DDI_SOM_2006_MICS_v01_M James, Rhiannon Croft, Trevor 2008-02-12 NADA Version 01 (October 2011) - Slightly edited version of UNICEF's DDI ref. DDI-SOM-UNICEF-MICS-2006-V1 Multiple Indicator Cluster Survey 2006 MICS 2006 SOM_2006_MICS_v01_M UNICEF Somalia Support Centre Pan Arab Population and Family Health Project Strategic Information Section, Division of Policy and Planning, UNICEF NYHQ NADA UNICEF WHO UNFPA Global Fund Chief of Social Policy and Planning Section, UNICEF Somalia General Inquiries MICS Programme Manager Multiple Indicator Cluster Survey - Round 3 [hh/mics-3] The Multiple Indicator Cluster Survey, Round 3 (MICS3) is the third round of MICS surveys, previously conducted around 1995 (MICS1) and 2000 (MICS2). Many questions and indicators are consistent and compatible with the prior round of MICS (MICS2) but less so with MICS1, although there have been a number of changes in definition of indicators between rounds. Details can be found by reviewing the indicator definitions. Version 1.0: Edited data used for final report Household members Education Water and sanitation Household characteristics Child labour Salt iodization Women's background Tetanus toxoid Child Mortality Birth History Maternal and newborn health Marriage and union Contraception HIV/AIDS Children's background Birth registration Early learning Vitamin A Breastfeeding Care of illness Immunization Anthropometry Malaria Female genital cutting Attitudes towards domestic violence Maternal mortality 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. The Pan Arab Population and Family Health Project(PAPFAM) is a programme conducted to enable national health institutions in the Arab region to obtain a timely and integrated flow of reliable information suitable for formulating, implementing, monitoring and evaluating the family health and reproductive health policies and programs in a cost-effective manner. MICS and PAPFAM are capable of producing statistically sound, internationally comparable estimates of social indicators. The current round of MICS/PAPFAM 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 Somali Multiple Indicator Cluster Survey (MICS)/Pan Arab Population and Family Health Project(PAPFAM) has as its primary objectives: - To provide up-to-date information for assessing the situation of children and women in Somalia - To furnish data needed for monitoring progress toward goals established in the Millennium Declaration, the goals of A World Fit For Children (WFFC), and other internationally agreed upon goals, as a basis for future action; - To contribute to the improvement of data and monitoring systems in Somalia and to strengthen technical expertise in the design, implementation, and analysis of such systems. Survey Content Following the MICS global questionnaire templates, the questionnaires were designed in a modular fashion customized to the needs of Somalia. The questionnaires 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). Survey Implementation The Somalia MICS/PAPFAM was carried out by UNICEF with the support and assistance the Ministry of Planning and International Cooperation of the Somali Transitional Federal Government, the Ministry of National Planning and Coordination of Somaliland and the Ministry of Planning and International Cooperation of Puntland. Technical assistance and training for the survey was provided through a series of regional workshops organised by UNICEF and PAPFAM, covering questionnaire content, sampling and survey implementation; data processing; data quality and data analysis; report writing and dissemination. Somalia The Somali 2006 MICS/PAPFAM covers all regions of Somalia. For the purposes of this survey, the analysis refers to the North West Zone, the North East Zone and Central South Zone according to prewar boundaries for Somaliland and Puntland and does not imply any recognition of administrative boundaries by the United Nations or the League of Arab States. Households (defined as a group of persons who usually live and eat together) De jure household members (defined as memers of the household who usually live in the household, which may include people who did not sleep in the household the previous night, but does not include visitors who slept in the household the previous night but do not usually live in the household) Women aged 15-49 Children aged 0-4 The survey covered all de jure household members (usual residents), all women aged 15-49 years resident in the household, and all children aged 0-4 years (under age 5) resident in the household. The survey also included a full birth history module which covered all live births born to ever-married women aged 15-49. Sample survey data [ssd] The scope of the 2006 Somali MICS/PAPFAM Survey includes: HOUSEHOLD: Household characteristics, household listing, orphaned children, education, child labour, water and sanitation, household use of insecticide treated mosquito nets, salt iodization and maternal mortality. WOMEN: Women's characteristics, child mortality, birth history, tetanus toxoid, maternal and newborn health, marriage, polygyny, female genital cutting, contraception, HIV/AIDS knowledge and domestic violence. CHILDREN: Children's characteristics, birth registration and early learning, vitamin A, breastfeeding, care of illness, malaria, immunization and anthropometry. Women Care (Middle Shabelle) Sean Deveroux Human Rights Organisation (Lower Juba) Natural Resource Management and Information Centre (Bakool) African Rescue Committee (Middle Juba) Community Care Centre (Bay Region) Community Research and Development Group (Benadir Region) Himilo Relief, Rehabilitation and Development Association (Gedo Region) Hiran HIV/AIDS Prevention and Child Protection (Hiran Region) Training and Research Group (Somaliland) Ministry of Planning and International Cooperation The principal objective of the sample design was to provide current and reliable estimates on a set of indicators covering the four major areas of the World Fit for Children declaration, including promoting healthy lives; providing quality education; protecting against abuse, exploitation and violence; and combating HIV/AIDS. The population covered by the 2006 MICS/PAPFAM is defined as the universe of all women aged 15-49 and all children aged under 5. A sample of households was selected and all women aged 15-49 identified as usual residents of these households were interviewed. In addition, the mother or the caretaker of all children aged under 5 who were usual residents of the household were also interviewed about the child. The 2006 MICS/PAPFAM collected data from a nationally representative sample of households, women and children. The primary focus of the 2006 MICS/PAPFAM was to provide estimates of key population and health, education, child protection and HIV related indicators for the country as a whole, for the North West, North East and Central South Zones and for urban and rural areas separately. Somalia is divided into 18 regions. Each region is subdivided into districts, and each district into settlements and towns. The sample frame for this survey was based on the list of settlements developed from the 2005-2006 UNDP Settlement Survey and WHO vaccination campaign data. The Sampling design follows a 4 stage-sample approach. The first stage is the selection of the districts in each of the 18 regions of the country selected using probability proportional to size (pps). The second stage is the selection of the secondary sampling units which are defined as permanent and temporary settlements. The third stage is the selection of the cluster(s) within the settlement and the fourth stage is the selection of the households to be interviewed. Once the districts had been selected great efforts went into compiling a complete list of permanent and temporary settlements within these districts. The main source was the WHO immunisation campaign data, this data was later backed up by the UNDP settlement survey for at least two out of the three zones. Other sources also contributed such as FAO data on water points which could act as proxy for surrounding nomadic areas and temporary settlements. Finally lists were shown to the NGO partners implementing the survey and UNICEF staff on the ground for additional contributions to recent movement of internally displaced persons and nomads. The settlement lists were then sorted into urban and non urban. The first two stages of sampling were thus completed by selecting the required number of clusters from each of the 3 zones by urban and rural areas separately. Mapping and Listing Activities For settlements over the estimated size of 150 households some form of segmentation through sketch mapping was necessary. For several district capitals it was possible to use maps from UN Habitat to assist the personnel deployed in sketch mapping. However for most of the larger non-urban settlements there were no maps available. The most important aspect of the sketch mapping was to divide the settlements into roughly equal sizes by estimating the number of households and to clearly delineate the segments using identifiable boundaries. Once sketch maps were prepared survey coordinators were then in a position to randomly select the cluster(s) where household would be selected. It must be added at this point that finding people trained in cartographic techniques is rare in Somalia. Thus the quality of the maps varied significantly across the country and resources and time also did not allow for a full household count. Selection of Households For the final stage of sampling, the Somali MICS/PAPFAM had no other option than to use the method used in MICS 2 of the Expanded Program for Immunization (EPI) random walk method; the expense of household/dwelling listing would simply be too considerable. Whilst the EPI method is quick and approximately self-weighting, it is recognised that this is not a probability sample, and so cannot ensure objectivity of household selection. In order to try and avoid the subjectivity involved in selecting households some measures were put in place. For example instead of relying on an arbitrary decision regarding the central point of a cluster, supervisors selected at least three or four possible starting points and then randomly choose one of them. Moreover only supervisors were able to select and number the households, not interviewers. Significant time was spent training supervisors on how to select households in order to avoid some of the criticisms typically directed towards this method. For clusters falling in nomadic areas (the temporary settlements) the survey teams were instructed to interview the first 24 households that they came across. Typically nomads do not move in large numbers, therefore in order to ensure representation of nomads in the sample it was necessary to assume a more purposive method of sampling for this group. No major deviations from the original sample design were made. All clusters were accessed and successfully interviewed with good response rates. Face-to-face [f2f] The questionnaires for the Somali MICS/PAPFAM 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 developed in English from the MICS3 Model Questionnaires, and were translated into Af-Somali. Differences in translation were reviewed and resolved in collaboration with the original translators. The English and Somali questionnaires were both piloted as part of the survey pretest. The questionnaires contained the following modules: HOUSEHOLD: Household characteristics, household listing, orphaned children, education, child labour, water and sanitation, household use of insecticide treated mosquito nets, salt iodization and maternal mortality. WOMEN: Women's characteristics, child mortality, birth history, tetanus toxoid, maternal and newborn health, marriage, polygyny, female genital cutting, contraception, HIV/AIDS knowledge and domestic violence. CHILDREN: Children's characteristics, birth registration and early learning, vitamin A, breastfeeding, care of illness, malaria, immunization and anthropometry. The pretest for the survey took place in July 2006 in each zone. Approximately ten percent of the total sample size was pre-tested; the three pre-tests combined lasted between 1 to 2 weeks. The pre-tests were conducted by the survey coordinators with the assistance of future supervisors and interviewers. The largest complaint regarding the questionnaires in the pretest was the length. For a household, the minimum time the questionnaires were completed in was one and a quarter hours, the maximum time was around two and a half hours. Supervisors noticed however that in the latter days of pre-testing interviewers gained much more speed. Therefore in the first week of data collection it was necessary to allow more time for survey teams to complete clusters but the time steadily reduced as fieldwork continued. Interviewing was conducted by teams of interviewers. Each interviewing team comprised of 4 female interviewers and 4 male interviewers, a field editor and a supervisor. Each team used 4 wheel drive vehicles to travel from cluster to cluster (and where necessary within cluster). The role of the supervisor was to coordinate field data collection activities, including management of the field team, supplies and equipment, finances, maps and listings, coordinate with local authorities concerning the survey plan and make arrangements for accommodation and travel. Additionally, the field supervisor assigned the work to the interviewers, spot checked work, maintained field control documents, and sent completed questionnaires and progress reports to the central office The field editor was responsible for reviewing each questionnaire at the end of the day, checking for missed questions, skip errors, fields incorrectly completed, and checking for inconsistencies in the data. The field editor also observed interviews and conducted review sessions with interviewers. Responsibilities of the supervisors and field editors are described in the Instructions for Supervisors and Field Editors, together with the different field controls that were in place to control the quality of the fieldwork. The Somali MICS also recruited field coordinators who were responsible for coordinating the work of several field teams. Field visits were made by coordinators throughout fieldwork. Planning, monitoring and evaluation staff of UNICEF also made regular visits to field teams to provide support and to review progress. The Somali MICS Coordinator visited several field teams during data collection across the country. Sample weights were calculated for each of the datafiles. Sample weights for the household data were computed as the inverse of the probability of selection of the household, computed at the sampling domain level (urban/rural within each region). The household weights were adjusted for non-response at the domain level, and were then normalized by a constant factor so that the total weighted number of households equals the total unweighted number of households. The household weight variable is called HHWEIGHT and is used with the HH data and the HL data. Sample weights for the women's data used the un-normalized household weights, adjusted for non-response for the women's questionnaire, and were then normalized by a constant factor so that the total weighted number of women's cases equals the total unweighted number of women's cases. Sample weights for the children's data followed the same approach as the women's and used the un-normalized household weights, adjusted for non-response for the children's questionnaire, and were then normalized by a constant factor so that the total weighted number of children's cases equals the total unweighted number of children's cases. Data were processed in clusters, with each cluster being processed as a complete unit through each stage of data processing. Each cluster goes through the following steps: 1) Questionnaire reception 2) Office editing and coding 3) Data entry 4) Structure and completeness checking 5) Verification entry 6) Comparison of verification data 7) Back up of raw data 8) Secondary editing 9) Edited data back up After all clusters are processed, all data is concatenated together and then the following steps are completed for all data files: 10) Export to SPSS in 5 files (hh - household, hl - household members, wm - women, ch - children under 5 bh - birth history) 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 Details of each of these steps can be found in the data processing documentation, data editing guidelines, data processing programs in CSPro and SPSS, and tabulation guidelines. Data entry was conducted by 12 data entry operators in tow shifts, supervised by 2 data entry supervisors, using a total of 7 computers (6 data entry computers plus one supervisors computer). All data entry was conducted at the GenCenStat head office using manual data entry. For data entry, CSPro version 2.6.007 was used with a highly structured data entry program, using system controlled approach, that controlled entry of each variable. All range checks and skips were controlled by the program and operators could not override these. A limited set of consistency checks were also included inthe data entry program. In addition, the calculation of anthropometric Z-scores was also included in the data entry programs for use during analysis. Open-ended responses ("Other" answers) were not entered or coded, except in rare circumstances where the response matched an existing code in the questionnaire. Structure and completeness checking ensured that all questionnaires for the cluster had been entered, were structurally sound, and that women's and children's questionnaires existed for each eligible woman and child. 100% verification of all variables was performed using independent verification, i.e. double entry of data, with separate comparison of data followed by modification of one or both datasets to correct keying errors by original operators who first keyed the files. After completion of all processing in CSPro, all individual cluster files were backed up before concatenating data together using the CSPro file concatenate utility. Data editing took place at a number of stages throughout the processing (see Other processing), including: a) Office editing and coding b) During data entry c) Structure checking and completeness d) Secondary editing e) Structural checking of SPSS data files Detailed documentation of the editing of data can be found in the data processing guidelines found in the global MICS manual http://www.childinfo.org/mics/mics3/manual.php Of the 6000 households selected for the sample 5969 were successfully interviewed for a household response rate of 99.5 percent. In the interviewed households, 7277 women (age 15-49) were identified. Of these, 6764 were successfully interviewed, yielding a response rate of 93 percent. In addition, 6373 children under age five were listed in the household questionnaire. Of these, questionnaires were completed for 6305 which corresponds to a response rate of 98.9 percent. Overall response rates of 92.5 percent and 98.4 are calculated for the women's and under-5's interviews respectively Estimates from a sample survey are affected by two types of errors: 1) non-sampling errors and 2) sampling errors. Non-sampling errors are the results of mistakes made in the implementation of data collection and data processing. Numerous efforts were made during implementation of the 2005-2006 MICS to minimize this type of error, however, non-sampling errors are impossible to avoid and difficult to evaluate statistically. Sampling errors can be evaluated statistically. The sample of respondents to the 2006 MICS is only one of many possible samples that could have been selected from the same population, using the same design and expected size. Each of these samples would yield results that differe somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability in the results of the survey between all possible samples, and, although, the degree of variability is not known exactly, it can be estimated from the survey results. The sampling erros are measured in terms of the standard error for a particular statistic (mean or percentage), which is the square root of the variance. Confidence intervals are calculated for each statistic within which the true value for the population can be assumed to fall. Plus or minus two standard errors of the statistic is used for key statistics presented in MICS, equivalent to a 95 percent confidence interval. If the sample of respondents had been a simple random sample, it would have been possible to use straightforward formulae for calculating sampling errors. However, the 2005-2006 MICS sample is the result of a multi-stage stratified design, and consequently needs to use more complex formulae. The SPSS complex samples module has been used to calculate sampling errors for the 2005-2006 MICS. This module uses the Taylor linearization method of variance estimation for survey estimates that are means or proportions. This method is documented in the SPSS file CSDescriptives.pdf found under the Help, Algorithms options in SPSS. Sampling errors have been calculated for a select set of statistics (all of which are proportions due to the limitations of the Taylor linearization method) for the national sample, urban and rural areas, and for each of the five regions. For each statistic, the estimate, its standard error, the coefficient of variation (or relative error -- the ratio between the standard error and the estimate), the design effect, and the square root design effect (DEFT -- the ratio between the standard error using the given sample design and the standard error that would result if a simple random sample had been used), as well as the 95 percent confidence intervals (+/-2 standard errors). Details of the sampling errors are presented in the sampling errors appendix to the final report. A series of data quality tables and graphs are available to review the quality of the data and include the following: Age distribution of the household population Age distribution of eligible women and interviewed women Age distribution of eligible children and children for whom the mother or caretaker was interviewed Age distribution of children under age 5 by 3 month groups Age and period ratios at boundaries of eligibility Percent of observations with missing information on selected variables Presence of mother inthe household and person interviewed for the under 5 questionnaire School attendance by single year age Sex ratio at birth among children ever born, surviving and dead by age of respondent Distribution of women by time since last birth Scatterplot of weight by height, weight by age and height by age Graph of male and female population by single years of age Population pyramid The results of each of these data quality tables is shown in the appendix of the final report. The generral rule for presentation of missing data in the final report tabulations is that a column is presented for missing data if the percentage of cases with missing data is 1% or more. Cases with missing data on the background characteristics (e.g. education) are included in the tables, but the missing data rows are suppressed and noted at the bottom of the tables in the report (not in the SPSS output, however). Users of the data agree to keep confidential all data contained in these datasets and to make no attempt to identify, trace or contact any individual whose data is included in these datasets. UNICEF Somalia Support Centre UNICEF Somalia, Multiple Indicator Cluster Survey: Household , household listing, women, children's and birth history files, 2006.Nairobi provided by New York: Strategic Information Section, Division of Policy and Planning, UNICEF, www.childinfo.org. Survey datasets are distributed at no cost for legitimate research, with the condition that we receive an abstract or a detailed 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 UNICEF Somalia: somalia@unicef.org Requests for access to the datasets may be made through the website: www.childinfo.org UNICEF provides these data to external users without any warranty or responsibility implied. UNICEF accepts no responsibility for the results and/or implications of any actions resulting from the use of these data. hh Data collected at the household level (MICS Household questionnaire: modules Household information panel, Water and sanitation, Household characteristics, Household use of insecticde treated nets, Child discipline, Salt iodization) 0 112 hl Data collected at the household member's level (MICS Household questionnaire: modules Household listing, Child labour and Maternal Mortality) 0 128 wm Data collected at the women's level (MICS Women's questionnaire: modules Women's Information Panel, Child mortality, Tetanus toxoid, Maternal and newborn health, Marriage/union, Contraception (and unmet need), HIV/AIDS, Female genital mutiliation/cutting, Sexual behaviour, Attitudes towards domestic violence) 0 269 ch Data collected at mother's or primary caretaker's level (MICS Child questionnaire: modules Birth Registration and Early Learning, Vitamin A, Breastfeeding, Care of Illness, Malaria, Immunization and Anthropometry) ) 0 295 bh Data collected at the women's level (MICS Women's questionnaire: modules Birth History) 0 162 Cluster number Cluster number Cluster number Cluster number Cluster number We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. During this time I would like to speak with the household head and all mothers or others who take care of children in the household. May I start now? If permission is given, begin the interview. Cluster number: Enter the cluster number as instructed by your supervisor. Households Unique identifier for the cluster in which the household exists Household number Household number Household number Household number Household number Household number: Enter the household number as instructed by your supervisor. Households Interviewer number Interviewer number Interviewer number Interviewer number Interviewer number Interviewer name and number: Enter your own name and identification number provided to you at the time of training. Households Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor name and number: Enter your supervisor's name and identification number. You will be provided with your supervisor's identification number as soon as you know who you will be working with. Households Day of interview Day of interview Day of interview Day of interview Day of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Month of interview Month of interview Month of interview Month of interview Month of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households 8 August 9 September Year of interview Year of interview Year of interview Year of interview Year of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Area with nomadic Area with nomadic Area with nomadic Area with nomadic Area with nomadic 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. Household 1 Urban 21 Rural 22 Nomadic For the purposes of this survey, the analysis refers to the North West Zone, the North East Zone and Central South Zone according to prewar boundaries for Somaliland and Puntland and does not imply any recognition of administrative boundaries by the United Nations or the League of Arab States. Area presented by urban (district capitals), rural (rural sedentary) and nomadic (rural non-sedentary) Zone Zone Zone Zone Zone Region: Circle the code for zone. Households 1 North West 2 North East 3 Central South Result of HH interview Result of HH interview Result of HH interview Result of HH interview Result of HH interview After all questionnaires for the household have been completed, fill in the following information: Result of HH interview: If the Household Questionnaire is completed, circle '1' for 'Completed'. If you have not been able to contact the household after repeated visits, circle '2' for 'Not at home'. If the household refuses to be interviewed, circle '3' for 'Refused'. If you are unable to locate the household or if the dwelling is destroyed, circle '4' for 'HH not found/destroyed'. If you have not been able to complete the Household Questionnaire for another reason, you should circle '6' for 'Other' and specify the reason in the space provided. Some examples of 'Other' codes might be: the household respondent is incapacitated; the questionnaire is partly completed; adult household members were not found at home after repeated visits. Households 1 Completed 2 Not at home 3 Refused 4 HH not found/destroyed 6 Other Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent to HH questionnaire: Enter the name and line number (from the Household Listing, columns HL1 and HL2) of the respondent to the Household Questionnaire. Households Number of household members Number of household members Number of household members Number of household members Number of household members Total number of household members: Count the number of household members recorded in column HL1 of the Household Listing and enter the total here. Households Total eligible women Total eligible women Total eligible women Total eligible women Total eligible women No.of women eligible for interview: Enter the total number of women eligible for interview for the Questionnaire for Individual Women - you will copy this from the row for totals at the bottom of the Household Listing, for HL6. Households Women interviews completed Women interviews completed Women interviews completed Women interviews completed Women interviews completed No.of women questionnaires completed: Once all of the Questionnaires for Individual Women have been completed for a particular household, enter the number completed here. Households Total children under 5 Total children under 5 Total children under 5 Total children under 5 Total children under 5 No.of children under age 5: Enter the total number of children under five eligible for inclusion in the survey from the row for totals at the bottom of the Household Listing, for HL8. You will be using the Questionnaire for Children Under Five to interview the mothers or primary caretakers of these children. Households Child interviews completed Child interviews completed Child interviews completed Child interviews completed Child interviews completed No.of under-5 questionnaires completed: Once all of the Questionnaires for Children Under Five have been completed for a particular household, enter the number completed here. Households Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk: Leave this space blank. The data clerk will enter his/her number in the space provided. Households Total number of Women 15-49 Total number of Women 15-49 Total number of Women 15-49 Total number of Women 15-49 Total number of Women 15-49 Are there any other persons living here - even if they are not members of your family or do not have parents living in this household? Including children at work or at school? If yes, insert child's name and complete form. Then, complete the totals below. Households Total number of Children 5-14 Total number of Children 5-14 Total number of Children 5-14 Total number of Children 5-14 Total number of Children 5-14 Households Total number of children Under 5 years Total number of children Under 5 years Total number of children Under 5 years Total number of children Under 5 years Total number of children Under 5 years Households Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water What is the main source of drinking water for members of your household? The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): · '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. · '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. · '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. · '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. · '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. · '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. · '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. · '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). · '52' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof and stored in a container, tank or cistern until used. · '53' Berkad · '54' Rain water catchment (Balli) · '61' - A tanker-truck water source transports and sells water by means of a tanker truck. · '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. · '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. · '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. Households 11 Piped into dwelling 12 Piped into yard or plot 13 Public tap/standpipe 21 Tubewell/borehole 31 Protected well 32 Unprotected well 41 Protected spring 42 Unprotected spring 52 Roof top 53 Berkad 54 Balli 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 91 Bottled water 96 Other Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes What is the main source of water used by your household for other purposes such as cooking and handwashing? The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): · '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. · '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. · '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. · '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. · '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. · '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. · '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. · '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). · '52' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof and stored in a container, tank or cistern until used. · '53' Berkad · '54' Rain water catchment (Balli) · '61' - A tanker-truck water source transports and sells water by means of a tanker truck. · '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. · '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. · '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. Households 11 Piped into dwelling 12 Piped into yard or plot 13 Public tap/standpipe 21 Tubewell/borehole 31 Protected well 32 Unprotected well 41 Protected spring 42 Unprotected spring 52 Roof top 53 Berkad 54 Balli 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 96 Other 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 Don't Know 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 Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Do you take any meausures to prevent contamination while handling the water or water storage containers? Circle '1' if 'Yes', and continue to the next question. If 'No' or 'DK' (Doesn't know'), circle '2' or '8', respectively. Household 1 Yes 2 No 8 D.K Definitions of various methods of prevention are as follows: · 'A' - Wash hands before collecting water · 'B' - Store drinking water in a clean container with cover · 'C' - Use a separate clean cup with a long handle for taking water out of the container · 'D' - Keep animals away from the container Wash Hands Wash Hands Wash Hands Wash Hands Wash Hands What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing A Wash Hands Store in clean container Store in clean container Store in clean container Store in clean container Store in clean container What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing B Container with cover Use separate container Use separate container Use separate container Use separate container Use separate container What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing C Use Separate container Keep animals away Keep animals away Keep animals away Keep animals away Keep animals away What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing D Keep animals Other Other Other Other Other What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing X Other D.K D.K D.K D.K D.K What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing Z D.K 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 Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Does your main drinking water source give you a reliable supply? If the respondent replies 'no' try to assess how often they encounter problems. If they encounter problems occasionally such as a few times a month circle '2', if a few times a week circle '3' for daily problems circle '4'. If the household complains that it is only at certain times of year they do not have a reliable supply then circle 5'. If the household does not know circle '8'. Household 1 Almost no problems 2 Occasionaly Problems 3 Weekly Problems 4 Daily Problems 5 Seasonaly Supply 8 D.K Kind of toilet facility Kind of toilet facility Kind of toilet facility Kind of toilet facility Kind of toilet facility What kind of toilet facility do members of your household usually use? If "flush" or "pour flush", probe: Where does it flush to? If necessary, ask permission to observe the facility. Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of this question is to obtain a measure of the cleanliness of the sanitary facility used by the household members. It may be necessary to observe the facility. If so, ask permission to do so. If the respondent answers or it is observed that the household members have no facilities or use the bush or field, enter '95' for 'No facilities or bush or field' and skip to the next module. If any of the flush or pour flush responses (11-15) are given, probe: "WHERE DOES IT FLUSH TO?" Circle the code corresponding to the response given. Definitions of various types of toilet facilities are as follows: A flush toilet uses a cistern or holding tank for flushing water and has a water seal, which is a U-shaped pipe, below the seat or squatting pan that prevents the passage of flies and odours. A pour flush toilet uses a water seal, but unlike a flush toilet, a pour flush toilet uses water poured by hand for flushing (no cistern is used). . '11' - A piped sewer system is a system of sewer pipes, also called sewerage, that is designed to collect human excreta (faeces and urine) and wastewater and remove them from the household environment. Sewerage systems consist of facilities for collection, pumping, treating and disposing of human excreta and wastewater. . '12' - A septic tank is an excreta collection device and is a water-tight settling tank normally located underground, away from the house or toilet. . '13' - A flush/pour flush to pit latrine refers to a system that flushes excreta to a hole in the ground. . '14' - A flush/pour flush to somewhere else refers to excreta being deposited in or nearby the household environment (not into pit, septic tank or sewer); excreta may be flushed to the street, yard/plot, drainage way or other location. . '15' - Flush to unknown place/not sure/DK where should be coded in cases when the respondent knows that the toilet facility is a flush toilet, but does not know where it flushes to. '21' - A ventilated improved pit latrine or VIP is a type of pit latrine that is ventilated by a pipe extending above the latrine roof. The open end of the vent pipe is covered with gauze mesh or fly-proof netting and the inside of the superstructure is kept dark. '22' - A pit latrine with slab uses a hole in the ground for excreta collection and has a squatting slab, platform or seat that is firmly supported on all sides, easy to clean and raised above the surrounding ground level to prevent surface water from entering the pit. '23' - A pit latrine without slab uses a hole in the ground for excreta collection and does not have a squatting slab, platform or seat. An open pit is a rudimentary hole in the ground where excreta is collected. '31' - A composting toilet is a toilet into which excreta and carbon-rich material are added (vegetable wastes, straw, grass, sawdust, ash) and special conditions maintained to produce inoffensive compost. '41' - Bucket refers to the use of a bucket or other container for the retention of faeces (and sometimes urine and anal cleaning material), which is periodically removed for treatment or disposal. '51' - A hanging toilet or hanging latrine is a toilet built over the sea, a river, or other body of water into which excreta drops directly. '95' - No facilities or bush or field includes excreta wrapped and thrown with garbage, the 'cat' method of burying excreta in dirt, defecation in the bush or field or ditch, and defecation into surface water (drainage channel, beach, river, stream or sea). Households 11 Flush to piped sewer system 12 Flush to septic tank 13 Flush to pit (latrine) 14 Flush to somewhere else 15 Flush to unknown place/not sure/DK where 21 Ventilated Improved Pit latrine (VIP) 22 Pit latrine with slab 23 Pit latrine without slab/open pit 95 No facilities or bush or field 96 Other 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 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 Wash hands before eating Wash hands before eating Wash hands before eating Wash hands before eating Wash hands before eating Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No wash hands after defecation wash hands after defecation wash hands after defecation wash hands after defecation wash hands after defecation Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No wash hands after eating wash hands after eating wash hands after eating wash hands after eating wash hands after eating Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No 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 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 32 Vinyl or asphalt strips 33 Ceramic tiles 34 Cement 35 Carpet 96 Other 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 Mud & Grass 21 Rustic mat 22 Palm/Grass 23 Wood Planks 24 Sacking/Plastic sheets 31 Metal 32 Wood 33 Calamine/cement fiber 35 Cement 36 Roofing shingles 96 Other 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 Sticks/palm/trunks 13 Mud 21 Bambo with mud 22 Stone with mud 23 Uncovered adobe 24 Plywood 25 Carton 26 Reused wood 27 Cloth/Matting 31 Cement 32 Stone with lime/cement 33 Bricks 34 Cement blocks 35 Covered adobe 36 Wood planks/shingles 96 Other Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking What type of fuel does your household mainly use for cooking? Information on the type of fuel used for cooking is collected as another measure of the socio-economic status of the household. The use of some cooking fuels can also have adverse health consequences. Circle the code corresponding to the answer given. Remember that this question asks about fuel for cooking, not fuel for heating or lighting. If the household uses more than one fuel for cooking, find out which type of fuel is used most often. If electricity, liquid propane gas (LPG), natural gas, or biogas is mainly used, circle '01', '02', '03', or '04', respectively, and skip to HC8. If any fuel other than the pre-coded ones is reported as being the main fuel used for cooking, circle '96' and specify the type of fuel on the line provided. Definitions of some of the types of fuel are as follows: 'Biogas' includes gases produced by fermenting manure in an enclosed pit. 'Lignite' is a derivative of coal that produces more smoke when burned but produces less heat than coal. Households 1 Electricity 2 Liquid propane gas (LPG) 5 Kerosene 7 Charcoal 8 Wood 9 Straw/shrubs/grass 10 Animal dung 11 Agricultural crop residue 96 Other 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 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 Cooking location Cooking location Cooking location Cooking location Cooking location Is the cooking usually done in the house, in a separate building, or outdoors? Circle the code corresponding to the response given. If a response is given other than the pre-coded ones, circle '6' and specify on the line provided. Households 1 In the house 2 In a separate bulding 3 Outdoors 6 Other Bed Bed Bed Bed Bed Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 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 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 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 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, VCD/DVD PLAYER, FAN? Households 1 Yes 2 No 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 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 VCD/DVD Player VCD/DVD Player VCD/DVD Player VCD/DVD Player VCD/DVD Player Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No Fan Fan Fan Fan Fan Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No Satellite Dish Satellite Dish Satellite Dish Satellite Dish Satellite Dish Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 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 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 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 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 Clock Clock Clock Clock Clock Does any member of your household own: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No Sewing Machine Sewing Machine Sewing Machine Sewing Machine Sewing Machine Does any member of your household own: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of this household own any land that can be used for agriculture? Circle the code corresponding to the response given. If 'No', skip to HC13. Households 1 Yes 2 No How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agricultural land do members of this household own? If more than 97, record '97'. If unknown, record '98'. Record the total number of hectares of land owned by all members of the household that can be used for agriculture. If 97 or more hectares (or other units) are owned, record '97'. If unknown, record '98'. Households 97 More than 97 Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, herds, or farm animals? Circle the code corresponding to the response given. If 'No', skip to the next module. Households 1 Yes 2 No Number of camels Number of camels Number of camels Number of camels Number of camels How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 98 Don't know Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 98 Don't know Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 98 Don't know Number of Goats Number of Goats Number of Goats Number of Goats Number of Goats How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 98 Don't know Number of sheep Number of sheep Number of sheep Number of sheep Number of sheep How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 98 Don't know Number of chickens Number of chickens Number of chickens Number of chickens Number of chickens How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 98 Don't know Sleep under mosquito net Sleep under mosquito net Sleep under mosquito net Sleep under mosquito net Sleep under mosquito net What do you in your houshold to protect against malaria? Circle all that apply Household ? Missing A Yes Keep environment clean Keep environment clean Keep environment clean Keep environment clean Keep environment clean What do you in your houshold to protect against malaria? Circle all that apply Household ? Missing B Yes Drink clean water Drink clean water Drink clean water Drink clean water Drink clean water What do you in your houshold to protect against malaria? Circle all that apply Household ? Missing C Yes Drain stagnant water Drain stagnant water Drain stagnant water Drain stagnant water Drain stagnant water What do you in your houshold to protect against malaria? Circle all that apply Household ? Missing D Yes Burn dung Burn dung Burn dung Burn dung Burn dung What do you in your houshold to protect against malaria? Circle all that apply Household ? Missing E Yes Use a spray Use a spray Use a spray Use a spray Use a spray What do you in your houshold to protect against malaria? Circle all that apply Household ? Missing F Yes Shake cloth Shake cloth Shake cloth Shake cloth Shake cloth What do you in your houshold to protect against malaria? Circle all that apply Household ? Missing G Yes Other Other Other Other Other What do you in your houshold to protect against malaria? Circle all that apply Household ? Missing X Yes Nothing Nothing Nothing Nothing Nothing What do you in your houshold to protect against malaria? Circle all that apply Household ? Missing Y Yes D.K D.K D.K D.K D.K What do you in your houshold to protect against malaria? Circle all that apply Household ? Missing Z Yes Household has mosquito nets Household has mosquito nets Household has mosquito nets Household has mosquito nets Household has mosquito nets Does your household have any mosquito nets that can be used while sleeping? It is recognized that consistent use of insecticide-treated mosquito nets (ITN) decreases the incidence of clinical malaria and malaria-related deaths, especially in very young children. Consequently, many countries are now instituting programmes that promote the use of ITNs. There are various types and brands of mosquito nets. Some require regular treatment with insecticide. Others are factory-treated and do not require re-treatment for 6 to 12 months (pre-treated) or 36 months (permanent type). By observing the mosquito nets yourself, you should be able to identify what brands or types of mosquito nets households own, but respondents may not always permit you to enter the sleeping areas where the nets are found. Your supervisor may provide you with photographs to help you to distinguish different brands of mosquito nets. In order to assess the effectiveness of mosquito net use in preventing malaria, we need to gather accurate information on the type of nets, whether and when they were last treated with insecticide and whether household members use the nets when they sleep at night. Note that 'cake covers' or baby nets that are used to keep flies off infants, usually during the daytime, are not considered mosquito nets. These nets cannot be treated with insecticide. Window screens are also not considered mosquito nets. --- Circle the code corresponding to the response given. If 'No', skip to the next module. Households 1 Yes 2 No Number of mosquito nets Number of mosquito nets Number of mosquito nets Number of mosquito nets Number of mosquito nets How many mosquito nets does your household have? If 7 or more nets, record '7'. Enter the number of mosquito nets that the household has. If the household has seven or more nets, record '7'. Households 7 7 or more Long-lasting - Brand A Long-lasting - Brand A Long-lasting - Brand A Long-lasting - Brand A Long-lasting - Brand A Is the net (are any of the nets) any of the following brands: Read each brand name, show picture card, and circle codes for Yes or No for each brand. If possible, observe the net to verify brand. During training, you will be shown all the common mosquito nets that are available in the country. The brand name is often located on the net itself. A picture of the different types of nets available in the country may also be provided for reference during interviews. Use this to identify the type of net in the dwelling and circle the corresponding number on the questionnaire. During training, you will be shown all the common mosquito nets that are available in the country. There are many types of nets available on the Markey in Somalia, so to is important for interviewers to be able to distinguish between long lasting, pre-treated and other. Long lasting nets: there is currently one main type of long lasting net available in Somalia. These nets usually come in blue packaging and have an easily identifiable label located on the net itself. Interviewers will be given a picture of this label. Use this to identify the type of net in the dwelling and circle the corresponding number on the questionnaire. Pre-treated nets: these are nets which may come treated but have to be treated again within a certain time. If the respondent is not sure of what type of net they have, try to observe it, if possible. If the net is neither long lasting nor pre-treated then code it as other. When you finish asking about the brands of nets from A to F, ask the respondent if there is any other brand of net. If 'Yes', code TN3o3, and write down the brand of the net. If there is another net for which the respondent does not know the brand, code 'Yes' for TN3o4. Households 1 Yes 2 No 8 DK Pre-treated - Brand C Pre-treated - Brand C Pre-treated - Brand C Pre-treated - Brand C Pre-treated - Brand C Is the net (are any of the nets) any of the following brands: Read each brand name, show picture card, and circle codes for Yes or No for each brand. If possible, observe the net to verify brand. During training, you will be shown all the common mosquito nets that are available in the country. There are many types of nets available on the Markey in Somalia, so to is important for interviewers to be able to distinguish between long lasting, pre-treated and other. Long lasting nets: there is currently one main type of long lasting net available in Somalia. These nets usually come in blue packaging and have an easily identifiable label located on the net itself. Interviewers will be given a picture of this label. Use this to identify the type of net in the dwelling and circle the corresponding number on the questionnaire. Pre-treated nets: these are nets which may come treated but have to be treated again within a certain time. If the respondent is not sure of what type of net they have, try to observe it, if possible. If the net is neither long lasting nor pre-treated then code it as other. When you finish asking about the brands of nets from A to F, ask the respondent if there is any other brand of net. If 'Yes', code TN3o3, and write down the brand of the net. If there is another net for which the respondent does not know the brand, code 'Yes' for TN3o4. Households 1 Yes 2 No 8 DK Other - Brand E Other - Brand E Other - Brand E Other - Brand E Other - Brand E Is the net (are any of the nets) any of the following brands: Read each brand name, show picture card, and circle codes for Yes or No for each brand. If possible, observe the net to verify brand. During training, you will be shown all the common mosquito nets that are available in the country. There are many types of nets available on the Markey in Somalia, so to is important for interviewers to be able to distinguish between long lasting, pre-treated and other. Long lasting nets: there is currently one main type of long lasting net available in Somalia. These nets usually come in blue packaging and have an easily identifiable label located on the net itself. Interviewers will be given a picture of this label. Use this to identify the type of net in the dwelling and circle the corresponding number on the questionnaire. Pre-treated nets: these are nets which may come treated but have to be treated again within a certain time. If the respondent is not sure of what type of net they have, try to observe it, if possible. If the net is neither long lasting nor pre-treated then code it as other. When you finish asking about the brands of nets from A to F, ask the respondent if there is any other brand of net. If 'Yes', code TN3o3, and write down the brand of the net. If there is another net for which the respondent does not know the brand, code 'Yes' for TN3o4. Households 1 Yes 2 No 8 DK Net was pre-treated Net was pre-treated Net was pre-treated Net was pre-treated Net was pre-treated Check TN3 for brand of net(s). Go through the above list in order until one box is checked and follow instructions: 1. Long-lasting treated net (brand A or brand B) mentioned? Go to Next Module 2. Pre-treated net (brand C or brand D) mentioned? Go to TN6 3. Other net (brand E, brand F or any other net, or an unknown brand) mentioned? Continue with TN5 When you got the (most recent) net, was it already treated with an insecticide to kill or repel mosquitoes? Go through the list in TN3 in order, and stop when you are able to check one of the three boxes in TN4. Follow the instructions below for the first box checked. Only one of the following three boxes should be checked. If a long-lasting treated net (brand A or brand B) was mentioned, check box 1 and skip to the next module. This means that the household has at least one long-lasting net. If either of the pre-treated nets (brand C or brand D) was mentioned, check box 2 and skip to TN6.This means that the household does not have a long-lasting net, but has at least one pre-treated net. If another brand of net (brand E or brand F), any other net, or an unknown brand was mentioned, check box 3 and continue with TN5 to learn more about the net. --- This question is only asked about all nets other than the long-lasting and pre-treated nets. With this question, we try to learn whether the net was actually treated with an insecticide when the household obtained it. Note that the question should refer to the net most recently obtained. If the household has only one net, you do not need to specify (MOST RECENT) when asking the question. Households 1 Yes 2 No 8 DK Months ago net obtained Months ago net obtained Months ago net obtained Months ago net obtained Months ago net obtained How many months ago was the (most recent) net obtained? If less than 1 month ago, record '00'. If answer is "12 months" or "1 year", probe to determine if net was obtained exactly 12 months ago or earlier or later. This question is only asked about pre-treated (not permanently treated) nets - that is, brand C or brand D, and all other nets. If the household owns more than one of these types of nets, we are interested in the net that was acquired most recently. If it was obtained within the last 2 years (24 months), calculate the number of months from the respondent's answer and record the number of months in the space provided. If the net was obtained within the last month, enter '00' in the space provided. For example, if the respondent says, "We bought the net a year and a half ago, during the planting season," the first step is to add 12 months for each year mentioned (1 year = 12 months). The season mentioned by the respondent was the 'planting season'. Using this memory cue, ask the respondent to be more precise about which month the net was purchased, that is, "at the beginning, middle or end of planting season?" or which planting season if there is more than one. If the respondent says that he/she bought it "at the beginning of the planting season in April," and it is October at the time of the interview, count the number of months between April and October, not counting the month of purchase (May, June, July, August, September, October = 6 months. Then add the sums, 12 months + 6 months = 18 months, and record '18' in the space provided). If the net was obtained more than 2 years ago, circle '95'. If the respondent does not know the exact number of months, probe to obtain the best estimate. If the respondent says 'a year ago', probe to try to determine if the net was obtained exactly 12 months ago, or earlier or later. Circle '98' for 'Not sure' only if the respondent cannot even estimate how long ago the net was obtained. Households 95 More than 24 months ago 98 Not sure Net soaked or dipped since obtained Net soaked or dipped since obtained Net soaked or dipped since obtained Net soaked or dipped since obtained Net soaked or dipped since obtained Since you got the net(s) has it (have any of these nets) ever been soaked or dipped in a liquid to kill/repel mosquitoes? Make sure that the respondent understands that you don't mean simply 'washing the net' or spraying it with insecticide from a can or canister. We want to know whether the net was soaked or dipped in an insecticide. Circle the code corresponding to the answer given. If 'No' or 'DK' ('Doesn't know'), skip to the next module. Households 1 Yes 2 No 8 DK Months ago net soaked or dipped Months ago net soaked or dipped Months ago net soaked or dipped Months ago net soaked or dipped Months ago net soaked or dipped How long ago was the most recent soaking/dipping done? If less than 1 month, record '00'. If answer is "12 months" or "1 year", probe to determine if net was treated exactly 12 months ago or earlier or later If the last time was within the last 2 years (24 months), record the number of months ago in the space provided. If the last time was less than 1 month ago, record '00'. If the last time was more than 2 years ago, circle '95'. If the respondent does not know the number of months, probe to obtain his/her best estimate. Circle '98' for 'Not sure' only if the respondent cannot even estimate when the net was last soaked or dipped. Households 95 More than 24 months ago 98 Not sure Where did you get the mosquito net Where did you get the mosquito net Where did you get the mosquito net Where did you get the mosquito net Where did you get the mosquito net Where did you get the (name of net highest in the list of nets available in the household, in TN3) mosquito net? Ask question in relation to the most effective mosquito net available in the household (Check TN3). If there is more than one net in the same category, ask question referring to the most recently obtained net. Before you ask the question, you should check the responses in TN3. The question should be phrased to refer to the most effective mosquito net in the household - in other words, the first net listed in TN3 that is circled '1'. If there is only one net in the household, the question should obviously refer to this net. The intent of this question is to identify where the first mosquito net listed in TN3 was obtained. Circle the code corresponding to the answer given. Probe to identify the type of source. If the household obtained the net from a medical sector source, ask whether the place is in the public (run by 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 (specify)' and circle '16'. Similarly, if the place where the net was obtained 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 (specify)' circle '26'. If the respondent answers that the mosquito net was obtained from another place not listed, write the description of the place in the space provided for 'Other' and circle '96'. Then notify 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. Circle '98' if the respondent does not know where the mosquito net was obtained. Households 12 Govt health centre 13 Govt health post 14 Village health worker 16 Other public source 21 Private hospital/clinic 22 Private physician 23 Private pharmacy 24 Mobile clinic 26 Other private medical 31 Relative or friend 32 Shop 33 Traditional practitioner 96 Other 98 DK How much did you pay for this mosquito net How much did you pay for this mosquito net How much did you pay for this mosquito net How much did you pay for this mosquito net How much did you pay for this mosquito net How much did you pay for the (name of net highest in the list of nets available in the household, in TN3) mosquito net? Ask question in relation to the most effective mosquito net available in the household (Check TN3). If there is more than one net in the same category, ask question referring to the most recently obtained net. Record how much was paid in the local currency for the mosquito net identified in TN3. If the mosquito net was free, circle '9996'. Circle '9998' if the respondent does not know how much was paid for the mosquito net. Households 9996 Free 9998 DK Salt iodization test outcome Salt iodization test outcome Salt iodization test outcome Salt iodization test outcome Salt iodization test outcome We would like to check whether the salt used in your household is iodized. May i see a sample of the salt used to cook the main meal eaten by members of your household last night? Once you have examined the salt, circle number that corresponds to test outcome. After you have completed all modules of the Household Questionnaire, administer the module on Salt Iodization. Note that in this module, you will most probably perform a test on a sample of salt provided by the respondent. This item is used to record the type of salt used to prepare the family's main meal the day before the questionnaire is administered, and the outcome of the test for salt iodization. Once you have a sample of salt, perform the test and circle the code that corresponds to the test outcome. Circle '1' if the test is negative (0 parts per million/no colour - not iodized). Circle '2' if the test shows less than 15 parts per million iodine (weak colour). Circle '3' if the test is positive (15 parts per million or more, strong colour). Circle '6' if there is 'No salt in home'. Circle '7' if the salt was present, but not tested for any reason. If the respondent indicates that no salt was used to cook the main meal last night, or that no meal was cooked, ask for a sample of the salt usually used for cooking in the household, and perform the test on this sample of salt. Households 1 Not iodized 0 PPM (no colour) 2 Less than 15 PPM (weak colour) 3 15 PPM or more (strong colour) 6 No salt in home 7 Salt not tested 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 Non Urban Regions Regions Regions Regions Regions Recoded variable Household 1 W/Galbeed 2 Awdal 3 Sanaag 4 Sool 5 Togdhere 6 Mudug 7 Nugal 8 Bari 9 Bakool 10 Bay 11 Gedo 12 Middle Juba 13 Hiran 14 Middle Shabelle 15 Lower Shabelle 16 Banadir 17 Galguduud 18 Lower Juba This variable was created during data analyses for weighting purposes only. Determined from the cluster numbers. Provinces correspond to the 18 prewar (1991) regions of Somalia. In the survey design regions were not set up as sampling domains therefore UNICEF does not recommend disaggregating data at the regional level. Education of household head Education of household head Education of household head Education of household head Education of household head Recoded variable Households None 1 Koranic 2 Primary 3 Secondary + 4 Non-formal curriculum 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 Household sample weight Household sample weight Household sample weight Household sample weight Household sample weight Recoded variable Households Wealth index score Wealth index score Wealth index score Wealth index score Wealth index score Recoded variable Households Wealth index quintiles Wealth index quintiles Wealth index quintiles Wealth index quintiles Wealth index quintiles Recoded variable Households Excluded 1 Poorest 2 Second 3 Middle 4 Fourth 5 Richest Cluster number Cluster number Cluster number Cluster number Cluster number We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. During this time I would like to speak with the household head and all mothers or others who take care of children in the household. May I start now? If permission is given, begin the interview. Cluster number: Enter the cluster number as instructed by your supervisor. Households Unique identifier for the cluster in which the household exists Household number Household number Household number Household number Household number Household number: Enter the household number as instructed by your supervisor. Households Line number Line number Line number Line number Line number Women aged 15-49 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 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) 97 97+ 98 DK Line number of eligible women Line number of eligible women Line number of eligible women Line number of eligible women Line number of eligible women Circle Line no. if woman is age 15-49 Circle the line number in this column if the household member is a woman 15-49 years of age (this includes those age 15 and age 49). You will not ask this question to the respondent. De jure household members (usual residents) Not eligible Line number of mother/caretaker for child labor module Line number of mother/caretaker for child labor module Line number of mother/caretaker for child labor module Line number of mother/caretaker for child labor module Line number of mother/caretaker for child labor module For each child age 5-14: Who is the mother or primary caretaker of this child? Record Line no. of mother/caretaker If the household member is a child between 5 and 14 years of age (this includes those age 5 and age 14), record the line number of his/her mother or primary caretaker in this column. Ask this question to the respondent if necessary. De jure household members (usual residents) Not eligible Line number of mother/caretaker for child health module Line number of mother/caretaker for child health module Line number of mother/caretaker for child health module Line number of mother/caretaker for child health module Line number of mother/caretaker for child health module For each child under 5: Who is the mother or primary caretaker of this child? Record Line no. of mother/caretaker If the household member is a child under the age of five (this includes those just born and those age 4, but not children who have completed 5 years of age), record the line number of his/her mother or primary caretaker in this column. Ask this question to the respondent if necessary. De jure household members (usual residents) Not eligible Mother alive Mother alive Mother alive Mother alive Mother alive For children age 0-17 years ask HL9-HL12 Is (name's) natural mother alive? For all children under age 18, we want to know whether either of their own (natural) parents is listed in the Household Listing, and their survival status. This information can be used to measure the prevalence of orphanhood and child fostering in the population. For everyone age 18 and older, HL9-12 will be left blank. --- By 'natural' we mean the biological mother. In many cultures, people consider other people's children whom they are raising as their own, especially children of their husband or sisters, etc. You should be certain that the respondent understands that you are asking about the woman who gave birth to the child. Record whether or not the child's natural mother is still alive by circling the code corresponding to the response given. If the child's natural mother is not alive or if the respondent does not know, skip to HL11. Otherwise, continue to the question in the next column. De jure household members (usual residents) aged 0-17 (under 18) 1 Yes 2 No 8 DK Mother line number in HH Mother line number in HH Mother line number in HH Mother line number in HH Mother line number in HH For children age 0-17 years ask HL9-HL12 If alive: Does (name's) natural mother live in this household? Record Line no. of mother or 00 for 'No' For all children under age 18, we want to know whether either of their own (natural) parents is listed in the Household Listing, and their survival status. This information can be used to measure the prevalence of orphanhood and child fostering in the population. For everyone age 18 and older, HL9-12 will be left blank. --- If the natural mother is still alive, we want to know whether she lives in the household. If the mother does live in the household, ask who she is (she should be listed in the Household Listing if she lives in the household) and record her line number in the space provided. If the mother is not a member of the household (not listed in the Household Listing), record '00'. De jure household members (usual residents) aged 0-17 (under 18) 97 Inconsistent 99 Missing Father alive Father alive Father alive Father alive Father alive For children age 0-17 years ask HL9-HL12 If alive: Is (name's) natural father alive? For all children under age 18, we want to know whether either of their own (natural) parents is listed in the Household Listing, and their survival status. This information can be used to measure the prevalence of orphanhood and child fostering in the population. For everyone age 18 and older, HL9-12 will be left blank. --- Fill in these questions in exactly the same way as HL9 and HL10. This time, make sure to record the survival status and the line number of the natural (biological) fathers. If the father of the household member is not alive or his survival status is now known by the respondent, move to the next person on the list. De jure household members (usual residents) aged 0-17 (under 18) 1 Yes 2 No 8 DK Father line number in HH Father line number in HH Father line number in HH Father line number in HH Father line number in HH For children age 0-17 years ask HL9-HL12 Does (name's) natural father live in this household? Record Line no. of father or 00 for 'No' For all children under age 18, we want to know whether either of their own (natural) parents is listed in the Household Listing, and their survival status. This information can be used to measure the prevalence of orphanhood and child fostering in the population. For everyone age 18 and older, HL9-12 will be left blank. --- Fill in these questions in exactly the same way as HL9 and HL10. This time, make sure to record the survival status and the line number of the natural (biological) fathers. If the father of the household member is not alive or his survival status is now known by the respondent, move to the next person on the list. --- When you have completed the listing of all household members and all questions in the Household Listing, probe to see if there are any other household members you have not included in the list: "ARE THERE ANY OTHER PERSONS LIVING HERE - EVEN IF THEY ARE NOT MEMBERS OF YOUR FAMILY OR DO NOT HAVE PARENTS LIVING IN THIS HOUSEHOLD? INCLUDING CHILDREN AT WORK OR AT SCHOOL?" If yes, insert child's name and complete the form. After you have made sure that there are no other household members to be included in the list, complete the row at the bottom of the household list, 'Totals'. Calculate the number of eligible women in the household and record the number under 'Women 15-49', calculate the number of children aged 5-14 years in the household and record the number under 'Children 5-14' and, finally, calculate the number of children under five, and record the number under 'Under-5s'. The numbers recorded here for the women 15-49 and under-5s will indicate to you the number of individual women's and under-five questionnaires you should have in the household (see below). You will also record these numbers in HH12 and HH14 in the Household Information Panel. When you have completed the Household Listing Form for all household members, prepare the individual questionnaire forms for this household: . For each woman age 15-49 years, write her name and line number in the spaces provided (WM3 and WM4) at the top of her Questionnaire for Individual Women. . For each child under age five, write his/her name and line number and the name and line number of his/her mother or caretaker in the spaces provided (UF3-6) at the top of the Questionnaire for Children Under Five. You should now have a separate questionnaire for each eligible woman and child under five in the household, ready for use when you administer the questionnaires later on. De jure household members (usual residents) aged 0-17 (under 18) 97 Inconsistent 99 Missing Line number Line number Line number Line number Line number For household members age 5 and above Continue line by line, asking the questions for each household member who is eligible (age five or older), as you did when completing the Household Listing Form. Note that the lines corresponding to household members under five should remain blank. This is the number assigned to each person on the Household Listing Form. You do not need to fill in or do anything in this column since the numbers are already provided. Copy the names of each person age five and older from the Household Listing Form (HL2) to their corresponding line numbers. De jure household members (usual residents) Ever attended school Ever attended school Ever attended school Ever attended school Ever attended school For household members age 5 and above Has (name) ever attended school or preschool? For each household member age five or older, ask ED2 and ED3. These questions ask about educational attainment for all household members in this age group. (If children younger than five attend school or pre-school, this information will be recorded in the Questionnaire for Children Under Five.) Any adult member of the household may provide this information for those not present. --- Circle '1' if the answer is 'Yes'. If the answer is 'No', circle '2' and go to the household member on the next line. The term 'school' includes primary, secondary and post-secondary schooling, as well as any other intermediate levels of schooling in the formal school system. It also includes technical or vocational training beyond the primary-school level, such as long-term courses in mechanics or secretarial work. Schools that carry out non-standard curriculum are also included here. Ensure that respondents understand what is meant by 'non-standard curriculum'. A non-standard curriculum includes religious schools, such as Koranic schools, that do not teach a full, standard school curriculum. If a school teaches religious courses but also includes the standard curriculum - such as many Catholic schools - it would be coded as a standard school. 'Pre-school' is listed for children who do not attend grade 1 at age 5, but do attend some form of organized learning or early childhood education programme, whether or not such a programme is considered part of the school system. The definition of organized early learning programme does not refer to programmes offering only babysitting or child-minding. De jure household members (usual residents) 1 Yes 2 No 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 4 Koranic 6 Non-standard curriculum 8 DK 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) 66 Don't Have Grades 97 Inconsistent 98 DK 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 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 4 Koranic 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 66 Don't Have Grades 97 Inconsistent 98 DK 99 Missing Attended school last year (2004-2005) Attended school last year (2004-2005) Attended school last year (2004-2005) Attended school last year (2004-2005) Attended school last year (2004-2005) 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 4 Koranic 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 66 Don't Have Grades 97 Inconsistent 98 DK 99 Missing Line number Line number Line number Line number Line number To be administered to mother/caretaker of each child in the household age 5 through 14 years. For household members below age 5 or above age 14, leave rows blank. Now I would like to ask about any work children in this household may do. This module is to be administered to the mother or primary caretaker of each child resident in the household aged 5 through 14 years (this includes those age 5 and age 14). For household members younger than five or older than 14, rows should be left blank. --- This is the number assigned to each person on the Household Listing Form. You do not need to fill in or do anything in this column since the numbers are already provided. Explain, "NOW I WOULD LIKE TO ASK ABOUT ANY WORK CHILDREN IN THIS HOUSEHOLD MAY DO." Insert the child's name, copying from the Household Listing, column HL2. This is done to prevent confusion during the interview. Children aged 5-14 Worked in past week Worked in past week Worked in past week Worked in past week Worked in past week During the past week, did (name) do any kind of work for someone who is not a member of this household? If yes: For pay in cash or kind? 