 85 1325 1 2 1 Yes 72 2 No 13 Sysmiss 1325 1101B. GROSS MOTOR: 10. Does your baby roll from his back to his tummy, getting Does your baby roll from his back to his tummy, getting both arms out from under him? 122 1288 1 2 1 Yes 106 2 No 16 Sysmiss 1288 1101B. GROSS MOTOR: 11. When you put your baby on the floor, does she lean on he When you put your baby on the floor, does she lean on her hands while sitting? (If she already sits up straight without leaning on her hands, mark “yes” for this item.) 122 1288 1 2 1 Yes 80 2 No 42 Sysmiss 1288 1101B. GROSS MOTOR: 12. If you hold both hands just to balance your baby, does h If you hold both hands just to balance your baby, does he support his own weight while standing? 221 1189 1 2 1 Yes 160 2 No 61 Sysmiss 1189 1101B. GROSS MOTOR: 13. Does your baby get into a crawling position by getting u Does your baby get into a crawling position by getting up on her hands and knees? 221 1189 1 2 1 Yes 158 2 No 63 Sysmiss 1189 1101B. GROSS MOTOR: 14. When sitting on the floor, does your baby sit up straigh When sitting on the floor, does your baby sit up straight for several minutes without using her hands for support? 163 1247 1 2 1 Yes 101 2 No 62 Sysmiss 1247 1101B. GROSS MOTOR: 15. When you stand your baby next to furniture or the crib r When you stand your baby next to furniture or the crib rail, does he hold on without leaning his chest against the furniture for support? 247 1163 1 2 1 Yes 155 2 No 92 Sysmiss 1163 1101B. GROSS MOTOR: 16. Does your baby walk beside furniture while holding on wi Does your baby walk beside furniture while holding on with only one hand? 183 1227 1 2 1 Yes 94 2 No 89 Sysmiss 1227 1101B. GROSS MOTOR: 17. If you hold both hands just to balance your baby, does h If you hold both hands just to balance your baby, does he take several steps without tripping or falling? (If your baby already walks alone, mark “yes” for this item.) 267 1143 1 2 1 Yes 134 2 No 133 Sysmiss 1143 1101B. GROSS MOTOR: 18. When you hold one hand just to balance your baby, does s When you hold one hand just to balance your baby, does she take several steps forward? (If your baby already walks alone, mark “yes” for this item.) 168 1242 1 2 1 Yes 92 2 No 76 Sysmiss 1242 1101B. GROSS MOTOR: 19. Does your baby stand up in the middle of the floor by hi Does your baby stand up in the middle of the floor by himself and take several steps forward? 222 1188 1 2 1 Yes 94 2 No 128 Sysmiss 1188 1101B. GROSS MOTOR: 20. Does your baby bend over or squat to pick up an object f Does your baby bend over or squat to pick up an object from the floor and then stand up again without any support? 222 1188 1 2 1 Yes 108 2 No 114 Sysmiss 1188 1101B. GROSS MOTOR: 21. Does your baby move around by walking, rather than by cr 194 1216 1 2 1 Yes 141 2 No 53 Sysmiss 1216 1101B. GROSS MOTOR: 22. Does your child walk well and seldom fall? 178 1232 1 2 1 Yes 121 2 No 57 Sysmiss 1232 1101B. GROSS MOTOR: 23. Does your child climb on an object such as a chair to re Does your child climb on an object such as a chair to reach something he wants (for example, to get a toy on a counter or to “help” you in the kitchen)? 262 1148 1 2 1 Yes 171 2 No 91 Sysmiss 1148 1101B. GROSS MOTOR: 24. Does your child walk down stairs if you hold onto one of 257 1153 1 2 1 Yes 176 2 No 81 Sysmiss 1153 1101B. GROSS MOTOR: 25. When you show your child how to kick a large ball, does 297 1113 1 2 1 Yes 226 2 No 71 Sysmiss 1113 1101B. GROSS MOTOR: 26. Does your child run fairly well, stopping herself withou 610 800 1 2 1 Yes 453 2 No 157 Sysmiss 800 1101B. GROSS MOTOR: 27. Does your child walk either up or down at least two step Does your child walk either up or down at least two steps by himself? He may also hold onto the railing or wall. 453 957 1 2 1 Yes 372 2 No 81 Sysmiss 957 1101B. GROSS MOTOR: 28. Does your child jump with both feet leaving the floor at Does your child jump with both feet leaving the floor at the same time? 610 800 1 2 1 Yes 397 2 No 213 Sysmiss 800 1101B. GROSS MOTOR: 29. Without holding onto anything for support, does your chi Without holding onto anything for support, does your child kick a ball by swinging his leg forward? 610 800 1 2 1 Yes 494 2 No 116 Sysmiss 800 1101B. GROSS MOTOR: 30. Does your child walk up stairs, using only one foot on e Does your child walk up stairs, using only one foot on each stair? (The left foot is on one step, and the right foot is on the next.) She may hold onto the railing or wall. 531 879 1 2 1 Yes 327 2 No 204 Sysmiss 879 1101B. GROSS MOTOR: 31. Does your child stand on one foot for about 1 second wit Does your child stand on one foot for about 1 second without holding onto anything? 437 973 1 2 1 Yes 321 2 No 116 Sysmiss 973 1101B. GROSS MOTOR: 32. While standing, does your child throw a ball overhand by While standing, does your child throw a ball overhand by raising his arm to shoulder height and throwing the ball forward? (Dropping the ball or throwing the ball underhand should be scored as “not yet.”) 225 1185 1 2 1 Yes 202 2 No 23 Sysmiss 1185 1101B. GROSS MOTOR: 33. Does your child jump forward at least 6 inches with both Does your child jump forward at least 6 inches with both feet leaving the ground at the same time? 124 1286 1 2 1 Yes 75 2 No 49 Sysmiss 1286 1101B. GROSS MOTOR: 34. Does your child catch a large ball with both hands? Does your child catch a large ball with both hands? (You should stand about 5 feet away and give your child two or three tries before you mark the answer.) 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101B. GROSS MOTOR: 35. Does your child climb the rungs of a ladder of a playgro Does your child climb the rungs of a ladder of a playground slide and slide down without help? 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101B. GROSS MOTOR: 36. Does your child hop up and down on either the right or l Does your child hop up and down on either the right or left foot at least one time without losing her balance or falling? 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101B. GROSS MOTOR: 37. Does your child jump forward a distance of 20 inches fro Does your child jump forward a distance of 20 inches from a standing position, starting with his feet together? 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101B. GROSS MOTOR: 38. Without holding onto anything, does your child stand on Without holding onto anything, does your child stand on one foot for at least 5 seconds without losing her balance and putting her foot down? (You may give your child two or three tries before you mark the answer.) 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101B. GROSS MOTOR: 39. Does your child walk on his tiptoes for 15 feet (about t Does your child walk on his tiptoes for 15 feet (about the length of a large car)? (You may show him how to do this.) 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101B. GROSS MOTOR: 40. Does your child hop forward on one foot for a distance o Does your child hop forward on one foot for a distance of 4–6 feet without putting down the other foot? (You may give her two tries on each foot.) 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101B. GROSS MOTOR: 41. Does your child skip using alternating feet? Does your child skip using alternating feet? (You may show him how to do this.) 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101C. FINE MOTOR : 01. Does your baby grasp your finger if you touch the palm o Does your baby grasp your finger if you touch the palm of her hand? 45 1365 1 2 1 Yes 34 2 No 11 Sysmiss 1365 1101C. FINE MOTOR : 02. When you put a toy in his hand, does your baby hold it i When you put a toy in his hand, does your baby hold it in his hand briefly? 72 1338 1 2 1 Yes 38 2 No 34 Sysmiss 1338 1101C. FINE MOTOR : 03. Does your baby touch her face with her hands? Does your baby touch her face with her hands? 45 1365 1 2 1 Yes 28 2 No 17 Sysmiss 1365 1101C. FINE MOTOR : 04. Does your baby hold his hands open or partly open when h Does your baby hold his hands open or partly open when he is awake (rather than in fists, as they were when he was a newborn)? 45 1365 1 2 1 Yes 24 2 No 21 Sysmiss 1365 1101C. FINE MOTOR : 05. Does your baby grab or scratch at her clothes? Does your baby grab or scratch at her clothes? 72 1338 1 2 1 Yes 46 2 No 26 Sysmiss 1338 1101C. FINE MOTOR : 06. When you put a toy in her hand, does your baby wave it a When you put a toy in her hand, does your baby wave it about, at least briefly? 72 1338 1 2 1 Yes 25 2 No 47 Sysmiss 1338 1101C. FINE MOTOR : 07. When you put a toy in her hand, does your baby hold onto When you put a toy in her hand, does your baby hold onto it for about 1 minute while looking at it, waving it about, or trying to chew it? 27 1383 1 2 1 Yes 14 2 No 13 Sysmiss 1383 1101C. FINE MOTOR : 08. When you hold your baby in a sitting position, does she When you hold your baby in a sitting position, does she reach for a toy on a table close by, even though her hand may not touch it? 85 1325 1 2 1 Yes 66 2 No 19 Sysmiss 1325 1101C. FINE MOTOR : 09. Does your baby grab a toy you offer and look at it, wave Does your baby grab a toy you offer and look at it, wave it about, or chew on it for about 1 minute? 85 1325 1 2 1 Yes 54 2 No 31 Sysmiss 1325 1101C. FINE MOTOR : 10. Does your baby reach for or grasp a toy using both hands Does your baby reach for or grasp a toy using both hands at once? 122 1288 1 2 1 Yes 97 2 No 25 Sysmiss 1288 1101C. FINE MOTOR : 11. Does your baby reach for a crumb or Cheerio and touch it Does your baby reach for a crumb or Cheerio and touch it with his finger or hand? (If he already picks up a small object the size of a pea, mark “yes” for this item.) 122 1288 1 2 1 Yes 84 2 No 38 Sysmiss 1288 1101C. FINE MOTOR : 12. Does your baby pick up a small toy, holding it in the ce Does your baby pick up a small toy, holding it in the center of her hand with her fingers around it? 122 1288 1 2 1 Yes 108 2 No 14 Sysmiss 1288 1101C. FINE MOTOR : 13. Does your baby pick up a small toy with only one hand? 221 1189 1 2 1 Yes 172 2 No 49 Sysmiss 1189 1101C. FINE MOTOR : 14. Does your baby successfully pick up a crumb or Cheerio b Does your baby successfully pick up a crumb or Cheerio by using his thumb and all of his fingers in a raking motion? (If he already picks up a crumb or Cheerio, mark “yes” for this item.) 163 1247 1 2 1 Yes 112 2 No 51 Sysmiss 1247 1101C. FINE MOTOR : 15. After one or two tries, does your baby pick up a piece o After one or two tries, does your baby pick up a piece of string with her first finger and thumb? (The string may be attached to a toy.) 247 1163 1 2 1 Yes 131 2 No 116 Sysmiss 1163 1101C. FINE MOTOR : 16. Does your baby put a small toy down, without dropping it Does your baby put a small toy down, without dropping it, and then take her hand off the toy? 267 1143 1 2 1 Yes 135 2 No 132 Sysmiss 1143 1101C. FINE MOTOR : 17. Does your baby help turn the pages of a book? Does your baby help turn the pages of a book? (You may lift a page for him to grasp.) 321 1089 1 2 1 Yes 135 2 No 186 Sysmiss 1089 1101C. FINE MOTOR : 18. Does your baby throw a small ball with a forward arm mot Does your baby throw a small ball with a forward arm motion? (If he simply drops the ball, mark “not yet” for this item.) 377 1033 1 2 1 Yes 229 2 No 148 Sysmiss 1033 1101C. FINE MOTOR : 19. Does your baby stack a small block or toy on top of anot Does your baby stack a small block or toy on top of another one? (You could also use spools of thread, small boxes, or toys that are about 1 inch in size.) 425 985 1 2 1 Yes 170 2 No 255 Sysmiss 985 1101C. FINE MOTOR : 20. Does your baby make a mark on the paper with the tip of Does your baby make a mark on the paper with the tip of a crayon (or pencil or pen) when trying to draw? 519 891 1 2 1 Yes 272 2 No 247 Sysmiss 891 1101C. FINE MOTOR : 21. Does your child turn the pages of a book by himself? Does your child turn the pages of a book by himself? (He may turn more than one page at a time.) 539 871 1 2 1 Yes 357 2 No 182 Sysmiss 871 1101C. FINE MOTOR : 22. Does your child get a spoon into her mouth right side up 455 955 1 2 1 Yes 275 2 No 180 Sysmiss 955 1101C. FINE MOTOR : 23. Does your child use a turning motion with her hand while 509 901 1 2 1 Yes 387 2 No 122 Sysmiss 901 1101C. FINE MOTOR : 24. Can your child string small items such as beads, macaron Can your child string small items such as beads, macaroni, or pasta “wagon wheels” onto a string or shoelace? 678 732 1 2 1 Yes 225 2 No 453 Sysmiss 732 1101C. FINE MOTOR : 25. Does your child copy you by drawing a single line in a v After your child watches you draw a line from the top of the paper to the bottom with a pencil, crayon, or pen, ask him to make a line like yours. Do not let your child trace your line. Does your child copy you by drawing a single line in a vertical direction? 531 879 1 2 1 Yes 232 2 No 299 Sysmiss 879 1101C. FINE MOTOR : 26. Does your child copy you by drawing a single line in a h After your child watches you draw a line from one side of the paper to the other side, ask her to make a line like yours. Do not let your child trace your line. Does your child copy you by drawing a single line in a horizontal direction? 437 973 1 2 1 Yes 156 2 No 281 Sysmiss 973 1101C. FINE MOTOR : 27. Do not let him trace your circle. Does your child copy y After your child watches you draw a single circle, ask him to make a circle like yours. Do not let him trace your circle. Does your child copy you by drawing a circle? 333 1077 1 2 1 Yes 146 2 No 187 Sysmiss 1077 1101C. FINE MOTOR : 28. Does your child turn pages in a book, one page at a time Does your child turn pages in a book, one page at a time? 333 1077 1 2 1 Yes 223 2 No 110 Sysmiss 1077 1101C. FINE MOTOR : 29. When drawing, does your child hold a pencil, crayon, or When drawing, does your child hold a pencil, crayon, or pen between her fingers and thumb like an adult does? 225 1185 1 2 1 Yes 99 2 No 126 Sysmiss 1185 1101C. FINE MOTOR : 30. Does your child put together a five- to seven-piece inte Does your child put together a five- to seven-piece interlocking puzzle? (If one is not available, take a full-page picture from a magazine or catalog and cut it into six pieces. Does your child put it back together correctly?) 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101C. FINE MOTOR : 31. Using the shape at right to look at, does your child cop Using the shape at right to look at, does your child copy it onto a large piece of paper using a pencil, crayon, or pen, without tracing? (Your child’s drawing should look like the design of the shape, except it may be different in size.) 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101C. FINE MOTOR : 32. Using the shapes below to look at, does your child copy Using the shapes below to look at, does your child copy at least three shapes onto a large piece of paper using a pencil, crayon, or pen, without tracing? (Your child’s drawings should look similar to the design of the shapes below, but they may be different in size.) 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101C. FINE MOTOR : 33. Does your child unbutton one or more buttons? Does your child unbutton one or more buttons? (Your child may use his own clothing or a doll’s clothing.) 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101C. FINE MOTOR : 34. Does your child draw pictures of people that have at lea Does your child draw pictures of people that have at least three of the following features: head, eyes, nose, mouth, neck, hair, trunk, arms, hands, legs, or feet? 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101C. FINE MOTOR : 35. Does your child color mostly within the lines in a color Does your child color mostly within the lines in a coloring book or within the lines of a 2-inch circle that you draw? (Your child should not go more than 1/4 inch outside the lines on most of the picture.) 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101C. FINE MOTOR : 36. Does your child trace on the line without going off the Ask your child to trace on the line below with a pencil. Does your child trace on the line without going off the line more than two times? 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101C. FINE MOTOR : 37. Ask your child to draw a picture of a person on a blank Ask your child to draw a picture of a person on a blank sheet of paper. You may ask your child, “Draw a picture of a girl or a boy.” If your child draws a person with head, body, arms, and legs, mark “yes.” If your child draws a person with three or fewer parts (head, body, arms, or legs), mark “not yet.” 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101C. FINE MOTOR : 38. Using the shapes below to look at, does your child copy Using the shapes below to look at, does your child copy the shapes in the space below without tracing? (Your child’s drawings should look similar to the design of the shapes below, but they may be different in size.) 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101C. FINE MOTOR : 39. Using the letters below to look at, does your child copy Using the letters below to look at, does your child copy the letters without tracing? 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101C. FINE MOTOR : 40. Print your child?s first name. Can your child copy the l Print your child’s first name. Can your child copy the letters? The letters may be large, backward, or reversed. 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101D. PROBLEM SOLVING : 01. Does your baby look at objects that are 8?10 inches Does your baby look at objects that are 8–10 inches away? 45 1365 1 2 1 Yes 30 2 No 15 Sysmiss 1365 1101D. PROBLEM SOLVING : 02. When you move around, does your baby follow you wit When you move around, does your baby follow you with his eyes? 45 1365 1 2 1 Yes 24 2 No 21 Sysmiss 1365 1101D. PROBLEM SOLVING : 03. When you move a toy slowly from side to side in fro When you move a toy slowly from side to side in front of your baby’s face (about 10 inches away), does your baby follow the toy with her eyes, sometimes turning her head? 72 1338 1 2 1 Yes 42 2 No 30 Sysmiss 1338 1101D. PROBLEM SOLVING : 04. When you move a small toy up and down slowly in fro When you move a small toy up and down slowly in front of your baby’s face (about 10 inches away), does your baby follow the toy with his eyes? 72 1338 1 2 1 Yes 48 2 No 24 Sysmiss 1338 1101D. PROBLEM SOLVING : 05. When you hold your baby in a sitting position, does When you hold your baby in a sitting position, does she look at a toy (about the size of a cup or rattle) that you place on the table or floor in front of her? 72 1338 1 2 1 Yes 48 2 No 24 Sysmiss 1338 1101D. PROBLEM SOLVING : 06. When you dangle a toy above your baby while he is l When you dangle a toy above your baby while he is lying on his back, does he wave his arms toward the toy? 72 1338 1 2 1 Yes 26 2 No 46 Sysmiss 1338 1101D. PROBLEM SOLVING : 07. When you put a toy in her hand, does your baby look When you put a toy in her hand, does your baby look at it? 27 1383 1 2 1 Yes 23 2 No 4 Sysmiss 1383 1101D. PROBLEM SOLVING : 08. When you put a toy in his hand, does your baby put When you put a toy in his hand, does your baby put the toy in his mouth? 85 1325 1 2 1 Yes 75 2 No 10 Sysmiss 1325 1101D. PROBLEM SOLVING : 09. When a toy is in front of your baby, does she reach When a toy is in front of your baby, does she reach for it with both hands? 58 1352 1 2 1 Yes 48 2 No 10 Sysmiss 1352 1101D. PROBLEM SOLVING : 10. When your baby is on her back, does she try to get When your baby is on her back, does she try to get a toy she has dropped if she can see it? 122 1288 1 2 1 Yes 95 2 No 27 Sysmiss 1288 1101D. PROBLEM SOLVING : 11. Does your baby pick up a toy and put it in his mout Does your baby pick up a toy and put it in his mouth? 122 1288 1 2 1 Yes 108 2 No 14 Sysmiss 1288 1101D. PROBLEM SOLVING : 12. Does your baby play by banging a toy up and down on Does your baby play by banging a toy up and down on the floor or table? 