DDI_THA_2005_MICS_v01_M
Daniel Clarke
Rhiannon James
2008-02-06
NADA
Version 01 (October 2011) - Slightly edited version of UNICEF's DDI ref. DDI-MICS-THA- UNICEF-2006-v1.0
Multiple Indicator Cluster Survey 2005-2006
MICS 2005-2006
THA_2005_MICS_v01_M
National Statistical Office
Ministry of Social Development & Human Security
Ministry of Education
Ministry of Public Health
United Nations Children's Fund
NADA
United Nations Children's Fund
United Nations Development Programme
United Nations Educational, Scientific and Cultural Organization
UNICEF Thailand Country Office
General Inquiries
MICS Programme Manager
Multiple Indicator Cluster Survey - Round 3 [hh/mics-3]
The Thailand Multiple Indicator Cluster Survey (MICS) December 2005 - February 2006 was developed for the first time to collect data on the situation of all children in Thailand to be used as tools in monitoring and evaluation of child development in Thailand.
Version 1.0: Edited data used for final report
The Multiple Indicator Cluster Survey (MICS) is a household survey programme developed by UNICEF to assist countries in filling data gaps for monitoring human development in general and the situation of children and women in particular. MICS is capable of producing statistically sound, internationally comparable estimates of social indicators. The current round of MICS is focused on providing a monitoring tool for the Millennium Development Goals (MDGs), the World Fit for Children (WFFC), as well as for other major international commitments, such as the United Nations General Assembly Special Session (UNGASS) on HIV/AIDS and the Abuja targets for malaria.
Survey Objectives
The 2006 Thailand Multiple Indicator Cluster Survey has as its primary objectives:
- To provide up-to-date information for assessing the situation of children and women in Thailand;
- To furnish data needed for monitoring progress toward goals established by the Millennium Development Goals (MDG), the goals of A World Fit for Children (WFFC) and other internationally agreed upon goals, as a basis for future action at national and provincial level; and
- To contribute to the improvement of data and monitoring systems on the situation of children and women in Thailand and strengthening technical expertise for the design, implementation, and analysis of such systems.
Survey Content
MICS questionnaires are designed in a modular fashion that can be easily customized to the needs of a country. They consist of a household questionnaire, a questionnaire for women aged 15-49 and a questionnaire for children under the age of five (to be administered to the mother or caretaker). Other than a set of core modules, countries can select which modules they want to include in each questionnaire.
Survey Implementation
The survey was implemented by the National Statistical Office of Thailand, with the support and assistance of UNICEF and other partners. Technical assistance and training for the surveys is provided through a series of regional workshops, covering questionnaire content, sampling and survey implementation; data processing; data quality and data analysis; report writing and dissemination.
Thailand
The survey was designed to produce estimates for indicators at the national level, by urban and rural disaggregation, for each of the 4 regions of Thailand (North, Northeast, Central, and South) and by individual province for 26 (out of 76 total) targeted provinces (note: additional data collections were performed for the targeted provinces during March-May 2006; separate results publications for each province are pending).
- Households
- Women aged 15-49
- Children under 5 years of age
The survey covered all de jure household members (usual residents), all women aged 15-49 years resident in the household, and all children aged 0-4 years (under age 5) resident in the household.
Sample survey data [ssd]
The Thailand Multiple Indicator Cluster Survey included the following modules in the questionnaires:
HOUSEHOLD QUESTIONNAIRE : Household characteristics, household listing, orphaned and vulnerable children, education, child labour, water and sanitation, disability and salt iodization.
WOMEN'S QUESTIONNAIRE: Women's characteristics, child mortality, tetanus toxoid, maternal and newborn health, marriage, contraception, and HIV/AIDS knowledge.
CHILDREN'S QUESTIONNAIRE: Children's characteristics, birth registration and early learning, child development, breastfeeding, care of illness, immunization and anthropometry.
National Statistical Office of Thailand
The Thailand Multiple Indicator Cluster Survey (MICS) was carried out by a sample survey method that used a stratified two stage sampling plan. The primary sample units (PSUs) consisted of blocks (in municipal areas) or villages (in non-municipal areas). The secondary sample units consisted of collective households systematically drawn from a household listing. The plan is designed to provide estimates of situation indicators for children and women at the national level, for municipal and non-municipal areas, and for four regions: Central (including Bangkok), North, Northeast and South. The household listing is obtained from The Basic Household Information Survey conducted every two years by the National Statistical Office (NSO). In the survey, members of each household located in the block/village samples are counted.
Data on basic household information from the survey are to be used as the sample frame in various survey projects of the NSO. Data from the 2006 Basic Household Information Survey were used as the frame for household samples in the Thailand MICS. Thirty collective household samples per block/village sample were selected in both municipal and non-municipal areas. Field staff then created a Listing of Household Samples by adding together all the names of household heads and the addresses. After a household listing was carried out within the selected 30 households in each block/village, a systematic sample of households was drawn. For national-level results, sample data were weighted in accordance with sampling plan.
A block is an operational boundary in a municipal area that is made up of approximately 100 to 200 households. Blocks are established on a map so that field staff know the exact area they are to cover in the survey.
A village is an administrative unit, a community, in a non-municipal area governed by a village head (Phuyaiban) or a district head (Kamnan).
The MICS national-level report included 1,449 block/village samples. Thirty collective household samples per block/village samples were selected and a total of 43,470 household samples were obtained.
For MICS provincial-level reports, 1,032 block/village samples were selected and 30,960 household samples were included.
More detailed information on the sample design is available in Appendix A of the Survey Final Report.
Face-to-face [f2f]
The questionnaires for the Thailand MICS were structured questionnaires based on the MICS3 Model Questionnaire with some modifications and additions. A household questionnaire was administered in each household, which collected various information on household members including sex, age, relationship, and orphanhood status.
In addition to a household questionnaire, questionnaires were administered in each household for women age 15-49 and children under age five. For children, the questionnaire was administered to the mother or caretaker of the child.
The questionnaires were translated into Thai by the NSO MICS coordinators in September 2005.
In addition to the administration of questionnaires, fieldwork teams tested salt used for cooking in the households surveyed for presence of iodine, and measured the weight and height of children under 5 years of age.
Pretesting:
The Thai Multiple Indicator Cluster Survey (MICS) questionnaires went through two pre-tests, first in Ratchaburi province and later in Ayutthaya province. Based on the results of the two pre-tests, modifications on wording and terminology in the Thai version were made to make them more suitable for the Thai population.
The first pre-test in Ratchaburi province was held during October 10-12, 2005. The interview was conducted by the National Statistical Office (NSO) MICS coordinators themselves to determine if the interviewee would understand the questions/wording used and to find out if there were any problems with particular modules. Results from the first pre-test were discussed among the NSO MICS coordinators, and the questionnaires were revised accordingly.
During the pre-test survey in Ratchaburi province, the NSO MICS coordinators obtained information on maternal and child health from the staff of Health Centre IV on topics such as birth registration for children born in hospitals, child vaccination, maternal tetanus prevention, contraception and antenatal care. The knowledge and information obtained from this process were used to improve the questionnaires and prepare field work manuals.
The second pre-test in Ayutthaya province was carried out by field staff using the revised questionnaires under the observation of the NSO MICS coordinators. Before commencing the test survey, field staff were provided with training on definitions and the survey's objectives.
Again, results from the pre-test, especially in relation to questions that interviewees did not understand or did not want to answer, were discussed among the NSO MICS coordinators and field staff. These related to questions that were considered either sensitive or difficult to answer due to the degree of detailed information required. In the case of child vaccination, respondents were asked what kind of vaccines the child had received, and when and how many times the child had received the vaccines. The discussion contributed positively to the interview process and the accuracy of the survey results. It took about 2-2.5 hours per household to finish all three questionnaires.
After the second pre-test, a final revision was made to both the questionnaires and the field work manuals to be used in the Thailand MICS.
Training:
In November 2005, before data collection, a three-day training programme was provided to 145 field staff from the North and Northeast regions in Khon Kaen province, and in Krabi province for 160 field staff from the South and Central (including Bangkok) regions. The NSO MICS coordinators and representatives from UNICEF Thailand participated in both training sessions as observers. Instructors from the Ministry of Public Health provided information on antenatal care, attendance at birth, child vaccination, maternal tetanus vaccination and oral rehydration treatment for children with diarrhoea. The knowledge and information acquired through the training were useful for the interview process and the accuracy of the survey results.
Fieldwork:
Administratively, Thailand is divided into 76 provinces, including Bangkok (Metropolis). In Bangkok, the field work was carried out under the responsibility of the Director of the Data Management Division of the Bangkok Metropolitan Administration (BMA), while Provincial Statistical Officers were responsible for the field work undertaken in the other 75 provinces. In each province, data were collected by three teams of four field staff, three interviewers and one supervisor.
The fieldwork began in December 2005 and concluded in February 2006. Also, additional data collections were performed for 26 targeted provinces during March-May 2006 (separate provincial reports are pending).
Each enumeration team included one supervisor. The supervisor provided advice on field work, helped in solving problems arising during the field work, and checked the completeness of data after the survey. The NSO MICS coordinators also provided overall supervision, with continuous visits to the field.
Survey weights are population based weights and have not been normalized.
After the fieldwork, the team supervisor checked the data collected during the interview for completeness. Then the Provincial Statistical Officer in each province and the Director of the Data Management Division of the Bangkok Metropolitan Administration randomly rechecked the data before sending all the questionnaires to the National Statistical Office (NSO) for processing.
Upon receiving the questionnaires from the 76 provinces, the collected data were entered on 30 microcomputers by data entry operators and data entry supervisors at the Thai NSO, using CSPro software. In order to ensure quality control, editing and structural checks, all questionnaires were double entered for verification and internal consistency checks were performed, followed by secondary editing. The data entry and verification used CSPro programme applications that were developed under the global Multiple Indicator Cluster Survey (MICS) project by UNICEF to be used as standard processing procedures worldwide. In Thailand, the standard CSPro programme was modified appropriately to the Thai version questionnaires. The modification was done by NSO staff that had been trained on data processing by MICS experts from UNICEF.
Data entry and data verification for the national level report began in February 2006 and was completed in April 2006. For the provincial reports, the process was completed in June 2006. Data were analysed using the Statistical Package for Social Sciences (SPSS) software programme, Version 14, and the model syntax and tabulation plans developed by UNICEF for this purpose.
Data processing used the CSPro programme applications developed under the global Multiple Indicator Cluster Survey project by UNICEF.
Data were processed in clusters, with each cluster being processed as a complete unit through each stage of data processing. Each cluster goes through the following steps:
1) Questionnaire reception
2) Office editing and coding
3) Data entry
4) Structure and completeness checking
5) Verification entry
6) Comparison of verification data
7) Back up of raw data
8) Secondary editing
9) Edited data back up
After all clusters are processed, all data is concatenated together and then the following steps are completed for all data files:
10) Export to SPSS in 4 files (hh - household, hl - household members, wm - women, ch - children under 5)
11) Recoding of variables needed for analysis
12) Adding of sample weights
13) Calculation of wealth quintiles and merging into data
14) Structural checking of SPSS files
15) Data quality tabulations
16) Production of analysis tabulations
For data entry, CSPro version 2.6.007 was used with a highly structured data entry program, using system controlled approach, that controlled entry of each variable. All range checks and skips were controlled by the program and operators could not override these. A limited set of consistency checks were also included inthe data entry program. In addition, the calculation of anthropometric Z-scores was also included in the data entry programs for use during analysis. Open-ended responses ("Other" answers) were not entered or coded, except in rare circumstances where the response matched an existing code in the questionnaire.
Structure and completeness checking ensured that all questionnaires for the cluster had been entered, were structurally sound, and that women's and children's questionnaires existed for each eligible woman and child.
100% verification of all variables was performed using independent verification, i.e. double entry of data, with separate comparison of data followed by modification of one or both datasets to correct keying errors by original operators who first keyed the files.
After completion of all processing in CSPro, all individual cluster files were backed up before concatenating data together using the CSPro file concatenate utility.
Data editing took place at a number of stages throughout the processing, including:
a) Office editing and coding
b) During data entry
c) Structure checking and completeness
d) Secondary editing
e) Structural checking of SPSS data files
Of the 43,440 households selected for the sample, 42,302 were found to be occupied. Of these, 40,511 were successfully interviewed, yielding a response rate of 95.8 percent. In the interviewed households, 37,187 eligible women (aged 15-49) were identified. Of these eligible women, 36,960 were successfully interviewed, yielding a response rate of 99.4 percent. In addition, 9,444 children under the age of 5 were listed as being eligible in the households. The mothers and/or caretakers of 9,409 of these children (99.6 per cent) were successfully interviewed.
Differentials in response rates by areas showed 94.9 percent of the households in municipal areas and 96.9 percent in non-municipal areas. Participant differentials in response rates were observed, with the highest in the North Region (98.8 percent), followed by the Northeast Region (98.1 percent), and the South and the Central regions' same low response rate of 93 percent.
The sample of respondents selected in the Thailand Multiple Indicator Cluster Survey (MICS) is only one of the samples that could have been selected from the same population, using the same design and size. Each of these samples would yield results that differ somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability between all possible samples. The extent of variability is not known exactly, but can be estimated statistically from the survey results.
The following sampling error measures are presented in this appendix to the Survey Final Report (attached in the External Resources) for each of the selected indicators:
- Standard error (se): Sampling errors are usually measured in terms of standard errors for particular indicators (means, proportions etc). Standard error is the square root of the variance. The Taylor linearization method is used for the estimation of standard errors.
- Coefficient of variation (se/r) is the ratio of the standard error to the value of the indicator
- Design effect (deff) is the ratio of the actual variance of an indicator, under the sampling method used in the survey, to the variance calculated under the assumption of simple random sampling. The square root of the design effect (deft) is used to show the efficiency of the sample design. A deft value of 1.0 indicates that the sample design is as efficient as a simple random sample, while a deft value above 1.0 indicates the increase in the standard error due to the use of a more complex sample design.
- Confidence limits are calculated to show the interval within which the true value for the population can be reasonably assumed to fall. For any given statistic calculated from the survey, the value of that statistics will fall within a range of plus or minus two times the standard error (p + 2.se or p - 2.se) of the statistic in 95 percent of all possible samples of identical size and design.
For the calculation of sampling errors from MICS data, SPSS (Statistical Package for Social Sciences) Version 14 Complex Samples module has been used. In addition to the sampling error measures described above, the tables also include weighted and un-weighted counts of denominators for each indicator.
Sampling errors are calculated for indicators of primary interest, for the national total, for the regions, and for urban and rural areas. Three of the selected indicators are based on households, 8 are based on household members, 13 are based on women, and 15 are based on children under 5. All indicators presented in the Final Report are in the form of proportions.
A series of data quality tables and graphs are available to review the quality of the data and include the following:
Age distribution of the household population
Age distribution of eligible women and interviewed women
Age distribution of eligible children and children for whom the mother or caretaker was interviewed
Age distribution of children under age 5 by 3 month groups
Age and period ratios at boundaries of eligibility
Percent of observations with missing information on selected variables
Presence of mother inthe household and person interviewed for the under 5 questionnaire
School attendance by single year age
Sex ratio at birth among children ever born, surviving and dead by age of respondent
Distribution of women by time since last birth
Scatterplot of weight by height, weight by age and height by age
Graph of male and female population by single years of age
Population pyramid
The Thailand Multiple Indicator Cluster Survey (MICS) covered a large number of samples from all 76 provinces in the country. It was expected that data deviation could possibly occur from the work of the field staff, or the interviewees. Therefore, the National Statistical Office (NSO) operated a post enumeration survey (PES) in Bangkok and 22 provinces selected from all four regions to aid data users in their consideration of data quality. The PES consisted of 150 block/village samples, in both municipal and non-municipal areas. Collective household samples – 20 households per block/village for a total of 3,000 household samples – were selected from the listing of household samples of the MICS survey. Staff were sent in to repeat the survey in these areas. Matching of questionnaires from the actual survey and the repeated survey was carried out and data were analysed for deviation.
Users of the data agree to keep confidential all data contained in these datasets and to make no attempt to identify, trace or contact any individual whose data is included in these datasets.
Thailand National Statistical Office. 2006. Thailand Multiple Indicator Cluster Survey December 2005- February 2006. Bangkok, Thailand: National Statistical Office.
Survey datasets are distributed at no cost for legitimate research, with the condition that we receive a description of any research project that will be using the data prior to authorizing their distribution. Copies of all reports and publications based on the requested data must be sent to UNICE: thailandao@unicef.org.
Requests for access to the datasets may be made through the website www.childinfo.org.
The National Statistical Office of Thailand and UNICEF provide these data to external users without any warranty or responsibility implied. The National Statistical Office of Thailand and UNICEF accept no responsibility for the results and/or implications of any actions resulting from the use of these data.
hh
Data collected at the household level (MICS Household questionnaire: Household information panel, Water and sanitation, household characteristics, Salt iodization)
0
78
hl
Data collected at the household member's level (MICS Household Questionnaire: Household listing, Child labour, Support to Orphaned and Vulnerable Children and Child Disability)
0
135
wm
Data collected at the women's level (MICS Women's Questionnaire: Women's Information Panel, Child mortality, Tetanus toxoid, Maternal and newborn health, Marriage, Contraception, HIV/AIDS knowledge)
0
180
ch
Data collected at the children's level (MICS Under Five Children's Questionnaire: Under Five Child Information Panel, Birth registration and early learning,Breastfeeding, Care of Illness, Immunization, Anthropometry and Child development)
0
248
Cluster number
Cluster number
Cluster number
Cluster number
Cluster number
We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. During this time I would like to speak with the household head and all mothers or others who take care of children in the household. May I start now? If permission is given, begin the interview. Cluster number:
Enter the cluster number as instructed by your supervisor.
Households
Unique identifier for the cluster in which the household exists
Household number
Household number
Household number
Household number
Household number
Household number:
Enter the household number as instructed by your supervisor.
Households
Houshold number within the cluster
Region
Region
Region
Region
Region
Region:
Circle the code for region.
Households
2
Central (include BKK.)
3
North
4
Northeast
5
South
Changwat/Province
Changwat/Province
Changwat/Province
Changwat/Province
Changwat/Province
Area
Area
Area
Area
Area
Area:
Circle the code for area of residence as instructed by your supervisor. This will have been pre-determined; you will not be required to assess whether the household is in an urban or rural area.
Households
1
Urban
2
Rural
PSU_NO
PSU_NO
PSU_NO
PSU_NO
PSU_NO
Day of interview
Day of interview
Day of interview
Day of interview
Day of interview
Day/Month/Year of interview:
Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household.
Households
Month of interview
Month of interview
Month of interview
Month of interview
Month of interview
Day/Month/Year of interview:
Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household.
Households
Year of interview
Year of interview
Year of interview
Year of interview
Year of interview
Day/Month/Year of interview:
Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household.
Households
Respondent HH questionnaire
Respondent HH questionnaire
Respondent HH questionnaire
Respondent HH questionnaire
Respondent HH questionnaire
Respondent to HH questionnaire:
Enter the name and line number (from the Household Listing, columns HL1 and HL2) of the respondent to the Household Questionnaire.
Households
99
Missing
Number of household members
Number of household members
Number of household members
Number of household members
Number of household members
Total number of household members:
Count the number of household members recorded in column HL1 of the Household Listing and enter the total here.
Households
Total eligible women
Total eligible women
Total eligible women
Total eligible women
Total eligible women
No.of women eligible for interview:
Enter the total number of women eligible for interview for the Questionnaire for Individual Women - you will copy this from the row for totals at the bottom of the Household Listing, for HL6.
Households
Women interviews completed
Women interviews completed
Women interviews completed
Women interviews completed
Women interviews completed
No.of women questionnaires completed:
Once all of the Questionnaires for Individual Women have been completed for a particular household, enter the number completed here.
Households
Total children under 5
Total children under 5
Total children under 5
Total children under 5
Total children under 5
No.of children under age 5:
Enter the total number of children under five eligible for inclusion in the survey from the row for totals at the bottom of the Household Listing, for HL8. You will be using the Questionnaire for Children Under Five to interview the mothers or primary caretakers of these children.
Households
Child interviews completed
Child interviews completed
Child interviews completed
Child interviews completed
Child interviews completed
No.of under-5 questionnaires completed:
Once all of the Questionnaires for Children Under Five have been completed for a particular household, enter the number completed here.
Households
Enu. Result
Enu. Result
Enu. Result
Enu. Result
Enu. Result
After all questionnaires for the household have been completed, fill in the following information: Result of HH interview:
If the Household Questionnaire is completed, circle '1' for 'Completed'. If you have not been able to contact the household after repeated visits, circle '2' for 'Not at home'. If the household refuses to be interviewed, circle '3' for 'Refused'. If you are unable to locate the household or if the dwelling is destroyed, circle '4' for 'HH not found/destroyed'. If you have not been able to complete the Household Questionnaire for another reason, you should circle '6' for 'Other' and specify the reason in the space provided. Some examples of 'Other' codes might be: the household respondent is incapacitated; the questionnaire is partly completed; adult household members were not found at home after repeated visits.
Households
1
Completed
2
Not at home
3
Refused
4
HH not found/destroyed
6
Others
Total number of Women 15-49
Total number of Women 15-49
Total number of Women 15-49
Total number of Women 15-49
Total number of Women 15-49
Are there any other persons living here - even if they are not members of your family or do not have parents living in this household? Including children at work or at school? If yes, insert child's name and complete form. Then, complete the totals below.
Households
Total number of Children 5-14
Total number of Children 5-14
Total number of Children 5-14
Total number of Children 5-14
Total number of Children 5-14
Households
Total number of children Under 5 years
Total number of children Under 5 years
Total number of children Under 5 years
Total number of children Under 5 years
Total number of children Under 5 years
Households
Total number of Very Sick
Total number of Very Sick
Total number of Very Sick
Total number of Very Sick
Total number of Very Sick
Total number of mothers dead
Total number of mothers dead
Total number of mothers dead
Total number of mothers dead
Total number of mothers dead
Total number of mothers very sick
Total number of mothers very sick
Total number of mothers very sick
Total number of mothers very sick
Total number of mothers very sick
Total number of father dead
Total number of father dead
Total number of father dead
Total number of father dead
Total number of father dead
Total number of fathers very sick
Total number of fathers very sick
Total number of fathers very sick
Total number of fathers very sick
Total number of fathers very sick
Have any usual member of your household died in the last 12
Have any usual member of your household died in the last 12
Have any usual member of your household died in the last 12
Have any usual member of your household died in the last 12
Have any usual member of your household died in the last 12
Check HL5: any children 0-17? Yes Continue to OV2 No Next Module
I would like you to think back over the past 12 months. Has any usual member of your household died in the last 12 months?
This module is made up of two sections: The first section identifies households where there is at least one adult aged 18-59 years who was very sick for 3 of the past 12 months and died. This is one of the criteria for identifying if there are eligible children aged 0-17 years for this module, in addition to the criteria in the Extended Household Listing module. The second section asks about different types of support provided to children aged 0-17 years in such households. Note that the module is administered only if there is at least one child aged 0-17 years residing in the household. --- Check the column HL5 for the entire household to see if there are any children 0-17 years of age (including age 17). If 'Yes', check the corresponding box, and continue to the next question. If 'No', check the second box and go to the next module. --- Care should be taken to determine whether or not the death was within the last 12 months. It can be helpful to probe the respondent by asking if they remember what month the person died, if they are having trouble remembering if the death was more or less than a year ago. Circle the code corresponding to the answer given. If the answer is 'Yes', continue to the next question. If the answer is 'No', skip to OV5.
Households
1
Yes
2
No
9
Missing
Of those who died is there any one between the ages of 18 an
Of those who died is there any one between the ages of 18 an
Of those who died is there any one between the ages of 18 an
Of those who died is there any one between the ages of 18 an
Of those who died is there any one between the ages of 18 an
(Of those who died in the past 12 months) were any of these people between the ages of 18 and 59?
Circle the code corresponding to the answer given. If the answer is 'No', skip to OV5.
Households
1
Yes
2
No
9
Missing
If yes ,were any seriously ill for 3 of the 12 months befor
If yes ,were any seriously ill for 3 of the 12 months befor
If yes ,were any seriously ill for 3 of the 12 months befor
If yes ,were any seriously ill for 3 of the 12 months befor
If yes ,were any seriously ill for 3 of the 12 months befor
(Of those who died in the past 12 months and were between the ages of 18 and 59) were any of these people seriously ill for 3 of the 12 months before he/she died?
Return to the Household Listing and check the following: 1. Check totals for HL9 and HL11. At least one mother or father dead. Go to OV8 No mother or father dead 2. Check totals for HL8A. At least one adult aged 18-59 very sick 3 of last 12 months. Go to OV8 No adult aged 18-59 very sick 3 of last 12 months 3. Check totals forHL10A and HL12A. At least one mother or father ill 3 of last 12 months. Go to OV8 No mother or father ill 3 of last 12 months. Go to Next Module
Circle the code corresponding to the answer given. A person should be considered 'seriously ill' if he/she was too sick to perform his/her normal activities at work or at home, such as cooking, cleaning, driving or participating in activities. Also, we are asking whether the person was sick for a substantial amount of time, specifically for 3 months or longer of the previous 12 months. The episodes of illness do not need to be consecutive. If 'Yes', skip to OV8 to ask about support systems to households with children - A 'Yes' answer to this question means that there is at least one adult who died during the past 12 months, who was 18-59 years of age and had been seriously ill for at least 3 months. If 'No', continue with the filter in question OV5.
Households
1
Yes
2
No
9
Missing
Main source of drinking water
Main source of drinking water
Main source of drinking water
Main source of drinking water
Main source of drinking water
What is the main source of drinking water for members of your household?
The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). '51' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof or ground catchment and stored in a container, tank or cistern until used. '61' - A tanker-truck water source transports and sells water by means of a tanker truck. '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. --- Circle the code for the most usual source. If several sources are mentioned, probe to determine the most usual source. If the source varies by season, record the source for the season of the interview. Note that the next question is only asked if the response to this question is 'Bottled water'. You should skip WS2 if the response to WS1 is other than 'Bottled water'. If the response is 'Piped into dwelling' or 'Piped into yard/plot', circle '11' or '12', respectively, and skip to WS5. Otherwise, skip to WS3.
Households
11
Piped into dwelling
12
Piped into yard or plot
13
Public tap/standpipe
21
Tubewell/borehole
31
Protected well
32
Unprotected well
41
Protected spring
42
Unprotected spring
51
Rainwater collection
61
Tanker-truck
81
Surface water
91
Bottled water
96
Other
99
Missing
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
What is the main source of water used by your household for other purposes such as cooking and handwashing?
The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). '51' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof or ground catchment and stored in a container, tank or cistern until used. '61' - A tanker-truck water source transports and sells water by means of a tanker truck. '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. --- This question should only be asked to households that use 'Bottled water' for drinking. Circle the code for the most usual source. If the source varies by season, record the source for the season of the interview. If the most usual source of non-drinking water is 'Piped into dwelling' or 'Piped into yard/plot', circle '11' or '12', respectively, and skip to WS5. Otherwise continue to the next question.
Households
11
Piped into dwelling
12
Piped into yard or plot
13
Public tap/standpipe
21
Tubewell/borehole
31
Protected well
32
Unprotected well
41
Protected spring
42
Unprotected spring
51
Rainwater collection
61
Tanker-truck
81
Surface water
96
Other
99
Missing
Time to get water and come back
Time to get water and come back
Time to get water and come back
Time to get water and come back
Time to get water and come back
How long does it take to go there, get water, and come back?
This question is used to find out how convenient the source of water is to the dwelling. Note that the question is asked for water sources coded as '13-81' and '96' in WS1, or water sources coded as '13-96' in WS2. Fill in the estimated time (in minutes, converting from hours, if necessary) it takes by the usual mode of transport to get to the water source, wait to get water, and get back to the dwelling. Use zero(s) preceding the number if less than 100 minutes (for example, '060' or '005'). Then continue to the next question. If the water source is on the dwelling premises or if water is delivered to the dwelling by a vendor, circle '995' for 'Water on premises' and skip to WS5. If the respondent does not know how long it takes, circle '998' and continue on to the next question.
Households
995
On premises
998
DK
999
Missing
Person fetching water
Person fetching water
Person fetching water
Person fetching water
Person fetching water
Who usually goes to this source to fetch the water for your household? Probe: Is this person under age 15? What sex?
Circle code that best describes this person.
The purpose of this question is to find out the age and gender of the person who usually performs the task of hauling water. This will provide an understanding of whether water hauling responsibilities are given to members of a particular sex or age group. Probe: "IS THIS PERSON UNDER AGE 15? WHAT SEX IS THIS PERSON?" Circle the code that corresponds with the response or '8' if the respondent does not know. Adult refers to anyone age 15 or over, regardless of whether he/she is a household member. Child refers to anyone under the age of 15, regardless of whether he/she is a household member.
Households
1
Adult woman
2
Adult man
3
Female child (under 15)
4
Male child (under 15)
8
DK
9
Missing
Treat water to make safer for drinking
Treat water to make safer for drinking
Treat water to make safer for drinking
Treat water to make safer for drinking
Treat water to make safer for drinking
Do you treat your water in any way to make it safer to drink?
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle '1' if 'Yes', and continue to the next question. If 'No' or 'DK' (Doesn't know'), circle '2' or '8', respectively, and skip to WS7.
Households
1
Yes
2
No
8
DK
9
Missing
Boil
Boil
Boil
Boil
Boil
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
A
Boil
Add bleach/chlorine
Add bleach/chlorine
Add bleach/chlorine
Add bleach/chlorine
Add bleach/chlorine
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
B
Add bleach/chlorine
Strain it through a cloth
Strain it through a cloth
Strain it through a cloth
Strain it through a cloth
Strain it through a cloth
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
C
Strain it through a cloth
Use water filter
Use water filter
Use water filter
Use water filter
Use water filter
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
D
Use water filter
Solar disinfection
Solar disinfection
Solar disinfection
Solar disinfection
Solar disinfection
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
E
Solar disinfection
Let it stand and settle
Let it stand and settle
Let it stand and settle
Let it stand and settle
Let it stand and settle
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
F
Let it stand and settle
Other
Other
Other
Other
Other
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
X
Other
DK
DK
DK
DK
DK
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
Z
DK
Kind of toilet facility
Kind of toilet facility
Kind of toilet facility
Kind of toilet facility
Kind of toilet facility
What kind of toilet facility do members of your household usually use? If "flush" or "pour flush", probe: Where does it flush to?
If necessary, ask permission to observe the facility.
Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of this question is to obtain a measure of the cleanliness of the sanitary facility used by the household members. It may be necessary to observe the facility. If so, ask permission to do so. If the respondent answers or it is observed that the household members have no facilities or use the bush or field, enter '95' for 'No facilities or bush or field' and skip to the next module. If any of the flush or pour flush responses (11-15) are given, probe: "WHERE DOES IT FLUSH TO?" Circle the code corresponding to the response given. Definitions of various types of toilet facilities are as follows: A flush toilet uses a cistern or holding tank for flushing water and has a water seal, which is a U-shaped pipe, below the seat or squatting pan that prevents the passage of flies and odours. A pour flush toilet uses a water seal, but unlike a flush toilet, a pour flush toilet uses water poured by hand for flushing (no cistern is used). . '11' - A piped sewer system is a system of sewer pipes, also called sewerage, that is designed to collect human excreta (faeces and urine) and wastewater and remove them from the household environment. Sewerage systems consist of facilities for collection, pumping, treating and disposing of human excreta and wastewater. . '12' - A septic tank is an excreta collection device and is a water-tight settling tank normally located underground, away from the house or toilet. . '13' - A flush/pour flush to pit latrine refers to a system that flushes excreta to a hole in the ground. . '14' - A flush/pour flush to somewhere else refers to excreta being deposited in or nearby the household environment (not into pit, septic tank or sewer); excreta may be flushed to the street, yard/plot, drainage way or other location. . '15' - Flush to unknown place/not sure/DK where should be coded in cases when the respondent knows that the toilet facility is a flush toilet, but does not know where it flushes to. '21' - A ventilated improved pit latrine or VIP is a type of pit latrine that is ventilated by a pipe extending above the latrine roof. The open end of the vent pipe is covered with gauze mesh or fly-proof netting and the inside of the superstructure is kept dark. '22' - A pit latrine with slab uses a hole in the ground for excreta collection and has a squatting slab, platform or seat that is firmly supported on all sides, easy to clean and raised above the surrounding ground level to prevent surface water from entering the pit. '23' - A pit latrine without slab uses a hole in the ground for excreta collection and does not have a squatting slab, platform or seat. An open pit is a rudimentary hole in the ground where excreta is collected. '31' - A composting toilet is a toilet into which excreta and carbon-rich material are added (vegetable wastes, straw, grass, sawdust, ash) and special conditions maintained to produce inoffensive compost. '41' - Bucket refers to the use of a bucket or other container for the retention of faeces (and sometimes urine and anal cleaning material), which is periodically removed for treatment or disposal. '51' - A hanging toilet or hanging latrine is a toilet built over the sea, a river, or other body of water into which excreta drops directly. '95' - No facilities or bush or field includes excreta wrapped and thrown with garbage, the 'cat' method of burying excreta in dirt, defecation in the bush or field or ditch, and defecation into surface water (drainage channel, beach, river, stream or sea).
Households
11
Flush to piped sewer system
12
Flush to septic tank
13
Flush to pit (latrine)
14
Flush to somewhere else
15
Flush to unknown place/not sure/DK where
22
Pit latrine with slab
23
Pit latrine without slab/open pit
95
No facilities or bush or field
96
Other
99
Missing
Toilet facility shared
Toilet facility shared
Toilet facility shared
Toilet facility shared
Toilet facility shared
Do you share this facility with other households?
Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of the following two questions is to determine whether the household shares their sanitation facility with other households. The shared status of a sanitation facility is important because shared facilities can be less hygienic than facilities used by only a single household. Unhygienic conditions (faeces on the floor, seat or wall and flies) may discourage use of the facility. --- Circle the code corresponding to the response given. If 'No', go to the next module.
Households
1
Yes
2
No
9
Missing
Households using this toilet facility
Households using this toilet facility
Households using this toilet facility
Households using this toilet facility
Households using this toilet facility
How many households in total use this toilet facility?
Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of the following two questions is to determine whether the household shares their sanitation facility with other households. The shared status of a sanitation facility is important because shared facilities can be less hygienic than facilities used by only a single household. Unhygienic conditions (faeces on the floor, seat or wall and flies) may discourage use of the facility. --- The total number of households using this facility should include the household being interviewed. If less than ten households use this toilet facility, enter the number of households on the line provided. Circle '10' if ten or more households use this toilet facility. Note that '01' is not a valid response (since it means that this is the only this household that uses the facility; if that is the case, you should go back to WS8 and correct the response there). Circle '98' for 'DK' ('Doesn't know').
Households
10
Ten or more households
98
DK
99
Missing
Religion of head
Religion of head
Religion of head
Religion of head
Religion of head
What is the religion of the head of this household?
Circle the code corresponding to the answer given. Make sure to get the religion, ethnicity or mother tongue/native language of the household head.
Households
1
Buddhist
2
Muslim
3
Christian
6
Other religion
7
No religion
9
Missing
Language
Language
Language
Language
Language
What is the mother tongue/native language of the head of this household?
Circle the code corresponding to the answer given. Make sure to get the religion, ethnicity or mother tongue/native language of the household head.
Households
1
Thai
2
Other Languages
3
Missing
Ethnic group of head
Ethnic group of head
Ethnic group of head
Ethnic group of head
Ethnic group of head
To what ethnic group does the head of this household belong?
Circle the code corresponding to the answer given. Make sure to get the religion, ethnicity or mother tongue/native language of the household head.
Households
1
Thai
2
Cambodia
3
Loas
4
China
5
Myanmar
6
Other Ethnic
7
Hill Tribe
9
Missing
Head of occupation
Head of occupation
Head of occupation
Head of occupation
Head of occupation
1
Government Officer
2
State Enterprises Officer
3
Private Officer
4
Business
5
Agriculturist
6
Labourer
7
Other
9
Missing
Mean of income
Mean of income
Mean of income
Mean of income
Mean of income
1
Lower 10000
2
10000-19999
3
20000-29999
4
30000-39999
5
40000-49999
6
Upper 50000
9
Missing
Number of rooms for sleeping
Number of rooms for sleeping
Number of rooms for sleeping
Number of rooms for sleeping
Number of rooms for sleeping
How many rooms in this household are used for sleeping?
This information provides a measure of how crowded the house is, and reflects the socio-economic condition of the household. A room in this case refers to a special area with a permanent partition that is used for sleeping. It is not necessarily the number of rooms in the household that are called 'bedrooms', but rather how many rooms get used for sleeping on a regular basis. Exclude rooms that are used only for sleeping by visitors to the household, but include those rooms that may not be regular 'bedrooms' but may be regularly used by one or more of the household members for sleeping. Enter the number of rooms in this household that are used for sleeping.
Households
99
Missing
Main material of floor
Main material of floor
Main material of floor
Main material of floor
Main material of floor
Main material of the dwelling floor:
Record observation.
Circle the correct code for the material of the dwelling floor based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the floor, record the main flooring material (the material that covers the largest amount of floor space).
Households
11
Earth/sand
21
Wood planks
22
Palm/bamboo
31
Parquet or polished wood
32
Vinyl or asphalt strips
33
Ceramic tiles
34
Cement
35
Carpet
36
Marble
37
Polished stone
96
Other
99
Missing
Main material of roof
Main material of roof
Main material of roof
Main material of roof
Main material of roof
Main material of the roof.
Record observation.
Circle the correct code for the material of the dwelling roof, based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the roof, record the main roofing material (the material that covers the largest amount of roof).
Households
11
No roof
12
Thatch/palm leaf
13
Sod
22
Palm/bamboo
23
Wood Planks
31
Metal
33
Calamine/cement fiber
34
Ceramic tiles
35
Cement
36
Roofing shingles
96
Other
99
Missing
Main material of wall
Main material of wall
Main material of wall
Main material of wall
Main material of wall
Main material of the walls.
Record observation.
Circle the correct code for the material of the dwelling walls, based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the walls, record the main wall material (the material that covers the largest amount of wall space).
Households
11
No walls
12
Cane/palm/trunks
13
Dirt
24
Plywood
25
Carton
26
Reused wood
27
Bamboo
31
Cement
32
Stone with lime/cement
33
Bricks
34
Cement blocks
36
Wood planks/shingles
37
Zinc
38
Tile
39
Shera wood
96
Other
99
Missing
Type of fuel using for cooking
Type of fuel using for cooking
Type of fuel using for cooking
Type of fuel using for cooking
Type of fuel using for cooking
What type of fuel does your household mainly use for cooking?
Information on the type of fuel used for cooking is collected as another measure of the socio-economic status of the household. The use of some cooking fuels can also have adverse health consequences. Circle the code corresponding to the answer given. Remember that this question asks about fuel for cooking, not fuel for heating or lighting. If the household uses more than one fuel for cooking, find out which type of fuel is used most often. If electricity, liquid propane gas (LPG), natural gas, or biogas is mainly used, circle '01', '02', '03', or '04', respectively, and skip to HC8. If any fuel other than the pre-coded ones is reported as being the main fuel used for cooking, circle '96' and specify the type of fuel on the line provided. Definitions of some of the types of fuel are as follows: 'Biogas' includes gases produced by fermenting manure in an enclosed pit. 'Lignite' is a derivative of coal that produces more smoke when burned but produces less heat than coal.
Households
1
Electricity
2
Liquid propane gas (LPG)
4
Biogas
5
Kerosene
6
Coal/lignite
7
Charcoal
8
Wood
9
Straw/shrubs/grass
10
Animal dung
11
Agricultural crop residue
96
Other
97
No Cooking
99
Missing
Food cooked on stove or open fire
Food cooked on stove or open fire
Food cooked on stove or open fire
Food cooked on stove or open fire
Food cooked on stove or open fire
In this household, is food cooked on an open fire, an open stove or a closed stove?
Probe for type.
Probe for type of stove and circle the code corresponding to the response given. If a response is given other than the pre-coded ones, circle '96' and specify the type of stove on the line provided. For 'Closed stove', skip the next question and ask HC8.
Households
1
Open fire
2
Open stove
3
Closed stove
6
Other
9
Missing
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire/stove have a chimney or a hood?
Circle the appropriate response.
Households
1
Yes
2
No
9
Missing
Cooking location
Cooking location
Cooking location
Cooking location
Cooking location
Is the cooking usually done in the house, in a separate building, or outdoors?
Circle the code corresponding to the response given. If a response is given other than the pre-coded ones, circle '6' and specify on the line provided.
Households
1
In the house
2
In a separate bulding
3
Outdoors
4
Terrace
6
Other
9
Missing
Electricity
Electricity
Electricity
Electricity
Electricity
Does your household have:
Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR?
Households
1
Yes
2
No
9
Missing
Radio
Radio
Radio
Radio
Radio
Does your household have:
Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR?
Households
1
Yes
2
No
9
Missing
Television
Television
Television
Television
Television
Does your household have:
Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR?
Households
1
Yes
2
No
9
Missing
Mobile phone
Mobile phone
Mobile phone
Mobile phone
Mobile phone
Does your household have:
Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR?
Households
1
Yes
2
No
9
Missing
Non-mobile phone
Non-mobile phone
Non-mobile phone
Non-mobile phone
Non-mobile phone
Does your household have:
Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR?
Households
1
Yes
2
No
9
Missing
Refrigerator
Refrigerator
Refrigerator
Refrigerator
Refrigerator
Does your household have:
Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR?
Households
1
Yes
2
No
9
Missing
Computer
Computer
Computer
Computer
Computer
Watch
Watch
Watch
Watch
Watch
Does any member of your household own:
This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR.
Households
1
Yes
2
No
9
Missing
Bicycle
Bicycle
Bicycle
Bicycle
Bicycle
Does any member of your household own:
This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR.
Households
1
Yes
2
No
9
Missing
Motorcycle or scooter
Motorcycle or scooter
Motorcycle or scooter
Motorcycle or scooter
Motorcycle or scooter
Does any member of your household own:
This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR.
Households
1
Yes
2
No
9
Missing
Animal-drawn cart
Animal-drawn cart
Animal-drawn cart
Animal-drawn cart
Animal-drawn cart
Does any member of your household own:
This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR.
Households
1
Yes
2
No
9
Missing
Car or truck
Car or truck
Car or truck
Car or truck
Car or truck
Does any member of your household own:
This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR.
Households
1
Yes
2
No
9
Missing
Boat with motor
Boat with motor
Boat with motor
Boat with motor
Boat with motor
Does any member of your household own:
This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR.
Households
1
Yes
2
No
9
Missing
Salt iodization test outcome
Salt iodization test outcome
Salt iodization test outcome
Salt iodization test outcome
Salt iodization test outcome
We would like to check whether the salt used in your household is iodized. May I see a sample of the salt used to cook the main meal eaten by members of your household last night?
Once you have examined the salt, circle number that corresponds to test outcome.
After you have completed all modules of the Household Questionnaire, administer the module on Salt Iodization. Note that in this module, you will most probably perform a test on a sample of salt provided by the respondent. This item is used to record the type of salt used to prepare the family's main meal the day before the questionnaire is administered, and the outcome of the test for salt iodization. Once you have a sample of salt, perform the test and circle the code that corresponds to the test outcome. Circle '1' if the test is negative (0 parts per million/no colour - not iodized). Circle '2' if the test shows less than 15 parts per million iodine (weak colour). Circle '3' if the test is positive (15 parts per million or more, strong colour). Circle '6' if there is 'No salt in home'. Circle '7' if the salt was present, but not tested for any reason. If the respondent indicates that no salt was used to cook the main meal last night, or that no meal was cooked, ask for a sample of the salt usually used for cooking in the household, and perform the test on this sample of salt.