'Pay' refers to any compensation for work, including cash or goods or services provided to the child or his family. 'The past week' refers to the 7 days preceding the interview day. Note that the person indicated - someone who is not a member of this household - may be a relative or a family member who lives in a different household. If the answer is 'Yes', ask if the work was done for pay in cash or kind. Circle '1' if work was done for pay in cash or kind. Circle '2' if work was not done for any form of pay. If '1' or '2' is circled, continue to the next question. If no work was done by that child in the past week, circle '3' and skip to CL5. Children aged 5-14 1 Yes, paid 2 Yes, unpaid 3 No 9 Missing Hours worked in past week Hours worked in past week Hours worked in past week Hours worked in past week Hours worked in past week If yes: Since last (day of the week), about how many hours did he/she do this work for someone who is not a member of this household? If more than one job, include all hours at all jobs. Record the estimated number of hours the child spent doing work in the past 7 days and skip to CL6. Make sure the mother or primary caretaker understands what you mean by "SINCE LAST (day of the week)" - specify the name of today's weekday, as you did in the Education Module. If the child works more than one such job, include the total hours spent doing such work in all jobs. Children aged 5-14 98 DK 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 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 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 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 Administer to each adult household member. Copy name and line number of each adult (age 15 or over) in the household. If one of these adults is not at home, another adult may respond for him/her. Indicate this by placing a '1' in MM3, and insert line number of proxy respondent in MM4. For household members below age 15, leave rows blank Maternal mortality refers to deaths among women who are pregnant, women who die during childbirth and women who die during the post-partum period. For this questionnaire, the post-partum period is defined as the 6-week period following the end of pregnancy. This module is administered to adult household members only. For the purposes of this module, adults are defined as persons aged 15 years or older. MM1. Line number: This is the number used to identify each household member eligible for this module (household members aged 15 years and older). You do not need to fill in or do anything in this column since the numbers are already provided. MM2. Name: Insert the name of each adult (those at least 15 years of age) in the household in this column next to his/her line number (from Household Listing, HL1), copying from the Household Listing, column HL2. After completing the list of adults, you will need to try and speak with everyone on the list available in the household at the time of your visit. Ask the following questions MM3 through MM8 to each adult, in turn, and then continue to the next adult on the list, until you have recorded answers for each adult listed. In the case of adults who are not available during your visit, you will ask for a proxy report (see MM3 below). Note that it is not necessary to do call-back visits to the household to complete this information. De jure household members (usual residents) Is this proxy report Is this proxy report Is this proxy report Is this proxy report Is this proxy report Is this a proxy report? MM3 asks if the responses recorded for this person on the list is a proxy report, that is, if the information that will be recorded for this adult is being provided by the person him/herself or by another adult household member. If the adult listed is available for interview, record '2' for 'No' and skip to MM5. If an adult listed is not at home, ask if there is another adult household member who is able to respond to questions about the absent person's sisters. If there is another adult who can respond, record a 'Yes' ('1') to question MM3 and continue to MM4. Even in cases where there are no adults in the household who feel they can answer questions regarding the absent person's family, always ask MM5-MM9 and record 'Doesn't know' ('98'), where necessary. If there is another adult present, ask questions MM5-MM9, specifying that you want to know about the sisters of the adult who is not present. Name that adult not present, and ask each question in turn, even if the respondent is unsure of some answers. In such cases, record '98' for 'Doesn't know'. De jure household members (usual residents) 1 Yes 2 No Line number of proxy Line number of proxy Line number of proxy Line number of proxy Line number of proxy Line no. of proxy respondent (from household listing HL1) Record the line number of the adult who will provide information for the absent person (from Household Listing, HL1). De jure household members (usual residents) How many sisters (born to the same mother) How many sisters (born to the same mother) How many sisters (born to the same mother) How many sisters (born to the same mother) How many sisters (born to the same mother) How many sisters (born to the same mother) have you ever had? This question asks how many sisters the respondent (or the adult for whom he/she is responding) has ever had. It is important that the respondent understands that you are asking about her true biological sisters, that is, all of the females born to the respondent's mother. For example, female cousins or sisters-in-law who may commonly be referred to as 'sister' should not be counted. Emphasize to the respondent that this number should include both her sisters who are living and those who have died. Note that there are no skips in questions MM5-MM9. If the respondent states in MM5 that she/he never had any sisters, you should enter '00' for the following four questions, MM6-MM9. De jure household members (usual residents) 98 Don't know How many of these sisters have been married How many of these sisters have been married How many of these sisters have been married How many of these sisters have been married How many of these sisters have been married How many of these sisters ever reached age 15? Enter the number of sisters who reached age 15 in the spaces provided. Use leading zeros if necessary. Again, this may include sisters who are alive now and age 15 or older and sisters who have died at some point after reaching their 15th birthday. The answer to this question must be less than (one or more sisters died before reaching age 15) or equal to (all of the sisters survived to age 15) the total number of sisters reported in MM5. Note that there are no skips in questions MM5-MM9. If the respondent states in MM5 that she/he never had any sisters, you should enter '00' for the following four questions, MM6-MM9. De jure household members (usual residents) 98 Don't know How many of these sisters are alive How many of these sisters are alive How many of these sisters are alive How many of these sisters are alive How many of these sisters are alive How many of these sisters (who are at least 15 years old) are alive now? Enter the number of sisters age 15 or older who are alive now in the spaces provided. Note that there are no skips in questions MM5-MM9. If the respondent states in MM5 that she/he never had any sisters, you should enter '00' for the following four questions, MM6-MM9. De jure household members (usual residents) 98 Don't know How many of these sisters have died How many of these sisters have died How many of these sisters have died How many of these sisters have died How many of these sisters have died How many of these sisters who reached age 15 or more have died? Enter the number of sisters who died when they were 15 or older. The sum of the numbers reported in MM7 and MM8 must equal the total number of sisters aged 15 or more reported in MM6. Note that there are no skips in questions MM5-MM9. If the respondent states in MM5 that she/he never had any sisters, you should enter '00' for the following four questions, MM6-MM9. De jure household members (usual residents) 98 Don't know How many of these died while pregnant or during childbirth How many of these died while pregnant or during childbirth How many of these died while pregnant or during childbirth How many of these died while pregnant or during childbirth How many of these died while pregnant or during childbirth How many of these dead sisters died while pregnant, or during childbirth, or during the six weeks after the end of pregnancy? This question asks about sisters reported in MM8 who died during any of the following three time periods: while pregnant, during childbirth or during the 6 weeks after the end of pregnancy. There are two important issues here. First, respondents should include any sister's death (recorded in MM8) that occurred during these time periods, regardless of the cause of death. For example, if a sister died from an accident and this accident occurred while she was pregnant or during the 6 weeks following her pregnancy, this death should be reported in MM9. It is also important to remember that not all pregnancies produce a live birth. Therefore, the 6-week period after the end of a pregnancy could refer to a 6-week period following a miscarriage, an induced abortion or a stillbirth. Note that there are no skips in questions MM5-MM9. If the respondent states in MM5 that she/he never had any sisters, you should enter '00' for the following four questions, MM6-MM9. De jure household members (usual residents) 98 Don't know Interviewer number Interviewer number Interviewer number Interviewer number Interviewer number Interviewer name and number: Enter your own name and identification number provided to you at the time of training. Households Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor name and number: Enter your supervisor's name and identification number. You will be provided with your supervisor's identification number as soon as you know who you will be working with. Households Day of interview Day of interview Day of interview Day of interview Day of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Month of interview Month of interview Month of interview Month of interview Month of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Year of interview Year of interview Year of interview Year of interview Year of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Area with nomadic Area with nomadic Area with nomadic Area with nomadic Area with nomadic 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. Household 1 Urban 21 Rural 22 Nomadic For the purposes of this survey, the analysis refers to the North West Zone, the North East Zone and Central South Zone according to prewar boundaries for Somaliland and Puntland and does not imply any recognition of administrative boundaries by the United Nations or the League of Arab States. Area presented by urban (district capitals), rural (rural sedentary) and nomadic (rural non-sedentary) Zone Zone Zone Zone Zone Region: Circle the code for zone. Households 1 North West 2 North East 3 Central South Result of HH interview Result of HH interview Result of HH interview Result of HH interview Result of HH interview After all questionnaires for the household have been completed, fill in the following information: Result of HH interview: If the Household Questionnaire is completed, circle '1' for 'Completed'. If you have not been able to contact the household after repeated visits, circle '2' for 'Not at home'. If the household refuses to be interviewed, circle '3' for 'Refused'. If you are unable to locate the household or if the dwelling is destroyed, circle '4' for 'HH not found/destroyed'. If you have not been able to complete the Household Questionnaire for another reason, you should circle '6' for 'Other' and specify the reason in the space provided. Some examples of 'Other' codes might be: the household respondent is incapacitated; the questionnaire is partly completed; adult household members were not found at home after repeated visits. Households 1 Completed 2 Not at home 3 Refused 4 HH not found/destroyed 6 Other Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent to HH questionnaire: Enter the name and line number (from the Household Listing, columns HL1 and HL2) of the respondent to the Household Questionnaire. Households 99 Missing Number of household members Number of household members Number of household members Number of household members Number of household members Total number of household members: Count the number of household members recorded in column HL1 of the Household Listing and enter the total here. Households Total eligible women Total eligible women Total eligible women Total eligible women Total eligible women No.of women eligible for interview: Enter the total number of women eligible for interview for the Questionnaire for Individual Women - you will copy this from the row for totals at the bottom of the Household Listing, for HL6. Households Women interviews completed Women interviews completed Women interviews completed Women interviews completed Women interviews completed No.of women questionnaires completed: Once all of the Questionnaires for Individual Women have been completed for a particular household, enter the number completed here. Households Total children under 5 Total children under 5 Total children under 5 Total children under 5 Total children under 5 No.of children under age 5: Enter the total number of children under five eligible for inclusion in the survey from the row for totals at the bottom of the Household Listing, for HL8. You will be using the Questionnaire for Children Under Five to interview the mothers or primary caretakers of these children. Households Child interviews completed Child interviews completed Child interviews completed Child interviews completed Child interviews completed No.of under-5 questionnaires completed: Once all of the Questionnaires for Children Under Five have been completed for a particular household, enter the number completed here. Households Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk: Leave this space blank. The data clerk will enter his/her number in the space provided. Households Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water What is the main source of drinking water for members of your household? The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): · '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. · '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. · '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. · '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. · '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. · '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. · '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. · '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). · '52' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof and stored in a container, tank or cistern until used. · '53' Berkad · '54' Rain water catchment (Balli) · '61' - A tanker-truck water source transports and sells water by means of a tanker truck. · '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. · '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. · '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. Households 11 Piped into dwelling 12 Piped into yard or plot 13 Public tap/standpipe 21 Tubewell/borehole 31 Protected well 32 Unprotected well 41 Protected spring 42 Unprotected spring 52 Roof top 53 Berkad 54 Balli 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 91 Bottled water 96 Other Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes What is the main source of water used by your household for other purposes such as cooking and handwashing? The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): · '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. · '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. · '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. · '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. · '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. · '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. · '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. · '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). · '52' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof and stored in a container, tank or cistern until used. · '53' Berkad · '54' Rain water catchment (Balli) · '61' - A tanker-truck water source transports and sells water by means of a tanker truck. · '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. · '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. · '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. Households 11 Piped into dwelling 12 Piped into yard or plot 13 Public tap/standpipe 21 Tubewell/borehole 31 Protected well 32 Unprotected well 41 Protected spring 42 Unprotected spring 52 Roof top 53 Berkad 54 Balli 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 96 Other 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 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 Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Do you take any meausures to prevent contamination while handling the water or water storage containers? Circle '1' if 'Yes', and continue to the next question. If 'No' or 'DK' (Doesn't know'), circle '2' or '8', respectively. Household 1 Yes 2 No 8 D.K Definitions of various methods of prevention are as follows: · 'A' - Wash hands before collecting water · 'B' - Store drinking water in a clean container with cover · 'C' - Use a separate clean cup with a long handle for taking water out of the container · 'D' - Keep animals away from the container Wash Hands Wash Hands Wash Hands Wash Hands Wash Hands What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing A Wash Hands Store in clean container Store in clean container Store in clean container Store in clean container Store in clean container What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing B Container with cover Use separate container Use separate container Use separate container Use separate container Use separate container What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing C Use Separate container Keep animals away Keep animals away Keep animals away Keep animals away Keep animals away What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing D Keep animals Other Other Other Other Other What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing X Other D.K D.K D.K D.K D.K What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing Z D.K 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 Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Does your main drinking water source give you a reliable supply? If the respondent replies 'no' try to assess how often they encounter problems. If they encounter problems occasionally such as a few times a month circle '2', if a few times a week circle '3' for daily problems circle '4'. If the household complains that it is only at certain times of year they do not have a reliable supply then circle 5'. If the household does not know circle '8'. Household 1 Almost no problems 2 Occasionaly Problems 3 Weekly Problems 4 Daily Problems 5 Seasonaly Supply 8 D.K Kind of toilet facility Kind of toilet facility Kind of toilet facility Kind of toilet facility Kind of toilet facility What kind of toilet facility do members of your household usually use? If "flush" or "pour flush", probe: Where does it flush to? If necessary, ask permission to observe the facility. Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of this question is to obtain a measure of the cleanliness of the sanitary facility used by the household members. It may be necessary to observe the facility. If so, ask permission to do so. If the respondent answers or it is observed that the household members have no facilities or use the bush or field, enter '95' for 'No facilities or bush or field' and skip to the next module. If any of the flush or pour flush responses (11-15) are given, probe: "WHERE DOES IT FLUSH TO?" Circle the code corresponding to the response given. Definitions of various types of toilet facilities are as follows: A flush toilet uses a cistern or holding tank for flushing water and has a water seal, which is a U-shaped pipe, below the seat or squatting pan that prevents the passage of flies and odours. A pour flush toilet uses a water seal, but unlike a flush toilet, a pour flush toilet uses water poured by hand for flushing (no cistern is used). . '11' - A piped sewer system is a system of sewer pipes, also called sewerage, that is designed to collect human excreta (faeces and urine) and wastewater and remove them from the household environment. Sewerage systems consist of facilities for collection, pumping, treating and disposing of human excreta and wastewater. . '12' - A septic tank is an excreta collection device and is a water-tight settling tank normally located underground, away from the house or toilet. . '13' - A flush/pour flush to pit latrine refers to a system that flushes excreta to a hole in the ground. . '14' - A flush/pour flush to somewhere else refers to excreta being deposited in or nearby the household environment (not into pit, septic tank or sewer); excreta may be flushed to the street, yard/plot, drainage way or other location. . '15' - Flush to unknown place/not sure/DK where should be coded in cases when the respondent knows that the toilet facility is a flush toilet, but does not know where it flushes to. '21' - A ventilated improved pit latrine or VIP is a type of pit latrine that is ventilated by a pipe extending above the latrine roof. The open end of the vent pipe is covered with gauze mesh or fly-proof netting and the inside of the superstructure is kept dark. '22' - A pit latrine with slab uses a hole in the ground for excreta collection and has a squatting slab, platform or seat that is firmly supported on all sides, easy to clean and raised above the surrounding ground level to prevent surface water from entering the pit. '23' - A pit latrine without slab uses a hole in the ground for excreta collection and does not have a squatting slab, platform or seat. An open pit is a rudimentary hole in the ground where excreta is collected. '31' - A composting toilet is a toilet into which excreta and carbon-rich material are added (vegetable wastes, straw, grass, sawdust, ash) and special conditions maintained to produce inoffensive compost. '41' - Bucket refers to the use of a bucket or other container for the retention of faeces (and sometimes urine and anal cleaning material), which is periodically removed for treatment or disposal. '51' - A hanging toilet or hanging latrine is a toilet built over the sea, a river, or other body of water into which excreta drops directly. '95' - No facilities or bush or field includes excreta wrapped and thrown with garbage, the 'cat' method of burying excreta in dirt, defecation in the bush or field or ditch, and defecation into surface water (drainage channel, beach, river, stream or sea). Households 11 Flush to piped sewer system 12 Flush to septic tank 13 Flush to pit (latrine) 14 Flush to somewhere else 15 Flush to unknown place/not sure/DK where 21 Ventilated Improved Pit latrine (VIP) 22 Pit latrine with slab 23 Pit latrine without slab/open pit 95 No facilities or bush or field 96 Other 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 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 Wash hands before eating Wash hands before eating Wash hands before eating Wash hands before eating Wash hands before eating Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No wash hands after defecation wash hands after defecation wash hands after defecation wash hands after defecation wash hands after defecation Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing wash hands after eating wash hands after eating wash hands after eating wash hands after eating wash hands after eating Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No 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 32 Vinyl or asphalt strips 33 Ceramic tiles 34 Cement 35 Carpet 96 Other 99 Missing Main material of roof Main material of roof Main material of roof Main material of roof Main material of roof Main material of the roof. Record observation. Circle the correct code for the material of the dwelling roof, based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the roof, record the main roofing material (the material that covers the largest amount of roof). Households 11 No roof 12 Thatch/palm leaf 13 Mud & Grass 21 Rustic mat 22 Palm/Grass 23 Wood Planks 24 Sacking/Plastic sheets 31 Metal 32 Wood 33 Calamine/cement fiber 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 Sticks/palm/trunks 13 Mud 21 Bambo with mud 22 Stone with mud 23 Uncovered adobe 24 Plywood 25 Carton 26 Reused wood 27 Cloth/Matting 31 Cement 32 Stone with lime/cement 33 Bricks 34 Cement blocks 35 Covered adobe 36 Wood planks/shingles 96 Other 99 Missing Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking What type of fuel does your household mainly use for cooking? Information on the type of fuel used for cooking is collected as another measure of the socio-economic status of the household. The use of some cooking fuels can also have adverse health consequences. Circle the code corresponding to the answer given. Remember that this question asks about fuel for cooking, not fuel for heating or lighting. If the household uses more than one fuel for cooking, find out which type of fuel is used most often. If electricity, liquid propane gas (LPG), natural gas, or biogas is mainly used, circle '01', '02', '03', or '04', respectively, and skip to HC8. If any fuel other than the pre-coded ones is reported as being the main fuel used for cooking, circle '96' and specify the type of fuel on the line provided. Definitions of some of the types of fuel are as follows: 'Biogas' includes gases produced by fermenting manure in an enclosed pit. 'Lignite' is a derivative of coal that produces more smoke when burned but produces less heat than coal. Households 1 Electricity 2 Liquid propane gas (LPG) 5 Kerosene 7 Charcoal 8 Wood 9 Straw/shrubs/grass 10 Animal dung 11 Agricultural crop residue 96 Other 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 6 Other 9 Missing Bed Bed Bed Bed Bed Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing 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, VCD/DVD PLAYER, FAN? 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 VCD/DVD Player VCD/DVD Player VCD/DVD Player VCD/DVD Player VCD/DVD Player Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Fan Fan Fan Fan Fan Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Satellite Dish Satellite Dish Satellite Dish Satellite Dish Satellite Dish Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing 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 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 Clock Clock Clock Clock Clock Does any member of your household own: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Sewing Machine Sewing Machine Sewing Machine Sewing Machine Sewing Machine Does any member of your household own: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of this household own any land that can be used for agriculture? Circle the code corresponding to the response given. If 'No', skip to HC13. Households 1 Yes 2 No 9 Missing How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agricultural land do members of this household own? If more than 97, record '97'. If unknown, record '98'. Record the total number of hectares of land owned by all members of the household that can be used for agriculture. If 97 or more hectares (or other units) are owned, record '97'. If unknown, record '98'. Households 97 More than 97 98 Don't know 99 Missing Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, herds, or farm animals? Circle the code corresponding to the response given. If 'No', skip to the next module. Households 1 Yes 2 No 9 Missing Number of camels Number of camels Number of camels Number of camels Number of camels How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 99 Missing 98 Don't know Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 98 Don't know 99 Missing Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 98 Don't know 99 Missing Number of Goats Number of Goats Number of Goats Number of Goats Number of Goats How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 98 Don't know 99 Missing Number of sheep Number of sheep Number of sheep Number of sheep Number of sheep How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 98 Don't know 99 Missing Number of chickens Number of chickens Number of chickens Number of chickens Number of chickens How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 98 Don't know 99 Missing 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 Non Urban Regions Regions Regions Regions Regions Recoded variable Household 1 W/Galbeed 2 Awdal 3 Sanaag 4 Sool 5 Togdhere 6 Mudug 7 Nugal 8 Bari 9 Bakool 10 Bay 11 Gedo 12 Middle Juba 13 Hiran 14 Middle Shabelle 15 Lower Shabelle 16 Banadir 17 Galguduud 18 Lower Juba This variable was created during data analyses for weighting purposes only. Determined from the cluster numbers. Provinces correspond to the 18 prewar (1991) regions of Somalia. In the survey design regions were not set up as sampling domains therefore UNICEF does not recommend disaggregating data at the regional level. Household sample weight Household sample weight Household sample weight Household sample weight Household sample weight Recoded variable Households Wealth index score Wealth index score Wealth index score Wealth index score Wealth index score Recoded variable Households Wealth index quintiles Wealth index quintiles Wealth index quintiles Wealth index quintiles Wealth index quintiles Recoded variable Households 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 Women age 15-49 None 1 Koranic 2 Primary 3 Secondary + 4 Non-formal curriculum 5 Mother not in household 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) None 1 Koranic 2 Primary 3 Secondary + 4 Non-formal curriculum 5 Father not in household Education of household head Education of household head Education of household head Education of household head Education of household head Recoded variable Households None 1 Koranic 2 Primary 3 Secondary + 4 Non-formal curriculum 9 Missing/DK Line number Line number Line number Line number Line number Cluster number Cluster number Cluster number Cluster number Cluster number We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. During this time I would like to speak with the household head and all mothers or others who take care of children in the household. May I start now? If permission is given, begin the interview. Cluster number: Enter the cluster number as instructed by your supervisor. Households Unique identifier for the cluster in which the household exists Household number Household number Household number Household number Household number Household number: Enter the household number as instructed by your supervisor. Households Line number Line number Line number Line number Line number Women aged 15-49 Cluster number Cluster number Cluster number Cluster number Cluster number Ever married women age 15-49 who have given birth Household number Household number Household number Household number Household number Ever married women age 15-49 who have given birth Woman's line number Woman's line number Woman's line number Woman's line number Woman's line number Ever married women age 15-49 who have given birth Interviewer number Interviewer number Interviewer number Interviewer number Interviewer number Day of interview Day of interview Day of interview Day of interview Day of interview Month of interview Month of interview Month of interview Month of interview Month of interview Year of interview Year of interview Year of interview Year of interview Year of interview Result of women 's interview Result of women 's interview Result of women 's interview Result of women 's interview Result of women 's interview 1 Completed 2 Not at home 3 Refused 4 Partly completed 5 Incapacitated 6 Other Month of birth of woman Month of birth of woman Month of birth of woman Month of birth of woman Month of birth of woman In what month and year were you born? 97 Inconsistent 98 DK Year of birth of woman Year of birth of woman Year of birth of woman Year of birth of woman Year of birth of woman In what month and year were you born? Women age 15-49 9997 Inconsistent 9998 DK Age of woman Age of woman Age of woman Age of woman Age of woman How old were you at your last birthday? Women age 15-49 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? Have you ever attended school? Women age 15-49 1 Yes 2 No 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? What is the highest level of school you attended: primary, secondary, or higher? Women age 15-49 1 Primary 2 Secondary 3 Higher 4 Koranic 5 Non-standard curriculum 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? What is the highest grade you completed at that level? Women age 15-49 66 Grades non-existent 97 Inconsistent 98 DK Can read part of the sentence Can read part of the sentence Can read part of the sentence Can read part of the sentence Can read part of the sentence Now I would like you to read this sentence to me. Show sentences to respondent. If respondent cannot read whole sentence, probe: Can you read part of the sentence to me? Show sentences to respondent. If respondent cannot read whole sentence, probe Women age 15-49 1 Cannot read at all 2 Able to read only parts of sentence 3 Able to read whole sentence 5 Blind/visually impaired Currently married Currently married Currently married Currently married Currently married Are you currently married or living together with a man as if married? Women age 15-49 1 Yes, currently married 3 No, not in union Age of husband Age of husband Age of husband Age of husband Age of husband How old was your husband/partner on his last birthday? Ever married women age 15-49 Husband has other wives Husband has other wives Husband has other wives Husband has other wives Husband has other wives Besides yourself, does your husband/partner have any other wives? Ever married women age 15-49 1 Yes 2 No 8 D.K Number of other wives Number of other wives Number of other wives Number of other wives Number of other wives How many other wives does he have? Ever married women age 15-49 98 DK Ever married Ever married Ever married Ever married Ever married Have you ever been married or lived together with a man? Women age 15-49 1 Yes, formerly married 3 No Marital status Marital status Marital status Marital status Marital status What is your marital status now: are you widowed, divorced or separated? Women age 15-49 1 Widowed 2 Divorced Married once or more than once Married once or more than once Married once or more than once Married once or more than once Married once or more than once Have you been married or lived with a man only once or more than once? Ever married women age 15-49 1 Only once 2 More than once Month of first union Month of first union Month of first union Month of first union Month of first union In what month and year did you first marry or start living with a man as if married? Ever married women age 15-49 97 Inconsistent 98 DK Year of first union Year of first union Year of first union Year of first union Year of first union In what month and year did you first marry or start living with a man as if married? Ever married women age 15-49 9997 Inconsistent 9998 DK Age at first union Age at first union Age at first union Age at first union Age at first union How old were you when you started living with your first husband/partner? Ever married women age 15-49 Ever given birth Ever given birth Ever given birth Ever given birth Ever given birth Now i would like to ask about all the births you have had during your life. Have you ever given birth? If "No" probe by asking: I mean, to a child who ever breathed or cried or showed other signs of life - even if he or she lived only a few minutes or hours? Ever married women age 15-49 1 Yes 2 No Any sons or daughters living with you Any sons or daughters living with you Any sons or daughters living with you Any sons or daughters living with you Any sons or daughters living with you Do you have any sons or daughters to whom you have given birth who are now living with you? Ever married women age 15-49 1 Yes 2 No Sons living with you Sons living with you Sons living with you Sons living with you Sons living with you How many sons live with you? Ever married women age 15-49 Daughters living with you Daughters living with you Daughters living with you Daughters living with you Daughters living with you How many daughters live with you? Ever married women age 15-49 Any sons or daughters not living with you Any sons or daughters not living with you Any sons or daughters not living with you Any sons or daughters not living with you Any sons or daughters not living with you Do you have any sons or daughters to whom you have given birth who are alive but do not live with you? Ever married women age 15-49 1 Yes 2 No Sons 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? Ever married women age 15-49 Daughters not living with you Daughters not living with you Daughters not living with you Daughters not living with you Daughters not living with you How many daughters are alive but do not live with you? Ever married women age 15-49 Ever had child who later died Ever had child who later died Ever had child who later died Ever had child who later died Ever had child who later died Have you ever given birth to a boy or girl who was born alive but later died? Ever married women age 15-49 1 Yes 2 No Boys dead Boys dead Boys dead Boys dead Boys dead How many boys have died? Ever married women age 15-49 Girls dead Girls dead Girls dead Girls dead Girls dead How many girls have died? Add the numbers of births reported in CM4, CM6 and CM8 and write the sum here, then check: If she says it is correct, check the box marked 'Yes' and continue to the next question. If she says 'No', first check your addition and then go back through the list to check with the respondent whether you have obtained the information correctly. For example, starting with CM4, you would ask: "YOU HAVE TWO SONS AND ONE DAUGHTER LIVING WITH YOU, IS THAT CORRECT?" Do the same for CM6 and CM8. Correct the answers and the sum mentioned in CM9 and then continue to the next question. Make sure to cancel the 'No' in CM10 and check 'Yes' after you have made the corrections. Ever married women age 15-49 Children ever born Children ever born Children ever born Children ever born Children ever born If the respondent's last birth occurred in the last 2 years, enter the name of the child on the line provided and check the box marked 'Yes'. Then continue with CM13. If the respondent's last birth did not occur in the last 2 years, check the box marked 'No' and go to the Marriage/Union module. Ever married women age 15-49 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. Ever married women aged 15-49 N No Y Yes 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 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 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 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 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 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 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. 