221 1189 1 2 1 Yes 161 2 No 60 Sysmiss 1189 1101D. PROBLEM SOLVING : 13.Does your baby pick up two small toys, one in each h Does your baby pick up two small toys, one in each hand, and hold onto them for about 1 minute? 221 1189 1 2 1 Yes 119 2 No 102 Sysmiss 1189 1101D. PROBLEM SOLVING : 14. When holding a toy in his hand, does your baby bang When holding a toy in his hand, does your baby bang it against another toy on the table? 247 1163 1 2 1 Yes 181 2 No 66 Sysmiss 1163 1101D. PROBLEM SOLVING : 15. While holding a small toy in each hand, does your b While holding a small toy in each hand, does your baby clap the toys together (like “Pat-a-cake”)? 247 1163 1 2 1 Yes 172 2 No 75 Sysmiss 1163 1101D. PROBLEM SOLVING : 16. After watching you hide a small toy under a piece o After watching you hide a small toy under a piece of paper or cloth, does your baby find it? (Be sure the toy is completely hidden.) 267 1143 1 2 1 Yes 152 2 No 115 Sysmiss 1143 1101D. PROBLEM SOLVING : 17. If you put a small toy into a bowl or box, does you If you put a small toy into a bowl or box, does your baby copy you by putting in a toy, although she may not let go of it? (If she already lets go of the toy into a bowl or box, mark “yes” for this item.) 267 1143 1 2 1 Yes 146 2 No 121 Sysmiss 1143 1101D. PROBLEM SOLVING : 18. After you scribble back and forth on paper with a c After you scribble back and forth on paper with a crayon (or a pencil or pen), does your baby copy you by scribbling? (If she already scribbles on her own, mark “yes” for this item.) 222 1188 1 2 1 Yes 104 2 No 118 Sysmiss 1188 1101D. PROBLEM SOLVING : 19. Does your baby drop two small toys, one after the o Does your baby drop two small toys, one after the other, into a container like a bowl or box? (You may show him how to do it.) 278 1132 1 2 1 Yes 162 2 No 116 Sysmiss 1132 1101D. PROBLEM SOLVING : 20. After you have shown your baby how, does he try to After you have shown your baby how, does he try to get a small toy that is slightly out of reach by using a spoon, stick, or similar tool? 262 1148 1 2 1 Yes 123 2 No 139 Sysmiss 1148 1101D. PROBLEM SOLVING : 21. Without your showing him how, does your child scrib Without your showing him how, does your child scribble back and forth when you give him a crayon (or pencil or pen)? 341 1069 1 2 1 Yes 210 2 No 131 Sysmiss 1069 1101D. PROBLEM SOLVING : 22. After a crumb or Cheerio is dropped into a small, c After a crumb or Cheerio is dropped into a small, clear bottle, does your child turn the bottle upside down to dump it out? 110 1300 1 2 1 Yes 77 2 No 33 Sysmiss 1300 1101D. PROBLEM SOLVING : 23. Does your child copy you by drawing a single line o After watching you draw a line from the top of the paper to the bottom with a crayon (or pencil or pen), does your child copy you by drawing a single line on the paper in any direction? (Mark “not yet” if your child scribbles back and forth.) 351 1059 1 2 1 Yes 77 2 No 274 Sysmiss 1059 1101D. PROBLEM SOLVING : 24. If you give your child a bottle, spoon, or pencil u If you give your child a bottle, spoon, or pencil upside down, does she turn it right side up so that she can use it properly? 297 1113 1 2 1 Yes 141 2 No 156 Sysmiss 1113 1101D. PROBLEM SOLVING : 25. If your child wants something he cannot reach, does If your child wants something he cannot reach, does he find a chair or box to stand on to reach it (for example, to get a toy on a counter or to “help” you in the kitchen)? 345 1065 1 2 1 Yes 251 2 No 94 Sysmiss 1065 1101D. PROBLEM SOLVING : 26. Does your child pretend objects are something else? 554 856 1 2 1 Yes 478 2 No 76 Sysmiss 856 1101D. PROBLEM SOLVING : 27. Does your child put things away where they belong? Does your child put things away where they belong? For example, does he know his toys belong on the toy shelf, his blanket goes on his bed, and dishes go in the kitchen? 610 800 1 2 1 Yes 365 2 No 245 Sysmiss 800 1101D. PROBLEM SOLVING : 28. When looking in the mirror, ask ?Where is _______?? When looking in the mirror, ask “Where is _______?” (Use your child’s name.) Does your child point to his image in the mirror? 531 879 1 2 1 Yes 426 2 No 105 Sysmiss 879 1101D. PROBLEM SOLVING : 29. When you point to the figure and ask your child, ?W When you point to the figure and ask your child, “What is this?” does your child say a word that means a person or something similar? (Mark “yes” for responses like “snowman,” “boy,” “man,” “girl,” “Daddy,” “spaceman,” and “monkey.”) Please write your child’s response here:_______________ 437 973 1 2 1 Yes 243 2 No 194 Sysmiss 973 1101D. PROBLEM SOLVING : 30. When you say, ?Say ?seven three,?? does your child When you say, “Say ‘seven three,’” does your child repeat just the two numbers in the same order? Do not repeat the numbers. If necessary, try another pair of numbers and say, “Say ‘eight two.’” Your child must repeat just one series of two numbers for you to answer “yes” to this question 437 973 1 2 1 Yes 215 2 No 222 Sysmiss 973 1101D. PROBLEM SOLVING : 31. After your child draws a ?picture,? even a simple s After your child draws a “picture,” even a simple scribble, does she tell you what she drew? (You may say, “Tell me about your picture,” or ask, “What is this?” to prompt her.) 333 1077 1 2 1 Yes 112 2 No 221 Sysmiss 1077 1101D. PROBLEM SOLVING : 32. When you say, ?Say ?five eight three,?? does your c When you say, “Say ‘five eight three,’” does your child repeat just the three numbers in the same order? Do not repeat the numbers. If necessary, try another series of numbers and say, “Say ‘six nine two.’ (Your child must repeat just one series of three numbers for you to answer “yes” to this question.) 124 1286 1 2 1 Yes 54 2 No 70 Sysmiss 1286 1101D. PROBLEM SOLVING : 33. When asked, ?Which circle is the smallest?? does yo When asked, “Which circle is the smallest?” does your child point to the smallest circle? (Ask this question without providing help by pointing, gesturing, or looking at the smallest circle.) 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101D. PROBLEM SOLVING : 34. Does your child dress up and ?play-act,? pretending Does your child dress up and “play-act,” pretending to be someone or something else? For example, your child may dress up in different clothes and pretend to be a mommy, daddy, brother or sister, or an imaginary animal or figure. 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101D. PROBLEM SOLVING : 35. Without your giving help by pointing, does your chi Without your giving help by pointing, does your child follow three different directions using the words “under,” “between,” and “middle”? For example, ask your child to put the shoe “under the couch.” Then ask her to put the ball “between the chairs” and the book “in the middle of the table.” 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101D. PROBLEM SOLVING : 36. When shown objects and asked, ?What color is this?? When shown objects and asked, “What color is this?” does your child name five different colors, like red, blue, yellow, orange, black, white, or pink? (Mark “yes” only if your child answers the question correctly using five colors.) 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101D. PROBLEM SOLVING : 37. If you place five objects in front of your child, c If you place five objects in front of your child, can he count them by saying, “one, two, three, four, five,” in order? (Ask this question without providing help by pointing, gesturing, or naming.) 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101D. PROBLEM SOLVING : 38. Does your child count up to 15 without making mista Does your child count up to 15 without making mistakes? 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101D. PROBLEM SOLVING : 39. Does your child know the names of the following num Does your child know the names of the following numbers? 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101D. PROBLEM SOLVING : 40. Does your child finish the following sentences usin Does your child finish the following sentences using a word that means the opposite of the word that is italicized? For example: “A rock is hard, and a pillow is soft.” A) "A cow is big, and a mouse is ______", B) "Ice is cold, and fire is ______", C) "We see the stars at night, and we see the sun during the ______", D) "When I throw the ball up, it comes ______" (Mark "yes" if he finishes three of the four sentences correctly.) 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101D. PROBLEM SOLVING : 41. Does your child name at least four letters in her n Does your child name at least four letters in her name? Point to the letters and ask, “What letter is this?” (Point to the letters out of order.) 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101E. PERSONAL SOCIAL : 01. Does your baby cry when he is hungry, wet, tired, o Does your baby cry when he is hungry, wet, tired, or wants to be held? 45 1365 1 2 1 Yes 42 2 No 3 Sysmiss 1365 1101E. PERSONAL SOCIAL : 02. When you smile at your baby, does she smile back? When you smile at your baby, does she smile back? 45 1365 1 2 1 Yes 29 2 No 16 Sysmiss 1365 1101E. PERSONAL SOCIAL : 03. Does your baby watch his hands? Does your baby watch his hands? 45 1365 1 2 1 Yes 27 2 No 18 Sysmiss 1365 1101E. PERSONAL SOCIAL : 04. When your baby sees the breast or bottle, does she When your baby sees the breast or bottle, does she seem to know she is about to be fed? 72 1338 1 2 1 Yes 52 2 No 20 Sysmiss 1338 1101E. PERSONAL SOCIAL : 05. When your baby has her hands together, does she pla When your baby has her hands together, does she play with her fingers? 72 1338 1 2 1 Yes 52 2 No 20 Sysmiss 1338 1101E. PERSONAL SOCIAL : 06. Does your baby help hold the bottle with both hands Does your baby help hold the bottle with both hands at once, or when nursing, does she hold the breast with her free hand? 72 1338 1 2 1 Yes 40 2 No 32 Sysmiss 1338 1101E. PERSONAL SOCIAL : 07. When in front of a large mirror, does your baby smi When in front of a large mirror, does your baby smile or coo at herself? 85 1325 1 2 1 Yes 59 2 No 26 Sysmiss 1325 1101E. PERSONAL SOCIAL : 08. Does your baby act differently toward strangers tha Does your baby act differently toward strangers than he does with you and other familiar people? (Reactions to strangers may include staring, frowning, withdrawing, or crying.) 85 1325 1 2 1 Yes 56 2 No 29 Sysmiss 1325 1101E. PERSONAL SOCIAL : 09. While lying on her back, does your baby play by gra While lying on her back, does your baby play by grabbing her foot? 149 1261 1 2 1 Yes 128 2 No 21 Sysmiss 1261 1101E. PERSONAL SOCIAL : 10. When in front of a large mirror, does your baby rea When in front of a large mirror, does your baby reach out to pat the mirror? 122 1288 1 2 1 Yes 78 2 No 44 Sysmiss 1288 1101E. PERSONAL SOCIAL : 11. Does your baby try to get a toy that is out of reac Does your baby try to get a toy that is out of reach? (She may roll, pivot on her tummy, or crawl to get it.) 122 1288 1 2 1 Yes 71 2 No 51 Sysmiss 1288 1101E. PERSONAL SOCIAL : 12. Does your baby drink water, juice, or formula from Does your baby drink water, juice, or formula from a cup while you hold it? 221 1189 1 2 1 Yes 152 2 No 69 Sysmiss 1189 1101E. PERSONAL SOCIAL : 13. Does your baby feed himself a cracker or a cookie? Does your baby feed himself a cracker or a cookie? 163 1247 1 2 1 Yes 133 2 No 30 Sysmiss 1247 1101E. PERSONAL SOCIAL : 14. When you hold out your hand and ask for her toy, do When you hold out your hand and ask for her toy, does your baby offer it to you even if she doesn’t let go of it? (If she already lets go of the toy into your hand, mark “yes” for this item.) 247 1163 1 2 1 Yes 154 2 No 93 Sysmiss 1163 1101E. PERSONAL SOCIAL : 15. When you hold out your hand and ask for her toy, do When you hold out your hand and ask for her toy, does your baby let go of it into your hand? 183 1227 1 2 1 Yes 84 2 No 99 Sysmiss 1227 1101E. PERSONAL SOCIAL : 16. When you dress your baby, does she lift her foot fo When you dress your baby, does she lift her foot for her shoe, sock, or pant leg? 183 1227 1 2 1 Yes 58 2 No 125 Sysmiss 1227 1101E. PERSONAL SOCIAL : 17. When you dress your baby, does he push his arm thro When you dress your baby, does he push his arm through a sleeve once his arm is started in the hole of the sleeve? 267 1143 1 2 1 Yes 77 2 No 190 Sysmiss 1143 1101E. PERSONAL SOCIAL : 18. Does your baby roll or throw a ball back to you so Does your baby roll or throw a ball back to you so that you can return it to him? 168 1242 1 2 1 Yes 51 2 No 117 Sysmiss 1242 1101E. PERSONAL SOCIAL : 19. Does your baby play with a doll or stuffed animal b Does your baby play with a doll or stuffed animal by hugging it? 222 1188 1 2 1 Yes 165 2 No 57 Sysmiss 1188 1101E. PERSONAL SOCIAL : 20. Does your baby help undress himself by taking off c Does your baby help undress himself by taking off clothes like socks, hat, shoes, or mittens? 262 1148 1 2 1 Yes 137 2 No 125 Sysmiss 1148 1101E. PERSONAL SOCIAL : 21. Does your baby get your attention or try to show yo Does your baby get your attention or try to show you something by pulling on your hand or clothes? 194 1216 1 2 1 Yes 171 2 No 23 Sysmiss 1216 1101E. PERSONAL SOCIAL : 22. While looking at himself in the mirror, does your c While looking at himself in the mirror, does your child offer a toy to his own image? 110 1300 1 2 1 Yes 68 2 No 42 Sysmiss 1300 1101E. PERSONAL SOCIAL : 23. Does your child come to you when she needs help, su Does your child come to you when she needs help, such as with wind- ing up a toy or unscrewing a lid from a jar? 341 1069 1 2 1 Yes 291 2 No 50 Sysmiss 1069 1101E. PERSONAL SOCIAL : 24. Does your child drink from a cup or glass, putting Does your child drink from a cup or glass, putting it down again with little spilling? 257 1153 1 2 1 Yes 167 2 No 90 Sysmiss 1153 1101E. PERSONAL SOCIAL : 25. Does your child copy the activities you do, such as Does your child copy the activities you do, such as wipe up a spill, sweep, shave, or comb hair? 297 1113 1 2 1 Yes 234 2 No 63 Sysmiss 1113 1101E. PERSONAL SOCIAL : 26. Does your child eat (with a fork) well? Does your child eat (with a fork) well? 678 732 1 2 1 Yes 584 2 No 94 Sysmiss 732 1101E. PERSONAL SOCIAL : 27. If you do any of the following gestures, does your 678 732 1 2 1 Yes 602 2 No 76 Sysmiss 732 1101E. PERSONAL SOCIAL : 28. Does your child push a little wagon, stroller, or o Does your child push a little wagon, stroller, or other toy on wheels, steering it around objects and backing out of corners if she cannot turn? 277 1133 1 2 1 Yes 208 2 No 69 Sysmiss 1133 1101E. PERSONAL SOCIAL : 29. Does your child call herself ?I? or ?me? more often Does your child call herself “I” or “me” more often than her own name? For example, “I do it,” more often than “Juanita do it.” 306 1104 1 2 1 Yes 203 2 No 103 Sysmiss 1104 1101E. PERSONAL SOCIAL : 30. Does your child put on a coat, jacket, or shirt by Does your child put on a coat, jacket, or shirt by himself? 531 879 1 2 1 Yes 182 2 No 349 Sysmiss 879 1101E. PERSONAL SOCIAL : 31. After you put on loose-fitting pants around her fee After you put on loose-fitting pants around her feet, does your child pull them completely up to her waist? 313 1097 1 2 1 Yes 225 2 No 88 Sysmiss 1097 1101E. PERSONAL SOCIAL : 32. When your child is looking in a mirror and you ask, When your child is looking in a mirror and you ask, “Who is in the mir- ror?” does he say either “me” or his own name? 333 1077 1 2 1 Yes 268 2 No 65 Sysmiss 1077 1101E. PERSONAL SOCIAL : 33. Using these exact words, ask your child, ?Are you a Using these exact words, ask your child, “Are you a girl or a boy?” Does your child answer correctly? 225 1185 1 2 1 Yes 151 2 No 74 Sysmiss 1185 1101E. PERSONAL SOCIAL : 34. Does your child take turns by waiting while another Does your child take turns by waiting while another child or adult takes a turn? 124 1286 1 2 1 Yes 39 2 No 85 Sysmiss 1286 1101E. PERSONAL SOCIAL : 35. Does your child serve himself, taking food from one Does your child serve himself, taking food from one container to an- other using utensils? For example, does your child use a large spoon to scoop applesauce from a jar into a bowl? 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101E. PERSONAL SOCIAL : 36. Does your child wash his hands using soap and wate Does your child wash his hands using soap and water and dry off with a towel without help? 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101E. PERSONAL SOCIAL : 37. Does your child tell you at least four of the follo 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101E. PERSONAL SOCIAL : 38. Does your child tell you the names of two or more p Does your child tell you the names of two or more playmates, not including brothers and sisters? (Ask this question without providing help by suggesting names of playmates or friends.) 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101E. PERSONAL SOCIAL : 39. Does your child brush her teeth by putting toothpas Does your child brush her teeth by putting toothpaste on the toothbrush and brushing all of her teeth without help? (You may still need to check and rebrush your child’s teeth.) 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101E. PERSONAL SOCIAL : 40. Does your child dress or undress himself without he Does your child dress or undress himself without help (except for snaps, buttons, and zippers)? 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101E. PERSONAL SOCIAL : 41. Does your child dress and undress herself, includin Does your child dress and undress herself, including buttoning medium-size buttons and zipping front zippers? 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101E. PERSONAL SOCIAL : 42. Does your child use the toilet by herself? Does your child use the toilet by herself? (She goes to the bathroom, sits on the toilet, wipes, and flushes.) Mark “yes” even if she does this after you remind her. 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 1101E. PERSONAL SOCIAL : 43. Does your child usually take turns and share with o Does your child usually take turns and share with other children? 