Households
1
No colour
4
Colour
6
No salt in home
9
Missing
Packet of salt
Packet of salt
Packet of salt
Packet of salt
Packet of salt
The packet of salt when purchased?
1
Bag had iodine label
2
Bottle had iodine label
3
Bag/bottle had not iodine label
6
DK
9
Missing
Type of salt
Type of salt
Type of salt
Type of salt
Type of salt
1
Coarse
2
Refined
PPM from lab test
PPM from lab test
PPM from lab test
PPM from lab test
PPM from lab test
Household sample weight
Household sample weight
Household sample weight
Household sample weight
Household sample weight
Recoded variable
De jure household members (usual residents)
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
Recoded variable
Children aged 0-4
wealth index quintiles
wealth index quintiles
wealth index quintiles
wealth index quintiles
wealth index quintiles
Recoded variable
Children aged 0-4
1
Poorest
2
Second
3
Middle
4
Fourth
5
Richest
Household Head's education
Household Head's education
Household Head's education
Household Head's education
Household Head's education
Recoded variable
De jure household members (usual residents)
1
None
2
Primary
3
Secondary +
Sex of household head
Sex of household head
Sex of household head
Sex of household head
Sex of household head
Recoded variable
Households
1
Male
2
Female
9
Missing/DK
Cluster number
Cluster number
Cluster number
Cluster number
Cluster number
We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. During this time I would like to speak with the household head and all mothers or others who take care of children in the household. May I start now? If permission is given, begin the interview. Cluster number:
Enter the cluster number as instructed by your supervisor.
Households
Unique identifier for the cluster in which the household exists
Household number
Household number
Household number
Household number
Household number
Household number:
Enter the household number as instructed by your supervisor.
Households
Houshold number within the cluster
Line number
Line number
Line number
Line number
Line number
FIRST, PLEASE TELL ME THE NAME OF EACH PERSON WHO USUALLY LIVES HERE, STARTING WITH THE HEAD OF THE HOUSEHOLD. List the head of the household in line 01. List all household members (HL2), their relationship to the household head (HL3), and their sex (HL4). Then ask: ARE THERE ANY OTHERS WHO LIVE HERE, EVEN IF THEY ARE NOT AT HOME NOW? (THESE MAY INCLUDE CHILDREN IN SCHOOL OR AT WORK). If yes, complete listing. Then, ask questions starting with HL5 for each person at a time. Add a continuation sheet if there are more than 15 household members. Tick here if continuation sheet used
A household is a person or group of persons who usually live and eat together. Any adult member of the household can serve as the respondent for this section. As described below, there are a number of modules in the Household Questionnaire that you have to administer to mothers or primary caretakers of children. Therefore, it can be an advantage if you begin the Household Questionnaire with a mother or primary caretaker. While you should not make a specific effort to ensure this, you will indeed start the interview with such persons in many cases, since, in practice, these persons are more likely to be at home than, say, male household heads. Note that the Household Listing Form includes HL1. Line No. This is the number used to identify each person listed. You must obtain a complete list of all persons who usually live in the household, but you do not need to fill in or do anything in this column since the numbers are already provided. This is a very important number, since once household members are assigned these line numbers as the Household Listing is being completed, they are identified with these line numbers throughout the questionnaires administered in this household. You should begin by saying: FIRST, PLEASE TELL ME THE NAME OF EACH PERSON WHO USUALLY LIVES HERE, STARTING WITH THE HEAD OF THE HOUSEHOLD. List the head of the household in line 01. List all household members (HL2), their relationship to the household head (HL3), and their sex (HL4). Then ask: ARE THERE ANY OTHERS WHO LIVE HERE - EVEN IF THEY ARE NOT AT HOME NOW? (THESE MAY INCLUDE CHILDREN AT SCHOOL OR AT WORK). If yes, complete the listing. Note that the household head is determined solely on the basis of what the respondent tells you. You are not required to assess who the household head is most likely to be, or whether the person stated as the household head has the necessary characteristics to be the household head. Also note that if there are more than 15 household members, you will need to use a continuation sheet to record the additional household members. Please remember to change the line numbers of household members on the continuation sheet to read '16', '17', '18', etc., and to tick the box provided at the top of the Household Listing indicating that a continuation sheet has been used. The Household Listing will be completed in two stages: first, names (HL2), relationship codes (HL3) and sex (HL4) of all household members are recorded until all household members are included in the list. When the respondent is asked to provide the names of persons living in the household, their relationship to the head of the household and their sex is naturally mentioned during the course of listing the names. For this reason, the list is completed vertically for HL2, HL3 and HL4 during the first stage. Then, questions from HL5 to HL12 are asked for each person before moving to the next person. Fill in the name of each household member, starting with the head of household (the person who is considered to be responsible for the household). It is up to the respondent to define who the head of the household is. The head of the household should always be on the first row of the list. Never contest the respondent's answer. Also note that the names of household members will never be used for analysis purposes. However, recording the names of all household members is important since you will be using these names to address the questions.
De jure household members (usual residents)
Line number
Line number
Line number
Line number
Line number
Child's line number:
Children aged 0-4
Relationship to the head
Relationship to the head
Relationship to the head
Relationship to the head
Relationship to the head
What is the relationship of (name) to the head of the household?
Enter the code corresponding to how the person listed is related to the head of the household. Use the codes at the bottom of the Household Listing. Be particularly careful in doing this if the respondent is not the head of the household. Make sure that you record the relationship of each person to the household head, not the relationship to the respondent. For example, if the respondent is the wife of the head of the household and she says that Sola is her brother, then Sola should be coded as '09' ('Brother or sister-in-law'), not as '08' ('Brother or sister'), because Sola is a brother-in-law of the head of the household. Be very careful in obtaining this information correctly, since respondents tend to provide the relationship of the person to themselves, rather than to the head of the household. If the head of the household is married to a woman who has a child from a previous marriage, that child's relationship to the head of the household should be coded as '14' ('Adopted/foster/stepchild'). If a household member is not related to the head of household, such as a friend who lives with the household, enter '15' ('Not related'). Enter '98' if the respondent doesn't know the relationship of a household member to the head of household.
De jure household members (usual residents)
1
Head
2
Wife or Husband
3
Son or Daugher
4
Son/Daughter in law
5
Grandchild
6
Parent
7
Parent in law
8
Brother or sister
9
Brother/sister in law
10
Uncle/Aunt
11
Niece/nephew by blood
12
Niece/nephew by marriage
13
Other relative
14
Adopted/foster/stepchild
15
Not related
97
Inconsistent
98
DK
99
Missing
Sex
Sex
Sex
Sex
Sex
Children aged 0-4
1
Male
2
Female
Age
Age
Age
Age
Age
How old is (name)? How old was (name) on his/her last birthday?
Record in completed years 98=DK* * See instructions: to be used only for elderly household members (code meaning "do not know/over age 50").
Enter each person's age in completed years, that is, his/her age at his/her last birthday. Completed age is also defined as 'the number of completed solar years since birth'. With this definition, since a 6-month-old baby has not completed a full solar year, his/her age will be entered as '00'. Note that you will be obtaining more accurate estimates of children's ages later. This column should never be left blank. If you have difficulty obtaining the ages of very elderly members of the household, you may enter the code '98', meaning 'Doesn't know/over age 50'. For household members younger than 50, completed ages must be entered.
De jure household members (usual residents)
Less than 1 year
97
97+
98
DK
99
Missing
Nationalily
Nationalily
Nationalily
Nationalily
Nationalily
1
Thai
2
Not Thai (Hill tribe, Minority group)
3
Other (Specify)
4
No Citizenship
8
DK
9
Missing
Line number of eligible women
Line number of eligible women
Line number of eligible women
Line number of eligible women
Line number of eligible women
Circle Line no. if woman is age 15-49
Circle the line number in this column if the household member is a woman 15-49 years of age (this includes those age 15 and age 49). You will not ask this question to the respondent.
De jure household members (usual residents)
Not eligible
Line number of mother/caretaker for child labor module
Line number of mother/caretaker for child labor module
Line number of mother/caretaker for child labor module
Line number of mother/caretaker for child labor module
Line number of mother/caretaker for child labor module
For each child age 5-14:
Who is the mother or primary caretaker of this child?
Record Line no. of mother/caretaker
If the household member is a child between 5 and 14 years of age (this includes those age 5 and age 14), record the line number of his/her mother or primary caretaker in this column. Ask this question to the respondent if necessary.
De jure household members (usual residents)
Not eligible
Line number of mother/caretaker for child health module
Line number of mother/caretaker for child health module
Line number of mother/caretaker for child health module
Line number of mother/caretaker for child health module
Line number of mother/caretaker for child health module
For each child under 5:
Who is the mother or primary caretaker of this child?
Record Line no. of mother/caretaker
If the household member is a child under the age of five (this includes those just born and those age 4, but not children who have completed 5 years of age), record the line number of his/her mother or primary caretaker in this column. Ask this question to the respondent if necessary.
De jure household members (usual residents)
Not eligible
Member ill 3 months in last 12 months
Member ill 3 months in last 12 months
Member ill 3 months in last 12 months
Member ill 3 months in last 12 months
Member ill 3 months in last 12 months
If age 18-59 years
Has (name) been very sick for at least 3 months during the past 12 months?
By chronically ill we mean that the person was too sick to perform his/her normal activities at work or at home, such as cooking, cleaning, driving or participating in activities. Also, we are asking whether the person was sick for a substantial amount of time, specifically for 3 months or longer during the previous 12 months. The episodes of illness do not need to be consecutive.
De jure household members (usual residents)
1
Yes
2
No
8
DK
9
Missing
Mother alive
Mother alive
Mother alive
Mother alive
Mother alive
For children age 0-17 years ask HL9-HL12
Is (name's) natural mother alive?
For all children under age 18, we want to know whether either of their own (natural) parents is listed in the Household Listing, and their survival status. This information can be used to measure the prevalence of orphanhood and child fostering in the population. For everyone age 18 and older, HL9-12 will be left blank. --- By 'natural' we mean the biological mother. In many cultures, people consider other people's children whom they are raising as their own, especially children of their husband or sisters, etc. You should be certain that the respondent understands that you are asking about the woman who gave birth to the child. Record whether or not the child's natural mother is still alive by circling the code corresponding to the response given. If the child's natural mother is not alive or if the respondent does not know, skip to HL11. Otherwise, continue to the question in the next column.
De jure household members (usual residents) aged 0-17 (under 18)
1
Yes
2
No
8
DK
9
Missing
Mother line number in HH
Mother line number in HH
Mother line number in HH
Mother line number in HH
Mother line number in HH
For children age 0-17 years ask HL9-HL12 If alive:
Does (name's) natural mother live in this household?
Record Line no. of mother or 00 for 'No'
For all children under age 18, we want to know whether either of their own (natural) parents is listed in the Household Listing, and their survival status. This information can be used to measure the prevalence of orphanhood and child fostering in the population. For everyone age 18 and older, HL9-12 will be left blank. --- If the natural mother is still alive, we want to know whether she lives in the household. If the mother does live in the household, ask who she is (she should be listed in the Household Listing if she lives in the household) and record her line number in the space provided. If the mother is not a member of the household (not listed in the Household Listing), record '00'.
De jure household members (usual residents) aged 0-17 (under 18)
Not eligible
97
Inconsistent
99
Missing
Mother ill 3 months in last 12 months
Mother ill 3 months in last 12 months
Mother ill 3 months in last 12 months
Mother ill 3 months in last 12 months
Mother ill 3 months in last 12 months
For children age 0-17 years ask HL9-HL12A If mother does not live in household:
Has (name's) mother been very sick for at least 3 months in the past 12 months?
Use the definition of 'very sick' from HL8A. Circle the code corresponding to the answer given. The question should be left blank if the mother lives in the household (See HL10).
De jure household members (usual residents) aged 0-17 (under 18)
1
Yes
2
No
8
DK
9
Missing
Father alive
Father alive
Father alive
Father alive
Father alive
For children age 0-17 years ask HL9-HL12 If alive:
Is (name's) natural father alive?
For all children under age 18, we want to know whether either of their own (natural) parents is listed in the Household Listing, and their survival status. This information can be used to measure the prevalence of orphanhood and child fostering in the population. For everyone age 18 and older, HL9-12 will be left blank. --- Fill in these questions in exactly the same way as HL9 and HL10. This time, make sure to record the survival status and the line number of the natural (biological) fathers. If the father of the household member is not alive or his survival status is now known by the respondent, move to the next person on the list.
De jure household members (usual residents) aged 0-17 (under 18)
1
Yes
2
No
8
DK
9
Missing
Father line number in HH
Father line number in HH
Father line number in HH
Father line number in HH
Father line number in HH
For children age 0-17 years ask HL9-HL12
Does (name's) natural father live in this household?
Record Line no. of father or 00 for 'No'
For all children under age 18, we want to know whether either of their own (natural) parents is listed in the Household Listing, and their survival status. This information can be used to measure the prevalence of orphanhood and child fostering in the population. For everyone age 18 and older, HL9-12 will be left blank. --- Fill in these questions in exactly the same way as HL9 and HL10. This time, make sure to record the survival status and the line number of the natural (biological) fathers. If the father of the household member is not alive or his survival status is now known by the respondent, move to the next person on the list. --- When you have completed the listing of all household members and all questions in the Household Listing, probe to see if there are any other household members you have not included in the list: "ARE THERE ANY OTHER PERSONS LIVING HERE - EVEN IF THEY ARE NOT MEMBERS OF YOUR FAMILY OR DO NOT HAVE PARENTS LIVING IN THIS HOUSEHOLD? INCLUDING CHILDREN AT WORK OR AT SCHOOL?" If yes, insert child's name and complete the form. After you have made sure that there are no other household members to be included in the list, complete the row at the bottom of the household list, 'Totals'. Calculate the number of eligible women in the household and record the number under 'Women 15-49', calculate the number of children aged 5-14 years in the household and record the number under 'Children 5-14' and, finally, calculate the number of children under five, and record the number under 'Under-5s'. The numbers recorded here for the women 15-49 and under-5s will indicate to you the number of individual women's and under-five questionnaires you should have in the household (see below). You will also record these numbers in HH12 and HH14 in the Household Information Panel. When you have completed the Household Listing Form for all household members, prepare the individual questionnaire forms for this household: . For each woman age 15-49 years, write her name and line number in the spaces provided (WM3 and WM4) at the top of her Questionnaire for Individual Women. . For each child under age five, write his/her name and line number and the name and line number of his/her mother or caretaker in the spaces provided (UF3-6) at the top of the Questionnaire for Children Under Five. You should now have a separate questionnaire for each eligible woman and child under five in the household, ready for use when you administer the questionnaires later on.
De jure household members (usual residents) aged 0-17 (under 18)
Not eligible
97
Inconsistent
99
Missing
Father ill 3 months in last 12 months
Father ill 3 months in last 12 months
Father ill 3 months in last 12 months
Father ill 3 months in last 12 months
Father ill 3 months in last 12 months
For children age 0-17 years ask HL9-HL12A If father does not live in household:
Has (name's) father been very sick for at least 3 months in the past 12 months?
Use the definition of 'very sick' as in HL8A. Circle the code corresponding to the answer given. This question should be left blank if the father lives in the household (See HL12).
De jure household members (usual residents) aged 0-17 (under 18)
1
Yes
2
No
8
DK
9
Missing
Total number of Women 15-49
Total number of Women 15-49
Total number of Women 15-49
Total number of Women 15-49
Total number of Women 15-49
Are there any other persons living here - even if they are not members of your family or do not have parents living in this household? Including children at work or at school? If yes, insert child's name and complete form. Then, complete the totals below.
Households
Total number of Children 5-14
Total number of Children 5-14
Total number of Children 5-14
Total number of Children 5-14
Total number of Children 5-14
Households
Total number of children Under 5 years
Total number of children Under 5 years
Total number of children Under 5 years
Total number of children Under 5 years
Total number of children Under 5 years
Households
Total number of Very Sick
Total number of Very Sick
Total number of Very Sick
Total number of Very Sick
Total number of Very Sick
Total number of mothers dead
Total number of mothers dead
Total number of mothers dead
Total number of mothers dead
Total number of mothers dead
Total number of mothers very sick
Total number of mothers very sick
Total number of mothers very sick
Total number of mothers very sick
Total number of mothers very sick
Total number of father dead
Total number of father dead
Total number of father dead
Total number of father dead
Total number of father dead
Total number of fathers very sick
Total number of fathers very sick
Total number of fathers very sick
Total number of fathers very sick
Total number of fathers very sick
Line number
Line number
Line number
Line number
Line number
For household members age 5 and above
Continue line by line, asking the questions for each household member who is eligible (age five or older), as you did when completing the Household Listing Form. Note that the lines corresponding to household members under five should remain blank. This is the number assigned to each person on the Household Listing Form. You do not need to fill in or do anything in this column since the numbers are already provided. Copy the names of each person age five and older from the Household Listing Form (HL2) to their corresponding line numbers.
De jure household members (usual residents)
Ever attended school
Ever attended school
Ever attended school
Ever attended school
Ever attended school
For household members age 5 and above
Has (name) ever attended school or preschool?
For each household member age five or older, ask ED2 and ED3. These questions ask about educational attainment for all household members in this age group. (If children younger than five attend school or pre-school, this information will be recorded in the Questionnaire for Children Under Five.) Any adult member of the household may provide this information for those not present. --- Circle '1' if the answer is 'Yes'. If the answer is 'No', circle '2' and go to the household member on the next line. The term 'school' includes primary, secondary and post-secondary schooling, as well as any other intermediate levels of schooling in the formal school system. It also includes technical or vocational training beyond the primary-school level, such as long-term courses in mechanics or secretarial work. Schools that carry out non-standard curriculum are also included here. Ensure that respondents understand what is meant by 'non-standard curriculum'. A non-standard curriculum includes religious schools, such as Koranic schools, that do not teach a full, standard school curriculum. If a school teaches religious courses but also includes the standard curriculum - such as many Catholic schools - it would be coded as a standard school. 'Pre-school' is listed for children who do not attend grade 1 at age 5, but do attend some form of organized learning or early childhood education programme, whether or not such a programme is considered part of the school system. The definition of organized early learning programme does not refer to programmes offering only babysitting or child-minding.
De jure household members (usual residents)
1
Yes
2
No
9
Missing
Highest level of school attended
Highest level of school attended
Highest level of school attended
Highest level of school attended
Highest level of school attended
What is the highest level of school (name) attended?
Children aged 0-4
Preschool/kindergarten
1
Primary
2
Secondary
3
Higher
6
Non-standard curriculum
8
DK
9
Missing
Highest grade at level
Highest grade at level
Highest grade at level
Highest grade at level
Highest grade at level
For household members age 5 and above
What is the highest grade (name) completed at this level?
For each household member age five or older, ask ED2 and ED3. These questions ask about educational attainment for all household members in this age group. (If children younger than five attend school or pre-school, this information will be recorded in the Questionnaire for Children Under Five.) Any adult member of the household may provide this information for those not present. --- If the person has been to school, record the highest level of schooling attended by circling the code for the response. You may need to probe for the type of school attended. Circle '8' if the respondent 'Doesn't know'. Then ask, "WHAT IS THE HIGHEST GRADE (name) COMPLETED AT THIS LEVEL?" Enter the highest grade completed or '98' for 'DK' ('Doesn't know'). If less than one grade, enter '00'. For instance, if a person has attended primary school but did not complete the first grade, then the level for this person will be circled as '1', and the grade will be entered as '00'. Similarly, for a child who is attending grade 5 in primary school at the time of the interview, the level will be coded as '1' and the grade as '4', since this person has not yet completed grade 5.
De jure household members (usual residents)
No education
97
Inconsistent
98
DK
99
Missing
Currently attending school during the school year (2004-2005
Currently attending school during the school year (2004-2005
Currently attending school during the school year (2004-2005
Currently attending school during the school year (2004-2005
Currently attending school during the school year (2004-2005
For household members age 5-24 years
During the (2004-2005) school year, did (name) attend school or preschool at any time?
For each household member 5-24 years of age (this includes those age 5 and age 24), ask questions ED4-ED8, which inquire about school attendance. While the ideal respondent for these questions would be the mother or primary caretaker, any adult member of the household may provide the information. Since questions from ED4 to ED8 refer to school attendance, they will have to be adapted to the situation at the time of the interview. All questions should be retained. However, the wording and coding will have to be changed. The objective of these questions is to capture the school attendance of household members in two consecutive school years. In the explanations below, information is provided on how this can be tackled. --- Circle the code corresponding to the answer given. If 'Yes', continue to the next question. If 'No', skip to ED7. If the interview is carried out during the school year, then the question should be worded to refer to the current school year. If the interview is carried out between school years, then the question should refer to the last school year that has ended. Take the example of a country where the school year ends in June and the new school year begins in September: If the interview is carried out in July 2005 (between school years), then the question should refer to the 2004-2005 school year; if the interview is carried out in October 2005 (during the new school year), then the question should refer to the 2005-2006 school year.
De jure household members (usual residents) aged 5-24
1
Yes
2
No
9
Missing
Reason of no attended school
Reason of no attended school
Reason of no attended school
Reason of no attended school
Reason of no attended school
1
Far from home
2
No Birth Certificate
3
No Citizenship
4
No Money
5
Language Problem
6
Sick/Disability
7
Member HH have sick
8
Finish at School
9
Other
98
DK
99
Missing
Days attended school in last week
Days attended school in last week
Days attended school in last week
Days attended school in last week
Days attended school in last week
For household members age 5-24 years
Since last (day of the week), how many days did (name) attend school?
Insert number of days in space below.
For each household member 5-24 years of age (this includes those age 5 and age 24), ask questions ED4-ED8, which inquire about school attendance. While the ideal respondent for these questions would be the mother or primary caretaker, any adult member of the household may provide the information. Since questions from ED4 to ED8 refer to school attendance, they will have to be adapted to the situation at the time of the interview. All questions should be retained. However, the wording and coding will have to be changed. The objective of these questions is to capture the school attendance of household members in two consecutive school years. In the explanations below, information is provided on how this can be tackled. --- When asking this question, insert the name of the day of the interview. For example, if the interview is taking place on a Tuesday, ask: "SINCE LAST TUESDAY, HOW MANY DAYS DID (name) ATTEND SCHOOL?" Note that the maximum number to be entered here should be '7' and not '8'.
De jure household members (usual residents) aged 5-24
8
Interview during school holidays
9
Missing
Level of education attended
Level of education attended
Level of education attended
Level of education attended
Level of education attended
For household members age 5-24 years
During this/that school year, which level and grade is/was (name) attending?
For each household member 5-24 years of age (this includes those age 5 and age 24), ask questions ED4-ED8, which inquire about school attendance. While the ideal respondent for these questions would be the mother or primary caretaker, any adult member of the household may provide the information. Since questions from ED4 to ED8 refer to school attendance, they will have to be adapted to the situation at the time of the interview. All questions should be retained. However, the wording and coding will have to be changed. The objective of these questions is to capture the school attendance of household members in two consecutive school years. In the explanations below, information is provided on how this can be tackled. --- Circle the code for the level of school, and enter the household member's current grade. If it applies, circle '8' for 'DK' ('Doesn't know'). Probe to determine the type of school, particularly to make sure if it is a standard or non-standard curriculum. Then enter the highest grade number completed using '01', '02', etc. If a child is in pre-school or kindergarten, and grades are not used, omit the grade. If less than one grade was completed, enter '00'. Enter '98' for 'DK'. If the interview is conducted during the time between two school years, the question should refer to the school year that has ended, and you should use 'THAT' and 'WAS' in the question. If the interview is conducted during the school year, the question should refer to the current school year. Note that these questions should capture children who may have been attending at the beginning of the school year, but have dropped out since then. If necessary, past tense could be used to make sure that you obtain information on the level and grade of children who may have dropped out from school during the course of the school year. Questions ED4, ED5 and ED6 collect information on the school attendance of household members during the current school year (if the interview is conducted when schools are open) or the last school year that has ended (if the interview is conducted between school years). Questions ED7 and ED8 collect information on the school attendance of household members during the previous school year.
De jure household members (usual residents) aged 5-24
Preschool/kindergarten
1
Primary
2
Secondary
3
Higher
6
Non-standard curriculum
8
DK
9
Missing
Grade of education attended
Grade of education attended
Grade of education attended
Grade of education attended
Grade of education attended
For household members age 5-24 years
During this/that school year, which level and grade is/was (name) attending?
For each household member 5-24 years of age (this includes those age 5 and age 24), ask questions ED4-ED8, which inquire about school attendance. While the ideal respondent for these questions would be the mother or primary caretaker, any adult member of the household may provide the information. Since questions from ED4 to ED8 refer to school attendance, they will have to be adapted to the situation at the time of the interview. All questions should be retained. However, the wording and coding will have to be changed. The objective of these questions is to capture the school attendance of household members in two consecutive school years. In the explanations below, information is provided on how this can be tackled. --- Circle the code for the level of school, and enter the household member's current grade. If it applies, circle '8' for 'DK' ('Doesn't know'). Probe to determine the type of school, particularly to make sure if it is a standard or non-standard curriculum. Then enter the highest grade number completed using '01', '02', etc. If a child is in pre-school or kindergarten, and grades are not used, omit the grade. If less than one grade was completed, enter '00'. Enter '98' for 'DK'. If the interview is conducted during the time between two school years, the question should refer to the school year that has ended, and you should use 'THAT' and 'WAS' in the question. If the interview is conducted during the school year, the question should refer to the current school year. Note that these questions should capture children who may have been attending at the beginning of the school year, but have dropped out since then. If necessary, past tense could be used to make sure that you obtain information on the level and grade of children who may have dropped out from school during the course of the school year. Questions ED4, ED5 and ED6 collect information on the school attendance of household members during the current school year (if the interview is conducted when schools are open) or the last school year that has ended (if the interview is conducted between school years). Questions ED7 and ED8 collect information on the school attendance of household members during the previous school year.
De jure household members (usual residents) aged 5-24
No education
97
Inconsistent
98
DK
99
Missing
Attended school last year (2003-2004)
Attended school last year (2003-2004)
Attended school last year (2003-2004)
Attended school last year (2003-2004)
Attended school last year (2003-2004)
For household members age 5-24 years
Did (name) attend school or preschool at any time during the previous school year, that is (2003-2004)?
For each household member 5-24 years of age (this includes those age 5 and age 24), ask questions ED4-ED8, which inquire about school attendance. While the ideal respondent for these questions would be the mother or primary caretaker, any adult member of the household may provide the information. Since questions from ED4 to ED8 refer to school attendance, they will have to be adapted to the situation at the time of the interview. All questions should be retained. However, the wording and coding will have to be changed. The objective of these questions is to capture the school attendance of household members in two consecutive school years. In the explanations below, information is provided on how this can be tackled. --- If the child attended school at any time during the last school year, circle '1'. If the answer is 'No' or 'DK', circle the appropriate code and go to the household member on the next line.
De jure household members (usual residents) aged 5-24
1
Yes
2
No
8
DK
9
Missing
Level of education attended last year
Level of education attended last year
Level of education attended last year
Level of education attended last year
Level of education attended last year
For household members age 5-24 years
During that previous school year, which level and grade did (name) attend?
For each household member 5-24 years of age (this includes those age 5 and age 24), ask questions ED4-ED8, which inquire about school attendance. While the ideal respondent for these questions would be the mother or primary caretaker, any adult member of the household may provide the information. Since questions from ED4 to ED8 refer to school attendance, they will have to be adapted to the situation at the time of the interview. All questions should be retained. However, the wording and coding will have to be changed. The objective of these questions is to capture the school attendance of household members in two consecutive school years. In the explanations below, information is provided on how this can be tackled. --- Circle the code for the level of school attended and fill in the child's grade or enter '8' if the respondent doesn't know the level and/or '98' if the respondent doesn't know the grade. If the child was in pre-school or kindergarten, and grades are not used, omit the grade.
De jure household members (usual residents) aged 5-24
Preschool/kindergarten
1
Primary
2
Secondary
3
Higher
6
Non-standard curriculum
8
DK
9
Missing
Grade of education attended last year
Grade of education attended last year
Grade of education attended last year
Grade of education attended last year
Grade of education attended last year
For household members age 5-24 years
During that previous school year, which level and grade did (name) attend?
For each household member 5-24 years of age (this includes those age 5 and age 24), ask questions ED4-ED8, which inquire about school attendance. While the ideal respondent for these questions would be the mother or primary caretaker, any adult member of the household may provide the information. Since questions from ED4 to ED8 refer to school attendance, they will have to be adapted to the situation at the time of the interview. All questions should be retained. However, the wording and coding will have to be changed. The objective of these questions is to capture the school attendance of household members in two consecutive school years. In the explanations below, information is provided on how this can be tackled. --- Circle the code for the level of school attended and fill in the child's grade or enter '8' if the respondent doesn't know the level and/or '98' if the respondent doesn't know the grade. If the child was in pre-school or kindergarten, and grades are not used, omit the grade.
De jure household members (usual residents) aged 5-24
No education
97
Inconsistent
98
DK
99
Missing
Have any usual member of your household died in the last 12
Have any usual member of your household died in the last 12
Have any usual member of your household died in the last 12
Have any usual member of your household died in the last 12
Have any usual member of your household died in the last 12
Check HL5: any children 0-17? Yes Continue to OV2 No Next Module
I would like you to think back over the past 12 months. Has any usual member of your household died in the last 12 months?
This module is made up of two sections: The first section identifies households where there is at least one adult aged 18-59 years who was very sick for 3 of the past 12 months and died. This is one of the criteria for identifying if there are eligible children aged 0-17 years for this module, in addition to the criteria in the Extended Household Listing module. The second section asks about different types of support provided to children aged 0-17 years in such households. Note that the module is administered only if there is at least one child aged 0-17 years residing in the household. --- Check the column HL5 for the entire household to see if there are any children 0-17 years of age (including age 17). If 'Yes', check the corresponding box, and continue to the next question. If 'No', check the second box and go to the next module. --- Care should be taken to determine whether or not the death was within the last 12 months. It can be helpful to probe the respondent by asking if they remember what month the person died, if they are having trouble remembering if the death was more or less than a year ago. Circle the code corresponding to the answer given. If the answer is 'Yes', continue to the next question. If the answer is 'No', skip to OV5.
Households
1
Yes
2
No
9
Missing
Of those who died is there any one between the ages of 18 an
Of those who died is there any one between the ages of 18 an
Of those who died is there any one between the ages of 18 an
Of those who died is there any one between the ages of 18 an
Of those who died is there any one between the ages of 18 an
(Of those who died in the past 12 months) were any of these people between the ages of 18 and 59?
Circle the code corresponding to the answer given. If the answer is 'No', skip to OV5.
Households
1
Yes
2
No
9
Missing
If yes ,were any seriously ill for 3 of the 12 months befor
If yes ,were any seriously ill for 3 of the 12 months befor
If yes ,were any seriously ill for 3 of the 12 months befor
If yes ,were any seriously ill for 3 of the 12 months befor
If yes ,were any seriously ill for 3 of the 12 months befor
(Of those who died in the past 12 months and were between the ages of 18 and 59) were any of these people seriously ill for 3 of the 12 months before he/she died?
Return to the Household Listing and check the following: 1. Check totals for HL9 and HL11. At least one mother or father dead. Go to OV8 No mother or father dead 2. Check totals for HL8A. At least one adult aged 18-59 very sick 3 of last 12 months. Go to OV8 No adult aged 18-59 very sick 3 of last 12 months 3. Check totals forHL10A and HL12A. At least one mother or father ill 3 of last 12 months. Go to OV8 No mother or father ill 3 of last 12 months. Go to Next Module
Circle the code corresponding to the answer given. A person should be considered 'seriously ill' if he/she was too sick to perform his/her normal activities at work or at home, such as cooking, cleaning, driving or participating in activities. Also, we are asking whether the person was sick for a substantial amount of time, specifically for 3 months or longer of the previous 12 months. The episodes of illness do not need to be consecutive. If 'Yes', skip to OV8 to ask about support systems to households with children - A 'Yes' answer to this question means that there is at least one adult who died during the past 12 months, who was 18-59 years of age and had been seriously ill for at least 3 months. If 'No', continue with the filter in question OV5.
Households
1
Yes
2
No
9
Missing
Child's line number
Child's line number
Child's line number
Child's line number
Child's line number
Return to the Household Listing and check the following: 1. Check totals for HL9 and HL11. At least one mother or father dead. Go to OV8 No mother or father dead 2. Check totals for HL8A. At least one adult aged 18-59 very sick 3 of last 12 months. Go to OV8 No adult aged 18-59 very sick 3 of last 12 months 3. Check totals for HL10A and HL12A. At least one mother or father ill 3 of last 12 months. Go to OV8 No mother or father ill 3 of last 12 months. Go to Next Module List all children aged 0-17 below. Record names, line numbers and ages of all children, beginning with the first child and continue in order in which listed in the household listing module. Use a continuation sheet if there are more than 4 children age 0-17 in the household. Ask all questions for one child before moving to the next child. Line number (from HL1)
Return to the Household Listing and check the following: 1. Whether the total number of mothers dead is higher than 0 or the total number of fathers dead is higher than 0 (from HL9 and HL11). 2. Whether the number of adults aged 18-59 years in the household who were very sick for at least 3 months during the past 12 months is higher than 0. 3. Whether the number of mothers or fathers who are not living in the household and were very sick for at least 3 months during the past 12 months is higher than 0. If any of these totals are higher than 0, this means that the household includes orphaned or vulnerable children and questions OV8 - OV18 should be asked. --- All children in the household are considered vulnerable if there is a 'Yes' response to question OV4, or if any of the checks yield a value of more than '0' in OV5. Thus all children will be listed in this module. If there are more than four children in the household, a separate questionnaire should be used for those children. Be sure to ask questions OV10-OV18 for the first child before you start with the second child.
Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS
Child's age
Child's age
Child's age
Child's age
Child's age
Age (from HL5)
Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS
Less than 1 year
97
97+
98
DK
99
Missing
Did you receive any medical support in the 12 months
Did you receive any medical support in the 12 months
Did you receive any medical support in the 12 months
Did you receive any medical support in the 12 months
Did you receive any medical support in the 12 months
I would like to ask you about any formal, organized help or support that your household may have received for (name) and for which you did not have to pay. By formal organized support I mean help provided by someone working for a program. This program could be government, private, religious, charity, or community-based. Remember this should be support for which you did not pay.
Now I would like to ask you about the support your household received for (name). In the last 12 months, has your household received any medical support for (name), such as medical care, supplies or medicine?
OV9 contains a statement that should be read to the respondent before starting on the questions OV10-OV18 for each child. Note that the respondent to this module can be the main respondent to the Household Questionnaire, and not necessarily the mothers or primary caretakers of children listed below OV8. We are not asking about all the help and support that a household may have received for a child; we are asking specifically about formal, organized support that came from an organization. The types of support we want to know about for the purposes of this survey are: " formal, organized support (government, private, religious, charity, community-based); " provided free of charge, the household did not have to pay, or " the help was provided specifically for the child. As an example of the kind of help to include or not include: a neighbour acting on her own, cooking meals for the family because the mother is too sick to cook meals. While this help is of great importance to the household, if the neighbour is acting from her own good heart, we will not include it here. However, if that neighbour is working for an organization and part of her task at that organization is to provide meals (for free) for people who are too sick to cook for themselves, then we will include that type of help in this section. --- Circle the code corresponding to the answer given.
Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS
1
Yes
2
No
8
DK
9
Missing
Did you receive any emotional or psychologigal support the 1
Did you receive any emotional or psychologigal support the 1
Did you receive any emotional or psychologigal support the 1
Did you receive any emotional or psychologigal support the 1
Did you receive any emotional or psychologigal support the 1
In the last 12 months, has your household received any emotional or psychological support for (name), such as companionship, counseling from a trained couselor, or spiritual support, which you received at home?
Circle the code corresponding to the answer given. If the household did not receive support of this kind for the child, skip to OV13.
Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS
1
Yes
2
No
8
DK
9
Missing
Did you receive any emotional or psychologigal support in la
Did you receive any emotional or psychologigal support in la
Did you receive any emotional or psychologigal support in la
Did you receive any emotional or psychologigal support in la
Did you receive any emotional or psychologigal support in la
Did your household receive any of this support in the past 3 months?
The medical support would have been provided in the previous 3 months, free of charge for a 'Yes' response to be appropriate. This question is asked for 3 months, in addition to 12 months, because this sort of assistance is needed more regularly than other types of support. Circle the code corresponding to the answer given.
Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS
1
Yes
2
No
8
DK
9
Missing
Did you receive any material support in the last 12 months
Did you receive any material support in the last 12 months
Did you receive any material support in the last 12 months
Did you receive any material support in the last 12 months
Did you receive any material support in the last 12 months
In the last 12 months, has your household received any material support for (name), such as clothing, food or financial support?
Circle the code corresponding to the answer given. If the household did not receive support of this kind for the child, skip to OV15.
Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS
1
Yes
2
No
8
DK
9
Missing
Did you receive any material support in the last 3 months
Did you receive any material support in the last 3 months
Did you receive any material support in the last 3 months
Did you receive any material support in the last 3 months
Did you receive any material support in the last 3 months
Did your household receive any of this support in the past 3 months?
The material support would have been provided in the previous 3 months, free of charge for a 'Yes' response to be appropriate. This question is asked for 3 months, in addition to 12 months, because this sort of assistance is needed more regularly than other types of support. Circle the code corresponding to the answer given.
Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS
1
Yes
2
No
8
DK
9
Missing
Did you receive any social support in the 12 months
Did you receive any social support in the 12 months
Did you receive any social support in the 12 months
Did you receive any social support in the 12 months
Did you receive any social support in the 12 months
In the last 12 months, has your household received any social support for (name), such as help in household work, training for a caregiver, or legal services?
Circle the code corresponding to the answer given. If the household did not receive support of this kind for the child, skip to OV17.
Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS
1
Yes
2
No
8
DK
9
Missing
Did you receive any social support in the last 3 months
Did you receive any social support in the last 3 months
Did you receive any social support in the last 3 months
Did you receive any social support in the last 3 months
Did you receive any social support in the last 3 months
Did your household receive any of this support in the past 3 months?
The social support would have been provided in the previous 3 months, free of charge for a 'Yes' response to be appropriate. This question is asked for 3 months, in addition to 12 months, because this sort of assistance is needed more regularly than other types of support. Circle the code corresponding to the answer given.
Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS
1
Yes
2
No
8
DK
9
Missing
Did you receive for child schooling in the 12 months
Did you receive for child schooling in the 12 months
Did you receive for child schooling in the 12 months
Did you receive for child schooling in the 12 months
Did you receive for child schooling in the 12 months
Check OV8 for age of child: Age 0-4. next child Age 5-17. OV18
In the last 12 months, has your household received any support for (name's) schooling, such as allowance, free admission, books or supplies?
The remaining question (OV18) is only for children aged 5-17 years. If a child is less than five, check the first box and skip to the next child. If there is no other child in the roster, skip to the next module. --- Ask whether any support was given for the child that was related to school, such as books, supplies or monetary compensation. Circle the code corresponding to the answer given.
Children living in households with at least one child considered as an orphan or asa child made vulnerable by HIV/AIDS
1
Yes
2
No
8
DK
9
Missing
Line number
Line number
Line number
Line number
Line number
To be administered to mother/caretaker of each child in the household age 5 through 14 years. For household members below age 5 or above age 14, leave rows blank. Now I would like to ask about any work children in this household may do.
This module is to be administered to the mother or primary caretaker of each child resident in the household aged 5 through 14 years (this includes those age 5 and age 14). For household members younger than five or older than 14, rows should be left blank. --- This is the number assigned to each person on the Household Listing Form. You do not need to fill in or do anything in this column since the numbers are already provided. Explain, "NOW I WOULD LIKE TO ASK ABOUT ANY WORK CHILDREN IN THIS HOUSEHOLD MAY DO." Insert the child's name, copying from the Household Listing, column HL2. This is done to prevent confusion during the interview.
Children aged 5-14
Worked in past week
Worked in past week
Worked in past week
Worked in past week
Worked in past week
During the past week, did (name) do any kind of work for someone who is not a member of this household? If yes: For pay in cash or kind?
'Pay' refers to any compensation for work, including cash or goods or services provided to the child or his family. 'The past week' refers to the 7 days preceding the interview day. Note that the person indicated - someone who is not a member of this household - may be a relative or a family member who lives in a different household. If the answer is 'Yes', ask if the work was done for pay in cash or kind. Circle '1' if work was done for pay in cash or kind. Circle '2' if work was not done for any form of pay. If '1' or '2' is circled, continue to the next question. If no work was done by that child in the past week, circle '3' and skip to CL5.
Children aged 5-14
1
Yes, paid
2
Yes, unpaid
3
No
9
Missing
Hours worked in past week
Hours worked in past week
Hours worked in past week
Hours worked in past week
Hours worked in past week
If yes:
Since last (day of the week), about how many hours did he/she do this work for someone who is not a member of this household?
If more than one job, include all hours at all jobs.
Record the estimated number of hours the child spent doing work in the past 7 days and skip to CL6. Make sure the mother or primary caretaker understands what you mean by "SINCE LAST (day of the week)" - specify the name of today's weekday, as you did in the Education Module. If the child works more than one such job, include the total hours spent doing such work in all jobs.
Children aged 5-14
98
DK
99
Missing
Worked in past year
Worked in past year
Worked in past year
Worked in past year
Worked in past year
At any time during the past year, did (name) do any kind of work for someone who is not a member of this household? If yes: For pay in cash or kind?
CL5 is essentially the same question as CL3; this time the reference period is 1 year rather than the last 1 week. Continue with the next question after you have circled the response to this question.
Children aged 5-14
1
Yes, paid
2
Yes, unpaid
3
No
9
Missing
Helped with household chores in past week
Helped with household chores in past week
Helped with household chores in past week
Helped with household chores in past week
Helped with household chores in past week
During the past week, did (name) help with household chores such as shopping, collecting firewood, cleaning, fetching water, or caring for children?
As was explained in CL3, 'the past week' refers to the 7 days preceding the interview day. Circle '1' if 'Yes', and continue to the next question. If 'No', circle '2' and skip to CL8.
Children aged 5-14
1
Yes
2
No
9
Missing
Hours spent on chores in past week
Hours spent on chores in past week
Hours spent on chores in past week
Hours spent on chores in past week
Hours spent on chores in past week
If yes:
Since last (day of the week), about how many hours did he/she spend doing these chores?
Insert the estimated number of hours the child spent doing household chores in the past 7 days. Make sure the mother/primary caretaker understands what you mean by 'since last (day of the week)' - specify the name of today's weekday, just as you did for CL4.
Children aged 5-14
98
DK
99
Missing
Did other family work in past week
Did other family work in past week
Did other family work in past week
Did other family work in past week
Did other family work in past week
During the past week, did (name) do any other family work (on the farm or in a business or selling goods in the street?)
As was explained in CL6, 'the past week' refers to the 7 days preceding the interview day. 'Other family work' means any work done other than household chores/housekeeping to help with family income generation or subsistence production. This may include raising livestock belonging to the household or working in a family business. Circle '1' if 'Yes', and continue to the next question. If 'No', circle '2' and go to the next line, corresponding to the next eligible child aged 5-14 years.