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. 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. 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. 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. 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 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 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: private doctor Antenatal care: private doctor Antenatal care: private doctor Antenatal care: private doctor Antenatal care: private doctor 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 D Private 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: 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 Pregnancy months when first received antenatal care Pregnancy months when first received antenatal care Pregnancy months when first received antenatal care Pregnancy months when first received antenatal care Pregnancy months when first received antenatal care How many months pregnant were you when you first received antenatal care for this pregnancy? Record in completed months. If the mother really can't remember then circle '98' for don't know. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 98 DK Times received antenatal care Times received antenatal care Times received antenatal care Times received antenatal care Times received antenatal care How many times did you receive antenatal care for this pregnancy? Record the number of times. If the mother really can't remember then circle '98' for don't know Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 98 DK Hospital Hospital Hospital Hospital Hospital which type of health facility did you go to, to get this antenatal care? This is to get an idea of whether the women visited a health facility (they may have already mentioned this in MN2 but still ask the question again to verify). Circle the response. Midwife refers to a home or clinic run only by midwives. 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 did not go to a health facility for antenatal checks, circle 'Y. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing A Hospital MCH MCH MCH MCH MCH which type of health facility did you go to, to get this antenatal care? This is to get an idea of whether the women visited a health facility (they may have already mentioned this in MN2 but still ask the question again to verify). Circle the response. Midwife refers to a home or clinic run only by midwives. 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 did not go to a health facility for antenatal checks, circle 'Y. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing B MCH Midwife Midwife Midwife Midwife Midwife which type of health facility did you go to, to get this antenatal care? This is to get an idea of whether the women visited a health facility (they may have already mentioned this in MN2 but still ask the question again to verify). Circle the response. Midwife refers to a home or clinic run only by midwives. 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 did not go to a health facility for antenatal checks, circle 'Y. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing C Midwife Other Other Other Other Other which type of health facility did you go to, to get this antenatal care? This is to get an idea of whether the women visited a health facility (they may have already mentioned this in MN2 but still ask the question again to verify). Circle the response. Midwife refers to a home or clinic run only by midwives. 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 did not go to a health facility for antenatal checks, circle 'Y. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing X Other 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 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 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 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 Didn't feel the need Didn't feel the need Didn't feel the need Didn't feel the need Didn't feel the need What are the reasons for not seeing anyone (for ANC)? If more than one reason is mentioned, circle each one. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing A No need Not convinced Not convinced Not convinced Not convinced Not convinced What are the reasons for not seeing anyone (for ANC)? If more than one reason is mentioned, circle each one. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing B Not convinced Not capable financially Not capable financially Not capable financially Not capable financially Not capable financially What are the reasons for not seeing anyone (for ANC)? If more than one reason is mentioned, circle each one. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing C Financially incapable Difficult to reach Difficult to reach Difficult to reach Difficult to reach Difficult to reach What are the reasons for not seeing anyone (for ANC)? If more than one reason is mentioned, circle each one. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing D Difficult to reach Non-availability of medicaments Non-availability of medicaments Non-availability of medicaments Non-availability of medicaments Non-availability of medicaments What are the reasons for not seeing anyone (for ANC)? If more than one reason is mentioned, circle each one. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing E Medicine not available Other Other Other Other Other What are the reasons for not seeing anyone (for ANC)? If more than one reason is mentioned, circle each one. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing X ther DK DK DK DK DK What are the reasons for not seeing anyone (for ANC)? If more than one reason is mentioned, circle each one. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing Z DK Took medicine in order to prevent malaria Took medicine in order to prevent malaria Took medicine in order to prevent malaria Took medicine in order to prevent malaria Took medicine in order to prevent malaria During this pregnancy, did you take any medicine in order to prevent you from getting malaria? During pregnancy, a woman's immune system is weakened, making her more susceptible to malaria infection than women who are not pregnant. Malaria in pregnant women can cause several complications that are dangerous to the mother and unborn child, including severe malaria and death, maternal anaemia and low birthweight in newborns. The World Health Organization recommends that pregnant women in malaria-endemic areas take a treatment dose of SP/Fansidar (usually three tablets taken all at once) as a preventive measure, once a month during the third trimester of pregnancy (months 7, 8 and 9 of the pregnancy). Such preventive treatment with SP/Fansidar, usually given during antenatal visits, is known as intermittent preventive treatment (IPT). The generic name for SP/Fansidar is sulfadoxine-pyrimethamine, and other brand names can exist. Other antimalarial medicines can be used as a preventive measure as well. Circle the code corresponding to the answer given. Medicines to prevent malaria include only those medicines that a woman takes during pregnancy when she does not already have malaria. If the respondent took medicines during pregnancy when she did not already have malaria, continue to the next question. If the respondent did not take any medicine to prevent her from getting malaria, circle '2'. If she does not know whether she received treatment to prevent malaria during her last pregnancy, circle '8' for 'DK'. In both cases, skip to MN7. If the respondent says that she had malaria or a fever during the pregnancy and was given medicines to treat the malaria or fever, this would not be considered preventive treatment. In such a case, circle '2' for 'No' and 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 Fansidar Fansidar Fansidar Fansidar Fansidar Which medicines did you take to prevent malaria? Circle all medicines taken. If type of medicine is not determined, show typical anti-malarial to respondent Circle the codes corresponding to all medicines reported taken to prevent malaria during the pregnancy. If the respondent cannot remember the name of the medicine taken, ask her to show you the package it came in. If she doesn't have the package, show her typical antimalarials and ask if she took any of them. If she mentions that during an antenatal visit she was given three tablets to take all at the same time in order to prevent malaria, circle 'A' on the assumption that she took SP/Fansidar. If she took another medicine, write the name in the space provided in 'Other', and circle 'X'. If she doesn't know the name of the medicine she took to prevent malaria, circle 'Z'. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing A SP/Fansidar Chloroquine Chloroquine Chloroquine Chloroquine Chloroquine Which medicines did you take to prevent malaria? Circle all medicines taken. If type of medicine is not determined, show typical anti-malarial to respondent Circle the codes corresponding to all medicines reported taken to prevent malaria during the pregnancy. If the respondent cannot remember the name of the medicine taken, ask her to show you the package it came in. If she doesn't have the package, show her typical antimalarials and ask if she took any of them. If she mentions that during an antenatal visit she was given three tablets to take all at the same time in order to prevent malaria, circle 'A' on the assumption that she took SP/Fansidar. If she took another medicine, write the name in the space provided in 'Other', and circle 'X'. If she doesn't know the name of the medicine she took to prevent malaria, circle 'Z'. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing B Chloroquine Other Other Other Other Other Which medicines did you take to prevent malaria? Circle all medicines taken. If type of medicine is not determined, show typical anti-malarial to respondent Circle the codes corresponding to all medicines reported taken to prevent malaria during the pregnancy. If the respondent cannot remember the name of the medicine taken, ask her to show you the package it came in. If she doesn't have the package, show her typical antimalarials and ask if she took any of them. If she mentions that during an antenatal visit she was given three tablets to take all at the same time in order to prevent malaria, circle 'A' on the assumption that she took SP/Fansidar. If she took another medicine, write the name in the space provided in 'Other', and circle 'X'. If she doesn't know the name of the medicine she took to prevent malaria, circle 'Z'. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing X Other DK DK DK DK DK Which medicines did you take to prevent malaria? Circle all medicines taken. If type of medicine is not determined, show typical anti-malarial to respondent Circle the codes corresponding to all medicines reported taken to prevent malaria during the pregnancy. If the respondent cannot remember the name of the medicine taken, ask her to show you the package it came in. If she doesn't have the package, show her typical antimalarials and ask if she took any of them. If she mentions that during an antenatal visit she was given three tablets to take all at the same time in order to prevent malaria, circle 'A' on the assumption that she took SP/Fansidar. If she took another medicine, write the name in the space provided in 'Other', and circle 'X'. If she doesn't know the name of the medicine she took to prevent malaria, circle 'Z'. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing Z DK Times took SP/fansidar Times took SP/fansidar Times took SP/fansidar Times took SP/fansidar Times took SP/fansidar Check MN6B for medicine taken: SP/Fansidar taken. Continue with MN6D SP/Fansidar not taken. Go to MN7 How many times did you take SP/fansidar during this pregnancy to prevent malaria? This filter is used to skip the next question if the woman did not take SP/Fansidar during her last pregnancy. If SP/Fansidar was taken (MN6B), continue with the next question. If SP/Fansidar was not taken, skip to question MN7. --- Here we are asking about preventive doses of SP/Fansidar, not curative doses given if she had a fever. Therefore, in this question, we want to know only about preventive doses. Record the number of times she took SP/Fansidar during pregnancy in the space provided. If the woman visited an antenatal clinic or other facility because she was sick with fever and was given SP/Fansidar, do not count this in the number of times she took SP/Fansidar during the pregnancy. Count only the 'doses' taken (three tablets taken at the same time = '1 dose') when the woman was pregnant and did not have a fever. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey Slept under mosquito net during pregnancy Slept under mosquito net during pregnancy Slept under mosquito net during pregnancy Slept under mosquito net during pregnancy Slept under mosquito net during pregnancy During this pregnancy, did you regularly sleep under a mosquito net? Regular means most nights of the pregnancy. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No 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: Private Doctor assistance at delivery: Private Doctor assistance at delivery: Private Doctor assistance at delivery: Private Doctor assistance at delivery: Private Doctor Who assisted with the delivery of your last child (name)? Anyone else? When asking this question, be sure to use the name of the child you are referring to, so that there is no confusion. Probe for the type of person who assisted with the delivery. If the woman is not sure of the status of the person who attended the delivery, for example, if she doesn't know whether the attendant was a midwife or a traditional birth attendant, probe further. Circle the codes corresponding to all persons assisting at the delivery. If you are unsure where to code a person mentioned, write it in the space provided 'Other' and circle 'X'. If no one attended the delivery, circle 'Y'. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing D Private Doctor Assistance at delivery: Nurse/midwife Assistance at delivery: Nurse/midwife Assistance at delivery: Nurse/midwife Assistance at delivery: Nurse/midwife Assistance at delivery: Nurse/midwife Who assisted with the delivery of your last child (name)? Anyone else? 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: 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 Ceasarian Delivery Ceasarian Delivery Ceasarian Delivery Ceasarian Delivery Ceasarian Delivery Was (name) delivered by caesarian section? A caesarean section is the delivery of the baby by surgical incision through the abdominal wall and uterus. If the respondent cannot remember how the baby was delivered circle '8' for don't know. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No 8 DK 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 13 Midwife's home 21 Government hospital 22 Government clinic/health center 26 Other public 31 Private hospital 32 Private clinic 36 Other private medical 96 Other Where would have gone for emergency Where would have gone for emergency Where would have gone for emergency Where would have gone for emergency Where would have gone for emergency If during your pregnancy you needed emergency obstrtic care where would you have gone? Sometime problems develop with the pregnancy and women may have to seek outside help. Emergency obstetric care can include the administration of antibiotics, oxytocics, or anticonvulsants, the manual removal of the placenta, removal of retained products following miscarriage or abortion, assisted vaginal delivery with forceps or vacuum extractor as well as Caesarean section and blood transfusion required due to complications in labour. If the woman delivered by caesarian ask her at which type of facility she went to. Even if the women did not need any of the above assistance, this question is trying to establish where women would most typically seek help so it is important to probe for an answer. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 11 Resondent's home 12 Other home 13 Midwife's home 21 Government hospital 22 Government clinic/health center 26 Other public 31 Private hospital 32 Private clinic 36 Other private medical 96 Other 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 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 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 8 DK 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 Doctor Doctor Doctor Doctor Doctor Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? Probe for the type of health facility seen and circle all answers Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing A Doctor Private Doctor Private Doctor Private Doctor Private Doctor Private Doctor Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? Probe for the type of health facility seen and circle all answers Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing B Private Doctor Nurse Nurse Nurse Nurse Nurse Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? Probe for the type of health facility seen and circle all answers Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing C Nurse Midwife Midwife Midwife Midwife Midwife Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? Probe for the type of health facility seen and circle all answers Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing D Midwife Other Other Other Other Other Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? Probe for the type of health facility seen and circle all answers Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing X Other None None None None None Now I would like to ask you some questions about the 40 days period after the delivary of (name). Did you see anyone for a check-up on your health? If 'Yes' ask: Whom did you see? Anyone else? Probe for the type of health facility seen and circle all answers Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing Y None Hospital Hospital Hospital Hospital Hospital Where did you receive your post-natal checkup? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing A Hospital MCH MCH MCH MCH MCH Where did you receive your post-natal checkup? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing B MCH Midwife Midwife Midwife Midwife Midwife Where did you receive your post-natal checkup? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing C Midwife Doctor's Doctor's Doctor's Doctor's Doctor's Where did you receive your post-natal checkup? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing D Doctor Other Other Other Other Other Where did you receive your post-natal checkup? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey ? Missing X Other Main reason for no postnatal checkup Main reason for no postnatal checkup Main reason for no postnatal checkup Main reason for no postnatal checkup Main reason for no postnatal checkup What was the main reason for not recieveing a post-natal checkup? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 No complications 2 Experienced 3 Unaware 4 Service not available 5 Costy 6 Too busy 7 Husband too busy 96 Other 98 DK Received a vitamin A dose Received a vitamin A dose Received a vitamin A dose Received a vitamin A dose Received a vitamin A dose In the first 40 days after your last birth [the birth of name], did you receive a Vitamin A dose like this? Show 200,000 IU capsule or dispenser. Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No 8 DK 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 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 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 Had fever Had fever Had fever Had fever Had fever Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. MN14A. Did you have fever? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No Had urine trouble Had urine trouble Had urine trouble Had urine trouble Had urine trouble Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. MN14B. Did you have trouble controlling your urine? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No Had Uti Had Uti Had Uti Had Uti Had Uti Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you suffer from any of the following? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No had Mastitis had Mastitis had Mastitis had Mastitis had Mastitis Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you suffer from any of the following? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No Had discharge Had discharge Had discharge Had discharge Had discharge Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you suffer from any of the following? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No Had Tear Had Tear Had Tear Had Tear Had Tear Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you suffer from any of the following? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No Had wound infection Had wound infection Had wound infection Had wound infection Had wound infection Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you suffer from any of the following? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No Had hemorphage Had hemorphage Had hemorphage Had hemorphage Had hemorphage Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you suffer from any of the following? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No Had depression Had depression Had depression Had depression Had depression Now I would like to talk about some specific health problems related to birth some women have. I will ask you about the time After your last delivary and in the 40 days following it. Did you suffer from any of the following? Women aged 15-49 who gave birth to a child in the 2 years preceding the survey 1 Yes 2 No 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 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 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: 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: Diaphragm Current method: Diaphragm Current method: Diaphragm Current method: Diaphragm Current method: Diaphragm 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 I Diaphragm Current method: Foam/jelly Current method: Foam/jelly Current method: Foam/jelly Current method: Foam/jelly Current method: Foam/jelly Which method are 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 J Foam/Jelly Current method: Lactational amenorrhea method Current method: Lactational amenorrhea method Current method: Lactational amenorrhea method Current method: Lactational amenorrhea method Current method: Lactational amenorrhea method Which method are 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 Place obtained current method Place obtained current method Place obtained current method Place obtained current method Place obtained current method Married women age 15-49 11 Gov Hospital 12 Gov health center 13 Gov health post 14 village health worker 15 Mobile clinic 16 Other public 21 Private hospital 22 Private physcian 23 Private pharmacy 24 Mobile clinic 25 Other private 31 Relative friend 32 Shop 33 Traditional practicer 41 relative outside country 42 Shop outside country 96 Other 98 DK Prefer to have or not to have any more children Prefer to have or not to have any more children Prefer to have or not to have any more children Prefer to have or not to have any more children Prefer to have or not to have any more children a. Now I would like to ask some questions about the future. Would you like to have (a/another) child, or would you prefer not to have any (more) children? b. If currently pregnant: Now I would like to ask some questions about the future. After the child you are now expecting, would you like to have another child, or would you prefer not to have any (more) children? CP4A. Ask the question choosing the appropriate wording, based on what you know about the woman. If she is not pregnant, and has no living children, ask: "NOW I WOULD LIKE TO ASK SOME QUESTIONS ABOUT THE FUTURE. WOULD YOU LIKE TO HAVE A CHILD OR WOULD YOU PREFER NOT TO HAVE ANY CHILDREN?" Ask the entire question before accepting an answer. If she is not pregnant and has one or more children, you will have to word the question differently, saying "WOULD YOU LIKE TO HAVE ANOTHER CHILD OR WOULD YOU PREFER NOT TO HAVE ANY MORE CHILDREN?" Circle the code corresponding to the response given. Note that each response leads to a different skip instruction. If the woman wants to have a/another child, you should circle '1' and continue with CP4C. If she wants no more children or does not want to have children at all, you should circle '2' and skip to CP4D. If she says she cannot get pregnant, circle '3' and skip to the next module. If she is undecided or does not know, circle '8' and skip to CP4D. For women who are currently pregnant, you will not be asking CP4A. Instead, you will be asking CP4B, which uses the same response categories and is essentially the same question as CP4A, worded slightly differently: CP4B. Note that we want to make sure that pregnant women do not think that we are asking them if they want the child they are pregnant with now. Response categories and skip instructions are the same as those for CP4A. Women aged 15-49 1 Have (a/another( child 2 No more /none 3 Says she cannot get pregnant 8 Undecided/don't know Desired waiting time (units) Desired waiting time (units) Desired waiting time (units) Desired waiting time (units) Desired waiting time (units) How long would you like to wait before the birth of (a/another) child? Here, you will also need to choose the appropriate phrasing for the question, based on what you already know about the respondent. This question should be asked of all women (pregnant or not pregnant) who say that they want to have another child. Note that the answer can be given in months or years. Circle '1' if the response is in months or '2' if in years, and record the answer in the appropriate spaces. If she says she would like to have a baby right away, record 993 for 'Soon/now'. If the woman says she cannot get pregnant, circle '994'. If the woman tells you she would like to wait until after she is married to have a child, record '995' for 'After marriage'. If she gives a different answer, circle '996' for 'Other'. If she says she does not know, circle '998'. For women who say that they cannot get pregnant, you should skip to the next module. Women aged 15-49 1 Months 2 Years 9 Special Desired waiting time (number) Desired waiting time (number) Desired waiting time (number) Desired waiting time (number) Desired waiting time (number) How long would you like to wait before the birth of (a/another) child? Here, you will also need to choose the appropriate phrasing for the question, based on what you already know about the respondent. This question should be asked of all women (pregnant or not pregnant) who say that they want to have another child. Note that the answer can be given in months or years. Circle '1' if the response is in months or '2' if in years, and record the answer in the appropriate spaces. If she says she would like to have a baby right away, record 993 for 'Soon/now'. If the woman says she cannot get pregnant, circle '994'. If the woman tells you she would like to wait until after she is married to have a child, record '995' for 'After marriage'. If she gives a different answer, circle '996' for 'Other'. If she says she does not know, circle '998'. For women who say that they cannot get pregnant, you should skip to the next module. Women aged 15-49 93 Soon/now 94 Says she cannot get pregnant 96 Other 98 Don't know If she goes out with out telling him If she goes out with out telling him If she goes out with out telling him If she goes out with out telling him If she goes out with out telling him Sometimes a husband is annoyed or angered by things that his wife does. In your opinion, is a husband justified in hitting or beating his wife in the following situations: If she goes out with out telling him? In this module, we have only one question, which asks for the woman's opinion on domestic violence. Note that we are not asking whether the woman has been subjected to domestic violence. Research has shown, however, that there is overall agreement in the proportion of women who think that a husband may be justified in hitting or beating his wife in certain situations, and the actual prevalence of domestic violence. The correlation may be on a societal level, and not on an individual level. Read each item aloud. For each situation, circle the code corresponding to the answer given - '1' if 'Yes' (she thinks the husband is justified in hitting or beating his wife in that situation), '2' if 'No', and '8' if the respondent does not know or does not have an opinion. Women aged 15-49 1 Yes 2 No 8 DK If she neclects the children If she neclects the children If she neclects the children If she neclects the children If she neclects the children Sometimes a husband is annoyed or angered by things that his wife does. In your opinion, is a husband justified in hitting or beating his wife in the following situations: If she neglects the children? In this module, we have only one question, which asks for the woman's opinion on domestic violence. Note that we are not asking whether the woman has been subjected to domestic violence. Research has shown, however, that there is overall agreement in the proportion of women who think that a husband may be justified in hitting or beating his wife in certain situations, and the actual prevalence of domestic violence. The correlation may be on a societal level, and not on an individual level. Read each item aloud. For each situation, circle the code corresponding to the answer given - '1' if 'Yes' (she thinks the husband is justified in hitting or beating his wife in that situation), '2' if 'No', and '8' if the respondent does not know or does not have an opinion. Women aged 15-49 1 Yes 2 No 8 DK If she argues with him If she argues with him If she argues with him If she argues with him If she argues with him Sometimes a husband is annoyed or angered by things that his wife does. In your opinion, is a husband justified in hitting or beating his wife in the following situations: If she argues with him? In this module, we have only one question, which asks for the woman's opinion on domestic violence. Note that we are not asking whether the woman has been subjected to domestic violence. Research has shown, however, that there is overall agreement in the proportion of women who think that a husband may be justified in hitting or beating his wife in certain situations, and the actual prevalence of domestic violence. The correlation may be on a societal level, and not on an individual level. Read each item aloud. For each situation, circle the code corresponding to the answer given - '1' if 'Yes' (she thinks the husband is justified in hitting or beating his wife in that situation), '2' if 'No', and '8' if the respondent does not know or does not have an opinion. Women aged 15-49 1 Yes 2 No 8 DK If she refuses sex with him If she refuses sex with him If she refuses sex with him If she refuses sex with him If she refuses sex with him Sometimes a husband is annoyed or angered by things that his wife does. In your opinion, is a husband justified in hitting or beating his wife in the following situations: If she refuses sex with him? In this module, we have only one question, which asks for the woman's opinion on domestic violence. Note that we are not asking whether the woman has been subjected to domestic violence. Research has shown, however, that there is overall agreement in the proportion of women who think that a husband may be justified in hitting or beating his wife in certain situations, and the actual prevalence of domestic violence. The correlation may be on a societal level, and not on an individual level. Read each item aloud. For each situation, circle the code corresponding to the answer given - '1' if 'Yes' (she thinks the husband is justified in hitting or beating his wife in that situation), '2' if 'No', and '8' if the respondent does not know or does not have an opinion. Women aged 15-49 1 Yes 2 No 8 DK If she burns the food If she burns the food If she burns the food If she burns the food If she burns the food Sometimes a husband is annoyed or angered by things that his wife does. In your opinion, is a husband justified in hitting or beating his wife in the following situations: If she burns the food? In this module, we have only one question, which asks for the woman's opinion on domestic violence. Note that we are not asking whether the woman has been subjected to domestic violence. Research has shown, however, that there is overall agreement in the proportion of women who think that a husband may be justified in hitting or beating his wife in certain situations, and the actual prevalence of domestic violence. The correlation may be on a societal level, and not on an individual level. Read each item aloud. For each situation, circle the code corresponding to the answer given - '1' if 'Yes' (she thinks the husband is justified in hitting or beating his wife in that situation), '2' if 'No', and '8' if the respondent does not know or does not have an opinion. Women aged 15-49 1 Yes 2 No 8 DK Ever circumcised Ever circumcised Ever circumcised Ever circumcised Ever circumcised Have you yourself ever been circumcised? Circle the code corresponding to the answer given. If 'No', skip to FG8. Women aged 15-49 1 Yes 2 No Flesh removed from the genital area Flesh removed from the genital area Flesh removed from the genital area Flesh removed from the genital area Flesh removed from the genital area Now I would like to ask you what was done to you at this time. Was any flesh removed from the genital area? Circle the code corresponding to the answer given. Skip to FG6 if 'Yes' ('1'). Women aged 15-49 1 Yes 2 No 8 DK Genital area just nicked without removing flesh Genital area just nicked without removing flesh Genital area just nicked without removing flesh Genital area just nicked without removing flesh Genital area just nicked without removing flesh Was the genital area just nicked without removing any flesh? Circle the code corresponding to the answer given. Women aged 15-49 1 Yes 2 No 8 DK Genital area sewn closed (or sealed) Genital area sewn closed (or sealed) Genital area sewn closed (or sealed) Genital area sewn closed (or sealed) Genital area sewn closed (or sealed) Was the genital area sewn closed (or 'sealed')? Circle the code corresponding to the answer given. Women aged 15-49 1 Yes 2 No 8 DK Number of daughters circumcised Number of daughters circumcised Number of daughters circumcised Number of daughters circumcised Number of daughters circumcised The following questions apply only to women who have at least one living daughter. Check CM4 and CM6, Child Mortality Module: Woman has living daughter? Yes. Continue with FG9 No. Go to FG16 Have any of your daughters been circumcised? If yes, how many? To which of your daughters did this happen most recently? Record the daughter's name. Check CM4 and CM6 of the Child Mortality module. If the respondent has a daughter who is now alive, even if the daughter does not live with the respondent, check the box marked 'Yes' and continue to the next question. If the woman does not have a living daughter, check the box marked 'No' and skip to FG16. At this point, you will start the second set of questions, which are related to the respondent's daughter(s) (FG8-FG15). These allow for the tracking of intergenerational changes in the practice of FGM/C. If (at least one of) the respondent's daughter(s) is circumcised, questions that focus on the most recently circumcised daughter are asked about the type of circumcision, the age at circumcision, and the type of practitioner who performed the operation. --- First ask if (any of) the respondent's daughter(s) has been circumcised. If 'Yes', enter the number in the space provided. If no daughters have been circumcised, circle '00' and skip to FG16. --- Record the daughter's name in the space provided. Women aged 15-49 No daughters circumcised 98 DK Flesh removed from the genital area: daughter Flesh removed from the genital area: daughter Flesh removed from the genital area: daughter Flesh removed from the genital area: daughter Flesh removed from the genital area: daughter Now I would like to ask you what was done to (name) at that time. Was any flesh removed from the genital area? Circle the code corresponding to the answer given. If 'Yes', skip to FG13. Otherwise, continue to the next question. Women aged 15-49 1 Yes 2 No 8 DK Genital area just nicked without removing any flesh: daughte Genital area just nicked without removing any flesh: daughte Genital area just nicked without removing any flesh: daughte Genital area just nicked without removing any flesh: daughte Genital area just nicked without removing any flesh: daughte Was the genital area just nicked without removing any flesh? Circle the code corresponding to the answer given. Women aged 15-49 1 Yes 2 No 8 DK Genital area sewn closed (or sealed): daughter Genital area sewn closed (or sealed): daughter Genital area sewn closed (or sealed): daughter Genital area sewn closed (or sealed): daughter Genital area sewn closed (or sealed): daughter Was the genital area sewn closed (or 'sealed')? Circle the code corresponding to the answer given. Women aged 15-49 1 Yes 2 No 8 DK Age of circumcision of daugher Age of circumcision of daugher Age of circumcision of daugher