1410 * 1 Yes 0 2 No 0 Sysmiss 1410 CO code CO Code 14577 8 593 Household number Household number 14577 1 50 1 685 2 590 3 590 4 586 5 645 6 546 7 501 8 496 9 472 10 516 11 493 12 507 13 455 14 490 15 433 16 465 17 469 18 466 19 472 20 429 21 448 22 421 23 388 24 379 25 332 26 305 27 272 28 294 29 235 30 192 31 172 32 144 33 130 34 101 35 92 36 75 37 68 38 49 39 33 40 27 41 27 42 16 43 18 44 6 45 12 46 12 47 12 48 7 50 4 Household sub-number (if separated) Household sub-number (if separated) 14577 0 3 0 14343 1 113 2 106 3 15 ID CODE of eligible women/children [Respondent: Eligible Women and Child] Name and ID Code of Eligible Woman/children -HH Roster 14439 138 1 99 1 441 2 1323 3 670 4 2248 5 1674 6 1239 7 826 8 638 9 414 10 283 11 196 12 124 13 70 14 55 15 39 16 28 17 16 18 8 19 11 20 8 21 4 22 5 23 2 24 3 25 4 26 1 28 1 99 SKIP 4108 Sysmiss 138 01A. ID CODE in 2013 survey (from rosster) ID CODE in 2013 survey (from rosster) 10331 4246 1 99 1 239 2 1050 3 407 4 1657 5 1059 6 806 7 554 8 474 9 320 10 206 11 144 12 90 13 65 14 48 15 36 16 28 17 9 18 17 19 12 20 8 21 1 22 3 23 3 24 2 25 1 99 New member for 2014 3092 Sysmiss 4246 02. Women or children? Women or children 10331 4246 1 2 1 Women 4674 2 Children 5657 Sysmiss 4246 03. If women, is she new? If women, is she new? 4674 9903 1 2 1 Yes 977 2 No 3697 Sysmiss 9903 04. Current status Current status 4674 9903 1 2 1 Pregnant 306 2 Mother 4368 3 Dead mother 0 Sysmiss 9903 05. ID code of mother ID code of mother 5657 8920 1 25 1 547 2 1696 3 460 4 1995 5 53 6 74 7 185 8 232 9 143 10 100 11 58 12 36 13 16 14 14 15 15 16 13 17 2 18 5 19 4 21 4 23 2 24 1 25 2 Sysmiss 8920 06A. Date of birth: YY Date of birth: YY 5657 8920 2067 2071 2067 282 2068 1215 2069 1596 2070 1642 2071 922 Sysmiss 8920 06A. Date of birth: MM Date of birth: MM 5657 8920 1 12 1 343 2 374 3 401 4 495 5 664 6 668 7 697 8 561 9 383 10 407 11 391 12 273 Sysmiss 8920 06A. Date of birth: DD Date of birth: DD 5657 8920 1 32 1 316 2 289 3 209 4 258 5 321 6 234 7 197 8 216 9 157 10 393 11 135 12 197 13 149 14 160 15 309 16 165 17 143 18 140 19 112 20 308 21 105 22 124 23 99 24 98 25 205 26 108 27 126 28 137 29 140 30 80 31 24 32 3 Sysmiss 8920 06B. Age: Year Age: Year 5657 8920 0 4 0 1390 1 1683 2 1558 3 867 4 159 Sysmiss 8920 06B. Age: Month Age: Month 5657 8920 0 11 0 628 1 666 2 678 3 662 4 453 5 396 6 360 7 309 8 296 9 417 10 386 11 406 Sysmiss 8920 06B. Age: Day Age: Day 5657 8920 0 33 0 183 1 242 2 240 3 252 4 277 5 240 6 226 7 205 8 213 9 183 10 210 11 193 12 206 13 167 14 158 15 189 16 170 17 169 18 174 19 165 20 177 21 174 22 166 23 124 24 173 25 148 26 158 27 181 28 148 29 143 30 2 33 1 Sysmiss 8920 07. Interview result (of eligible women/children) Interview result (of eligible women/children) 10331 4246 1 7 1 Completed 8639 3 Separated 12 4 Out of home 1524 5 Dead 9 6 Refused to answer 0 7 Other 147 Sysmiss 4246 CO code CO Code 4246 8 593 Household number Household number 4246 1 50 1 187 2 168 3 166 4 168 5 184 6 159 7 138 8 137 9 133 10 153 11 139 12 148 13 133 14 142 15 124 16 133 17 135 18 135 19 138 20 126 21 129 22 127 23 118 24 116 25 98 26 92 27 81 28 88 29 70 30 56 31 52 32 44 33 40 34 35 35 31 36 27 37 21 38 16 39 12 40 9 41 9 42 6 43 6 44 2 45 4 46 4 47 4 48 2 50 1 Household sub-number (if separated) Household sub-number (if separated) 4246 0 3 0 4169 1 37 2 35 3 5 101. Round Number Round Number 4246 3 3 3 4246 103. CO Code No CO Code No (see the code sheet) 4246 8 593 104. House Serial No House Serial No (Copy from Q5 of Listing Form) 4246 1 50 1 187 2 168 3 166 4 168 5 184 6 159 7 138 8 137 9 133 10 153 11 139 12 148 13 133 14 142 15 124 16 133 17 135 18 135 19 138 20 126 21 129 22 127 23 118 24 116 25 98 26 92 27 81 28 88 29 70 30 56 31 52 32 44 33 40 34 35 35 31 36 27 37 21 38 16 39 12 40 9 41 9 42 6 43 6 44 2 45 4 46 4 47 4 48 2 50 1 104. Household sub-number (if separated) Household sub-number (if separated) 4246 0 3 0 4169 1 37 2 35 3 5 105A. Number of eligible woman SN eligible woman (From listing form) 4246 0 5 0 3 1 3740 2 444 3 53 4 4 5 2 105B. Interviewed eligible woman SN eligible woman (From listing form) - Interviewed 4246 0 5 0 8 1 3737 2 442 3 53 4 4 5 2 106B. Is this hh in baseline? 4246 1 2 1 Yes 3514 2 No 732 107. Date of Interview: DD 4246 1 30 1 89 2 188 3 236 4 171 5 212 6 216 7 192 8 184 9 180 10 154 11 118 12 78 13 108 14 98 15 135 16 123 17 175 18 157 19 138 20 175 21 127 22 142 23 111 24 146 25 132 26 108 27 105 28 115 29 118 30 15 107. Date of Interview: MM 4246 1 12 1 1 2 1 3 1 4 1 5 6 6 1 7 21 8 3522 9 691 12 1 107. Date of Interview: YY 4246 2071 2071 2071 4246 108. Interviewer's name Name of enumerator 4246 0 71 0 1 1 110 2 96 3 88 4 66 5 69 6 65 7 126 8 115 9 117 10 138 11 114 12 120 13 133 14 142 15 126 16 118 17 136 18 142 19 148 20 157 21 143 22 132 23 123 24 127 25 118 26 117 27 121 28 114 29 104 30 120 31 134 32 61 33 140 34 104 35 126 36 130 58 1 60 1 69 1 71 2 109. Supervisor's name Name of supervisor 4246 1 99 1 281 2 5 3 2 4 200 6 3 7 354 8 4 9 1 10 371 11 1 12 1 13 401 14 1 15 3 16 397 19 451 20 2 21 1 22 377 23 2 24 1 25 352 26 2 28 329 29 4 30 3 31 327 32 3 33 5 34 358 35 2 36 1 99 1 110. Editor's name Name of Editor 4246 0 99 0 1 1 10 2 923 3 972 4 667 5 826 6 833 7 2 12 1 19 1 21 1 22 1 23 1 47 1 58 1 63 1 99 4 111. Name of data entry operator Name of data entry operator 4246 . 1 .3 7 ``` 1 1 69 10 1 11 69 12 87 132 1 2 987 2. 11 21 2 24 4 28 1 3 226 4 965 5 13 6 2 7 710 7+ 1 8 1021 83 2 9 64 adm 1 CO code CO Code 4246 8 593 Household number Household number 4246 1 50 1 187 2 168 3 166 4 168 5 184 6 159 7 138 8 137 9 133 10 153 11 139 12 148 13 133 14 142 15 124 16 133 17 135 18 135 19 138 20 126 21 129 22 127 23 118 24 116 25 98 26 92 27 81 28 88 29 70 30 56 31 52 32 44 33 40 34 35 35 31 36 27 37 21 38 16 39 12 40 9 41 9 42 6 43 6 44 2 45 4 46 4 47 4 48 2 50 1 201. District District: 4246 1 4 1 Ramechhap 485 2 Sindhuli 851 3 Sarlahi 1184 4 Rautahat 1726 202. Is this a VDC or a Municipality? Is this a VDC or a Municipality? 4246 1 2 1 VDC 4181 2 Municipality 65 203. Code of VDC/Municipality Name and Code of VDC/Municipality (see code sheet) 4246 2 185 4246 0 1 0 2933 1 1313 4246 0 1 0 2863 1 1383 4246 0 1 0 2696 1 1550 Household sub-number (if separated) Household sub-number (if separated) 4246 0 3 0 4169 1 37 2 35 3 5 204. Ward Number Ward Number 4246 1 9 1 437 2 550 3 419 4 391 5 366 6 510 7 685 8 405 9 483 206A. ID code of the Main Respondent 4246 1 34 1 1548 2 1802 3 212 4 450 5 30 6 38 7 44 8 48 9 27 10 13 11 13 12 4 13 6 14 3 15 3 16 1 17 1 19 1 23 1 34 1 206B. ID code of the second Respondent 4246 1 99 1 180 2 424 3 110 4 506 5 13 6 36 7 46 8 61 9 32 10 23 11 12 12 10 13 5 14 2 15 4 16 1 17 1 19 2 23 1 99 2777 207B. ID code of the Household Head Name of the Household Head and code: 4246 1 1 1 4246 208. Caste/ethnicity of HH head Caste/ethnicity of HH head 4246 1 102 1 Chhetri 205 2 Bhamhin - Hill 91 3 Magar 173 4 Tharu 149 5 Tamang 349 6 Newar 108 7 Muslim 400 8 Kami 127 9 Yadav 271 10 Rai 6 11 Gurung 3 12 Damai/dholi 77 13 Limbu 0 14 Thakuri 2 15 Sarki 137 16 Teli 89 17 Chamar/harijan/ram 301 18 Koiri 63 19 Kurmi 90 20 Sanyasi 13 21 Dhanuk 18 22 Musahar 142 23 Dusadh/paswan/pasi 261 24 Sherpa 2 25 Sonar 47 26 Kewat 0 27 Bramhin - Terai 24 28 Baniya 34 29 Gharti/bhujel 31 30 Mallah 127 31 Kalwar 33 32 Kumal 2 33 Hajam/thakur 53 34 Kanu 121 35 Rajbansi 0 36 Sunuwar 42 37 Sudhi 11 38 Lohar 58 39 Tatma 98 40 Khatwe 4 41 Dhobi 71 42 Majhi 75 43 Niniya 58 44 Kumhar 41 45 Danuwar 111 46 Chepang/praja 0 47 Haluwai 3 48 Rajput 5 49 Kayastha 2 50 Badhae 1 51 Marwadi 0 52 Santhal/satar 0 53 Jhangad 0 54 Bantar 0 55 Barae 14 56 Kahar 1 57 Gangai 0 58 Lodha 0 59 Rajbhar 0 60 Thami 0 61 Dhimal 0 62 Bhote 2 63 Bing/bida 70 64 Bhediyar/gaderi 4 65 Nurang 0 66 Yakha 0 67 Darai 0 68 Tajpuriya 0 69 Thakali 0 70 Chidimar 0 71 Pahari 2 72 Mali 5 73 Bangali 0 74 Chhantyal 0 75 Dom 4 76 Kamar 1 77 Bote 0 78 Baramu 0 79 Gaine 0 80 Jirel 0 81 Adibasi/janajati 0 82 Dura 0 83 Churoute 0 84 Badi 2 85 Meche 0 86 Lepcha 0 87 Halkhor 0 88 Panjabi/sikh 0 89 Kisan 0 90 Raji 0 91 Byasi 0 92 Hayu 9 93 Koche 0 94 Dhniya 0 95 Walung 0 96 Jaine 0 97 Munda 0 98 Raute 0 99 Yholmo 0 100 Pattharkatta/kuswadiya 0 101 Kusunda 0 102 Other caste 3 103 Unidentified caste 0 212. Result of Interview Result of Interview (fill out after the interview): 4246 1 2 1 Completed 4108 2 Not completed 138 3 MIgrated 0 213. Which religion do you follow mainly in your household? Which religion do you follow mainly in your household? 4108 138 1 8 1 Hindu 3349 2 Bouddha 328 3 Islam 381 4 Kirat 15 5 Jain 1 6 Christian 29 7 Shikh 0 8 Other 5 Sysmiss 138 214. Total family number Total family number 4108 138 2 28 2 4 3 95 4 252 5 577 6 757 7 696 8 534 9 394 10 228 11 177 12 115 13 85 14 56 15 43 16 27 17 33 18 8 19 4 20 7 21 4 22 1 23 4 24 2 25 1 26 1 27 2 28 1 Sysmiss 138 4246 1 3 1 Control 1313 2 Info Only 1383 3 Info + Cash 1550 CO code CO Code 31429 8 593 Household number Household number 31429 1 50 1 1474 2 1290 3 1253 4 1227 5 1370 6 1127 7 1008 8 1048 9 998 10 1097 11 1042 12 1107 13 946 14 1027 15 934 16 1022 17 1034 18 988 19 1003 20 897 21 1004 22 900 23 864 24 822 25 733 26 695 27 592 28 687 29 538 30 423 31 389 32 311 33 289 34 224 35 208 36 177 37 157 38 117 39 80 40 63 41 68 42 36 43 41 44 14 45 32 46 23 47 24 48 22 50 4 Household sub-number (if separated) 31429 0 3 0 31070 1 199 2 145 3 15 ID CODE ID Code 31291 138 1 28 1 4108 2 4108 3 4104 4 4009 5 3757 6 3180 7 2423 8 1727 9 1193 10 799 11 571 12 394 13 279 14 194 15 138 16 95 17 68 18 35 19 27 20 23 21 16 22 12 23 11 24 7 25 5 26 4 27 3 28 1 99 SKIP 0 Sysmiss 138 302. Relationship to HH head Relationship to HH head 31291 138 1 99 1 Head 4108 2 Spouse 3754 3 Son/Daughter 12371 4 Grandchild 5615 5 Parent 740 6 Brother/Sister 384 7 Nephew/Niece 476 8 Son/Daughter-in-law 3260 9 Brother/Sister-in-law 344 10 Parent-in-law 157 11 Other relative (grandparents etc) 64 12 Domestic helper 6 13 Adopted/foster child 0 14 Other not related 6 99 Dead mother 6 Sysmiss 138 303. Sex Sex 31291 138 1 2 1 Male 15444 2 Female 15847 Sysmiss 138 304. Age (Completed): A. Year Age (Completed)? - Year 31291 138 0 99 304. Age (Completed): B. Month Age (Completed)? - Month 31291 138 0 11 0 25827 1 697 2 706 3 697 4 478 5 427 6 437 7 338 8 335 9 462 10 440 11 447 Sysmiss 138 305. Can [NAME] read and write a letter in any one language? Ask only to those who are aged 5 years and older Can [NAME] read and write a letter in any one language? 25139 6290 1 2 1 Can read/write 11130 2 Can't read/write 14009 Sysmiss 6290 306. Has [NAME] ever attended formal school/ college? Ask only to those who are aged 5 years and older Has [NAME] ever attended formal school/ college? No, go to Q308 25139 6290 1 2 1 Yes 12606 2 No 12533 Sysmiss 6290 307. What is the highest grade [NAME] completed? Ask only to those who are aged 5 years and older What is the highest grade [NAME] completed? (Use EDUCATION CODE) 12606 18823 0 98 0 CLASS 1 NOT PASSED 1670 1 CLASS 1 886 2 CLASS 2 1113 3 CLASS 3 1029 4 CLASS 4 1092 5 CLASS 5 1463 6 CLASS 6 755 7 CLASS 7 813 8 CLASS 8 890 9 CLASS 9 498 10 CLASS 10 689 11 SLC 835 12 CLASS 11 332 13 CLASS 12 OR INTERMEDIATE 397 14 BACHELOR LEVEL 101 15 MASTER LEVEL/PH.D 32 98 DON'T KNOW 11 Sysmiss 18823 308. Marital status Ask only to those who are aged 5 years and older Marital status 25143 6286 1 4 1 Unmarried 9122 2 Married 15101 3 Divorced/separated 48 4 Widow/er 872 Sysmiss 6286 309. Occupation: A. Main occupation Ask only to those who are aged 5 years and older What is [NAME’s] main and secondary occupation? - Primary (Use OCCUPATION CODE) 25139 6290 1 36 1 Self-agri 3518 2 Self-livestock 311 3 Agri (other) 746 4 Self/other agri 420 5 Self-trade/service 653 6 Self-small/cottage industry 156 7 Self-middle/big industry 17 8 Self-construction 39 9 Self-transportation 29 10 Self-other 86 11 Wage-agri 1243 12 Wage-construction skill labour 481 13 Wage-construction unskilled labour 440 14 Wage-manufacturing skill labour 167 15 Wage-manufacturing unskilled labour 148 16 Wage-other skilled labour 245 17 Wage-other unskilled labour 276 18 Labour of transport sector 180 19 Goverment employee (NIJAMATI) 25 20 Security force 154 21 Employee on corporation sector 21 22 Employee on financial sector 19 23 Employee of education sector 158 24 Employee of healthe service 34 25 Lawer 2 26 Employee of NGOs/CBOs 30 27 Student 5516 28 Household duties/child care 5552 29 Retired/old age 516 30 Disable, can work 43 31 Disable, can not work 283 32 Unemployed/seeking work 157 33 Small age (too young) 1530 35 Foreign employee 1932 36 Other 12 Sysmiss 6290 309. Occupation: B. Secondary occupation Ask only to those who are aged 5 years and older What is [NAME’s] main and secondary occupation? - Secondary (Use OCCUPATION CODE) 25139 6290 1 36 1 Self-agri 2526 2 Self-livestock 1189 3 Agri (other) 532 4 Self/other agri 154 5 Self-trade/service 111 6 Self-small/cottage industry 19 7 Self-middle/big industry 7 8 Self-construction 8 9 Self-transportation 3 10 Self-other 31 11 Wage-agri 966 12 Wage-construction skill labour 80 13 Wage-construction unskilled labour 83 14 Wage-manufacturing skill labour 27 15 Wage-manufacturing unskilled labour 21 16 Wage-other skilled labour 39 17 Wage-other unskilled labour 76 18 Labour of transport sector 12 19 Goverment employee (NIJAMATI) 0 20 Security force 2 21 Employee on corporation sector 3 22 Employee on financial sector 3 23 Employee of education sector 14 24 Employee of healthe service 13 25 Lawer 1 26 Employee of NGOs/CBOs 11 27 Student 167 28 Household duties/child care 2939 29 Retired/old age 45 30 Disable, can work 16 31 Disable, can not work 67 32 Unemployed/seeking work 190 33 Small age (too young) 1803 34 No secondary occupation 13826 35 Foreign employee 146 36 Other 9 Sysmiss 6290 310. Is [name] currently residing in this HH? Is [name] currently residing in this HH? No, go to another 31291 138 1 3 1 Yes 27816 2 No 3469 3 Dead 6 Sysmiss 138 311. Is this child or mother eligible for interview? Is this child or mother eligible for interview? 27822 3607 1 2 1 Yes 10331 2 No 17491 Sysmiss 3607 CO code CO Code 4246 8 593 Household number Household number 4246 1 50 1 187 2 168 3 166 4 168 5 184 6 159 7 138 8 137 9 133 10 153 11 139 12 148 13 133 14 142 15 124 16 133 17 135 18 135 19 138 20 126 21 129 22 127 23 118 24 116 25 98 26 92 27 81 28 88 29 70 30 56 31 52 32 44 33 40 34 35 35 31 36 27 37 21 38 16 39 12 40 9 41 9 42 6 43 6 44 2 45 4 46 4 47 4 48 2 50 1 Household sub-number (if separated) Household sub-number (if separated) 4246 0 3 0 4169 1 37 2 35 3 5 401. Is this dwelling unit occupied by your household only? I would like to know more about your housing units used by your household or currently residing. Is this dwelling unit occupied by your household only? 4108 138 1 2 1 Yes 3935 2 No 173 Sysmiss 138 402. What is the ownership status of the dwelling that your household residing? What is the ownership status of the dwelling that your household residing? 4108 138 1 5 1 Own house (Male ownership) 2961 2 Own house (Female ownership) 385 3 Own house (Joint ownership) 16 4 No ownership 742 5 Rented 4 Sysmiss 138 403. How many rooms are used by your household? How many rooms are used by your household? 4108 138 1 12 1 460 2 1252 3 996 4 768 5 310 6 198 7 47 8 49 9 14 10 8 11 3 12 3 Sysmiss 138 404. How many stories are there in your household? How many stories are there in your household? 4108 138 1 4 1 2515 2 1536 3 53 4 4 Sysmiss 138 405. Has your household used separate room as a kitchen? Has your household used separate room as a kitchen? 4108 138 1 2 1 Yes 1783 2 No 2325 Sysmiss 138 406. What is the main flooring material of the house that your family using? What is the main flooring material of the house that your family using? 4108 138 1 5 1 Earth/mud 3855 2 Wood/Planks 60 3 Stone/Brick 27 4 Cement 165 5 Other 1 Sysmiss 138 407. What is the main construction material of the outside wall of the house? 4108 138 1 8 1 Bamboo/Wood/Cement mix (centre wall) 146 2 Cement bonded Stones/Bricks/Concrete 498 3 Mud bonded Stones/Bricks 1145 4 Wood 138 5 Unbaked Bricks 31 6 Bamboo and mud 1496 7 Clay, Husk, Mud, Straw, Hay 652 8 Other 2 9 No outside walls 0 Sysmiss 138 408. What is the main construction material of the roof of the house? What is the main construction material of the roof of the house? 4108 138 1 7 1 Hay/Straw 921 2 Earth/Mud 27 3 Wood 6 4 Galvanized iron 292 5 Concrete/Cement 188 6 Tiles/Slates/Stone 2666 7 Other 8 Sysmiss 138 409. Does your household: A. Regular electricity 4108 138 1 2 1 Yes 2977 2 No 1131 Sysmiss 138 409. Does your household: B. Power generator 4108 138 1 2 1 Yes 9 2 No 4099 Sysmiss 138 409. Does your household: C. Solar power 4108 138 1 2 1 Yes 585 2 No 3523 Sysmiss 138 410. What is the main source of drinking water? What is the main source of drinking water? 4108 138 1 13 1 Piped water directly to the household/compound 490 2 Piped water from a public water tap 666 3 Private Hand-pump (Shallow) 1612 4 Public Hand-pump (Shallow) 601 5 Private Hand-pump (Deep) 67 6 Public Hand-pump (Deep) 55 7 Covered Well 11 8 Open Well 97 9 Stored Rain Water 7 10 Stone tape 218 11 River, Pond, Stream, or other open water bodies 49 12 Neighbour's tube-well 219 13 Other 16 Sysmiss 138 411. How many minutes does it take to fetch water? How many minutes does it take to fetch water? (Write 000 if less than one minute) 4108 138 0 999 0 1682 1 113 2 170 3 89 4 19 5 765 6 28 7 31 8 23 9 4 10 564 12 3 15 256 16 1 20 179 25 10 30 100 40 2 45 6 50 2 60 38 90 5 110 1 120 7 130 1 180 5 240 2 300 1 999 1 Sysmiss 138 412. Fuel used for cooking and heating - A. Main (If none of A, B, or C is 01 go to question 414) 4108 138 1 10 1 Wood 2507 2 Crop residues (Husk/Straw) 1351 3 Dung cakes 165 4 Charcoal 2 5 Coal/cake 1 6 Kerosene 2 7 Electricity 0 8 Liquid Petroleum Gas 55 9 Bio Gas 23 10 Other (Specify) 2 Sysmiss 138 412. Fuel used for cooking and heating - B. Second (If none of A, B, or C is 01 go to question 414) 4108 138 1 99 1 Wood 238 2 Crop residues (Husk/Straw) 752 3 Dung cakes 908 4 Charcoal 6 5 Coal/cake 1 6 Kerosene 0 7 Electricity 8 8 Liquid Petroleum Gas 115 9 Bio Gas 37 10 Other (Specify) 0 99 No 2nd/3rd answer 2043 Sysmiss 138 412. Fuel used for cooking and heating - C. Third (If none of A, B, or C is 01 go to question 414) 4108 138 1 99 1 Wood 51 2 Crop residues (Husk/Straw) 88 3 Dung cakes 318 4 Charcoal 6 5 Coal/cake 0 6 Kerosene 1 7 Electricity 0 8 Liquid Petroleum Gas 16 9 Bio Gas 7 10 Other (Specify) 0 99 No 2nd/3rd answer 3621 Sysmiss 138 413. How many minutes do you walk/bicycle to get one bhari of firewood? 413. How many minutes do you walk/bicycle to get one bhari of firewood? Fill out only if one of the answers in Q412 is 01. For those using firewood but not fetching, write 99 99) 2796 1450 10 999 10 9 20 9 25 4 30 63 35 1 40 7 45 5 60 157 75 1 80 2 90 90 100 1 110 1 120 466 130 1 140 7 150 53 160 20 170 2 180 428 190 2 200 32 208 1 210 2 220 4 230 7 240 303 242 1 250 6 260 2 280 2 300 183 320 6 340 2 350 8 360 105 370 4 380 1 420 21 430 1 480 24 500 2 600 1 620 4 630 2 670 2 720 2 900 1 999 Not fetching water 738 Sysmiss 1450 414. What type of toilet does your household use? What type of toilet does your household use? 4108 138 1 6 1 Flush toilet 361 2 Covered Pit/Pan within Household Compound 999 3 Open Pit within Household Compound 87 4 Community Latrine 9 5 Other type of Latrine (Specify) 3 6 No Toilet/Open Defecation 2649 Sysmiss 138 415. How many minutes does it take to get to the nearest market to your house? How many minutes does it take to get to the nearest market to your house? (Record in minutes even if the answer is in hours) 4108 138 0 690 416. Does your household own land? Does your household own land? No, go to Q418 4108 138 1 2 1 Yes 3525 2 No 583 Sysmiss 138 CO code CO Code 7018 8 593 Household number Household number 7018 1 50 1 311 2 278 3 285 4 248 5 276 6 242 7 225 8 210 9 221 10 262 11 213 12 237 13 217 14 230 15 199 16 232 17 226 18 211 19 239 20 213 21 203 22 210 23 203 24 217 25 172 26 162 27 145 28 150 29 125 30 97 31 92 32 63 33 68 34 53 35 46 36 50 37 37 38 32 39 29 40 13 41 15 42 10 43 11 44 6 45 11 46 11 47 9 48 2 50 1 Household sub-number (if separated) Household sub-number (if separated) 7018 0 3 0 6911 1 49 2 50 3 8 417. Land - A. Type Type of land 7018 1 4 1 Household land 3397 2 Farm land 2141 3 Bari/Pakho 1048 4 Baran/forest/etc. 432 99 SKIP 0 417. Land - B. Unit Units 7018 1 2 1 Ropani 2494 2 Bigha 4524 417. Land - C. Area (ropani/bigha) Area - Ropani/ Bigha 7018 0 60 0 5118 1 431 2 405 3 257 4 194 5 172 6 79 7 42 8 57 9 25 10 88 11 11 12 31 13 9 14 7 15 29 16 5 17 6 18 2 19 1 20 18 22 3 24 1 25 10 26 1 27 1 28 1 30 7 32 1 40 2 45 1 50 2 60 1 417. Land - D. Area (aana/kattha) Area - Ana/ Kattha 7018 0 20 0 3803 1 464 2 435 3 269 4 448 5 391 6 197 7 125 8 263 9 42 10 363 11 9 12 54 13 19 14 19 15 74 16 20 17 7 18 14 20 2 417. Land - C. Area (dhur/paisa) Area - Paisa/ Dhur 7018 0 20 0 4693 1 31 2 131 3 234 4 273 5 431 6 156 7 129 8 121 9 50 10 500 11 28 12 58 13 24 14 29 15 69 16 23 17 16 18 19 19 2 20 1 CO code CO Code 4246 8 593 Household number Household number 4246 1 50 1 187 2 168 3 166 4 168 5 184 6 159 7 138 8 137 9 133 10 153 11 139 12 148 13 133 14 142 15 124 16 133 17 135 18 135 19 138 20 126 21 129 22 127 23 118 24 116 25 98 26 92 27 81 28 88 29 70 30 56 31 52 32 44 33 40 34 35 35 31 36 27 37 21 38 16 39 12 40 9 41 9 42 6 43 6 44 2 45 4 46 4 47 4 48 2 50 1 Household sub-number (if separated) Household sub-number (if separated) 4246 0 3 0 4169 1 37 2 35 3 5 418. Does your household have a garden where you grow vegetables? Does your household have a garden where you grow vegetables? No, go to 420 4108 138 1 2 1 Yes 1786 2 No 2322 Sysmiss 138 419. For what purpose, do you grow vegetables? For what purpose, do you grow vegetables? 1786 2460 1 3 1 Household consumption 1672 2 Selling 46 3 Both 68 Sysmiss 2460 420. Has your household owned any livestock? Has your household owned any livestock? 