Children aged 5-14
1
Yes
2
No
9
Missing
Hours worked on other family work
Hours worked on other family work
Hours worked on other family work
Hours worked on other family work
Hours worked on other family work
If yes:
Since last (day of the week), about how many hours did he/she do this work?
Insert the estimated number of hours worked. Again, make sure the mother/primary caretaker understands what you mean by 'since last (day of the week)' - specify the name of today's weekday, just as you did for CL4 and CL7.
Children aged 5-14
98
DK
99
Missing
Line number from household listing
Line number from household listing
Line number from household listing
Line number from household listing
Line number from household listing
To be administered to caretakers of all children 2 through 9 years old living in the household. For household members below age 2 or above age 9, leave rows blank I would like to ask you if any children in this household aged 2 through 9 has any of the health conditions I am going to mention to you. Line no.
This module is to be administered to the mother or primary caretaker of each child resident in the household aged 2-9 years (this includes those age 2 and age 9). For household members below age 2 or above age 9, rows should be left blank. DA1. Line No: This is the number used to identify each child eligible for this module. You do not need to fill in or do anything in this column since the numbers are already provided. DA2. Child's name: For each child in the household 2-9 years of age, insert the child's name in this column next to his/ her line number (from Household Listing HL1), copying from the Household Listing, column HL2. This is done to prevent confusion during the interview. For all other household members less than 2 years of age or older than 9, leave the space next to their line numbers blank. Now, read the introduction to this module to the mother or primary caretaker of each child by saying: "I WOULD LIKE TO ASK YOU IF ANY CHILD IN THIS HOUSEHOLD AGED 2 THROUGH 9 HAS ANY OF THE HEALTH CONDITIONS I AM GOING TO MENTION TO YOU." Next, ask the following questions DA3 through DA13 about each child, in turn. Ask the entire set of questions about the first child, and then go on to ask about the next child in the list, asking the entire set of questions about the next child, until you have recorded answers for each child listed. In cases when there is more than one mother/primary caretaker for children listed in the module, complete asking questions about the children of the first mother/primary caretaker, then move to the next mother/primary caretaker.
De jure children aged 2-14
Any serious delay sitting, standang or walking
Any serious delay sitting, standang or walking
Any serious delay sitting, standang or walking
Any serious delay sitting, standang or walking
Any serious delay sitting, standang or walking
Compared with other children, does or did (name) have any serious delay in sitting, standing, or walking?
Circle '1' for 'Yes' and '2' for 'No' for all questions in this module. Insert the child's name in the question. Read out the entire question as it is written.
De jure children aged 2-14
1
Yes
2
No
9
Missing
Does he have difficulty seeing in daytime or nightime
Does he have difficulty seeing in daytime or nightime
Does he have difficulty seeing in daytime or nightime
Does he have difficulty seeing in daytime or nightime
Does he have difficulty seeing in daytime or nightime
Compared with other children, does (name) have difficulty seeing, either in the daytime or at night?
Circle '1' for 'Yes' and '2' for 'No' for all questions in this module. Insert the child's name in the question. Read out the entire question as it is written.
De jure children aged 2-14
1
Yes
2
No
9
Missing
Does he apprea to have difficulty hearing
Does he apprea to have difficulty hearing
Does he apprea to have difficulty hearing
Does he apprea to have difficulty hearing
Does he apprea to have difficulty hearing
Does (name) appear to have difficulty hearing? (uses hearing aid, hears with difficulty, completely deaf?)
Circle '1' for 'Yes' and '2' for 'No' for all questions in this module. Insert the child's name in the question. Read out the entire question as it is written. --- Do not mention the probing questions unless the respondent cannot answer the first question.
De jure children aged 2-14
1
Yes
2
No
9
Missing
When you ask him to do something, does he understand what y
When you ask him to do something, does he understand what y
When you ask him to do something, does he understand what y
When you ask him to do something, does he understand what y
When you ask him to do something, does he understand what y
When you tell (name) to do something, does he/she seem to understand what you are saying?
Circle '1' for 'Yes' and '2' for 'No' for all questions in this module. Insert the child's name in the question. Read out the entire question as it is written.
De jure children aged 2-14
1
Yes
2
No
9
Missing
Does he have difficulty walking or moving
Does he have difficulty walking or moving
Does he have difficulty walking or moving
Does he have difficulty walking or moving
Does he have difficulty walking or moving
Does (name) have difficulty in walking or moving his/her arms or does he/she have weakness and/or stiffness in the arms or legs?
Circle '1' for 'Yes' and '2' for 'No' for all questions in this module. Insert the child's name in the question. Read out the entire question as it is written.
De jure children aged 2-14
1
Yes
2
No
9
Missing
Does he have fits, become rigid or los consciousnes
Does he have fits, become rigid or los consciousnes
Does he have fits, become rigid or los consciousnes
Does he have fits, become rigid or los consciousnes
Does he have fits, become rigid or los consciousnes
Does (name) sometimes have fits, become rigid, or lose consciousness?
Circle '1' for 'Yes' and '2' for 'No' for all questions in this module. Insert the child's name in the question. Read out the entire question as it is written.
De jure children aged 2-14
1
Yes
2
No
9
Missing
Does he learn to do thing like other
Does he learn to do thing like other
Does he learn to do thing like other
Does he learn to do thing like other
Does he learn to do thing like other
Does (name) learn to do things like other children his/her age?
Circle '1' for 'Yes' and '2' for 'No' for all questions in this module. Insert the child's name in the question. Read out the entire question as it is written.
De jure children aged 2-14
1
Yes
2
No
9
Missing
Can says recognizable words
Can says recognizable words
Can says recognizable words
Can says recognizable words
Can says recognizable words
Does (name) speak at all (can he/she make him or herself understood in words; can say any recognizable words)?
Circle '1' for 'Yes' and '2' for 'No' for all questions in this module. Insert the child's name in the question. Read out the entire question as it is written. --- If needed, use the additional probing questions in parentheses, replacing he/she with the appropriate pronoun.
De jure children aged 2-14
1
Yes
2
No
9
Missing
Speech in any way different from normal
Speech in any way different from normal
Speech in any way different from normal
Speech in any way different from normal
Speech in any way different from normal
For 3-9 year olds:
Is (name)'s speech in any way different from normal (not clear enough to be understood by people other than the immediate family)?
Circle '1' for 'Yes' and '2' for 'No' for all questions in this module. Insert the child's name in the question. Read out the entire question as it is written. --- This question should be asked only for children aged 3-9 years (children age 2 should not be asked this question). Check Household Listing, HL5, for the child's age. If the child is 2 years of age, leave the question blank. If needed, use the additional probing questions in parentheses.
De jure children aged 2-14
1
Yes
2
No
9
Missing
Can he name at least one object
Can he name at least one object
Can he name at least one object
Can he name at least one object
Can he name at least one object
For 2 year olds:
Can (name) name at least one object (for example, an animal, a toy, a cup, a spoon)?
Circle '1' for 'Yes' and '2' for 'No' for all questions in this module. Insert the child's name in the question. Read out the entire question as it is written. --- This question should be asked only for children age 2. Check Household Listing, HL5, for the child's age. If the child is 3-9 years old, leave the question blank. If needed, use the additional probing questions in parentheses.
De jure children aged 2-14
1
Yes
2
No
9
Missing
Compared to other children does he appear mentally backward,
Compared to other children does he appear mentally backward,
Compared to other children does he appear mentally backward,
Compared to other children does he appear mentally backward,
Compared to other children does he appear mentally backward,
Compared with other children of the same age, does (name) appear in any way mentally backward, dull or slow?
Circle '1' for 'Yes' and '2' for 'No' for all questions in this module. Insert the child's name in the question. Read out the entire question as it is written. --- This question should be asked about each child listed in this module (that is, each child age 2 through 9).
De jure children aged 2-14
1
Yes
2
No
9
Missing
Region
Region
Region
Region
Region
Region:
Circle the code for region.
Households
2
Central (include BKK.)
3
North
4
Northeast
5
South
Changwat/Province
Changwat/Province
Changwat/Province
Changwat/Province
Changwat/Province
Area
Area
Area
Area
Area
Area:
Circle the code for area of residence as instructed by your supervisor. This will have been pre-determined; you will not be required to assess whether the household is in an urban or rural area.
Households
1
Urban
2
Rural
PSU_NO
PSU_NO
PSU_NO
PSU_NO
PSU_NO
Day of interview
Day of interview
Day of interview
Day of interview
Day of interview
Day/Month/Year of interview:
Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household.
Households
Month of interview
Month of interview
Month of interview
Month of interview
Month of interview
Day/Month/Year of interview:
Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household.
Households
Year of interview
Year of interview
Year of interview
Year of interview
Year of interview
Day/Month/Year of interview:
Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household.
Households
Respondent HH questionnaire
Respondent HH questionnaire
Respondent HH questionnaire
Respondent HH questionnaire
Respondent HH questionnaire
Respondent to HH questionnaire:
Enter the name and line number (from the Household Listing, columns HL1 and HL2) of the respondent to the Household Questionnaire.
Households
99
Missing
Number of household members
Number of household members
Number of household members
Number of household members
Number of household members
Total number of household members:
Count the number of household members recorded in column HL1 of the Household Listing and enter the total here.
Households
Total eligible women
Total eligible women
Total eligible women
Total eligible women
Total eligible women
No.of women eligible for interview:
Enter the total number of women eligible for interview for the Questionnaire for Individual Women - you will copy this from the row for totals at the bottom of the Household Listing, for HL6.
Households
Women interviews completed
Women interviews completed
Women interviews completed
Women interviews completed
Women interviews completed
No.of women questionnaires completed:
Once all of the Questionnaires for Individual Women have been completed for a particular household, enter the number completed here.
Households
Total children under 5
Total children under 5
Total children under 5
Total children under 5
Total children under 5
No.of children under age 5:
Enter the total number of children under five eligible for inclusion in the survey from the row for totals at the bottom of the Household Listing, for HL8. You will be using the Questionnaire for Children Under Five to interview the mothers or primary caretakers of these children.
Households
Child interviews completed
Child interviews completed
Child interviews completed
Child interviews completed
Child interviews completed
No.of under-5 questionnaires completed:
Once all of the Questionnaires for Children Under Five have been completed for a particular household, enter the number completed here.
Households
Enu. Result
Enu. Result
Enu. Result
Enu. Result
Enu. Result
After all questionnaires for the household have been completed, fill in the following information: Result of HH interview:
If the Household Questionnaire is completed, circle '1' for 'Completed'. If you have not been able to contact the household after repeated visits, circle '2' for 'Not at home'. If the household refuses to be interviewed, circle '3' for 'Refused'. If you are unable to locate the household or if the dwelling is destroyed, circle '4' for 'HH not found/destroyed'. If you have not been able to complete the Household Questionnaire for another reason, you should circle '6' for 'Other' and specify the reason in the space provided. Some examples of 'Other' codes might be: the household respondent is incapacitated; the questionnaire is partly completed; adult household members were not found at home after repeated visits.
Households
1
Completed
2
Refused
3
Not at home
4
HH not found/destroyed
6
Others
Main source of drinking water
Main source of drinking water
Main source of drinking water
Main source of drinking water
Main source of drinking water
What is the main source of drinking water for members of your household?
The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). '51' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof or ground catchment and stored in a container, tank or cistern until used. '61' - A tanker-truck water source transports and sells water by means of a tanker truck. '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. --- Circle the code for the most usual source. If several sources are mentioned, probe to determine the most usual source. If the source varies by season, record the source for the season of the interview. Note that the next question is only asked if the response to this question is 'Bottled water'. You should skip WS2 if the response to WS1 is other than 'Bottled water'. If the response is 'Piped into dwelling' or 'Piped into yard/plot', circle '11' or '12', respectively, and skip to WS5. Otherwise, skip to WS3.
Households
11
Piped into dwelling
12
Piped into yard or plot
13
Public tap/standpipe
21
Tubewell/borehole
31
Protected well
32
Unprotected well
41
Protected spring
42
Unprotected spring
51
Rainwater collection
61
Tanker-truck
81
Surface water
91
Bottled water
96
Other
99
Missing
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
What is the main source of water used by your household for other purposes such as cooking and handwashing?
The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). '51' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof or ground catchment and stored in a container, tank or cistern until used. '61' - A tanker-truck water source transports and sells water by means of a tanker truck. '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. --- This question should only be asked to households that use 'Bottled water' for drinking. Circle the code for the most usual source. If the source varies by season, record the source for the season of the interview. If the most usual source of non-drinking water is 'Piped into dwelling' or 'Piped into yard/plot', circle '11' or '12', respectively, and skip to WS5. Otherwise continue to the next question.
Households
11
Piped into dwelling
12
Piped into yard or plot
13
Public tap/standpipe
21
Tubewell/borehole
31
Protected well
32
Unprotected well
41
Protected spring
42
Unprotected spring
51
Rainwater collection
61
Tanker-truck
81
Surface water
96
Other
99
Missing
Time to get water and come back
Time to get water and come back
Time to get water and come back
Time to get water and come back
Time to get water and come back
How long does it take to go there, get water, and come back?
This question is used to find out how convenient the source of water is to the dwelling. Note that the question is asked for water sources coded as '13-81' and '96' in WS1, or water sources coded as '13-96' in WS2. Fill in the estimated time (in minutes, converting from hours, if necessary) it takes by the usual mode of transport to get to the water source, wait to get water, and get back to the dwelling. Use zero(s) preceding the number if less than 100 minutes (for example, '060' or '005'). Then continue to the next question. If the water source is on the dwelling premises or if water is delivered to the dwelling by a vendor, circle '995' for 'Water on premises' and skip to WS5. If the respondent does not know how long it takes, circle '998' and continue on to the next question.
Households
995
On premises
998
DK
999
Missing
Person fetching water
Person fetching water
Person fetching water
Person fetching water
Person fetching water
Who usually goes to this source to fetch the water for your household? Probe: Is this person under age 15? What sex?
Circle code that best describes this person.
The purpose of this question is to find out the age and gender of the person who usually performs the task of hauling water. This will provide an understanding of whether water hauling responsibilities are given to members of a particular sex or age group. Probe: "IS THIS PERSON UNDER AGE 15? WHAT SEX IS THIS PERSON?" Circle the code that corresponds with the response or '8' if the respondent does not know. Adult refers to anyone age 15 or over, regardless of whether he/she is a household member. Child refers to anyone under the age of 15, regardless of whether he/she is a household member.
Households
1
Adult woman
2
Adult man
3
Female child (under 15)
4
Male child (under 15)
8
DK
9
Missing
Treat water to make safer for drinking
Treat water to make safer for drinking
Treat water to make safer for drinking
Treat water to make safer for drinking
Treat water to make safer for drinking
Do you treat your water in any way to make it safer to drink?
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle '1' if 'Yes', and continue to the next question. If 'No' or 'DK' (Doesn't know'), circle '2' or '8', respectively, and skip to WS7.
Households
1
Yes
2
No
8
DK
9
Missing
Boil
Boil
Boil
Boil
Boil
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
A
Boil
Add bleach/chlorine
Add bleach/chlorine
Add bleach/chlorine
Add bleach/chlorine
Add bleach/chlorine
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
B
Add bleach/chlorine
Strain it through a cloth
Strain it through a cloth
Strain it through a cloth
Strain it through a cloth
Strain it through a cloth
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
C
Strain it through a cloth
Use water filter
Use water filter
Use water filter
Use water filter
Use water filter
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
D
Use water filter
Solar disinfection
Solar disinfection
Solar disinfection
Solar disinfection
Solar disinfection
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
E
Solar disinfection
Let it stand and settle
Let it stand and settle
Let it stand and settle
Let it stand and settle
Let it stand and settle
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
F
Let it stand and settle
Other
Other
Other
Other
Other
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
X
Other
DK
DK
DK
DK
DK
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
Z
DK
Kind of toilet facility
Kind of toilet facility
Kind of toilet facility
Kind of toilet facility
Kind of toilet facility
What kind of toilet facility do members of your household usually use? If "flush" or "pour flush", probe: Where does it flush to?
If necessary, ask permission to observe the facility.
Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of this question is to obtain a measure of the cleanliness of the sanitary facility used by the household members. It may be necessary to observe the facility. If so, ask permission to do so. If the respondent answers or it is observed that the household members have no facilities or use the bush or field, enter '95' for 'No facilities or bush or field' and skip to the next module. If any of the flush or pour flush responses (11-15) are given, probe: "WHERE DOES IT FLUSH TO?" Circle the code corresponding to the response given. Definitions of various types of toilet facilities are as follows: A flush toilet uses a cistern or holding tank for flushing water and has a water seal, which is a U-shaped pipe, below the seat or squatting pan that prevents the passage of flies and odours. A pour flush toilet uses a water seal, but unlike a flush toilet, a pour flush toilet uses water poured by hand for flushing (no cistern is used). . '11' - A piped sewer system is a system of sewer pipes, also called sewerage, that is designed to collect human excreta (faeces and urine) and wastewater and remove them from the household environment. Sewerage systems consist of facilities for collection, pumping, treating and disposing of human excreta and wastewater. . '12' - A septic tank is an excreta collection device and is a water-tight settling tank normally located underground, away from the house or toilet. . '13' - A flush/pour flush to pit latrine refers to a system that flushes excreta to a hole in the ground. . '14' - A flush/pour flush to somewhere else refers to excreta being deposited in or nearby the household environment (not into pit, septic tank or sewer); excreta may be flushed to the street, yard/plot, drainage way or other location. . '15' - Flush to unknown place/not sure/DK where should be coded in cases when the respondent knows that the toilet facility is a flush toilet, but does not know where it flushes to. '21' - A ventilated improved pit latrine or VIP is a type of pit latrine that is ventilated by a pipe extending above the latrine roof. The open end of the vent pipe is covered with gauze mesh or fly-proof netting and the inside of the superstructure is kept dark. '22' - A pit latrine with slab uses a hole in the ground for excreta collection and has a squatting slab, platform or seat that is firmly supported on all sides, easy to clean and raised above the surrounding ground level to prevent surface water from entering the pit. '23' - A pit latrine without slab uses a hole in the ground for excreta collection and does not have a squatting slab, platform or seat. An open pit is a rudimentary hole in the ground where excreta is collected. '31' - A composting toilet is a toilet into which excreta and carbon-rich material are added (vegetable wastes, straw, grass, sawdust, ash) and special conditions maintained to produce inoffensive compost. '41' - Bucket refers to the use of a bucket or other container for the retention of faeces (and sometimes urine and anal cleaning material), which is periodically removed for treatment or disposal. '51' - A hanging toilet or hanging latrine is a toilet built over the sea, a river, or other body of water into which excreta drops directly. '95' - No facilities or bush or field includes excreta wrapped and thrown with garbage, the 'cat' method of burying excreta in dirt, defecation in the bush or field or ditch, and defecation into surface water (drainage channel, beach, river, stream or sea).
Households
11
Flush to piped sewer system
12
Flush to septic tank
13
Flush to pit (latrine)
14
Flush to somewhere else
15
Flush to unknown place/not sure/DK where
22
Pit latrine with slab
23
Pit latrine without slab/open pit
95
No facilities or bush or field
96
Other
99
Missing
Toilet facility shared
Toilet facility shared
Toilet facility shared
Toilet facility shared
Toilet facility shared
Do you share this facility with other households?
Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of the following two questions is to determine whether the household shares their sanitation facility with other households. The shared status of a sanitation facility is important because shared facilities can be less hygienic than facilities used by only a single household. Unhygienic conditions (faeces on the floor, seat or wall and flies) may discourage use of the facility. --- Circle the code corresponding to the response given. If 'No', go to the next module.
Households
1
Yes
2
No
9
Missing
Households using this toilet facility
Households using this toilet facility
Households using this toilet facility
Households using this toilet facility
Households using this toilet facility
How many households in total use this toilet facility?
Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of the following two questions is to determine whether the household shares their sanitation facility with other households. The shared status of a sanitation facility is important because shared facilities can be less hygienic than facilities used by only a single household. Unhygienic conditions (faeces on the floor, seat or wall and flies) may discourage use of the facility. --- The total number of households using this facility should include the household being interviewed. If less than ten households use this toilet facility, enter the number of households on the line provided. Circle '10' if ten or more households use this toilet facility. Note that '01' is not a valid response (since it means that this is the only this household that uses the facility; if that is the case, you should go back to WS8 and correct the response there). Circle '98' for 'DK' ('Doesn't know').
Households
10
Ten or more households
98
DK
99
Missing
Religion of head
Religion of head
Religion of head
Religion of head
Religion of head
What is the religion of the head of this household?
Circle the code corresponding to the answer given. Make sure to get the religion, ethnicity or mother tongue/native language of the household head.
Households
1
Buddhist
2
Muslim
3
Christian
6
Other religion
7
No religion
9
Missing
Language
Language
Language
Language
Language
What is the mother tongue/native language of the head of this household?
Circle the code corresponding to the answer given. Make sure to get the religion, ethnicity or mother tongue/native language of the household head.
Households
1
Thai
2
Other Languages
3
Missing
Ethnic group of head
Ethnic group of head
Ethnic group of head
Ethnic group of head
Ethnic group of head
To what ethnic group does the head of this household belong?
Circle the code corresponding to the answer given. Make sure to get the religion, ethnicity or mother tongue/native language of the household head.
Households
1
Thai
2
Cambodia
3
Loas
4
China
5
Myanmar
6
Other Ethnic
7
Hill Tribe
9
Missing
Head of occupation
Head of occupation
Head of occupation
Head of occupation
Head of occupation
1
Government Officer
2
State Enterprises Officer
3
Private Officer
4
Business
5
Agriculturist
6
Labourer
7
Other
9
Missing
Mean of income
Mean of income
Mean of income
Mean of income
Mean of income
1
Lower 10000
2
10000-19999
3
20000-29999
4
30000-39999
5
40000-49999
6
Upper 50000
9
Missing
Number of rooms for sleeping
Number of rooms for sleeping
Number of rooms for sleeping
Number of rooms for sleeping
Number of rooms for sleeping
How many rooms in this household are used for sleeping?
This information provides a measure of how crowded the house is, and reflects the socio-economic condition of the household. A room in this case refers to a special area with a permanent partition that is used for sleeping. It is not necessarily the number of rooms in the household that are called 'bedrooms', but rather how many rooms get used for sleeping on a regular basis. Exclude rooms that are used only for sleeping by visitors to the household, but include those rooms that may not be regular 'bedrooms' but may be regularly used by one or more of the household members for sleeping. Enter the number of rooms in this household that are used for sleeping.
Households
99
Missing
Main material of floor
Main material of floor
Main material of floor
Main material of floor
Main material of floor
Main material of the dwelling floor:
Record observation.
Circle the correct code for the material of the dwelling floor based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the floor, record the main flooring material (the material that covers the largest amount of floor space).
Households
11
Earth/sand
21
Wood planks
22
Palm/bamboo
31
Parquet or polished wood
32
Vinyl or asphalt strips
33
Ceramic tiles
34
Cement
35
Carpet
36
Marble
37
Polished stone
96
Other
99
Missing
Main material of roof
Main material of roof
Main material of roof
Main material of roof
Main material of roof
Main material of the roof.
Record observation.
Circle the correct code for the material of the dwelling roof, based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the roof, record the main roofing material (the material that covers the largest amount of roof).
Households
11
No roof
12
Thatch/palm leaf
13
Sod
22
Palm/bamboo
23
Wood Planks
31
Metal
33
Calamine/cement fiber
34
Ceramic tiles
35
Cement
36
Roofing shingles
96
Other
99
Missing
Main material of wall
Main material of wall
Main material of wall
Main material of wall
Main material of wall
Main material of the walls.
Record observation.
Circle the correct code for the material of the dwelling walls, based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the walls, record the main wall material (the material that covers the largest amount of wall space).
Households
11
No walls
12
Cane/palm/trunks
13
Dirt
24
Plywood
25
Carton
26
Reused wood
27
Bamboo
31
Cement
32
Stone with lime/cement
33
Bricks
34
Cement blocks
36
Wood planks/shingles
37
Zinc
38
Tile
39
Shera wood
96
Other
99
Missing
Type of fuel using for cooking
Type of fuel using for cooking
Type of fuel using for cooking
Type of fuel using for cooking
Type of fuel using for cooking
What type of fuel does your household mainly use for cooking?
Information on the type of fuel used for cooking is collected as another measure of the socio-economic status of the household. The use of some cooking fuels can also have adverse health consequences. Circle the code corresponding to the answer given. Remember that this question asks about fuel for cooking, not fuel for heating or lighting. If the household uses more than one fuel for cooking, find out which type of fuel is used most often. If electricity, liquid propane gas (LPG), natural gas, or biogas is mainly used, circle '01', '02', '03', or '04', respectively, and skip to HC8. If any fuel other than the pre-coded ones is reported as being the main fuel used for cooking, circle '96' and specify the type of fuel on the line provided. Definitions of some of the types of fuel are as follows: 'Biogas' includes gases produced by fermenting manure in an enclosed pit. 'Lignite' is a derivative of coal that produces more smoke when burned but produces less heat than coal.
Households
1
Electricity
2
Liquid propane gas (LPG)
4
Biogas
5
Kerosene
6
Coal/lignite
7
Charcoal
8
Wood
9
Straw/shrubs/grass
10
Animal dung
11
Agricultural crop residue
96
Other
97
No Cooking
99
Missing
Food cooked on stove or open fire
Food cooked on stove or open fire
Food cooked on stove or open fire
Food cooked on stove or open fire
Food cooked on stove or open fire
In this household, is food cooked on an open fire, an open stove or a closed stove?
Probe for type.
Probe for type of stove and circle the code corresponding to the response given. If a response is given other than the pre-coded ones, circle '96' and specify the type of stove on the line provided. For 'Closed stove', skip the next question and ask HC8.
Households
1
Open fire
2
Open stove
3
Closed stove
6
Other
9
Missing
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire/stove have a chimney or a hood?
Circle the appropriate response.
Households
1
Yes
2
No
9
Missing
Cooking location
Cooking location
Cooking location
Cooking location
Cooking location
Is the cooking usually done in the house, in a separate building, or outdoors?
Circle the code corresponding to the response given. If a response is given other than the pre-coded ones, circle '6' and specify on the line provided.
Households
1
In the house
2
In a separate bulding
3
Outdoors
4
Terrace
6
Other
9
Missing
Electricity
Electricity
Electricity
Electricity
Electricity
Does your household have:
Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR?
Households
1
Yes
2
No
9
Missing
Radio
Radio
Radio
Radio
Radio
Does your household have:
Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR?
Households
1
Yes
2
No
9
Missing
Television
Television
Television
Television
Television
Does your household have:
Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR?
Households
1
Yes
2
No
9
Missing
Mobile phone
Mobile phone
Mobile phone
Mobile phone
Mobile phone
Does your household have:
Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR?
Households
1
Yes
2
No
9
Missing
Non-mobile phone
Non-mobile phone
Non-mobile phone
Non-mobile phone
Non-mobile phone
Does your household have:
Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR?
Households
1
Yes
2
No
9
Missing
Refrigerator
Refrigerator
Refrigerator
Refrigerator
Refrigerator
Does your household have:
Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR?
Households
1
Yes
2
No
9
Missing
Computer
Computer
Computer
Computer
Computer
Watch
Watch
Watch
Watch
Watch
Does any member of your household own:
This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR.
Households
1
Yes
2
No
9
Missing
Bicycle
Bicycle
Bicycle
Bicycle
Bicycle
Does any member of your household own:
This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR.
Households
1
Yes
2
No
9
Missing
Motorcycle or scooter
Motorcycle or scooter
Motorcycle or scooter
Motorcycle or scooter
Motorcycle or scooter
Does any member of your household own:
This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR.
Households
1
Yes
2
No
9
Missing
Animal-drawn cart
Animal-drawn cart
Animal-drawn cart
Animal-drawn cart
Animal-drawn cart
Does any member of your household own:
This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR.
Households
1
Yes
2
No
9
Missing
Car or truck
Car or truck
Car or truck
Car or truck
Car or truck
Does any member of your household own:
This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR.
Households
1
Yes
2
No
9
Missing
Boat with motor
Boat with motor
Boat with motor
Boat with motor
Boat with motor
Does any member of your household own:
This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR.
Households
1
Yes
2
No
9
Missing
Household sample weight
Household sample weight
Household sample weight
Household sample weight
Household sample weight
Recoded variable
De jure household members (usual residents)
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
Recoded variable
Children aged 0-4
wealth index quintiles
wealth index quintiles
wealth index quintiles
wealth index quintiles
wealth index quintiles
Recoded variable
Children aged 0-4
1
Poorest
2
Second
3
Middle
4
Fourth
5
Richest
Mother's line number
Mother's line number
Mother's line number
Mother's line number
Mother's line number
Recoded variable
De jure household members (usual residents)
Mother's education
Mother's education
Mother's education
Mother's education
Mother's education
Recoded variable
Children aged 0-4
1
None
2
Primary
3
Secondary +
Father's line number
Father's line number
Father's line number
Father's line number
Father's line number
Recoded variable
De jure household members (usual residents)
Father's education
Father's education
Father's education
Father's education
Father's education
Recoded variable
De jure household members (usual residents)
1
None
2
Primary
3
Secondary +
Household head's education
Household head's education
Household head's education
Household head's education
Household head's education
Recoded variable
De jure household members (usual residents)
1
None
2
Primary
3
Secondary +
Cluster number
Cluster number
Cluster number
Cluster number
Cluster number
We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. During this time I would like to speak with the household head and all mothers or others who take care of children in the household. May I start now? If permission is given, begin the interview. Cluster number:
Enter the cluster number as instructed by your supervisor.
Households
Unique identifier for the cluster in which the household exists
Household number
Household number
Household number
Household number
Household number
Household number:
Enter the household number as instructed by your supervisor.
Households
Houshold number within the cluster
Line number
Line number
Line number
Line number
Line number
Child's line number:
Children aged 0-4
Cluster number
Cluster number
Cluster number
Cluster number
Cluster number
Cluster number:
Enter the cluster number from the Household Questionnaire, question HH1.
Women aged 15-49
Household number
Household number
Household number
Household number
Household number
Household number:
Enter the household number from the Household Questionnaire, question HH2.
Women aged 15-49
Woman's line number
Woman's line number
Woman's line number
Woman's line number
Woman's line number
Woman's Line Number:
Enter the woman's line number from the Household Questionnaire, column HL1 of the Household Listing.
Women aged 15-49
Day of interview
Day of interview
Day of interview
Day of interview
Day of interview
Day/Month/Year of interview:
Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household to interview the woman again, revise and enter the final date of interview. In other words, the date here should be the date when you have either completed the woman's questionnaire, or when the interview has not been conducted but it has been decided that there will be no more attempts to interview the eligible woman.
Women aged 15-49
Month of interview
Month of interview
Month of interview
Month of interview
Month of interview
Day/Month/Year of interview:
Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household to interview the woman again, revise and enter the final date of interview. In other words, the date here should be the date when you have either completed the woman's questionnaire, or when the interview has not been conducted but it has been decided that there will be no more attempts to interview the eligible woman.
Women aged 15-49
Year of interview
Year of interview
Year of interview
Year of interview
Year of interview
Day/Month/Year of interview:
Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household to interview the woman again, revise and enter the final date of interview. In other words, the date here should be the date when you have either completed the woman's questionnaire, or when the interview has not been conducted but it has been decided that there will be no more attempts to interview the eligible woman.
Women aged 15-49
Result of women 's interview
Result of women 's interview
Result of women 's interview
Result of women 's interview
Result of women 's interview
Result of women's interview
Complete this question once you have concluded the interview with the woman. Circle the code corresponding to the result of the interview. If the questionnaire is completed, circle '1' for 'Completed'. If you have not been able to contact the woman after repeated visits, circle '2' for 'Not at home'. If the woman refuses to be interviewed, circle '3' for 'Refused'. If you were able to only partly complete the questionnaire, circle '4' for 'Partly completed'. If the woman is incapacitated, circle '5'. If you have not been able to complete this questionnaire for another reason, you should circle '6' for 'Other' and specify the reason in the space provided. Make every attempt to carry out the woman's interview in privacy. Ask all other household members or anyone else who is present (including male members of the survey team) to leave in a courteous manner. If the respondent is a mother/caretaker, ask her to collect all the birth certificates and health/ immunization cards she has for her children or the children she cares for before you begin the interview. You will need these when you go on to interview her about her children under age five. Repeat greeting if not already read to this woman: "WE ARE FROM (country-specific affiliation). WE ARE WORKING ON A PROJECT CONCERNED WITH FAMILY HEALTH AND EDUCATION. I WOULD LIKE TO TALK TO YOU ABOUT THIS. THE INTERVIEW WILL TAKE ABOUT (number) MINUTES. ALL THE INFORMATION WE OBTAIN WILL REMAIN STRICTLY CONFIDENTIAL AND YOUR ANSWERS WILL NEVER BE IDENTIFIED. ALSO, YOU ARE NOT OBLIGED TO ANSWER ANY QUESTION YOU DON'T WANT TO, AND YOU MAY WITHDRAW FROM THE INTERVIEW AT ANY TIME. MAY I START NOW?" As with the similar sentence at the beginning of the Household Questionnaire, you may change the wording of these introductory sentences as appropriate. You must make sure, however, to include the following when you are introducing yourself: The name of the implementing agency; the topic of the survey; approximate duration of the interview; the issue of confidentiality; and with whom you would like to speak. If permission is given, begin the interview. If the respondent does not agree to continue, thank her and go on to the next interview. Later, discuss the refusal with your supervisor; you or another person from the team may attempt to interview the woman for a second time. This will depend on your description of the refusal. However, remember that a woman's participation in the survey must be on a voluntary basis, and potential respondents must never be forced to participate.
Women aged 15-49
1
Completed
2
Not at home
3
Refused
5
Incapacitated
6
Other (specify)
Month of birth of woman
Month of birth of woman
Month of birth of woman
Month of birth of woman
Month of birth of woman
Repeat greeting if not already read to this woman: We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. Also, you are not obliged to answer any question you don't want to, and you may withdraw from the interview at any time. May I start now? If permission is given, begin the interview. If the woman does not agree to continue, thank her, complete WM7, and go to the next interview. Discuss this result with your supervisor for a future revisit.
In what month and year were you born?
Age (WM8 or WM9) is one of the most important questions in the interview, since almost all analysis of the data depends on the respondent's age. This question must be asked independently of the information on the Household Questionnaire. Even if you already asked the respondent her age when you were completing the Household Questionnaire, you must ask again for her date of birth and age on the Questionnaire for Individual Women. --- If the respondent knows her date of birth, write it in the appropriate spaces for 'Month' and 'Year'. You will need to convert the month into numbers. For this, January is '01', February is '02', March is '03', etc. If the month or day contains only one digit, use a leading zero to fill in the first space. For example, the month of March is coded as '03'. If she does not know her month of birth, circle '98' for 'DK month' and ask her for the year of her birth. If she knows the year, write it in the spaces for 'Year'. Try under all circumstances to obtain at least the year of birth. If the respondent is unable to provide this information, ask whether she has any documentation such as an identification card, horoscope, or a birth or baptismal certificate that might give her date of birth. If such documentation is available, ask the woman if the information on the document(s) is correct. Only when it is absolutely impossible to even estimate the year of birth should you circle '9998' for 'DK year'.
Women aged 15-49
97
Inconsistent
98
DK
99
Missing
Year of birth of woman
Year of birth of woman
Year of birth of woman
Year of birth of woman
Year of birth of woman
Repeat greeting if not already read to this woman: We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. Also, you are not obliged to answer any question you don't want to, and you may withdraw from the interview at any time. May I start now? If permission is given, begin the interview. If the woman does not agree to continue, thank her, complete WM7, and go to the next interview. Discuss this result with your supervisor for a future revisit.
In what month and year were you born?
Age (WM8 or WM9) is one of the most important questions in the interview, since almost all analysis of the data depends on the respondent's age. This question must be asked independently of the information on the Household Questionnaire. Even if you already asked the respondent her age when you were completing the Household Questionnaire, you must ask again for her date of birth and age on the Questionnaire for Individual Women. --- If the respondent knows her date of birth, write it in the appropriate spaces for 'Month' and 'Year'. You will need to convert the month into numbers. For this, January is '01', February is '02', March is '03', etc. If the month or day contains only one digit, use a leading zero to fill in the first space. For example, the month of March is coded as '03'. If she does not know her month of birth, circle '98' for 'DK month' and ask her for the year of her birth. If she knows the year, write it in the spaces for 'Year'. Try under all circumstances to obtain at least the year of birth. If the respondent is unable to provide this information, ask whether she has any documentation such as an identification card, horoscope, or a birth or baptismal certificate that might give her date of birth. If such documentation is available, ask the woman if the information on the document(s) is correct. Only when it is absolutely impossible to even estimate the year of birth should you circle '9998' for 'DK year'.
Women aged 15-49
9997
Inconsistent
9998
DK
9999
Missing
Age of woman
Age of woman
Age of woman
Age of woman
Age of woman
How old were you at your last birthday?
Age (WM8 or WM9) is one of the most important questions in the interview, since almost all analysis of the data depends on the respondent's age. This question must be asked independently of the information on the Household Questionnaire. Even if you already asked the respondent her age when you were completing the Household Questionnaire, you must ask again for her date of birth and age on the Questionnaire for Individual Women. --- Enter her age in completed years, that is, her age at her last birthday. If she knows her age, write it in the space provided. If she does not know the answer to either of these two questions, probe for clues that might indicate her age. Ask how old she was when she was first married or first gave birth. Try to find out how long ago she got married or had her first child. (You may be able to find out the age of her oldest child if the child is still living. You may be able to relate her age to someone else in the household whose age is known. You may be able to determine her age based on how old she was when an important event occurred, and the number of years that have elapsed since.) You MUST fill in this information. Do not leave this blank. Finally, before moving on to the next question, verify that the respondent is indeed eligible. If the woman is younger than 15 or older than 49, you have to terminate the interview. Do this tactfully by asking two or three more questions and then thank the respondent for her cooperation; write 'INELIGIBLE' on the cover page of the questionnaire, and correct the age and eligibility information for this woman on the cover page and in Columns HL5 and HL6 of the Household Questionnaire.
Women aged 15-49
Have you ever attended school
Have you ever attended school
Have you ever attended school
Have you ever attended school
Have you ever attended school
Have you ever attended school?
Questions WM10-WM14 are about the educational attainment and literacy of the woman. Note that you will have collected some of this information on the woman in the Education module of the Household Questionnaire, either from another household member or from the woman herself. You should still ask these questions. You will be collecting slightly different information with these questions. --- Circle the code corresponding to the response given. If 'No', skip to WM14. Otherwise, continue on to the next question. The term 'school' includes primary, secondary and post-secondary schooling, as well as any other intermediate levels of schooling in the formal school system. It also includes technical or vocational training beyond the primary-school level, such as long-term courses in mechanics or secretarial work. Schools that carry out non-standard curriculum are also included here. Ensure that the woman understands what is meant by 'non-standard curriculum'. A non-standard curriculum includes religious schools, such as Koranic schools, that do not teach a full, standard school curriculum. If a school teaches religious courses but also includes the standard curriculum - such as many Catholic schools - it would be coded as a standard school.
Women aged 15-49
1
Yes
2
No
9
Missing
What is the highest level of school you attended
What is the highest level of school you attended
What is the highest level of school you attended
What is the highest level of school you attended
What is the highest level of school you attended
What is the highest level of school you attended: primary, secondary, or higher?
Questions WM10-WM14 are about the educational attainment and literacy of the woman. Note that you will have collected some of this information on the woman in the Education module of the Household Questionnaire, either from another household member or from the woman herself. You should still ask these questions. You will be collecting slightly different information with these questions. --- Circle the code corresponding to the highest level ever attended, regardless of whether or not the year was completed. For example, if she attended Form/Year 1 of secondary school for only 2 weeks, record 'Secondary'.
Women aged 15-49
1
Primary
2
Secondary
3
Higher
6
Non-standard curriculum
9
Missing
What is the highest grade completed at that level
What is the highest grade completed at that level
What is the highest grade completed at that level
What is the highest grade completed at that level
What is the highest grade completed at that level
What is the highest grade you completed at that level?
Questions WM10-WM14 are about the educational attainment and literacy of the woman. Note that you will have collected some of this information on the woman in the Education module of the Household Questionnaire, either from another household member or from the woman herself. You should still ask these questions. You will be collecting slightly different information with these questions. --- For this question, record the number of years that the respondent successfully completed at that level recorded in WM11. For example, if a woman was attending grade 3 of secondary school and left school before completing that year, record '02'. Although grade 3 was the highest year she attended, she completed 2 years of secondary school. If less than 1 year, record '00' for completed years. For example, if she attended only 2 weeks of grade 1 of secondary school, record '00' for completed years.
Women aged 15-49
No education
97
Inconsistent
98
DK
99
Missing
Can read part of the sentence
Can read part of the sentence
Can read part of the sentence
Can read part of the sentence
Can read part of the sentence
Check WM11: Secondary or higher. Go to Next Module Primary or non-standard curriculum. Continue with WM14
Now I would like you to read this sentence to me. Show sentences to respondent. If respondent cannot read whole sentence, probe: Can you read part of the sentence to me?
Example sentences for literacy test: 1. The child is reading a book. 2. The rains came late this year. 3. Parents must care for their children. 4. Farming is hard work
Questions WM10-WM14 are about the educational attainment and literacy of the woman. Note that you will have collected some of this information on the woman in the Education module of the Household Questionnaire, either from another household member or from the woman herself. You should still ask these questions. You will be collecting slightly different information with these questions. --- If the respondent attended secondary school or a higher level, check the corresponding box and go to the next module. If the highest level the respondent attended was primary school, check the appropriate box and continue to WM14. To ascertain whether women are literate or not, you will be showing women you interview cards with pre-printed sentences on them, and asking women to read them. Note that this question will be asked only to women who have not attended school, or did not attend school beyond the primary level. We assume that women who have attended secondary school or higher are literate. However, it is also known that some women who have attended or even completed primary school may be functionally illiterate. Therefore, we need to ask this question to such women. Based on your knowledge of the respondent, choose the card with the language in which the respondent is likely to be able to read if she is literate. Show the first sentence on the card to the respondent. Give the respondent enough time to read the sentence; do not rush her. If the respondent cannot read the whole sentence, probe: "CAN YOU READ PART OF THE SENTENCE TO ME?" Record whether the respondent was not able to read the sentence at all, was able to read only parts of the sentence, or was able to read the whole sentence. If the respondent asks for the sentences in another language and you were provided a card with sentences in that language, show the respondent the appropriate card. If there is no card with sentences in the language required, circle '4', and specify the language. If the respondent is blind/mute or visually/speech impaired, circle '5'. It is important to avoid the problem of having other respondents in the household overhear the sentence being read. Subsequent respondents in the household might be able to repeat the sentence when they are interviewed, even if they are unable to read. If there is a second eligible woman in the household, show her the second sentence on the card. Show the third respondent the third sentence on the card, and the fourth respondent the fourth sentence. If there are more than five respondents, start again with the first sentence on the card.
Women aged 15-49
1
Cannot read at all
2
Able to read only parts of sentence
3
Able to read whole sentence
4
Required language
5
Blind/visually impaired
9
Missing
Ever given birth
Ever given birth
Ever given birth
Ever given birth
Ever given birth
Now i would like to ask about all the births you have had during your life. Have you ever given birth? If "No" probe by asking: I mean, to a child who ever breathed or cried or showed other signs of life - even if he or she lived only a few minutes or hours?