Age of circumcision of daugher Age of circumcision of daugher How old was (name) when this occurred? If the respondent does not know the age, probe to get an estimate. Enter the daughter's age at the time she was circumcised in the space provided. If the respondent does not know how old her daughter was at circumcision, probe to get an estimate. If she is still unable to provide her daughter's age at circumcision, circle '98'. Women aged 15-49 97 Inconsistent 98 DK Should practice be continued or discountinued Should practice be continued or discountinued Should practice be continued or discountinued Should practice be continued or discountinued Should practice be continued or discountinued Do you think this practice should be continued or should it be discontinued? The last question in the module aims to elicit the respondent's opinion of FGM/C. The question is asked of all women who have ever heard of FGM/C (FG1=1 or FG2=1). Circle the code corresponding to the answer given. Women aged 15-49 1 Continued 2 Discountinued 3 Depends 8 DK Type of circumcision Type of circumcision Type of circumcision Type of circumcision Type of circumcision What type of circumcision should be continued? Women age 15-49 1 Pharonic 2 Intermediate 3 Sunna 8 DK 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 Ever had HIV test Ever had HIV test Ever had HIV test Ever had HIV test Ever had HIV test Check MN5: Tested for HIV during antenatal care? Yes. Go to HA18A No. Continue with HA15 I do not want to know the results, but have you ever been tested to see if you have HIV, the virus that causes AIDS? The following questions aim to obtain information about the level of 'unmet need' for HIV-testing. They first ask about experience of HIV testing. Voluntary testing and counselling are now encouraged, in the belief that if a person knows his or her status, he or she is more likely to adopt behaviours to prevent contracting the virus or (if positive) transmitting it. Many of those who get tested do not return to learn the results of the test, but the proportion of those who return should rise as the quality of pre-test counselling improves. It is important to obtain an estimate of the number of those tested who return to learn the results, in order to monitor this proxy indicator of the quality of available counselling and the level of demand for such services. --- Check the respondent's answer to MN5 in the Maternal and Newborn Health module regarding whether or not she was tested for HIV during her antenatal care visits. If the respondent has already answered that she was tested during antenatal care visits, you do not need to ask her questions HA15-HA18. In such cases, check the box marked 'Yes' and go to HA18A. If her answer was 'No', check the corresponding box and continue to HA15. --- Ask the respondent if she was tested for the HIV. Be clear to the respondent that you are not asking to know the results of the test. Circle the code for the response given. If her answer is 'No', skip to HA18. Women aged 15-49 1 Yes 2 No Received results of HIV test Received results of HIV test Received results of HIV test Received results of HIV test Received results of HIV test I do not want you to tell me the results of the test, but have you been told the results? The following questions aim to obtain information about the level of 'unmet need' for HIV-testing. They first ask about experience of HIV testing. Voluntary testing and counselling are now encouraged, in the belief that if a person knows his or her status, he or she is more likely to adopt behaviours to prevent contracting the virus or (if positive) transmitting it. Many of those who get tested do not return to learn the results of the test, but the proportion of those who return should rise as the quality of pre-test counselling improves. It is important to obtain an estimate of the number of those tested who return to learn the results, in order to monitor this proxy indicator of the quality of available counselling and the level of demand for such services. --- 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. It is important that you do not attempt to find out the HIV status of any respondent who has been tested, or imply that you have any interest in knowing her HIV status. Ask the question, ensuring that the respondent knows that you are not interested in learning the results of any test she may have undergone. Circle the code corresponding to her response. Women aged 15-49 1 Yes 2 No Asked for HIV test or was it offered to you Asked for HIV test or was it offered to you Asked for HIV test or was it offered to you Asked for HIV test or was it offered to you Asked for HIV test or was it offered to you Did you, yourself, ask for the test, was it offered to you and you accepted, or was it required? The following questions aim to obtain information about the level of 'unmet need' for HIV-testing. They first ask about experience of HIV testing. Voluntary testing and counselling are now encouraged, in the belief that if a person knows his or her status, he or she is more likely to adopt behaviours to prevent contracting the virus or (if positive) transmitting it. Many of those who get tested do not return to learn the results of the test, but the proportion of those who return should rise as the quality of pre-test counselling improves. It is important to obtain an estimate of the number of those tested who return to learn the results, in order to monitor this proxy indicator of the quality of available counselling and the level of demand for such services. --- If the respondent has been tested for HIV, we want to know whose idea it was to get the test. There are three options, so read the entire question before expecting an answer. Perhaps the respondent asked to be tested for HIV. Perhaps a health worker offered to test the respondent and the respondent accepted being tested. Perhaps the test was required for some reason. Circle the code corresponding to the response. If the respondent got tested because her partner asked her to do so, you would circle '1', corresponding to 'Asked for the test', because she got the test of her own volition, in response to someone asking her to do so. This would be the case if a girlfriend or boyfriend or spouse or other concerned person personally asked them to get tested. If the respondent was offered the test during a normal health centre visit, for instance, and the respondent accepted the test, this would be coded as '2', 'Offered and accepted'. By 'required', we mean formally required. For example, an employer may require their employees to get tested for the AIDS virus. If so, you would circle '3' for 'Required'. Also, some countries require applicants applying for work permits or applicants applying for visas to show proof of an AIDS test. Women aged 15-49 1 Asked for the test 2 Offered and accepted 3 Required Know a place to get HIV test Know a place to get HIV test Know a place to get HIV test Know a place to get HIV test Know a place to get HIV test At this time, do you know of a place where you can go to get such a test to see if you have the AIDS virus? A. If tested for HIV during antenatal care: Other than at the antenatal clinic, do you know of a place where you can go to get a test to see if you have the AIDS virus? Note that some women will be asked HA18 and others will be asked HA18A, but the same set of response codes will be used to indicate the woman's response. Specifically, women who have not been tested for HIV during antenatal care ('No' marked in HA14) or any other time ('2' circled in HA15) are asked HA18. For women who have been tested for HIV during antenatal care, you should ask HA18A. Even if the respondent has been tested for HIV during antenatal care, we still ask this question, since the original testing place may no longer be accessible to the respondent. Circle the code corresponding to the response. When you have finished asking HA18 or HA18A, thank the woman. Check whether she is the mother or primary caretaker of any children that live with her and that are under the age of five by checking the Household Questionnaire, column HL8, for the woman's line number. If so, start interviewing her with the Questionnaire for Children Under Five for those children. If this woman is not the mother or primary caretaker of any children under five in the household, check if there is another eligible woman residing in the same household. If so, go on to administer the Questionnaire for Individual Women to the next eligible woman. Continue until you have completed questionnaires for all eligible women and children in the household. Women aged 15-49 1 Yes 2 No Interviewer number Interviewer number Interviewer number Interviewer number Interviewer number Interviewer name and number: Enter your own name and identification number provided to you at the time of training. Households Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor name and number: Enter your supervisor's name and identification number. You will be provided with your supervisor's identification number as soon as you know who you will be working with. Households Day of interview Day of interview Day of interview Day of interview Day of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Month of interview Month of interview Month of interview Month of interview Month of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Year of interview Year of interview Year of interview Year of interview Year of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Area with nomadic Area with nomadic Area with nomadic Area with nomadic Area with nomadic 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. Household 1 Urban 21 Rural 22 Nomadic For the purposes of this survey, the analysis refers to the North West Zone, the North East Zone and Central South Zone according to prewar boundaries for Somaliland and Puntland and does not imply any recognition of administrative boundaries by the United Nations or the League of Arab States. Area presented by urban (district capitals), rural (rural sedentary) and nomadic (rural non-sedentary) Zone Zone Zone Zone Zone Region: Circle the code for zone. Households 1 North West 2 North East 3 Central South Result of HH interview Result of HH interview Result of HH interview Result of HH interview Result of HH interview After all questionnaires for the household have been completed, fill in the following information: Result of HH interview: If the Household Questionnaire is completed, circle '1' for 'Completed'. If you have not been able to contact the household after repeated visits, circle '2' for 'Not at home'. If the household refuses to be interviewed, circle '3' for 'Refused'. If you are unable to locate the household or if the dwelling is destroyed, circle '4' for 'HH not found/destroyed'. If you have not been able to complete the Household Questionnaire for another reason, you should circle '6' for 'Other' and specify the reason in the space provided. Some examples of 'Other' codes might be: the household respondent is incapacitated; the questionnaire is partly completed; adult household members were not found at home after repeated visits. Households 1 Completed 2 Not at home 3 Refused 4 HH not found/destroyed 6 Other Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent to HH questionnaire: Enter the name and line number (from the Household Listing, columns HL1 and HL2) of the respondent to the Household Questionnaire. Households 99 Missing Number of household members Number of household members Number of household members Number of household members Number of household members Total number of household members: Count the number of household members recorded in column HL1 of the Household Listing and enter the total here. Households Total eligible women Total eligible women Total eligible women Total eligible women Total eligible women No.of women eligible for interview: Enter the total number of women eligible for interview for the Questionnaire for Individual Women - you will copy this from the row for totals at the bottom of the Household Listing, for HL6. Households Women interviews completed Women interviews completed Women interviews completed Women interviews completed Women interviews completed No.of women questionnaires completed: Once all of the Questionnaires for Individual Women have been completed for a particular household, enter the number completed here. Households Total children under 5 Total children under 5 Total children under 5 Total children under 5 Total children under 5 No.of children under age 5: Enter the total number of children under five eligible for inclusion in the survey from the row for totals at the bottom of the Household Listing, for HL8. You will be using the Questionnaire for Children Under Five to interview the mothers or primary caretakers of these children. Households Child interviews completed Child interviews completed Child interviews completed Child interviews completed Child interviews completed No.of under-5 questionnaires completed: Once all of the Questionnaires for Children Under Five have been completed for a particular household, enter the number completed here. Households Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk: Leave this space blank. The data clerk will enter his/her number in the space provided. Households Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water What is the main source of drinking water for members of your household? The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): · '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. · '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. · '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. · '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. · '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. · '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. · '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. · '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). · '52' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof and stored in a container, tank or cistern until used. · '53' Berkad · '54' Rain water catchment (Balli) · '61' - A tanker-truck water source transports and sells water by means of a tanker truck. · '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. · '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. · '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. Households 11 Piped into dwelling 12 Piped into yard or plot 13 Public tap/standpipe 21 Tubewell/borehole 31 Protected well 32 Unprotected well 41 Protected spring 42 Unprotected spring 52 Roof top 53 Berkad 54 Balli 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 91 Bottled water 96 Other Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes What is the main source of water used by your household for other purposes such as cooking and handwashing? The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): · '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. · '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. · '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. · '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. · '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. · '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. · '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. · '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). · '52' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof and stored in a container, tank or cistern until used. · '53' Berkad · '54' Rain water catchment (Balli) · '61' - A tanker-truck water source transports and sells water by means of a tanker truck. · '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. · '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. · '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. Households 11 Piped into dwelling 12 Piped into yard or plot 13 Public tap/standpipe 21 Tubewell/borehole 31 Protected well 32 Unprotected well 41 Protected spring 42 Unprotected spring 52 Roof top 53 Berkad 54 Balli 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 96 Other 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 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 Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Do you take any meausures to prevent contamination while handling the water or water storage containers? Circle '1' if 'Yes', and continue to the next question. If 'No' or 'DK' (Doesn't know'), circle '2' or '8', respectively. Household 1 Yes 2 No 8 D.K Definitions of various methods of prevention are as follows: · 'A' - Wash hands before collecting water · 'B' - Store drinking water in a clean container with cover · 'C' - Use a separate clean cup with a long handle for taking water out of the container · 'D' - Keep animals away from the container Wash Hands Wash Hands Wash Hands Wash Hands Wash Hands What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing A Wash Hands Store in clean container Store in clean container Store in clean container Store in clean container Store in clean container What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing B Container with cover Use separate container Use separate container Use separate container Use separate container Use separate container What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing C Use Separate container Keep animals away Keep animals away Keep animals away Keep animals away Keep animals away What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing D Keep animals Other Other Other Other Other What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing X Other D.K D.K D.K D.K D.K What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing Z D.K 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 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 Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Does your main drinking water source give you a reliable supply? If the respondent replies 'no' try to assess how often they encounter problems. If they encounter problems occasionally such as a few times a month circle '2', if a few times a week circle '3' for daily problems circle '4'. If the household complains that it is only at certain times of year they do not have a reliable supply then circle 5'. If the household does not know circle '8'. Household 1 Almost no problems 2 Occasionaly Problems 3 Weekly Problems 4 Daily Problems 5 Seasonaly Supply 8 D.K Kind of toilet facility Kind of toilet facility Kind of toilet facility Kind of toilet facility Kind of toilet facility What kind of toilet facility do members of your household usually use? If "flush" or "pour flush", probe: Where does it flush to? If necessary, ask permission to observe the facility. Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of this question is to obtain a measure of the cleanliness of the sanitary facility used by the household members. It may be necessary to observe the facility. If so, ask permission to do so. If the respondent answers or it is observed that the household members have no facilities or use the bush or field, enter '95' for 'No facilities or bush or field' and skip to the next module. If any of the flush or pour flush responses (11-15) are given, probe: "WHERE DOES IT FLUSH TO?" Circle the code corresponding to the response given. Definitions of various types of toilet facilities are as follows: A flush toilet uses a cistern or holding tank for flushing water and has a water seal, which is a U-shaped pipe, below the seat or squatting pan that prevents the passage of flies and odours. A pour flush toilet uses a water seal, but unlike a flush toilet, a pour flush toilet uses water poured by hand for flushing (no cistern is used). . '11' - A piped sewer system is a system of sewer pipes, also called sewerage, that is designed to collect human excreta (faeces and urine) and wastewater and remove them from the household environment. Sewerage systems consist of facilities for collection, pumping, treating and disposing of human excreta and wastewater. . '12' - A septic tank is an excreta collection device and is a water-tight settling tank normally located underground, away from the house or toilet. . '13' - A flush/pour flush to pit latrine refers to a system that flushes excreta to a hole in the ground. . '14' - A flush/pour flush to somewhere else refers to excreta being deposited in or nearby the household environment (not into pit, septic tank or sewer); excreta may be flushed to the street, yard/plot, drainage way or other location. . '15' - Flush to unknown place/not sure/DK where should be coded in cases when the respondent knows that the toilet facility is a flush toilet, but does not know where it flushes to. '21' - A ventilated improved pit latrine or VIP is a type of pit latrine that is ventilated by a pipe extending above the latrine roof. The open end of the vent pipe is covered with gauze mesh or fly-proof netting and the inside of the superstructure is kept dark. '22' - A pit latrine with slab uses a hole in the ground for excreta collection and has a squatting slab, platform or seat that is firmly supported on all sides, easy to clean and raised above the surrounding ground level to prevent surface water from entering the pit. '23' - A pit latrine without slab uses a hole in the ground for excreta collection and does not have a squatting slab, platform or seat. An open pit is a rudimentary hole in the ground where excreta is collected. '31' - A composting toilet is a toilet into which excreta and carbon-rich material are added (vegetable wastes, straw, grass, sawdust, ash) and special conditions maintained to produce inoffensive compost. '41' - Bucket refers to the use of a bucket or other container for the retention of faeces (and sometimes urine and anal cleaning material), which is periodically removed for treatment or disposal. '51' - A hanging toilet or hanging latrine is a toilet built over the sea, a river, or other body of water into which excreta drops directly. '95' - No facilities or bush or field includes excreta wrapped and thrown with garbage, the 'cat' method of burying excreta in dirt, defecation in the bush or field or ditch, and defecation into surface water (drainage channel, beach, river, stream or sea). Households 11 Flush to piped sewer system 12 Flush to septic tank 13 Flush to pit (latrine) 14 Flush to somewhere else 15 Flush to unknown place/not sure/DK where 21 Ventilated Improved Pit latrine (VIP) 22 Pit latrine with slab 23 Pit latrine without slab/open pit 95 No facilities or bush or field 96 Other 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 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 Wash hands before eating Wash hands before eating Wash hands before eating Wash hands before eating Wash hands before eating Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No wash hands after defecation wash hands after defecation wash hands after defecation wash hands after defecation wash hands after defecation Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No wash hands after eating wash hands after eating wash hands after eating wash hands after eating wash hands after eating Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No 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 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 32 Vinyl or asphalt strips 33 Ceramic tiles 34 Cement 35 Carpet 96 Other 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 Mud & Grass 21 Rustic mat 22 Palm/Grass 23 Wood Planks 24 Sacking/Plastic sheets 31 Metal 32 Wood 33 Calamine/cement fiber 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 Sticks/palm/trunks 13 Mud 21 Bambo with mud 22 Stone with mud 23 Uncovered adobe 24 Plywood 25 Carton 26 Reused wood 27 Cloth/Matting 31 Cement 32 Stone with lime/cement 33 Bricks 34 Cement blocks 35 Covered adobe 36 Wood planks/shingles 96 Other 99 Missing Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking What type of fuel does your household mainly use for cooking? Information on the type of fuel used for cooking is collected as another measure of the socio-economic status of the household. The use of some cooking fuels can also have adverse health consequences. Circle the code corresponding to the answer given. Remember that this question asks about fuel for cooking, not fuel for heating or lighting. If the household uses more than one fuel for cooking, find out which type of fuel is used most often. If electricity, liquid propane gas (LPG), natural gas, or biogas is mainly used, circle '01', '02', '03', or '04', respectively, and skip to HC8. If any fuel other than the pre-coded ones is reported as being the main fuel used for cooking, circle '96' and specify the type of fuel on the line provided. Definitions of some of the types of fuel are as follows: 'Biogas' includes gases produced by fermenting manure in an enclosed pit. 'Lignite' is a derivative of coal that produces more smoke when burned but produces less heat than coal. Households 1 Electricity 2 Liquid propane gas (LPG) 5 Kerosene 7 Charcoal 8 Wood 9 Straw/shrubs/grass 10 Animal dung 11 Agricultural crop residue 96 Other 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 6 Other 9 Missing Bed Bed Bed Bed Bed Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing 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, VCD/DVD PLAYER, FAN? 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 VCD/DVD Player VCD/DVD Player VCD/DVD Player VCD/DVD Player VCD/DVD Player Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Fan Fan Fan Fan Fan Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Satellite Dish Satellite Dish Satellite Dish Satellite Dish Satellite Dish Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing 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 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 Clock Clock Clock Clock Clock Does any member of your household own: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Sewing Machine Sewing Machine Sewing Machine Sewing Machine Sewing Machine Does any member of your household own: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of this household own any land that can be used for agriculture? Circle the code corresponding to the response given. If 'No', skip to HC13. Households 1 Yes 2 No 9 Missing How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agricultural land do members of this household own? If more than 97, record '97'. If unknown, record '98'. Record the total number of hectares of land owned by all members of the household that can be used for agriculture. If 97 or more hectares (or other units) are owned, record '97'. If unknown, record '98'. Households 97 More than 97 98 Don't know 99 Missing Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, herds, or farm animals? Circle the code corresponding to the response given. If 'No', skip to the next module. Households 1 Yes 2 No 9 Missing Number of camels Number of camels Number of camels Number of camels Number of camels How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 99 Missing 98 Don't know Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 98 Don't know 99 Missing Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 98 Don't know 99 Missing Number of Goats Number of Goats Number of Goats Number of Goats Number of Goats How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 98 Don't know 99 Missing Number of sheep Number of sheep Number of sheep Number of sheep Number of sheep How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 98 Don't know 99 Missing Number of chickens Number of chickens Number of chickens Number of chickens Number of chickens How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 98 Don't know 99 Missing 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 Non Urban Regions Regions Regions Regions Regions Recoded variable Household 1 W/Galbeed 2 Awdal 3 Sanaag 4 Sool 5 Togdhere 6 Mudug 7 Nugal 8 Bari 9 Bakool 10 Bay 11 Gedo 12 Middle Juba 13 Hiran 14 Middle Shabelle 15 Lower Shabelle 16 Banadir 17 Galguduud 18 Lower Juba This variable was created during data analyses for weighting purposes only. Determined from the cluster numbers. Provinces correspond to the 18 prewar (1991) regions of Somalia. In the survey design regions were not set up as sampling domains therefore UNICEF does not recommend disaggregating data at the regional level. Regional stratum and urban/rural Regional stratum and urban/rural Regional stratum and urban/rural Regional stratum and urban/rural Regional stratum and urban/rural Recoded variable Household This variable was created during data analyses for weighting purposes only. Date of interview women (CMC) Date of interview women (CMC) Date of interview women (CMC) Date of interview women (CMC) Date of interview women (CMC) Recoded Variable Women age 15-49 Date of birth (CMC) Date of birth (CMC) Date of birth (CMC) Date of birth (CMC) Date of birth (CMC) Recoded Variable Women age 15-49 Age Age Age Age Age Recoded Variable Women age 15-49 1 15-19 2 20-24 3 25-29 4 30-34 5 35-39 6 40-44 7 45-49 Age at first marriage/union Age at first marriage/union Age at first marriage/union Age at first marriage/union Age at first marriage/union Recoded Variable Women age 15-49 Marital status Marital status Marital status Marital status Marital status Recoded Variable Women age 15-49 1 Currently married 2 Formerly married 3 Never married Education Education Education Education Education Recoded Variable Women age 15-49 None 1 Koranic 2 Primary 3 Secondary + 4 Non-standard curriculum Children ever born Children ever born Children ever born Children ever born Children ever born Recoded Variable Women age 15-49 Dead children Dead children Dead children Dead children Dead children Recoded Variable Women age 15-49 Number of children surviving Number of children surviving Number of children surviving Number of children surviving Number of children surviving Recoded Variable Women age 15-49 Women's sample weight Women's sample weight Women's sample weight Women's sample weight Women's sample weight Recoded Variable Women age 15-49 The sample is not self weighting therefore survey sample weights have been created using urban and rural population estimates at the regional level. (See data processing folder under external documents which contains excel sheets and syntax files related to constructing and merging sample weights to file). Wealth index score Wealth index score Wealth index score Wealth index score Wealth index score Recoded variable Households Wealth index quintiles Wealth index quintiles Wealth index quintiles Wealth index quintiles Wealth index quintiles Recoded variable Households Excluded 1 Poorest 2 Second 3 Middle 4 Fourth 5 Richest Line number of live birth Line number of live birth Line number of live birth Line number of live birth Line number of live birth BH1 should be a list in chronological order of all the names of all the babies a women has ever had in her life time. Each child's name should be recorded on a separate line. Once a name is recorded go onto BH2. Do not list all the names at once as the women may not at first report births where they child has later died. From constant probing she may then talk about children that have died. Ever married women age 15-49 who have given birth Type of pregnancy Type of pregnancy Type of pregnancy Type of pregnancy Type of pregnancy WERE ANY OF THESE BIRTHS TWINS? If the woman responds that (name) was part of a twin or triplets etc circle '2' for multiple birth. For all other births circle '1' for single. Ever married women age 15-49 who have given birth 1 Single 2 Multiple Sex of child Sex of child Sex of child Sex of child Sex of child IS (name) A BOY OR A GIRL? Circle '1' for 'Male' and '2' for 'Female'. Do not guess the sex of the child from the name provided to you. When the woman is listing each birth she may indicate the sex at the same time, by saying “My son Ahmed,” for instance. In this case, you do not need to ask the sex again, since it is already obvious that the person is a male. However, when a name is mentioned that can be used for both males and females, never use your judgement. Even in cases when you think that the name would most likely be a male's (or a female's) name, have the respondent confirm the sex. Ever married women age 15-49 who have given birth 1 Male 2 Female 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 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 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 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 Cluster number Cluster number Cluster number Cluster number Cluster number We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. During this time I would like to speak with the household head and all mothers or others who take care of children in the household. May I start now? If permission is given, begin the interview. Cluster number: Enter the cluster number as instructed by your supervisor. Households Unique identifier for the cluster in which the household exists Household number Household number Household number Household number Household number Household number: Enter the household number as instructed by your supervisor. Households Line number Line number Line number Line number Line number Women aged 15-49 Cluster number Cluster number Cluster number Cluster number Cluster number Cluster number: Enter the cluster number from the Household Questionnaire, question HH1. Children aged 0-4 Household number Household number Household number Household number Household number Household number: Enter the household number from the Household Questionnaire, question HH2. Children aged 0-4 Child's line number Child's line number Child's line number Child's line number Child's line number Child's line number: Enter the child's line number from the Household Questionnaire, column HL1 of the Household Listing. Children aged 0-4 Caretaker's line number Caretaker's line number Caretaker's line number Caretaker's line number Caretaker's line number Mother's/Caretaker's Line Number: Enter the mother's/primary caretaker's line number from the Household Questionnaire, column HL1 of the Household Listing. Children aged 0-4 Interviewer number Interviewer number Interviewer number Interviewer number Interviewer number Interviewer name and number: Enter your own name and identifying number. You will be provided with these identification numbers during training. Children aged 0-4 Day of interview Day of interview Day of interview Day of interview Day of interview Day/Month/Year of interview: Enter the date of the interview: day/month/year. If the interview is not completed on your first visit and you visit the household to interview the mother/caretaker again, revise and enter the final date of the interview. In other words, the date here should be the date when you have either completed the Questionnaire for Children Under Five, or when the interview was not conducted but when it was decided that there will be no more attempts to interview the mother or primary caretaker of the under-five child. Children aged 0-4 Month of interview Month of interview Month of interview Month of interview Month of interview Day/Month/Year of interview: Enter the date of the interview: day/month/year. If the interview is not completed on your first visit and you visit the household to interview the mother/caretaker again, revise and enter the final date of the interview. In other words, the date here should be the date when you have either completed the Questionnaire for Children Under Five, or when the interview was not conducted but when it was decided that there will be no more attempts to interview the mother or primary caretaker of the under-five child. Children aged 0-4 Year of interview Year of interview Year of interview Year of interview Year of interview Day/Month/Year of interview: Enter the date of the interview: day/month/year. If the interview is not completed on your first visit and you visit the household to interview the mother/caretaker again, revise and enter the final date of the interview. In other words, the date here should be the date when you have either completed the Questionnaire for Children Under Five, or when the interview was not conducted but when it was decided that there will be no more attempts to interview the mother or primary caretaker of the under-five child. Children aged 0-4 Result of interview for chidren under 5 Result of interview for chidren under 5 Result of interview for chidren under 5 Result of interview for chidren under 5 Result of interview for chidren under 5 Result of interview for children under 5 Complete this question once you have concluded the interview. Remember that the code refers to the mother or primary caretaker of the under-five child. Circle the code corresponding to the results of the interview. If the questionnaire is completed, circle '1' for 'Completed'. If you have not been able to contact the mother/primary caretaker after repeated visits, circle '2' for 'Not at home'. If the mother/primary caretaker refuses to be interviewed, circle '3' for 'Refused'. If you were able to only partly complete the questionnaire, circle '4' for 'Partly completed'. If the mother/primary caretaker is incapacitated, circle '5'. If you have not been able to complete this questionnaire for another reason, you should circle '6' for 'Other' and specify the reason in the space provided. Ask the mother/primary caretaker to collect all the birth certificates and health/ immunization cards she has for this child before you begin the interview. You will need these during the interview. Repeat greeting if not already read to this mother/primary caretaker: "WE ARE FROM (country-specific affiliation). WE ARE WORKING ON A PROJECT CONCERNED WITH FAMILY HEALTH AND EDUCATION. I WOULD LIKE TO TALK TO YOU ABOUT THIS. THE INTERVIEW WILL TAKE ABOUT (number) MINUTES. ALL THE INFORMATION WE OBTAIN WILL REMAIN STRICTLY CONFIDENTIAL AND YOUR ANSWERS WILL NEVER BE IDENTIFIED. ALSO, YOU ARE NOT OBLIGED TO ANSWER ANY QUESTION YOU DON'T WANT TO, AND YOU MAY WITHDRAW FROM THE INTERVIEW AT ANY TIME. MAY I START NOW?" As with similar sentences at the beginning of the Household Questionnaire and Questionnaire for Individual Women, you may change the wording of these introductory sentences as appropriate. You must make sure, however, to include the following when you are introducing yourself: The name of the implementing agency; the topic of the survey; the approximate duration of the interview; the issue of confidentiality; and with whom you would like to speak. If permission is given, begin the interview. If the respondent does not agree to continue, thank her/him and go to the next interview. Later, discuss the refusal with your supervisor; you or another person from the team may attempt to interview the respondent for a second time. This will depend on your description of the refusal. However, remember that the respondent's participation in the survey must be on a voluntary basis, and potential respondents must never be forced to participate. Children aged 0-4 1 Completed 2 Not at home 3 Refused 4 Partly completed 5 Incapacitated 6 Other Day of birth of child Day of birth of child Day of birth of child Day of birth of child Day of birth of child Repeat greeting if not already read to this respondent: We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. Also, you are not obliged to answer any question you don't want to, and you may withdraw from the interview at any time. May I start now? If permission is given, begin the interview. If the respondent does not agree to continue, thank him/her and go to the next interview. Discuss this result with your supervisor for a future revisit. Now I would like to ask you some questions about the health of each child under the age of 5 in your care, who lives with you now. Now I want to ask you about (NAME). In what month and year was (NAME) born? Probe: What is his/her birthday? If the mother/caretaker knows the exact birth date, also enter the day; otherwise, circle 98 for day. You will begin the interview with questions about the child's date of birth and age. These are two of the most important questions in the interview, since almost all analysis of the data depends on the child's exact age. While completed age in years is sufficient for women's interviews, we need to obtain accurate information on the child's age in months. This is necessary because some of the analysis of the information that you will be collecting can only be done on the basis of age in months. You will collect this information by learning the child's date of birth. It will then be possible to compare the date of interview with the date of birth of the child and, after the data is collected, calculate the child's age in months by comparing these two pieces of information. The questions on age and date of birth must be asked independently from similar questions on the Household Questionnaire and Questionnaire for Individual Women. The person you may be interviewing for this questionnaire may be the same woman you interviewed for the Questionnaire for Individual Women, and you may have obtained dates of birth of her children in that questionnaire. Also, you may have obtained the child's age in the Household Questionnaire. Even in such cases, you must ask these questions again. --- Note that you may modify the first sentence based on the number of children in the respondent's care. If this is the only child the respondent cares for, change the sentences to "NOW I WOULD LIKE TO ASK YOU SOME QUESTIONS ABOUT THE HEALTH OF (name). IN WHAT MONTH AND YEAR WAS (name) BORN?" Ask the mother or primary caretaker for the child's date of birth. Probe: "WHAT IS HIS/HER BIRTHDAY?" It is important to record the child's month and year of birth accurately. If the mother/primary caretaker knows the exact birth date, including the day, enter the day of birth. Otherwise, circle '98' for 'DK day'. You do not need to probe further for day of birth. Convert the month to a number as you have done before. Enter the number in the space provided. If the month or day contains only one digit, use a leading zero. For example, the month of March is coded as '03'. Note that you are not allowed to enter DK for month or year of birth. You have to obtain month and year of birth of the child. Since all MICS3 surveys will be conducted in 2005 or 2006, the year of birth of the child cannot be earlier than 2000 (for surveys in 2005) or 2001 (for surveys in 2006). If the mother/primary caretaker is unable to provide the date of birth information, ask whether she/he has any documentation such as an identification card, health card, horoscope, or a birth or baptismal certificate that might give the date of birth of the child. However, confirm with the respondent that the date of birth recorded on such documents is indeed correct. Children aged 0-4 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 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 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 Type of registry Type of registry Type of registry Type of registry Type of registry Has (name's) birth been registered with a notary or the municipality? or any other authorities? 