4108 138 1 2 1 Yes 3271 2 No 837 Sysmiss 138 CO code CO Code 69974 8 593 Household number Household number 69974 1 50 1 3067 2 2760 3 2726 4 2792 5 2984 6 2559 7 2282 8 2249 9 2197 10 2505 11 2283 12 2388 13 2165 14 2350 15 2028 16 2229 17 2215 18 2215 19 2202 20 2110 21 2161 22 2079 23 1942 24 1956 25 1634 26 1532 27 1345 28 1480 29 1190 30 936 31 852 32 732 33 664 34 579 35 527 36 443 37 357 38 272 39 204 40 137 41 153 42 102 43 102 44 34 45 68 46 68 47 68 48 34 50 17 Household sub-number (if separated) Household sub-number (if separated) 69974 0 3 0 68745 1 581 2 563 3 85 501. Expenditure: A. Item 69836 138 1 17 1 Fuel (Wood, Kerosene, LPG, etc.) 4108 2 Clothes, Apparel 4108 3 Personal care items (Soap, Comb, Shampoo, cosmetics, etc.) 4108 4 Transportation (Horse, Mule, Bus, Taxi, Rickshaw, etc) 4108 5 Entertainment/Excursion (Movies, picnics, melas, etc) 4108 6 Newspapers, Books, Copies, etc. 4108 7 Educational and Professional Services 4108 8 Medicines and Health Services 4108 9 Legal Expenses and Insurance 4108 10 Repair/Maintenance of House and Household Effects and electrician, plumber, etc. 4108 11 Religious, Marriage, Funeral, etc. expenses 4108 12 Donations/gifts 4108 13 Electricity, Water, etc. 4108 14 Household goods 4108 15 Agri. related goods 4108 16 Ornaments, land, livestock etc. purchase 4108 17 Other 4108 Sysmiss 138 501. Expenditure: B. Amount (NRs.) (Answer in Rupees, if there is no expenditure, write zero if there is no expenditure on the item.) 69836 138 0 1500000 CO code CO C 49434 8 593 Household number Household number 49434 1 50 1 2167 2 1950 3 1926 4 1972 5 2109 6 1809 7 1612 8 1589 9 1552 10 1770 11 1613 12 1688 13 1530 14 1660 15 1433 16 1574 17 1565 18 1565 19 1557 20 1490 21 1526 22 1469 23 1372 24 1381 25 1154 26 1082 27 950 28 1045 29 840 30 661 31 602 32 517 33 469 34 409 35 372 36 313 37 252 38 192 39 144 40 97 41 108 42 72 43 72 44 24 45 48 46 48 47 48 48 24 50 12 Household sub-number (if separated) Household sub-number (if separated) 49434 0 3 0 48565 1 411 2 398 3 60 502. Income: A. Particulars of Income 49296 138 1 12 1 Agriculture (Agriculture, NTFP, Livestock, etc) 4108 2 Non-Agriculture Enterprise 4108 3 From within the home town 4108 4 Inside the country 4108 5 Outside the country 4108 6 Old age pension/allowances 4108 7 Widow pension/Allowances 4108 8 Disability allowances 4108 9 Other social protection program payments 4108 10 Income from interest, bonus, profit, commission, fees, royalties, etc 4108 11 Prize 4108 12 Other 4108 Sysmiss 138 502. Income: B. Annual income (NRs.) (Answer in Rupees, write zero if there is no income from the item). 49296 138 0 1900000 CO code CO Code 4246 8 593 Household number Household number 4246 1 50 1 187 2 168 3 166 4 168 5 184 6 159 7 138 8 137 9 133 10 153 11 139 12 148 13 133 14 142 15 124 16 133 17 135 18 135 19 138 20 126 21 129 22 127 23 118 24 116 25 98 26 92 27 81 28 88 29 70 30 56 31 52 32 44 33 40 34 35 35 31 36 27 37 21 38 16 39 12 40 9 41 9 42 6 43 6 44 2 45 4 46 4 47 4 48 2 50 1 Household sub-number (if separated) Household sub-number (if separated) 4246 0 3 0 4169 1 37 2 35 3 5 503. How many borrowed loans does your household have over the past 12 months? How many borrowed loans does your household have over the past 12 months? None (➔505) 4108 138 0 20 0 None 849 1 1124 2 1129 3 584 4 241 5 99 6 41 7 11 8 10 9 1 10 15 11 1 12 2 20 1 Sysmiss 138 504. What was or is the annual rate of interest of the most recent loan borrowed What was or is the annual rate of interest of the most recent loan borrowed? (If eight and a half percent, write 8.5) 3259 987 1 72 1 1 2 4 3 2 3.5 1 4 2 5 9 6 87 8 5 9 18 10 27 11 1 12 493 12.5 1 14 5 15 2 16 9 17 1 18 96 20 9 22 1 24 503 25 4 30 14 34 1 36 1220 40 1 48 411 50 1 60 323 61 1 72 6 Sysmiss 987 CO code CO Code 143918 8 593 Household number Household number 143918 1 50 1 6307 2 5676 3 5606 4 5744 5 6134 6 5259 7 4694 8 4625 9 4519 10 5151 11 4695 12 4908 13 4451 14 4834 15 4170 16 4587 17 4555 18 4555 19 4524 20 4342 21 4447 22 4275 23 3994 24 4026 25 3362 26 3152 27 2767 28 3046 29 2450 30 1926 31 1752 32 1506 33 1366 34 1191 35 1085 36 911 37 735 38 560 39 420 40 281 41 315 42 210 43 210 44 70 45 140 46 140 47 140 48 70 50 35 Household sub-number (if separated) Household sub-number (if separated) 143918 0 3 0 141393 1 1193 2 1157 3 175 506. Consumption: A. Food item 143780 138 1 35 1 Rice 4108 2 Beaten rice 4108 3 Maize 4108 4 Wheat 4108 5 Barley/Oat/Sorghum 4108 6 Millet/ Buckwheat 4108 7 Pulses 4108 8 Gram/Pea 4108 9 Other beans 4108 10 Fish 4108 11 Meat 4108 12 Egg 4108 13 Milk 4108 14 Curd/Whey etc. 4108 15 Baby/Powder milk 4108 16 Ghee 4108 17 Honey 4108 18 Vegetable ghee 4108 19 Oil (Mustard, Soyabean, etc.) 4108 20 Potato/Colocasia 4108 21 Onion 4108 22 Green leafy vegetables 4108 23 Other vergetables (cauliflower, okra, etc) 4108 24 Fruits/nuts 4108 25 Salt 4108 26 Other Spices (scumin seed, marich, garlic, ginger, chillies, etc.) 4108 27 Sugar 4108 28 Sakhar/Gud/Khudo 4108 29 Sweets 4108 30 Tea/Coffee 4108 31 Alcoholic beverages (Jand, Wine, Beer, etc.) 4108 32 Non-alcoholic beverages (Coke, Frooti, Sarbat, etc.) 4108 33 Tobacco and tobacco products 4108 34 Noodles and Biscuits 4108 35 Other Foods 4108 Sysmiss 138 506. Consumption: B. Quantity (If none, write 0 and ➔Next item) 143780 138 0 900 506. Consumption: B. Unit (If none, write 0 and ➔Next item) 46839 97079 1 10 1 Kilogram 9890 2 Gram 10089 3 Litre 2264 4 Ml 3295 5 Pathi 23 6 Mana 2119 7 Kuruwa 18 8 Number 7745 9 Dozen 7 10 Spoons 11389 Sysmiss 97079 CO code CO Code 41218 8 593 Household number Household number 41218 1 50 1 1807 2 1626 3 1606 4 1644 5 1759 6 1509 7 1344 8 1325 9 1294 10 1476 11 1345 12 1408 13 1276 14 1384 15 1195 16 1312 17 1305 18 1305 19 1299 20 1242 21 1272 22 1225 23 1144 24 1151 25 962 26 902 27 792 28 871 29 700 30 551 31 502 32 431 33 391 34 341 35 310 36 261 37 210 38 160 39 120 40 81 41 90 42 60 43 60 44 20 45 40 46 40 47 40 48 20 50 10 Household sub-number (if separated) Household sub-number (if separated) 41218 0 3 0 40493 1 343 2 332 3 50 507. Unexpected events - A. Type of shock 41080 138 1 10 1 Getting a new job of any kind 4108 2 Inheritance 4108 3 Death of HH member 4108 4 Accidental or Violent injury 4108 5 Loss of employment of any kind 4108 6 Failure/loss of business 4108 7 Livestock died 4108 8 Crop disease/pests 4108 9 Theft/robbery/burglary/assault 4108 10 Drought/floods 4108 Sysmiss 138 507. Unexpected events - B. Has the household experienced? No, go to Next item 41080 138 1 2 1 Yes 2023 2 No 39057 Sysmiss 138 507. Unexpected events - C. Who did this shock affect? 2023 39195 1 3 1 Just this household 1613 2 Several HHs in the village 262 3 All HHs in the village 148 Sysmiss 39195 507. Unexpected events - D. What was the strength of this shock? 2023 39195 1 5 1 Not important 105 2 Mild 411 3 Average 550 4 Quite strong 703 5 Very strong 254 Sysmiss 39195 CO code CO Code 4668 8 593 Household number Household No. (copy from Q104) 4668 1 50 1 219 2 186 3 189 4 185 5 200 6 176 7 158 8 155 9 150 10 164 11 156 12 158 13 143 14 155 15 138 16 149 17 149 18 146 19 150 20 136 21 142 22 132 23 125 24 121 25 112 26 101 27 88 28 100 29 77 30 65 31 55 32 48 33 45 34 35 35 32 36 26 37 25 38 18 39 12 40 9 41 9 42 6 43 6 44 2 45 4 46 4 47 4 48 2 50 1 Household sub-number (if separated) Household sub-number (if separated) 4668 0 3 0 4596 1 34 2 33 3 5 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 4668 1 25 1 440 2 1322 3 369 4 1650 5 52 6 81 7 169 8 216 9 120 10 81 11 61 12 35 13 15 14 12 15 16 16 11 17 2 18 3 19 5 21 4 23 1 24 1 25 2 601. Were you or any of your children who are younger than 60 months sick in the Were you or any of your children who are younger than 36 months sick in the last 30 days? No, go to Section 7 4668 1 2 1 Yes 2063 2 No 2605 ***** CHECK: Number person that was sick (Sec 06) CHECK: Number person that was sick (Sec 06) 2063 2605 0 4 0 28 1 1630 2 365 3 37 4 3 Sysmiss 2605 CO code CO Code 2483 8 593 Household number Household No. (copy from Q104) 2483 1 48 1 117 2 102 3 102 4 110 5 99 6 83 7 100 8 78 9 77 10 80 11 78 12 88 13 76 14 89 15 77 16 81 17 78 18 73 19 79 20 71 21 78 22 76 23 65 24 73 25 64 26 40 27 37 28 64 29 43 30 36 31 28 32 28 33 16 34 16 35 15 36 14 37 14 38 5 39 4 40 5 41 3 42 3 43 7 44 3 45 3 46 2 47 2 48 1 Household sub-number (if separated) Household sub-number (if separated) 2483 0 3 0 2426 1 23 2 29 3 5 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 2483 1 25 1 307 2 868 3 167 4 817 5 16 6 40 7 66 8 76 9 43 10 27 11 15 12 8 13 5 14 4 15 8 16 7 17 1 18 4 19 2 21 1 25 1 ID Code ID Code (Enter from section 3) 2483 1 28 1 65 2 210 3 152 4 441 5 545 6 414 7 239 8 148 9 92 10 59 11 42 12 19 13 14 14 6 15 12 16 8 17 5 18 1 19 4 20 4 22 1 24 1 28 1 99 SKIP 0 603. What type of illness does [NAME] suffer from last time during the past 30 d What type of illness does [NAME] suffer from last time during the past 30 days? 2483 1 18 1 Diarrhoea 237 2 Dysentry 22 3 Pneumonia/Cough 1110 4 Malaria 61 5 Other fever 707 6 Skin disease 38 7 TB 1 8 Measles 6 9 Jaundice 10 10 Parasites 9 11 Injury 20 12 Pregnancy related complications 45 13 Stomach-ache 99 14 STDs/STIs 1 15 Eye-ache 15 16 Head-ache 27 17 Orthopedic 22 18 Other 53 604. Where did [NAME] go for the first consultation of the illness reported in Q Where did [NAME] go for the first consultation of the illness reported in Q.603? Not consulted, go to 606 2483 1 12 1 SHP 161 2 HP 414 3 PHC 36 4 Govt. hospital 206 5 Mobile clinic 3 6 Ayurvedic centre 1 7 Pharmacy/Clinic 1088 8 Pvt. hospital 283 9 Health worker's home 90 10 Traditional healer 37 11 GHUMTI SIBIR 5 12 Not consulted 159 605. Whom did [NAME] first consult with of the illness reported in Q.603? Whom did [NAME] first consult with of the illness reported in Q.603? → Go To Next Member 2324 159 1 5 1 Doctor 596 2 Paramedic (HA,SAHW, AHW, ANM) 1487 3 Kaviraj/Vaidya 9 4 Untrained Pharmacist 195 5 Traditional Healer 37 6 Other 0 Sysmiss 159 606. Why didn't you consult for the illness? Why didn't you consult for the illness? 159 2324 1 7 1 No money 28 2 Illness not serious 104 3 Health worker far 20 4 No good health worker 1 5 Treatment expensive 2 6 Don't know about health institution 2 7 Pregnant 2 Sysmiss 2324 CO code CO Code 3907 8 593 Household number Household No. (copy from Q104) 3907 1 50 1 188 2 156 3 154 4 152 5 159 6 146 7 131 8 111 9 123 10 138 11 136 12 132 13 122 14 133 15 118 16 123 17 117 18 114 19 129 20 111 21 117 22 113 23 112 24 105 25 90 26 85 27 78 28 88 29 71 30 55 31 49 32 43 33 37 34 30 35 29 36 25 37 22 38 15 39 9 40 8 41 7 42 6 43 6 44 2 45 4 46 4 47 2 48 1 50 1 Household sub-number (if separated) Household sub-number (if separated) 3907 0 3 0 3840 1 31 2 31 3 5 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3907 1 25 1 428 2 1247 3 297 4 1311 5 39 6 62 7 116 8 159 9 83 10 57 11 38 12 21 13 9 14 8 15 11 16 10 17 1 18 3 19 3 21 2 23 1 25 1 701. In your opinion, what should be done with the first milk (colostrums)? Now I’d like to ask you some questions about the nutrition for under 2 children In your opinion, what should be done with the first milk (colostrums)? 3907 1 8 1 Given to baby 3484 2 Thrown away 364 3 Other 5 8 Do not know 54 702. In your opinion, for how long should a newborn infant be given nothing but In your opinion, for how long should a newborn infant be given nothing but breast milk? 3907 1 8 1 Less than 6 months 424 2 6 months 2483 3 More than 6 months 909 8 Do not know 91 CO code CO Code 62512 8 593 Household number Household No. (copy from Q104) 62512 1 50 1 3008 2 2496 3 2464 4 2432 5 2544 6 2336 7 2096 8 1776 9 1968 10 2208 11 2176 12 2112 13 1952 14 2128 15 1888 16 1968 17 1872 18 1824 19 2064 20 1776 21 1872 22 1808 23 1792 24 1680 25 1440 26 1360 27 1248 28 1408 29 1136 30 880 31 784 32 688 33 592 34 480 35 464 36 400 37 352 38 240 39 144 40 128 41 112 42 96 43 96 44 32 45 64 46 64 47 32 48 16 50 16 Household sub-number (if separated) Household sub-number (if separated) 62512 0 3 0 61440 1 496 2 496 3 80 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 62512 1 25 1 6848 2 19952 3 4752 4 20976 5 624 6 992 7 1856 8 2544 9 1328 10 912 11 608 12 336 13 144 14 128 15 176 16 160 17 16 18 48 19 48 21 32 23 16 25 16 703. What foods are best? - A. Item (DO NOT DO NOT PROMPT THE MOTHER. CHECK ALL FOODS THE MOTHER MENTIONS UNPROMPTED) 62512 1 16 1 Porridge that is not enriched with other foods 3907 2 Porridge that is enriched with other foods/sarbottam pitho 3907 3 Yellow, orange and green vegetables 3907 4 Fruits 3907 5 Eggs 3907 6 Milk or yogurt 3907 7 Chicken or meat including liver 3907 8 Ghee, butter, or oil 3907 9 Lentils/pulses 3907 10 Biscuit 3907 11 Cerelac 3907 12 Horlicks 3907 13 Noodles 3907 14 Vitamin 3907 15 Bread 3907 16 Others 3907 703. What foods are best? - B. Mentioned/Not Mentioned? (DO NOT DO NOT PROMPT THE MOTHER. CHECK ALL FOODS THE MOTHER MENTIONS UNPROMPTED) 62512 1 2 1 Mentioned 21072 2 Not mentioned 41440 CO code CO Code 3907 8 593 Household number Household No. (copy from Q104) 3907 1 50 1 188 2 156 3 154 4 152 5 159 6 146 7 131 8 111 9 123 10 138 11 136 12 132 13 122 14 133 15 118 16 123 17 117 18 114 19 129 20 111 21 117 22 113 23 112 24 105 25 90 26 85 27 78 28 88 29 71 30 55 31 49 32 43 33 37 34 30 35 29 36 25 37 22 38 15 39 9 40 8 41 7 42 6 43 6 44 2 45 4 46 4 47 2 48 1 50 1 Household sub-number (if separated) Household sub-number (if separated) 3907 0 3 0 3840 1 31 2 31 3 5 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3907 1 25 1 428 2 1247 3 297 4 1311 5 39 6 62 7 116 8 159 9 83 10 57 11 38 12 21 13 9 14 8 15 11 16 10 17 1 18 3 19 3 21 2 23 1 25 1 704. How many times a day should a 6-11 month old baby be fed a meal in addition How many times a day should a 6-11 month old baby be fed a meal in addition to breast milk? 3907 0 98 0 8 1 53 2 49 3 350 4 691 5 336 6 288 7 146 8 318 9 207 10 324 11 107 12 262 13 70 14 175 15 125 16 106 17 17 18 26 19 10 20 28 21 5 22 3 23 7 24 5 25 9 28 2 29 1 30 3 40 1 98 Do not know 175 705. How many snacks a day should a 12-24 month old baby be given in addition to How many snacks a day should a 12-24 month old baby be given in addition to breast milk? 3907 0 98 0 2 1 1 2 50 3 831 4 1385 5 609 6 385 7 161 8 187 9 51 10 62 11 3 12 34 13 1 15 10 16 2 18 3 20 1 98 Do not know 129 706. In your opinion, should you breastfeed your baby less, the same or more tha In your opinion, should you breastfeed your baby less, the same or more than usual during an episode of diarrhea? 3907 1 8 1 Less than usual 1126 2 Same as usual 645 3 More than usual 1996 8 Do not know 140 707. In your opinion, at least how many times should a pregnant mother visit for Now I’d like to ask you some questions about the nutrition for women. In your opinion, at least how many times should a pregnant mother visit for ANC check up, 1, 2, 3, 4 or more? 3907 0 98 0 1 1 17 2 225 3 1031 4 1805 5 217 6 128 7 27 8 21 9 85 10 1 12 4 98 Do not know 345 708. When should a pregnant woman start iron supplementation (in months)? When should a pregnant woman start iron supplementation (in months)? 3907 0 98 0 1 1 51 2 124 3 1016 4 1265 5 406 6 431 7 40 8 22 9 4 98 Do not know 547 709. When should a pregnant woman take deworming tablets (in months)? When should a pregnant woman take deworming tablets (in months)? 3907 1 98 1 36 2 76 3 318 4 858 5 548 6 972 7 147 8 27 9 8 98 Do not know 917 710. When should a recently delivered woman take Vitamin A capsule (within When should a recently delivered woman take Vitamin A capsule (within days of delivery)? 3907 0 98 0 2 1 101 2 49 3 87 4 25 5 59 6 43 7 160 8 15 9 9 10 73 11 3 12 21 13 4 14 2 15 87 16 1 17 1 18 4 19 1 20 30 21 4 22 37 23 1 24 7 25 11 26 1 28 1 30 408 35 71 36 1 39 1 40 169 42 116 43 1 45 315 48 2 50 20 60 66 90 19 98 Do not know 1879 711. In your opinion, is it best for a pregnant woman to eat less food, the same In your opinion, is it best for a pregnant woman to eat less food, the same amount or more food than she ate before becoming pregnant? 3907 1 8 1 More than usual 2588 2 Same as usual 516 3 Less than usual 762 8 Do not know 41 CO code CO Code 54698 8 593 Household number Household No. (copy from Q104) 54698 1 50 1 2632 2 2184 3 2156 4 2128 5 2226 6 2044 7 1834 8 1554 9 1722 10 1932 11 1904 12 1848 13 1708 14 1862 15 1652 16 1722 17 1638 18 1596 19 1806 20 1554 21 1638 22 1582 23 1568 24 1470 25 1260 26 1190 27 1092 28 1232 29 994 30 770 31 686 32 602 33 518 34 420 35 406 36 350 37 308 38 210 39 126 40 112 41 98 42 84 43 84 44 28 45 56 46 56 47 28 48 14 50 14 Household sub-number (if separated) Household sub-number (if separated) 54698 0 3 0 53760 1 434 2 434 3 70 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 54698 1 25 1 5992 2 17458 3 4158 4 18354 5 546 6 868 7 1624 8 2226 9 1162 10 798 11 532 12 294 13 126 14 112 15 154 16 140 17 14 18 42 19 42 21 28 23 14 25 14 712. Good foods for a woman - A. Item (DO NOT PROMPT THE MOTHER. CHECK ALL FOODS THE MOTHER MENTIONS UNPROMPTED) 54698 1 14 1 Yellow, orange and green vegetables 3907 2 Fruit 3907 3 Eggs 3907 4 Milk or yogurt 3907 5 Meat 3907 6 Beans/pulses 3907 7 Rice 3907 8 Bread 3907 9 Horlicks 3907 10 Vitamin 3907 11 Noodles 3907 12 Biscuit 3907 13 HALUWA 3907 14 Others 3907 712. Good foods for a woman - B. Mentioned/Not Mentioned? (DO NOT PROMPT THE MOTHER. CHECK ALL FOODS THE MOTHER MENTIONS UNPROMPTED) 54698 1 2 1 Mentioned 20569 2 Not Mentioned 34129 CO code CO Code 31256 8 593 Household number Household No. (copy from Q104) 31256 1 50 1 1504 2 1248 3 1232 4 1216 5 1272 6 1168 7 1048 8 888 9 984 10 1104 11 1088 12 1056 13 976 14 1064 15 944 16 984 17 936 18 912 19 1032 20 888 21 936 22 904 23 896 24 840 25 720 26 680 27 624 28 704 29 568 30 440 31 392 32 344 33 296 34 240 35 232 36 200 37 176 38 120 39 72 40 64 41 56 42 48 43 48 44 16 45 32 46 32 47 16 48 8 50 8 Household sub-number (if separated) Household sub-number (if separated) 31256 0 3 0 30720 1 248 2 248 3 40 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 31256 1 25 1 3424 2 9976 3 2376 4 10488 5 312 6 496 7 928 8 1272 9 664 10 456 11 304 12 168 13 72 14 64 15 88 16 80 17 8 18 24 19 24 21 16 23 8 25 8 713. With whom do you usually seek advice? - A. People giving advice Now I would like to ask you about health, tobacco and alcohol consumption. (Circle all responses given, ask open-ended) 31256 1 8 1 FCHV 3907 2 AAMA Mothers group 3907 3 MCHW/VHW 3907 4 Other Health Workers 3907 5 Local private pharmacy 3907 6 Traditional healers 3907 7 Family members 3907 8 Other 3907 713. With whom do you usually seek advice? - B. Yes/No? (Circle all responses given, ask open-ended) 31256 1 2 1 Yes 6123 2 No 25133 CO code CO Code 3907 8 593 Household number Household No. (copy from Q104) 3907 1 50 1 188 2 156 3 154 4 152 5 159 6 146 7 131 8 111 9 123 10 138 11 136 12 132 13 122 14 133 15 118 16 123 17 117 18 114 19 129 20 111 21 117 22 113 23 112 24 105 25 90 26 85 27 78 28 88 29 71 30 55 31 49 32 43 33 37 34 30 35 29 36 25 37 22 38 15 39 9 40 8 41 7 42 6 43 6 44 2 45 4 46 4 47 2 48 1 50 1 Household sub-number (if separated) Household sub-number (if separated) 3907 0 3 0 3840 1 31 2 31 3 5 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3907 1 25 1 428 2 1247 3 297 4 1311 5 39 6 62 7 116 8 159 9 83 10 57 11 38 12 21 13 9 14 8 15 11 16 10 17 1 18 3 19 3 21 2 23 1 25 1 714. What kind of salt do you normally use in your house? What kind of salt do you normally use in your house? 3907 1 2 1 Aayunoon/Two child logo salt 3436 2 Other salt 471 715. Are you smoking, chewing tobacco and drinking alcohol regularly? Are you smoking, chewing tobacco and drinking alcohol regularly? 3907 1 4 1 Yes smoking and taking tobacco 107 2 Yes drinking alcohol 246 3 Yes taking both 66 4 No, taking nothing 3488 716. Rank the most important: A. Health 3907 1 4 1 1082 2 1745 3 746 4 334 716. Rank the most important: B. Food 3907 1 4 1 2232 2 1064 3 471 4 140 716. Rank the most important: C. Education 3907 1 4 1 408 2 750 3 1964 4 785 716. Rank the most important: D. Security 3907 1 4 1 185 2 348 3 726 4 2648 717. What is the highest level of education that you think your child will obtai What is the highest level of education that you think your child will obtain? 