This module is to be administered to all eligible women age 15-49. All questions refer only to live births. These questions are used to collect information about all births the woman has ever had (including births from earlier marriages). The answers are used to estimate childhood mortality rates. It is important that the respondent understands which events to include in these reports. We want to know about all of the woman's natural births, even if the child no longer lives with her and even if the child is no longer alive. We want to know about children who were born alive - ever breathed or cried or showed other signs of life - even if they lived only a few minutes or hours. We do not want you to record any stillbirths (children who were born dead), or miscarriages, or children adopted by the woman, or children of her present husband born to another wife (to whom the respondent herself did not give birth). The first question of the module is used to determine if the rest of the module and several subsequent modules should be administered to this woman. If the answer is 'Yes', circle '1', and continue with the next question. If the woman says she has never given birth, read out the probe to make sure the woman understands the meaning of 'birth', as described during your training. Explain:" I MEAN, TO A CHILD WHO EVER BREATHED OR CRIED OR SHOWED OTHER SIGNS OF LIFE - EVEN IF HE OR SHE LIVED ONLY A FEW MINUTES OR HOURS?" If her answer is still 'No', skip directly to the Marriage/Union module.
Women aged 15-49
1
Yes
2
No
Day of first birth
Day of first birth
Day of first birth
Day of first birth
Day of first birth
What was the date of your first birth? I mean the very first time you gave birth, even if the child is no longer living, or whose father is not your current partner.
Skip to CM3 only if year of first birth is given. Otherwise, continue with CM2B.
You need to obtain the year of the woman's first birth, which means the very first time she gave birth, even if the child is no longer living, or is the child of a partner other than her current one. As with all questions about dates and ages, you may need to probe to obtain the best information. Ask for the child's date of birth. If she knows the exact birth date, enter the day, month and year of birth on the lines provided and continue to CM3. You will have to convert the month to a number, as you have been instructed. If the month or day contains only one digit, use a zero to fill in the first space. For example, the month of March is coded as '03'. If she does not know the exact birth date, ask her the day, month and year separately. Enter the information as provided. If she does not know the day, circle '98'. If she can give the month of birth, convert it to a number and enter it on the line provided. If she cannot give the month, probe to try to estimate the month. If you cannot estimate the child's month of birth from this information, you may need to find out in which season he/she was born. If it is still not possible to estimate the child's month of birth, circle '98' in the space for month of birth. If the she can give a year of birth, write it in the space provided and continue to CM3. If she cannot give the year of the birth, circle '9998' and go to CM2B.
Women aged 15-49
97
Inconsistent
98
DK
99
Missing
Month of first birth
Month of first birth
Month of first birth
Month of first birth
Month of first birth
What was the date of your first birth? I mean the very first time you gave birth, even if the child is no longer living, or whose father is not your current partner.
Skip to CM3 only if year of first birth is given. Otherwise, continue with CM2B.
You need to obtain the year of the woman's first birth, which means the very first time she gave birth, even if the child is no longer living, or is the child of a partner other than her current one. As with all questions about dates and ages, you may need to probe to obtain the best information. Ask for the child's date of birth. If she knows the exact birth date, enter the day, month and year of birth on the lines provided and continue to CM3. You will have to convert the month to a number, as you have been instructed. If the month or day contains only one digit, use a zero to fill in the first space. For example, the month of March is coded as '03'. If she does not know the exact birth date, ask her the day, month and year separately. Enter the information as provided. If she does not know the day, circle '98'. If she can give the month of birth, convert it to a number and enter it on the line provided. If she cannot give the month, probe to try to estimate the month. If you cannot estimate the child's month of birth from this information, you may need to find out in which season he/she was born. If it is still not possible to estimate the child's month of birth, circle '98' in the space for month of birth. If the she can give a year of birth, write it in the space provided and continue to CM3. If she cannot give the year of the birth, circle '9998' and go to CM2B.
Women aged 15-49
97
Inconsistent
98
DK
99
Missing
Year of first birth
Year of first birth
Year of first birth
Year of first birth
Year of first birth
What was the date of your first birth? I mean the very first time you gave birth, even if the child is no longer living, or whose father is not your current partner.
Skip to CM3 only if year of first birth is given. Otherwise, continue with CM2B.
You need to obtain the year of the woman's first birth, which means the very first time she gave birth, even if the child is no longer living, or is the child of a partner other than her current one. As with all questions about dates and ages, you may need to probe to obtain the best information. Ask for the child's date of birth. If she knows the exact birth date, enter the day, month and year of birth on the lines provided and continue to CM3. You will have to convert the month to a number, as you have been instructed. If the month or day contains only one digit, use a zero to fill in the first space. For example, the month of March is coded as '03'. If she does not know the exact birth date, ask her the day, month and year separately. Enter the information as provided. If she does not know the day, circle '98'. If she can give the month of birth, convert it to a number and enter it on the line provided. If she cannot give the month, probe to try to estimate the month. If you cannot estimate the child's month of birth from this information, you may need to find out in which season he/she was born. If it is still not possible to estimate the child's month of birth, circle '98' in the space for month of birth. If the she can give a year of birth, write it in the space provided and continue to CM3. If she cannot give the year of the birth, circle '9998' and go to CM2B.
Women aged 15-49
9997
Inconsistent
9998
DK
9999
Missing
Years since first birth
Years since first birth
Years since first birth
Years since first birth
Years since first birth
How many years ago did you have your first birth?
This question is asked only to women who are not able to give the year of their first birth in CM2. It may be easier to obtain this information, especially if the first child is still alive. In this case, the answer is the first child's current age in completed years. Record the response in the space provided.
Women aged 15-49
97
Inconsistent
99
Missing
Any sons or daughters living with you
Any sons or daughters living with you
Any sons or daughters living with you
Any sons or daughters living with you
Any sons or daughters living with you
Do you have any sons or daughters to whom you have given birth who are now living with you?
Read the question slowly. The sons and daughters being considered are those who live with her in her household (these children should have been listed in the Household Listing). Circle the code corresponding to the response. If she answers 'No', skip to CM5.
Women aged 15-49
1
Yes
2
No
Sons living with you
Sons living with you
Sons living with you
Sons living with you
Sons living with you
How many sons live with you?
If the answer to CM3 is 'Yes', record the number of sons and daughters living with the woman in the space provided. If the answer is 'None' for sons (or if she does not have any sons), record '00' in the space provided for sons. Similarly, if she has no daughters now living with her (or if she does not have any daughters), record '00' in the space for daughters. Do not leave either of the spaces blank. Since the question is asked only to women who have children living with them in the same household, at least one of the spaces should have a value higher than 00. Remember, we are interested only in the respondent's OWN children - not foster children, children of her husband by another woman, or children of another relative.
Women aged 15-49
Daughters living with you
Daughters living with you
Daughters living with you
Daughters living with you
Daughters living with you
How many daughters live with you?
If the answer to CM3 is 'Yes', record the number of sons and daughters living with the woman in the space provided. If the answer is 'None' for sons (or if she does not have any sons), record '00' in the space provided for sons. Similarly, if she has no daughters now living with her (or if she does not have any daughters), record '00' in the space for daughters. Do not leave either of the spaces blank. Since the question is asked only to women who have children living with them in the same household, at least one of the spaces should have a value higher than 00. Remember, we are interested only in the respondent's OWN children - not foster children, children of her husband by another woman, or children of another relative.
Women aged 15-49
Any sons or daughters not living with you
Any sons or daughters not living with you
Any sons or daughters not living with you
Any sons or daughters not living with you
Any sons or daughters not living with you
Do you have any sons or daughters to whom you have given birth who are alive but do not live with you?
This refers to sons and daughters who are alive but not living with the woman. For example, one or more of her children may be living with a relative, staying in a boarding school, been given up for adoption, or may be grown-up children who have left home. Make sure the respondent is not reporting dead children in this question. Circle the code corresponding to the response. If she answers 'No', skip to CM7.
Women aged 15-49
1
Yes
2
No
Sons living not with you
Sons living not with you
Sons living not with you
Sons living not with you
Sons living not with you
How many sons are alive but do not live with you?
If the answer to CM5 is 'Yes', record the number of sons and daughters who are alive but not living with the respondent in the space provided. If the answer is 'None' for sons (or if she does not have any sons who are alive), record '00' in the space provided for sons. If the answer is 'None' for daughters (or if she does not have any daughters who are alive), record '00' in the space provided for daughters. Since this question is asked only to women who have children alive who are not living with them, at least one of the spaces should have a value higher than 00. For women who have been asked this question, the spaces should not be left blank.
Women aged 15-49
Daughters not living with you
Daughters not living with you
Daughters not living with you
Daughters not living with you
Daughters not living with you
How many daughters are alive but do not live with you?
If the answer to CM5 is 'Yes', record the number of sons and daughters who are alive but not living with the respondent in the space provided. If the answer is 'None' for sons (or if she does not have any sons who are alive), record '00' in the space provided for sons. If the answer is 'None' for daughters (or if she does not have any daughters who are alive), record '00' in the space provided for daughters. Since this question is asked only to women who have children alive who are not living with them, at least one of the spaces should have a value higher than 00. For women who have been asked this question, the spaces should not be left blank.
Women aged 15-49
Ever had child who later died
Ever had child who later died
Ever had child who later died
Ever had child who later died
Ever had child who later died
Have you ever given birth to a boy or girl who was born alive but later died?
This question is extremely important. Circle the code corresponding to the response. Some respondents may fail to mention children who died very young, so if she answers 'No', it is important to probe by asking "…THAT IS, ANY BABY WHO CRIED OR SHOWED SIGNS OF LIFE BUT SURVIVED ONLY A FEW HOURS OR DAYS (OR ONLY A SHORT TIME)?" If the answer is still 'No', skip to CM9. Some respondents may be reluctant to talk about this subject and may become sad or upset that you are asking such questions. Be sympathetic and tactful in such situations. Say that you know the subject is painful, but the information is important.
Women aged 15-49
1
Yes
2
No
Boys dead
Boys dead
Boys dead
Boys dead
Boys dead
How many boys have died?
If the answer to CM7 is 'Yes', record the number of sons and daughters who were born alive but later died in the spaces provided. Do not leave either of the spaces blank. For women who have been asked this question, at least one of the spaces should have a value higher than 00.
Women aged 15-49
Girls dead
Girls dead
Girls dead
Girls dead
Girls dead
How many girls have died?
If the answer to CM7 is 'Yes', record the number of sons and daughters who were born alive but later died in the spaces provided. Do not leave either of the spaces blank. For women who have been asked this question, at least one of the spaces should have a value higher than 00.
Women aged 15-49
Children ever born
Children ever born
Children ever born
Children ever born
Children ever born
Sum answers to CM4, CM6, and CM8.
Just to make sure that I have this right, you have had in total (total number) births during your life. Is this correct? Yes. Go to CM11 No. Check responses and make corrections before proceeding to CM11
Add the numbers of births reported in CM4, CM6 and CM8 and write the sum here, then check: If she says it is correct, check the box marked 'Yes' and continue to the next question. If she says 'No', first check your addition and then go back through the list to check with the respondent whether you have obtained the information correctly. For example, starting with CM4, you would ask: "YOU HAVE TWO SONS AND ONE DAUGHTER LIVING WITH YOU, IS THAT CORRECT?" Do the same for CM6 and CM8. Correct the answers and the sum mentioned in CM9 and then continue to the next question. Make sure to cancel the 'No' in CM10 and check 'Yes' after you have made the corrections.
Women aged 15-49
Day of last birth
Day of last birth
Day of last birth
Day of last birth
Day of last birth
Of these (total number) births you have had, when did you deliver the last one (even if he or she has died)?
If day is not known, enter '98' in space for day.
This question is used to ascertain the woman's eligibility for the subsequent two modules. Enter the date of the woman's most recent birth, even if the child is no longer alive, in the space provided. If the child has died, take special care when referring to this child by name in the following modules. If the woman does not remember the day of birth, you may enter '98' to the space provided for 'Day'. Note that you MUST obtain exact information on the month and year of the last birth; '98' is not allowed for month and year.
Women aged 15-49
97
Inconsistent
98
DK
99
Missing
Month of last birth
Month of last birth
Month of last birth
Month of last birth
Month of last birth
Of these (total number) births you have had, when did you deliver the last one (even if he or she has died)?
This question is used to ascertain the woman's eligibility for the subsequent two modules. Enter the date of the woman's most recent birth, even if the child is no longer alive, in the space provided. If the child has died, take special care when referring to this child by name in the following modules. If the woman does not remember the day of birth, you may enter '98' to the space provided for 'Day'. Note that you MUST obtain exact information on the month and year of the last birth; '98' is not allowed for month and year.
Women aged 15-49
97
Inconsistent
Year of last birth
Year of last birth
Year of last birth
Year of last birth
Year of last birth
Of these (total number) births you have had, when did you deliver the last one (even if he or she has died)?
This question is used to ascertain the woman's eligibility for the subsequent two modules. Enter the date of the woman's most recent birth, even if the child is no longer alive, in the space provided. If the child has died, take special care when referring to this child by name in the following modules. If the woman does not remember the day of birth, you may enter '98' to the space provided for 'Day'. Note that you MUST obtain exact information on the month and year of the last birth; '98' is not allowed for month and year.
Women aged 15-49
9997
Inconsistent
Live birth in last 2 years
Live birth in last 2 years
Live birth in last 2 years
Live birth in last 2 years
Live birth in last 2 years
Check CM11: Did the woman's last birth occur within the last 2 years, that is, since (day and month of interview in 2003)? If child has died, take special care when referring to this child by name in the following modules. No live birth in last 2 years. Go to MARRIAGE/UNION module. Yes, live birth in last 2 years. Continue with CM13 Name of child_______________________
If the respondent's last birth occurred in the last 2 years, enter the name of the child on the line provided and check the box marked 'Yes'. Then continue with CM13. If the respondent's last birth did not occur in the last 2 years, check the box marked 'No' and go to the Marriage/Union module.
Women aged 15-49
N
No
Y
Yes
Wanted last child
Wanted last child
Wanted last child
Wanted last child
Wanted last child
At the time you became pregnant with (name), did you want to become pregnant then, did you want to wait until later, or did you want no (more) children at all?
Ask this question to women who have had a live birth during the last 2 years. The question is asked to find out whether the pregnancy for this child was wanted at the time, whether the woman actually wanted to have the child later than she did, or whether she did not want the pregnancy and the subsequent birth at all. Circle the appropriate code and continue with the next module.
Women aged 15-49
1
Then
2
later
3
No more
9
Missing
Has immunization card
Has immunization card
Has immunization card
Has immunization card
Has immunization card
This module is to be administered to all women with a live birth in the 2 years preceding date of interview.
Do you have a card or other document with your own immunizations listed?
If a card is presented, use it to assist with answers to the following questions.
This module is to be administered to all women who have had a live birth in the 2 years preceding the date of the interview. If the woman has had no live births during the 2 years preceding the interview, you should leave this module blank and skip to the next module. The purpose of this module is to obtain information about protection from tetanus for infants through vaccination of their mothers. Neonatal tetanus is easily prevented if a woman receives the immunization while she is pregnant with the baby, or receives several vaccinations against it at an appropriate interval before the birth. Ask these questions, even if the most recent baby is no longer alive. --- First, ask whether she has a vaccination card or other documentary evidence of vaccination. Ask to see this evidence and record that you have seen it by circling '1'. If a card is presented, use it to assist with answers to the following questions. If the woman says she has a card but does not/cannot show it to you, circle '2'. If the card is not available ('2' or '3' circled in TT1), you must try to find out how long ago the last tetanus toxoid (TT) dose was received, and the total number of TT doses the mother has received in her lifetime. Use the probing questions, and record her answers in the spaces provided. Women who do not have immunization cards may have difficulty identifying whether injections they received were tetanus toxoid injections.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Yes (card seen)
2
Yes (card not seen)
3
No
8
DK
9
Missing
Any tetanus toxoid injection during last pregnancy
Any tetanus toxoid injection during last pregnancy
Any tetanus toxoid injection during last pregnancy
Any tetanus toxoid injection during last pregnancy
Any tetanus toxoid injection during last pregnancy
When you were pregnant with your last child, did you receive any injection to prevent him or her from getting tetanus, that is convulsions after birth (an anti-tetanus shot, an injection at the top of the arm or shoulder)?
Ask if she received any tetanus toxoid injection during her last pregnancy. Circle '1' for a 'Yes' response. If the answer is 'No' or 'DK', circle the code corresponding to the response and skip to TT5.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Yes
2
No
8
DK
9
Missing
Doses of tetanus toxoid during last pregnancy
Doses of tetanus toxoid during last pregnancy
Doses of tetanus toxoid during last pregnancy
Doses of tetanus toxoid during last pregnancy
Doses of tetanus toxoid during last pregnancy
If yes: How many times did you receive this anti-tetanus injection during your last pregnancy?
How many TT doses during last pregnancy were reported in TT3? At least two TT injections during last pregnancy. Go to Next Module Fewer than two TT injections during last pregnancy. Continue with TT5
Enter the number of doses she reports in the space provided and continue to TT4. If she does not know, circle '98' and skip to TT5.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
98
DK
99
Missing
Any tetanus toxoid injection before last pregnancy
Any tetanus toxoid injection before last pregnancy
Any tetanus toxoid injection before last pregnancy
Any tetanus toxoid injection before last pregnancy
Any tetanus toxoid injection before last pregnancy
Did you receive any tetanus toxoid injection at any time before your last pregnancy?
Check the box corresponding to the number of TT doses during last pregnancy. If she reported at least two TT injections during her last pregnancy, go to the next module. If she reported fewer than two TT injections during her last pregnancy, continue with TT5. --- Circle the code corresponding to her response. If she reports never having received any TT prior to her last pregnancy, or does not know, circle the code corresponding to the answer given and go to the next module. If 'Yes', continue with TT6.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Yes
2
No
8
DK
9
Missing
Doses of tetanus toxoid before last pregnancy
Doses of tetanus toxoid before last pregnancy
Doses of tetanus toxoid before last pregnancy
Doses of tetanus toxoid before last pregnancy
Doses of tetanus toxoid before last pregnancy
How many times did you receive it?
Ask about doses received during or before the next-to-last pregnancy or between pregnancies (at any time before the last pregnancy). Enter her response in the space provided, as in TT3.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
98
DK
99
Missing
Month last tetanus toxoid received
Month last tetanus toxoid received
Month last tetanus toxoid received
Month last tetanus toxoid received
Month last tetanus toxoid received
In what month and year did you receive the last anti-tetanus injection before that last pregnancy?
Skip to next module only if year of injection is given. Otherwise, continue with TT8.
Ask the mother the month and year in which she received the last dose of TT before her last pregnancy. You will need to convert the month to a number, as done earlier. If she cannot supply the month, circle '98' for 'DK Month'. If she can provide the year, fill in the year in the space provided and skip to the next module. If she does not know the year, circle '9998' and continue to TT8.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
97
Inconsistent
98
DK
99
Missing
Year last tetanus toxoid received
Year last tetanus toxoid received
Year last tetanus toxoid received
Year last tetanus toxoid received
Year last tetanus toxoid received
In what month and year did you receive the last anti-tetanus injection before that last pregnancy?
Skip to next module only if year of injection is given. Otherwise, continue with TT8.
Ask the mother the month and year in which she received the last dose of TT before her last pregnancy. You will need to convert the month to a number, as done earlier. If she cannot supply the month, circle '98' for 'DK Month'. If she can provide the year, fill in the year in the space provided and skip to the next module. If she does not know the year, circle '9998' and continue to TT8.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
9997
Inconsistent
9998
DK
9999
Missing
Years ago last tetanus toxoid received
Years ago last tetanus toxoid received
Years ago last tetanus toxoid received
Years ago last tetanus toxoid received
Years ago last tetanus toxoid received
How many years ago did you receive the last anti-tetanus injection before that last pregnancy?
Ask her to estimate how long ago she received the last dose of TT (the dose before her last pregnancy), and enter her response in years.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
99
Missing
Antenatal care: Doctor
Antenatal care: Doctor
Antenatal care: Doctor
Antenatal care: Doctor
Antenatal care: Doctor
Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else?
Probe for the type of person seen and circle all answers given.
Antenatal care check-ups help to detect problems associated with pregnancy and delivery. All pregnant women should have routine check-ups. This question refers to any antenatal care received during the pregnancy - a check specifically for the pregnancy and not for other reasons. This is a three-part question. First, ask if she saw anyone for antenatal care for this pregnancy. Then, if the woman answers 'Yes', you must ask whom she saw for the check-up. Finally, ask if she saw more than one person and record all persons seen. If you are unsure how to code a person mentioned, write the words used to describe the person in the space provided 'Other' and circle 'X'. If she saw no one for antenatal checks, circle 'Y' and skip to MN7. Doctors, nurses, midwives and auxiliary nurse midwives are skilled health personnel who have midwifery skills to manage normal deliveries and diagnose or refer obstetric complications. 'Traditional birth attendants' may be trained or untrained. If the woman gives the name of a health facility, ask her to tell you who she saw there.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
A
Doctor
Antenatal care: Nurse/midwife
Antenatal care: Nurse/midwife
Antenatal care: Nurse/midwife
Antenatal care: Nurse/midwife
Antenatal care: Nurse/midwife
Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else?
Probe for the type of person seen and circle all answers given.
Antenatal care check-ups help to detect problems associated with pregnancy and delivery. All pregnant women should have routine check-ups. This question refers to any antenatal care received during the pregnancy - a check specifically for the pregnancy and not for other reasons. This is a three-part question. First, ask if she saw anyone for antenatal care for this pregnancy. Then, if the woman answers 'Yes', you must ask whom she saw for the check-up. Finally, ask if she saw more than one person and record all persons seen. If you are unsure how to code a person mentioned, write the words used to describe the person in the space provided 'Other' and circle 'X'. If she saw no one for antenatal checks, circle 'Y' and skip to MN7. Doctors, nurses, midwives and auxiliary nurse midwives are skilled health personnel who have midwifery skills to manage normal deliveries and diagnose or refer obstetric complications. 'Traditional birth attendants' may be trained or untrained. If the woman gives the name of a health facility, ask her to tell you who she saw there.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
B
Nurse/midwife
Antenatal care: Auxilary midwife
Antenatal care: Auxilary midwife
Antenatal care: Auxilary midwife
Antenatal care: Auxilary midwife
Antenatal care: Auxilary midwife
Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else?
Probe for the type of person seen and circle all answers given.
Antenatal care check-ups help to detect problems associated with pregnancy and delivery. All pregnant women should have routine check-ups. This question refers to any antenatal care received during the pregnancy - a check specifically for the pregnancy and not for other reasons. This is a three-part question. First, ask if she saw anyone for antenatal care for this pregnancy. Then, if the woman answers 'Yes', you must ask whom she saw for the check-up. Finally, ask if she saw more than one person and record all persons seen. If you are unsure how to code a person mentioned, write the words used to describe the person in the space provided 'Other' and circle 'X'. If she saw no one for antenatal checks, circle 'Y' and skip to MN7. Doctors, nurses, midwives and auxiliary nurse midwives are skilled health personnel who have midwifery skills to manage normal deliveries and diagnose or refer obstetric complications. 'Traditional birth attendants' may be trained or untrained. If the woman gives the name of a health facility, ask her to tell you who she saw there.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
C
Auxiliary/midwife
Antenatal care: Traditional birth attendant
Antenatal care: Traditional birth attendant
Antenatal care: Traditional birth attendant
Antenatal care: Traditional birth attendant
Antenatal care: Traditional birth attendant
Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else?
Probe for the type of person seen and circle all answers given.
Antenatal care check-ups help to detect problems associated with pregnancy and delivery. All pregnant women should have routine check-ups. This question refers to any antenatal care received during the pregnancy - a check specifically for the pregnancy and not for other reasons. This is a three-part question. First, ask if she saw anyone for antenatal care for this pregnancy. Then, if the woman answers 'Yes', you must ask whom she saw for the check-up. Finally, ask if she saw more than one person and record all persons seen. If you are unsure how to code a person mentioned, write the words used to describe the person in the space provided 'Other' and circle 'X'. If she saw no one for antenatal checks, circle 'Y' and skip to MN7. Doctors, nurses, midwives and auxiliary nurse midwives are skilled health personnel who have midwifery skills to manage normal deliveries and diagnose or refer obstetric complications. 'Traditional birth attendants' may be trained or untrained. If the woman gives the name of a health facility, ask her to tell you who she saw there.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
F
Traditional birth attendance
Antenatal care: Community health worker
Antenatal care: Community health worker
Antenatal care: Community health worker
Antenatal care: Community health worker
Antenatal care: Community health worker
Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else?
Probe for the type of person seen and circle all answers given.
Antenatal care check-ups help to detect problems associated with pregnancy and delivery. All pregnant women should have routine check-ups. This question refers to any antenatal care received during the pregnancy - a check specifically for the pregnancy and not for other reasons. This is a three-part question. First, ask if she saw anyone for antenatal care for this pregnancy. Then, if the woman answers 'Yes', you must ask whom she saw for the check-up. Finally, ask if she saw more than one person and record all persons seen. If you are unsure how to code a person mentioned, write the words used to describe the person in the space provided 'Other' and circle 'X'. If she saw no one for antenatal checks, circle 'Y' and skip to MN7. Doctors, nurses, midwives and auxiliary nurse midwives are skilled health personnel who have midwifery skills to manage normal deliveries and diagnose or refer obstetric complications. 'Traditional birth attendants' may be trained or untrained. If the woman gives the name of a health facility, ask her to tell you who she saw there.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
G
Community/health worker
Antenatal care: Relative/friend
Antenatal care: Relative/friend
Antenatal care: Relative/friend
Antenatal care: Relative/friend
Antenatal care: Relative/friend
Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else?
Probe for the type of person seen and circle all answers given.
Antenatal care check-ups help to detect problems associated with pregnancy and delivery. All pregnant women should have routine check-ups. This question refers to any antenatal care received during the pregnancy - a check specifically for the pregnancy and not for other reasons. This is a three-part question. First, ask if she saw anyone for antenatal care for this pregnancy. Then, if the woman answers 'Yes', you must ask whom she saw for the check-up. Finally, ask if she saw more than one person and record all persons seen. If you are unsure how to code a person mentioned, write the words used to describe the person in the space provided 'Other' and circle 'X'. If she saw no one for antenatal checks, circle 'Y' and skip to MN7. Doctors, nurses, midwives and auxiliary nurse midwives are skilled health personnel who have midwifery skills to manage normal deliveries and diagnose or refer obstetric complications. 'Traditional birth attendants' may be trained or untrained. If the woman gives the name of a health facility, ask her to tell you who she saw there.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
H
Relative/friend
Antenatal care: Other
Antenatal care: Other
Antenatal care: Other
Antenatal care: Other
Antenatal care: Other
Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else?
Probe for the type of person seen and circle all answers given.
Antenatal care check-ups help to detect problems associated with pregnancy and delivery. All pregnant women should have routine check-ups. This question refers to any antenatal care received during the pregnancy - a check specifically for the pregnancy and not for other reasons. This is a three-part question. First, ask if she saw anyone for antenatal care for this pregnancy. Then, if the woman answers 'Yes', you must ask whom she saw for the check-up. Finally, ask if she saw more than one person and record all persons seen. If you are unsure how to code a person mentioned, write the words used to describe the person in the space provided 'Other' and circle 'X'. If she saw no one for antenatal checks, circle 'Y' and skip to MN7. Doctors, nurses, midwives and auxiliary nurse midwives are skilled health personnel who have midwifery skills to manage normal deliveries and diagnose or refer obstetric complications. 'Traditional birth attendants' may be trained or untrained. If the woman gives the name of a health facility, ask her to tell you who she saw there.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
X
Other
Antenatal care: No one
Antenatal care: No one
Antenatal care: No one
Antenatal care: No one
Antenatal care: No one
Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else?
Probe for the type of person seen and circle all answers given.
Antenatal care check-ups help to detect problems associated with pregnancy and delivery. All pregnant women should have routine check-ups. This question refers to any antenatal care received during the pregnancy - a check specifically for the pregnancy and not for other reasons. This is a three-part question. First, ask if she saw anyone for antenatal care for this pregnancy. Then, if the woman answers 'Yes', you must ask whom she saw for the check-up. Finally, ask if she saw more than one person and record all persons seen. If you are unsure how to code a person mentioned, write the words used to describe the person in the space provided 'Other' and circle 'X'. If she saw no one for antenatal checks, circle 'Y' and skip to MN7. Doctors, nurses, midwives and auxiliary nurse midwives are skilled health personnel who have midwifery skills to manage normal deliveries and diagnose or refer obstetric complications. 'Traditional birth attendants' may be trained or untrained. If the woman gives the name of a health facility, ask her to tell you who she saw there.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
Y
No one
Weighed
Weighed
Weighed
Weighed
Weighed
As part of your antenatal care, were any of the following done at least once? Were you weighed?
Ask about each procedure and record the response before asking about the next one. Circle '1' for 'Yes', or '2' for 'No' in each case. It may be necessary to explain some of the procedures. We want to know whether each of the procedures listed was performed during any of the antenatal check-ups during her last pregnancy. It does not matter if they were performed only once or more than once, or performed in the same visit or spread over several visits. The question asks for the following procedures: A. WERE YOU WEIGHED?
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Yes
2
No
9
Missing
Blood pressure measured
Blood pressure measured
Blood pressure measured
Blood pressure measured
Blood pressure measured
As part of your antenatal care, were any of the following done at least once? Was your blood pressure measured?
Ask about each procedure and record the response before asking about the next one. Circle '1' for 'Yes', or '2' for 'No' in each case. It may be necessary to explain some of the procedures. We want to know whether each of the procedures listed was performed during any of the antenatal check-ups during her last pregnancy. It does not matter if they were performed only once or more than once, or performed in the same visit or spread over several visits. The question asks for the following procedures: B. WAS YOUR BLOOD PRESSURE MEASURED? Blood pressure is measured with a medical instrument. A rubber cuff is wrapped around a person's upper arm and is inflated. While slowly releasing air from the cuff, the person measuring the blood pressure listens to the pulsing of the blood vessels with a stethoscope to determine the pressure.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Yes
2
No
9
Missing
Urine sample
Urine sample
Urine sample
Urine sample
Urine sample
As part of your antenatal care, were any of the following done at least once? Did you give a urine sample?
Ask about each procedure and record the response before asking about the next one. Circle '1' for 'Yes', or '2' for 'No' in each case. It may be necessary to explain some of the procedures. We want to know whether each of the procedures listed was performed during any of the antenatal check-ups during her last pregnancy. It does not matter if they were performed only once or more than once, or performed in the same visit or spread over several visits. The question asks for the following procedures: C. DID YOU GIVE A URINE SAMPLE?
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Yes
2
No
9
Missing
Blood sample
Blood sample
Blood sample
Blood sample
Blood sample
As part of your antenatal care, were any of the following done at least once? Did you give a blood sample?
Ask about each procedure and record the response before asking about the next one. Circle '1' for 'Yes', or '2' for 'No' in each case. It may be necessary to explain some of the procedures. We want to know whether each of the procedures listed was performed during any of the antenatal check-ups during her last pregnancy. It does not matter if they were performed only once or more than once, or performed in the same visit or spread over several visits. The question asks for the following procedures: D. DID YOU GIVE A BLOOD SAMPLE? A blood sample may be taken from the woman's fingertip or from a vein (usually from a vein near the elbow or on the wrist). The blood sample is used to test for various diseases, such as anaemia, parasite infestations or infectious diseases.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Yes
2
No
9
Missing
Counseled about AIDS or the AIDS virus
Counseled about AIDS or the AIDS virus
Counseled about AIDS or the AIDS virus
Counseled about AIDS or the AIDS virus
Counseled about AIDS or the AIDS virus
During any of the antenatal visits for the pregnancy, were you given any information or counseled about AIDS or the AIDS virus?
We want to know if someone spoke with the respondent about AIDS or the AIDS virus during any of her antenatal care visits. This covers topics such as babies getting the AIDS virus, things that you can do to prevent getting the AIDS virus, or getting tests for the AIDS virus. It does not matter whether the topic was discussed only once or more than once, or discussed in one visit or over several visits.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Yes
2
No
8
DK
9
Missing
Tested for HIV/AIDS
Tested for HIV/AIDS
Tested for HIV/AIDS
Tested for HIV/AIDS
Tested for HIV/AIDS
I don't want to know the results, but were you tested for HIV/AIDS as part of your antenatal care?
Be clear to the respondent that you are not asking to know the results of the test, simply whether or not she was tested. Circle the code corresponding to the response. If the answer is 'No' or 'DK', skip to MN7.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Yes
2
No
8
DK
9
Missing
Received result of HIV test
Received result of HIV test
Received result of HIV test
Received result of HIV test
Received result of HIV test
I don't want to know the results, but did you get the results of the test?
Sometimes people are tested for the AIDS virus but are not told whether or not they have the virus, or do not go to get the results. Be clear to the respondent that you are not asking to know the results of the test, simply whether or not she knows the results of the test. Circle the code corresponding to the response.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Yes
2
No
8
DK
9
Missing
Assistance at delivery: Doctor
Assistance at delivery: Doctor
Assistance at delivery: Doctor
Assistance at delivery: Doctor
Assistance at delivery: Doctor
Who assisted with the delivery of your last child (name)? Anyone else?
Probe for the type of person assisting and circle all answers given.
When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
A
Doctor
Assistance at delivery: Nurse/midwife
Assistance at delivery: Nurse/midwife
Assistance at delivery: Nurse/midwife
Assistance at delivery: Nurse/midwife
Assistance at delivery: Nurse/midwife
Who assisted with the delivery of your last child (name)? Anyone else?
Probe for the type of person assisting and circle all answers given.
When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
B
Nurse/midwife
Assistance at delivery: Auxiliary midwife
Assistance at delivery: Auxiliary midwife
Assistance at delivery: Auxiliary midwife
Assistance at delivery: Auxiliary midwife
Assistance at delivery: Auxiliary midwife
Who assisted with the delivery of your last child (name)? Anyone else?
Probe for the type of person assisting and circle all answers given.
When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
C
Auxiliary/midwife
Assistance at delivery: Traditional birth attendant
Assistance at delivery: Traditional birth attendant
Assistance at delivery: Traditional birth attendant
Assistance at delivery: Traditional birth attendant
Assistance at delivery: Traditional birth attendant
Who assisted with the delivery of your last child (name)? Anyone else?
Probe for the type of person assisting and circle all answers given.
When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
F
Traditional birth attendance
Assistance at delivery: Community health worker
Assistance at delivery: Community health worker
Assistance at delivery: Community health worker
Assistance at delivery: Community health worker
Assistance at delivery: Community health worker
Who assisted with the delivery of your last child (name)? Anyone else?
Probe for the type of person assisting and circle all answers given.
When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
G
Community/health worker
Assistance at delivery: Relative/friend
Assistance at delivery: Relative/friend
Assistance at delivery: Relative/friend
Assistance at delivery: Relative/friend
Assistance at delivery: Relative/friend
Who assisted with the delivery of your last child (name)? Anyone else?
Probe for the type of person assisting and circle all answers given.
When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
H
Relative/friend
Assistance at delivery: Other
Assistance at delivery: Other
Assistance at delivery: Other
Assistance at delivery: Other
Assistance at delivery: Other
Who assisted with the delivery of your last child (name)? Anyone else?
Probe for the type of person assisting and circle all answers given.
When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
X
Other
Assistance at delivery: No one
Assistance at delivery: No one
Assistance at delivery: No one
Assistance at delivery: No one
Assistance at delivery: No one
Who assisted with the delivery of your last child (name)? Anyone else?
Probe for the type of person assisting and circle all answers given.
When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
?
Missing
Y
No one
Place of delivery
Place of delivery
Place of delivery
Place of delivery
Place of delivery
Where did you give birth to (NAME)?
If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code.
The intent of this question is to identify births delivered in a health facility. If the woman gave birth in a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the place is in the public (run by the government) or private sector. If the place is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle '26'. Similarly, if the place is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle '36'. If the respondent answers that she delivered in another place not listed, write the description of the place in the space provided for 'Other' and circle '96'. Then write the name of the place in the space provided on the questionnaire 'Name of place' and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response. Places that are not health facilities, other than home, should also be coded as 'Other' and described.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
11
Resondent's home
12
Other home
21
Government hospital
22
Government clinic/health center
26
Other public
31
Private hospital
32
Private clinic
36
Other private medical
96
Other
99
Missing
Size of child at birth
Size of child at birth
Size of child at birth
Size of child at birth
Size of child at birth
When your last child (name) was born, was he/she very large, larger than average, average, smaller than average, or very small?
Low-birthweight babies are at higher risk of serious illness or death than other babies. Mothers are asked to give the baby's birthweight, but since some babies are not weighed at birth, a mother's subjective assessment of the baby's size at birth is important. When the information from women who answer these questions is analysed, we can obtain an indication of what women mean by these subjective categories. This information can provide an estimate of the average birthweight. Read the entire question exactly as written before accepting an answer. This is the woman's own opinion about the size of her baby. Even if she knows the child's birthweight, tell her that you want to know her own idea of whether the baby was very large, larger than average, average, smaller than average or very small. If the respondent is unable to tell you, do not try to guess the answer based on the birthweight information or the appearance of the baby; circle '8' for 'DK'. In cases when the woman knows the birthweight of the baby and tells you the exact weight, do not use your judgement to influence her response in MN9. In other words, even if the woman tells you that her baby was smaller than average while the birthweight she is stating is quite large in your opinion, do not probe further to 'correct' the woman's perception of the size of the baby.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Very large
2
Larger than average
3
Average
4
Smaller than average
5
Very small
8
DK
9
Missing
Child weighed at birth
Child weighed at birth
Child weighed at birth
Child weighed at birth
Child weighed at birth
Was (name) weighed at birth?
Circle the code corresponding to the response given. If the baby was not weighed at birth or the mother doesn't know, skip to MN12.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Yes
2
No
8
DK
9
Missing
Weight from card or recall
Weight from card or recall
Weight from card or recall
Weight from card or recall
Weight from card or recall
How much did (name) weigh?
Record weight from health card, if available.
Ask the woman to show you her (or the child's) health card, if available. Record the birthweight in kilograms. If the weight is 'From card' or is recorded on another written document (such as a vaccination card, antenatal card or birth certificate), circle '1' and record the weight in the corresponding space. If the birthweight is reported by the mother, but no card or document is available, circle '2' for 'From recall' and record the weight in the corresponding space. Fill in the weight only once. Use zeros to fill in all digits if necessary. For example, if the woman tells you that the baby was 3.5 kilograms at birth; enter the information as '3.500'. Always record the birthweight from the card when possible. If there is no card, and the mother cannot remember the exact weight, record her best estimate. Only circle '99998' for 'DK' if she absolutely cannot remember even the approximate weight.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Card
2
Recall
7
Inconsistent
9
Missing
Weight at birth (Kilograms)
Weight at birth (Kilograms)
Weight at birth (Kilograms)
Weight at birth (Kilograms)
Weight at birth (Kilograms)
How much did (name) weigh?
Record weight from health card, if available.
Ask the woman to show you her (or the child's) health card, if available. Record the birthweight in kilograms. If the weight is 'From card' or is recorded on another written document (such as a vaccination card, antenatal card or birth certificate), circle '1' and record the weight in the corresponding space. If the birthweight is reported by the mother, but no card or document is available, circle '2' for 'From recall' and record the weight in the corresponding space. Fill in the weight only once. Use zeros to fill in all digits if necessary. For example, if the woman tells you that the baby was 3.5 kilograms at birth; enter the information as '3.500'. Always record the birthweight from the card when possible. If there is no card, and the mother cannot remember the exact weight, record her best estimate. Only circle '99998' for 'DK' if she absolutely cannot remember even the approximate weight.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
9.998
DK
9.999
Missing
Ever breastfeed
Ever breastfeed
Ever breastfeed
Ever breastfeed
Ever breastfeed
Did you ever breastfeed (name)?
Breastfeeding is important for a child's health and because it prevents pregnancy during the period when the mother is breastfeeding. For this question, it does not matter how long the respondent breastfed the child, only whether or not she ever gave the child the breast, even if the baby died very young. Circle the code corresponding to the response given. If the response is 'No' (she never breastfed the child), go to the next module.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
1
Yes
2
No
9
Missing
Time baby put to breast (unit)
Time baby put to breast (unit)
Time baby put to breast (unit)
Time baby put to breast (unit)
Time baby put to breast (unit)
How long after birth did you first put (name) to the breast?
If less than 1 hour, record '00' hours. If less than 24 hours, record hours. Otherwise, record days.
If the mother reports that the baby was put to the breast immediately after birth, circle '000'. Otherwise, record the time in completed hours or days. If less than 1 hour, circle '1' for 'Hours' and record '00' in the space provided. For example, if the woman said she began breastfeeding within 10 minutes of the birth, circle '1' and record '00' hours. If the mother began breastfeeding within 24 hours of the birth, circle '1' and record the number of hours that passed before the baby was put to the breast. If she began breastfeeding 24 hours or more after the birth, circle '2' and record the number of days. Record in completed number of days. For example, if the baby was first breastfed 30 hours after delivery, circle '2' and record '01' days. If the woman does not know or does not remember how long after birth she put the baby to the breast, circle '998'.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
Immediately
1
Hours
2
Days
9
Missing
Time baby put to breast (number)
Time baby put to breast (number)
Time baby put to breast (number)
Time baby put to breast (number)
Time baby put to breast (number)
How long after birth did you first put (name) to the breast?
If less than 1 hour, record '00' hours. If less than 24 hours, record hours. Otherwise, record days.
If the mother reports that the baby was put to the breast immediately after birth, circle '000'. Otherwise, record the time in completed hours or days. If less than 1 hour, circle '1' for 'Hours' and record '00' in the space provided. For example, if the woman said she began breastfeeding within 10 minutes of the birth, circle '1' and record '00' hours. If the mother began breastfeeding within 24 hours of the birth, circle '1' and record the number of hours that passed before the baby was put to the breast. If she began breastfeeding 24 hours or more after the birth, circle '2' and record the number of days. Record in completed number of days. For example, if the baby was first breastfed 30 hours after delivery, circle '2' and record '01' days. If the woman does not know or does not remember how long after birth she put the baby to the breast, circle '998'.
Women aged 15-49 who gave birth to a child in the 2 years preceding the survey
98
DK
99
Missing
Currently married or living with a man
Currently married or living with a man
Currently married or living with a man
Currently married or living with a man
Currently married or living with a man
Are you currently married or living together with a man as if married?
This module is to be administered to all women aged 15-49 years (including women age 15 and age 49). In the questionnaire and this manual, 'marriage' always refers to both formal and informal unions, such as living together. An informal union is one in which the man and woman live together for some time, intending to have a lasting relationship, but do not have a formal civil or religious ceremony. For example, if a woman went to live with her boyfriend and his family and stayed there for several years, they would be considered 'living together', whether or not they have any children. On the other hand, if a woman has a boyfriend but has never lived with him, she would not be considered in a union. Casual sexual encounters are not included here. --- The options here are currently married, living with a man, or not in union (the woman is neither married nor living with a man). Circle the code corresponding to the respondent's status at the time of the interview. If the woman is currently neither married or in a union, skip to MA3.
Women aged 15-49
1
Yes, currently married
2
Yes, living with a man
3
No, not in union
9
Missing
Age of husband/partner
Age of husband/partner
Age of husband/partner
Age of husband/partner
Age of husband/partner
How old was your husband/partner on his last birthday?
If she knows the age of her current partner on his last birthday, enter his age in the space provided. If she does not know his age, circle '98'. Skip to MA5, irrespective of the response.