1 Notary 2 Municipiality 3 Other 4 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 5 Does not know where to register 6 Other 7 No need 8 DK 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 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 Child ever received vitamin A Child ever received vitamin A Child ever received vitamin A Child ever received vitamin A Child ever received vitamin A Has (name) ever received a vitamin A capsule (supplement) like this one? Show capsule or dispenser for different doses - 100,000 IU for those 6-11 months old, 200,000 IU for those 12-59 months old This question asks if the child has received a vitamin A supplement. Show the capsule or dispenser you were given to help the caretaker remember. You may be instructed to show different capsules, 100,000 IU for children 6-11 months old and 200,000 IU for children 12-59 months old, asking the caretaker to identify the correct one. Circle the code corresponding to the response. If the child has never received a vitamin A supplement or the mother/caretaker does not know if he/she has ever received one, skip to the next module. Children aged 0-4 1 Yes 2 No 8 DK Months ago child took last Vitamin A dose Months ago child took last Vitamin A dose Months ago child took last Vitamin A dose Months ago child took last Vitamin A dose Months ago child took last Vitamin A dose How many months ago did (name) take the last dose? If the answer to VA1 was 'Yes', record the number of months ago the last dose was given to the child. As you have done before, use a leading zero if necessary. If the child received the supplement during the 1-month period preceding the interview, record '00'. Circle '98' if the mother/primary caretaker does not know when the child took the last dose. Children aged 0-4 97 Inconsistent 98 DK Place child got last Vitamin A dose Place child got last Vitamin A dose Place child got last Vitamin A dose Place child got last Vitamin A dose Place child got last Vitamin A dose Where did (name) get this last dose? This question is meant to provide information for health programmes about where children are most likely to get their vitamin A dose. Circle the code corresponding to the answer given. If the dose was obtained during a routine visit to a health facility, circle '1'. If the child was taken to a health facility because she/he was sick, and the supplement was obtained during this visit, circle '2'. If vitamin A supplement was given during a National Immunization Campaign, circle '3'. If the supplement was obtained from a source not listed, write the description next to 'Other' and circle '6'. Children aged 0-4 1 On routine visit to health centre 2 Sick child visit to health centre 3 National immunization day campain 6 Other 8 DK 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 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 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 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 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 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 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 Blood present in diarrohea Blood present in diarrohea Blood present in diarrohea Blood present in diarrohea Blood present in diarrohea 1 Yes 2 No 8 DK 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 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 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 Breastfed during diarohea Breastfed during diarohea Breastfed during diarohea Breastfed during diarohea Breastfed during diarohea During (name's) illness, did he/she breastfeed? 1 Yes 2 No 8 DK 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 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 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 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 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 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 Place sought care: Govt Hospital Place sought care: Govt Hospital Place sought care: Govt Hospital Place sought care: Govt Hospital Place sought care: Govt Hospital From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response. Children aged 0-4 ? Missing A Govt. Hospital Place sought care: Govt Health centre Place sought care: Govt Health centre Place sought care: Govt Health centre Place sought care: Govt Health centre Place sought care: Govt Health centre From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response. Children aged 0-4 ? Missing B Govt. Health centre Place sought care: Govt Health post Place sought care: Govt Health post Place sought care: Govt Health post Place sought care: Govt Health post Place sought care: Govt Health post From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response. Children aged 0-4 ? Missing C Govt. health post Place sought care: Village health worker Place sought care: Village health worker Place sought care: Village health worker Place sought care: Village health worker Place sought care: 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 Place sought care: Other public source Place sought care: Other public source Place sought care: Other public source Place sought care: Other public source Place sought care: Other public source 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 Place sought care: Private hospital/clinic Place sought care: Private hospital/clinic Place sought care: Private hospital/clinic Place sought care: Private hospital/clinic Place sought care: Private hospital/clinic From where did you seek care? Anywhere else? 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 Place sought care: Private physician Place sought care: Private physician Place sought care: Private physician Place sought care: Private physician Place sought care: Private physician From where did you seek care? Anywhere else? 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 phisician Place sought care: Private pharmacy Place sought care: Private pharmacy Place sought care: Private pharmacy Place sought care: Private pharmacy Place sought care: Private pharmacy From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response. Children aged 0-4 ? Missing K Pharmacy Place sought care: Other private medical Place sought care: Other private medical Place sought care: Other private medical Place sought care: Other private medical Place sought care: Other private medical From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response. Children aged 0-4 ? Missing O Other private Place sought care: Relative or friend Place sought care: Relative or friend Place sought care: Relative or friend Place sought care: Relative or friend Place sought care: Relative or friend From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response. Children aged 0-4 ? Missing P Relative or friend Place sought care: Shop Place sought care: Shop Place sought care: Shop Place sought care: Shop Place sought care: Shop From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response. Children aged 0-4 ? Missing Q Shop Place sought care: Traditional practitioner Place sought care: Traditional practitioner Place sought care: Traditional practitioner Place sought care: Traditional practitioner Place sought care: 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 Place sought care: Other Place sought care: Other Place sought care: Other Place sought care: Other Place sought care: Other From where did you seek care? Anywhere else? Circle all providers mentioned, but do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) After the first reply, ask: "ANYWHERE ELSE?" until all providers are mentioned. However, do not suggest or prompt any answers. Circle the code for every provider mentioned. If the source of care is a hospital, health centre or clinic, write the name of the place in the space provided on the questionnaire. Ask whether the source is in the public (run by the government) or private sector. If the source is in the public sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other public' and circle 'H'. Similarly, if the source is in the private medical sector, but is not one of the pre-coded choices, write the description in the space provided for 'Other private medical' and circle 'O'. If the respondent answers that he/she sought care from another place not listed, write the description of the place in the space provided for 'Other' and circle 'X'. Then write the name of the place in the space provided on the questionnaire (Name of place) and tell your supervisor. Your supervisor will learn from other people in the community whether the place is public or private and then circle the code corresponding to the response. Children aged 0-4 ? Missing X Other 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 Antibiotic Antibiotic Antibiotic Antibiotic Antibiotic What medicine was (name) given? Circle all medicines given. This question aims to determine whether the child was given an antibiotic for the illness. More than one medicine may have been administered to the child. Circle the codes corresponding to all medicines given. If the respondent does not know the name of the medicine, ask him/her to show you the medicines. If he/she cannot show the packaged medicine, follow the guidelines provided to you during training. If the respondent names a medicine that is not listed, circle 'X' for 'Other' medicine and fill in the name of the medicine in the space provided. If you cannot determine the type of medicine given to the child with a cough, circle 'Z' for 'DK'. Children aged 0-4 ? Missing A Antibiotic Paracetamol/Panadol/Acetaminophen Paracetamol/Panadol/Acetaminophen Paracetamol/Panadol/Acetaminophen Paracetamol/Panadol/Acetaminophen 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/Acetaminophen Aspirin Aspirin Aspirin Aspirin 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 Ibupropfen Ibupropfen Ibupropfen Ibupropfen 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 Ibuprofen Other Other Other Other Other What medicine was (name) given? Circle all medicines given. This question aims to determine whether the child was given an antibiotic for the illness. More than one medicine may have been administered to the child. Circle the codes corresponding to all medicines given. If the respondent does not know the name of the medicine, ask him/her to show you the medicines. If he/she cannot show the packaged medicine, follow the guidelines provided to you during training. If the respondent names a medicine that is not listed, circle 'X' for 'Other' medicine and fill in the name of the medicine in the space provided. If you cannot determine the type of medicine given to the child with a cough, circle 'Z' for 'DK'. Children aged 0-4 ? Missing X Other DK DK DK DK DK What medicine was (name) given? Circle all medicines given. This question aims to determine whether the child was given an antibiotic for the illness. More than one medicine may have been administered to the child. Circle the codes corresponding to all medicines given. If the respondent does not know the name of the medicine, ask him/her to show you the medicines. If he/she cannot show the packaged medicine, follow the guidelines provided to you during training. If the respondent names a medicine that is not listed, circle 'X' for 'Other' medicine and fill in the name of the medicine in the space provided. If you cannot determine the type of medicine given to the child with a cough, circle 'Z' for 'DK'. Children aged 0-4 ? Missing Z DK 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 Symptoms: Child not able to drink or breastfeed Symptoms: Child not able to drink or breastfeed Symptoms: Child not able to drink or breastfeed Symptoms: Child not able to drink or breastfeed Symptoms: Child not able to drink or breastfeed Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later. Children aged 0-4 ? Missing A Child not able to drink or breatfeed Symptoms: Child becomes sicker Symptoms: Child becomes sicker Symptoms: Child becomes sicker Symptoms: Child becomes sicker Symptoms: Child becomes sicker Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later. Children aged 0-4 ? Missing B Child becomes sicker Symptoms: Child develops a fever Symptoms: Child develops a fever Symptoms: Child develops a fever Symptoms: Child develops a fever Symptoms: Child develops a fever Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later. Children aged 0-4 ? Missing C Child develops a fever Symptoms: Child has faster breathing Symptoms: Child has faster breathing Symptoms: Child has faster breathing Symptoms: Child has faster breathing Symptoms: Child has faster breathing Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later. Children aged 0-4 ? Missing D Child has fast breathing Symptoms: Child has difficult breathing Symptoms: Child has difficult breathing Symptoms: Child has difficult breathing Symptoms: Child has difficult breathing Symptoms: Child has difficult breathing Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later. Children aged 0-4 ? Missing E Child has difficult breathing Symptoms: Child has blood in stool Symptoms: Child has blood in stool Symptoms: Child has blood in stool Symptoms: Child has blood in stool Symptoms: Child has blood in stool Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later. Children aged 0-4 ? Missing F Child has blood in stool Symptoms: Child is drinking poorly Symptoms: Child is drinking poorly Symptoms: Child is drinking poorly Symptoms: Child is drinking poorly Symptoms: Child is drinking poorly Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later. Children aged 0-4 ? Missing G Child is drinking poorly Symptoms: Coughing Symptoms: Coughing Symptoms: Coughing Symptoms: Coughing Symptoms: Coughing Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? ? Missing H Coughing Symptoms: Diarrhea Symptoms: Diarrhea Symptoms: Diarrhea Symptoms: Diarrhea Symptoms: Diarrhea Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? ? Missing I Diarohea Symptoms: Other Symptoms: Other Symptoms: Other Symptoms: Other Symptoms: Other Ask the following question (CA14) only once for each caretaker. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. This question asks for symptoms that would cause the respondent to take a child to a health facility right away. Note that this question will only be asked once per mother/primary caretaker. If you are interviewing the same mother/primary caretaker for more than one child, ask this question when you interview her/him for the first child. Copy the response to this question to the same question in the questionnaire for the second child. If you are interviewing more than one mother/primary caretaker in the same household, ask the question once of each of the mothers/primary caretakers. Circle the codes for the symptoms mentioned. If the caretaker mentions a few signs and stops, continue by asking "ANY OTHERS?" until the caretaker cannot recall any additional symptoms, but do not prompt with any suggestions. Circle the codes corresponding to all symptoms mentioned. If you are not sure whether a certain sign as reported by the respondent fits in one of the above categories, write it down in full and check with your supervisor later. Children aged 0-4 ? Missing X Other D.K D.K D.K D.K D.K 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 DK Fever Fever Fever Fever Fever What are the symptoms or signs of malaria? ? Missing A Fever Headaches Headaches Headaches Headaches Headaches What are the symptoms or signs of malaria? ? Missing B Headaches Chilis Chilis Chilis Chilis Chilis What are the symptoms or signs of malaria? ? Missing C Chills Neckache Neckache Neckache Neckache Neckache What are the symptoms or signs of malaria? ? Missing D Neckache Weakness Weakness Weakness Weakness Weakness What are the symptoms or signs of malaria? ? Missing E Weakness Loss of appetite Loss of appetite Loss of appetite Loss of appetite Loss of appetite What are the symptoms or signs of malaria? ? Missing F Loss of appetite Bitterness Bitterness Bitterness Bitterness Bitterness What are the symptoms or signs of malaria? ? Missing G Bitterness Vomiting Vomiting Vomiting Vomiting Vomiting What are the symptoms or signs of malaria? ? Missing H Vomiting Other Other Other Other Other What are the symptoms or signs of malaria? ? Missing X Other DK DK DK DK DK What are the symptoms or signs of malaria? ? Missing X DK Z DK 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 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 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 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 Day of OPV0 immunization Day of OPV0 immunization Day of OPV0 immunization Day of OPV0 immunization Day of OPV0 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio at birth You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 Not given 44 Marked on card - no date given 66 Reported by mother Month of OPV0 immunization Month of OPV0 immunization Month of OPV0 immunization Month of OPV0 immunization Month of OPV0 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio at birth You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 Year of OPV0 immunization Year of OPV0 immunization Year of OPV0 immunization Year of OPV0 immunization Year of OPV0 immunization (a) Copy dates for each vaccination from the card. (b) Write '44' in day column if card shows that vaccination was given but no date recorded. Date of immunization Polio at birth You will complete questions from IM2 through IM8B when respondents show you the vaccination card for the child: " Copy the dates in the spaces provided for IM2-IM8B for each type of immunization or vitamin A dose recorded on the card or document. " If the card shows only part of the date, record '98' for 'DK' in the column for which the information is not given. For example, if the date given was July 2004, you would record '98' for 'Day', '07' for 'Month', and '2004' for 'Year'. " If the card shows that a vaccination or vitamin A dose was administered but the date is not specified, write '44' in the day column, and leave the month and year columns blank. " However, if a date is given for a DPT vaccination and there is simply a check to show that a polio vaccine was also given, record the date of the DPT injection on the polio line since this probably indicates that the vaccinations were given on the same day. Remember that vaccines may be listed on the card in a different order than the one that appears on the questionnaire. Be sure to check the card carefully because sometimes the month may be listed first, sometimes the day. Be careful to record the dates correctly. Besides recording vaccination dates on the card, some health facilities may also record the dates (appointments) that children should be brought in for their next immunizations. Be very careful not to record a scheduled appointment date as a vaccination date. It is possible that an appointment date was given, but the child never received the vaccination. Only record dates that vaccinations were actually given, and not date of appointments. Be patient and read the card thoroughly. It is very important that you copy the information on administered vaccinations on the card to the questionnaire accurately. After you have completed transferring the information from the card to the questionnaire, proceed with question IM9. Children aged 0-4 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 Day of Vitamin A (1) Day of Vitamin A (1) Day of Vitamin A (1) Day of Vitamin A (1) Day of Vitamin A (1) (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 Vitamin A 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 Month of Vitamin A (1) Month of Vitamin A (1) Month of Vitamin A (1) Month of Vitamin A (1) Month of Vitamin A (1) (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 Vitamin A 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 Year of Vitamin A (1) Year of Vitamin A (1) Year of Vitamin A (1) Year of Vitamin A (1) Year of Vitamin A (1) (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 Vitamin A 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 Day of Vitamin A (2) Day of Vitamin A (2) Day of Vitamin A (2) Day of Vitamin A (2) Day of Vitamin A (2) (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 Vitamin A 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 Month of Vitamin A (2) Month of Vitamin A (2) Month of Vitamin A (2) Month of Vitamin A (2) Month of Vitamin A (2) Year of Vitamin A (2) Year of Vitamin A (2) Year of Vitamin A (2) Year of Vitamin A (2) Year of Vitamin A (2) (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 Vitamin A 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 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 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 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 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 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 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 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 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 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 Heard of POLIO Heard of POLIO Heard of POLIO Heard of POLIO Heard of POLIO Have you ever heard of a disease called polio? 1 Yes 2 No 8 DK Agree to receiving a vaccine Agree to receiving a vaccine Agree to receiving a vaccine Agree to receiving a vaccine Agree to receiving a vaccine Do you agree to receiving repeat doses of polio vaccines every month? 1 Yes 2 No 8 DK Ever refused vaccination Ever refused vaccination Ever refused vaccination Ever refused vaccination Ever refused vaccination Have you ever refused to vaccinate one of your children against polio disease? 1 Never 2 Once 3 Several times Father Father Father Father Father Who in the household takes the decision to vaccinate the child? ? Missing A Father Mother Mother Mother Mother Mother Who in the household takes the decision to vaccinate the child? ? Missing B Mother Grandparents Grandparents Grandparents Grandparents Grandparents Who in the household takes the decision to vaccinate the child? ? Missing C Grandparents Others Others Others Others Others Who in the household takes the decision to vaccinate the child? ? Missing X Other Child ill with fever in last 2 weeks Child ill with fever in last 2 weeks Child ill with fever in last 2 weeks Child ill with fever in last 2 weeks Child ill with fever in last 2 weeks In the last two weeks, that is, since (day of the week) of the week before last, has (name) been ill with a fever? Most children living in areas with malaria experience their first malaria infections during the first year or two of life, when they have not yet acquired adequate clinical immunity. In these young children, the disease can progress rapidly to severe malaria and death. About 90 per cent of deaths due to malaria are among children under 5 years of age. The World Health Organization recommends that all children under age five be presumptively treated with antimalarial medication within 24 hours of the onset of fever to prevent severe malaria and death. --- Fever is a symptom of malaria, and in areas where malaria is prevalent, mothers are advised to take action to treat for malaria as soon as fever begins. 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: "IN THE LAST TWO WEEKS, THAT IS, SINCE TUESDAY OF THE WEEK BEFORE LAST, HAS (name) BEEN ILL WITH A FEVER?" Circle the code corresponding to the answer given. Circle the code corresponding to 'Yes' only if the child has been ill with a fever at any time in the 2 weeks prior to the date of the interview. If the child has not been ill with a fever or the respondent doesn't know, skip to ML10. Children aged 0-4 1 Yes 2 No 8 DK Child seen at health facility during illness Child seen at health facility during illness Child seen at health facility during illness Child seen at health facility during illness Child seen at health facility during illness Was (name) seen at a health facility during this illness? Circle the code corresponding to the answer given. If the child was not seen at a health facility during this illness or the mother/primary caretaker doesn't know, skip to ML6. Children aged 0-4 1 Yes 2 No 8 DK Child took medicine prescribed at health facility Child took medicine prescribed at health facility Child took medicine prescribed at health facility Child took medicine prescribed at health facility Child took medicine prescribed at health facility Did (name) take a medicine for fever or malaria that was provided or prescribed at the health facility? Circle the code corresponding to the answer given. If the child did not take any medicine for the fever or malaria that was provided or prescribed at the health facility, or if the mother/primary caretaker does not know, skip to ML5. Children aged 0-4 1 Yes 2 No 8 DK Medicine provided/prescribed: SP/Fansidar Medicine provided/prescribed: SP/Fansidar Medicine provided/prescribed: SP/Fansidar Medicine provided/prescribed: SP/Fansidar Medicine provided/prescribed: SP/Fansidar What medicine did (name) take that was provided or prescribed at the health facility? Circle all medicines mentioned. Circle the codes corresponding to all medicines taken by the child to treat the fever, both antimalarials and other types of medicines such as acetaminophen that were provided or prescribed at the health facility. If the respondent cannot remember the names of all the medicines the child took, use the following approach to probe for the correct names of the antimalarial and other types of medicines taken: (1) Ask to see the package of leftover medicines; some households keep popular antimalarial and other medicines at home. (2) Show the respondent a sample of each common antimalarial - from both public and private sources - in the original packages, in case some respondents remember the containers. (3) Use common brand names when asking the respondent about antimalarial medicines. If the medicine is an antimalarial but is not listed, circle 'H' and fill in the name in the space provided. If the medicine is another type of medicine, but is not listed, circle 'X' and fill in the name in the space provided. If the mother/primary caretaker still doesn't know, circle 'Z'. Children aged 0-4 ? Missing A SP/Fansidar Medicine provided/prescribed: Chloroquine Medicine provided/prescribed: Chloroquine Medicine provided/prescribed: Chloroquine Medicine provided/prescribed: Chloroquine Medicine provided/prescribed: Chloroquine What medicine did (name) take that was provided or prescribed at the health facility? Circle all medicines mentioned. Circle the codes corresponding to all medicines taken by the child to treat the fever, both antimalarials and other types of medicines such as acetaminophen that were provided or prescribed at the health facility. If the respondent cannot remember the names of all the medicines the child took, use the following approach to probe for the correct names of the antimalarial and other types of medicines taken: (1) Ask to see the package of leftover medicines; some households keep popular antimalarial and other medicines at home. (2) Show the respondent a sample of each common antimalarial - from both public and private sources - in the original packages, in case some respondents remember the containers. (3) Use common brand names when asking the respondent about antimalarial medicines. If the medicine is an antimalarial but is not listed, circle 'H' and fill in the name in the space provided. If the medicine is another type of medicine, but is not listed, circle 'X' and fill in the name in the space provided. If the mother/primary caretaker still doesn't know, circle 'Z'. Children aged 0-4 ? Missing B Chloroquine Medicine provided/prescribed: Amodiaquine Medicine provided/prescribed: Amodiaquine Medicine provided/prescribed: Amodiaquine Medicine provided/prescribed: Amodiaquine Medicine provided/prescribed: Amodiaquine What medicine did (name) take that was provided or prescribed at the health facility? Circle all medicines mentioned. Circle the codes corresponding to all medicines taken by the child to treat the fever, both antimalarials and other types of medicines such as acetaminophen that were provided or prescribed at the health facility. If the respondent cannot remember the names of all the medicines the child took, use the following approach to probe for the correct names of the antimalarial and other types of medicines taken: (1) Ask to see the package of leftover medicines; some households keep popular antimalarial and other medicines at home. (2) Show the respondent a sample of each common antimalarial - from both public and private sources - in the original packages, in case some respondents remember the containers. (3) Use common brand names when asking the respondent about antimalarial medicines. If the medicine is an antimalarial but is not listed, circle 'H' and fill in the name in the space provided. If the medicine is another type of medicine, but is not listed, circle 'X' and fill in the name in the space provided. If the mother/primary caretaker still doesn't know, circle 'Z'. Children aged 0-4 ? Missing C Amodiaquine Medicine provided/prescribed: Quinine Medicine provided/prescribed: Quinine Medicine provided/prescribed: Quinine Medicine provided/prescribed: Quinine Medicine provided/prescribed: Quinine What medicine did (name) take that was provided or prescribed at the health facility? Circle all medicines mentioned. Circle the codes corresponding to all medicines taken by the child to treat the fever, both antimalarials and other types of medicines such as acetaminophen that were provided or prescribed at the health facility. If the respondent cannot remember the names of all the medicines the child took, use the following approach to probe for the correct names of the antimalarial and other types of medicines taken: (1) Ask to see the package of leftover medicines; some households keep popular antimalarial and other medicines at home. (2) Show the respondent a sample of each common antimalarial - from both public and private sources - in the original packages, in case some respondents remember the containers. (3) Use common brand names when asking the respondent about antimalarial medicines. If the medicine is an antimalarial but is not listed, circle 'H' and fill in the name in the space provided. If the medicine is another type of medicine, but is not listed, circle 'X' and fill in the name in the space provided. If the mother/primary caretaker still doesn't know, circle 'Z'. Children aged 0-4 ? Missing D Quinine Medicine provided/prescribed: Artemisinin-based combinations Medicine provided/prescribed: Artemisinin-based combinations Medicine provided/prescribed: Artemisinin-based combinations Medicine provided/prescribed: Artemisinin-based combinations Medicine provided/prescribed: Artemisinin-based combinations What medicine did (name) take that was provided or prescribed at the health facility? Circle all medicines mentioned. Circle the codes corresponding to all medicines taken by the child to treat the fever, both antimalarials and other types of medicines such as acetaminophen that were provided or prescribed at the health facility. If the respondent cannot remember the names of all the medicines the child took, use the following approach to probe for the correct names of the antimalarial and other types of medicines taken: (1) Ask to see the package of leftover medicines; some households keep popular antimalarial and other medicines at home. (2) Show the respondent a sample of each common antimalarial - from both public and private sources - in the original packages, in case some respondents remember the containers. (3) Use common brand names when asking the respondent about antimalarial medicines. If the medicine is an antimalarial but is not listed, circle 'H' and fill in the name in the space provided. If the medicine is another type of medicine, but is not listed, circle 'X' and fill in the name in the space provided. If the mother/primary caretaker still doesn't know, circle 'Z'. Children aged 0-4 ? Missing E Artemisinin-based combinaitions Medicine provided/prescribed: Other anti-malaria Medicine provided/prescribed: Other anti-malaria Medicine provided/prescribed: Other anti-malaria Medicine provided/prescribed: Other anti-malaria Medicine provided/prescribed: Other anti-malaria What medicine did (name) take that was provided or prescribed at the health facility? Circle all medicines mentioned. Circle the codes corresponding to all medicines taken by the child to treat the fever, both antimalarials and other types of medicines such as acetaminophen that were provided or prescribed at the health facility. If the respondent cannot remember the names of all the medicines the child took, use the following approach to probe for the correct names of the antimalarial and other types of medicines taken: (1) Ask to see the package of leftover medicines; some households keep popular antimalarial and other medicines at home. (2) Show the respondent a sample of each common antimalarial - from both public and private sources - in the original packages, in case some respondents remember the containers. (3) Use common brand names when asking the respondent about antimalarial medicines. If the medicine is an antimalarial but is not listed, circle 'H' and fill in the name in the space provided. If the medicine is another type of medicine, but is not listed, circle 'X' and fill in the name in the space provided. If the mother/primary caretaker still doesn't know, circle 'Z'. Children aged 0-4 ? Missing H Other Anti-malaria Medicine provided/prescribed: Paracetamol/Panadol/Acetaminop Medicine provided/prescribed: Paracetamol/Panadol/Acetaminop Medicine provided/prescribed: Paracetamol/Panadol/Acetaminop Medicine provided/prescribed: Paracetamol/Panadol/Acetaminop Medicine provided/prescribed: Paracetamol/Panadol/Acetaminop What medicine did (name) take that was provided or prescribed at the health facility? Circle all medicines mentioned. Circle the codes corresponding to all medicines taken by the child to treat the fever, both antimalarials and other types of medicines such as acetaminophen that were provided or prescribed at the health facility. If the respondent cannot remember the names of all the medicines the child took, use the following approach to probe for the correct names of the antimalarial and other types of medicines taken: (1) Ask to see the package of leftover medicines; some households keep popular antimalarial and other medicines at home. (2) Show the respondent a sample of each common antimalarial - from both public and private sources - in the original packages, in case some respondents remember the containers. (3) Use common brand names when asking the respondent about antimalarial medicines. If the medicine is an antimalarial but is not listed, circle 'H' and