3907 0 98 0 CLASS 1 NOT PASSED 78 1 CLASS 1 1 2 CLASS 2 1 3 CLASS 3 6 4 CLASS 4 16 5 CLASS 5 128 6 CLASS 6 54 7 CLASS 7 54 8 CLASS 8 108 9 CLASS 9 64 10 CLASS 10 795 11 SLC 604 12 CLASS 11 587 13 CLASS 12 OR INTERMEDIATE 419 14 BACHELOR LEVEL 180 15 MASTER LEVEL/PH.D 431 98 DON'T KNOW 381 718. In the past month, have you been to a CO meeting? In the past month, have you been to a CO meeting? 3907 1 2 1 Yes 1418 2 No 2489 719. Do you think your child will work in agriculture or industry? Do you think your child will work in agriculture or industry? 3907 1 5 1 Agriculture 725 2 Industry 906 3 Foreign employee 157 4 Service 1323 5 Other 796 CO code CO Code 3907 8 593 Household number Household No. (copy from Q104) 3907 1 50 1 188 2 156 3 154 4 152 5 159 6 146 7 131 8 111 9 123 10 138 11 136 12 132 13 122 14 133 15 118 16 123 17 117 18 114 19 129 20 111 21 117 22 113 23 112 24 105 25 90 26 85 27 78 28 88 29 71 30 55 31 49 32 43 33 37 34 30 35 29 36 25 37 22 38 15 39 9 40 8 41 7 42 6 43 6 44 2 45 4 46 4 47 2 48 1 50 1 Household sub-number (if separated) Household sub-number (if separated) 3907 0 3 0 3840 1 31 2 31 3 5 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3907 1 25 1 428 2 1247 3 297 4 1311 5 39 6 62 7 116 8 159 9 83 10 57 11 38 12 21 13 9 14 8 15 11 16 10 17 1 18 3 19 3 21 2 23 1 25 1 801. How old were you when you got married? How old were you when you got married? 3907 10 42 10 27 11 3 12 94 13 110 14 307 15 653 16 929 17 494 18 546 19 221 20 268 21 74 22 76 23 38 24 27 25 21 26 4 27 5 28 1 29 1 30 5 33 2 42 1 802. Was the marriage arranged? Was the marriage arranged? 3907 1 2 1 Yes 3347 2 No 560 803. Are you currently pregnant? Are you currently pregnant? No, go to 806 3907 1 2 1 Yes 593 2 No 3314 804. How long have you been pregnant for? How long have you been pregnant for? (Write 0 if less than 1 month) 593 3314 0 9 0 2 1 22 2 69 3 76 4 74 5 65 6 57 7 65 8 97 9 66 Sysmiss 3314 805. Is this your first pregnancy? Is this your first pregnancy? 593 3314 1 3 1 Yes 164 2 No, and have kids who are alive 410 3 No, and other kid(s) died 19 Sysmiss 3314 806. During your pregnancy with your youngest child, how many times did you rece During your pregnancy with your youngest child (name:___________), how many times did you receive antenatal care? 3724 183 0 98 0 451 1 174 2 485 3 912 4 1225 5 210 6 119 7 42 8 35 9 49 10 4 12 7 14 2 15 2 31 2 60 1 64 1 98 3 Sysmiss 183 807. Did you receive TT injection at any time during this pregnancy (with name)? Did you receive TT injection at any time during this pregnancy (with name)? No, go to 809 3724 183 1 2 1 Yes 3340 2 No 384 Sysmiss 183 808. While pregnant with (name of youngest child), how many times did you receiv While pregnant with (name of youngest child), how many times did you receive such an injection? 3340 567 1 6 1 544 2 2184 3 535 4 56 5 16 6 5 Sysmiss 567 809. When you were pregnant with (name of youngest child), did you receive iron When you were pregnant with (name of youngest child), did you receive iron tablets? No, go to 812 3724 183 1 2 1 Yes 3045 2 No 679 Sysmiss 183 810. How many days during your pregnancy did you take the iron tablets? How many days during your pregnancy did you take the iron tablets? 3045 862 0 660 CO code CO Code 21315 8 593 Household number Household No. (copy from Q104) 21315 1 50 1 1078 2 931 3 896 4 798 5 931 6 875 7 749 8 574 9 665 10 805 11 714 12 700 13 651 14 714 15 623 16 679 17 623 18 623 19 679 20 581 21 616 22 623 23 616 24 609 25 455 26 455 27 378 28 420 29 385 30 322 31 266 32 259 33 203 34 168 35 140 36 112 37 105 38 70 39 28 40 35 41 28 42 28 43 35 44 7 45 21 46 14 47 14 48 7 50 7 Household sub-number (if separated) Household sub-number (if separated) 21315 0 3 0 20958 1 168 2 161 3 28 ID Code of Eligible Woman/respondent (Sec 06) Name and ID Code of Respondent -HH Roster 21315 1 25 1 2366 2 6678 3 1666 4 7406 5 196 6 273 7 602 8 840 9 399 10 301 11 189 12 112 13 35 14 56 15 63 16 63 17 7 18 21 19 21 21 14 25 7 811. From where? - A. Place where the tablets were taken (Choose all that apply, ask open-ended) 21315 1 7 1 FCHV 3045 2 Health Facility 3045 3 Clinic/pharmacy 3045 4 Hospital 3045 5 NGOs/INGOs 3045 6 Privat nursing home 3045 7 Other 3045 811. From where? - B. Yes/No? (Choose all that apply, ask open-ended) 21315 1 2 1 Yes 3710 2 No 17605 CO code CO Code 3907 8 593 Household number Household No. (copy from Q104) 3907 1 50 1 188 2 156 3 154 4 152 5 159 6 146 7 131 8 111 9 123 10 138 11 136 12 132 13 122 14 133 15 118 16 123 17 117 18 114 19 129 20 111 21 117 22 113 23 112 24 105 25 90 26 85 27 78 28 88 29 71 30 55 31 49 32 43 33 37 34 30 35 29 36 25 37 22 38 15 39 9 40 8 41 7 42 6 43 6 44 2 45 4 46 4 47 2 48 1 50 1 Household sub-number (if separated) Household sub-number (if separated) 3907 0 3 0 3840 1 31 2 31 3 5 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3907 1 25 1 428 2 1247 3 297 4 1311 5 39 6 62 7 116 8 159 9 83 10 57 11 38 12 21 13 9 14 8 15 11 16 10 17 1 18 3 19 3 21 2 23 1 25 1 812. During your last pregnancy, (with name) did you take de-worming tablet? During your last pregnancy, (with name) did you take de-worming tablet? 3724 183 1 2 1 Yes 2765 2 No 959 Sysmiss 183 813. Did you suffer from night blindness or ratandho in your last pregnancy? Did you suffer from night blindness or ratandho in your last pregnancy? 3724 183 1 2 1 Yes 689 2 No 3035 Sysmiss 183 814. Where did you give birth in your most recent delivery? Where did you give birth in your most recent delivery? 3724 183 1 6 1 Home 2757 2 Government hospital 545 3 PHC/HP/SHP 250 4 Private hospital/nursing home 146 5 Field/jungle 19 6 Road/Vehicle 7 Sysmiss 183 815. Who assisted with your most recent delivery? Who assisted with your most recent delivery? 3724 183 1 9 1 Doctor 487 2 Staff nurse/ANM 514 3 HA/AHW 364 4 MCHW 23 5 FCHV 131 6 TBA 367 7 Untrained household member/neighbor 1755 8 Other 7 9 No one 76 Sysmiss 183 816. In the first 42 days after delivery, did you take Vitamin A capsules? In the first 42 days after delivery, did you take Vitamin A capsules? 3724 183 1 2 1 Yes 2095 2 No 1629 Sysmiss 183 817. If yes, from where did you receive? If yes, from where did you receive? 2095 1812 1 4 1 FCHV 1108 2 Health workers 888 3 Shop/Medical 80 4 Other 19 Sysmiss 1812 818. Are you or your husband currently using any family planning method? Are you or your husband currently using any family planning method? 3724 183 1 2 1 Yes 709 2 No 3015 Sysmiss 183 CO code CO Code 3724 8 593 Household number Household No. (copy from Q104) 3724 1 50 1 182 2 154 3 149 4 149 5 156 6 146 7 128 8 104 9 121 10 136 11 130 12 126 13 120 14 132 15 112 16 119 17 114 18 108 19 119 20 103 21 110 22 109 23 104 24 101 25 84 26 77 27 72 28 77 29 65 30 50 31 46 32 40 33 36 34 26 35 26 36 20 37 18 38 12 39 6 40 7 41 7 42 5 43 5 44 2 45 4 46 3 47 2 48 1 50 1 Household sub-number (if separated) Household sub-number (if separated) 3724 0 3 0 3660 1 30 2 29 3 5 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3724 1 25 1 425 2 1239 3 287 4 1224 5 34 6 49 7 104 8 139 9 74 10 53 11 33 12 18 13 7 14 8 15 9 16 10 17 1 18 3 19 3 21 2 23 1 25 1 901. Did you ever breastfeed to your youngest child (name of child)? Did you ever breastfeed to your youngest child (name of child)? No…, go to 904 3724 1 2 1 Yes 3707 2 No 17 902. How long after giving birth did you first put (name of child) to the breast How long after giving birth did you first put (name of child) to the breast? (If less than 1 hour, record ‘00’ hours. Convert days to hours.) 3707 17 0 360 903. During the first three days after delivery, did you give (name) the liquid During the first three days after delivery, did you give (name) the liquid that came from your breasts? 3707 17 1 2 1 Yes 3325 2 No 382 Sysmiss 17 904. In the first three days after delivery, was (name) given anything to drink In the first three days after delivery, was (name) given anything to drink other than breast milk? No, go to 906 3724 1 2 1 Yes 933 2 No 2791 CO code CO Code 11196 8 593 Household number Household No. (copy from Q104) 11196 1 43 1 468 2 504 3 420 4 420 5 552 6 384 7 420 8 300 9 372 10 372 11 408 12 432 13 384 14 384 15 384 16 408 17 420 18 252 19 288 20 360 21 384 22 384 23 288 24 228 25 312 26 180 27 204 28 276 29 144 30 120 31 120 32 120 33 96 34 72 35 84 36 60 37 96 38 24 39 12 40 12 41 12 42 12 43 24 Household sub-number (if separated) Household sub-number (if separated) 11196 0 3 0 11016 1 108 2 60 3 12 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 11196 1 25 1 1188 2 3348 3 840 4 3876 5 108 6 120 7 408 8 504 9 240 10 240 11 108 12 60 13 24 14 36 15 12 16 36 18 24 19 12 25 12 905. What was (name) given to drink? - A. Liquid Food (Circle all responses given) 11196 1 12 1 Milk (other than breast milk) 933 2 Other mother milk 933 3 Plain water 933 4 Sugar or glucose water 933 5 Gripe water 933 6 Sugar-salt-water solution 933 7 Fruit juice 933 8 Infant formula 933 9 Honey 933 10 Ghee 933 11 Milk pouder 933 12 Others 933 905. What was (name) given to drink? - B. Fed/not fed? (Circle all responses given) 11196 1 2 1 Fed 1426 2 Not fed 9770 CO code CO Code 3724 8 593 Household number Household No. (copy from Q104) 3724 1 50 1 182 2 154 3 149 4 149 5 156 6 146 7 128 8 104 9 121 10 136 11 130 12 126 13 120 14 132 15 112 16 119 17 114 18 108 19 119 20 103 21 110 22 109 23 104 24 101 25 84 26 77 27 72 28 77 29 65 30 50 31 46 32 40 33 36 34 26 35 26 36 20 37 18 38 12 39 6 40 7 41 7 42 5 43 5 44 2 45 4 46 3 47 2 48 1 50 1 Household sub-number (if separated) Household sub-number (if separated) 3724 0 3 0 3660 1 30 2 29 3 5 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3724 1 25 1 425 2 1239 3 287 4 1224 5 34 6 49 7 104 8 139 9 74 10 53 11 33 12 18 13 7 14 8 15 9 16 10 17 1 18 3 19 3 21 2 23 1 25 1 906. For how many months did you exclusively breastfeed (name)? (If less than one month record 00 months.) 3724 0 99 0 130 1 63 2 68 3 123 4 137 5 198 6 1415 7 288 8 306 9 164 10 80 11 17 12 77 13 5 14 5 15 2 17 1 18 2 24 1 30 1 99 Still breastfeeding 641 907. For how many months did you breastfeed (name)? (If less than one month record 00 months.) 3724 0 99 0 30 1 1 2 2 3 1 4 1 5 1 6 7 7 3 8 7 9 7 10 4 11 3 12 32 13 4 14 4 15 13 16 12 17 3 18 43 19 5 20 21 21 6 22 7 23 7 24 136 25 13 26 16 27 7 28 9 29 6 30 31 31 4 32 2 34 5 35 3 36 36 39 1 42 1 48 5 50 1 60 3 90 1 99 Still breastfeeding 3220 908. ENUMERATOR: Is [name] younger than 24 months or older? ENUMERATOR: Is [name] younger than 24 months or older? Older than 24 m 30 d, go to Section 10 3724 1 3 1 Younger than 24 m 30 d 2582 2 Older than 24 m 30 d 1126 3 Child dead 16 909. Are you still breastfeeding (name)? Are you still breastfeeding (name)? No, go to 911 2582 1142 1 2 1 Yes 2494 2 No 88 Sysmiss 1142 910. How often did you breastfeed your child (name) day and night during last 24 How often did you breastfeed your child (name) day and night during last 24 hours? (Go to Q911 if answer is 0, if more than that go to Q912) 2494 1230 0 80 0 1 1 3 2 3 3 18 4 31 5 60 6 113 7 109 8 236 9 135 10 495 11 74 12 389 13 75 14 106 15 250 16 86 17 25 18 49 19 7 20 152 21 1 22 11 23 2 24 2 25 28 26 4 28 1 30 25 32 1 60 1 80 1 Sysmiss 1230 CO code CO Code 623 13 578 Household number Household No. (copy from Q104) 623 1 40 1 28 2 14 3 28 4 21 5 21 6 21 7 14 8 35 9 49 10 35 11 21 12 21 13 14 14 42 15 7 16 14 17 28 18 14 19 14 20 21 21 14 22 28 23 7 24 7 26 7 27 35 28 28 32 7 33 7 36 7 37 7 40 7 Household sub-number (if separated) Household sub-number (if separated) 623 0 3 0 609 1 7 3 7 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 623 1 16 1 63 2 168 3 91 4 196 7 21 8 28 9 14 10 14 12 14 14 7 16 7 911. Why not? - A. Reasons for not breastfeeding (Circle all responses given, ask open-ended) 623 1 7 1 No milking 89 2 Inadequacy of breastmilks 89 3 Work load/lack of time 89 4 Child ill 89 5 Pregnant 89 6 Mother is/was sick 89 7 Other 89 911. Why not? - B. Yes/No? 623 1 2 1 Yes 98 2 No 525 CO code CO Code 3724 8 593 Household number Household No. (copy from Q104) 3724 1 50 1 182 2 154 3 149 4 149 5 156 6 146 7 128 8 104 9 121 10 136 11 130 12 126 13 120 14 132 15 112 16 119 17 114 18 108 19 119 20 103 21 110 22 109 23 104 24 101 25 84 26 77 27 72 28 77 29 65 30 50 31 46 32 40 33 36 34 26 35 26 36 20 37 18 38 12 39 6 40 7 41 7 42 5 43 5 44 2 45 4 46 3 47 2 48 1 50 1 Household sub-number (if separated) Household sub-number (if separated) 3724 0 3 0 3660 1 30 2 29 3 5 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3724 1 25 1 425 2 1239 3 287 4 1224 5 34 6 49 7 104 8 139 9 74 10 53 11 33 12 18 13 7 14 8 15 9 16 10 17 1 18 3 19 3 21 2 23 1 25 1 912. Did (name) drink anything milk or liquidy from a bottle with a nipple yeste Did (name) drink anything milk or liquidy from a bottle with a nipple yesterday or last night? 2582 1142 1 8 1 Yes 1578 2 Nothing 998 8 Do not know 6 Sysmiss 1142 CO code CO Code 61968 8 593 Household number Household No. (copy from Q104) 61968 1 50 1 3048 2 2256 3 2184 4 2520 5 2568 6 2304 7 1944 8 1920 9 2064 10 2184 11 2400 12 2136 13 1728 14 2040 15 1704 16 1656 17 1824 18 1944 19 1968 20 1728 21 1968 22 1968 23 1680 24 1776 25 1488 26 1344 27 1320 28 1296 29 1248 30 936 31 816 32 792 33 624 34 432 35 432 36 336 37 360 38 192 39 144 40 144 41 120 42 96 43 120 44 48 45 48 46 72 47 24 50 24 Household sub-number (if separated) Household sub-number (if separated) 61968 0 3 0 60864 1 480 2 528 3 96 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 61968 1 25 1 6360 2 18432 3 4848 4 22128 5 648 6 936 7 1968 8 2616 9 1296 10 984 11 552 12 336 13 168 14 168 15 168 16 120 17 24 18 48 19 72 21 48 23 24 25 24 913. liquids or foods - A. Item 61968 1 24 1 Breast milk 2582 2 Plain water 2582 3 Milk such as commercially produced infant formula 2582 4 Any fortified, commercially available infant and young child food 2582 5 Any other porridge or gruel 2582 6 Fresh animal milk 2582 7 Yogurt or other milk products 2582 8 Rice, chapattis other foods made from grains such as millet, maize, lito 2582 9 White potatoes or other [roots] tubers 2582 10 Pupmkin, carrots, or other yellow or orange vegetables 2582 11 Ripe mangoes, papaya, or other yellow or orange fruits 2582 12 Any dark green leafy vegetables 2582 13 Other fruits such as banana, orange, apple 2582 14 Eggs 2582 15 Any meat such as goat, lamb, chicken, pork, ducks 2582 16 Any organ meat such as liver, kidney 2582 17 Fresh or dried fish or shellfish/dried meat 2582 18 Snails or other small protein foods 2582 19 Lentils, beans, peas, or nuts 2582 20 Any oils, fats or foods made with any of these foods 2582 21 Tea 2582 22 Sugary foods such as sweets, chocolate 2582 23 Processed foods such as biscuits, noodles 2582 24 Any other solid or soft foods/JAAND 2582 913. liquids or foods - B. Yes/No? 61968 1 2 1 Yes 11955 2 No 50013 CO code CO Code 3724 8 593 Household number Household No. copy from Q104 3724 1 50 1 182 2 154 3 149 4 149 5 156 6 146 7 128 8 104 9 121 10 136 11 130 12 126 13 120 14 132 15 112 16 119 17 114 18 108 19 119 20 103 21 110 22 109 23 104 24 101 25 84 26 77 27 72 28 77 29 65 30 50 31 46 32 40 33 36 34 26 35 26 36 20 37 18 38 12 39 6 40 7 41 7 42 5 43 5 44 2 45 4 46 3 47 2 48 1 50 1 Household sub-number (if separated) Household sub-number (if separated) 3724 0 3 0 3660 1 30 2 29 3 5 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3724 1 25 1 425 2 1239 3 287 4 1224 5 34 6 49 7 104 8 139 9 74 10 53 11 33 12 18 13 7 14 8 15 9 16 10 17 1 18 3 19 3 21 2 23 1 25 1 914. How many times did (name) youngest child eat solid, semi-solid, or soft foo How many times did (name) youngest child eat solid, semi-solid, or soft food other than liquids yesterday during the day or at night? 2582 1142 0 98 0 722 1 24 2 189 3 540 4 608 5 244 6 138 7 23 8 48 9 6 10 15 12 4 14 1 98 Do not know 20 Sysmiss 1142 CO code CO Code 29175 8 593 Household number Household No. (copy from Q104) 29175 1 47 1 1560 2 1215 3 1035 4 1365 5 1185 6 1140 7 900 8 990 9 1020 10 1125 11 1185 12 1110 13 825 14 1050 15 750 16 735 17 900 18 960 19 1035 20 780 21 780 22 900 23 840 24 795 25 600 26 555 27 510 28 600 29 525 30 360 31 330 32 330 33 285 34 150 35 165 36 150 37 105 38 45 39 75 40 45 41 30 42 15 43 30 44 30 45 30 46 15 47 15 Household sub-number (if separated) Household sub-number (if separated) 29175 0 3 0 28560 1 255 2 300 3 60 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 29175 1 25 1 3285 2 8910 3 2220 4 9990 5 285 6 480 7 930 8 1230 9 615 10 420 11 225 12 195 13 60 14 90 15 75 16 75 17 15 18 15 21 30 23 15 25 15 915. Food usually given to the child - A. Type of food 29175 1 15 1 Solid (Dal Bhat Vegetable) 1945 2 Semi-solid (Jaulo/Porridge) 1945 3 Mashed/pureed 1945 4 Liquidy 1945 5 Milk 1945 6 Biscuit 1945 7 Horlicks 1945 8 Cerelac 1945 9 HALUWA 1945 10 Noodles 1945 11 Egg 1945 12 Meat 1945 13 Bread 1945 14 Fruits 1945 15 Others 1945 915. Food usually given to the child - B. Given/not given 29175 1 2 1 Given 8624 2 Not given 20551 CO code CO Code 3724 8 593 Household number Household No. (copy from Q104) 3724 1 50 1 182 2 154 3 149 4 149 5 156 6 146 7 128 8 104 9 121 10 136 11 130 12 126 13 120 14 132 15 112 16 119 17 114 18 108 19 119 20 103 21 110 22 109 23 104 24 101 25 84 26 77 27 72 28 77 29 65 30 50 31 46 32 40 33 36 34 26 35 26 36 20 37 18 38 12 39 6 40 7 41 7 42 5 43 5 44 2 45 4 46 3 47 2 48 1 50 1 Household sub-number (if separated) Household sub-number (if separated) 3724 0 3 0 3660 1 30 2 29 3 5 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3724 1 25 1 425 2 1239 3 287 4 1224 5 34 6 49 7 104 8 139 9 74 10 53 11 33 12 18 13 7 14 8 15 9 16 10 17 1 18 3 19 3 21 2 23 1 25 1 916. Did the child receive vitamin A capsule within the last 6 months? Did the child receive vitamin A capsule within the last 6 months? 2582 1142 1 3 1 Yes 1768 2 No 332 3 Child below 6 months old 482 Sysmiss 1142 917. How many hours were you away from your child due to work or other reasons d How many hours were you away from your child due to work or other reasons during the past 24 hours? (If answer is no or less than 1 hour, record 00) 2582 1142 0 12 0 1991 1 103 2 145 3 135 4 104 5 62 6 25 7 4 8 7 9 3 10 1 11 1 12 1 Sysmiss 1142 918. Did you say you would feed the baby later when he/she (name) expressed the Did you say you would feed the baby later when he/she (name) expressed the desire for it (within the last 24 hours)? 591 3133 1 2 1 I did 24 2 I did not 567 Sysmiss 3133 CO code CO Code 4668 8 593 Household number Household No. (copy from Q104) 4668 1 50 1 219 2 186 3 189 4 185 5 200 6 176 7 158 8 155 9 150 10 164 11 156 12 158 13 143 14 155 15 138 16 149 17 149 18 146 19 150 20 136 21 142 22 132 23 125 24 121 25 112 26 101 27 88 28 100 29 77 30 65 31 55 32 48 33 45 34 35 35 32 36 26 37 25 38 18 39 12 40 9 41 9 42 6 43 6 44 2 45 4 46 4 47 4 48 2 50 1 Household sub-number (if separated) Household sub-number (if separated) 4668 0 3 0 4596 1 34 2 33 3 5 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 4668 1 25 1 440 2 1322 3 369 4 1650 5 52 6 81 7 169 8 216 9 120 10 81 11 61 12 35 13 15 14 12 15 16 16 11 17 2 18 3 19 5 21 4 23 1 24 1 25 2 1001. Weight of the female respondent (in kilograms) Now, I would like to talk to you about your physical feature and request for measuring weight and height Weight of the female respondent (in kilograms). 3907 761 26.5 998 998 Could not weigh 2 Sysmiss 761 1002. Height of the female respondent (in centimeters) Height of the female respondent (in centimeters) (Scale the height in nearest 0.5 centimeter, for example, if the height is 150.4-150.7 write 150.5, if the height is 150.8 or 150.9 write 151.0 3907 761 115 998 998 Could not measure 4 Sysmiss 761 1003A. How many children under 5 years of age in your household from the eligibl How many children under 3 years (0-36 months or up to 36 months 30 days) of age in your household from the eligible woman? [If this is 0, it is the end of the interview.] 4668 0 4 0 342 1 3062 2 1206 3 57 4 1 1003B. Interviewed children under 5 years of age (for Section 11)? Interviewed children under 5 years of age (for Section 11)? 