Women aged 15-49
98
DK
99
Missing
Ever married or lived with a man
Ever married or lived with a man
Ever married or lived with a man
Ever married or lived with a man
Ever married or lived with a man
Have you ever been married or lived together with a man?
For women who are not currently married or living with a man, ask whether they have ever been married or lived with a man. Remember that 'married' refers to both formal and informal unions. Circle the code corresponding to the response given. Notice that there are two different response categories for a 'Yes' response: 'Yes, formerly married' and 'Yes, formerly lived with a man'. Be sure to make the distinction between the two categories. If the respondent just answers 'Yes', probe by asking, "WERE YOU FORMERLY MARRIED OR DID YOU LIVE WITH A MAN?" If she was formerly married and also reports living with a man, circle the code for 'Yes, formerly married'. If she was never married and never lived with a man circle '3' for 'No' and go to the next module. Otherwise, continue on to MA4.
Women aged 15-49
1
Yes, formerly married
2
Yes, formerly lived with a man
3
No
9
Missing
Marital status
Marital status
Marital status
Marital status
Marital status
What is your marital status now: are you widowed, divorced or separated?
Circle the code corresponding to the response given. For a woman who is not currently married and not currently living with someone but who was formerly in a union, record her current marital status at the time of the interview. Since she was in a union at one time, but is not on the day you are interviewing her, she will be either widowed, divorced or separated. You should use 'widowed' (a) for women who were married and their husband died, and (b) for women who were in an informal union and their partner died. 'Divorced' should be used for women who were married and whose marriage formally ended. 'Separated' should be used (a) for women who were married, but are no longer continuing the marriage with their husband, and (b) for women who were in an informal union and are no longer continuing the union with their partner.
Women aged 15-49
1
Widowed
2
Divorced
3
Separated
9
Missing
Married or lived with a man once or more than once
Married or lived with a man once or more than once
Married or lived with a man once or more than once
Married or lived with a man once or more than once
Married or lived with a man once or more than once
Have you been married or lived with a man only once or more than once?
As with MA1, we are interested in formal marriages as well as informal arrangements. If a woman was married or lived with a man and then was widowed, divorced, or separated from her husband or partner and is now either married to or living with someone else, record 'More than once'. If a woman is not currently married or in an informal union but was previously married or living with someone else two or more times, record 'More than once' by circling '2'. If she has married or lived with someone else only once, circle '1.' Note that the question refers to periods of marriage or informal unions, and not to numbers of husbands or partners. If a woman was married to a man and divorced him, and then married the same person again, she should be considered as having married 'More than once'. The same applies to informal unions with the same person.
Women aged 15-49
1
Only once
2
More than once
9
Missing
Month of first union
Month of first union
Month of first union
Month of first union
Month of first union
In what month and year did you first marry or start living with a man as if married?
If the respondent knows the date that she first married or started living with a man as if married, write it in the appropriate spaces for 'Month' and 'Year'. You will need to convert the month into numbers, as instructed earlier. For example, January is '01,' February is '02,' March is '03,' etc. If she does not recall the date that she first married or started living with a man as if married, ask whether she has any documentation that might give the date. If she does not know or have documentation of the month, circle '98' for 'DK month' and ask her the year that she first married or started living with a man as if married. Enter the year in the space provided. Once again, if she does not know and does not have documentation of the year that she first married or started living with a man as if married, circle '9998' for 'DK year'.
Women aged 15-49
97
Inconsistent
98
DK
99
Missing
Year of first union
Year of first union
Year of first union
Year of first union
Year of first union
In what month and year did you first marry or start living with a man as if married?
If the respondent knows the date that she first married or started living with a man as if married, write it in the appropriate spaces for 'Month' and 'Year'. You will need to convert the month into numbers, as instructed earlier. For example, January is '01,' February is '02,' March is '03,' etc. If she does not recall the date that she first married or started living with a man as if married, ask whether she has any documentation that might give the date. If she does not know or have documentation of the month, circle '98' for 'DK month' and ask her the year that she first married or started living with a man as if married. Enter the year in the space provided. Once again, if she does not know and does not have documentation of the year that she first married or started living with a man as if married, circle '9998' for 'DK year'.
Women aged 15-49
9997
Inconsistent
9998
DK
9999
Missing
Age at first union
Age at first union
Age at first union
Age at first union
Age at first union
Check MA6: Both month and year of marriage/union known? Go to Next Module Either month or year of marriage/union not known? Continue with MA8
How old were you when you started living with your first husband/partner?
If both the month and year are known, go to the next module. If either the month or the year is not known, continue to MA8. As with other age questions, if she does not know, probe. For instance, ask how old she was when her first child was born and then ask how long before or after giving birth she began living with her first husband or partner. Do not leave this question blank.
Women aged 15-49
97
Inconsistent
98
DK
99
Missing
Currently pregnant
Currently pregnant
Currently pregnant
Currently pregnant
Currently pregnant
I would like to talk with you about another subject - family planning - and your reproductive health.
Are you pregnant now?
The module should be administered to all women aged 15-49 years (including women age 15 and age 49). These questions and the ones in the HIV/AIDS module deal with private behaviour and attitudes. These questions are designed to collect the basic information needed to estimate contraceptive prevalence rates and types of methods used, as well as to measure the need for family planning by identifying women who want no more children or want to postpone their next birth. If present, male members of field teams (such as supervisors, editors and drivers) should be asked to leave the interview area. Even in cases where women are being interviewed alone, they will be reluctant to answer these questions if they sense that you are part of a team that includes males and that her responses may be shared with the males in the team. This question is important because later questions in this module will not need to be asked of pregnant women. A woman who is pregnant does not need to use contraception! Circle the code corresponding to the response given. If she is pregnant, circle '1' and go to the next module. If the woman is unsure or does not know for certain if she is pregnant, circle '8' for 'Unsure or DK'. In both cases, skip to CP2.
Women aged 15-49
1
Yes, currently pregnant
2
No
8
Unsure or DK
9
Missing
Currently using a method to avoid pregnancy
Currently using a method to avoid pregnancy
Currently using a method to avoid pregnancy
Currently using a method to avoid pregnancy
Currently using a method to avoid pregnancy
Some people use various ways or methods to delay or avoid a pregnancy. Are you currently doing something or using any method to delay or avoid getting pregnant?
Circle the code corresponding to the response given. If the answer is 'No', go to the next module.
Women aged 15-49
1
Yes
2
No
9
Missing
Current method: Female sterilization
Current method: Female sterilization
Current method: Female sterilization
Current method: Female sterilization
Current method: Female sterilization
Which method are you using?
Do not prompt. If more than one method is mentioned, circle each one.
Circle the code corresponding to the response given. Do not prompt the woman. If she mentions more than one method, circle the code for each method that is currently being used. If she mentions a method you do not know of, write her description in the space provided in 'Other' and circle 'X'. Since methods are effective for different lengths of time, you may have difficulty determining if a particular respondent is currently using a method. Current users of the pill should be taking pills daily. Methods such as condom use, vaginal methods and withdrawal are used with each act of intercourse, so current users of these methods will have used them during the most recent acts of intercourse. Other methods provide ongoing protection without daily or regular action by the woman. Contraceptive injections may be administered 2 to 6 months earlier and still provide protection. Implants provide protection for up to 5 years or until removed. An IUD protects against pregnancy until it is removed or expelled. If needed, consider the last 1 month as 'current use'. If the woman has been sterilized, you will circle 'A' for 'Female sterilization' as the current method. If the woman's current partner has been sterilized, you will circle 'B' for 'Male sterilization' as the current method. However, if she is no longer married to (or living with) a former partner who had a vasectomy, this should not be noted as the current method. Lactational amenorrhoea method (LAM) should be circled only if the woman explicitly states that she is breastfeeding for contraceptive purposes or that she believes that she is being protected from the risk of pregnancy because she is breastfeeding.
Women aged 15-49
?
Missing
A
Female sterilization
Current method: Male sterilization
Current method: Male sterilization
Current method: Male sterilization
Current method: Male sterilization
Current method: Male sterilization
Which method are you using?
Do not prompt. If more than one method is mentioned, circle each one.
Circle the code corresponding to the response given. Do not prompt the woman. If she mentions more than one method, circle the code for each method that is currently being used. If she mentions a method you do not know of, write her description in the space provided in 'Other' and circle 'X'. Since methods are effective for different lengths of time, you may have difficulty determining if a particular respondent is currently using a method. Current users of the pill should be taking pills daily. Methods such as condom use, vaginal methods and withdrawal are used with each act of intercourse, so current users of these methods will have used them during the most recent acts of intercourse. Other methods provide ongoing protection without daily or regular action by the woman. Contraceptive injections may be administered 2 to 6 months earlier and still provide protection. Implants provide protection for up to 5 years or until removed. An IUD protects against pregnancy until it is removed or expelled. If necessary, consider the last 1 month as 'current use'. If the woman has been sterilized, you will circle 'A' for 'Female sterilization' as the current method. If the woman's current partner has been sterilized, you will circle 'B' for 'Male sterilization' as the current method. However, if she is no longer married to (or living with) a former partner who had a vasectomy, this should not be noted as the current method. Lactational amenorrhoea method (LAM) should be circled only if the woman explicitly states that she is breastfeeding for contraceptive purposes or that she believes that she is being protected from the risk of pregnancy because she is breastfeeding.
Women aged 15-49
?
Missing
B
Male sterilization
Current method: Pill
Current method: Pill
Current method: Pill
Current method: Pill
Current method: Pill
Which method are you using?
Do not prompt. If more than one method is mentioned, circle each one.
Circle the code corresponding to the response given. Do not prompt the woman. If she mentions more than one method, circle the code for each method that is currently being used. If she mentions a method you do not know of, write her description in the space provided in 'Other' and circle 'X'. Since methods are effective for different lengths of time, you may have difficulty determining if a particular respondent is currently using a method. Current users of the pill should be taking pills daily. Methods such as condom use, vaginal methods and withdrawal are used with each act of intercourse, so current users of these methods will have used them during the most recent acts of intercourse. Other methods provide ongoing protection without daily or regular action by the woman. Contraceptive injections may be administered 2 to 6 months earlier and still provide protection. Implants provide protection for up to 5 years or until removed. An IUD protects against pregnancy until it is removed or expelled. If needed, consider the last 1 month as 'current use'. If the woman has been sterilized, you will circle 'A' for 'Female sterilization' as the current method. If the woman's current partner has been sterilized, you will circle 'B' for 'Male sterilization' as the current method. However, if she is no longer married to (or living with) a former partner who had a vasectomy, this should not be noted as the current method. Lactational amenorrhoea method (LAM) should be circled only if the woman explicitly states that she is breastfeeding for contraceptive purposes or that she believes that she is being protected from the risk of pregnancy because she is breastfeeding.
Women aged 15-49
?
Missing
C
PILL
Current method: IUD
Current method: IUD
Current method: IUD
Current method: IUD
Current method: IUD
Which method are you using?
Do not prompt. If more than one method is mentioned, circle each one.
Circle the code corresponding to the response given. Do not prompt the woman. If she mentions more than one method, circle the code for each method that is currently being used. If she mentions a method you do not know of, write her description in the space provided in 'Other' and circle 'X'. Since methods are effective for different lengths of time, you may have difficulty determining if a particular respondent is currently using a method. Current users of the pill should be taking pills daily. Methods such as condom use, vaginal methods and withdrawal are used with each act of intercourse, so current users of these methods will have used them during the most recent acts of intercourse. Other methods provide ongoing protection without daily or regular action by the woman. Contraceptive injections may be administered 2 to 6 months earlier and still provide protection. Implants provide protection for up to 5 years or until removed. An IUD protects against pregnancy until it is removed or expelled. If needed, consider the last 1 month as 'current use'. If the woman has been sterilized, you will circle 'A' for 'Female sterilization' as the current method. If the woman's current partner has been sterilized, you will circle 'B' for 'Male sterilization' as the current method. However, if she is no longer married to (or living with) a former partner who had a vasectomy, this should not be noted as the current method. Lactational amenorrhoea method (LAM) should be circled only if the woman explicitly states that she is breastfeeding for contraceptive purposes or that she believes that she is being protected from the risk of pregnancy because she is breastfeeding.
Women aged 15-49
?
Missing
D
IUD
Current method: Injections
Current method: Injections
Current method: Injections
Current method: Injections
Current method: Injections
Which method are you using?
Do not prompt. If more than one method is mentioned, circle each one.
Circle the code corresponding to the response given. Do not prompt the woman. If she mentions more than one method, circle the code for each method that is currently being used. If she mentions a method you do not know of, write her description in the space provided in 'Other' and circle 'X'. Since methods are effective for different lengths of time, you may have difficulty determining if a particular respondent is currently using a method. Current users of the pill should be taking pills daily. Methods such as condom use, vaginal methods and withdrawal are used with each act of intercourse, so current users of these methods will have used them during the most recent acts of intercourse. Other methods provide ongoing protection without daily or regular action by the woman. Contraceptive injections may be administered 2 to 6 months earlier and still provide protection. Implants provide protection for up to 5 years or until removed. An IUD protects against pregnancy until it is removed or expelled. If needed, consider the last 1 month as 'current use'. If the woman has been sterilized, you will circle 'A' for 'Female sterilization' as the current method. If the woman's current partner has been sterilized, you will circle 'B' for 'Male sterilization' as the current method. However, if she is no longer married to (or living with) a former partner who had a vasectomy, this should not be noted as the current method. Lactational amenorrhoea method (LAM) should be circled only if the woman explicitly states that she is breastfeeding for contraceptive purposes or that she believes that she is being protected from the risk of pregnancy because she is breastfeeding.
Women aged 15-49
?
Missing
E
Injections
Current method: Implants
Current method: Implants
Current method: Implants
Current method: Implants
Current method: Implants
Which method are you using?
Do not prompt. If more than one method is mentioned, circle each one.
Circle the code corresponding to the response given. Do not prompt the woman. If she mentions more than one method, circle the code for each method that is currently being used. If she mentions a method you do not know of, write her description in the space provided in 'Other' and circle 'X'. Since methods are effective for different lengths of time, you may have difficulty determining if a particular respondent is currently using a method. Current users of the pill should be taking pills daily. Methods such as condom use, vaginal methods and withdrawal are used with each act of intercourse, so current users of these methods will have used them during the most recent acts of intercourse. Other methods provide ongoing protection without daily or regular action by the woman. Contraceptive injections may be administered 2 to 6 months earlier and still provide protection. Implants provide protection for up to 5 years or until removed. An IUD protects against pregnancy until it is removed or expelled. If needed, consider the last 1 month as 'current use'. If the woman has been sterilized, you will circle 'A' for 'Female sterilization' as the current method. If the woman's current partner has been sterilized, you will circle 'B' for 'Male sterilization' as the current method. However, if she is no longer married to (or living with) a former partner who had a vasectomy, this should not be noted as the current method. Lactational amenorrhoea method (LAM) should be circled only if the woman explicitly states that she is breastfeeding for contraceptive purposes or that she believes that she is being protected from the risk of pregnancy because she is breastfeeding.
Women aged 15-49
?
Missing
F
Implants
Current method: Condom
Current method: Condom
Current method: Condom
Current method: Condom
Current method: Condom
Which method are you using?
Do not prompt. If more than one method is mentioned, circle each one.
Circle the code corresponding to the response given. Do not prompt the woman. If she mentions more than one method, circle the code for each method that is currently being used. If she mentions a method you do not know of, write her description in the space provided in 'Other' and circle 'X'. Since methods are effective for different lengths of time, you may have difficulty determining if a particular respondent is currently using a method. Current users of the pill should be taking pills daily. Methods such as condom use, vaginal methods and withdrawal are used with each act of intercourse, so current users of these methods will have used them during the most recent acts of intercourse. Other methods provide ongoing protection without daily or regular action by the woman. Contraceptive injections may be administered 2 to 6 months earlier and still provide protection. Implants provide protection for up to 5 years or until removed. An IUD protects against pregnancy until it is removed or expelled. If needed, consider the last 1 month as 'current use'. If the woman has been sterilized, you will circle 'A' for 'Female sterilization' as the current method. If the woman's current partner has been sterilized, you will circle 'B' for 'Male sterilization' as the current method. However, if she is no longer married to (or living with) a former partner who had a vasectomy, this should not be noted as the current method. Lactational amenorrhoea method (LAM) should be circled only if the woman explicitly states that she is breastfeeding for contraceptive purposes or that she believes that she is being protected from the risk of pregnancy because she is breastfeeding.
Women aged 15-49
?
Missing
G
Condom
Current method: Lactational amenorrhea method
Current method: Lactational amenorrhea method
Current method: Lactational amenorrhea method
Current method: Lactational amenorrhea method
Current method: Lactational amenorrhea method
Which method are you using?
Do not prompt. If more than one method is mentioned, circle each one.
Circle the code corresponding to the response given. Do not prompt the woman. If she mentions more than one method, circle the code for each method that is currently being used. If she mentions a method you do not know of, write her description in the space provided in 'Other' and circle 'X'. Since methods are effective for different lengths of time, you may have difficulty determining if a particular respondent is currently using a method. Current users of the pill should be taking pills daily. Methods such as condom use, vaginal methods and withdrawal are used with each act of intercourse, so current users of these methods will have used them during the most recent acts of intercourse. Other methods provide ongoing protection without daily or regular action by the woman. Contraceptive injections may be administered 2 to 6 months earlier and still provide protection. Implants provide protection for up to 5 years or until removed. An IUD protects against pregnancy until it is removed or expelled. If needed, consider the last 1 month as 'current use'. If the woman has been sterilized, you will circle 'A' for 'Female sterilization' as the current method. If the woman's current partner has been sterilized, you will circle 'B' for 'Male sterilization' as the current method. However, if she is no longer married to (or living with) a former partner who had a vasectomy, this should not be noted as the current method. Lactational amenorrhoea method (LAM) should be circled only if the woman explicitly states that she is breastfeeding for contraceptive purposes or that she believes that she is being protected from the risk of pregnancy because she is breastfeeding.
Women aged 15-49
?
Missing
K
Lactational amenorrhoea (LAM)
Current method: Periodic abstinence
Current method: Periodic abstinence
Current method: Periodic abstinence
Current method: Periodic abstinence
Current method: Periodic abstinence
Which method are you using?
Do not prompt. If more than one method is mentioned, circle each one.
Circle the code corresponding to the response given. Do not prompt the woman. If she mentions more than one method, circle the code for each method that is currently being used. If she mentions a method you do not know of, write her description in the space provided in 'Other' and circle 'X'. Since methods are effective for different lengths of time, you may have difficulty determining if a particular respondent is currently using a method. Current users of the pill should be taking pills daily. Methods such as condom use, vaginal methods and withdrawal are used with each act of intercourse, so current users of these methods will have used them during the most recent acts of intercourse. Other methods provide ongoing protection without daily or regular action by the woman. Contraceptive injections may be administered 2 to 6 months earlier and still provide protection. Implants provide protection for up to 5 years or until removed. An IUD protects against pregnancy until it is removed or expelled. If needed, consider the last 1 month as 'current use'. If the woman has been sterilized, you will circle 'A' for 'Female sterilization' as the current method. If the woman's current partner has been sterilized, you will circle 'B' for 'Male sterilization' as the current method. However, if she is no longer married to (or living with) a former partner who had a vasectomy, this should not be noted as the current method. Lactational amenorrhoea method (LAM) should be circled only if the woman explicitly states that she is breastfeeding for contraceptive purposes or that she believes that she is being protected from the risk of pregnancy because she is breastfeeding.
Women aged 15-49
?
Missing
L
Periodic abstinence
Current method: Withdrawal
Current method: Withdrawal
Current method: Withdrawal
Current method: Withdrawal
Current method: Withdrawal
Which method are you using?
Do not prompt. If more than one method is mentioned, circle each one.
Circle the code corresponding to the response given. Do not prompt the woman. If she mentions more than one method, circle the code for each method that is currently being used. If she mentions a method you do not know of, write her description in the space provided in 'Other' and circle 'X'. Since methods are effective for different lengths of time, you may have difficulty determining if a particular respondent is currently using a method. Current users of the pill should be taking pills daily. Methods such as condom use, vaginal methods and withdrawal are used with each act of intercourse, so current users of these methods will have used them during the most recent acts of intercourse. Other methods provide ongoing protection without daily or regular action by the woman. Contraceptive injections may be administered 2 to 6 months earlier and still provide protection. Implants provide protection for up to 5 years or until removed. An IUD protects against pregnancy until it is removed or expelled. If needed, consider the last 1 month as 'current use'. If the woman has been sterilized, you will circle 'A' for 'Female sterilization' as the current method. If the woman's current partner has been sterilized, you will circle 'B' for 'Male sterilization' as the current method. However, if she is no longer married to (or living with) a former partner who had a vasectomy, this should not be noted as the current method. Lactational amenorrhoea method (LAM) should be circled only if the woman explicitly states that she is breastfeeding for contraceptive purposes or that she believes that she is being protected from the risk of pregnancy because she is breastfeeding.
Women aged 15-49
?
Missing
M
Withdrawal
Current method: Other
Current method: Other
Current method: Other
Current method: Other
Current method: Other
Which method are you using?
Do not prompt. If more than one method is mentioned, circle each one.
Circle the code corresponding to the response given. Do not prompt the woman. If she mentions more than one method, circle the code for each method that is currently being used. If she mentions a method you do not know of, write her description in the space provided in 'Other' and circle 'X'. Since methods are effective for different lengths of time, you may have difficulty determining if a particular respondent is currently using a method. Current users of the pill should be taking pills daily. Methods such as condom use, vaginal methods and withdrawal are used with each act of intercourse, so current users of these methods will have used them during the most recent acts of intercourse. Other methods provide ongoing protection without daily or regular action by the woman. Contraceptive injections may be administered 2 to 6 months earlier and still provide protection. Implants provide protection for up to 5 years or until removed. An IUD protects against pregnancy until it is removed or expelled. If needed, consider the last 1 month as 'current use'. If the woman has been sterilized, you will circle 'A' for 'Female sterilization' as the current method. If the woman's current partner has been sterilized, you will circle 'B' for 'Male sterilization' as the current method. However, if she is no longer married to (or living with) a former partner who had a vasectomy, this should not be noted as the current method. Lactational amenorrhoea method (LAM) should be circled only if the woman explicitly states that she is breastfeeding for contraceptive purposes or that she believes that she is being protected from the risk of pregnancy because she is breastfeeding.
Women aged 15-49
?
Missing
X
Other
Ever heard of HIV or AIDS
Ever heard of HIV or AIDS
Ever heard of HIV or AIDS
Ever heard of HIV or AIDS
Ever heard of HIV or AIDS
Now I would like to talk with you about something else.
Have you ever heard of the virus HIV or an illness called AIDS?
This module is to be administered to all women aged 15-49 years (including woman age 15 and age 49). The purpose of this module is to obtain information to help programme managers and policy makers plan more effective programmes to prevent HIV infection. The questions assess knowledge, attitudes and behaviour related to AIDS transmission, prevention and testing for the virus that causes AIDS. First, questions are asked to estimate the respondent's basic knowledge about HIV transmission and AIDS. This question serves as an introduction and allows us to verify whether a respondent has heard of AIDS. If there is a local term for AIDS, use the local term in addition to 'AIDS'. If a respondent has never heard of the HIV virus or AIDS, go to the next module.
Women aged 15-49
1
Yes
2
No
9
Missing
Can avoid AIDS by having one unifected partner
Can avoid AIDS by having one unifected partner
Can avoid AIDS by having one unifected partner
Can avoid AIDS by having one unifected partner
Can avoid AIDS by having one unifected partner
Can people protect themselves from getting infected with the AIDS virus by having one sex partner who is not infected and also has no other partners?
The following questions ask the respondent about specific ways to avoid HIV transmission. They focus on programmatically important ways to avoid HIV - by limiting the number of partners and by using condoms. They also probe into misconceptions concerning HIV transmission, through mosquito bites or sharing food, for example. For questions HA2-HA8, circle the code for the response given. If the respondent cannot provide a 'Yes' or 'No' answer, circle '8' for 'DK'. Do not prompt the respondent or indicate the 'correct' answer in any way. ---
Women aged 15-49
1
Yes
2
No
8
DK
9
Missing
Can get AIDS through supernatural means
Can get AIDS through supernatural means
Can get AIDS through supernatural means
Can get AIDS through supernatural means
Can get AIDS through supernatural means
Can people get infected with the AIDS virus because of witchcraft or other supernatural means?
The following questions ask the respondent about specific ways to avoid HIV transmission. They focus on programmatically important ways to avoid HIV - by limiting the number of partners and by using condoms. They also probe into misconceptions concerning HIV transmission, through mosquito bites or sharing food, for example. For questions HA2-HA8, circle the code for the response given. If the respondent cannot provide a 'Yes' or 'No' answer, circle '8' for 'DK'. Do not prompt the respondent or indicate the 'correct' answer in any way. ---
Women aged 15-49
1
Yes
2
No
8
DK
9
Missing
Can avoid AIDS by using a condom correctly every time
Can avoid AIDS by using a condom correctly every time
Can avoid AIDS by using a condom correctly every time
Can avoid AIDS by using a condom correctly every time
Can avoid AIDS by using a condom correctly every time
Can people reduce their chance of getting the AIDS virus by using a condom every time they have sex?
The following questions ask the respondent about specific ways to avoid HIV transmission. They focus on programmatically important ways to avoid HIV - by limiting the number of partners and by using condoms. They also probe into misconceptions concerning HIV transmission, through mosquito bites or sharing food, for example. For questions HA2-HA8, circle the code for the response given. If the respondent cannot provide a 'Yes' or 'No' answer, circle '8' for 'DK'. Do not prompt the respondent or indicate the 'correct' answer in any way. ---
Women aged 15-49
1
Yes
2
No
8
DK
9
Missing
Can get AIDS from mosquito bites
Can get AIDS from mosquito bites
Can get AIDS from mosquito bites
Can get AIDS from mosquito bites
Can get AIDS from mosquito bites
Can people get the AIDS virus from mosquito bites?
The following questions ask the respondent about specific ways to avoid HIV transmission. They focus on programmatically important ways to avoid HIV - by limiting the number of partners and by using condoms. They also probe into misconceptions concerning HIV transmission, through mosquito bites or sharing food, for example. For questions HA2-HA8, circle the code for the response given. If the respondent cannot provide a 'Yes' or 'No' answer, circle '8' for 'DK'. Do not prompt the respondent or indicate the 'correct' answer in any way. ---
Women aged 15-49
1
Yes
2
No
8
DK
9
Missing
Can avoid AIDS by not having sex at all
Can avoid AIDS by not having sex at all
Can avoid AIDS by not having sex at all
Can avoid AIDS by not having sex at all
Can avoid AIDS by not having sex at all
Can people reduce their chance of getting infected with the AIDS virus by not having sex at all?
The following questions ask the respondent about specific ways to avoid HIV transmission. They focus on programmatically important ways to avoid HIV - by limiting the number of partners and by using condoms. They also probe into misconceptions concerning HIV transmission, through mosquito bites or sharing food, for example. For questions HA2-HA8, circle the code for the response given. If the respondent cannot provide a 'Yes' or 'No' answer, circle '8' for 'DK'. Do not prompt the respondent or indicate the 'correct' answer in any way. ---
Women aged 15-49
1
Yes
2
No
8
DK
9
Missing
Can get AIDS by sharing food with person with AIDS virus
Can get AIDS by sharing food with person with AIDS virus
Can get AIDS by sharing food with person with AIDS virus
Can get AIDS by sharing food with person with AIDS virus
Can get AIDS by sharing food with person with AIDS virus
Can people get the AIDS virus by sharing food with a person who has AIDS?
The following questions ask the respondent about specific ways to avoid HIV transmission. They focus on programmatically important ways to avoid HIV - by limiting the number of partners and by using condoms. They also probe into misconceptions concerning HIV transmission, through mosquito bites or sharing food, for example. For questions HA2-HA8, circle the code for the response given. If the respondent cannot provide a 'Yes' or 'No' answer, circle '8' for 'DK'. Do not prompt the respondent or indicate the 'correct' answer in any way. ---
Women aged 15-49
1
Yes
2
No
8
DK
9
Missing
Can get AIDS by injection with needle already used by someon
Can get AIDS by injection with needle already used by someon
Can get AIDS by injection with needle already used by someon
Can get AIDS by injection with needle already used by someon
Can get AIDS by injection with needle already used by someon
Can people get the AIDS virus by getting injections with a needle that was already used by someone else?
The following questions ask the respondent about specific ways to avoid HIV transmission. They focus on programmatically important ways to avoid HIV - by limiting the number of partners and by using condoms. They also probe into misconceptions concerning HIV transmission, through mosquito bites or sharing food, for example. For questions HA2-HA8, circle the code for the response given. If the respondent cannot provide a 'Yes' or 'No' answer, circle '8' for 'DK'. Do not prompt the respondent or indicate the 'correct' answer in any way. ---
Women aged 15-49
1
Yes
2
No
8
DK
9
Missing
Healthy-looking person to have AIDS
Healthy-looking person to have AIDS
Healthy-looking person to have AIDS
Healthy-looking person to have AIDS
Healthy-looking person to have AIDS
Is it possible for a healthy-looking person to have the AIDS virus?
The following questions ask the respondent about specific ways to avoid HIV transmission. They focus on programmatically important ways to avoid HIV - by limiting the number of partners and by using condoms. They also probe into misconceptions concerning HIV transmission, through mosquito bites or sharing food, for example. For questions HA2-HA8, circle the code for the response given. If the respondent cannot provide a 'Yes' or 'No' answer, circle '8' for 'DK'. Do not prompt the respondent or indicate the 'correct' answer in any way. ---
Women aged 15-49
1
Yes
2
No
8
DK
9
Missing
AIDS from mother to child during pregnancy
AIDS from mother to child during pregnancy
AIDS from mother to child during pregnancy
AIDS from mother to child during pregnancy
AIDS from mother to child during pregnancy
Can the AIDS virus be transmitted from a mother to a baby? During pregnancy?
An understanding of more in-depth AIDS-related knowledge is obtained with this question, which aims to determine whether the woman knows that a mother who has AIDS can pass on the disease to her baby. Ask each item one at a time and circle the code for the response given. The items ask whether the respondent thinks that a mother with AIDS can transfer the disease to her baby 'During pregnancy', 'During delivery' or 'By breastfeeding' him/her. Circle '1' for 'Yes' and '2' for 'No' for each of the items. If the woman does not know the answer or is unsure, circle '8'.
Women aged 15-49
1
Yes
2
No
8
DK
9
Missing
AIDS from mother to child at delivery
AIDS from mother to child at delivery
AIDS from mother to child at delivery
AIDS from mother to child at delivery
AIDS from mother to child at delivery
Can the AIDS virus be transmitted from a mother to a baby? During delivery?
An understanding of more in-depth AIDS-related knowledge is obtained with this question, which aims to determine whether the woman knows that a mother who has AIDS can pass on the disease to her baby. Ask each item one at a time and circle the code for the response given. The items ask whether the respondent thinks that a mother with AIDS can transfer the disease to her baby 'During pregnancy', 'During delivery' or 'By breastfeeding' him/her. Circle '1' for 'Yes' and '2' for 'No' for each of the items. If the woman does not know the answer or is unsure, circle '8'.
Women aged 15-49
1
Yes
2
No
8
DK
9
Missing
AIDS from mother to child through breastmilk
AIDS from mother to child through breastmilk
AIDS from mother to child through breastmilk
AIDS from mother to child through breastmilk
AIDS from mother to child through breastmilk
Can the AIDS virus be transmitted from a mother to a baby? By breastfeeding?
An understanding of more in-depth AIDS-related knowledge is obtained with this question, which aims to determine whether the woman knows that a mother who has AIDS can pass on the disease to her baby. Ask each item one at a time and circle the code for the response given. The items ask whether the respondent thinks that a mother with AIDS can transfer the disease to her baby 'During pregnancy', 'During delivery' or 'By breastfeeding' him/her. Circle '1' for 'Yes' and '2' for 'No' for each of the items. If the woman does not know the answer or is unsure, circle '8'.
Women aged 15-49
1
Yes
2
No
8
DK
9
Missing
Should teacher with HIV/AIDS be allowed to teach in school
Should teacher with HIV/AIDS be allowed to teach in school
Should teacher with HIV/AIDS be allowed to teach in school
Should teacher with HIV/AIDS be allowed to teach in school
Should teacher with HIV/AIDS be allowed to teach in school
If a female teacher has the AIDS virus but is not sick, should she be allowed to continue teaching in school?
The following four questions are meant to ascertain the respondent's personal opinion and attitude towards people with AIDS. We present a situation to the respondent, asking her to imagine a particular scenario. Then we ask her to tell us how she would react to the situation. Circle the code for the response given. Once again, do not prompt the respondent or indicate the 'correct' answer in any way. If a respondent says she doesn't know, is unsure, or that it depends, circle '8' for 'DK/not sure/depends'. --- If a school learns that a female teacher has the AIDS virus, but she is not sick, how should the school handle this information? Should the teacher be allowed to continue teaching at the school, or should she be removed from her teaching position? We are not asking about whether or not a teacher has actually been asked to leave a teaching position, but rather, what is the respondent's opinion about how such a case should be handled; should the teacher be allowed to continue teaching?
Women aged 15-49
1
Yes
2
No
8
DK/not sure/depends
9
Missing
Would buy fresh vegetables from shopseller with HIV/AIDS
Would buy fresh vegetables from shopseller with HIV/AIDS
Would buy fresh vegetables from shopseller with HIV/AIDS
Would buy fresh vegetables from shopseller with HIV/AIDS
Would buy fresh vegetables from shopseller with HIV/AIDS
Would you buy fresh vegetables from a shopkeeper or vendor if you knew that this person had the AIDS virus?
The following four questions are meant to ascertain the respondent's personal opinion and attitude towards people with AIDS. We present a situation to the respondent, asking her to imagine a particular scenario. Then we ask her to tell us how she would react to the situation. Circle the code for the response given. Once again, do not prompt the respondent or indicate the 'correct' answer in any way. If a respondent says she doesn't know, is unsure, or that it depends, circle '8' for 'DK/not sure/depends'. ---
Women aged 15-49
1
Yes
2
No
8
DK/not sure/depends
9
Missing
If a member became infected with the virus, would you want i
If a member became infected with the virus, would you want i
If a member became infected with the virus, would you want i
If a member became infected with the virus, would you want i
If a member became infected with the virus, would you want i
If a member of your family became infected with the AIDS virus, would you want it to remain a secret?
The following four questions are meant to ascertain the respondent's personal opinion and attitude towards people with AIDS. We present a situation to the respondent, asking her to imagine a particular scenario. Then we ask her to tell us how she would react to the situation. Circle the code for the response given. Once again, do not prompt the respondent or indicate the 'correct' answer in any way. If a respondent says she doesn't know, is unsure, or that it depends, circle '8' for 'DK/not sure/depends'. ---
Women aged 15-49
1
Yes
2
No
8
DK/not sure/depends
9
Missing
Willing to care for person with AIDS in household
Willing to care for person with AIDS in household
Willing to care for person with AIDS in household
Willing to care for person with AIDS in household
Willing to care for person with AIDS in household
If a member of your family became sick with the AIDS virus, would you be willing to care for him or her in your household?
The following four questions are meant to ascertain the respondent's personal opinion and attitude towards people with AIDS. We present a situation to the respondent, asking her to imagine a particular scenario. Then we ask her to tell us how she would react to the situation. Circle the code for the response given. Once again, do not prompt the respondent or indicate the 'correct' answer in any way. If a respondent says she doesn't know, is unsure, or that it depends, circle '8' for 'DK/not sure/depends'. ---
Women aged 15-49
1
Yes
2
No
8
DK/not sure/depends
9
Missing
Region
Region
Region
Region
Region
Region:
Circle the code for region.
Households
2
Central (include BKK.)
3
North
4
Northeast
5
South
Changwat/Province
Changwat/Province
Changwat/Province
Changwat/Province
Changwat/Province
Area
Area
Area
Area
Area
Area:
Circle the code for area of residence as instructed by your supervisor. This will have been pre-determined; you will not be required to assess whether the household is in an urban or rural area.
Households
1
Urban
2
Rural
PSU_NO
PSU_NO
PSU_NO
PSU_NO
PSU_NO
Day of interview
Day of interview
Day of interview
Day of interview
Day of interview
Day/Month/Year of interview:
Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household.
Households
Month of interview
Month of interview
Month of interview
Month of interview
Month of interview
Day/Month/Year of interview:
Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household.
Households
Year of interview
Year of interview
Year of interview
Year of interview
Year of interview
Day/Month/Year of interview:
Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household.
Households
Respondent HH questionnaire
Respondent HH questionnaire
Respondent HH questionnaire
Respondent HH questionnaire
Respondent HH questionnaire
Respondent to HH questionnaire:
Enter the name and line number (from the Household Listing, columns HL1 and HL2) of the respondent to the Household Questionnaire.
Households
99
Missing
Number of household members
Number of household members
Number of household members
Number of household members
Number of household members
Total number of household members:
Count the number of household members recorded in column HL1 of the Household Listing and enter the total here.
Households
Total eligible women
Total eligible women
Total eligible women
Total eligible women
Total eligible women
No.of women eligible for interview:
Enter the total number of women eligible for interview for the Questionnaire for Individual Women - you will copy this from the row for totals at the bottom of the Household Listing, for HL6.
Households
Women interviews completed
Women interviews completed
Women interviews completed
Women interviews completed
Women interviews completed
No.of women questionnaires completed:
Once all of the Questionnaires for Individual Women have been completed for a particular household, enter the number completed here.
Households
Total children under 5
Total children under 5
Total children under 5
Total children under 5
Total children under 5
No.of children under age 5:
Enter the total number of children under five eligible for inclusion in the survey from the row for totals at the bottom of the Household Listing, for HL8. You will be using the Questionnaire for Children Under Five to interview the mothers or primary caretakers of these children.
Households
Child interviews completed
Child interviews completed
Child interviews completed
Child interviews completed
Child interviews completed
No.of under-5 questionnaires completed:
Once all of the Questionnaires for Children Under Five have been completed for a particular household, enter the number completed here.
Households
Enu. Result
Enu. Result
Enu. Result
Enu. Result
Enu. Result
After all questionnaires for the household have been completed, fill in the following information: Result of HH interview:
If the Household Questionnaire is completed, circle '1' for 'Completed'. If you have not been able to contact the household after repeated visits, circle '2' for 'Not at home'. If the household refuses to be interviewed, circle '3' for 'Refused'. If you are unable to locate the household or if the dwelling is destroyed, circle '4' for 'HH not found/destroyed'. If you have not been able to complete the Household Questionnaire for another reason, you should circle '6' for 'Other' and specify the reason in the space provided. Some examples of 'Other' codes might be: the household respondent is incapacitated; the questionnaire is partly completed; adult household members were not found at home after repeated visits.
Households
1
Completed
2
Refused
3
Not at home
4
HH not found/destroyed
6
Others
Main source of drinking water
Main source of drinking water
Main source of drinking water
Main source of drinking water
Main source of drinking water
What is the main source of drinking water for members of your household?
The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). '51' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof or ground catchment and stored in a container, tank or cistern until used. '61' - A tanker-truck water source transports and sells water by means of a tanker truck. '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. --- Circle the code for the most usual source. If several sources are mentioned, probe to determine the most usual source. If the source varies by season, record the source for the season of the interview. Note that the next question is only asked if the response to this question is 'Bottled water'. You should skip WS2 if the response to WS1 is other than 'Bottled water'. If the response is 'Piped into dwelling' or 'Piped into yard/plot', circle '11' or '12', respectively, and skip to WS5. Otherwise, skip to WS3.
Households
11
Piped into dwelling
12
Piped into yard or plot
13
Public tap/standpipe
21
Tubewell/borehole
31
Protected well
32
Unprotected well
41
Protected spring
42
Unprotected spring
51
Rainwater collection
61
Tanker-truck
81
Surface water
91
Bottled water
96
Other
99
Missing
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
What is the main source of water used by your household for other purposes such as cooking and handwashing?
The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). '51' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof or ground catchment and stored in a container, tank or cistern until used. '61' - A tanker-truck water source transports and sells water by means of a tanker truck. '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. --- This question should only be asked to households that use 'Bottled water' for drinking. Circle the code for the most usual source. If the source varies by season, record the source for the season of the interview. If the most usual source of non-drinking water is 'Piped into dwelling' or 'Piped into yard/plot', circle '11' or '12', respectively, and skip to WS5. Otherwise continue to the next question.
Households
11
Piped into dwelling
12
Piped into yard or plot
13
Public tap/standpipe
21
Tubewell/borehole
31
Protected well
32
Unprotected well
41
Protected spring
42
Unprotected spring
51
Rainwater collection
61
Tanker-truck
81
Surface water
96
Other
99
Missing
Time to get water and come back
Time to get water and come back
Time to get water and come back
Time to get water and come back
Time to get water and come back
How long does it take to go there, get water, and come back?
This question is used to find out how convenient the source of water is to the dwelling. Note that the question is asked for water sources coded as '13-81' and '96' in WS1, or water sources coded as '13-96' in WS2. Fill in the estimated time (in minutes, converting from hours, if necessary) it takes by the usual mode of transport to get to the water source, wait to get water, and get back to the dwelling. Use zero(s) preceding the number if less than 100 minutes (for example, '060' or '005'). Then continue to the next question. If the water source is on the dwelling premises or if water is delivered to the dwelling by a vendor, circle '995' for 'Water on premises' and skip to WS5. If the respondent does not know how long it takes, circle '998' and continue on to the next question.
Households
995
On premises
998
DK
999
Missing
Person fetching water
Person fetching water
Person fetching water
Person fetching water
Person fetching water
Who usually goes to this source to fetch the water for your household? Probe: Is this person under age 15? What sex?
Circle code that best describes this person.
The purpose of this question is to find out the age and gender of the person who usually performs the task of hauling water. This will provide an understanding of whether water hauling responsibilities are given to members of a particular sex or age group. Probe: "IS THIS PERSON UNDER AGE 15? WHAT SEX IS THIS PERSON?" Circle the code that corresponds with the response or '8' if the respondent does not know. Adult refers to anyone age 15 or over, regardless of whether he/she is a household member. Child refers to anyone under the age of 15, regardless of whether he/she is a household member.
Households
1
Adult woman
2
Adult man
3
Female child (under 15)
4
Male child (under 15)
8
DK
9
Missing
Treat water to make safer for drinking
Treat water to make safer for drinking
Treat water to make safer for drinking
Treat water to make safer for drinking
Treat water to make safer for drinking
Do you treat your water in any way to make it safer to drink?
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle '1' if 'Yes', and continue to the next question. If 'No' or 'DK' (Doesn't know'), circle '2' or '8', respectively, and skip to WS7.
Households
1
Yes
2
No
8
DK
9
Missing
Boil
Boil
Boil
Boil
Boil
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
A
Boil
Add bleach/chlorine
Add bleach/chlorine
Add bleach/chlorine
Add bleach/chlorine
Add bleach/chlorine
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
B
Add bleach/chlorine
Strain it through a cloth
Strain it through a cloth
Strain it through a cloth
Strain it through a cloth
Strain it through a cloth
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
C
Strain it through a cloth
Use water filter
Use water filter
Use water filter
Use water filter
Use water filter
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
D
Use water filter
Solar disinfection
Solar disinfection
Solar disinfection
Solar disinfection
Solar disinfection
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
E
Solar disinfection
Let it stand and settle
Let it stand and settle
Let it stand and settle
Let it stand and settle
Let it stand and settle
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
F
Let it stand and settle
Other
Other
Other
Other
Other
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
X
Other
DK
DK
DK
DK
DK
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
Z
DK
Kind of toilet facility
Kind of toilet facility
Kind of toilet facility
Kind of toilet facility
Kind of toilet facility
What kind of toilet facility do members of your household usually use? If "flush" or "pour flush", probe: Where does it flush to?