fill in the name in the space provided. If the medicine is another type of medicine, but is not listed, circle 'X' and fill in the name in the space provided. If the mother/primary caretaker still doesn't know, circle 'Z'. Children aged 0-4 ? Missing P Paracetamol/panadol/Acetaminophen Medicine provided/prescribed: Aspirin Medicine provided/prescribed: Aspirin Medicine provided/prescribed: Aspirin Medicine provided/prescribed: Aspirin Medicine provided/prescribed: Aspirin What medicine did (name) take that was provided or prescribed at the health facility? Circle all medicines mentioned. Circle the codes corresponding to all medicines taken by the child to treat the fever, both antimalarials and other types of medicines such as acetaminophen that were provided or prescribed at the health facility. If the respondent cannot remember the names of all the medicines the child took, use the following approach to probe for the correct names of the antimalarial and other types of medicines taken: (1) Ask to see the package of leftover medicines; some households keep popular antimalarial and other medicines at home. (2) Show the respondent a sample of each common antimalarial - from both public and private sources - in the original packages, in case some respondents remember the containers. (3) Use common brand names when asking the respondent about antimalarial medicines. If the medicine is an antimalarial but is not listed, circle 'H' and fill in the name in the space provided. If the medicine is another type of medicine, but is not listed, circle 'X' and fill in the name in the space provided. If the mother/primary caretaker still doesn't know, circle 'Z'. Children aged 0-4 ? Missing Q Aspirin Medicine provided/prescribed: Ibuprofen Medicine provided/prescribed: Ibuprofen Medicine provided/prescribed: Ibuprofen Medicine provided/prescribed: Ibuprofen Medicine provided/prescribed: Ibuprofen What medicine did (name) take that was provided or prescribed at the health facility? Circle all medicines mentioned. Circle the codes corresponding to all medicines taken by the child to treat the fever, both antimalarials and other types of medicines such as acetaminophen that were provided or prescribed at the health facility. If the respondent cannot remember the names of all the medicines the child took, use the following approach to probe for the correct names of the antimalarial and other types of medicines taken: (1) Ask to see the package of leftover medicines; some households keep popular antimalarial and other medicines at home. (2) Show the respondent a sample of each common antimalarial - from both public and private sources - in the original packages, in case some respondents remember the containers. (3) Use common brand names when asking the respondent about antimalarial medicines. If the medicine is an antimalarial but is not listed, circle 'H' and fill in the name in the space provided. If the medicine is another type of medicine, but is not listed, circle 'X' and fill in the name in the space provided. If the mother/primary caretaker still doesn't know, circle 'Z'. Children aged 0-4 ? Missing R Ibuprofen Medicine provided/prescribed: Other Medicine provided/prescribed: Other Medicine provided/prescribed: Other Medicine provided/prescribed: Other Medicine provided/prescribed: Other What medicine did (name) take that was provided or prescribed at the health facility? Circle all medicines mentioned. Circle the codes corresponding to all medicines taken by the child to treat the fever, both antimalarials and other types of medicines such as acetaminophen that were provided or prescribed at the health facility. If the respondent cannot remember the names of all the medicines the child took, use the following approach to probe for the correct names of the antimalarial and other types of medicines taken: (1) Ask to see the package of leftover medicines; some households keep popular antimalarial and other medicines at home. (2) Show the respondent a sample of each common antimalarial - from both public and private sources - in the original packages, in case some respondents remember the containers. (3) Use common brand names when asking the respondent about antimalarial medicines. If the medicine is an antimalarial but is not listed, circle 'H' and fill in the name in the space provided. If the medicine is another type of medicine, but is not listed, circle 'X' and fill in the name in the space provided. If the mother/primary caretaker still doesn't know, circle 'Z'. Children aged 0-4 ? Missing X Other Medicine provided/prescribed: DK Medicine provided/prescribed: DK Medicine provided/prescribed: DK Medicine provided/prescribed: DK Medicine provided/prescribed: DK What medicine did (name) take that was provided or prescribed at the health facility? Circle all medicines mentioned. Circle the codes corresponding to all medicines taken by the child to treat the fever, both antimalarials and other types of medicines such as acetaminophen that were provided or prescribed at the health facility. If the respondent cannot remember the names of all the medicines the child took, use the following approach to probe for the correct names of the antimalarial and other types of medicines taken: (1) Ask to see the package of leftover medicines; some households keep popular antimalarial and other medicines at home. (2) Show the respondent a sample of each common antimalarial - from both public and private sources - in the original packages, in case some respondents remember the containers. (3) Use common brand names when asking the respondent about antimalarial medicines. If the medicine is an antimalarial but is not listed, circle 'H' and fill in the name in the space provided. If the medicine is another type of medicine, but is not listed, circle 'X' and fill in the name in the space provided. If the mother/primary caretaker still doesn't know, circle 'Z'. Children aged 0-4 ? Missing Z DK Days after fever started took anti-malarial Days after fever started took anti-malarial Days after fever started took anti-malarial Days after fever started took anti-malarial Days after fever started took anti-malarial Check ML4 and ML7: Anti-malarial mentioned (codes A - H)? Yes. Continue with ML9 No. Go to ML10 How long after the fever started did (name) first take (name of anti-malarial from ML4 or ML7)? If multiple anti-malarials mentioned in ML4 or ML7, name all anti-malarial medicines mentioned. Record the code for the day on which the first anti-malarial was given. If an antimalarial was mentioned either in ML4 or ML7 (codes A-H), check the box marked 'Yes' and continue to the next question. If 'No', check the corresponding box and skip to ML10. --- This question asks about the time interval between the beginning of the child's fever and when he/she took the first dose of an antimalarial medicine to treat the fever. If multiple antimalarial medicines are mentioned in ML4 or ML7, name all antimalarials mentioned. Record the code for the day on which an antimalarial was given for the first time. If he/she started taking (the antimalarial) the same day the fever started, circle '0' for 'Same day'. If the antimalarial was first given the next day (the day after the fever began), circle '1' for 'Next day' and so on. If the respondent does not know how long after the fever started the child first took the antimalarial, circle '8'. Children aged 0-4 Same day 1 Next day 2 2 days after the fever 3 3 days after the fever 4 4 or more days after the fever 8 DK Where did you get the anti malaria Where did you get the anti malaria Where did you get the anti malaria Where did you get the anti malaria Where did you get the anti malaria Where did you get the (name of anti-malarial from ML4 or ML7)? If more than one anti-malarial is mentioned in ML4 or ML7, refer to the first anti-malarial given for the fever (the anti-malarial given on the day recorded in ML9). The intent of this question is to identify where the antimalarial first given for fever was obtained. If more than one antimalarial is mentioned in ML4 or ML7, refer to the first antimalarial given - that is, the antimalarial given on the day recorded in ML9. Circle the code corresponding to the answer given. If the respondent obtained the antimalarial from a medical sector source, 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 '16'. Similarly, if the place is in the private medical sector, but is not one of the pre-coded categories, write the description in the space provided for 'Other private medical' and circle '26'. If the respondent answers that the antimalarial was obtained from another place not listed, write the description of the place in the space provided for 'Other' and circle '96'. Then notify 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. Circle '98' if the respondent does not know where the antimalarial was obtained. Children aged 0-4 11 Hospital 12 Govt health centre 13 Govt health post 14 Village health worker 15 Mobile/outreach clinic 16 Other public source 21 Private hospital/clinic 22 Private physician 23 Private pharmacy 24 Mobile clinic 26 Other private medical 31 Relative or friend 32 Shop 33 Traditional practitioner 96 Other 98 DK Child slept under bednet last night Child slept under bednet last night Child slept under bednet last night Child slept under bednet last night Child slept under bednet last night Did (name) sleep under a mosquito net last night? Ask the respondent if (name) slept under a mosquito net the previous night and circle the code corresponding to the answer given. If the respondent answers that the child did not sleep under a mosquito net last night or that he/she does not know, circle the appropriate code and skip to the next module. Otherwise, continue to the next question. You will have asked about mosquito nets in the household to the respondent to the Household Questionnaire. Some similar questions are asked here, from ML11 to ML15. Note that these questions are asked of the net the child slept under the previous night, which might not necessarily be the mosquito net for which detailed information was collected in the ITN module of the Household Questionnaire. Children aged 0-4 1 Yes 2 No 8 DK Net type Net type Net type Net type Net type What TYPE is this net? If the respondent does not know the TYPE of the net, show pictorials, or if possible, observe the net. 1 Long last treated net 2 Pre-treated net 3 Other net 8 DK 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 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 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 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 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 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 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 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 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 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 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 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 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 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 4 Koranic 6 Non-standard curriculum 8 DK Interviewer number Interviewer number Interviewer number Interviewer number Interviewer number Interviewer name and number: Enter your own name and identification number provided to you at the time of training. Households Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor name and number: Enter your supervisor's name and identification number. You will be provided with your supervisor's identification number as soon as you know who you will be working with. Households Day of interview Day of interview Day of interview Day of interview Day of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Month of interview Month of interview Month of interview Month of interview Month of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Year of interview Year of interview Year of interview Year of interview Year of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Area with nomadic Area with nomadic Area with nomadic Area with nomadic Area with nomadic Household 1 Urban 21 Rural 22 Nomadic All district capitols were considered as urban Zone Zone Zone Zone Zone Region: Circle the code for zone. Households 1 North West 2 North East 3 Central South Result of HH interview Result of HH interview Result of HH interview Result of HH interview Result of HH interview After all questionnaires for the household have been completed, fill in the following information: Result of HH interview: If the Household Questionnaire is completed, circle '1' for 'Completed'. If you have not been able to contact the household after repeated visits, circle '2' for 'Not at home'. If the household refuses to be interviewed, circle '3' for 'Refused'. If you are unable to locate the household or if the dwelling is destroyed, circle '4' for 'HH not found/destroyed'. If you have not been able to complete the Household Questionnaire for another reason, you should circle '6' for 'Other' and specify the reason in the space provided. Some examples of 'Other' codes might be: the household respondent is incapacitated; the questionnaire is partly completed; adult household members were not found at home after repeated visits. Households 1 Completed 2 Not at home 3 Refused 4 HH not found/destroyed 6 Other Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent to HH questionnaire: Enter the name and line number (from the Household Listing, columns HL1 and HL2) of the respondent to the Household Questionnaire. Households 99 Missing Number of household members Number of household members Number of household members Number of household members Number of household members Total number of household members: Count the number of household members recorded in column HL1 of the Household Listing and enter the total here. Households Total eligible women Total eligible women Total eligible women Total eligible women Total eligible women No.of women eligible for interview: Enter the total number of women eligible for interview for the Questionnaire for Individual Women - you will copy this from the row for totals at the bottom of the Household Listing, for HL6. Households Women interviews completed Women interviews completed Women interviews completed Women interviews completed Women interviews completed No.of women questionnaires completed: Once all of the Questionnaires for Individual Women have been completed for a particular household, enter the number completed here. Households Total children under 5 Total children under 5 Total children under 5 Total children under 5 Total children under 5 No.of children under age 5: Enter the total number of children under five eligible for inclusion in the survey from the row for totals at the bottom of the Household Listing, for HL8. You will be using the Questionnaire for Children Under Five to interview the mothers or primary caretakers of these children. Households Child interviews completed Child interviews completed Child interviews completed Child interviews completed Child interviews completed No.of under-5 questionnaires completed: Once all of the Questionnaires for Children Under Five have been completed for a particular household, enter the number completed here. Households Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk: Leave this space blank. The data clerk will enter his/her number in the space provided. Households Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water What is the main source of drinking water for members of your household? The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): · '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. · '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. · '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. · '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. · '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. · '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. · '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. · '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). · '52' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof and stored in a container, tank or cistern until used. · '53' Berkad · '54' Rain water catchment (Balli) · '61' - A tanker-truck water source transports and sells water by means of a tanker truck. · '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. · '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. · '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. Households 11 Piped into dwelling 12 Piped into yard or plot 13 Public tap/standpipe 21 Tubewell/borehole 31 Protected well 32 Unprotected well 41 Protected spring 42 Unprotected spring 52 Roof top 53 Berkad 54 Balli 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 91 Bottled water 96 Other Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes What is the main source of water used by your household for other purposes such as cooking and handwashing? The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): · '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. · '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. · '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. · '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. · '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. · '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. · '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. · '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). · '52' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof and stored in a container, tank or cistern until used. · '53' Berkad · '54' Rain water catchment (Balli) · '61' - A tanker-truck water source transports and sells water by means of a tanker truck. · '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. · '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. · '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. Households 11 Piped into dwelling 12 Piped into yard or plot 13 Public tap/standpipe 21 Tubewell/borehole 31 Protected well 32 Unprotected well 41 Protected spring 42 Unprotected spring 52 Roof top 53 Berkad 54 Balli 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 96 Other 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 9995 On premises 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 Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Do you take any meausures to prevent contamination while handling the water or water storage containers? Circle '1' if 'Yes', and continue to the next question. If 'No' or 'DK' (Doesn't know'), circle '2' or '8', respectively. Household 1 Yes 2 No 8 D.K Definitions of various methods of prevention are as follows: · 'A' - Wash hands before collecting water · 'B' - Store drinking water in a clean container with cover · 'C' - Use a separate clean cup with a long handle for taking water out of the container · 'D' - Keep animals away from the container Wash Hands Wash Hands Wash Hands Wash Hands Wash Hands What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing A Wash Hands Store in clean container Store in clean container Store in clean container Store in clean container Store in clean container What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing B Container with cover Use separate container Use separate container Use separate container Use separate container Use separate container What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing C Use Separate container Keep animals away Keep animals away Keep animals away Keep animals away Keep animals away What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing D Keep animals Other Other Other Other Other What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing X Other D.K D.K D.K D.K D.K What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing Z D.K 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 Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Does your main drinking water source give you a reliable supply? If the respondent replies 'no' try to assess how often they encounter problems. If they encounter problems occasionally such as a few times a month circle '2', if a few times a week circle '3' for daily problems circle '4'. If the household complains that it is only at certain times of year they do not have a reliable supply then circle 5'. If the household does not know circle '8'. Household 1 Almost no problems 2 Occasionaly Problems 3 Weekly Problems 4 Daily Problems 5 Seasonaly Supply 8 D.K Kind of toilet facility Kind of toilet facility Kind of toilet facility Kind of toilet facility Kind of toilet facility What kind of toilet facility do members of your household usually use? If "flush" or "pour flush", probe: Where does it flush to? If necessary, ask permission to observe the facility. Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of this question is to obtain a measure of the cleanliness of the sanitary facility used by the household members. It may be necessary to observe the facility. If so, ask permission to do so. If the respondent answers or it is observed that the household members have no facilities or use the bush or field, enter '95' for 'No facilities or bush or field' and skip to the next module. If any of the flush or pour flush responses (11-15) are given, probe: "WHERE DOES IT FLUSH TO?" Circle the code corresponding to the response given. Definitions of various types of toilet facilities are as follows: A flush toilet uses a cistern or holding tank for flushing water and has a water seal, which is a U-shaped pipe, below the seat or squatting pan that prevents the passage of flies and odours. A pour flush toilet uses a water seal, but unlike a flush toilet, a pour flush toilet uses water poured by hand for flushing (no cistern is used). . '11' - A piped sewer system is a system of sewer pipes, also called sewerage, that is designed to collect human excreta (faeces and urine) and wastewater and remove them from the household environment. Sewerage systems consist of facilities for collection, pumping, treating and disposing of human excreta and wastewater. . '12' - A septic tank is an excreta collection device and is a water-tight settling tank normally located underground, away from the house or toilet. . '13' - A flush/pour flush to pit latrine refers to a system that flushes excreta to a hole in the ground. . '14' - A flush/pour flush to somewhere else refers to excreta being deposited in or nearby the household environment (not into pit, septic tank or sewer); excreta may be flushed to the street, yard/plot, drainage way or other location. . '15' - Flush to unknown place/not sure/DK where should be coded in cases when the respondent knows that the toilet facility is a flush toilet, but does not know where it flushes to. '21' - A ventilated improved pit latrine or VIP is a type of pit latrine that is ventilated by a pipe extending above the latrine roof. The open end of the vent pipe is covered with gauze mesh or fly-proof netting and the inside of the superstructure is kept dark. '22' - A pit latrine with slab uses a hole in the ground for excreta collection and has a squatting slab, platform or seat that is firmly supported on all sides, easy to clean and raised above the surrounding ground level to prevent surface water from entering the pit. '23' - A pit latrine without slab uses a hole in the ground for excreta collection and does not have a squatting slab, platform or seat. An open pit is a rudimentary hole in the ground where excreta is collected. '31' - A composting toilet is a toilet into which excreta and carbon-rich material are added (vegetable wastes, straw, grass, sawdust, ash) and special conditions maintained to produce inoffensive compost. '41' - Bucket refers to the use of a bucket or other container for the retention of faeces (and sometimes urine and anal cleaning material), which is periodically removed for treatment or disposal. '51' - A hanging toilet or hanging latrine is a toilet built over the sea, a river, or other body of water into which excreta drops directly. '95' - No facilities or bush or field includes excreta wrapped and thrown with garbage, the 'cat' method of burying excreta in dirt, defecation in the bush or field or ditch, and defecation into surface water (drainage channel, beach, river, stream or sea). Households 11 Flush to piped sewer system 12 Flush to septic tank 13 Flush to pit (latrine) 14 Flush to somewhere else 15 Flush to unknown place/not sure/DK where 21 Ventilated Improved Pit latrine (VIP) 22 Pit latrine with slab 23 Pit latrine without slab/open pit 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 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 Wash hands before eating Wash hands before eating Wash hands before eating Wash hands before eating Wash hands before eating Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No wash hands after defecation wash hands after defecation wash hands after defecation wash hands after defecation wash hands after defecation Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No wash hands after eating wash hands after eating wash hands after eating wash hands after eating wash hands after eating Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No 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 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 32 Vinyl or asphalt strips 33 Ceramic tiles 34 Cement 35 Carpet 96 Other 99 Missing Main material of roof Main material of roof Main material of roof Main material of roof Main material of roof Main material of the roof. Record observation. Circle the correct code for the material of the dwelling roof, based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the roof, record the main roofing material (the material that covers the largest amount of roof). Households 11 No roof 12 Thatch/palm leaf 13 Mud & Grass 21 Rustic mat 22 Palm/Grass 23 Wood Planks 24 Sacking/Plastic sheets 31 Metal 32 Wood 33 Calamine/cement fiber 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 Sticks/palm/trunks 13 Mud 21 Bambo with mud 22 Stone with mud 23 Uncovered adobe 24 Plywood 25 Carton 26 Reused wood 27 Cloth/Matting 31 Cement 32 Stone with lime/cement 33 Bricks 34 Cement blocks 35 Covered adobe 36 Wood planks/shingles 96 Other 99 Missing Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking What type of fuel does your household mainly use for cooking? Information on the type of fuel used for cooking is collected as another measure of the socio-economic status of the household. The use of some cooking fuels can also have adverse health consequences. Circle the code corresponding to the answer given. Remember that this question asks about fuel for cooking, not fuel for heating or lighting. If the household uses more than one fuel for cooking, find out which type of fuel is used most often. If electricity, liquid propane gas (LPG), natural gas, or biogas is mainly used, circle '01', '02', '03', or '04', respectively, and skip to HC8. If any fuel other than the pre-coded ones is reported as being the main fuel used for cooking, circle '96' and specify the type of fuel on the line provided. Definitions of some of the types of fuel are as follows: 'Biogas' includes gases produced by fermenting manure in an enclosed pit. 'Lignite' is a derivative of coal that produces more smoke when burned but produces less heat than coal. Households 1 Electricity 2 Liquid propane gas (LPG) 5 Kerosene 7 Charcoal 8 Wood 9 Straw/shrubs/grass 10 Animal dung 11 Agricultural crop residue 96 Other 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 6 Other 9 Missing Bed Bed Bed Bed Bed Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing 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, VCD/DVD PLAYER, FAN? 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 VCD/DVD Player VCD/DVD Player VCD/DVD Player VCD/DVD Player VCD/DVD Player Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Fan Fan Fan Fan Fan Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Satellite Dish Satellite Dish Satellite Dish Satellite Dish Satellite Dish Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing 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 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 Clock Clock Clock Clock Clock Does any member of your household own: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Sewing Machine Sewing Machine Sewing Machine Sewing Machine Sewing Machine Does any member of your household own: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of this household own any land that can be used for agriculture? Circle the code corresponding to the response given. If 'No', skip to HC13. Households 1 Yes 2 No 9 Missing How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agricultural land do members of this household own? If more than 97, record '97'. If unknown, record '98'. Record the total number of hectares of land owned by all members of the household that can be used for agriculture. If 97 or more hectares (or other units) are owned, record '97'. If unknown, record '98'. Households 97 More than 97 98 Don't know 99 Missing Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, herds, or farm animals? Circle the code corresponding to the response given. If 'No', skip to the next module. Households 1 Yes 2 No 9 Missing Number of camels Number of camels Number of camels Number of camels Number of camels How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 99 Missing 98 Don't know Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 98 Don't know 99 Missing Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 98 Don't know 99 Missing Number of Goats Number of Goats Number of Goats Number of Goats Number of Goats How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 98 Don't know 99 Missing Number of sheep Number of sheep Number of sheep Number of sheep Number of sheep How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 98 Don't know 99 Missing Number of chickens Number of chickens Number of chickens Number of chickens Number of chickens How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 98 Don't know 99 Missing 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 Non Urban Regions Regions Regions Regions Regions Recoded variable Household 1 W/Galbeed 2 Awdal 3 Sanaag 4 Sool 5 Togdhere 6 Mudug 7 Nugal 8 Bari 9 Bakool 10 Bay 11 Gedo 12 Middle Juba 13 Hiran 14 Middle Shabelle 15 Lower Shabelle 16 Banadir 17 Galguduud 18 Lower Juba This variable was created during data analyses for weighting purposes only. Determined from the cluster numbers. Provinces correspond to the 18 prewar (1991) regions of Somalia. In the survey design regions were not set up as sampling domains therefore UNICEF does not recommend disaggregating data at the regional level. Children's sample weight Children's sample weight Children's sample weight Children's sample weight Children's sample weight Recoded variable Children aged 0-4 Date of interview child (CMC) Date of interview child (CMC) Date of interview child (CMC) Date of interview child (CMC) Date of interview child (CMC) Recoded variable Children aged 0-4 Date of birth (CMC) Date of birth (CMC) Date of birth (CMC) Date of birth (CMC) Date of birth (CMC) Recoded variable Children aged 0-4 Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Required for date of birth calculation Age (months) Age (months) Age (months) Age (months) Age (months) Recoded variable Children aged 0-4 Age Age Age Age Age Recoded variable Children aged 0-4 1 < 6 months 2 6-11 months 3 12-23 months 4 24-35 months 5 36-47 months 6 48-59 months Age Age Age Age Age Recoded variable Children aged 0-4 1 0-11 months 2 12-23 months 3 24-35 months 4 36-47 months 5 48-59 months Mother's education Mother's education Mother's education Mother's education Mother's education Recoded Variable Women age 15-49 None 1 Koranic 2 Primary 3 Secondary 4 Non-standard curriculum Wealth index score Wealth index score Wealth index score Wealth index score Wealth index score Recoded variable Households Wealth index quintiles Wealth index quintiles Wealth index quintiles Wealth index quintiles Wealth index quintiles Recoded variable Households 1 Poorest 2 Second 3 Middle 4 Fourth 5 Richest Children 0-3 months Children 0-3 months Children 0-3 months Children 0-3 months Children 0-3 months Children 0-5 months Children 0-5 months Children 0-5 months Children 0-5 months Children 0-5 months Children 6-9 months Children 6-9 months Children 6-9 months Children 6-9 months Children 6-9 months Children 12-15 months Children 12-15 months Children 12-15 months Children 12-15 months Children 12-15 months Children 20-23 months Children 20-23 months Children 20-23 months Children 20-23 months Children 20-23 months Cluster number Cluster number Cluster number Cluster number Cluster number We are from (COUNTRY-SPECIFIC AFFILIATION). We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (NUMBER) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. During this time I would like to speak with the household head and all mothers or others who take care of children in the household. May I start now? If permission is given, begin the interview. Cluster number: Enter the cluster number as instructed by your supervisor. Households Unique identifier for the cluster in which the household exists Household number Household number Household number Household number Household number Household number: Enter the household number as instructed by your supervisor. Households Line number Line number Line number Line number Line number Women aged 15-49 Line number of live birth Line number of live birth Line number of live birth Line number of live birth Line number of live birth BH1 should be a list in chronological order of all the names of all the babies a women has ever had in her life time. Each child's name should be recorded on a separate line. Once a name is recorded go onto BH2. Do not list all the names at once as the women may not at first report births where they child has later died. From constant probing she may then talk about children that have died. Ever married women age 15-49 who have given birth Type of pregnancy Type of pregnancy Type of pregnancy Type of pregnancy Type of pregnancy WERE ANY OF THESE BIRTHS TWINS? If the woman responds that (name) was part of a twin or triplets etc circle '2' for multiple birth. For all other births circle '1' for single. Ever married women age 15-49 who have given birth 1 Single 2 Multiple Sex of child Sex of child Sex of child Sex of child Sex of child IS (name) A BOY OR A GIRL? Circle '1' for 'Male' and '2' for 'Female'. Do not guess the sex of the child from the name provided to you. When the woman is listing each birth she may indicate the sex at the same time, by saying “My son Ahmed,” for instance. In this case, you do not need to ask the sex again, since it is already obvious that the person is a male. However, when a name is mentioned that can be used for both males and females, never use your judgement. Even in cases when you think that the name would most likely be a male's (or a female's) name, have the respondent confirm the sex. Ever married women age 15-49 who have given birth 1 Male 2 Female 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 In what month and year was (name) born? If the woman knows the date of birth, write it in the appropriate spaces for 'Month' and 'Year'. You will need to convert the month into numbers. For this, January is '01', February is '02', March is '03', etc. If the month contains only one digit, use a leading zero to fill in the first space. For example, the month of March is coded as '03'. If she does not know the month of birth, circle '98' for 'DK month' and ask her for the year of her birth. If she knows the year, write it in the spaces for 'Year'. Try under all circumstances to obtain at least the year of birth. Only when it is absolutely impossible to even estimate the year of birth should you circle '9998' for 'DK year'. If she does not know the probe to clues that might indicate the age. Ask how old she was when she gave birth. Try to find out how long ago she got married or had her first child. You MUST fill in this information. Do not leave this blank. Ever married women age 15-49 who have given birth 98 D.K. 