4326 342 0 4 0 674 1 2617 2 995 3 39 4 1 Sysmiss 342 1004. Weight of mother holding child #1 (kilograms) If child is below 24 months 30 days, ask the mother to hold the child, weigh both mother and child. If the child is 25 months or older, do not fill out Q1004-1006. Weight of mother holding child #1 (kilograms) 4326 342 31.5 999 998 Could not weigh 7 999 NA (>=25 months child) 1813 Sysmiss 342 1004. ID CODE OF CHILD #1 If child is below 24 months 30 days, ask the mother to hold the child, weigh both mother and child. If the child is 25 months or older, do not fill out Q1004-1006. ID CODE OF CHILD 1 (HH Roster) 2513 2155 3 28 3 118 4 241 5 672 6 573 7 307 8 213 9 136 10 83 11 56 12 33 13 25 14 15 15 12 16 6 17 7 18 2 19 2 20 6 22 3 24 1 25 1 28 1 Sysmiss 2155 1005. Weight of mother holding child #2 (kilograms) If child is below 24 months 30 days, ask the mother to hold the child, weigh both mother and child. If the child is 25 months or older, do not fill out Q1004-1006. Weight of mother holding child #2 (kilograms) 1264 3404 37.4000015258789 999 37.4000015258789 1 38.5 1 39.4000015258789 1 40.2000007629395 1 41 1 41.2000007629395 1 41.4000015258789 1 41.7000007629395 1 42.2999992370605 1 42.7000007629395 1 42.7999992370605 1 43.5999984741211 1 44 3 44.7999992370605 1 45.4000015258789 1 45.5 2 45.5999984741211 1 45.7000007629395 1 46 2 46.0999984741211 1 46.4000015258789 2 46.5 1 47.0999984741211 2 47.2000007629395 2 47.5 1 47.7999992370605 1 48.2000007629395 1 48.2999992370605 1 48.5999984741211 1 48.7000007629395 2 48.9000015258789 1 49 2 49.4000015258789 2 49.5999984741211 2 49.7000007629395 1 50 3 50.2999992370605 1 50.4000015258789 2 50.7000007629395 2 50.7999992370605 2 51.2000007629395 2 51.2999992370605 1 51.5999984741211 3 51.7999992370605 1 51.9000015258789 2 52 4 52.2999992370605 1 52.4000015258789 1 52.5999984741211 2 52.7999992370605 1 53 1 53.0999984741211 2 53.4000015258789 2 53.5999984741211 1 53.7000007629395 1 54 2 54.2999992370605 1 54.5 1 54.7000007629395 2 55 1 55.2000007629395 1 55.4000015258789 1 55.5999984741211 1 56 7 56.2000007629395 1 56.2999992370605 2 56.4000015258789 2 56.5999984741211 1 56.7000007629395 2 56.7999992370605 1 57 2 57.4000015258789 1 57.7999992370605 1 57.9000015258789 1 58 2 58.2999992370605 1 59.0999984741211 1 59.2000007629395 1 59.9000015258789 1 61 1 61.7999992370605 1 62.2000007629395 1 62.5 1 63.7999992370605 1 63.9000015258789 1 64 1 64.0999984741211 1 65.5999984741211 1 70.1999969482422 1 71.0999984741211 1 73 1 73.6999969482422 1 998 Could not weigh 0 999 NA (>=25 months child) 1133 Sysmiss 3404 1005. ID CODE OF CHILD #2 If child is below 24 months 30 days, ask the mother to hold the child, weigh both mother and child. If the child is 25 months or older, do not fill out Q1004-1006. ID CODE OF CHILD 2 (HH Roster) 131 4537 3 20 3 2 4 14 5 22 6 40 7 22 8 11 9 4 10 8 11 1 12 1 13 2 15 2 16 1 20 1 Sysmiss 4537 1006. Weight of mother holding child #3 (kilograms) If child is below 24 months 30 days, ask the mother to hold the child, weigh both mother and child. If the child is 25 months or older, do not fill out Q1004-1006. Weight of mother holding child #3 (kilograms) 58 4610 48.5 999 48.5 1 998 Could not weigh 0 999 NA (>=25 months child) 57 Sysmiss 4610 1006. ID CODE OF CHILD #3 If child is below 24 months 30 days, ask the mother to hold the child, weigh both mother and child. If the child is 25 months or older, do not fill out Q1004-1006. ID CODE OF CHILD 3 (HH Roster) 1 4667 5 5 5 1 Sysmiss 4667 1006A. Weight of mother holding child #4 (kilograms) If child is below 24 months 30 days, ask the mother to hold the child, weigh both mother and child. If the child is 25 months or older, do not fill out Q1004-1006. Weight of mother holding child #4 (kilograms) 2 4666 999 999 998 Could not weigh 0 999 NA (>=25 months child) 2 Sysmiss 4666 1006A. ID CODE OF CHILD #4 If child is below 24 months 30 days, ask the mother to hold the child, weigh both mother and child. If the child is 25 months or older, do not fill out Q1004-1006. ID CODE OF CHILD 4 (HH Roster) 4668 * Sysmiss 4668 CO code CO Code 4728 8 593 Household number Household No. (copy from Q104) 4728 1 50 1 244 2 205 3 192 4 188 5 212 6 177 7 177 8 144 9 151 10 169 11 176 12 165 13 155 14 164 15 147 16 147 17 148 18 153 19 160 20 132 21 145 22 139 23 131 24 121 25 100 26 90 27 88 28 92 29 77 30 58 31 57 32 44 33 37 34 25 35 26 36 19 37 19 38 11 39 5 40 9 41 7 42 3 43 6 44 2 45 4 46 3 47 2 48 1 50 1 Household sub-number (if separated) Household sub-number (if separated) 4728 0 3 0 4650 1 37 2 36 3 5 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 4728 1 25 1 522 2 1585 3 371 4 1584 5 36 6 53 7 128 8 168 9 94 10 67 11 36 12 23 13 11 14 11 15 10 16 13 17 2 18 5 19 3 21 3 23 2 25 1 ID Code of child According to Q1003, ask the following questions about children under 3 years (0-36 months) of age and measure weight and height of those children. If the child is below 24 m 30 d ask the mother to hold the child and take measurements of both together, and then calculate the child’s weight deducting that of the mother’s. ID CODE of Children (From HH Roster) 4728 2 28 2 1 3 278 4 528 5 1358 6 1002 7 556 8 347 9 224 10 141 11 99 12 60 13 39 14 25 15 20 16 12 17 12 18 4 19 6 20 8 22 4 24 2 25 1 28 1 1007. Date of Birth of Child - DD 4728 1 32 1 274 2 239 3 183 4 219 5 264 6 188 7 163 8 174 9 128 10 320 11 115 12 161 13 128 14 134 15 261 16 133 17 115 18 119 19 101 20 265 21 87 22 98 23 87 24 84 25 176 26 88 27 108 28 109 29 114 30 69 31 21 32 3 1007. Date of Birth of Child - MM 4728 1 12 1 294 2 318 3 346 4 442 5 575 6 560 7 532 8 411 9 329 10 358 11 333 12 230 1007. Date of Birth of Child - YY 4728 2067 2071 2067 244 2068 1070 2069 1364 2070 1388 2071 662 1008. Was there any problem at delivery of this child (delivery complications)? Was there any problem at delivery of this child (delivery complications)? 4728 1 2 1 Yes 978 2 No 3750 1009. How long was the child breastfed? How long was the child breastfed? (Specify breastfed period in months. If not breastfed, write 00. If currently breastfeeding, write 99) 4728 0 99 0 Not breastfed 36 1 5 2 3 3 6 4 7 5 3 6 33 7 10 8 59 9 25 10 32 11 22 12 180 13 21 14 26 15 52 16 44 17 14 18 254 19 16 20 66 21 9 22 22 23 16 24 361 25 21 26 23 27 22 28 26 29 8 30 45 31 6 32 2 34 6 35 4 36 37 37 1 39 1 99 Currently breastfeeding 3204 1010. Has child been occulated? Has child been occulated? [BCG(1); DPT(3); Polio(3); Measles(1)] 4728 1 3 1 Fully occulated 3137 2 Being fully occulated 1316 3 Not occulated 275 1011. Height of Child If height not measured record 999 and go to Q1013 4728 39 999 999 Not measured 143 1012. Height is measured laying or standing Height is measured laying or standing 4585 143 1 2 1 Laying 2129 2 Standing 2456 Sysmiss 143 1013. Weight of Child Weight of Child If weight not measured record 999 and go to Q1015 4728 1.89999997615814 999 999 Not measured 136 1014. Was child weighed with the mother or alone? Was child weighed with the mother or alone? → Go To Next Member 4592 136 1 2 1 Alone 2079 2 With mum 2513 Sysmiss 136 1015. Reason for not taking Height/Weight Reason for not taking Height/Weight (If you filled out 999 for question 1011 or 1013) 136 4592 1 3 1 Child not at home 88 2 Child was sick 21 3 Not allowed to take Height/Weight 27 Sysmiss 4592 CO code CO Code 4728 8 593 Household number Household No. (copy from Q104) 4728 1 50 1 244 2 205 3 192 4 188 5 212 6 177 7 177 8 144 9 151 10 169 11 176 12 165 13 155 14 164 15 147 16 147 17 148 18 153 19 160 20 132 21 145 22 139 23 131 24 121 25 100 26 90 27 88 28 92 29 77 30 58 31 57 32 44 33 37 34 25 35 26 36 19 37 19 38 11 39 5 40 9 41 7 42 3 43 6 44 2 45 4 46 3 47 2 48 1 50 1 Household sub-number (if separated) Household sub-number (if separated) 4728 0 3 0 4650 1 37 2 36 3 5 ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women and Child] Name and ID Code of Respondent -HH Roster 4728 1 25 1 522 2 1585 3 371 4 1584 5 36 6 53 7 128 8 168 9 94 10 67 11 36 12 23 13 11 14 11 15 10 16 13 17 2 18 5 19 3 21 3 23 2 25 1 ID Code of child ID Code of Child (See HH Roster) 4728 2 28 2 1 3 278 4 528 5 1358 6 1002 7 556 8 347 9 224 10 141 11 99 12 60 13 39 14 25 15 20 16 12 17 12 18 4 19 6 20 8 22 4 24 2 25 1 28 1 Age of chid (month) [Attention: Use the ASQ Questionnaire according to the ages you marked in the table.] 4728 1 58 1101A. COMMUNICATION: 01. Does your baby sometimes make throaty or gurgling soun Does your baby sometimes make throaty or gurgling sounds? 207 4521 1 2 1 Yes 177 2 No 30 Sysmiss 4521 1101A. COMMUNICATION: 02. Does your baby make cooing sounds such as ?ooo,? ?gah, Does your baby make cooing sounds such as “ooo,” “gah,” and “aah”? 207 4521 1 2 1 Yes 168 2 No 39 Sysmiss 4521 1101A. COMMUNICATION: 03. When you speak to your baby, does she make sounds back When you speak to your baby, does she make sounds back to you? 207 4521 1 2 1 Yes 121 2 No 86 Sysmiss 4521 1101A. COMMUNICATION: 04. Does your baby smile when you talk to him? Does your baby smile when you talk to him? 439 4289 1 2 1 Yes 385 2 No 54 Sysmiss 4289 1101A. COMMUNICATION: 05. Does your baby chuckle softly? Does your baby chuckle softly? 439 4289 1 2 1 Yes 297 2 No 142 Sysmiss 4289 1101A. COMMUNICATION: 06. After you have been out of sight, does your baby smile After you have been out of sight, does your baby smile or get excited when she sees you? 439 4289 1 2 1 Yes 311 2 No 128 Sysmiss 4289 1101A. COMMUNICATION: 07. Does your baby make high-pitched squeals? Does your baby make high-pitched squeals? 384 4344 1 2 1 Yes 330 2 No 54 Sysmiss 4344 1101A. COMMUNICATION: 08. Does your baby make sounds when looking at toys or peo Does your baby make sounds when looking at toys or people? 529 4199 1 2 1 Yes 423 2 No 106 Sysmiss 4199 1101A. COMMUNICATION: 09. If you call your baby when you are out of sight, does If you call your baby when you are out of sight, does she look in the direction of your voice? 529 4199 1 2 1 Yes 442 2 No 87 Sysmiss 4199 1101A. COMMUNICATION: 10. When a loud noise occurs, does your baby turn to see w When a loud noise occurs, does your baby turn to see where the sound came from? 297 4431 1 2 1 Yes 253 2 No 44 Sysmiss 4431 1101A. COMMUNICATION: 11. If you copy the sounds your baby makes, does your baby If you copy the sounds your baby makes, does your baby repeat the same sounds back to you? 506 4222 1 2 1 Yes 318 2 No 188 Sysmiss 4222 1101A. COMMUNICATION: 12. Does your baby respond to the tone of your voice and s Does your baby respond to the tone of your voice and stop his activity at least briefly when you say “no-no” to him? 506 4222 1 2 1 Yes 228 2 No 278 Sysmiss 4222 1101A. COMMUNICATION: 13. Does your baby make two similar sounds like ?ba-ba,? ? Does your baby make two similar sounds like “ba-ba,” “da-da,” or “ga-ga”? (The sounds do not need to mean anything.) 589 4139 1 2 1 Yes 557 2 No 32 Sysmiss 4139 1101A. COMMUNICATION: 14. If you ask your baby to, does he play at least one nur If you ask your baby to, does he play at least one nursery game even if you don’t show him the activity yourself (such as “bye-bye,” “Peeka- boo,” “clap your hands,” “So Big”)? 444 4284 1 2 1 Yes 299 2 No 145 Sysmiss 4284 1101A. COMMUNICATION: 15. Does your baby follow one simple command, such as ?Com Does your baby follow one simple command, such as “Come here,” “Give it to me,” or “Put it back,” without your using gestures? 742 3986 1 2 1 Yes 433 2 No 309 Sysmiss 3986 1101A. COMMUNICATION: 16. Does your baby say three words, such as ?Mama,? ?Dada, Does your baby say three words, such as “Mama,” “Dada,” and “Baba”? (A “word” is a sound or sounds your baby says consistently to mean someone or something.) 444 4284 1 2 1 Yes 318 2 No 126 Sysmiss 4284 1101A. COMMUNICATION: 17. When your baby wants something, does he tell you by po When your baby wants something, does he tell you by pointing to it? 1058 3670 1 2 1 Yes 935 2 No 123 Sysmiss 3670 1101A. COMMUNICATION: 18. Does your baby shake his head when he means ?no? or ?y Does your baby shake his head when he means “no” or “yes”? 533 4195 1 2 1 Yes 329 2 No 204 Sysmiss 4195 1101A. COMMUNICATION: 19. Does your baby point to, pat, or try to pick up pictur Does your baby point to, pat, or try to pick up pictures in a book? 598 4130 1 2 1 Yes 506 2 No 92 Sysmiss 4130 1101A. COMMUNICATION: 20. Does your baby say four or more words in addition to ? Does your baby say four or more words in addition to “Mama” and “Dada”? 823 3905 1 2 1 Yes 555 2 No 268 Sysmiss 3905 1101A. COMMUNICATION: 21. When you ask her to, does your baby go into another ro When you ask her to, does your baby go into another room to find a familiar toy or object? (You might ask, “Where is your ball?” or say, “Bring me your coat,” or “Go get your blanket.”) 823 3905 1 2 1 Yes 557 2 No 266 Sysmiss 3905 1101A. COMMUNICATION: 22. Does your child imitate a two-word sentence? For examp Does your child imitate a two-word sentence? For example, when you say a two-word phrase, such as “Mama eat,” “Daddy play,” “Go home,” or “What’s this?” does your child say both words back to you? (Mark “yes” even if her words are difficult to understand.) 679 4049 1 2 1 Yes 225 2 No 454 Sysmiss 4049 1101A. COMMUNICATION: 23. Without your showing him, does your child point to the Without your showing him, does your child point to the correct picture when you say, “Show me the kitty,” or ask, “Where is the dog?” (He needs to identify only one picture correctly.) 1131 3597 1 2 1 Yes 574 2 No 557 Sysmiss 3597 1101A. COMMUNICATION: 24. Does your child say two or three words that represent Does your child say two or three words that represent different ideas together, such as “See dog,” “Mommy come home,” or “Kitty gone”? (Don’t count word combinations that express one idea, such as “bye- bye,” “all gone,” “all right,” and “What’s that?”) 831 3897 1 2 1 Yes 475 2 No 356 Sysmiss 3897 1101A. COMMUNICATION: 25. If you point to a picture of a ball (kitty, cup, hat, If you point to a picture of a ball (kitty, cup, hat, etc.) and ask your child, “What is this?” does your child correctly name at least one picture? 1042 3686 1 2 1 Yes 586 2 No 456 Sysmiss 3686 1101A. COMMUNICATION: 26. Without your giving him clues by pointing or using ges 1953 2775 1 2 1 Yes 1717 2 No 236 Sysmiss 2775 1101A. COMMUNICATION: 27. When you ask your child to point to her nose, eyes, ha When you ask your child to point to her nose, eyes, hair, feet, ears, and so forth, does she correctly point to at least seven body parts? (She can point to parts of herself, you, or a doll. Mark “sometimes” if she correctly points to at least three different body parts.) 1953 2775 1 2 1 Yes 1627 2 No 326 Sysmiss 2775 1101A. COMMUNICATION: 28. Does your child correctly use at least two words like Does your child correctly use at least two words like “me,” “I,” “mine,” and “you”? 888 3840 1 2 1 Yes 576 2 No 312 Sysmiss 3840 1101A. COMMUNICATION: 29. Does your child make sentences that are three or four Does your child make sentences that are three or four words long? Please give an example: 1347 3381 1 2 1 Yes 1083 2 No 264 Sysmiss 3381 1101A. COMMUNICATION: 30. Without giving your child help by pointing or using ge Without giving your child help by pointing or using gestures, ask him to “put the book on the table” and “put the shoe under the chair.” Does your child carry out both of these directions correctly? 1347 3381 1 2 1 Yes 1026 2 No 321 Sysmiss 3381 1101A. COMMUNICATION: 31. When looking at a picture book, does your child tell y When looking at a picture book, does your child tell you what is hap- pening or what action is taking place in the picture (for example, “bark- ing,” “running,” “eating,” or “crying”)? You may ask, “What is the dog (or boy) doing?” 911 3817 1 2 1 Yes 581 2 No 330 Sysmiss 3817 1101A. COMMUNICATION: 32. When you ask, ?What is your name?? does your child say When you ask, “What is your name?” does your child say his first name or nickname? 911 3817 1 2 1 Yes 698 2 No 213 Sysmiss 3817 1101A. COMMUNICATION: 33. Without your giving help by pointing or repeating dire Without your giving help by pointing or repeating directions, does your child follow three directions that are unrelated to one another? Give all three directions before your child starts. For example, you may ask your child, “Clap your hands, walk to the door, and sit down,” or “Give me the pen, open the book, and stand up.” 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101A. COMMUNICATION: 34. Does your child use all of the words in a sentence to Does your child use all of the words in a sentence (for example, “a,” “the,” “am,” “is,” and “are”) to make complete sentences, such as “I am going to the park,” or “Is there a toy to play with?” or “Are you coming, too?” 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101A. COMMUNICATION: 35. Does your child name at least three items from a commo Does your child name at least three items from a common category? For example, if you say to your child, “Tell me some things that you can eat,” does your child answer with something like “cookies, eggs, and cereal”? Or if you say, “Tell me the names of some animals,” does your child answer with something like “cow, dog, and elephant”? 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101A. COMMUNICATION: 36. Does your child answer the following questions? - 1. ? 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101A. COMMUNICATION: 37. Does your child tell you at least two things about com Does your child tell you at least two things about common objects? For example, if you say to your child, “Tell me about your ball,” does she say something like, “It’s round. I throw it. It’s big”? 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101A. COMMUNICATION: 38. Does your child use endings of words, such as ?-s,? ?- Does your child use endings of words, such as “-s,” “-ed,” and “-ing”? For example, does your child say things like, “I see two cats,” “I am playing,” or “I kicked the ball”? 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101A. COMMUNICATION: 39. Does your child use four- and five-word sentences? For Does your child use four- and five-word sentences? For example, does your child say, “I want the car”? 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101A. COMMUNICATION: 40. When talking about something that already happened, do When talking about something that already happened, does your child use words that end in “-ed,” such as “walked,” “jumped,” or “played”? Ask your child questions, such as “How did you get to the store?” (“We walked.”) “What did you do at your friend’s house?” (“We played.”) 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101A. COMMUNICATION: 41. Does your child use comparison words, such as ?heavier Does your child use comparison words, such as “heavier,” “stronger,” or “shorter”? Ask your child questions, such as “A car is big, but a bus is _____” (bigger); “A cat is heavy, but a man is _____” (heavier); “A TV is small, but a book is _____” (smaller). 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101A. COMMUNICATION: 42. Does your child repeat the sentences shown below back 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101B. GROSS MOTOR: 01. While your baby is on his back, does he wave his arms an While your baby is on his back, does he wave his arms and legs, wiggle, and squirm? 207 4521 1 2 1 Yes 186 2 No 21 Sysmiss 4521 1101B. GROSS MOTOR: 02. When your baby is on her tummy does she turn her head to When your baby is on her tummy does she turn her head to the side? 207 4521 1 2 1 Yes 103 2 No 104 Sysmiss 4521 1101B. GROSS MOTOR: 03. When your baby is on his tummy, does he hold his head up When your baby is on his tummy, does he hold his head up longer than a few seconds? 207 4521 1 2 1 Yes 46 2 No 161 Sysmiss 4521 1101B. GROSS MOTOR: 04. When your baby is on her back, does she kick her legs? When your baby is on her back, does she kick her legs? 439 4289 1 2 1 Yes 366 2 No 73 Sysmiss 4289 1101B. GROSS MOTOR: 05. After holding her head up while on her tummy does your b After holding her head up while on her tummy does your baby lay her head down on the floor, rather than let it drop or fall forward? 