If necessary, ask permission to observe the facility.
Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of this question is to obtain a measure of the cleanliness of the sanitary facility used by the household members. It may be necessary to observe the facility. If so, ask permission to do so. If the respondent answers or it is observed that the household members have no facilities or use the bush or field, enter '95' for 'No facilities or bush or field' and skip to the next module. If any of the flush or pour flush responses (11-15) are given, probe: "WHERE DOES IT FLUSH TO?" Circle the code corresponding to the response given. Definitions of various types of toilet facilities are as follows: A flush toilet uses a cistern or holding tank for flushing water and has a water seal, which is a U-shaped pipe, below the seat or squatting pan that prevents the passage of flies and odours. A pour flush toilet uses a water seal, but unlike a flush toilet, a pour flush toilet uses water poured by hand for flushing (no cistern is used). . '11' - A piped sewer system is a system of sewer pipes, also called sewerage, that is designed to collect human excreta (faeces and urine) and wastewater and remove them from the household environment. Sewerage systems consist of facilities for collection, pumping, treating and disposing of human excreta and wastewater. . '12' - A septic tank is an excreta collection device and is a water-tight settling tank normally located underground, away from the house or toilet. . '13' - A flush/pour flush to pit latrine refers to a system that flushes excreta to a hole in the ground. . '14' - A flush/pour flush to somewhere else refers to excreta being deposited in or nearby the household environment (not into pit, septic tank or sewer); excreta may be flushed to the street, yard/plot, drainage way or other location. . '15' - Flush to unknown place/not sure/DK where should be coded in cases when the respondent knows that the toilet facility is a flush toilet, but does not know where it flushes to. '21' - A ventilated improved pit latrine or VIP is a type of pit latrine that is ventilated by a pipe extending above the latrine roof. The open end of the vent pipe is covered with gauze mesh or fly-proof netting and the inside of the superstructure is kept dark. '22' - A pit latrine with slab uses a hole in the ground for excreta collection and has a squatting slab, platform or seat that is firmly supported on all sides, easy to clean and raised above the surrounding ground level to prevent surface water from entering the pit. '23' - A pit latrine without slab uses a hole in the ground for excreta collection and does not have a squatting slab, platform or seat. An open pit is a rudimentary hole in the ground where excreta is collected. '31' - A composting toilet is a toilet into which excreta and carbon-rich material are added (vegetable wastes, straw, grass, sawdust, ash) and special conditions maintained to produce inoffensive compost. '41' - Bucket refers to the use of a bucket or other container for the retention of faeces (and sometimes urine and anal cleaning material), which is periodically removed for treatment or disposal. '51' - A hanging toilet or hanging latrine is a toilet built over the sea, a river, or other body of water into which excreta drops directly. '95' - No facilities or bush or field includes excreta wrapped and thrown with garbage, the 'cat' method of burying excreta in dirt, defecation in the bush or field or ditch, and defecation into surface water (drainage channel, beach, river, stream or sea).
Households
11
Flush to piped sewer system
12
Flush to septic tank
13
Flush to pit (latrine)
14
Flush to somewhere else
15
Flush to unknown place/not sure/DK where
22
Pit latrine with slab
23
Pit latrine without slab/open pit
95
No facilities or bush or field
96
Other
99
Missing
Toilet facility shared
Toilet facility shared
Toilet facility shared
Toilet facility shared
Toilet facility shared
Do you share this facility with other households?
Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of the following two questions is to determine whether the household shares their sanitation facility with other households. The shared status of a sanitation facility is important because shared facilities can be less hygienic than facilities used by only a single household. Unhygienic conditions (faeces on the floor, seat or wall and flies) may discourage use of the facility. --- Circle the code corresponding to the response given. If 'No', go to the next module.
Households
1
Yes
2
No
9
Missing
Households using this toilet facility
Households using this toilet facility
Households using this toilet facility
Households using this toilet facility
Households using this toilet facility
How many households in total use this toilet facility?
Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of the following two questions is to determine whether the household shares their sanitation facility with other households. The shared status of a sanitation facility is important because shared facilities can be less hygienic than facilities used by only a single household. Unhygienic conditions (faeces on the floor, seat or wall and flies) may discourage use of the facility. --- The total number of households using this facility should include the household being interviewed. If less than ten households use this toilet facility, enter the number of households on the line provided. Circle '10' if ten or more households use this toilet facility. Note that '01' is not a valid response (since it means that this is the only this household that uses the facility; if that is the case, you should go back to WS8 and correct the response there). Circle '98' for 'DK' ('Doesn't know').
Households
10
Ten or more households
98
DK
99
Missing
Religion of head
Religion of head
Religion of head
Religion of head
Religion of head
What is the religion of the head of this household?
Circle the code corresponding to the answer given. Make sure to get the religion, ethnicity or mother tongue/native language of the household head.
Households
1
Buddhist
2
Muslim
3
Christian
6
Other religion
7
No religion
9
Missing
Language
Language
Language
Language
Language
What is the mother tongue/native language of the head of this household?
Circle the code corresponding to the answer given. Make sure to get the religion, ethnicity or mother tongue/native language of the household head.
Households
1
Thai
2
Other Languages
3
Missing
Ethnic group of head
Ethnic group of head
Ethnic group of head
Ethnic group of head
Ethnic group of head
To what ethnic group does the head of this household belong?
Circle the code corresponding to the answer given. Make sure to get the religion, ethnicity or mother tongue/native language of the household head.
Households
1
Thai
2
Cambodia
3
Loas
4
China
5
Myanmar
6
Other Ethnic
7
Hill Tribe
9
Missing
Head of occupation
Head of occupation
Head of occupation
Head of occupation
Head of occupation
1
Government Officer
2
State Enterprises Officer
3
Private Officer
4
Business
5
Agriculturist
6
Labourer
7
Other
9
Missing
Mean of income
Mean of income
Mean of income
Mean of income
Mean of income
1
Lower 10000
2
10000-19999
3
20000-29999
4
30000-39999
5
40000-49999
6
Upper 50000
9
Missing
Number of rooms for sleeping
Number of rooms for sleeping
Number of rooms for sleeping
Number of rooms for sleeping
Number of rooms for sleeping
How many rooms in this household are used for sleeping?
This information provides a measure of how crowded the house is, and reflects the socio-economic condition of the household. A room in this case refers to a special area with a permanent partition that is used for sleeping. It is not necessarily the number of rooms in the household that are called 'bedrooms', but rather how many rooms get used for sleeping on a regular basis. Exclude rooms that are used only for sleeping by visitors to the household, but include those rooms that may not be regular 'bedrooms' but may be regularly used by one or more of the household members for sleeping. Enter the number of rooms in this household that are used for sleeping.
Households
99
Missing
Main material of floor
Main material of floor
Main material of floor
Main material of floor
Main material of floor
Main material of the dwelling floor:
Record observation.
Circle the correct code for the material of the dwelling floor based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the floor, record the main flooring material (the material that covers the largest amount of floor space).
Households
11
Earth/sand
21
Wood planks
22
Palm/bamboo
31
Parquet or polished wood
32
Vinyl or asphalt strips
33
Ceramic tiles
34
Cement
35
Carpet
36
Marble
37
Polished stone
96
Other
99
Missing
Main material of roof
Main material of roof
Main material of roof
Main material of roof
Main material of roof
Main material of the roof.
Record observation.
Circle the correct code for the material of the dwelling roof, based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the roof, record the main roofing material (the material that covers the largest amount of roof).
Households
11
No roof
12
Thatch/palm leaf
13
Sod
22
Palm/bamboo
23
Wood Planks
31
Metal
33
Calamine/cement fiber
34
Ceramic tiles
35
Cement
36
Roofing shingles
96
Other
99
Missing
Main material of wall
Main material of wall
Main material of wall
Main material of wall
Main material of wall
Main material of the walls.
Record observation.
Circle the correct code for the material of the dwelling walls, based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the walls, record the main wall material (the material that covers the largest amount of wall space).
Households
11
No walls
12
Cane/palm/trunks
13
Dirt
24
Plywood
25
Carton
26
Reused wood
27
Bamboo
31
Cement
32
Stone with lime/cement
33
Bricks
34
Cement blocks
36
Wood planks/shingles
37
Zinc
38
Tile
39
Shera wood
96
Other
99
Missing
Type of fuel using for cooking
Type of fuel using for cooking
Type of fuel using for cooking
Type of fuel using for cooking
Type of fuel using for cooking
What type of fuel does your household mainly use for cooking?
Information on the type of fuel used for cooking is collected as another measure of the socio-economic status of the household. The use of some cooking fuels can also have adverse health consequences. Circle the code corresponding to the answer given. Remember that this question asks about fuel for cooking, not fuel for heating or lighting. If the household uses more than one fuel for cooking, find out which type of fuel is used most often. If electricity, liquid propane gas (LPG), natural gas, or biogas is mainly used, circle '01', '02', '03', or '04', respectively, and skip to HC8. If any fuel other than the pre-coded ones is reported as being the main fuel used for cooking, circle '96' and specify the type of fuel on the line provided. Definitions of some of the types of fuel are as follows: 'Biogas' includes gases produced by fermenting manure in an enclosed pit. 'Lignite' is a derivative of coal that produces more smoke when burned but produces less heat than coal.
Households
1
Electricity
2
Liquid propane gas (LPG)
4
Biogas
5
Kerosene
6
Coal/lignite
7
Charcoal
8
Wood
9
Straw/shrubs/grass
10
Animal dung
11
Agricultural crop residue
96
Other
97
No Cooking
99
Missing
Food cooked on stove or open fire
Food cooked on stove or open fire
Food cooked on stove or open fire
Food cooked on stove or open fire
Food cooked on stove or open fire
In this household, is food cooked on an open fire, an open stove or a closed stove?
Probe for type.
Probe for type of stove and circle the code corresponding to the response given. If a response is given other than the pre-coded ones, circle '96' and specify the type of stove on the line provided. For 'Closed stove', skip the next question and ask HC8.
Households
1
Open fire
2
Open stove
3
Closed stove
6
Other
9
Missing
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire/stove have a chimney or a hood?
Circle the appropriate response.
Households
1
Yes
2
No
9
Missing
Cooking location
Cooking location
Cooking location
Cooking location
Cooking location
Is the cooking usually done in the house, in a separate building, or outdoors?
Circle the code corresponding to the response given. If a response is given other than the pre-coded ones, circle '6' and specify on the line provided.
Households
1
In the house
2
In a separate bulding
3
Outdoors
4
Terrace
6
Other
9
Missing
Electricity
Electricity
Electricity
Electricity
Electricity
Does your household have:
Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR?
Households
1
Yes
2
No
9
Missing
Radio
Radio
Radio
Radio
Radio
Does your household have:
Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR?
Households
1
Yes
2
No
9
Missing
Television
Television
Television
Television
Television
Does your household have:
Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR?
Households
1
Yes
2
No
9
Missing
Mobile phone
Mobile phone
Mobile phone
Mobile phone
Mobile phone
Does your household have:
Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR?
Households
1
Yes
2
No
9
Missing
Non-mobile phone
Non-mobile phone
Non-mobile phone
Non-mobile phone
Non-mobile phone
Does your household have:
Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR?
Households
1
Yes
2
No
9
Missing
Refrigerator
Refrigerator
Refrigerator
Refrigerator
Refrigerator
Does your household have:
Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR?
Households
1
Yes
2
No
9
Missing
Computer
Computer
Computer
Computer
Computer
Watch
Watch
Watch
Watch
Watch
Does any member of your household own:
This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR.
Households
1
Yes
2
No
9
Missing
Bicycle
Bicycle
Bicycle
Bicycle
Bicycle
Does any member of your household own:
This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR.
Households
1
Yes
2
No
9
Missing
Motorcycle or scooter
Motorcycle or scooter
Motorcycle or scooter
Motorcycle or scooter
Motorcycle or scooter
Does any member of your household own:
This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR.
Households
1
Yes
2
No
9
Missing
Animal-drawn cart
Animal-drawn cart
Animal-drawn cart
Animal-drawn cart
Animal-drawn cart
Does any member of your household own:
This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR.
Households
1
Yes
2
No
9
Missing
Car or truck
Car or truck
Car or truck
Car or truck
Car or truck
Does any member of your household own:
This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR.
Households
1
Yes
2
No
9
Missing
Boat with motor
Boat with motor
Boat with motor
Boat with motor
Boat with motor
Does any member of your household own:
This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR.
Households
1
Yes
2
No
9
Missing
Women's sample weight
Women's sample weight
Women's sample weight
Women's sample weight
Women's sample weight
Recoded variable
Women aged 15-49
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
Recoded variable
Children aged 0-4
wealth index quintiles
wealth index quintiles
wealth index quintiles
wealth index quintiles
wealth index quintiles
Recoded variable
Children aged 0-4
1
Poorest
2
Second
3
Middle
4
Fourth
5
Richest
Date of interview women (CMC)
Date of interview women (CMC)
Date of interview women (CMC)
Date of interview women (CMC)
Date of interview women (CMC)
Recoded variable
Women aged 15-49
Date of birth (CMC)
Date of birth (CMC)
Date of birth (CMC)
Date of birth (CMC)
Date of birth (CMC)
Recoded variable
Women aged 15-49
Age
Age
Age
Age
Age
Recoded variable
Women aged 15-49
1
15-19
2
20-24
3
25-29
4
30-34
5
35-39
6
40-44
7
45-49
Age at first marriage/union
Age at first marriage/union
Age at first marriage/union
Age at first marriage/union
Age at first marriage/union
Recoded variable
Women aged 15-49
Marital/Union status
Marital/Union status
Marital/Union status
Marital/Union status
Marital/Union status
Recoded variable
Women aged 15-49
1
Currently married/in union
2
Formerly married/in union
3
Never married/in union
Mother's education
Mother's education
Mother's education
Mother's education
Mother's education
Recoded variable
Children aged 0-4
1
None
2
Primary
3
Secondary +
Children ever born
Children ever born
Children ever born
Children ever born
Children ever born
Recoded variable
Women aged 15-49
Dead children
Dead children
Dead children
Dead children
Dead children
Recoded variable
Women aged 15-49
Cluster number
Cluster number
Cluster number
Cluster number
Cluster number
We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. During this time I would like to speak with the household head and all mothers or others who take care of children in the household. May I start now? If permission is given, begin the interview. Cluster number:
Enter the cluster number as instructed by your supervisor.
Households
Unique identifier for the cluster in which the household exists
Household number
Household number
Household number
Household number
Household number
Household number:
Enter the household number as instructed by your supervisor.
Households
Houshold number within the cluster
Line number
Line number
Line number
Line number
Line number
Child's line number:
Children aged 0-4
Cluster number
Cluster number
Cluster number
Cluster number
Cluster number
Cluster number:
Enter the cluster number from the Household Questionnaire, question HH1.
Children aged 0-4
Household number
Household number
Household number
Household number
Household number
Household number:
Enter the household number from the Household Questionnaire, question HH2.
Children aged 0-4
Child's line number
Child's line number
Child's line number
Child's line number
Child's line number
Child's line number:
Enter the child's line number from the Household Questionnaire, column HL1 of the Household Listing.
Children aged 0-4
Caretaker's line number
Caretaker's line number
Caretaker's line number
Caretaker's line number
Caretaker's line number
Mother's/Caretaker's Line Number:
Enter the mother's/primary caretaker's line number from the Household Questionnaire, column HL1 of the Household Listing.
Children aged 0-4
Day of interview
Day of interview
Day of interview
Day of interview
Day of interview
Day/Month/Year of interview:
Enter the date of the interview: day/month/year. If the interview is not completed on your first visit and you visit the household to interview the mother/caretaker again, revise and enter the final date of the interview. In other words, the date here should be the date when you have either completed the Questionnaire for Children Under Five, or when the interview was not conducted but when it was decided that there will be no more attempts to interview the mother or primary caretaker of the under-five child.
Children aged 0-4
Month of interview
Month of interview
Month of interview
Month of interview
Month of interview
Day/Month/Year of interview:
Enter the date of the interview: day/month/year. If the interview is not completed on your first visit and you visit the household to interview the mother/caretaker again, revise and enter the final date of the interview. In other words, the date here should be the date when you have either completed the Questionnaire for Children Under Five, or when the interview was not conducted but when it was decided that there will be no more attempts to interview the mother or primary caretaker of the under-five child.
Children aged 0-4
Year of interview
Year of interview
Year of interview
Year of interview
Year of interview
Day/Month/Year of interview:
Enter the date of the interview: day/month/year. If the interview is not completed on your first visit and you visit the household to interview the mother/caretaker again, revise and enter the final date of the interview. In other words, the date here should be the date when you have either completed the Questionnaire for Children Under Five, or when the interview was not conducted but when it was decided that there will be no more attempts to interview the mother or primary caretaker of the under-five child.
Children aged 0-4
Result of interview for chidren under 5
Result of interview for chidren under 5
Result of interview for chidren under 5
Result of interview for chidren under 5
Result of interview for chidren under 5
Result of interview for children under 5
Complete this question once you have concluded the interview. Remember that the code refers to the mother or primary caretaker of the under-five child. Circle the code corresponding to the results of the interview. If the questionnaire is completed, circle '1' for 'Completed'. If you have not been able to contact the mother/primary caretaker after repeated visits, circle '2' for 'Not at home'. If the mother/primary caretaker refuses to be interviewed, circle '3' for 'Refused'. If you were able to only partly complete the questionnaire, circle '4' for 'Partly completed'. If the mother/primary caretaker is incapacitated, circle '5'. If you have not been able to complete this questionnaire for another reason, you should circle '6' for 'Other' and specify the reason in the space provided. Ask the mother/primary caretaker to collect all the birth certificates and health/ immunization cards she has for this child before you begin the interview. You will need these during the interview. Repeat greeting if not already read to this mother/primary caretaker: "WE ARE FROM (country-specific affiliation). WE ARE WORKING ON A PROJECT CONCERNED WITH FAMILY HEALTH AND EDUCATION. I WOULD LIKE TO TALK TO YOU ABOUT THIS. THE INTERVIEW WILL TAKE ABOUT (number) MINUTES. ALL THE INFORMATION WE OBTAIN WILL REMAIN STRICTLY CONFIDENTIAL AND YOUR ANSWERS WILL NEVER BE IDENTIFIED. ALSO, YOU ARE NOT OBLIGED TO ANSWER ANY QUESTION YOU DON'T WANT TO, AND YOU MAY WITHDRAW FROM THE INTERVIEW AT ANY TIME. MAY I START NOW?" As with similar sentences at the beginning of the Household Questionnaire and Questionnaire for Individual Women, you may change the wording of these introductory sentences as appropriate. You must make sure, however, to include the following when you are introducing yourself: The name of the implementing agency; the topic of the survey; the approximate duration of the interview; the issue of confidentiality; and with whom you would like to speak. If permission is given, begin the interview. If the respondent does not agree to continue, thank her/him and go to the next interview. Later, discuss the refusal with your supervisor; you or another person from the team may attempt to interview the respondent for a second time. This will depend on your description of the refusal. However, remember that the respondent's participation in the survey must be on a voluntary basis, and potential respondents must never be forced to participate.
Children aged 0-4
1
Completed
2
Not at home
3
Refused
5
Incapacitated
6
Other
Day of birth of child
Day of birth of child
Day of birth of child
Day of birth of child
Day of birth of child
Repeat greeting if not already read to this respondent: We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. Also, you are not obliged to answer any question you don't want to, and you may withdraw from the interview at any time. May I start now? If permission is given, begin the interview. If the respondent does not agree to continue, thank him/her and go to the next interview. Discuss this result with your supervisor for a future revisit.
Now I would like to ask you some questions about the health of each child under the age of 5 in your care, who lives with you now. Now I want to ask you about (NAME). In what month and year was (NAME) born? Probe: What is his/her birthday?
If the mother/caretaker knows the exact birth date, also enter the day; otherwise, circle 98 for day.
You will begin the interview with questions about the child's date of birth and age. These are two of the most important questions in the interview, since almost all analysis of the data depends on the child's exact age. While completed age in years is sufficient for women's interviews, we need to obtain accurate information on the child's age in months. This is necessary because some of the analysis of the information that you will be collecting can only be done on the basis of age in months. You will collect this information by learning the child's date of birth. It will then be possible to compare the date of interview with the date of birth of the child and, after the data is collected, calculate the child's age in months by comparing these two pieces of information. The questions on age and date of birth must be asked independently from similar questions on the Household Questionnaire and Questionnaire for Individual Women. The person you may be interviewing for this questionnaire may be the same woman you interviewed for the Questionnaire for Individual Women, and you may have obtained dates of birth of her children in that questionnaire. Also, you may have obtained the child's age in the Household Questionnaire. Even in such cases, you must ask these questions again. --- Note that you may modify the first sentence based on the number of children in the respondent's care. If this is the only child the respondent cares for, change the sentences to "NOW I WOULD LIKE TO ASK YOU SOME QUESTIONS ABOUT THE HEALTH OF (name). IN WHAT MONTH AND YEAR WAS (name) BORN?" Ask the mother or primary caretaker for the child's date of birth. Probe: "WHAT IS HIS/HER BIRTHDAY?" It is important to record the child's month and year of birth accurately. If the mother/primary caretaker knows the exact birth date, including the day, enter the day of birth. Otherwise, circle '98' for 'DK day'. You do not need to probe further for day of birth. Convert the month to a number as you have done before. Enter the number in the space provided. If the month or day contains only one digit, use a leading zero. For example, the month of March is coded as '03'. Note that you are not allowed to enter DK for month or year of birth. You have to obtain month and year of birth of the child. Since all MICS3 surveys will be conducted in 2005 or 2006, the year of birth of the child cannot be earlier than 2000 (for surveys in 2005) or 2001 (for surveys in 2006). If the mother/primary caretaker is unable to provide the date of birth information, ask whether she/he has any documentation such as an identification card, health card, horoscope, or a birth or baptismal certificate that might give the date of birth of the child. However, confirm with the respondent that the date of birth recorded on such documents is indeed correct.
Children aged 0-4
97
Inconsistent
98
DK
99
Missing
Month of birth of child
Month of birth of child
Month of birth of child
Month of birth of child
Month of birth of child
Repeat greeting if not already read to this respondent: We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. Also, you are not obliged to answer any question you don't want to, and you may withdraw from the interview at any time. May I start now? If permission is given, begin the interview. If the respondent does not agree to continue, thank him/her and go to the next interview. Discuss this result with your supervisor for a future revisit.
Now I would like to ask you some questions about the health of each child under the age of 5 in your care, who lives with you now. Now I want to ask you about (NAME). In what month and year was (NAME) born? Probe: What is his/her birthday?
If the mother/caretaker knows the exact birth date, also enter the day; otherwise, circle 98 for day.
You will begin the interview with questions about the child's date of birth and age. These are two of the most important questions in the interview, since almost all analysis of the data depends on the child's exact age. While completed age in years is sufficient for women's interviews, we need to obtain accurate information on the child's age in months. This is necessary because some of the analysis of the information that you will be collecting can only be done on the basis of age in months. You will collect this information by learning the child's date of birth. It will then be possible to compare the date of interview with the date of birth of the child and, after the data is collected, calculate the child's age in months by comparing these two pieces of information. The questions on age and date of birth must be asked independently from similar questions on the Household Questionnaire and Questionnaire for Individual Women. The person you may be interviewing for this questionnaire may be the same woman you interviewed for the Questionnaire for Individual Women, and you may have obtained dates of birth of her children in that questionnaire. Also, you may have obtained the child's age in the Household Questionnaire. Even in such cases, you must ask these questions again. --- Note that you may modify the first sentence based on the number of children in the respondent's care. If this is the only child the respondent cares for, change the sentences to "NOW I WOULD LIKE TO ASK YOU SOME QUESTIONS ABOUT THE HEALTH OF (name). IN WHAT MONTH AND YEAR WAS (name) BORN?" Ask the mother or primary caretaker for the child's date of birth. Probe: "WHAT IS HIS/HER BIRTHDAY?" It is important to record the child's month and year of birth accurately. If the mother/primary caretaker knows the exact birth date, including the day, enter the day of birth. Otherwise, circle '98' for 'DK day'. You do not need to probe further for day of birth. Convert the month to a number as you have done before. Enter the number in the space provided. If the month or day contains only one digit, use a leading zero. For example, the month of March is coded as '03'. Note that you are not allowed to enter DK for month or year of birth. You have to obtain month and year of birth of the child. Since all MICS3 surveys will be conducted in 2005 or 2006, the year of birth of the child cannot be earlier than 2000 (for surveys in 2005) or 2001 (for surveys in 2006). If the mother/primary caretaker is unable to provide the date of birth information, ask whether she/he has any documentation such as an identification card, health card, horoscope, or a birth or baptismal certificate that might give the date of birth of the child. However, confirm with the respondent that the date of birth recorded on such documents is indeed correct.
Children aged 0-4
97
Inconsistent
98
DK
99
Missing
Year of birth of child
Year of birth of child
Year of birth of child
Year of birth of child
Year of birth of child
Repeat greeting if not already read to this respondent: We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. Also, you are not obliged to answer any question you don't want to, and you may withdraw from the interview at any time. May I start now? If permission is given, begin the interview. If the respondent does not agree to continue, thank him/her and go to the next interview. Discuss this result with your supervisor for a future revisit.
Now I would like to ask you some questions about the health of each child under the age of 5 in your care, who lives with you now. Now I want to ask you about (NAME). In what month and year was (NAME) born? Probe: What is his/her birthday?
If the mother/caretaker knows the exact birth date, also enter the day; otherwise, circle 98 for day.
You will begin the interview with questions about the child's date of birth and age. These are two of the most important questions in the interview, since almost all analysis of the data depends on the child's exact age. While completed age in years is sufficient for women's interviews, we need to obtain accurate information on the child's age in months. This is necessary because some of the analysis of the information that you will be collecting can only be done on the basis of age in months. You will collect this information by learning the child's date of birth. It will then be possible to compare the date of interview with the date of birth of the child and, after the data is collected, calculate the child's age in months by comparing these two pieces of information. The questions on age and date of birth must be asked independently from similar questions on the Household Questionnaire and Questionnaire for Individual Women. The person you may be interviewing for this questionnaire may be the same woman you interviewed for the Questionnaire for Individual Women, and you may have obtained dates of birth of her children in that questionnaire. Also, you may have obtained the child's age in the Household Questionnaire. Even in such cases, you must ask these questions again. --- Note that you may modify the first sentence based on the number of children in the respondent's care. If this is the only child the respondent cares for, change the sentences to "NOW I WOULD LIKE TO ASK YOU SOME QUESTIONS ABOUT THE HEALTH OF (name). IN WHAT MONTH AND YEAR WAS (name) BORN?" Ask the mother or primary caretaker for the child's date of birth. Probe: "WHAT IS HIS/HER BIRTHDAY?" It is important to record the child's month and year of birth accurately. If the mother/primary caretaker knows the exact birth date, including the day, enter the day of birth. Otherwise, circle '98' for 'DK day'. You do not need to probe further for day of birth. Convert the month to a number as you have done before. Enter the number in the space provided. If the month or day contains only one digit, use a leading zero. For example, the month of March is coded as '03'. Note that you are not allowed to enter DK for month or year of birth. You have to obtain month and year of birth of the child. Since all MICS3 surveys will be conducted in 2005 or 2006, the year of birth of the child cannot be earlier than 2000 (for surveys in 2005) or 2001 (for surveys in 2006). If the mother/primary caretaker is unable to provide the date of birth information, ask whether she/he has any documentation such as an identification card, health card, horoscope, or a birth or baptismal certificate that might give the date of birth of the child. However, confirm with the respondent that the date of birth recorded on such documents is indeed correct.
Children aged 0-4
9997
Inconsistent
9998
DK
9999
Missing
Age of child
Age of child
Age of child
Age of child
Age of child
How old was (NAME) at his/her last birthday?
Record age in completed years.
You will begin the interview with questions about the child's date of birth and age. These are two of the most important questions in the interview, since almost all analysis of the data depends on the child's exact age. While completed age in years is sufficient for women's interviews, we need to obtain accurate information on the child's age in months. This is necessary because some of the analysis of the information that you will be collecting can only be done on the basis of age in months. You will collect this information by learning the child's date of birth. It will then be possible to compare the date of interview with the date of birth of the child and, after the data is collected, calculate the child's age in months by comparing these two pieces of information. The questions on age and date of birth must be asked independently from similar questions on the Household Questionnaire and Questionnaire for Individual Women. The person you may be interviewing for this questionnaire may be the same woman you interviewed for the Questionnaire for Individual Women, and you may have obtained dates of birth of her children in that questionnaire. Also, you may have obtained the child's age in the Household Questionnaire. Even in such cases, you must ask these questions again. --- After having obtained the child's date of birth, ask the child's age in completed years, and record in the space provided. Remember, ages must refer to the last birthday. If the mother/primary caretaker does not know the current age of the child, try asking "HOW MANY YEARS AGO WAS (name) BORN?" You may help the respondent by relating the child's age to that of other children or to some important event or to the season of birth, by asking, for example, "HOW MANY WET SEASONS AGO WAS (name) BORN?" Ask UF10 and UF11 independently. Then, check for consistency between the date of birth and completed age. You have to be meticulous in checking for the consistency between the date of birth and age. You also have to be fairly quick in doing so. A good interviewer will perform the check without causing a lull in the conversation. Checking for consistency between date of birth (UF10) and completed age (UF11). After having obtained both date of birth and age, check for the consistency between the two. The child's age plus her year of birth must equal the year in which the child last had a birthday. Assuming that you were able to obtain a month and year of birth, you should check the consistency by following these steps: If the month of birth is before the month of interview (the child had his/her birthday this year), then her/his age plus her/his year of birth should equal the year of interview. . Example: A child who was born in October 2003, in a survey conducted in November 2005, should be age 2 (2003 + 2 = 2005). If the month of birth is after the month of interview (the child has not had his/her birthday this year), then her/his age plus year of birth should equal the previous year. . Example: A child who was born in December 2003, in a survey conducted in October 2005, should be age 1 (2003 + 1 = 2004). If the month of birth is the same as the month of interview, and the day of birth is not known, then a sum of either the current or the previous year is correct. . Example: A child born in November 2002, in a survey conducted in November 2005, could be age 3 or age 2. Probe further to see if the date of birth is correct and whether the child has completed age 2 or 3. If the month of birth is the same as the month of interview, and the day of birth is known, the sum of age and year of birth should equal the year of interview if the day of birth is before the day of interview, and the sum of age and year of birth should equal the previous year if the day of birth is after the day of interview. . Example: A child born on 8 February 2002, in an interview conducted on 15 February 2006, should be age four. A child born on 28 February 2002, in an interview conducted on 3 February 2006, should be age three, since this child will complete 4 full years on 28 February 2006. If you find that the date of birth and age are inconsistent, either the date of birth or the age, or both, are incorrect, and need to be corrected. Do not assume that one is more accurate than the other. Probe, using documents that may be available, dates of well-known events and ages of other children, of the respondent herself/himself, etc.
Children aged 0-4
Child has birth certificate
Child has birth certificate
Child has birth certificate
Child has birth certificate
Child has birth certificate
Does (name) have a birth certificate? May I see it?
This question aims to provide an estimate of the extent of birth registration in your country. Respondents must be assured that the information about individual families will never be given to authorities, and that they cannot be identified in any way. Ask to see the birth certificate. Circle the appropriate corresponding code, noting whether or not the certificate was seen. If the child has a birth certificate and it was seen, circle '1' and skip to BR5. If the child does not have a birth certificate ('3'), or if the child has a birth certificate but the mother/primary caretaker is unable to show you the certificate ('2'), continue to the next question.
Children aged 0-4
1
Yes, seen
2
Yes, not seen
3
No
8
DK
9
Missing
Child registered
Child registered
Child registered
Child registered
Child registered
Has (name's) birth been registered with the civil authorities?
Circle the code corresponding to the response. If the answer is 'Yes', skip to BR5. If the child's birth has not been registered with civil authorities, continue to the next question. If the answer is 'DK', skip to BR4.
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Reason birth not registered
Reason birth not registered
Reason birth not registered
Reason birth not registered
Reason birth not registered
Why is (name's) birth not registered?
This question aims to elicit the reason for non-registration. Circle the code corresponding to the response. Note that although there might be more than one reason for not registering a child, we need to get only one response - the most important one according to the mother/primary caretaker. If the response is definitely not one of the pre-coded responses, circle '6' for 'Other' and specify the response in the space provided.
Children aged 0-4
1
Costs too much
2
Must travel too far
3
Did not know it should be registered
4
Late, and did not want to pay fine
5
Does not know where to register
6
Other
8
DK
9
Missing
Know how to register birth
Know how to register birth
Know how to register birth
Know how to register birth
Know how to register birth
Do you know how to register your child's birth?
The purpose of this question is to assess how important lack of knowledge (of the process of registering or, if applicable, the place to go to register) may be among the reasons for non-registration. This information can inform advocacy efforts and help in the formulation of education campaigns. Circle the code corresponding to the response.
Children aged 0-4
1
Yes
2
No
9
Missing
Child attends early childhood education programme
Child attends early childhood education programme
Child attends early childhood education programme
Child attends early childhood education programme
Child attends early childhood education programme
BR5. Check age of child in UF11: Child is 3 or 4 years old? Yes. Continue with BR6 No. Go to BR8
Does (name) attend any organized learning or early childhood education programme, such as a private or government facility, including kindergarten or community child care?
If the child is 3 or 4 years old, check the box marked 'Yes' and continue on to BR6. If not (if the child is 0, 1 or 2 years old), check the box marked 'No' and skip to BR8. --- This question aims to find out if the child is participating in early learning activities. Baby-sitting or child-minding, even if done in a special place such as a day-care centre, does not qualify as such a programme unless it includes organized learning activities. You must ensure that the mother or primary caretaker understands the meaning of 'Early Childhood Education Programme', explaining it as instructed. Circle the appropriate code. Skip to BR8 if the answer to this question is 'No' or 'DK'.
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Hours attended education in last 7 days
Hours attended education in last 7 days
Hours attended education in last 7 days
Hours attended education in last 7 days
Hours attended education in last 7 days
Within the last seven days, about how many hours did (name) attend?
This question is asked if the child is attending an early childhood education programme. Record the estimated number of hours the child attended any organized learning or early childhood education programme in the last 7 days. Use a leading zero if necessary.
Children aged 0-4
98
DK
99
Missing
Books-Mother
Books-Mother
Books-Mother
Books-Mother
Books-Mother
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Read books or look at picture books with (name)?
Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here.
Children aged 0-4
?
Missing
A
Mother
Books-Father
Books-Father
Books-Father
Books-Father
Books-Father
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Read books or look at picture books with (name)?
Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here.
Children aged 0-4
?
Missing
B
Father
Books-Other
Books-Other
Books-Other
Books-Other
Books-Other
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Read books or look at picture books with (name)?
Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here.
Children aged 0-4
?
Missing
X
Other
Books-No one
Books-No one
Books-No one
Books-No one
Books-No one
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Read books or look at picture books with (name)?
Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here.
Children aged 0-4
?
Missing
Y
No one
Stories-Mother
Stories-Mother
Stories-Mother
Stories-Mother
Stories-Mother
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Tell stories to (name)?
Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here.
Children aged 0-4
?
Missing
A
Mother
Stories-Father
Stories-Father
Stories-Father
Stories-Father
Stories-Father
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Tell stories to (name)?
Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here.
Children aged 0-4
?
Missing
B
Father
Stories-Other
Stories-Other
Stories-Other
Stories-Other
Stories-Other
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Tell stories to (name)?
Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here.
Children aged 0-4
?
Missing
X
Other
Stories-No one
Stories-No one
Stories-No one
Stories-No one
Stories-No one
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Tell stories to (name)?
Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here.
Children aged 0-4
?
Missing
Y
No one
Songs-Mother
Songs-Mother
Songs-Mother
Songs-Mother
Songs-Mother
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Sing songs with (name)?
Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here.
Children aged 0-4
?
Missing
A
Mother
Songs-Father
Songs-Father
Songs-Father
Songs-Father
Songs-Father
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Sing songs with (name)?
Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here.
Children aged 0-4
?
Missing
B
Father
Songs-Other
Songs-Other
Songs-Other
Songs-Other
Songs-Other
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Sing songs with (name)?
Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here.
Children aged 0-4
?
Missing
X
Other
Songs-No one
Songs-No one
Songs-No one
Songs-No one
Songs-No one
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Sing songs with (name)?
Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here.
Children aged 0-4
?
Missing
Y
No one
Outside-Mother
Outside-Mother
Outside-Mother
Outside-Mother
Outside-Mother
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Take (name) outside the home, compound, yard or enclosure?
Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here.
Children aged 0-4
?
Missing
A
Mother
Outside-Father
Outside-Father
Outside-Father
Outside-Father
Outside-Father
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Take (name) outside the home, compound, yard or enclosure?
Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here.
Children aged 0-4
?
Missing
B
Father
Outside-Other
Outside-Other
Outside-Other
Outside-Other
Outside-Other
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Take (name) outside the home, compound, yard or enclosure?
Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here.
Children aged 0-4
?
Missing
X
Other
Outside-No one
Outside-No one
Outside-No one
Outside-No one
Outside-No one
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Take (name) outside the home, compound, yard or enclosure?
Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here.
Children aged 0-4
?
Missing
Y
No one
Play-Mother
Play-Mother
Play-Mother
Play-Mother
Play-Mother
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Play with (name)?
Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here.
Children aged 0-4
?
Missing
A
Mother
Play-Father
Play-Father
Play-Father
Play-Father
Play-Father
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Play with (name)?
Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here.
Children aged 0-4
?
Missing
B
Father
Play-Other
Play-Other
Play-Other
Play-Other
Play-Other
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Play with (name)?
Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here.
Children aged 0-4
?
Missing
X
Other
Play-No one
Play-No one
Play-No one
Play-No one
Play-No one
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Play with (name)?
Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here.
Children aged 0-4
?
Missing
Y
No one
Naming-Mother
Naming-Mother
Naming-Mother
Naming-Mother
Naming-Mother
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Spend time with (name) naming, counting, and/or drawing things?
Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here.
Children aged 0-4
?
Missing
A
Mother
Naming-Father
Naming-Father
Naming-Father
Naming-Father
Naming-Father
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Spend time with (name) naming, counting, and/or drawing things?
Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here.
Children aged 0-4
?
Missing
B
Father
Naming-Other
Naming-Other
Naming-Other
Naming-Other
Naming-Other
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Spend time with (name) naming, counting, and/or drawing things?
Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here.
Children aged 0-4
?
Missing
X
Other
Naming-No one
Naming-No one
Naming-No one
Naming-No one
Naming-No one
In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child's father or another adult member of the household (including the caretaker/respondent)? Spend time with (name) naming, counting, and/or drawing things?
Read each items shown below. If 'No', circle 'Y' and move to the next item on the list. If 'Yes', ask: "WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)?" For each activity, circle the code for every person who engaged in the activity with the child before proceeding to the next item. If someone other than the mother or father engaged in the activity with the child, circle 'X'. Note that in a household where there are no adults other than the child's mother and father, 'X' should not be circled. Adults who are not members of the household but who may have engaged in the listed activities with the child should not be coded here.
Children aged 0-4
?
Missing
Y
No one
How many books are there in the household
How many books are there in the household
How many books are there in the household
How many books are there in the household
How many books are there in the household
Question CE1 is to be administered only once to each caretaker
How many books are there in the household? Please include schoolbooks, but not other books meant for children, such as picture books
If 'none' enter 00
The questions in this module are used to obtain information about the extent to which households provide a supportive and stimulating learning environment. The first two questions are about books in the household; the third question is about things that the child plays with; the last two questions are about whether the child is left alone or left with another child as a caregiver. This question asks for the number of books in the household, including schoolbooks and books for older children, but not picture books or books especially meant for young children. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Note that their responses to the number of books in the same household may be different. Record the number of books in the space provided. There is no need to make an actual count of books yourself. Rely on the respondent's answer, and avoid asking to see and count the books yourself, since this is likely to require extra time. If the respondent is unsure about the number of books and is not able to provide an answer the first time you ask the question, ask her/him if there are more than 10 books. If yes, circle '10'. If she/he says that there are less than 10 books, probe further to get an exact number. If there are no such books in the household, record '00'.
Children aged 0-4
10
Ten or more books
99
Missing
How many children books or picture books do you have for him
How many children books or picture books do you have for him
How many children books or picture books do you have for him
How many children books or picture books do you have for him
How many children books or picture books do you have for him
How many children's books or picture books do you have for (name)?
If 'none' enter 00
This question asks specifically about children's books or picture books for the child. This excludes schoolbooks (appropriate for or belonging to older children), as well as other books for adults that are present in the household. Those books for older children and adults are already included in the previous question, CE1. Record the number of books in the space provided. There is no need to make an actual count of books yourself. Rely on the respondent's answer, and avoid asking to see and count the books yourself, since this is likely to require extra time. If the respondent is unsure about the number of children's books or picture books and is not able to provide an answer the first time you ask the question, ask her/him if there are more than 10 such books. If yes, circle '10'. If she/he says that there are less than 10 such books, probe further to get an exact number. If there are no such books in the household, record '00'.
Children aged 0-4
10
Ten or more books
99
Missing
Bowls, plate, cups ,pots
Bowls, plate, cups ,pots
Bowls, plate, cups ,pots
Bowls, plate, cups ,pots
Bowls, plate, cups ,pots
I am interested in learning about the things that (NAME) plays with when he/she is at home. What does (NAME) play with? Does he/she play with household objects, such as bowls, plates, cups or pots?
This question is used to learn about different types of playthings used by the child. We want to know if the child has objects to play with, and what these are, even if they do not include store-bought toys. We are interested in learning about other objects that are used as playthings, such as ordinary household objects and natural materials. Extra care should be taken to ask this question and record the responses. Experience has shown that respondents find it very easy to give the same answer to a list of different playthings. Often they will answer 'Yes' to all items, whether or not it is true, perhaps because they think this is the 'correct' response or one that will please the interviewer. After asking "WHAT DOES (name) PLAY WITH?" do not pause; start asking whether the child plays with playthings from each of the categories listed. For example, ask: "DOES HE/SHE PLAY WITH HOUSEHOLD OBJECTS, SUCH AS BOWLS, PLATES, CUPS OR POTS?" and so on. If the respondent answers 'Yes' to any of these prompted categories, then probe to learn specifically what the child plays with to ascertain the response. For example, probe by saying "WHAT DOES HE/SHE SPECIFICALLY PLAY WITH?" or "CAN YOU PLEASE GIVE AN EXAMPLE?" If you ascertain that the child uses playthings that would fall into each of the prompted categories, circle the appropriate code. Circle 'Y' if the child does not play with any of the items mentioned. Note that if 'Y' is circled, none of the other codes should be circled.
Children aged 0-4
?
Missing
A
Household objects
Sticks , rocks, animals shells, leaves
Sticks , rocks, animals shells, leaves
Sticks , rocks, animals shells, leaves
Sticks , rocks, animals shells, leaves
Sticks , rocks, animals shells, leaves
I am interested in learning about the things that (NAME) plays with when he/she is at home. What does (NAME) play with? Does he/she play with objects and materials found outside the living quarters, such as sticks, rocks, animals, shells, or leaves?