439 4289 1 2 1 Yes 131 2 No 308 Sysmiss 4289 1101B. GROSS MOTOR: 06. When your baby is on his tummy, does he hold his head up When your baby is on his tummy, does he hold his head up so that his chin is about 3 inches from the floor for at least 15 seconds? 439 4289 1 2 1 Yes 104 2 No 335 Sysmiss 4289 1101B. GROSS MOTOR: 07. When your baby is on her tummy, does she hold her head s When your baby is on her tummy, does she hold her head straight up, looking around? 232 4496 1 2 1 Yes 55 2 No 177 Sysmiss 4496 1101B. GROSS MOTOR: 08. When you hold him in a sitting position, does your baby When you hold him in a sitting position, does your baby hold his head steady? 384 4344 1 2 1 Yes 174 2 No 210 Sysmiss 4344 1101B. GROSS MOTOR: 09. While your baby is on his back, does your baby lift his While your baby is on his back, does your baby lift his legs high enough to see his feet? 384 4344 1 2 1 Yes 271 2 No 113 Sysmiss 4344 1101B. GROSS MOTOR: 10. Does your baby roll from his back to his tummy, getting Does your baby roll from his back to his tummy, getting both arms out from under him? 297 4431 1 2 1 Yes 248 2 No 49 Sysmiss 4431 1101B. GROSS MOTOR: 11. When you put your baby on the floor, does she lean on he When you put your baby on the floor, does she lean on her hands while sitting? (If she already sits up straight without leaning on her hands, mark “yes” for this item.) 297 4431 1 2 1 Yes 186 2 No 111 Sysmiss 4431 1101B. GROSS MOTOR: 12. If you hold both hands just to balance your baby, does h If you hold both hands just to balance your baby, does he support his own weight while standing? 506 4222 1 2 1 Yes 311 2 No 195 Sysmiss 4222 1101B. GROSS MOTOR: 13. Does your baby get into a crawling position by getting u Does your baby get into a crawling position by getting up on her hands and knees? 506 4222 1 2 1 Yes 323 2 No 183 Sysmiss 4222 1101B. GROSS MOTOR: 14. When sitting on the floor, does your baby sit up straigh When sitting on the floor, does your baby sit up straight for several minutes without using her hands for support? 354 4374 1 2 1 Yes 259 2 No 95 Sysmiss 4374 1101B. GROSS MOTOR: 15. When you stand your baby next to furniture or the crib r When you stand your baby next to furniture or the crib rail, does he hold on without leaning his chest against the furniture for support? 589 4139 1 2 1 Yes 404 2 No 185 Sysmiss 4139 1101B. GROSS MOTOR: 16. Does your baby walk beside furniture while holding on wi Does your baby walk beside furniture while holding on with only one hand? 444 4284 1 2 1 Yes 265 2 No 179 Sysmiss 4284 1101B. GROSS MOTOR: 17. If you hold both hands just to balance your baby, does h If you hold both hands just to balance your baby, does he take several steps without tripping or falling? (If your baby already walks alone, mark “yes” for this item.) 742 3986 1 2 1 Yes 415 2 No 327 Sysmiss 3986 1101B. GROSS MOTOR: 18. When you hold one hand just to balance your baby, does s When you hold one hand just to balance your baby, does she take several steps forward? (If your baby already walks alone, mark “yes” for this item.) 533 4195 1 2 1 Yes 363 2 No 170 Sysmiss 4195 1101B. GROSS MOTOR: 19. Does your baby stand up in the middle of the floor by hi Does your baby stand up in the middle of the floor by himself and take several steps forward? 833 3895 1 2 1 Yes 426 2 No 407 Sysmiss 3895 1101B. GROSS MOTOR: 20. Does your baby bend over or squat to pick up an object f Does your baby bend over or squat to pick up an object from the floor and then stand up again without any support? 833 3895 1 2 1 Yes 436 2 No 397 Sysmiss 3895 1101B. GROSS MOTOR: 21. Does your baby move around by walking, rather than by cr Does your baby move around by walking, rather than by crawling on his hands and knees? 823 3905 1 2 1 Yes 569 2 No 254 Sysmiss 3905 1101B. GROSS MOTOR: 22. Does your child walk well and seldom fall? Does your child walk well and seldom fall? 679 4049 1 2 1 Yes 446 2 No 233 Sysmiss 4049 1101B. GROSS MOTOR: 23. Does your child climb on an object such as a chair to re Does your child climb on an object such as a chair to reach something he wants (for example, to get a toy on a counter or to “help” you in the kitchen)? 977 3751 1 2 1 Yes 550 2 No 427 Sysmiss 3751 1101B. GROSS MOTOR: 24. Does your child walk down stairs if you hold onto one of Does your child walk down stairs if you hold onto one of her hands? She may also hold onto the railing or wall. (You can look for this at a store, on a playground, or at home.) 899 3829 1 2 1 Yes 609 2 No 290 Sysmiss 3829 1101B. GROSS MOTOR: 25. When you show your child how to kick a large ball, does When you show your child how to kick a large ball, does he try to kick the ball by moving his leg forward or by walking into it? (If your child already kicks a ball, mark “yes” for this item.) 831 3897 1 2 1 Yes 622 2 No 209 Sysmiss 3897 1101B. GROSS MOTOR: 26. Does your child run fairly well, stopping herself withou Does your child run fairly well, stopping herself without bumping into things or falling? 1844 2884 1 2 1 Yes 1446 2 No 398 Sysmiss 2884 1101B. GROSS MOTOR: 27. Does your child walk either up or down at least two step Does your child walk either up or down at least two steps by himself? He may also hold onto the railing or wall. 1350 3378 1 2 1 Yes 1036 2 No 314 Sysmiss 3378 1101B. GROSS MOTOR: 28. Does your child jump with both feet leaving the floor at Does your child jump with both feet leaving the floor at the same time? 1799 2929 1 2 1 Yes 1197 2 No 602 Sysmiss 2929 1101B. GROSS MOTOR: 29. Without holding onto anything for support, does your chi Without holding onto anything for support, does your child kick a ball by swinging his leg forward? 1799 2929 1 2 1 Yes 1468 2 No 331 Sysmiss 2929 1101B. GROSS MOTOR: 30. Does your child walk up stairs, using only one foot on e Does your child walk up stairs, using only one foot on each stair? (The left foot is on one step, and the right foot is on the next.) She may hold onto the railing or wall. 1579 3149 1 2 1 Yes 974 2 No 605 Sysmiss 3149 1101B. GROSS MOTOR: 31. Does your child stand on one foot for about 1 second wit Does your child stand on one foot for about 1 second without holding onto anything? 1347 3381 1 2 1 Yes 936 2 No 411 Sysmiss 3381 1101B. GROSS MOTOR: 32. While standing, does your child throw a ball overhand by While standing, does your child throw a ball overhand by raising his arm to shoulder height and throwing the ball forward? (Dropping the ball or throwing the ball underhand should be scored as “not yet.”) 603 4125 1 2 1 Yes 530 2 No 73 Sysmiss 4125 1101B. GROSS MOTOR: 33. Does your child jump forward at least 6 inches with both Does your child jump forward at least 6 inches with both feet leaving the ground at the same time? 334 4394 1 2 1 Yes 198 2 No 136 Sysmiss 4394 1101B. GROSS MOTOR: 34. Does your child catch a large ball with both hands? Does your child catch a large ball with both hands? (You should stand about 5 feet away and give your child two or three tries before you mark the answer.) 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101B. GROSS MOTOR: 35. Does your child climb the rungs of a ladder of a playgro Does your child climb the rungs of a ladder of a playground slide and slide down without help? 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101B. GROSS MOTOR: 36. Does your child hop up and down on either the right or l Does your child hop up and down on either the right or left foot at least one time without losing her balance or falling? 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101B. GROSS MOTOR: 37. Does your child jump forward a distance of 20 inches fro Does your child jump forward a distance of 20 inches from a standing position, starting with his feet together? 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101B. GROSS MOTOR: 38. Without holding onto anything, does your child stand on Without holding onto anything, does your child stand on one foot for at least 5 seconds without losing her balance and putting her foot down? (You may give your child two or three tries before you mark the answer.) 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101B. GROSS MOTOR: 39. Does your child walk on his tiptoes for 15 feet (about t Does your child walk on his tiptoes for 15 feet (about the length of a large car)? (You may show him how to do this.) 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101B. GROSS MOTOR: 40. Does your child hop forward on one foot for a distance o Does your child hop forward on one foot for a distance of 4–6 feet without putting down the other foot? (You may give her two tries on each foot.) 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101B. GROSS MOTOR: 41. Does your child skip using alternating feet? Does your child skip using alternating feet? (You may show him how to do this.) 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101C. FINE MOTOR : 01. Does your baby grasp your finger if you touch the palm o Does your baby grasp your finger if you touch the palm of her hand? 207 4521 1 2 1 Yes 150 2 No 57 Sysmiss 4521 1101C. FINE MOTOR : 02. When you put a toy in his hand, does your baby hold it i When you put a toy in his hand, does your baby hold it in his hand briefly? 439 4289 1 2 1 Yes 277 2 No 162 Sysmiss 4289 1101C. FINE MOTOR : 03. Does your baby touch her face with her hands? Does your baby touch her face with her hands? 207 4521 1 2 1 Yes 134 2 No 73 Sysmiss 4521 1101C. FINE MOTOR : 04. Does your baby hold his hands open or partly open when h Does your baby hold his hands open or partly open when he is awake (rather than in fists, as they were when he was a newborn)? 207 4521 1 2 1 Yes 113 2 No 94 Sysmiss 4521 1101C. FINE MOTOR : 05. Does your baby grab or scratch at her clothes? Does your baby grab or scratch at her clothes? 439 4289 1 2 1 Yes 307 2 No 132 Sysmiss 4289 1101C. FINE MOTOR : 06. When you put a toy in her hand, does your baby wave it a When you put a toy in her hand, does your baby wave it about, at least briefly? 439 4289 1 2 1 Yes 153 2 No 286 Sysmiss 4289 1101C. FINE MOTOR : 07. When you put a toy in her hand, does your baby hold onto When you put a toy in her hand, does your baby hold onto it for about 1 minute while looking at it, waving it about, or trying to chew it? 232 4496 1 2 1 Yes 105 2 No 127 Sysmiss 4496 1101C. FINE MOTOR : 08. When you hold your baby in a sitting position, does she When you hold your baby in a sitting position, does she reach for a toy on a table close by, even though her hand may not touch it? 384 4344 1 2 1 Yes 213 2 No 171 Sysmiss 4344 1101C. FINE MOTOR : 09. Does your baby grab a toy you offer and look at it, wave Does your baby grab a toy you offer and look at it, wave it about, or chew on it for about 1 minute? 384 4344 1 2 1 Yes 185 2 No 199 Sysmiss 4344 1101C. FINE MOTOR : 10. Does your baby reach for or grasp a toy using both hands Does your baby reach for or grasp a toy using both hands at once? 297 4431 1 2 1 Yes 236 2 No 61 Sysmiss 4431 1101C. FINE MOTOR : 11. Does your baby reach for a crumb or Cheerio and touch it Does your baby reach for a crumb or Cheerio and touch it with his finger or hand? (If he already picks up a small object the size of a pea, mark “yes” for this item.) 297 4431 1 2 1 Yes 180 2 No 117 Sysmiss 4431 1101C. FINE MOTOR : 12. Does your baby pick up a small toy, holding it in the ce 297 4431 1 2 1 Yes 236 2 No 61 Sysmiss 4431 1101C. FINE MOTOR : 13. Does your baby pick up a small toy with only one hand? Does your baby pick up a small toy with only one hand? 506 4222 1 2 1 Yes 333 2 No 173 Sysmiss 4222 1101C. FINE MOTOR : 14. Does your baby successfully pick up a crumb or Cheerio b Does your baby successfully pick up a crumb or Cheerio by using his thumb and all of his fingers in a raking motion? (If he already picks up a crumb or Cheerio, mark “yes” for this item.) 354 4374 1 2 1 Yes 229 2 No 125 Sysmiss 4374 1101C. FINE MOTOR : 15. After one or two tries, does your baby pick up a piece o After one or two tries, does your baby pick up a piece of string with her first finger and thumb? (The string may be attached to a toy.) 589 4139 1 2 1 Yes 296 2 No 293 Sysmiss 4139 1101C. FINE MOTOR : 16. Does your baby put a small toy down, without dropping it Does your baby put a small toy down, without dropping it, and then take her hand off the toy? 742 3986 1 2 1 Yes 428 2 No 314 Sysmiss 3986 1101C. FINE MOTOR : 17. Does your baby help turn the pages of a book? Does your baby help turn the pages of a book? (You may lift a page for him to grasp.) 1042 3686 1 2 1 Yes 520 2 No 522 Sysmiss 3686 1101C. FINE MOTOR : 18. Does your baby throw a small ball with a forward arm mot Does your baby throw a small ball with a forward arm motion? (If he simply drops the ball, mark “not yet” for this item.) 1267 3461 1 2 1 Yes 818 2 No 449 Sysmiss 3461 1101C. FINE MOTOR : 19. Does your baby stack a small block or toy on top of anot Does your baby stack a small block or toy on top of another one? (You could also use spools of thread, small boxes, or toys that are about 1 inch in size.) 1432 3296 1 2 1 Yes 610 2 No 822 Sysmiss 3296 1101C. FINE MOTOR : 20. Does your baby make a mark on the paper with the tip of Does your baby make a mark on the paper with the tip of a crayon (or pencil or pen) when trying to draw? 1664 3064 1 2 1 Yes 523 2 No 1141 Sysmiss 3064 1101C. FINE MOTOR : 21. Does your child turn the pages of a book by himself? Does your child turn the pages of a book by himself? (He may turn more than one page at a time.) 1865 2863 1 2 1 Yes 1146 2 No 719 Sysmiss 2863 1101C. FINE MOTOR : 22. Does your child get a spoon into her mouth right side up Does your child get a spoon into her mouth right side up so that the food usually doesn’t spill? 1567 3161 1 2 1 Yes 958 2 No 609 Sysmiss 3161 1101C. FINE MOTOR : 23. Does your child use a turning motion with her hand while Does your child use a turning motion with her hand while trying to turn doorknobs, wind up toys, twist tops, or screw lids on and off jars? 1575 3153 1 2 1 Yes 1117 2 No 458 Sysmiss 3153 1101C. FINE MOTOR : 24. Can your child string small items such as beads, macaron Can your child string small items such as beads, macaroni, or pasta “wagon wheels” onto a string or shoelace? 1953 2775 1 2 1 Yes 549 2 No 1404 Sysmiss 2775 1101C. FINE MOTOR : 25. Does your child copy you by drawing a single line in a v After your child watches you draw a line from the top of the paper to the bottom with a pencil, crayon, or pen, ask him to make a line like yours. Do not let your child trace your line. Does your child copy you by drawing a single line in a vertical direction? 1579 3149 1 2 1 Yes 350 2 No 1229 Sysmiss 3149 1101C. FINE MOTOR : 26. Does your child copy you by drawing a single line in a h After your child watches you draw a line from one side of the paper to the other side, ask her to make a line like yours. Do not let your child trace your line. Does your child copy you by drawing a single line in a horizontal direction? 1347 3381 1 2 1 Yes 262 2 No 1085 Sysmiss 3381 1101C. FINE MOTOR : 27. Do not let him trace your circle. Does your child copy y After your child watches you draw a single circle, ask him to make a circle like yours. Do not let him trace your circle. Does your child copy you by drawing a circle? 911 3817 1 2 1 Yes 251 2 No 660 Sysmiss 3817 1101C. FINE MOTOR : 28. Does your child turn pages in a book, one page at a time Does your child turn pages in a book, one page at a time? 911 3817 1 2 1 Yes 538 2 No 373 Sysmiss 3817 1101C. FINE MOTOR : 29. When drawing, does your child hold a pencil, crayon, or When drawing, does your child hold a pencil, crayon, or pen between her fingers and thumb like an adult does? 603 4125 1 2 1 Yes 272 2 No 331 Sysmiss 4125 1101C. FINE MOTOR : 30. Does your child put together a five- to seven-piece inte Does your child put together a five- to seven-piece interlocking puzzle? (If one is not available, take a full-page picture from a magazine or catalog and cut it into six pieces. Does your child put it back together correctly?) 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101C. FINE MOTOR : 31. Using the shape at right to look at, does your child cop Using the shape at right to look at, does your child copy it onto a large piece of paper using a pencil, crayon, or pen, without tracing? (Your child’s drawing should look like the design of the shape, except it may be different in size.) 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101C. FINE MOTOR : 32. Using the shapes below to look at, does your child copy Using the shapes below to look at, does your child copy at least three shapes onto a large piece of paper using a pencil, crayon, or pen, without tracing? (Your child’s drawings should look similar to the design of the shapes below, but they may be different in size.) 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101C. FINE MOTOR : 33. Does your child unbutton one or more buttons? Does your child unbutton one or more buttons? (Your child may use his own clothing or a doll’s clothing.) 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101C. FINE MOTOR : 34. Does your child draw pictures of people that have at lea Does your child draw pictures of people that have at least three of the following features: head, eyes, nose, mouth, neck, hair, trunk, arms, hands, legs, or feet? 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101C. FINE MOTOR : 35. Does your child color mostly within the lines in a color Does your child color mostly within the lines in a coloring book or within the lines of a 2-inch circle that you draw? (Your child should not go more than 1/4 inch outside the lines on most of the picture.) 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101C. FINE MOTOR : 36. Does your child trace on the line without going off the Ask your child to trace on the line below with a pencil. Does your child trace on the line without going off the line more than two times? 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101C. FINE MOTOR : 37. Ask your child to draw a picture of a person on a blank Ask your child to draw a picture of a person on a blank sheet of paper. You may ask your child, “Draw a picture of a girl or a boy.” If your child draws a person with head, body, arms, and legs, mark “yes.” If your child draws a person with three or fewer parts (head, body, arms, or legs), mark “not yet.” 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101C. FINE MOTOR : 38. Using the shapes below to look at, does your child copy Using the shapes below to look at, does your child copy the shapes in the space below without tracing? (Your child’s drawings should look similar to the design of the shapes below, but they may be different in size.) 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101C. FINE MOTOR : 39. Using the letters below to look at, does your child copy Using the letters below to look at, does your child copy the letters without tracing? 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101C. FINE MOTOR : 40. Print your child?s first name. Can your child copy the l Print your child’s first name. Can your child copy the letters? The letters may be large, backward, or reversed. 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101D. PROBLEM SOLVING : 01. Does your baby look at objects that are 8?10 inches Does your baby look at objects that are 8–10 inches away? 207 4521 1 2 1 Yes 134 2 No 73 Sysmiss 4521 1101D. PROBLEM SOLVING : 02. When you move around, does your baby follow you wit When you move around, does your baby follow you with his eyes? 207 4521 1 2 1 Yes 119 2 No 88 Sysmiss 4521 1101D. PROBLEM SOLVING : 03. When you move a toy slowly from side to side in fro When you move a toy slowly from side to side in front of your baby’s face (about 10 inches away), does your baby follow the toy with her eyes, sometimes turning her head? 439 4289 1 2 1 Yes 217 2 No 222 Sysmiss 4289 1101D. PROBLEM SOLVING : 04. When you move a small toy up and down slowly in fro When you move a small toy up and down slowly in front of your baby’s face (about 10 inches away), does your baby follow the toy with his eyes? 439 4289 1 2 1 Yes 225 2 No 214 Sysmiss 4289 1101D. PROBLEM SOLVING : 05. When you hold your baby in a sitting position, does When you hold your baby in a sitting position, does she look at a toy (about the size of a cup or rattle) that you place on the table or floor in front of her? 439 4289 1 2 1 Yes 252 2 No 187 Sysmiss 4289 1101D. PROBLEM SOLVING : 06. When you dangle a toy above your baby while he is l When you dangle a toy above your baby while he is lying on his back, does he wave his arms toward the toy? 439 4289 1 2 1 Yes 160 2 No 279 Sysmiss 4289 1101D. PROBLEM SOLVING : 07. When you put a toy in her hand, does your baby look When you put a toy in her hand, does your baby look at it? 232 4496 1 2 1 Yes 156 2 No 76 Sysmiss 4496 1101D. PROBLEM SOLVING : 08. When you put a toy in his hand, does your baby put When you put a toy in his hand, does your baby put the toy in his mouth? 