This question is used to learn about different types of playthings used by the child. We want to know if the child has objects to play with, and what these are, even if they do not include store-bought toys. We are interested in learning about other objects that are used as playthings, such as ordinary household objects and natural materials. Extra care should be taken to ask this question and record the responses. Experience has shown that respondents find it very easy to give the same answer to a list of different playthings. Often they will answer 'Yes' to all items, whether or not it is true, perhaps because they think this is the 'correct' response or one that will please the interviewer. After asking "WHAT DOES (name) PLAY WITH?" do not pause; start asking whether the child plays with playthings from each of the categories listed. For example, ask: "DOES HE/SHE PLAY WITH HOUSEHOLD OBJECTS, SUCH AS BOWLS, PLATES, CUPS OR POTS?" and so on. If the respondent answers 'Yes' to any of these prompted categories, then probe to learn specifically what the child plays with to ascertain the response. For example, probe by saying "WHAT DOES HE/SHE SPECIFICALLY PLAY WITH?" or "CAN YOU PLEASE GIVE AN EXAMPLE?" If you ascertain that the child uses playthings that would fall into each of the prompted categories, circle the appropriate code. Circle 'Y' if the child does not play with any of the items mentioned. Note that if 'Y' is circled, none of the other codes should be circled.
Children aged 0-4
?
Missing
B
Outside objects
Homemae toys
Homemae toys
Homemae toys
Homemae toys
Homemae toys
I am interested in learning about the things that (NAME) plays with when he/she is at home. What does (NAME) play with? Does he/she play with homemade toys, such as dolls, cars and other toys made at home?
This question is used to learn about different types of playthings used by the child. We want to know if the child has objects to play with, and what these are, even if they do not include store-bought toys. We are interested in learning about other objects that are used as playthings, such as ordinary household objects and natural materials. Extra care should be taken to ask this question and record the responses. Experience has shown that respondents find it very easy to give the same answer to a list of different playthings. Often they will answer 'Yes' to all items, whether or not it is true, perhaps because they think this is the 'correct' response or one that will please the interviewer. After asking "WHAT DOES (name) PLAY WITH?" do not pause; start asking whether the child plays with playthings from each of the categories listed. For example, ask: "DOES HE/SHE PLAY WITH HOUSEHOLD OBJECTS, SUCH AS BOWLS, PLATES, CUPS OR POTS?" and so on. If the respondent answers 'Yes' to any of these prompted categories, then probe to learn specifically what the child plays with to ascertain the response. For example, probe by saying "WHAT DOES HE/SHE SPECIFICALLY PLAY WITH?" or "CAN YOU PLEASE GIVE AN EXAMPLE?" If you ascertain that the child uses playthings that would fall into each of the prompted categories, circle the appropriate code. Circle 'Y' if the child does not play with any of the items mentioned. Note that if 'Y' is circled, none of the other codes should be circled.
Children aged 0-4
?
Missing
C
Homemade toys
Toys that came from a store
Toys that came from a store
Toys that came from a store
Toys that came from a store
Toys that came from a store
I am interested in learning about the things that (NAME) plays with when he/she is at home. What does (NAME) play with? Does he/she play with toys that came from a store?
This question is used to learn about different types of playthings used by the child. We want to know if the child has objects to play with, and what these are, even if they do not include store-bought toys. We are interested in learning about other objects that are used as playthings, such as ordinary household objects and natural materials. Extra care should be taken to ask this question and record the responses. Experience has shown that respondents find it very easy to give the same answer to a list of different playthings. Often they will answer 'Yes' to all items, whether or not it is true, perhaps because they think this is the 'correct' response or one that will please the interviewer. After asking "WHAT DOES (name) PLAY WITH?" do not pause; start asking whether the child plays with playthings from each of the categories listed. For example, ask: "DOES HE/SHE PLAY WITH HOUSEHOLD OBJECTS, SUCH AS BOWLS, PLATES, CUPS OR POTS?" and so on. If the respondent answers 'Yes' to any of these prompted categories, then probe to learn specifically what the child plays with to ascertain the response. For example, probe by saying "WHAT DOES HE/SHE SPECIFICALLY PLAY WITH?" or "CAN YOU PLEASE GIVE AN EXAMPLE?" If you ascertain that the child uses playthings that would fall into each of the prompted categories, circle the appropriate code. Circle 'Y' if the child does not play with any of the items mentioned. Note that if 'Y' is circled, none of the other codes should be circled.
Children aged 0-4
?
Missing
D
Store bought toys
No playthings mentioned
No playthings mentioned
No playthings mentioned
No playthings mentioned
No playthings mentioned
I am interested in learning about the things that (NAME) plays with when he/she is at home. What does (NAME) play with? Does he/she play with household objects, such as bowls, plates, cups or pots?
If the respondent says "YES" to any of the prompted categories, then probe to learn specifically what the child plays with to ascertain the response Code Y if child does not play with any of the items mentioned.
This question is used to learn about different types of playthings used by the child. We want to know if the child has objects to play with, and what these are, even if they do not include store-bought toys. We are interested in learning about other objects that are used as playthings, such as ordinary household objects and natural materials. Extra care should be taken to ask this question and record the responses. Experience has shown that respondents find it very easy to give the same answer to a list of different playthings. Often they will answer 'Yes' to all items, whether or not it is true, perhaps because they think this is the 'correct' response or one that will please the interviewer. After asking "WHAT DOES (name) PLAY WITH?" do not pause; start asking whether the child plays with playthings from each of the categories listed. For example, ask: "DOES HE/SHE PLAY WITH HOUSEHOLD OBJECTS, SUCH AS BOWLS, PLATES, CUPS OR POTS?" and so on. If the respondent answers 'Yes' to any of these prompted categories, then probe to learn specifically what the child plays with to ascertain the response. For example, probe by saying "WHAT DOES HE/SHE SPECIFICALLY PLAY WITH?" or "CAN YOU PLEASE GIVE AN EXAMPLE?" If you ascertain that the child uses playthings that would fall into each of the prompted categories, circle the appropriate code. Circle 'Y' if the child does not play with any of the items mentioned. Note that if 'Y' is circled, none of the other codes should be circled.
Children aged 0-4
?
Missing
Y
No playthings mentioned
How many time was he/her left in the care of another child
How many time was he/her left in the care of another child
How many time was he/her left in the care of another child
How many time was he/her left in the care of another child
How many time was he/her left in the care of another child
Sometimes adults taking care of children have to leave the house to go shopping, wash clothes, or for other reasons and have to leave young children with others. since last (day of the week) how many times was (name) left in the care of another child (that is, someone less than 10 years old)?
If 'none' enter 00
This and the following question are used to assess whether children are at increased risk, either because they are left alone or are left with a child as caregiver. These situations have been shown to be associated with higher risk for children, although there are many exceptions. The question sets up a hypothetical situation, one in which the mother/primary caretaker would be gone for more than just a moment - situations in which the child could be left alone for an hour or more. The question specifies that we want to know about situations in which the respondent actually leaves the premises, not simply going out of sight of the child, such as to another part or another room of the house. When asking this question, insert the name of the day of the interview. For example, if the interview is taking place on a Tuesday, ask: "SINCE LAST TUESDAY…" Enter the response in the spaces provided. If the child was not left in the care of another child during this period, enter '00' for 'None'. Note that 'another child' is defined as a child less than 10 years old.
Children aged 0-4
98
DK
99
Missing
How many time he was left alone
How many time he was left alone
How many time he was left alone
How many time he was left alone
How many time he was left alone
In the past week, how many times was (name) left alone?
If 'none' enter 00
This question asks, given the same situation as in CE4, whether and how many times the child was left completely unattended, even by another child. As in CE4, make it clear to the respondent that you are asking only about the week previous to the day of interview. Enter the response in the spaces provided. If the answer is 'None', enter '00'.
Children aged 0-4
98
DK
99
Missing
Child ever been breastfed
Child ever been breastfed
Child ever been breastfed
Child ever been breastfed
Child ever been breastfed
Has (name) ever been breastfed?
This question asks if the child has ever been breastfed. It includes any breastfeeding experience of the child - not necessarily by the mother/primary caretaker. Circle the code corresponding to the response. Continue to the next question if the child was ever breastfed ('1'). If the child was never breastfed, circle 'No' and skip to BF3. Skip to BF3 in the case of a 'DK' response as well.
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Child still being breastfed
Child still being breastfed
Child still being breastfed
Child still being breastfed
Child still being breastfed
Is he/she still being breastfed?
'Being breastfed' is defined as putting the child to the breast at least once a day. Circle the code corresponding to the response.
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Child received vitamin, mineral supplements or medicine
Child received vitamin, mineral supplements or medicine
Child received vitamin, mineral supplements or medicine
Child received vitamin, mineral supplements or medicine
Child received vitamin, mineral supplements or medicine
Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Vitamin, mineral supplements or medicine?
This question asks about what the child was fed in the preceding 24 hours. The purpose of this question is to determine what liquids or foods the child was given. Prompt by asking each listed item in turn, such as: "DID (name) RECEIVE VITAMIN OR MINERAL SUPPLEMENTS OR MEDICINE?" or "DID HE/SHE RECEIVE PLAIN WATER?" and so on through the list. Read each item aloud and record the response before proceeding to the next item. Use the local terms for these liquids or foods. Make sure that the respondent understands the question, particularly what is meant by 'since this time yesterday'. Specify to the mother/primary caretaker: mid-morning, mid-afternoon, etc., depending on the time of the interview. Circle the code corresponding to the response. If the mother/primary caretaker does not know the answer, repeat the question using other local words for the fluid or food. If the answer is still not known, circle '8' for 'DK'
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Child received plain water
Child received plain water
Child received plain water
Child received plain water
Child received plain water
Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Plain water?
This question asks about what the child was fed in the preceding 24 hours. The purpose of this question is to determine what liquids or foods the child was given. Prompt by asking each listed item in turn, such as: "DID (name) RECEIVE VITAMIN OR MINERAL SUPPLEMENTS OR MEDICINE?" or "DID HE/SHE RECEIVE PLAIN WATER?" and so on through the list. Read each item aloud and record the response before proceeding to the next item. Use the local terms for these liquids or foods. Make sure that the respondent understands the question, particularly what is meant by 'since this time yesterday'. Specify to the mother/primary caretaker: mid-morning, mid-afternoon, etc., depending on the time of the interview. Circle the code corresponding to the response. If the mother/primary caretaker does not know the answer, repeat the question using other local words for the fluid or food. If the answer is still not known, circle '8' for 'DK'
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Child received sweetened water or juice
Child received sweetened water or juice
Child received sweetened water or juice
Child received sweetened water or juice
Child received sweetened water or juice
Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Sweetened, flavoured water or fruit juice or tea or infusion?
This question asks about what the child was fed in the preceding 24 hours. The purpose of this question is to determine what liquids or foods the child was given. Prompt by asking each listed item in turn, such as: "DID (name) RECEIVE VITAMIN OR MINERAL SUPPLEMENTS OR MEDICINE?" or "DID HE/SHE RECEIVE PLAIN WATER?" and so on through the list. Read each item aloud and record the response before proceeding to the next item. Use the local terms for these liquids or foods. Make sure that the respondent understands the question, particularly what is meant by 'since this time yesterday'. Specify to the mother/primary caretaker: mid-morning, mid-afternoon, etc., depending on the time of the interview. Circle the code corresponding to the response. If the mother/primary caretaker does not know the answer, repeat the question using other local words for the fluid or food. If the answer is still not known, circle '8' for 'DK'
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Child received oral rehydration solution
Child received oral rehydration solution
Child received oral rehydration solution
Child received oral rehydration solution
Child received oral rehydration solution
Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Oral rehydration solution (ORS)?
This question asks about what the child was fed in the preceding 24 hours. The purpose of this question is to determine what liquids or foods the child was given. Prompt by asking each listed item in turn, such as: "DID (name) RECEIVE VITAMIN OR MINERAL SUPPLEMENTS OR MEDICINE?" or "DID HE/SHE RECEIVE PLAIN WATER?" and so on through the list. Read each item aloud and record the response before proceeding to the next item. Use the local terms for these liquids or foods. Make sure that the respondent understands the question, particularly what is meant by 'since this time yesterday'. Specify to the mother/primary caretaker: mid-morning, mid-afternoon, etc., depending on the time of the interview. Circle the code corresponding to the response. If the mother/primary caretaker does not know the answer, repeat the question using other local words for the fluid or food. If the answer is still not known, circle '8' for 'DK'
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Child received infant formula
Child received infant formula
Child received infant formula
Child received infant formula
Child received infant formula
Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Infant formula?
This question asks about what the child was fed in the preceding 24 hours. The purpose of this question is to determine what liquids or foods the child was given. Prompt by asking each listed item in turn, such as: "DID (name) RECEIVE VITAMIN OR MINERAL SUPPLEMENTS OR MEDICINE?" or "DID HE/SHE RECEIVE PLAIN WATER?" and so on through the list. Read each item aloud and record the response before proceeding to the next item. Use the local terms for these liquids or foods. Make sure that the respondent understands the question, particularly what is meant by 'since this time yesterday'. Specify to the mother/primary caretaker: mid-morning, mid-afternoon, etc., depending on the time of the interview. Circle the code corresponding to the response. If the mother/primary caretaker does not know the answer, repeat the question using other local words for the fluid or food. If the answer is still not known, circle '8' for 'DK'
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Child received milk
Child received milk
Child received milk
Child received milk
Child received milk
Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Tinned, powdered or fresh milk?
This question asks about what the child was fed in the preceding 24 hours. The purpose of this question is to determine what liquids or foods the child was given. Prompt by asking each listed item in turn, such as: "DID (name) RECEIVE VITAMIN OR MINERAL SUPPLEMENTS OR MEDICINE?" or "DID HE/SHE RECEIVE PLAIN WATER?" and so on through the list. Read each item aloud and record the response before proceeding to the next item. Use the local terms for these liquids or foods. Make sure that the respondent understands the question, particularly what is meant by 'since this time yesterday'. Specify to the mother/primary caretaker: mid-morning, mid-afternoon, etc., depending on the time of the interview. Circle the code corresponding to the response. If the mother/primary caretaker does not know the answer, repeat the question using other local words for the fluid or food. If the answer is still not known, circle '8' for 'DK'
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Child received other liquids
Child received other liquids
Child received other liquids
Child received other liquids
Child received other liquids
Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Any other liquids?
This question asks about what the child was fed in the preceding 24 hours. The purpose of this question is to determine what liquids or foods the child was given. Prompt by asking each listed item in turn, such as: "DID (name) RECEIVE VITAMIN OR MINERAL SUPPLEMENTS OR MEDICINE?" or "DID HE/SHE RECEIVE PLAIN WATER?" and so on through the list. Read each item aloud and record the response before proceeding to the next item. Use the local terms for these liquids or foods. Make sure that the respondent understands the question, particularly what is meant by 'since this time yesterday'. Specify to the mother/primary caretaker: mid-morning, mid-afternoon, etc., depending on the time of the interview. Circle the code corresponding to the response. If the mother/primary caretaker does not know the answer, repeat the question using other local words for the fluid or food. If the answer is still not known, circle '8' for 'DK'
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Child received solid or mushy food
Child received solid or mushy food
Child received solid or mushy food
Child received solid or mushy food
Child received solid or mushy food
Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. Solid or semi-solid (mushy) food?
This question asks about what the child was fed in the preceding 24 hours. The purpose of this question is to determine what liquids or foods the child was given. Prompt by asking each listed item in turn, such as: "DID (name) RECEIVE VITAMIN OR MINERAL SUPPLEMENTS OR MEDICINE?" or "DID HE/SHE RECEIVE PLAIN WATER?" and so on through the list. Read each item aloud and record the response before proceeding to the next item. Use the local terms for these liquids or foods. Make sure that the respondent understands the question, particularly what is meant by 'since this time yesterday'. Specify to the mother/primary caretaker: mid-morning, mid-afternoon, etc., depending on the time of the interview. Circle the code corresponding to the response. If the mother/primary caretaker does not know the answer, repeat the question using other local words for the fluid or food. If the answer is still not known, circle '8' for 'DK'
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Time ate solid, semisolid or soft food other than liquids
Time ate solid, semisolid or soft food other than liquids
Time ate solid, semisolid or soft food other than liquids
Time ate solid, semisolid or soft food other than liquids
Time ate solid, semisolid or soft food other than liquids
Check BF3H: Child received solid or semi-solid (mushy) food? Yes. Continue with BF5 No or DK. Go to Next Module
Since this time yesterday, how many times did (NAME) eat solid, semisolid, or soft foods other than liquids?
If 7 or more times, record '7'.
If the child received solid or semi-solid (mushy) food (BF3H=1), check the box marked 'Yes' and continue to the next question. If 'No' or 'DK', check the corresponding box and go to the next module. --- In this question, we want to find out how many times the child was given non-liquid foods in the 24 hours prior to the interview. Record the number of times in the space provided. If the number is seven or more, record '7'. If the respondent does not know, circle '8'.
Children aged 0-4
7
7+
8
DK
9
Missing
Child had diarrhoea in last 2 weeks
Child had diarrhoea in last 2 weeks
Child had diarrhoea in last 2 weeks
Child had diarrhoea in last 2 weeks
Child had diarrhoea in last 2 weeks
Has (name) had diarrhoea in the last two weeks, that is, since (day of the week) of the week before last?
Diarrhoea is determined as perceived by mother or caretaker, or as three or more loose or watery stools per day, or blood in stool.
These questions aim to find out if the child has recently had diarrhoea or any other illness and, if so, what treatments, drinks and foods the child took during the episode. Diarrhoea is determined by the perception of the mother or caretaker, or by three or more loose or watery stools per day, or by blood in stool. When asking this question, insert the name of the day of the interview. For example, if the interview is taking place on a Tuesday, ask: "HAS (name) HAD DIARRHOEA IN THE LAST TWO WEEKS, THAT IS, SINCE TUESDAY OF THE WEEK BEFORE LAST?" Record the mother's/primary caretaker's answer by circling the corresponding code. If a respondent is not sure what is meant by diarrhoea, tell her/him it means "THREE OR MORE LOOSE OR WATERY STOOLS PER DAY, OR BLOOD IN THE STOOL." Make sure the respondent understands what is meant by 'in the last 2 weeks'. If the child has not had diarrhoea in the last 2 weeks or the caretaker doesn't know, skip to CA5.
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Drank fluid made from special packet (ORS)
Drank fluid made from special packet (ORS)
Drank fluid made from special packet (ORS)
Drank fluid made from special packet (ORS)
Drank fluid made from special packet (ORS)
During this last episode of diarrhoea, did (name) drink any of the following: Read each item aloud and record response before proceeding to the next item. A fluid made from a special packet called (local name for ORS packet solution)?
We want to know if and what type of oral rehydration solution (ORS) the child took during the last episode of diarrhoea. Ask each question separately: "WAS (name) GIVEN A FLUID MADE FROM A SPECIAL PACKET CALLED (local name for ORS packet solution)? WAS HE/SHE GIVEN GOVERNMENT-RECOMMENDED HOMEMADE FLUID?" and so forth. Read each item aloud and circle the code corresponding to the response before proceeding to the next item.
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Government-recommended homemade fluid
Government-recommended homemade fluid
Government-recommended homemade fluid
Government-recommended homemade fluid
Government-recommended homemade fluid
During this last episode of diarrhoea, did (name) drink any of the following: Read each item aloud and record response before proceeding to the next item. Government-recommended homemade fluid?
We want to know if and what type of oral rehydration solution (ORS) the child took during the last episode of diarrhoea. Ask each question separately: "WAS (name) GIVEN A FLUID MADE FROM A SPECIAL PACKET CALLED (local name for ORS packet solution)? WAS HE/SHE GIVEN GOVERNMENT-RECOMMENDED HOMEMADE FLUID?" and so forth. Read each item aloud and circle the code corresponding to the response before proceeding to the next item.
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Pre-packaged ORS fluid for diarrhoea
Pre-packaged ORS fluid for diarrhoea
Pre-packaged ORS fluid for diarrhoea
Pre-packaged ORS fluid for diarrhoea
Pre-packaged ORS fluid for diarrhoea
During this last episode of diarrhoea, did (name) drink any of the following: Read each item aloud and record response before proceeding to the next item. A pre-packaged ORS fluid for diarrhoea?
We want to know if and what type of oral rehydration solution (ORS) the child took during the last episode of diarrhoea. Ask each question separately: "WAS (name) GIVEN A FLUID MADE FROM A SPECIAL PACKET CALLED (local name for ORS packet solution)? WAS HE/SHE GIVEN GOVERNMENT-RECOMMENDED HOMEMADE FLUID?" and so forth. Read each item aloud and circle the code corresponding to the response before proceeding to the next item.
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Child drank less or more during illness
Child drank less or more during illness
Child drank less or more during illness
Child drank less or more during illness
Child drank less or more during illness
During (name's) illness, did he/she drink much less, about the same, or more than usual?
For those children who had diarrhoea in the past 2 weeks, 'illness' in this and the next question refers to the diarrhoea episode. Disregard any additional illness these children might have had. If dehydrated, a child may take more fluids than usual. We want to know if the pattern of fluid consumption changed during the illness. The focus in this question is on how much fluid was actually consumed by the child. Ask the question just as it is worded here. Read out the entire question and circle the appropriate code for the caretaker's response. Get the respondent's best judgement of the relative amount of total fluids actually consumed by the child. All fluids are included, not just special ones given during diarrhoea. For example, water, tea, fruit juice, breastmilk and formula are included as well as special fluids such as ORS. Try to find out what actually happened, not what the respondent thinks ought to have happened. An answer such as, "A child with diarrhoea (or 'a child who is ill') needs more fluids" is not satisfactory. You would need to ask, "BUT HOW MUCH DID YOUR CHILD ACTUALLY DRINK DURING THIS DIARRHOEA?" It may be difficult to estimate the relative amount of breastmilk taken by the child. The respondent may make an estimate based on whether the child nursed longer or more frequently.
Children aged 0-4
1
Much less or none
2
About the same (or somewhat less)
3
More
8
DK
9
Missing
Child ate less or more during illness
Child ate less or more during illness
Child ate less or more during illness
Child ate less or more during illness
Child ate less or more during illness
During (name's) illness, did he/she eat less, about the same, or more food than usual? If "less", probe: Much less or a little less?
During an episode of diarrhoea or other illness, a child may change the amount usually eaten. The focus in this question is on how much food was actually consumed by the child. Ask the question just as it is worded here. Read out the entire question and circle the code corresponding to the caretaker's response. Get the caretaker's best judgement of the relative amount of total food actually consumed by the child. Try to find out what actually happened, not what the caretaker thinks ought to have happened. An answer such as, "A child with diarrhoea (or 'a child who is ill') needs more food" is not satisfactory. You would need to ask, "BUT HOW MUCH DID YOUR CHILD ACTUALLY EAT DURING THIS DIARRHOEA?" If the caretaker replies that the child took only fluids (that is, the child did not 'eat'), circle '1' for 'None'. If the caretaker's answer is 'less than usual', probe by asking "MUCH LESS OR A LITTLE LESS?" to find out if she/he thinks the amount was 'much less' or 'somewhat less'. Then circle the appropriate code. If the mother/primary caretaker offered more food than usual, but the child ate much less, the answer is 'much less'; circle '2'. Make sure that the respondent understands that this includes breastmilk, if the child is still being breastfed. If the child is very young and the caretaker replies that he/she takes only fluids or breastmilk (that is, has not started 'eating' yet), there is no need to probe, since 'drinking' and 'eating' count as the same for this child. Circle the answer for this question (eating) that comes closest to the answer you circle for CA3 (drinking).
Children aged 0-4
1
None
2
Much less
3
Somewhat less
4
About the same
5
More
8
DK
9
Missing
Child ill with cough in last 2 weeks
Child ill with cough in last 2 weeks
Child ill with cough in last 2 weeks
Child ill with cough in last 2 weeks
Child ill with cough in last 2 weeks
Has (name) had an illness with a cough at any time in the last two weeks, that is, since (day of the week) of the week before last?
Illness with a cough means a cold or other acute respiratory illness with a cough. Circle the code corresponding to the response given. If the respondent says "He coughs all the time," or "She's been coughing for months," do not count this as an 'illness with a cough' since it is a chronic problem. If the answer is 'No' or 'DK', circle the appropriate code and go to CA12. If the symptoms started before but continued into the 2-week period, this counts as 'Yes'.
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Difficulty breathing during illness with cough
Difficulty breathing during illness with cough
Difficulty breathing during illness with cough
Difficulty breathing during illness with cough
Difficulty breathing during illness with cough
When (name) had an illness with a cough, did he/she breathe faster than usual with short, quick breaths or have difficulty breathing?
The question aims to find out if the child has or had an illness needing assessment by a health professional (as defined by the US Centers for Disease Control/Integrated Management of Childhood Illness programme). If the respondent asks "What do you mean by 'fast breathing'?" you may say "NOTICEABLY FASTER THAN NORMAL WHEN THE CHILD IS RESTED." If the respondent asks "What do you mean by 'difficulty breathing'?" you may say "THE CHILD SOUNDED/LOOKED AS IF HE/SHE WAS HAVING TROUBLE BREATHING." You may give other explanations that were developed and tested during the adaptation and pre-testing of the questionnaire. Circle the code corresponding to the response. If the answer is 'Yes', continue to the next question. Otherwise, skip to CA12.
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Symptoms due to problem in chest or blocked nose
Symptoms due to problem in chest or blocked nose
Symptoms due to problem in chest or blocked nose
Symptoms due to problem in chest or blocked nose
Symptoms due to problem in chest or blocked nose
Were the symptoms due to a problem in the chest or a blocked nose?
This question aims to find out if the problem needs assessment by a health professional, which does not include a simple cold. Circle the code corresponding to the caretaker's response. If the symptoms were from a 'Blocked nose', skip to CA12. If the symptoms were due to 'Other' reasons, write the respondent's description in the line provided, circle '6' and skip to CA12. Otherwise, continue to the next question.
Children aged 0-4
1
Problem in chest
2
Blocked nose
3
Both
6
Other
8
DK
9
Missing
Sought advice or teatment for illness
Sought advice or teatment for illness
Sought advice or teatment for illness
Sought advice or teatment for illness
Sought advice or teatment for illness
Did you seek advice or treatment for the illness outside the home?
'Seeking care outside the home' means going outside the family or household for advice or treatment. Seeking care could include anything from asking a neighbour for advice, to holding a religious ceremony on the child's behalf, to going to a hospital. If a physician or other provider visits the household to give care, this counts as seeking care outside the home. The child may or may not have accompanied the respondent when he/she sought care. For example, going to buy medicine without the child counts as seeking care. Circle the code corresponding to the response given. If the answer is 'Yes', continue to the next question. Otherwise, skip to CA10.
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Place sought advice or treatment
Place sought advice or treatment
Place sought advice or treatment
Place sought advice or treatment
Place sought advice or treatment
Advice Govt. hospital
Advice Govt. hospital
Advice Govt. hospital
Advice Govt. hospital
Advice Govt. hospital
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response.
Children aged 0-4
?
Missing
A
Govt. hospital
Advice Govt. health centre
Advice Govt. health centre
Advice Govt. health centre
Advice Govt. health centre
Advice Govt. health centre
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response.
Children aged 0-4
?
Missing
B
Govt. health centre
Advice Govt. health post
Advice Govt. health post
Advice Govt. health post
Advice Govt. health post
Advice Govt. health post
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response.
Children aged 0-4
?
Missing
C
Govt. health post
Advice Village health worker
Advice Village health worker
Advice Village health worker
Advice Village health worker
Advice Village health worker
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response.
Children aged 0-4
?
Missing
D
Village health worker
Advice Mobile/outreach clinic
Advice Mobile/outreach clinic
Advice Mobile/outreach clinic
Advice Mobile/outreach clinic
Advice Mobile/outreach clinic
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response.
Children aged 0-4
?
Missing
E
Mobile/outreach clinic
Advice Other public sources
Advice Other public sources
Advice Other public sources
Advice Other public sources
Advice Other public sources
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response.
Children aged 0-4
?
Missing
H
Other public sources
Advice Private hospital/clinic
Advice Private hospital/clinic
Advice Private hospital/clinic
Advice Private hospital/clinic
Advice Private hospital/clinic
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response.
Children aged 0-4
?
Missing
I
Private hospital/clinic
Advice Private phusician
Advice Private phusician
Advice Private phusician
Advice Private phusician
Advice Private phusician
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response.
Children aged 0-4
?
Missing
J
Private physician
Advice Private pharmacy
Advice Private pharmacy
Advice Private pharmacy
Advice Private pharmacy
Advice Private pharmacy
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response.
Children aged 0-4
?
Missing
K
Private pharmacy
Advice Mobile clinic
Advice Mobile clinic
Advice Mobile clinic
Advice Mobile clinic
Advice Mobile clinic
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response.
Children aged 0-4
?
Missing
L
Mobile clinic
Advice Other private medical
Advice Other private medical
Advice Other private medical
Advice Other private medical
Advice Other private medical
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response.
Children aged 0-4
?
Missing
O
Other private medical
Advice Relative or friend
Advice Relative or friend
Advice Relative or friend
Advice Relative or friend
Advice Relative or friend
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response.
Children aged 0-4
?
Missing
P
Relative or friend
Advice Shop
Advice Shop
Advice Shop
Advice Shop
Advice Shop
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response.
Children aged 0-4
?
Missing
Q
Shop
Advice Traditional practitioner
Advice Traditional practitioner
Advice Traditional practitioner
Advice Traditional practitioner
Advice Traditional practitioner
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response.
Children aged 0-4
?
Missing
R
Traditional practitioner
Advice Other
Advice Other
Advice Other
Advice Other
Advice Other
From where did you seek care? Anywhere else?
Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place)
After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response.
Children aged 0-4
?
Missing
X
Other
Given medicine to treat this illness
Given medicine to treat this illness
Given medicine to treat this illness
Given medicine to treat this illness
Given medicine to treat this illness
Was (name) given medicine to treat this illness?
Circle the appropriate code. If the answer is 'Yes', continue to the next question. Otherwise, go to CA12.
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Medicine given to treat illness
Medicine given to treat illness
Medicine given to treat illness
Medicine given to treat illness
Medicine given to treat illness
Medicine Antibiotic
Medicine Antibiotic
Medicine Antibiotic
Medicine Antibiotic
Medicine Antibiotic
What medicine was (name) given?
Circle all medicines given.
This question aims to determine whether the child was given an antibiotic for the illness. More than one medicine may have been administered to the child. Circle the codes corresponding to all medicines given. If the respondent does not know the name of the medicine, ask him/her to show you the medicines. If he/she cannot show the packaged medicine, follow the guidelines provided to you during training. If the respondent names a medicine that is not listed, circle 'X' for 'Other' medicine and fill in the name of the medicine in the space provided. If you cannot determine the type of medicine given to the child with a cough, circle 'Z' for 'DK'.
Children aged 0-4
?
Missing
A
Antibiotic
Medicine Paracetamol/Panadol/Acetaminophen
Medicine Paracetamol/Panadol/Acetaminophen
Medicine Paracetamol/Panadol/Acetaminophen
Medicine Paracetamol/Panadol/Acetaminophen
Medicine Paracetamol/Panadol/Acetaminophen
What medicine was (name) given?
Circle all medicines given.
This question aims to determine whether the child was given an antibiotic for the illness. More than one medicine may have been administered to the child. Circle the codes corresponding to all medicines given. If the respondent does not know the name of the medicine, ask him/her to show you the medicines. If he/she cannot show the packaged medicine, follow the guidelines provided to you during training. If the respondent names a medicine that is not listed, circle 'X' for 'Other' medicine and fill in the name of the medicine in the space provided. If you cannot determine the type of medicine given to the child with a cough, circle 'Z' for 'DK'.
Children aged 0-4
?
Missing
P
Paracetamol/Panadol/Acetaminophenc
Medicine Aspirin
Medicine Aspirin
Medicine Aspirin
Medicine Aspirin
Medicine Aspirin
What medicine was (name) given?
Circle all medicines given.
This question aims to determine whether the child was given an antibiotic for the illness. More than one medicine may have been administered to the child. Circle the codes corresponding to all medicines given. If the respondent does not know the name of the medicine, ask him/her to show you the medicines. If he/she cannot show the packaged medicine, follow the guidelines provided to you during training. If the respondent names a medicine that is not listed, circle 'X' for 'Other' medicine and fill in the name of the medicine in the space provided. If you cannot determine the type of medicine given to the child with a cough, circle 'Z' for 'DK'.
Children aged 0-4
?
Missing
Q
Aspirin
Medicine Ibupropfen
Medicine Ibupropfen
Medicine Ibupropfen
Medicine Ibupropfen
Medicine Ibupropfen
What medicine was (name) given?
Circle all medicines given.
This question aims to determine whether the child was given an antibiotic for the illness. More than one medicine may have been administered to the child. Circle the codes corresponding to all medicines given. If the respondent does not know the name of the medicine, ask him/her to show you the medicines. If he/she cannot show the packaged medicine, follow the guidelines provided to you during training. If the respondent names a medicine that is not listed, circle 'X' for 'Other' medicine and fill in the name of the medicine in the space provided. If you cannot determine the type of medicine given to the child with a cough, circle 'Z' for 'DK'.
Children aged 0-4
?
Missing
R
Ibuprppfen
Medicine Other
Medicine Other
Medicine Other
Medicine Other
Medicine Other
What medicine was (name) given?
Circle all medicines given.
This question aims to determine whether the child was given an antibiotic for the illness. More than one medicine may have been administered to the child. Circle the codes corresponding to all medicines given. If the respondent does not know the name of the medicine, ask him/her to show you the medicines. If he/she cannot show the packaged medicine, follow the guidelines provided to you during training. If the respondent names a medicine that is not listed, circle 'X' for 'Other' medicine and fill in the name of the medicine in the space provided. If you cannot determine the type of medicine given to the child with a cough, circle 'Z' for 'DK'.
Children aged 0-4
?
Missing
X
Other
Medicine DK
Medicine DK
Medicine DK
Medicine DK
Medicine DK
What medicine was (name) given?
Circle all medicines given.
This question aims to determine whether the child was given an antibiotic for the illness. More than one medicine may have been administered to the child. Circle the codes corresponding to all medicines given. If the respondent does not know the name of the medicine, ask him/her to show you the medicines. If he/she cannot show the packaged medicine, follow the guidelines provided to you during training. If the respondent names a medicine that is not listed, circle 'X' for 'Other' medicine and fill in the name of the medicine in the space provided. If you cannot determine the type of medicine given to the child with a cough, circle 'Z' for 'DK'.
Children aged 0-4
?
Missing
Z
DK
What was done to dispose of the stools
What was done to dispose of the stools
What was done to dispose of the stools
What was done to dispose of the stools
What was done to dispose of the stools
Check UF11: Child aged under 3? Yes. Continue with CA13 No. Go to CA14
The last time (name) passed stools, what was done to dispose of the stools?
CA13 is used to filter out children aged 3, 4 and 5 years, since the next question is to be asked only of children under age three. Check UF11; if the child is under three (he/she is 0, 1 or 2 years old), mark the box corresponding to 'Yes' and continue with the next question. If the child is not under three (she/he is 3, 4 or 5 years old), mark the box corresponding to 'No' and skip to CA14. --- The purpose of this question is to know what was done with the most recent stools passed by the child in the household. The safe disposal of children's stools is of particular importance because children's stools are the most likely cause of faecal contamination to the immediate household environment. Correct disposal of stools is linked with lower risks of diarrhoea. Respondents are asked where they usually dispose of their children's stools if the child did not use the toilet facility. Circle the most appropriate code.
Children aged 0-4
1
Child used toilet/latrine
2
Put/rinsed into toilet or latrine
3
Put/rinsed into drain or ditch
4
Thrown into garbage (solid waste)
5
Buried
6
Left in the open
96
Other
98
DK
99
Missing
What type of symptoms would cause to take him to a health fa
What type of symptoms would cause to take him to a health fa
What type of symptoms would cause to take him to a health fa
What type of symptoms would cause to take him to a health fa
What type of symptoms would cause to take him to a health fa
Child not able to drink or breastfeed
Child not able to drink or breastfeed
Child not able to drink or breastfeed
Child not able to drink or breastfeed
Child not able to drink or breastfeed
Ask the following question (CA14) only once for each caretaker.
Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away?
Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions.
This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later.
Children aged 0-4
?
Missing
A
Child not able to drink or breastfeed
Child becomes sicker
Child becomes sicker
Child becomes sicker
Child becomes sicker
Child becomes sicker
Ask the following question (CA14) only once for each caretaker.
Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away?
Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions.
This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later.
Children aged 0-4
?
Missing
B
Child Becomes sicker
Child develops a fever
Child develops a fever
Child develops a fever
Child develops a fever
Child develops a fever
Ask the following question (CA14) only once for each caretaker.
Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away?
Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions.
This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later.
Children aged 0-4
?
Missing
C
Child develops a fever
Child has fast breathing
Child has fast breathing
Child has fast breathing
Child has fast breathing
Child has fast breathing
Ask the following question (CA14) only once for each caretaker.
Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away?
Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions.
This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later.
Children aged 0-4
?
Missing
D
Child has fast breathing
Child has difficult breathing
Child has difficult breathing
Child has difficult breathing
Child has difficult breathing
Child has difficult breathing
Ask the following question (CA14) only once for each caretaker.
Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away?
Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions.
This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later.
Children aged 0-4
?
Missing
E
Child has difficult breathing
Child has blood in stool
Child has blood in stool
Child has blood in stool
Child has blood in stool
Child has blood in stool
Ask the following question (CA14) only once for each caretaker.
Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away?
Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions.
This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later.
Children aged 0-4
?
Missing
F
Child has blood in stool
Child is drinking poorly
Child is drinking poorly
Child is drinking poorly
Child is drinking poorly
Child is drinking poorly
Ask the following question (CA14) only once for each caretaker.
Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away?
Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions.
This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later.
Children aged 0-4
?
Missing
G
Child is drinking poorly
Child has fit, becomes rigid
Child has fit, becomes rigid
Child has fit, becomes rigid
Child has fit, becomes rigid
Child has fit, becomes rigid
Ask the following question (CA14) only once for each caretaker.
Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away?
Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions.
This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later.
Children aged 0-4
?
Missing
X
Child has fit, becomes rigid
Child vomits
Child vomits
Child vomits
Child vomits
Child vomits
Ask the following question (CA14) only once for each caretaker.
Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away?
Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions.
This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later.
Children aged 0-4
?
Missing
Y
Child vomits
Other
Other
Other
Other
Other
Ask the following question (CA14) only once for each caretaker.
Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away?
Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions.
This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later.
Children aged 0-4
?
Missing
Z
Other
Vaccination card for child
Vaccination card for child
Vaccination card for child
Vaccination card for child
Vaccination card for child
If an immunization card is available, copy the dates in IM2-IM8 for each type of immunization or vitamin A dose recorded on the card. IM10-IM18 are for recording vaccinations that are not recorded on the card. IM10-IM18 will only be asked when a card is not available.
Is there a vaccination card for (name)?
If the respondent reports that there is a vaccination card for the child, ask to see it. You should have obtained vaccination cards at the beginning of the interview. If you did not already obtain the card for the child, now is the time to ask for it again. In some cases, the respondent may not be willing to take time to look for the vaccination card, thinking that you are in a hurry. Encourage the respondent to look for the vaccination card for the child. It is critical to obtain written documentation of the child's immunization history. Therefore, be patient if the respondent needs to search for the card. If the respondent does not have a vaccination card but the vaccine doses are registered in another document (for example, a booklet with records of clinic visits), ask to see it. If the card or other document is seen, circle '1' and continue to the next question. If the card or other document is not seen, circle '2' and skip to IM10 - you will be asking the respondent to recall the child's vaccinations. If the respondent does not have a vaccination card or any other document where the vaccine doses are registered for the child, circle '3' and skip to IM10.
Children aged 0-4
1
Yes, seen
2
Yes, not seen
3
No
9
Missing
Day of BCG immunization
Day of BCG immunization
Day of BCG immunization
Day of BCG immunization
Day of BCG immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization BCG
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of BCG immunization
Month of BCG immunization
Month of BCG immunization
Month of BCG immunization
Month of BCG immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization BCG
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
97
Inconsistency
99
Missing
Year of BCG immunization
Year of BCG immunization
Year of BCG immunization
Year of BCG immunization
Year of BCG immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization BCG
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
9997
Inconsistency
9999
Missing
Day of OPV1 immunization
Day of OPV1 immunization
Day of OPV1 immunization
Day of OPV1 immunization
Day of OPV1 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 1
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of OPV1 immunization
Month of OPV1 immunization
Month of OPV1 immunization
Month of OPV1 immunization
Month of OPV1 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 1
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
97
Inconsistency
99
Missing
Year of OPV1 immunization
Year of OPV1 immunization
Year of OPV1 immunization
Year of OPV1 immunization
Year of OPV1 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 1
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
9997
Inconsistency
9999
Missing
Day of OPV2 immunization
Day of OPV2 immunization
Day of OPV2 immunization
Day of OPV2 immunization
Day of OPV2 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 2
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of OPV2 immunization
Month of OPV2 immunization
Month of OPV2 immunization
Month of OPV2 immunization
Month of OPV2 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 2
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
97
Inconsistency
99
Missing
Year of OPV2 immunization
Year of OPV2 immunization
Year of OPV2 immunization
Year of OPV2 immunization
Year of OPV2 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 2
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
9997
Inconsistency
9999
Missing
Day of OPV3 immunization
Day of OPV3 immunization
Day of OPV3 immunization
Day of OPV3 immunization
Day of OPV3 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 3
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of OPV3 immunization
Month of OPV3 immunization
Month of OPV3 immunization
Month of OPV3 immunization
Month of OPV3 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 3
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
97
Inconsistency
99
Missing
Year of OPV3 immunization
Year of OPV3 immunization
Year of OPV3 immunization
Year of OPV3 immunization
Year of OPV3 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio 3
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
9997
Inconsistency
9999
Missing
Day of OPV4 immunization
Day of OPV4 immunization
Day of OPV4 immunization
Day of OPV4 immunization
Day of OPV4 immunization
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of OPV4 immunization
Month of OPV4 immunization
Month of OPV4 immunization
Month of OPV4 immunization
Month of OPV4 immunization
97
Inconsistency
99
Missing
Year of OPV4 immunization
Year of OPV4 immunization
Year of OPV4 immunization
Year of OPV4 immunization
Year of OPV4 immunization
9997
Inconsistency
9999
Missing
Day of OPV5 immunization
Day of OPV5 immunization
Day of OPV5 immunization
Day of OPV5 immunization
Day of OPV5 immunization
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of OPV5 immunization
Month of OPV5 immunization
Month of OPV5 immunization
Month of OPV5 immunization
Month of OPV5 immunization
97
Inconsistency
99
Missing
Year of OPV5 immunization
Year of OPV5 immunization
Year of OPV5 immunization
Year of OPV5 immunization
Year of OPV5 immunization
9997
Inconsistency
9999
Missing
Day of DPT1 immunization
Day of DPT1 immunization
Day of DPT1 immunization
Day of DPT1 immunization
Day of DPT1 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 1
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of DPT1 immunization
Month of DPT1 immunization
Month of DPT1 immunization
Month of DPT1 immunization
Month of DPT1 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 1
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
97
Inconsistency
99
Missing
Year of DPT1 immunization
Year of DPT1 immunization
Year of DPT1 immunization
Year of DPT1 immunization
Year of DPT1 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 1
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
9997
Inconsistency
9999
Missing
Day of DPT2 immunization
Day of DPT2 immunization
Day of DPT2 immunization
Day of DPT2 immunization
Day of DPT2 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 2
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of DPT2 immunization
Month of DPT2 immunization
Month of DPT2 immunization
Month of DPT2 immunization
Month of DPT2 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 2
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
97
Inconsistency
99
Missing
Year of DPT2 immunization
Year of DPT2 immunization
Year of DPT2 immunization
Year of DPT2 immunization
Year of DPT2 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 2
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
9997
Inconsistency
9999
Missing
Day of DPT3 immunization
Day of DPT3 immunization
Day of DPT3 immunization
Day of DPT3 immunization
Day of DPT3 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 3
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of DPT3 immunization
Month of DPT3 immunization
Month of DPT3 immunization
Month of DPT3 immunization
Month of DPT3 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 3
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
97
Inconsistency
99
Missing
Year of DPT3 immunization
Year of DPT3 immunization
Year of DPT3 immunization
Year of DPT3 immunization
Year of DPT3 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization DPT 3
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
9997
Inconsistency
9999
Missing
Day of DPT4 immunization
Day of DPT4 immunization
Day of DPT4 immunization
Day of DPT4 immunization
Day of DPT4 immunization
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of DPT4 immunization
Month of DPT4 immunization
Month of DPT4 immunization
Month of DPT4 immunization
Month of DPT4 immunization
97
Inconsistency
99
Missing
Year of DPT4 immunization
Year of DPT4 immunization
Year of DPT4 immunization
Year of DPT4 immunization
Year of DPT4 immunization
9997
Inconsistency
9999
Missing
Day of DPT5 immunization
Day of DPT5 immunization
Day of DPT5 immunization
Day of DPT5 immunization
Day of DPT5 immunization
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of DPT5 immunization
Month of DPT5 immunization
Month of DPT5 immunization
Month of DPT5 immunization
Month of DPT5 immunization
97
Inconsistency
99
Missing
Year of DPT5 immunization
Year of DPT5 immunization
Year of DPT5 immunization
Year of DPT5 immunization
Year of DPT5 immunization
9997
Inconsistency
9999
Missing
Day of HepB1 or DPTHepB1 immunization
Day of HepB1 or DPTHepB1 immunization
Day of HepB1 or DPTHepB1 immunization
Day of HepB1 or DPTHepB1 immunization
Day of HepB1 or DPTHepB1 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization HepB1 (or DPTHepB1)
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of HepB1 or DPThepB1 immunization
Month of HepB1 or DPThepB1 immunization
Month of HepB1 or DPThepB1 immunization
Month of HepB1 or DPThepB1 immunization
Month of HepB1 or DPThepB1 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization HepB1 (or DPTHepB1)
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
97
Inconsistency
99
Missing
Year of HepB1 or DPTHepB1 immunization
Year of HepB1 or DPTHepB1 immunization
Year of HepB1 or DPTHepB1 immunization
Year of HepB1 or DPTHepB1 immunization
Year of HepB1 or DPTHepB1 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization HepB1 (or DPTHepB1)
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
9997
Inconsistency
9999
Missing
Day HepB2 or DPTHepB2 immunization
Day HepB2 or DPTHepB2 immunization
Day HepB2 or DPTHepB2 immunization
Day HepB2 or DPTHepB2 immunization
Day HepB2 or DPTHepB2 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization HepB2 (or DPTHepB2)
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of HepB2 or DPTHepB2 imunization
Month of HepB2 or DPTHepB2 imunization
Month of HepB2 or DPTHepB2 imunization
Month of HepB2 or DPTHepB2 imunization
Month of HepB2 or DPTHepB2 imunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization HepB2 (or DPTHepB2)
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
97
Inconsistency
99
Missing
Year of HepB2 or DPTHepB2 immunization
Year of HepB2 or DPTHepB2 immunization
Year of HepB2 or DPTHepB2 immunization
Year of HepB2 or DPTHepB2 immunization
Year of HepB2 or DPTHepB2 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization HepB2 (or DPTHepB2)
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
9997
Inconsistency
9999
Missing
Day of DPTHepB3 or HepB3 immunization
Day of DPTHepB3 or HepB3 immunization
Day of DPTHepB3 or HepB3 immunization
Day of DPTHepB3 or HepB3 immunization
Day of DPTHepB3 or HepB3 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization HepB3 (or DPTHepB3)
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month of DPTHepB3 or HepB3 ummunization
Month of DPTHepB3 or HepB3 ummunization
Month of DPTHepB3 or HepB3 ummunization
Month of DPTHepB3 or HepB3 ummunization
Month of DPTHepB3 or HepB3 ummunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization HepB3 (or DPTHepB3)
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
97
Inconsistency
99
Missing
Year of DPTHepB3 or HepB3 immunization
Year of DPTHepB3 or HepB3 immunization
Year of DPTHepB3 or HepB3 immunization
Year of DPTHepB3 or HepB3 immunization
Year of DPTHepB3 or HepB3 immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization HepB3 (or DPTHepB3)
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
9997
Inconsistency
9999
Missing
Day measles or MMR immunization
Day measles or MMR immunization
Day measles or MMR immunization
Day measles or MMR immunization
Day measles or MMR immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Measles (or MMR)
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
Not given
44
Marked on card - no date given
66
Reported by mother
97
Inconsistency
98
DK
99
Missing
Month Measles or MMR immunization
Month Measles or MMR immunization
Month Measles or MMR immunization
Month Measles or MMR immunization
Month Measles or MMR immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Measles (or MMR)
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
97
Inconsistency
99
Missing
Year of Measles or MMR immunization
Year of Measles or MMR immunization
Year of Measles or MMR immunization
Year of Measles or MMR immunization
Year of Measles or MMR immunization
(a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Measles (or MMR)
You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9.
Children aged 0-4
9997
Inconsistency
9999
Missing
Child received any other vaccinations
Child received any other vaccinations
Child received any other vaccinations
Child received any other vaccinations
Child received any other vaccinations
In addition to the vaccinations and vitamin A capsules shown on this card, did (name) receive any other vaccinations - including vaccinations received in campaigns or immunization days?
Record 'Yes' only if respondent mentions BCG, OPV 0-3, DPT 1-3, Hepatitis B 1-3, Measles, Yellow Fever vaccine(s), or Vitamin A supplements. (If yes, Probe for vaccinations and write '66' in the corresponding day column on IM2 to IM8B.)
It is possible that some of the vaccinations received by the child were not recorded. For example, the respondent may have forgotten to bring the card to the health facility or the respondent may have taken (name) to a National Immunization Day. If the answer is 'Yes', circle '1' only if the respondent mentions vaccines included in the questionnaire. You can refer to the information already obtained from the vaccination card to make sure that the mother/primary caretaker is referring only to these vaccines. Write '66' in the corresponding 'Day' column for IM2-IM8B, and leave the month and year columns blank. For example, if two doses of DPT were recorded on the card, and another dose was given but not recorded, the answer to IM4C should be '66' in the 'Day' column. Do not ask the respondent to supply dates from memory. Enter a date only if the card or other document is available and lists a date for the immunization dose. Once you have probed for all vaccinations, skip to IM19.
1
Yes
2
No
8
DK
9
Missing
Child ever received any vaccinations
Child ever received any vaccinations
Child ever received any vaccinations
Child ever received any vaccinations
Child ever received any vaccinations
Has (name) ever received any vaccinations to prevent him/her from getting diseases, including vaccinations received in a campaign or immunization day?
Questions IM10 through IM18 are asked only to mothers/primary caretakers of children who do not have vaccination cards, or those children for whom vaccination cards were not shown. --- Only ask IM10-18 to obtain the child's vaccination status if a vaccination card or other document is not available (that is, if the answer to IM1 was '2' for 'Yes, 'Not seen' or '3' for 'No'). Describe the vaccination techniques in detail to the caretaker and provide further explanations if needed. When mentioning the vaccines or the specific diseases, use local synonyms if needed. We are not interested in injections for treating a disease - antibiotics, antimalarials, etc. - but only in vaccines. Circle the code corresponding to the response. If the answer is 'Yes', continue to the next question, to start asking about each of the vaccines. If the answer is 'No' or 'DK', skip to IM19.
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Child ever given BCG vaccination
Child ever given BCG vaccination
Child ever given BCG vaccination
Child ever given BCG vaccination
Child ever given BCG vaccination
Has (name) ever been given a BCG vaccination against tuberculosis - that is, an injection in the arm or shoulder that caused a scar?
Questions IM10 through IM18 are asked only to mothers/primary caretakers of children who do not have vaccination cards, or those children for whom vaccination cards were not shown. --- Circle the code corresponding to the response.
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Child ever given Polio vaccination
Child ever given Polio vaccination
Child ever given Polio vaccination
Child ever given Polio vaccination
Child ever given Polio vaccination
Has (name) ever been given any "vaccination drops in the mouth" to protect him/her from getting diseases - that is, polio?
Questions IM10 through IM18 are asked only to mothers/primary caretakers of children who do not have vaccination cards, or those children for whom vaccination cards were not shown. --- Circle the code corresponding to the response. If the answer is 'Yes', continue to the next question. If the answer is 'No' or 'DK', skip to IM15.
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Polio first given just after birth or later
Polio first given just after birth or later
Polio first given just after birth or later
Polio first given just after birth or later
Polio first given just after birth or later
How old was he/she when the first dose was given - just after birth (within two weeks) or later?
Questions IM10 through IM18 are asked only to mothers/primary caretakers of children who do not have vaccination cards, or those children for whom vaccination cards were not shown. --- Ask how old the child was at first dose, prompting "JUST AFTER BIRTH OR LATER?" Circle the code corresponding to the response.
Children aged 0-4
1
Just after birth (within 2 weeks)
2
Later
9
Missing
Times child given Polio vaccination
Times child given Polio vaccination
Times child given Polio vaccination
Times child given Polio vaccination
Times child given Polio vaccination
How many times has he/she been given these drops?
Questions IM10 through IM18 are asked only to mothers/primary caretakers of children who do not have vaccination cards, or those children for whom vaccination cards were not shown. --- Fill in the number in the space provided.
Children aged 0-4
99
Missing
Child ever given DPT vaccination
Child ever given DPT vaccination
Child ever given DPT vaccination
Child ever given DPT vaccination
Child ever given DPT vaccination
Has (name) ever been given "DPT vaccination injections" - that is, an injection in the thigh or buttocks - to prevent him/her from getting tetanus, whooping cough, diphtheria? (sometimes given at the same time as polio)
Questions IM10 through IM18 are asked only to mothers/primary caretakers of children who do not have vaccination cards, or those children for whom vaccination cards were not shown. --- Circle the code corresponding to the response. If the answer is 'Yes', continue to the next question. If 'No' or 'DK', skip to IM17.
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Times child given DPT vaccination
Times child given DPT vaccination
Times child given DPT vaccination
Times child given DPT vaccination
Times child given DPT vaccination
How many times?
Questions IM10 through IM18 are asked only to mothers/primary caretakers of children who do not have vaccination cards, or those children for whom vaccination cards were not shown. --- Fill in the number in the space provided.
Children aged 0-4
99
Missing
Child ever given Measles or MMR vaccination
Child ever given Measles or MMR vaccination
Child ever given Measles or MMR vaccination
Child ever given Measles or MMR vaccination
Child ever given Measles or MMR vaccination
Has (name) ever been given "Measles vaccination injections" or MMR - that is, a shot in the arm at the age of 9 months or older - to prevent him/her from getting measles?
Questions IM10 through IM18 are asked only to mothers/primary caretakers of children who do not have vaccination cards, or those children for whom vaccination cards were not shown. --- Circle the code corresponding to the response. If the caretaker specifically mentions measles vaccine but refers to an injection in the thigh, accept the answer as valid and circle '1' for 'Yes'.
Children aged 0-4
1
Yes
2
No
8
DK
9
Missing
Child participated in national immunization day A
Child participated in national immunization day A
Child participated in national immunization day A
Child participated in national immunization day A
Child participated in national immunization day A
1
Yes
2
No
8
DK
9
Missing
Child's weight (kilograms)
Child's weight (kilograms)
Child's weight (kilograms)
Child's weight (kilograms)
Child's weight (kilograms)
After questionnaires for all children are complete, the measurer weighs and measures each child. Record weight and length/height below, taking care to record the measurements on the correct questionnaire for each child. Check the child's name and line number on the household listing before recording measurements. Child's weight.
Weights and heights of all eligible children under five in the household will be measured after all the Questionnaires for Children Under Five are completed. However, if some respondents or children have to leave the household before all questionnaires in the household have been completed, or if a call-back has to be made to interview another respondent, it is best to complete the measurements on those children who are present. The most important thing is not to miss measuring those who are eligible. Measurement of heights and weights will normally be the responsibility of field editors. Each fieldwork team will have one set of measuring boards and weighing scales. Therefore, once you have completed the questionnaires and are ready to start anthropometric measurements, you should call upon field editors to join you in the household, together with the equipment. Although the field editor will be the main team member responsible for anthropometric measurements, you will also receive training on how to weigh and measure children. In some cases, the entrance of field editors to the household may not be possible; in such cases, you may yourself perform the measurements, with the assistance of the mother. Each child will be weighed and measured, and the results will be recorded in his/her questionnaire. Be sure the weight for each child is recorded on the correct questionnaire. Procedures for weight and height measurements are discussed in detail in Appendix Five. This section is confined to explaining how the results will be coded. --- The child should be weighed according to the instructions given during training. Record the result to the nearest tenth of a kilogram (100 grams). Place the kilograms to the left of the decimal point and grams to the right of the decimal point. Use a leading zero if the number of kilograms is one digit.
Children aged 0-4
99.9
Missing
Child measured lying or standing
Child measured lying or standing
Child measured lying or standing
Child measured lying or standing
Child measured lying or standing
Child's length or height.
Check age of child in UF11: Child under 2 years old. Measure length (lying down). Child age 2 or more years. Measure height (standing up).
Weights and heights of all eligible children under five in the household will be measured after all the Questionnaires for Children Under Five are completed. However, if some respondents or children have to leave the household before all questionnaires in the household have been completed, or if a call-back has to be made to interview another respondent, it is best to complete the measurements on those children who are present. The most important thing is not to miss measuring those who are eligible. Measurement of heights and weights will normally be the responsibility of field editors. Each fieldwork team will have one set of measuring boards and weighing scales. Therefore, once you have completed the questionnaires and are ready to start anthropometric measurements, you should call upon field editors to join you in the household, together with the equipment. Although the field editor will be the main team member responsible for anthropometric measurements, you will also receive training on how to weigh and measure children. In some cases, the entrance of field editors to the household may not be possible; in such cases, you may yourself perform the measurements, with the assistance of the mother. Each child will be weighed and measured, and the results will be recorded in his/her questionnaire. Be sure the weight for each child is recorded on the correct questionnaire. Procedures for weight and height measurements are discussed in detail in Appendix Five. This section is confined to explaining how the results will be coded. --- Check the age of the child in UF11. If the child is under 2 years old, check the appropriate box, measure and record recumbent length (that is, lying down), to the nearest tenth of a centimetre. If the child is age two or older, check the corresponding box and then measure and record standing height. Write a zero first if the number of centimetres is two digits.
Children aged 0-4
1
Lying down
2
Standing up
9
Missing
Child's length or height
Child's length or height
Child's length or height
Child's length or height
Child's length or height
Child's length or height.
Check age of child in UF11: Child under 2 years old. Measure length (lying down). Child age 2 or more years. Measure height (standing up).
Weights and heights of all eligible children under five in the household will be measured after all the Questionnaires for Children Under Five are completed. However, if some respondents or children have to leave the household before all questionnaires in the household have been completed, or if a call-back has to be made to interview another respondent, it is best to complete the measurements on those children who are present. The most important thing is not to miss measuring those who are eligible. Measurement of heights and weights will normally be the responsibility of field editors. Each fieldwork team will have one set of measuring boards and weighing scales. Therefore, once you have completed the questionnaires and are ready to start anthropometric measurements, you should call upon field editors to join you in the household, together with the equipment. Although the field editor will be the main team member responsible for anthropometric measurements, you will also receive training on how to weigh and measure children. In some cases, the entrance of field editors to the household may not be possible; in such cases, you may yourself perform the measurements, with the assistance of the mother. Each child will be weighed and measured, and the results will be recorded in his/her questionnaire. Be sure the weight for each child is recorded on the correct questionnaire. Procedures for weight and height measurements are discussed in detail in Appendix Five. This section is confined to explaining how the results will be coded. --- Check the age of the child in UF11. If the child is under 2 years old, check the appropriate box, measure and record recumbent length (that is, lying down), to the nearest tenth of a centimetre. If the child is age two or older, check the corresponding box and then measure and record standing height. Write a zero first if the number of centimetres is two digits.
Children aged 0-4
999.9
Missing
Result of measurement
Result of measurement
Result of measurement
Result of measurement
Result of measurement
Result of measurement.
Circle the appropriate code corresponding to the result of the measurement. If the reason is 'Other', write a description in the line provided and circle '6'.
Children aged 0-4
1
Measured
2
Not present
3
Refused
6
Other
7
Inconsistent
9
Missing
Height for age percentile
Height for age percentile
Height for age percentile
Height for age percentile
Height for age percentile
Recoded variable
Is (name) male or female?
Children aged 0-4
Height for age z-score
Height for age z-score
Height for age z-score
Height for age z-score
Height for age z-score
Recoded variable
Is (name) male or female?
Children aged 0-4
Height for age percent of reference median
Height for age percent of reference median
Height for age percent of reference median
Height for age percent of reference median
Height for age percent of reference median
Recoded variable
Is (name) male or female?
Children aged 0-4
Weight for age percentile
Weight for age percentile
Weight for age percentile
Weight for age percentile
Weight for age percentile
Recoded variable
Is (name) male or female?
Children aged 0-4
Weight for age z-score
Weight for age z-score
Weight for age z-score
Weight for age z-score
Weight for age z-score
Recoded variable
Is (name) male or female?
Children aged 0-4
Weight for age percent of reference median
Weight for age percent of reference median
Weight for age percent of reference median
Weight for age percent of reference median
Weight for age percent of reference median
Recoded variable
Is (name) male or female?
Children aged 0-4
Weight for height percentile
Weight for height percentile
Weight for height percentile
Weight for height percentile
Weight for height percentile
Recoded variable
Is (name) male or female?
Children aged 0-4
Weight for height z-score
Weight for height z-score
Weight for height z-score
Weight for height z-score
Weight for height z-score
Recoded variable
Is (name) male or female?
Children aged 0-4
Weight for height percent of reference median
Weight for height percent of reference median
Weight for height percent of reference median
Weight for height percent of reference median
Weight for height percent of reference median
Recoded variable
Is (name) male or female?
Children aged 0-4
Flag for anthropometric indicators
Flag for anthropometric indicators
Flag for anthropometric indicators
Flag for anthropometric indicators
Flag for anthropometric indicators
Recoded variable
Is (name) male or female?
Children aged 0-4
No flag
1
Height for age
2
Weight for height
3
Weight for height, Height for age
4
Weight for age
5
Weight for age, Height for age
6
Weight for age, Weight for height
7
Weight for age, Weight for height, Height for age
Sex
Sex
Sex
Sex
Sex
Children aged 0-4
1
Male
2
Female
Highest level of school attended
Highest level of school attended
Highest level of school attended
Highest level of school attended
Highest level of school attended
What is the highest level of school (name) attended?
Children aged 0-4
Preschool/kindergarten
1
Primary
2
Secondary
3
Higher
6
Non-standard curriculum
8
DK
9
Missing
Region
Region
Region
Region
Region
Region:
Circle the code for region.
Households
2
Central (include BKK.)
3
North
4
Northeast
5
South
Changwat/Province
Changwat/Province
Changwat/Province
Changwat/Province
Changwat/Province
Area
Area
Area
Area
Area
Area:
Circle the code for area of residence as instructed by your supervisor. This will have been pre-determined; you will not be required to assess whether the household is in an urban or rural area.
Households
1
Urban
2
Rural
PSU_NO
PSU_NO
PSU_NO
PSU_NO
PSU_NO
Day of interview
Day of interview
Day of interview
Day of interview
Day of interview
Day/Month/Year of interview:
Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household.
Households
Month of interview
Month of interview
Month of interview
Month of interview
Month of interview
Day/Month/Year of interview:
Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household.
Households
Year of interview
Year of interview
Year of interview
Year of interview
Year of interview
Day/Month/Year of interview:
Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household.
Households
Respondent HH questionnaire
Respondent HH questionnaire
Respondent HH questionnaire
Respondent HH questionnaire
Respondent HH questionnaire
Respondent to HH questionnaire:
Enter the name and line number (from the Household Listing, columns HL1 and HL2) of the respondent to the Household Questionnaire.
Households
99
Missing
Number of household members
Number of household members
Number of household members
Number of household members
Number of household members
Total number of household members:
Count the number of household members recorded in column HL1 of the Household Listing and enter the total here.
Households
Total eligible women
Total eligible women
Total eligible women
Total eligible women
Total eligible women
No.of women eligible for interview:
Enter the total number of women eligible for interview for the Questionnaire for Individual Women - you will copy this from the row for totals at the bottom of the Household Listing, for HL6.
Households
Women interviews completed
Women interviews completed
Women interviews completed
Women interviews completed
Women interviews completed
No.of women questionnaires completed:
Once all of the Questionnaires for Individual Women have been completed for a particular household, enter the number completed here.
Households
Total children under 5
Total children under 5
Total children under 5
Total children under 5
Total children under 5
No.of children under age 5:
Enter the total number of children under five eligible for inclusion in the survey from the row for totals at the bottom of the Household Listing, for HL8. You will be using the Questionnaire for Children Under Five to interview the mothers or primary caretakers of these children.
Households
Child interviews completed
Child interviews completed
Child interviews completed
Child interviews completed
Child interviews completed
No.of under-5 questionnaires completed:
Once all of the Questionnaires for Children Under Five have been completed for a particular household, enter the number completed here.
Households
Enu. Result
Enu. Result
Enu. Result
Enu. Result
Enu. Result
After all questionnaires for the household have been completed, fill in the following information: Result of HH interview:
If the Household Questionnaire is completed, circle '1' for 'Completed'. If you have not been able to contact the household after repeated visits, circle '2' for 'Not at home'. If the household refuses to be interviewed, circle '3' for 'Refused'. If you are unable to locate the household or if the dwelling is destroyed, circle '4' for 'HH not found/destroyed'. If you have not been able to complete the Household Questionnaire for another reason, you should circle '6' for 'Other' and specify the reason in the space provided. Some examples of 'Other' codes might be: the household respondent is incapacitated; the questionnaire is partly completed; adult household members were not found at home after repeated visits.
Households
1
Completed
2
Refused
3
Not at home
4
HH not found/destroyed
6
Others
Main source of drinking water
Main source of drinking water
Main source of drinking water
Main source of drinking water
Main source of drinking water
What is the main source of drinking water for members of your household?
The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). '51' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof or ground catchment and stored in a container, tank or cistern until used. '61' - A tanker-truck water source transports and sells water by means of a tanker truck. '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. --- Circle the code for the most usual source. If several sources are mentioned, probe to determine the most usual source. If the source varies by season, record the source for the season of the interview. Note that the next question is only asked if the response to this question is 'Bottled water'. You should skip WS2 if the response to WS1 is other than 'Bottled water'. If the response is 'Piped into dwelling' or 'Piped into yard/plot', circle '11' or '12', respectively, and skip to WS5. Otherwise, skip to WS3.
Households
11
Piped into dwelling
12
Piped into yard or plot
13
Public tap/standpipe
21
Tubewell/borehole
31
Protected well
32
Unprotected well
41
Protected spring
42
Unprotected spring
51
Rainwater collection
61
Tanker-truck
81
Surface water
91
Bottled water
96
Other
99
Missing
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
Main source of water used for other purposes (if bottled wat
What is the main source of water used by your household for other purposes such as cooking and handwashing?
The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). '51' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof or ground catchment and stored in a container, tank or cistern until used. '61' - A tanker-truck water source transports and sells water by means of a tanker truck. '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. --- This question should only be asked to households that use 'Bottled water' for drinking. Circle the code for the most usual source. If the source varies by season, record the source for the season of the interview. If the most usual source of non-drinking water is 'Piped into dwelling' or 'Piped into yard/plot', circle '11' or '12', respectively, and skip to WS5. Otherwise continue to the next question.
Households
11
Piped into dwelling
12
Piped into yard or plot
13
Public tap/standpipe
21
Tubewell/borehole
31
Protected well
32
Unprotected well
41
Protected spring
42
Unprotected spring
51
Rainwater collection
61
Tanker-truck
81
Surface water
96
Other
99
Missing
Time to get water and come back
Time to get water and come back
Time to get water and come back
Time to get water and come back
Time to get water and come back
How long does it take to go there, get water, and come back?
This question is used to find out how convenient the source of water is to the dwelling. Note that the question is asked for water sources coded as '13-81' and '96' in WS1, or water sources coded as '13-96' in WS2. Fill in the estimated time (in minutes, converting from hours, if necessary) it takes by the usual mode of transport to get to the water source, wait to get water, and get back to the dwelling. Use zero(s) preceding the number if less than 100 minutes (for example, '060' or '005'). Then continue to the next question. If the water source is on the dwelling premises or if water is delivered to the dwelling by a vendor, circle '995' for 'Water on premises' and skip to WS5. If the respondent does not know how long it takes, circle '998' and continue on to the next question.
Households
995
On premises
998
DK
999
Missing
Person fetching water
Person fetching water
Person fetching water
Person fetching water
Person fetching water
Who usually goes to this source to fetch the water for your household? Probe: Is this person under age 15? What sex?
Circle code that best describes this person.
The purpose of this question is to find out the age and gender of the person who usually performs the task of hauling water. This will provide an understanding of whether water hauling responsibilities are given to members of a particular sex or age group. Probe: "IS THIS PERSON UNDER AGE 15? WHAT SEX IS THIS PERSON?" Circle the code that corresponds with the response or '8' if the respondent does not know. Adult refers to anyone age 15 or over, regardless of whether he/she is a household member. Child refers to anyone under the age of 15, regardless of whether he/she is a household member.
Households
1
Adult woman
2
Adult man
3
Female child (under 15)
4
Male child (under 15)
8
DK
9
Missing
Treat water to make safer for drinking
Treat water to make safer for drinking
Treat water to make safer for drinking
Treat water to make safer for drinking
Treat water to make safer for drinking
Do you treat your water in any way to make it safer to drink?
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle '1' if 'Yes', and continue to the next question. If 'No' or 'DK' (Doesn't know'), circle '2' or '8', respectively, and skip to WS7.
Households
1
Yes
2
No
8
DK
9
Missing
Boil
Boil
Boil
Boil
Boil
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
A
Boil
Add bleach/chlorine
Add bleach/chlorine
Add bleach/chlorine
Add bleach/chlorine
Add bleach/chlorine
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
B
Add bleach/chlorine
Strain it through a cloth
Strain it through a cloth
Strain it through a cloth
Strain it through a cloth
Strain it through a cloth
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
C
Strain it through a cloth
Use water filter
Use water filter
Use water filter
Use water filter
Use water filter
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
D
Use water filter
Solar disinfection
Solar disinfection
Solar disinfection
Solar disinfection
Solar disinfection
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
E
Solar disinfection
Let it stand and settle
Let it stand and settle
Let it stand and settle
Let it stand and settle
Let it stand and settle
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
F
Let it stand and settle
Other
Other
Other
Other
Other
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
X
Other
DK
DK
DK
DK
DK
What do you usually do to the water to make it safer to drink? Anything else?
Record all items mentioned.
The purpose of the following two questions, WS5 and WS6, is to determine whether the household drinking water is treated within the household and, if so, what type of treatment is used. This question is intended to gather information on water treatment at the household level and not water treatment at the municipal or vendor level. --- Circle the code corresponding to the response. The household may be using a method that you know does not make water safer to drink. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be filtering the water and adding chlorine at the same time). Probe: "Anything else?" Circle 'X' for 'Other' and specify on the line provided what the household does to the water to make it safer to drink. Circle 'Z' if the respondent 'Doesn't know'. Definitions of various methods of water treatment are as follows: 'A' - Boil refers to boiling or heating water with fuel. 'B' - Add bleach/chlorine refers to using liquid chlorine bleach or bleaching powder to treat drinking water. SURVEY COORDINATORS: FREE CHLORINE MAY BE USED IN THE FORM OF LIQUID SODIUM HYPOCHLORITE, SOLID CALCIUM HYPOCHLORITE AND BLEACHING POWDER (CHLORIDE OF LIME) 'C' - Strain it through a cloth refers to pouring water through a cloth that acts as a filter for collecting particles from the water. 'D' - Use water filter involves water flowing through a filter made of ceramic, sand or a combination of materials to remove particles and at least some microbes from the water. SURVEY COORDINATORS: CERAMIC MAY INCLUDE CLAYS, DIATOMACEOUS EARTH, GLASS AND OTHER FINE PARTICLES. 'E' - Solar disinfection consists of exposing water, stored in buckets, containers or clear vessels, to sunlight. 'F' - Let it stand and settle refers to storing water undisturbed and without mixing long enough for larger particles to settle to the bottom by gravity. The settled water is carefully removed by decanting, ladling or other gentle methods that do not disturb the settled particles.
Households
?
Missing
Z
DK
Kind of toilet facility
Kind of toilet facility
Kind of toilet facility
Kind of toilet facility
Kind of toilet facility
What kind of toilet facility do members of your household usually use? If "flush" or "pour flush", probe: Where does it flush to?
If necessary, ask permission to observe the facility.
Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of this question is to obtain a measure of the cleanliness of the sanitary facility used by the household members. It may be necessary to observe the facility. If so, ask permission to do so. If the respondent answers or it is observed that the household members have no facilities or use the bush or field, enter '95' for 'No facilities or bush or field' and skip to the next module. If any of the flush or pour flush responses (11-15) are given, probe: "WHERE DOES IT FLUSH TO?" Circle the code corresponding to the response given. Definitions of various types of toilet facilities are as follows: A flush toilet uses a cistern or holding tank for flushing water and has a water seal, which is a U-shaped pipe, below the seat or squatting pan that prevents the passage of flies and odours. A pour flush toilet uses a water seal, but unlike a flush toilet, a pour flush toilet uses water poured by hand for flushing (no cistern is used). . '11' - A piped sewer system is a system of sewer pipes, also called sewerage, that is designed to collect human excreta (faeces and urine) and wastewater and remove them from the household environment. Sewerage systems consist of facilities for collection, pumping, treating and disposing of human excreta and wastewater. . '12' - A septic tank is an excreta collection device and is a water-tight settling tank normally located underground, away from the house or toilet. . '13' - A flush/pour flush to pit latrine refers to a system that flushes excreta to a hole in the ground. . '14' - A flush/pour flush to somewhere else refers to excreta being deposited in or nearby the household environment (not into pit, septic tank or sewer); excreta may be flushed to the street, yard/plot, drainage way or other location. . '15' - Flush to unknown place/not sure/DK where should be coded in cases when the respondent knows that the toilet facility is a flush toilet, but does not know where it flushes to. '21' - A ventilated improved pit latrine or VIP is a type of pit latrine that is ventilated by a pipe extending above the latrine roof. The open end of the vent pipe is covered with gauze mesh or fly-proof netting and the inside of the superstructure is kept dark. '22' - A pit latrine with slab uses a hole in the ground for excreta collection and has a squatting slab, platform or seat that is firmly supported on all sides, easy to clean and raised above the surrounding ground level to prevent surface water from entering the pit. '23' - A pit latrine without slab uses a hole in the ground for excreta collection and does not have a squatting slab, platform or seat. An open pit is a rudimentary hole in the ground where excreta is collected. '31' - A composting toilet is a toilet into which excreta and carbon-rich material are added (vegetable wastes, straw, grass, sawdust, ash) and special conditions maintained to produce inoffensive compost. '41' - Bucket refers to the use of a bucket or other container for the retention of faeces (and sometimes urine and anal cleaning material), which is periodically removed for treatment or disposal. '51' - A hanging toilet or hanging latrine is a toilet built over the sea, a river, or other body of water into which excreta drops directly. '95' - No facilities or bush or field includes excreta wrapped and thrown with garbage, the 'cat' method of burying excreta in dirt, defecation in the bush or field or ditch, and defecation into surface water (drainage channel, beach, river, stream or sea).
Households
11
Flush to piped sewer system
12
Flush to septic tank
13
Flush to pit (latrine)
14
Flush to somewhere else
15
Flush to unknown place/not sure/DK where
22
Pit latrine with slab
23
Pit latrine without slab/open pit
95
No facilities or bush or field
96
Other
99
Missing
Toilet facility shared
Toilet facility shared
Toilet facility shared
Toilet facility shared
Toilet facility shared
Do you share this facility with other households?
Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of the following two questions is to determine whether the household shares their sanitation facility with other households. The shared status of a sanitation facility is important because shared facilities can be less hygienic than facilities used by only a single household. Unhygienic conditions (faeces on the floor, seat or wall and flies) may discourage use of the facility. --- Circle the code corresponding to the response given. If 'No', go to the next module.
Households
1
Yes
2
No
9
Missing
Households using this toilet facility
Households using this toilet facility
Households using this toilet facility
Households using this toilet facility
Households using this toilet facility
How many households in total use this toilet facility?
Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of the following two questions is to determine whether the household shares their sanitation facility with other households. The shared status of a sanitation facility is important because shared facilities can be less hygienic than facilities used by only a single household. Unhygienic conditions (faeces on the floor, seat or wall and flies) may discourage use of the facility. --- The total number of households using this facility should include the household being interviewed. If less than ten households use this toilet facility, enter the number of households on the line provided. Circle '10' if ten or more households use this toilet facility. Note that '01' is not a valid response (since it means that this is the only this household that uses the facility; if that is the case, you should go back to WS8 and correct the response there). Circle '98' for 'DK' ('Doesn't know').
Households
10
Ten or more households
98
DK
99
Missing
Religion of head
Religion of head
Religion of head
Religion of head
Religion of head
What is the religion of the head of this household?
Circle the code corresponding to the answer given. Make sure to get the religion, ethnicity or mother tongue/native language of the household head.
Households
1
Buddhist
2
Muslim
3
Christian
6
Other religion
7
No religion
9
Missing
Language
Language
Language
Language
Language
What is the mother tongue/native language of the head of this household?
Circle the code corresponding to the answer given. Make sure to get the religion, ethnicity or mother tongue/native language of the household head.
Households
1
Thai
2
Other Languages
3
Missing
Ethnic group of head
Ethnic group of head
Ethnic group of head
Ethnic group of head
Ethnic group of head
To what ethnic group does the head of this household belong?
Circle the code corresponding to the answer given. Make sure to get the religion, ethnicity or mother tongue/native language of the household head.
Households
1
Thai
2
Cambodia
3
Loas
4
China
5
Myanmar
6
Other Ethnic
7
Hill Tribe
9
Missing
Head of occupation
Head of occupation
Head of occupation
Head of occupation
Head of occupation
1
Government Officer
2
State Enterprises Officer
3
Private Officer
4
Business
5
Agriculturist
6
Labourer
7
Other
9
Missing
Mean of income
Mean of income
Mean of income
Mean of income
Mean of income
1
Lower 10000
2
10000-19999
3
20000-29999
4
30000-39999
5
40000-49999
6
Upper 50000
9
Missing
Number of rooms for sleeping
Number of rooms for sleeping
Number of rooms for sleeping
Number of rooms for sleeping
Number of rooms for sleeping
How many rooms in this household are used for sleeping?
This information provides a measure of how crowded the house is, and reflects the socio-economic condition of the household. A room in this case refers to a special area with a permanent partition that is used for sleeping. It is not necessarily the number of rooms in the household that are called 'bedrooms', but rather how many rooms get used for sleeping on a regular basis. Exclude rooms that are used only for sleeping by visitors to the household, but include those rooms that may not be regular 'bedrooms' but may be regularly used by one or more of the household members for sleeping. Enter the number of rooms in this household that are used for sleeping.
Households
99
Missing
Main material of floor
Main material of floor
Main material of floor
Main material of floor
Main material of floor
Main material of the dwelling floor:
Record observation.
Circle the correct code for the material of the dwelling floor based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the floor, record the main flooring material (the material that covers the largest amount of floor space).
Households
11
Earth/sand
21
Wood planks
22
Palm/bamboo
31
Parquet or polished wood
32
Vinyl or asphalt strips
33
Ceramic tiles
34
Cement
35
Carpet
36
Marble
37
Polished stone
96
Other
99
Missing
Main material of roof
Main material of roof
Main material of roof
Main material of roof
Main material of roof
Main material of the roof.
Record observation.
Circle the correct code for the material of the dwelling roof, based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the roof, record the main roofing material (the material that covers the largest amount of roof).
Households
11
No roof
12
Thatch/palm leaf
13
Sod
22
Palm/bamboo
23
Wood Planks
31
Metal
33
Calamine/cement fiber
34
Ceramic tiles
35
Cement
36
Roofing shingles
96
Other
99
Missing
Main material of wall
Main material of wall
Main material of wall
Main material of wall
Main material of wall
Main material of the walls.
Record observation.
Circle the correct code for the material of the dwelling walls, based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the walls, record the main wall material (the material that covers the largest amount of wall space).
Households
11
No walls
12
Cane/palm/trunks
13
Dirt
24
Plywood
25
Carton
26
Reused wood
27
Bamboo
31
Cement
32
Stone with lime/cement
33
Bricks
34
Cement blocks
36
Wood planks/shingles
37
Zinc
38
Tile
39
Shera wood
96
Other
99
Missing
Type of fuel using for cooking
Type of fuel using for cooking
Type of fuel using for cooking
Type of fuel using for cooking
Type of fuel using for cooking
What type of fuel does your household mainly use for cooking?
Information on the type of fuel used for cooking is collected as another measure of the socio-economic status of the household. The use of some cooking fuels can also have adverse health consequences. Circle the code corresponding to the answer given. Remember that this question asks about fuel for cooking, not fuel for heating or lighting. If the household uses more than one fuel for cooking, find out which type of fuel is used most often. If electricity, liquid propane gas (LPG), natural gas, or biogas is mainly used, circle '01', '02', '03', or '04', respectively, and skip to HC8. If any fuel other than the pre-coded ones is reported as being the main fuel used for cooking, circle '96' and specify the type of fuel on the line provided. Definitions of some of the types of fuel are as follows: 'Biogas' includes gases produced by fermenting manure in an enclosed pit. 'Lignite' is a derivative of coal that produces more smoke when burned but produces less heat than coal.
Households
1
Electricity
2
Liquid propane gas (LPG)
4
Biogas
5
Kerosene
6
Coal/lignite
7
Charcoal
8
Wood
9
Straw/shrubs/grass
10
Animal dung
11
Agricultural crop residue
96
Other
97
No Cooking
99
Missing
Food cooked on stove or open fire
Food cooked on stove or open fire
Food cooked on stove or open fire
Food cooked on stove or open fire
Food cooked on stove or open fire
In this household, is food cooked on an open fire, an open stove or a closed stove?
Probe for type.
Probe for type of stove and circle the code corresponding to the response given. If a response is given other than the pre-coded ones, circle '96' and specify the type of stove on the line provided. For 'Closed stove', skip the next question and ask HC8.
Households
1
Open fire
2
Open stove
3
Closed stove
6
Other
9
Missing
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire stove have a chimney or a hood
Does the fire/stove have a chimney or a hood?
Circle the appropriate response.
Households
1
Yes
2
No
9
Missing
Cooking location
Cooking location
Cooking location
Cooking location
Cooking location
Is the cooking usually done in the house, in a separate building, or outdoors?
Circle the code corresponding to the response given. If a response is given other than the pre-coded ones, circle '6' and specify on the line provided.
Households
1
In the house
2
In a separate bulding
3
Outdoors
4
Terrace
6
Other
9
Missing
Electricity
Electricity
Electricity
Electricity
Electricity
Does your household have:
Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR?
Households
1
Yes
2
No
9
Missing
Radio
Radio
Radio
Radio
Radio
Does your household have:
Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR?
Households
1
Yes
2
No
9
Missing
Television
Television
Television
Television
Television
Does your household have:
Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR?
Households
1
Yes
2
No
9
Missing
Mobile phone
Mobile phone
Mobile phone
Mobile phone
Mobile phone
Does your household have:
Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR?
Households
1
Yes
2
No
9
Missing
Non-mobile phone
Non-mobile phone
Non-mobile phone
Non-mobile phone
Non-mobile phone
Does your household have:
Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR?
Households
1
Yes
2
No
9
Missing
Refrigerator
Refrigerator
Refrigerator
Refrigerator
Refrigerator
Does your household have:
Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: ELECTRICITY, RADIO, TELEVISION, MOBILE TELEPHONE, NON-MOBILE TELEPHONE, REFRIGERATOR?
Households
1
Yes
2
No
9
Missing
Computer
Computer
Computer
Computer
Computer
Watch
Watch
Watch
Watch
Watch
Does any member of your household own:
This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR.
Households
1
Yes
2
No
9
Missing
Bicycle
Bicycle
Bicycle
Bicycle
Bicycle
Does any member of your household own:
This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR.
Households
1
Yes
2
No
9
Missing
Motorcycle or scooter
Motorcycle or scooter
Motorcycle or scooter
Motorcycle or scooter
Motorcycle or scooter
Does any member of your household own:
This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR.
Households
1
Yes
2
No
9
Missing
Animal-drawn cart
Animal-drawn cart
Animal-drawn cart
Animal-drawn cart
Animal-drawn cart
Does any member of your household own:
This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR.
Households
1
Yes
2
No
9
Missing
Car or truck
Car or truck
Car or truck
Car or truck
Car or truck
Does any member of your household own:
This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR.
Households
1
Yes
2
No
9
Missing
Boat with motor
Boat with motor
Boat with motor
Boat with motor
Boat with motor
Does any member of your household own:
This question collects information on the ownership of various items owned by any of the household members. Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that an item such as a motorcycle is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Ask the question for the following items: WATCH, BICYCLE, MOTORCYCLE OR SCOOTER, ANIMAL-DRAWN CART, CAR OR TRUCK, BOAT WITH A MOTOR.
Households
1
Yes
2
No
9
Missing
Children's sample weight
Children's sample weight
Children's sample weight
Children's sample weight
Children's sample weight
Recoded variable
Children aged 0-4
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
REGR factor score 1 for analysis 1
Recoded variable
Children aged 0-4
wealth index quintiles
wealth index quintiles
wealth index quintiles
wealth index quintiles
wealth index quintiles
Recoded variable
Children aged 0-4
1
Poorest
2
Second
3
Middle
4
Fourth
5
Richest
Date of interview child (CMC)
Date of interview child (CMC)
Date of interview child (CMC)
Date of interview child (CMC)
Date of interview child (CMC)
Recoded variable
Children aged 0-4
Date of birth (CMC)
Date of birth (CMC)
Date of birth (CMC)
Date of birth (CMC)
Date of birth (CMC)
Recoded variable
Children aged 0-4
Age (months)
Age (months)
Age (months)
Age (months)
Age (months)
Recoded variable
Children aged 0-4
Age
Age
Age
Age
Age
Recoded variable
Children aged 0-4
1
< 6 months
2
6-11 months
3
12-23 months
4
24-35 months
5
36-47 months
6
48-59 months
Age
Age
Age
Age
Age
Recoded variable
Children aged 0-4
1
0-11 months
2
12-23 months
3
24-35 months
4
36-47 months
5
48-59 months
Mother's education
Mother's education
Mother's education
Mother's education
Mother's education
Recoded variable
Children aged 0-4
1
None
2
Primary
3
Secondary +