384 4344 1 2 1 Yes 273 2 No 111 Sysmiss 4344 1101D. PROBLEM SOLVING : 09. When a toy is in front of your baby, does she reach When a toy is in front of your baby, does she reach for it with both hands? 152 4576 1 2 1 Yes 109 2 No 43 Sysmiss 4576 1101D. PROBLEM SOLVING : 10. When your baby is on her back, does she try to get When your baby is on her back, does she try to get a toy she has dropped if she can see it? 297 4431 1 2 1 Yes 220 2 No 77 Sysmiss 4431 1101D. PROBLEM SOLVING : 11. Does your baby pick up a toy and put it in his mout Does your baby pick up a toy and put it in his mouth? 297 4431 1 2 1 Yes 249 2 No 48 Sysmiss 4431 1101D. PROBLEM SOLVING : 12. Does your baby play by banging a toy up and down on Does your baby play by banging a toy up and down on the floor or table? 506 4222 1 2 1 Yes 339 2 No 167 Sysmiss 4222 1101D. PROBLEM SOLVING : 13.Does your baby pick up two small toys, one in each h Does your baby pick up two small toys, one in each hand, and hold onto them for about 1 minute? 506 4222 1 2 1 Yes 283 2 No 223 Sysmiss 4222 1101D. PROBLEM SOLVING : 14. When holding a toy in his hand, does your baby bang When holding a toy in his hand, does your baby bang it against another toy on the table? 589 4139 1 2 1 Yes 404 2 No 185 Sysmiss 4139 1101D. PROBLEM SOLVING : 15. While holding a small toy in each hand, does your b While holding a small toy in each hand, does your baby clap the toys together (like “Pat-a-cake”)? 589 4139 1 2 1 Yes 420 2 No 169 Sysmiss 4139 1101D. PROBLEM SOLVING : 16. After watching you hide a small toy under a piece o After watching you hide a small toy under a piece of paper or cloth, does your baby find it? (Be sure the toy is completely hidden.) 742 3986 1 2 1 Yes 397 2 No 345 Sysmiss 3986 1101D. PROBLEM SOLVING : 17. If you put a small toy into a bowl or box, does you If you put a small toy into a bowl or box, does your baby copy you by putting in a toy, although she may not let go of it? (If she already lets go of the toy into a bowl or box, mark “yes” for this item.) 742 3986 1 2 1 Yes 466 2 No 276 Sysmiss 3986 1101D. PROBLEM SOLVING : 18. After you scribble back and forth on paper with a c After you scribble back and forth on paper with a crayon (or a pencil or pen), does your baby copy you by scribbling? (If she already scribbles on her own, mark “yes” for this item.) 833 3895 1 2 1 Yes 397 2 No 436 Sysmiss 3895 1101D. PROBLEM SOLVING : 19. Does your baby drop two small toys, one after the o Does your baby drop two small toys, one after the other, into a container like a bowl or box? (You may show him how to do it.) 1058 3670 1 2 1 Yes 677 2 No 381 Sysmiss 3670 1101D. PROBLEM SOLVING : 20. After you have shown your baby how, does he try to After you have shown your baby how, does he try to get a small toy that is slightly out of reach by using a spoon, stick, or similar tool? 977 3751 1 2 1 Yes 406 2 No 571 Sysmiss 3751 1101D. PROBLEM SOLVING : 21. Without your showing him how, does your child scrib Without your showing him how, does your child scribble back and forth when you give him a crayon (or pencil or pen)? 1197 3531 1 2 1 Yes 601 2 No 596 Sysmiss 3531 1101D. PROBLEM SOLVING : 22. After a crumb or Cheerio is dropped into a small, c After a crumb or Cheerio is dropped into a small, clear bottle, does your child turn the bottle upside down to dump it out? 525 4203 1 2 1 Yes 312 2 No 213 Sysmiss 4203 1101D. PROBLEM SOLVING : 23. Does your child copy you by drawing a single line o After watching you draw a line from the top of the paper to the bottom with a crayon (or pencil or pen), does your child copy you by drawing a single line on the paper in any direction? (Mark “not yet” if your child scribbles back and forth.) 1131 3597 1 2 1 Yes 131 2 No 1000 Sysmiss 3597 1101D. PROBLEM SOLVING : 24. If you give your child a bottle, spoon, or pencil u If you give your child a bottle, spoon, or pencil upside down, does she turn it right side up so that she can use it properly? 831 3897 1 2 1 Yes 352 2 No 479 Sysmiss 3897 1101D. PROBLEM SOLVING : 25. If your child wants something he cannot reach, does If your child wants something he cannot reach, does he find a chair or box to stand on to reach it (for example, to get a toy on a counter or to “help” you in the kitchen)? 1042 3686 1 2 1 Yes 693 2 No 349 Sysmiss 3686 1101D. PROBLEM SOLVING : 26. Does your child pretend objects are something else? Does your child pretend objects are something else? For example, does your child hold a cup to his ear, pretending it is a telephone? Does he put a box on his head, pretending it is a hat? Does he use a block or small toy to stir food? 1619 3109 1 2 1 Yes 1347 2 No 272 Sysmiss 3109 1101D. PROBLEM SOLVING : 27. Does your child put things away where they belong? Does your child put things away where they belong? For example, does he know his toys belong on the toy shelf, his blanket goes on his bed, and dishes go in the kitchen? 1799 2929 1 2 1 Yes 996 2 No 803 Sysmiss 2929 1101D. PROBLEM SOLVING : 28. When looking in the mirror, ask ?Where is _______?? When looking in the mirror, ask “Where is _______?” (Use your child’s name.) Does your child point to his image in the mirror? 1579 3149 1 2 1 Yes 1156 2 No 423 Sysmiss 3149 1101D. PROBLEM SOLVING : 29. When you point to the figure and ask your child, ?W When you point to the figure and ask your child, “What is this?” does your child say a word that means a person or something similar? (Mark “yes” for responses like “snowman,” “boy,” “man,” “girl,” “Daddy,” “spaceman,” and “monkey.”) Please write your child’s response here:_______________ 1347 3381 1 2 1 Yes 539 2 No 808 Sysmiss 3381 1101D. PROBLEM SOLVING : 30. When you say, ?Say ?seven three,?? does your child When you say, “Say ‘seven three,’” does your child repeat just the two numbers in the same order? Do not repeat the numbers. If necessary, try another pair of numbers and say, “Say ‘eight two.’” Your child must repeat just one series of two numbers for you to answer “yes” to this question 1347 3381 1 2 1 Yes 609 2 No 738 Sysmiss 3381 1101D. PROBLEM SOLVING : 31. After your child draws a ?picture,? even a simple s After your child draws a “picture,” even a simple scribble, does she tell you what she drew? (You may say, “Tell me about your picture,” or ask, “What is this?” to prompt her.) 911 3817 1 2 1 Yes 297 2 No 614 Sysmiss 3817 1101D. PROBLEM SOLVING : 32. When you say, ?Say ?five eight three,?? does your c When you say, “Say ‘five eight three,’” does your child repeat just the three numbers in the same order? Do not repeat the numbers. If neces- sary, try another series of numbers and say, “Say ‘six nine two.’ (Your child must repeat just one series of three numbers for you to answer “yes” to this question.) 334 4394 1 2 1 Yes 136 2 No 198 Sysmiss 4394 1101D. PROBLEM SOLVING : 33. When asked, ?Which circle is the smallest?? does yo When asked, “Which circle is the smallest?” does your child point to the smallest circle? (Ask this question without providing help by pointing, gesturing, or looking at the smallest circle.) 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101D. PROBLEM SOLVING : 34. Does your child dress up and ?play-act,? pretending Does your child dress up and “play-act,” pretending to be someone or something else? For example, your child may dress up in different clothes and pretend to be a mommy, daddy, brother or sister, or an imaginary animal or figure. 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101D. PROBLEM SOLVING : 35. Without your giving help by pointing, does your chi Without your giving help by pointing, does your child follow three different directions using the words “under,” “between,” and “middle”? For example, ask your child to put the shoe “under the couch.” Then ask her to put the ball “between the chairs” and the book “in the middle of the table.” 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101D. PROBLEM SOLVING : 36. When shown objects and asked, ?What color is this?? When shown objects and asked, “What color is this?” does your child name five different colors, like red, blue, yellow, orange, black, white, or pink? (Mark “yes” only if your child answers the question correctly using five colors.) 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101D. PROBLEM SOLVING : 37. If you place five objects in front of your child, c If you place five objects in front of your child, can he count them by saying, “one, two, three, four, five,” in order? (Ask this question without providing help by pointing, gesturing, or naming.) 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101D. PROBLEM SOLVING : 38. Does your child count up to 15 without making mista Does your child count up to 15 without making mistakes? 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101D. PROBLEM SOLVING : 39. Does your child know the names of the following num Does your child know the names of the following numbers? 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101D. PROBLEM SOLVING : 40. Does your child finish the following sentences usin Does your child finish the following sentences using a word that means the opposite of the word that is italicized? For example: “A rock is hard, and a pillow is soft.” A) "A cow is big, and a mouse is ______", B) "Ice is cold, and fire is ______", C) "We see the stars at night, and we see the sun during the ______", D) "When I throw the ball up, it comes ______" (Mark "yes" if he finishes three of the four sentences correctly.) 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101D. PROBLEM SOLVING : 41. Does your child name at least four letters in her n Does your child name at least four letters in her name? Point to the letters and ask, “What letter is this?” (Point to the letters out of order.) 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101E. PERSONAL SOCIAL : 01. Does your baby cry when he is hungry, wet, tired, o Does your baby cry when he is hungry, wet, tired, or wants to be held? 207 4521 1 2 1 Yes 161 2 No 46 Sysmiss 4521 1101E. PERSONAL SOCIAL : 02. When you smile at your baby, does she smile back? When you smile at your baby, does she smile back? 207 4521 1 2 1 Yes 127 2 No 80 Sysmiss 4521 1101E. PERSONAL SOCIAL : 03. Does your baby watch his hands? Does your baby watch his hands? 207 4521 1 2 1 Yes 84 2 No 123 Sysmiss 4521 1101E. PERSONAL SOCIAL : 04. When your baby sees the breast or bottle, does she When your baby sees the breast or bottle, does she seem to know she is about to be fed? 439 4289 1 2 1 Yes 277 2 No 162 Sysmiss 4289 1101E. PERSONAL SOCIAL : 05. When your baby has her hands together, does she pla When your baby has her hands together, does she play with her fingers? 439 4289 1 2 1 Yes 321 2 No 118 Sysmiss 4289 1101E. PERSONAL SOCIAL : 06. Does your baby help hold the bottle with both hands Does your baby help hold the bottle with both hands at once, or when nursing, does she hold the breast with her free hand? 439 4289 1 2 1 Yes 258 2 No 181 Sysmiss 4289 1101E. PERSONAL SOCIAL : 07. When in front of a large mirror, does your baby smi When in front of a large mirror, does your baby smile or coo at herself? 384 4344 1 2 1 Yes 206 2 No 178 Sysmiss 4344 1101E. PERSONAL SOCIAL : 08. Does your baby act differently toward strangers tha Does your baby act differently toward strangers than he does with you and other familiar people? (Reactions to strangers may include staring, frowning, withdrawing, or crying.) 384 4344 1 2 1 Yes 201 2 No 183 Sysmiss 4344 1101E. PERSONAL SOCIAL : 09. While lying on her back, does your baby play by gra While lying on her back, does your baby play by grabbing her foot? 529 4199 1 2 1 Yes 374 2 No 155 Sysmiss 4199 1101E. PERSONAL SOCIAL : 10. When in front of a large mirror, does your baby rea When in front of a large mirror, does your baby reach out to pat the mirror? 297 4431 1 2 1 Yes 150 2 No 147 Sysmiss 4431 1101E. PERSONAL SOCIAL : 11. Does your baby try to get a toy that is out of reac Does your baby try to get a toy that is out of reach? (She may roll, pivot on her tummy, or crawl to get it.) 297 4431 1 2 1 Yes 171 2 No 126 Sysmiss 4431 1101E. PERSONAL SOCIAL : 12. Does your baby drink water, juice, or formula from Does your baby drink water, juice, or formula from a cup while you hold it? 506 4222 1 2 1 Yes 357 2 No 149 Sysmiss 4222 1101E. PERSONAL SOCIAL : 13. Does your baby feed himself a cracker or a cookie? Does your baby feed himself a cracker or a cookie? 354 4374 1 2 1 Yes 283 2 No 71 Sysmiss 4374 1101E. PERSONAL SOCIAL : 14. When you hold out your hand and ask for her toy, do When you hold out your hand and ask for her toy, does your baby offer it to you even if she doesn’t let go of it? (If she already lets go of the toy into your hand, mark “yes” for this item.) 589 4139 1 2 1 Yes 394 2 No 195 Sysmiss 4139 1101E. PERSONAL SOCIAL : 15. When you hold out your hand and ask for her toy, do When you hold out your hand and ask for her toy, does your baby let go of it into your hand? 444 4284 1 2 1 Yes 289 2 No 155 Sysmiss 4284 1101E. PERSONAL SOCIAL : 16. When you dress your baby, does she lift her foot fo When you dress your baby, does she lift her foot for her shoe, sock, or pant leg? 444 4284 1 2 1 Yes 230 2 No 214 Sysmiss 4284 1101E. PERSONAL SOCIAL : 17. When you dress your baby, does he push his arm thro When you dress your baby, does he push his arm through a sleeve once his arm is started in the hole of the sleeve? 742 3986 1 2 1 Yes 330 2 No 412 Sysmiss 3986 1101E. PERSONAL SOCIAL : 18. Does your baby roll or throw a ball back to you so Does your baby roll or throw a ball back to you so that you can return it to him? 533 4195 1 2 1 Yes 235 2 No 298 Sysmiss 4195 1101E. PERSONAL SOCIAL : 19. Does your baby play with a doll or stuffed animal b Does your baby play with a doll or stuffed animal by hugging it? 833 3895 1 2 1 Yes 715 2 No 118 Sysmiss 3895 1101E. PERSONAL SOCIAL : 20. Does your baby help undress himself by taking off c Does your baby help undress himself by taking off clothes like socks, hat, shoes, or mittens? 977 3751 1 2 1 Yes 669 2 No 308 Sysmiss 3751 1101E. PERSONAL SOCIAL : 21. Does your baby get your attention or try to show yo Does your baby get your attention or try to show you something by pulling on your hand or clothes? 823 3905 1 2 1 Yes 744 2 No 79 Sysmiss 3905 1101E. PERSONAL SOCIAL : 22. While looking at himself in the mirror, does your c While looking at himself in the mirror, does your child offer a toy to his own image? 525 4203 1 2 1 Yes 347 2 No 178 Sysmiss 4203 1101E. PERSONAL SOCIAL : 23. Does your child come to you when she needs help, su Does your child come to you when she needs help, such as with wind- ing up a toy or unscrewing a lid from a jar? 1197 3531 1 2 1 Yes 1013 2 No 184 Sysmiss 3531 1101E. PERSONAL SOCIAL : 24. Does your child drink from a cup or glass, putting Does your child drink from a cup or glass, putting it down again with little spilling? 899 3829 1 2 1 Yes 567 2 No 332 Sysmiss 3829 1101E. PERSONAL SOCIAL : 25. Does your child copy the activities you do, such as Does your child copy the activities you do, such as wipe up a spill, sweep, shave, or comb hair? 831 3897 1 2 1 Yes 645 2 No 186 Sysmiss 3897 1101E. PERSONAL SOCIAL : 26. Does your child eat (with a fork) well? Does your child eat (with a fork) well? 1953 2775 1 2 1 Yes 1679 2 No 274 Sysmiss 2775 1101E. PERSONAL SOCIAL : 27. If you do any of the following gestures, does your 1953 2775 1 2 1 Yes 1792 2 No 161 Sysmiss 2775 1101E. PERSONAL SOCIAL : 28. Does your child push a little wagon, stroller, or o Does your child push a little wagon, stroller, or other toy on wheels, steering it around objects and backing out of corners if she cannot turn? 888 3840 1 2 1 Yes 620 2 No 268 Sysmiss 3840 1101E. PERSONAL SOCIAL : 29. Does your child call herself ?I? or ?me? more often Does your child call herself “I” or “me” more often than her own name? For example, “I do it,” more often than “Juanita do it.” 976 3752 1 2 1 Yes 666 2 No 310 Sysmiss 3752 1101E. PERSONAL SOCIAL : 30. Does your child put on a coat, jacket, or shirt by Does your child put on a coat, jacket, or shirt by himself? 1579 3149 1 2 1 Yes 491 2 No 1088 Sysmiss 3149 1101E. PERSONAL SOCIAL : 31. After you put on loose-fitting pants around her fee After you put on loose-fitting pants around her feet, does your child pull them completely up to her waist? 1013 3715 1 2 1 Yes 731 2 No 282 Sysmiss 3715 1101E. PERSONAL SOCIAL : 32. When your child is looking in a mirror and you ask, When your child is looking in a mirror and you ask, “Who is in the mirror?” does he say either “me” or his own name? 911 3817 1 2 1 Yes 680 2 No 231 Sysmiss 3817 1101E. PERSONAL SOCIAL : 33. Using these exact words, ask your child, ?Are you a Using these exact words, ask your child, “Are you a girl or a boy?” Does your child answer correctly? 603 4125 1 2 1 Yes 430 2 No 173 Sysmiss 4125 1101E. PERSONAL SOCIAL : 34. Does your child take turns by waiting while another Does your child take turns by waiting while another child or adult takes a turn? 334 4394 1 2 1 Yes 126 2 No 208 Sysmiss 4394 1101E. PERSONAL SOCIAL : 35. Does your child serve himself, taking food from one Does your child serve himself, taking food from one container to an- other using utensils? For example, does your child use a large spoon to scoop applesauce from a jar into a bowl? 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101E. PERSONAL SOCIAL : 36. Does your child wash his hands using soap and wate Does your child wash his hands using soap and water and dry off with a towel without help? 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101E. PERSONAL SOCIAL : 37. Does your child tell you at least four of the follo 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101E. PERSONAL SOCIAL : 38. Does your child tell you the names of two or more p Does your child tell you the names of two or more playmates, not including brothers and sisters? (Ask this question without providing help by suggesting names of playmates or friends.) 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101E. PERSONAL SOCIAL : 39. Does your child brush her teeth by putting toothpas Does your child brush her teeth by putting toothpaste on the toothbrush and brushing all of her teeth without help? (You may still need to check and rebrush your child’s teeth.) 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101E. PERSONAL SOCIAL : 40. Does your child dress or undress himself without he Does your child dress or undress himself without help (except for snaps, buttons, and zippers)? 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101E. PERSONAL SOCIAL : 41. Does your child dress and undress herself, includin Does your child dress and undress herself, including buttoning medium-size buttons and zipping front zippers? 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101E. PERSONAL SOCIAL : 42. Does your child use the toilet by herself? Does your child use the toilet by herself? (She goes to the bathroom, sits on the toilet, wipes, and flushes.) Mark “yes” even if she does this after you remind her. 4728 * 1 Yes 0 2 No 0 Sysmiss 4728 1101E. PERSONAL SOCIAL : 43. Does your child usually take turns and share with o Does your child usually take turns and share with other children? 4728 * 1 Yes 0 2 No 0 Sysmiss 4728