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 In what month and year was (name) born? Probe: What is his/her birthday? If the woman knows the date of birth, write it in the appropriate spaces for 'Month' and 'Year'. You will need to convert the month into numbers. For this, January is '01', February is '02', March is '03', etc. If the month contains only one digit, use a leading zero to fill in the first space. For example, the month of March is coded as '03'. If she does not know the month of birth, circle '98' for 'DK month' and ask her for the year of her birth. If she knows the year, write it in the spaces for 'Year'. Try under all circumstances to obtain at least the year of birth. Only when it is absolutely impossible to even estimate the year of birth should you circle '9998' for 'DK year'. If she does not know the probe to clues that might indicate the age. Ask how old she was when she gave birth. Try to find out how long ago she got married or had her first child. You MUST fill in this information. Do not leave this blank. Ever married women age 15-49 who have given birth 9998 D.K. Survival status of child Survival status of child Survival status of child Survival status of child Survival status of child IS (name) STILL ALIVE? Ever married women age 15-49 who have given birth 1 Alive 2 Dead Age of alive child in years Age of alive child in years Age of alive child in years Age of alive child in years Age of alive child in years How old was (name) at his/her last birthday? Record age in completed years Ever married women age 15-49 who have given birth 99 Missing Residence of alive child Residence of alive child Residence of alive child Residence of alive child Residence of alive child IS (name) LIVING WITH YOU? Ever married women age 15-49 who have given birth 1 Living at home 2 Away Line number of child in HH Line number of child in HH Line number of child in HH Line number of child in HH Line number of child in HH Refer back to the household listing module in the household questionnaire and observe the line number of the child. Transfer this number into the column under BH8. If the child was not on the household list check again to make sure the child does not live in the household. If the woman confirms that the child lives elsewhere record '00'. Move to the next birth. If no more births go to BH11A Ever married women age 15-49 who have given birth Not member of HH 99 Missing Code for age at death Code for age at death Code for age at death Code for age at death Code for age at death How old was (name) when he/she died? If '1 YR', probe: How many months old was (Name)? This information is very important but interviewers must probe gently as women may not like talking about their dead children. Do not leave this question blank. Record the information in complete years if the child died after it was 2 year old, complete months if the infant died after it was one month old but not older than 2 years and complete days if the infant died before it reached a month old. Ever married women age 15-49 who have given birth 1 In days 2 In months 3 In years Age at death Age at death Age at death Age at death Age at death How old was (name) when he/she died? If '1 YR', probe: How many months old was (Name)? Ever married women age 15-49 who have given birth Any live births in between Any live births in between Any live births in between Any live births in between Any live births in between Where there any other live births between (name of previous birth) and (name Ever married women age 15-49 who have given birth 1 Yes 2 No Any births since last birth Any births since last birth Any births since last birth Any births since last birth Any births since last birth Have you had any live births since the birth of (Name of last birth)? Ever married women age 15-49 who have given birth 1 Yes 2 No Any miscarriages Any miscarriages Any miscarriages Any miscarriages Any miscarriages Some pregnancies end before full term as a miscarriage, while others may result in a stillbirth. have you had a miscarriage? This purpose of this question is to find out about miscarriages (not still births), therefore care should be taken to make sure the women understands that a miscarriage occurs before the baby is due i.e. before the full 9 months. If the woman reports she has never had a miscarriage proceed to BH15. Ever married women age 15-49 who have given birth 1 Yes 2 No Number of miscarriages Number of miscarriages Number of miscarriages Number of miscarriages Number of miscarriages In all how many pregnancies did you have that ended in a miscarriage? Ever married women age 15-49 who have given birth 98 D.K Any still births Any still births Any still births Any still births Any still births Have you had a still birth? Ever married women age 15-49 who have given birth 1 Yes 2 No Number of still births Number of still births Number of still births Number of still births Number of still births In all how many pregnancies did you have that ended in a stillbirth Ever married women age 15-49 who have given birth 98 D.K Any birth in last 2 years Any birth in last 2 years Any birth in last 2 years Any birth in last 2 years Any birth in last 2 years Check BH4 of last birth: Did the woman's last birth occur within the last 2 years, that is, since (day and month of interview in 2006? Ever married women age 15-49 who have given birth 1 Yes 2 No Cluster number Cluster number Cluster number Cluster number Cluster number Ever married women age 15-49 who have given birth Household number Household number Household number Household number Household number Ever married women age 15-49 who have given birth Woman's line number Woman's line number Woman's line number Woman's line number Woman's line number Ever married women age 15-49 who have given birth Interviewer number Interviewer number Interviewer number Interviewer number Interviewer number Day of interview Day of interview Day of interview Day of interview Day of interview Month of interview Month of interview Month of interview Month of interview Month of interview Year of interview Year of interview Year of interview Year of interview Year of interview Result of women 's interview Result of women 's interview Result of women 's interview Result of women 's interview Result of women 's interview 1 Completed 2 Not at home 3 Refused 4 Partly completed 5 Incapacitated 6 Other Month of birth of woman Month of birth of woman Month of birth of woman Month of birth of woman Month of birth of woman In what month and year were you born? 97 Inconsistent 98 DK Year of birth of woman Year of birth of woman Year of birth of woman Year of birth of woman Year of birth of woman In what month and year were you born? Women age 15-49 9997 Inconsistent 9998 DK Age of woman Age of woman Age of woman Age of woman Age of woman How old were you at your last birthday? Women age 15-49 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? Have you ever attended school? Women age 15-49 1 Yes 2 No 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? What is the highest level of school you attended: primary, secondary, or higher? Women age 15-49 1 Primary 2 Secondary 3 Higher 4 Koranic 5 Non-standard curriculum 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? What is the highest grade you completed at that level? Women age 15-49 66 Grades non-existent 97 Inconsistent 98 DK Can read part of the sentence Can read part of the sentence Can read part of the sentence Can read part of the sentence Can read part of the sentence Now I would like you to read this sentence to me. Show sentences to respondent. If respondent cannot read whole sentence, probe: Can you read part of the sentence to me? Show sentences to respondent. If respondent cannot read whole sentence, probe Women age 15-49 1 Cannot read at all 2 Able to read only parts of sentence 3 Able to read whole sentence 5 Blind/visually impaired Currently married Currently married Currently married Currently married Currently married Are you currently married or living together with a man as if married? Women age 15-49 1 Yes, currently married 3 No, not in union Age of husband Age of husband Age of husband Age of husband Age of husband How old was your husband/partner on his last birthday? Ever married women age 15-49 98 DK Husband has other wives Husband has other wives Husband has other wives Husband has other wives Husband has other wives Besides yourself, does your husband/partner have any other wives? Ever married women age 15-49 1 Yes 2 No 8 D.K Number of other wives Number of other wives Number of other wives Number of other wives Number of other wives How many other wives does he have? Ever married women age 15-49 98 DK Ever married Ever married Ever married Ever married Ever married Have you ever been married or lived together with a man? Women age 15-49 1 Yes, formerly married 3 No Marital status Marital status Marital status Marital status Marital status What is your marital status now: are you widowed, divorced or separated? Women age 15-49 1 Widowed 2 Divorced Married once or more than once Married once or more than once Married once or more than once Married once or more than once Married once or more than once Have you been married or lived with a man only once or more than once? Ever married women age 15-49 1 Only once 2 More than once Month of first union Month of first union Month of first union Month of first union Month of first union In what month and year did you first marry or start living with a man as if married? Ever married women age 15-49 97 Inconsistent 98 DK Year of first union Year of first union Year of first union Year of first union Year of first union In what month and year did you first marry or start living with a man as if married? Ever married women age 15-49 9997 Inconsistent 9998 DK Age at first union Age at first union Age at first union Age at first union Age at first union How old were you when you started living with your first husband/partner? Ever married women age 15-49 97 Inconsistent 98 DK Ever given birth Ever given birth Ever given birth Ever given birth Ever given birth Now i would like to ask about all the births you have had during your life. Have you ever given birth? If "No" probe by asking: I mean, to a child who ever breathed or cried or showed other signs of life - even if he or she lived only a few minutes or hours? Ever married women age 15-49 1 Yes 2 No Any sons or daughters living with you Any sons or daughters living with you Any sons or daughters living with you Any sons or daughters living with you Any sons or daughters living with you Do you have any sons or daughters to whom you have given birth who are now living with you? Ever married women age 15-49 1 Yes 2 No Sons living with you Sons living with you Sons living with you Sons living with you Sons living with you How many sons live with you? Ever married women age 15-49 Daughters living with you Daughters living with you Daughters living with you Daughters living with you Daughters living with you How many daughters live with you? Ever married women age 15-49 Any sons or daughters not living with you Any sons or daughters not living with you Any sons or daughters not living with you Any sons or daughters not living with you Any sons or daughters not living with you Do you have any sons or daughters to whom you have given birth who are alive but do not live with you? Ever married women age 15-49 1 Yes 2 No Sons 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? Ever married women age 15-49 Daughters not living with you Daughters not living with you Daughters not living with you Daughters not living with you Daughters not living with you How many daughters are alive but do not live with you? Ever married women age 15-49 Ever had child who later died Ever had child who later died Ever had child who later died Ever had child who later died Ever had child who later died Have you ever given birth to a boy or girl who was born alive but later died? Ever married women age 15-49 1 Yes 2 No Boys dead Boys dead Boys dead Boys dead Boys dead How many boys have died? Ever married women age 15-49 Girls dead Girls dead Girls dead Girls dead Girls dead How many girls have died? Add the numbers of births reported in CM4, CM6 and CM8 and write the sum here, then check: If she says it is correct, check the box marked 'Yes' and continue to the next question. If she says 'No', first check your addition and then go back through the list to check with the respondent whether you have obtained the information correctly. For example, starting with CM4, you would ask: "YOU HAVE TWO SONS AND ONE DAUGHTER LIVING WITH YOU, IS THAT CORRECT?" Do the same for CM6 and CM8. Correct the answers and the sum mentioned in CM9 and then continue to the next question. Make sure to cancel the 'No' in CM10 and check 'Yes' after you have made the corrections. Ever married women age 15-49 Children ever born Children ever born Children ever born Children ever born Children ever born If the respondent's last birth occurred in the last 2 years, enter the name of the child on the line provided and check the box marked 'Yes'. Then continue with CM13. If the respondent's last birth did not occur in the last 2 years, check the box marked 'No' and go to the Marriage/Union module. Ever married women age 15-49 Interviewer number Interviewer number Interviewer number Interviewer number Interviewer number Interviewer name and number: Enter your own name and identification number provided to you at the time of training. Households Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor Number Supervisor name and number: Enter your supervisor's name and identification number. You will be provided with your supervisor's identification number as soon as you know who you will be working with. Households Day of interview Day of interview Day of interview Day of interview Day of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Month of interview Month of interview Month of interview Month of interview Month of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Year of interview Year of interview Year of interview Year of interview Year of interview Day/Month/Year of interview: Enter the date of the interview as day, month and year. If the interview is not completed on your first visit and you visit the household again, revise and enter final date of interview. In other words, the date here should be either when you have completed the Household Questionnaire or when the interview has not been conducted but there will be no more attempts to interview the household. Households Area Area Area Area Area Circle the code for area of residence as instructed by your supervisor. This will have been pre-determined; you will not be required to assess whether the household is in an urban or rural area. Households 1 Urban 21 Rural 22 Nomadic Zone Zone Zone Zone Zone Region: Circle the code for zone. Households 1 Somalialand 2 Puntland 3 Central South Result of HH interview Result of HH interview Result of HH interview Result of HH interview Result of HH interview After all questionnaires for the household have been completed, fill in the following information: Result of HH interview: If the Household Questionnaire is completed, circle '1' for 'Completed'. If you have not been able to contact the household after repeated visits, circle '2' for 'Not at home'. If the household refuses to be interviewed, circle '3' for 'Refused'. If you are unable to locate the household or if the dwelling is destroyed, circle '4' for 'HH not found/destroyed'. If you have not been able to complete the Household Questionnaire for another reason, you should circle '6' for 'Other' and specify the reason in the space provided. Some examples of 'Other' codes might be: the household respondent is incapacitated; the questionnaire is partly completed; adult household members were not found at home after repeated visits. Households 1 Completed 2 Not at home 3 Refused 4 HH not found/destroyed 6 Other Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent HH questionnaire Respondent to HH questionnaire: Enter the name and line number (from the Household Listing, columns HL1 and HL2) of the respondent to the Household Questionnaire. Households 99 Missing Number of household members Number of household members Number of household members Number of household members Number of household members Total number of household members: Count the number of household members recorded in column HL1 of the Household Listing and enter the total here. Households Total eligible women Total eligible women Total eligible women Total eligible women Total eligible women No.of women eligible for interview: Enter the total number of women eligible for interview for the Questionnaire for Individual Women - you will copy this from the row for totals at the bottom of the Household Listing, for HL6. Households Women interviews completed Women interviews completed Women interviews completed Women interviews completed Women interviews completed No.of women questionnaires completed: Once all of the Questionnaires for Individual Women have been completed for a particular household, enter the number completed here. Households Total children under 5 Total children under 5 Total children under 5 Total children under 5 Total children under 5 No.of children under age 5: Enter the total number of children under five eligible for inclusion in the survey from the row for totals at the bottom of the Household Listing, for HL8. You will be using the Questionnaire for Children Under Five to interview the mothers or primary caretakers of these children. Households Child interviews completed Child interviews completed Child interviews completed Child interviews completed Child interviews completed No.of under-5 questionnaires completed: Once all of the Questionnaires for Children Under Five have been completed for a particular household, enter the number completed here. Households Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk Data entry clerk: Leave this space blank. The data clerk will enter his/her number in the space provided. Households Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water Main source of drinking water What is the main source of drinking water for members of your household? The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): · '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. · '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. · '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. · '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. · '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. · '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. · '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. · '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). · '52' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof and stored in a container, tank or cistern until used. · '53' Berkad · '54' Rain water catchment (Balli) · '61' - A tanker-truck water source transports and sells water by means of a tanker truck. · '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. · '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. · '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. Households 11 Piped into dwelling 12 Piped into yard or plot 13 Public tap/standpipe 21 Tubewell/borehole 31 Protected well 32 Unprotected well 41 Protected spring 42 Unprotected spring 52 Roof top 53 Berkad 54 Balli 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 91 Bottled water 96 Other Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes Main source of water used for other purposes What is the main source of water used by your household for other purposes such as cooking and handwashing? The purpose of the first two questions of this module is to assess the type of household water used for drinking as well as for other purposes, such as cooking and washing hands. Definitions of the various sources of water are as follows (codes refer to those used in WS1 and WS2): · '11' - Piped into dwelling, also called a house connection, is defined as water service connected by pipe with in-house plumbing to one or more taps, for example, in the kitchen and/or bathroom. · '12' - Piped water to yard/plot, also called a yard connection, is defined as a piped water connection to a tap placed in the yard or plot outside the house. · '13' - A public tap or standpipe is a water point from which the public may collect their water. A standpipe may also be known as a public fountain or public tap. Public standpipes can have one or more taps and are typically made of brickwork, masonry or concrete. · '21' - A tube-well or borehole is a deep hole that has been driven, bored or drilled with the purpose of reaching groundwater supplies. Boreholes/tube-wells are constructed with casing, or pipes, which prevent the small-diameter hole from caving in and provide protection from infiltration of run-off water. Water is delivered from a tube-well or borehole through a pump that may be powered by humans, animals, wind, electricity, diesel fuel or solar energy. · '31' - A protected dug well is a dug well that is protected from run-off water through a well lining or casing that is raised above ground level and a platform that diverts spilled water away from the well. Additionally, a protected dug well is covered so that bird droppings and animals cannot fall down the hole. · '32' - An unprotected dug well is a dug well for which one or both of the following are true: (1) the well is not protected from run-off water; (2) the well is not protected from bird droppings and animals. If at least one of these conditions is true, the well is unprotected. · '41' - A protected spring is a spring that is free from run-off and from bird droppings and animals. A spring is typically protected by a 'spring box' that is constructed of brick, masonry or concrete and is built around the spring so that water flows directly out of the box into a pipe without being exposed to outside pollution. · '42' - An unprotected spring is a spring that is subject to run-off or bird droppings or animals. Unprotected springs typically do not have a 'spring box' (described above). · '52' - Rainwater collection refers to rain that is collected or harvested from surfaces by roof and stored in a container, tank or cistern until used. · '53' Berkad · '54' Rain water catchment (Balli) · '61' - A tanker-truck water source transports and sells water by means of a tanker truck. · '71' - Cart with small tank/drum is used by a water provider who transports water into a community and then sells the water. Types of transports may include donkey cart, motorized vehicle or other means. · '81' - Surface water is water located above ground and includes rivers, dams, lakes, ponds, streams, canals and irrigation channels from which water is taken directly. · '91' - Bottled water is purchased water sold in bottles. Note that the code refers only to bottled water that is commercially available. Sometimes household members may store water from other sources in bottles - this should not be coded as bottled water. Households 11 Piped into dwelling 12 Piped into yard or plot 13 Public tap/standpipe 21 Tubewell/borehole 31 Protected well 32 Unprotected well 41 Protected spring 42 Unprotected spring 52 Roof top 53 Berkad 54 Balli 61 Tanker-truck 71 Cart with small tank/drum 81 Surface water 96 Other 99 Missing Time to get water and come back Time to get water and come back Time to get water and come back Time to get water and come back Time to get water and come back How long does it take to go there, get water, and come back? This question is used to find out how convenient the source of water is to the dwelling. Note that the question is asked for water sources coded as '13-81' and '96' in WS1, or water sources coded as '13-96' in WS2. Fill in the estimated time (in minutes, converting from hours, if necessary) it takes by the usual mode of transport to get to the water source, wait to get water, and get back to the dwelling. Use zero(s) preceding the number if less than 100 minutes (for example, '060' or '005'). Then continue to the next question. If the water source is on the dwelling premises or if water is delivered to the dwelling by a vendor, circle '995' for 'Water on premises' and skip to WS5. If the respondent does not know how long it takes, circle '998' and continue on to the next question. Households 995 On premises 998 DK 999 Missing Person fetching water Person fetching water Person fetching water Person fetching water Person fetching water Who usually goes to this source to fetch the water for your household? Probe: Is this person under age 15? What sex? Circle code that best describes this person. The purpose of this question is to find out the age and gender of the person who usually performs the task of hauling water. This will provide an understanding of whether water hauling responsibilities are given to members of a particular sex or age group. Probe: "IS THIS PERSON UNDER AGE 15? WHAT SEX IS THIS PERSON?" Circle the code that corresponds with the response or '8' if the respondent does not know. Adult refers to anyone age 15 or over, regardless of whether he/she is a household member. Child refers to anyone under the age of 15, regardless of whether he/she is a household member. Households 1 Adult woman 2 Adult man 3 Female child (under 15) 4 Male child (under 15) 8 DK 9 Missing Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Measure to prevent contamination Do you take any meausures to prevent contamination while handling the water or water storage containers? Circle '1' if 'Yes', and continue to the next question. If 'No' or 'DK' (Doesn't know'), circle '2' or '8', respectively. Household 1 Yes 2 No 8 D.K Definitions of various methods of prevention are as follows: · 'A' - Wash hands before collecting water · 'B' - Store drinking water in a clean container with cover · 'C' - Use a separate clean cup with a long handle for taking water out of the container · 'D' - Keep animals away from the container Wash Hands Wash Hands Wash Hands Wash Hands Wash Hands What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing A Wash Hands Store in clean container Store in clean container Store in clean container Store in clean container Store in clean container What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing B Container with cover Use separate container Use separate container Use separate container Use separate container Use separate container What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing C Use Separate container Keep animals away Keep animals away Keep animals away Keep animals away Keep animals away What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing D Keep animals Other Other Other Other Other What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing X Other D.K D.K D.K D.K D.K What do you usually do to prevent cotamination while handling water and water storage containers? Anything else? Circle the code corresponding to the response. The household may be using a method that you know does not prevent contamination. Do not use your own judgement, just record the response. Record all items mentioned (for example, the household may be washing hands and covering the water). 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'. Household ? Missing Z D.K 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 Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Reliable drinking water supply Does your main drinking water source give you a reliable supply? If the respondent replies 'no' try to assess how often they encounter problems. If they encounter problems occasionally such as a few times a month circle '2', if a few times a week circle '3' for daily problems circle '4'. If the household complains that it is only at certain times of year they do not have a reliable supply then circle 5'. If the household does not know circle '8'. Household 1 Almost no problems 2 Occasionaly Problems 3 Weekly Problems 4 Daily Problems 5 Seasonaly Supply 8 D.K Kind of toilet facility Kind of toilet facility Kind of toilet facility Kind of toilet facility Kind of toilet facility What kind of toilet facility do members of your household usually use? If "flush" or "pour flush", probe: Where does it flush to? If necessary, ask permission to observe the facility. Questions WS7, WS8 and WS9 are about the toilet facility household members use. --- The purpose of this question is to obtain a measure of the cleanliness of the sanitary facility used by the household members. It may be necessary to observe the facility. If so, ask permission to do so. If the respondent answers or it is observed that the household members have no facilities or use the bush or field, enter '95' for 'No facilities or bush or field' and skip to the next module. If any of the flush or pour flush responses (11-15) are given, probe: "WHERE DOES IT FLUSH TO?" Circle the code corresponding to the response given. Definitions of various types of toilet facilities are as follows: A flush toilet uses a cistern or holding tank for flushing water and has a water seal, which is a U-shaped pipe, below the seat or squatting pan that prevents the passage of flies and odours. A pour flush toilet uses a water seal, but unlike a flush toilet, a pour flush toilet uses water poured by hand for flushing (no cistern is used). . '11' - A piped sewer system is a system of sewer pipes, also called sewerage, that is designed to collect human excreta (faeces and urine) and wastewater and remove them from the household environment. Sewerage systems consist of facilities for collection, pumping, treating and disposing of human excreta and wastewater. . '12' - A septic tank is an excreta collection device and is a water-tight settling tank normally located underground, away from the house or toilet. . '13' - A flush/pour flush to pit latrine refers to a system that flushes excreta to a hole in the ground. . '14' - A flush/pour flush to somewhere else refers to excreta being deposited in or nearby the household environment (not into pit, septic tank or sewer); excreta may be flushed to the street, yard/plot, drainage way or other location. . '15' - Flush to unknown place/not sure/DK where should be coded in cases when the respondent knows that the toilet facility is a flush toilet, but does not know where it flushes to. '21' - A ventilated improved pit latrine or VIP is a type of pit latrine that is ventilated by a pipe extending above the latrine roof. The open end of the vent pipe is covered with gauze mesh or fly-proof netting and the inside of the superstructure is kept dark. '22' - A pit latrine with slab uses a hole in the ground for excreta collection and has a squatting slab, platform or seat that is firmly supported on all sides, easy to clean and raised above the surrounding ground level to prevent surface water from entering the pit. '23' - A pit latrine without slab uses a hole in the ground for excreta collection and does not have a squatting slab, platform or seat. An open pit is a rudimentary hole in the ground where excreta is collected. '31' - A composting toilet is a toilet into which excreta and carbon-rich material are added (vegetable wastes, straw, grass, sawdust, ash) and special conditions maintained to produce inoffensive compost. '41' - Bucket refers to the use of a bucket or other container for the retention of faeces (and sometimes urine and anal cleaning material), which is periodically removed for treatment or disposal. '51' - A hanging toilet or hanging latrine is a toilet built over the sea, a river, or other body of water into which excreta drops directly. '95' - No facilities or bush or field includes excreta wrapped and thrown with garbage, the 'cat' method of burying excreta in dirt, defecation in the bush or field or ditch, and defecation into surface water (drainage channel, beach, river, stream or sea). Households 11 Flush to piped sewer system 12 Flush to septic tank 13 Flush to pit (latrine) 14 Flush to somewhere else 15 Flush to unknown place/not sure/DK where 21 Ventilated Improved Pit latrine (VIP) 22 Pit latrine with slab 23 Pit latrine without slab/open pit 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 Wash hands before eating Wash hands before eating Wash hands before eating Wash hands before eating Wash hands before eating Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Wash hands before feeding babies Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing wash hands after defecation wash hands after defecation wash hands after defecation wash hands after defecation wash hands after defecation Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Wash hands after cleaning babies bottoms Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Wash hands before cooking food Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing wash hands after eating wash hands after eating wash hands after eating wash hands after eating wash hands after eating Do you usually wash your hands using soap at any of the following times? This question is asked to establish whether members of the houshold are regularly using soap to wash ther hands. Read out each situation and circle the code corresponding to the answer given after each item. Do not leave any blank. Household 1 Yes 2 No 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 32 Vinyl or asphalt strips 33 Ceramic tiles 34 Cement 35 Carpet 96 Other 99 Missing Main material of roof Main material of roof Main material of roof Main material of roof Main material of roof Main material of the roof. Record observation. Circle the correct code for the material of the dwelling roof, based on your observation. You will be able to observe the correct answer in most cases, but if in doubt, ask. If there is more than one kind of material making up the roof, record the main roofing material (the material that covers the largest amount of roof). Households 11 No roof 12 Thatch/palm leaf 13 Mud & Grass 21 Rustic mat 22 Palm/Grass 23 Wood Planks 24 Sacking/Plastic sheets 31 Metal 32 Wood 33 Calamine/cement fiber 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 Sticks/palm/trunks 13 Mud 21 Bambo with mud 22 Stone with mud 23 Uncovered adobe 24 Plywood 25 Carton 26 Reused wood 27 Cloth/Matting 31 Cement 32 Stone with lime/cement 33 Bricks 34 Cement blocks 35 Covered adobe 36 Wood planks/shingles 96 Other 99 Missing Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking Type of fuel using for cooking What type of fuel does your household mainly use for cooking? Information on the type of fuel used for cooking is collected as another measure of the socio-economic status of the household. The use of some cooking fuels can also have adverse health consequences. Circle the code corresponding to the answer given. Remember that this question asks about fuel for cooking, not fuel for heating or lighting. If the household uses more than one fuel for cooking, find out which type of fuel is used most often. If electricity, liquid propane gas (LPG), natural gas, or biogas is mainly used, circle '01', '02', '03', or '04', respectively, and skip to HC8. If any fuel other than the pre-coded ones is reported as being the main fuel used for cooking, circle '96' and specify the type of fuel on the line provided. Definitions of some of the types of fuel are as follows: 'Biogas' includes gases produced by fermenting manure in an enclosed pit. 'Lignite' is a derivative of coal that produces more smoke when burned but produces less heat than coal. Households 1 Electricity 2 Liquid propane gas (LPG) 5 Kerosene 7 Charcoal 8 Wood 9 Straw/shrubs/grass 10 Animal dung 11 Agricultural crop residue 96 Other 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 6 Other 9 Missing Bed Bed Bed Bed Bed Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing 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, VCD/DVD PLAYER, FAN? 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 VCD/DVD Player VCD/DVD Player VCD/DVD Player VCD/DVD Player VCD/DVD Player Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Fan Fan Fan Fan Fan Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Satellite Dish Satellite Dish Satellite Dish Satellite Dish Satellite Dish Does your household have: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing 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 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 Clock Clock Clock Clock Clock Does any member of your household own: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Sewing Machine Sewing Machine Sewing Machine Sewing Machine Sewing Machine Does any member of your household own: Read out each item and circle the code corresponding to the answer given after each item. If the respondent reports that a household item such as a radio is broken, try to find out how long it has been broken and whether it will be fixed. If the item appears to be out of use only temporarily, circle '1' for 'Yes'. Otherwise, circle '2' for 'No'. Be sure to circle either a '1' or a '2' for each item. Do not leave any blank. Household 1 Yes 2 No 9 Missing Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of your household own any land for agricultu Does any member of this household own any land that can be used for agriculture? Circle the code corresponding to the response given. If 'No', skip to HC13. Households 1 Yes 2 No 9 Missing How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agriculture How many hectares of agricultural land do members of this household own? If more than 97, record '97'. If unknown, record '98'. Record the total number of hectares of land owned by all members of the household that can be used for agriculture. If 97 or more hectares (or other units) are owned, record '97'. If unknown, record '98'. Households 97 More than 97 98 Don't know 99 Missing Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, cattle, or animals Does this household own any livestock, herds, or farm animals? Circle the code corresponding to the response given. If 'No', skip to the next module. Households 1 Yes 2 No 9 Missing Number of camels Number of camels Number of camels Number of camels Number of camels How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 99 Missing 98 Don't know Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls Number of Milk cows or bulls How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 98 Don't know 99 Missing Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules Number of horses donkeys, or mules How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 98 Don't know 99 Missing Number of Goats Number of Goats Number of Goats Number of Goats Number of Goats How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 98 Don't know 99 Missing Number of sheep Number of sheep Number of sheep Number of sheep Number of sheep How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 98 Don't know 99 Missing Number of chickens Number of chickens Number of chickens Number of chickens Number of chickens How many of the following animals does this household have? Read out each item and enter the number corresponding to the answer given. Add numbers of milk cows and bulls together, even if the respondent gives separate numbers for each. Similarly, count horses, donkeys and mules together. If the answer is 'none', record '00' for that animal. If the household has 97 or more of any one type of animal, record '97'. If the household owns a particular type of animal, but the respondent does not know how many, circle '98'. Do not leave any items blank. Ask the question for the following animals: CAMELS; MILK COWS OR BULLS; HORSES, DONKEYS OR MULES; GOATS; SHEEP; CHICKENS. Households 97 More than 97 98 Don't know 99 Missing Area Area Area Area Area Household 1 Urban 2 Non Urban All district capitols were considered as urban Regions Regions Regions Regions Regions Recoded variable Household 1 W/Galbeed 2 Awdal 3 Sanaag 4 Sool 5 Togdhere 6 Mudug 7 Nugal 8 Bari 9 Bakool 10 Bay 11 Gedo 12 Middle Juba 13 Hiran 14 Middle Shabelle 15 Lower Shabelle 16 Banadir 17 Galguduud 18 Lower Juba This variable was created during data analyses for weighting purposes only. Determined from the cluster numbers. Provinces correspond to the 18 prewar (1991) regions of Somalia. In the survey design regions were not set up as sampling domains therefore UNICEF does not recommend disaggregating data at the regional level. Regional stratum and urban/rural Regional stratum and urban/rural Regional stratum and urban/rural Regional stratum and urban/rural Regional stratum and urban/rural Recoded variable Household This variable was created during data analyses for weighting purposes only. Date of interview women (CMC) Date of interview women (CMC) Date of interview women (CMC) Date of interview women (CMC) Date of interview women (CMC) Recoded Variable Women age 15-49 Child's date of birth (CMC) Child's date of birth (CMC) Child's date of birth (CMC) Child's date of birth (CMC) Child's date of birth (CMC) Recoded Variable Women age 15-49 Women's date of birth (CMC) Women's date of birth (CMC) Women's date of birth (CMC) Women's date of birth (CMC) Women's date of birth (CMC) Recoded Variable Women age 15-49 Women's age Women's age Women's age Women's age Women's age Recoded Variable Women age 15-49 1 15-19 2 20-24 3 25-29 4 30-34 5 35-39 6 40-44 7 45-49 Age at first marriage Age at first marriage Age at first marriage Age at first marriage Age at first marriage Recoded Variable Women age 15-49 Marital status Marital status Marital status Marital status Marital status Recoded Variable Women age 15-49 1 Currently married 2 Formerly married 3 Never married Education Education Education Education Education Recoded Variable Women age 15-49 None 1 Koranic 2 Primary 3 Secondary + 4 Non-standard curriculum 9 Missing/DK Children ever born Children ever born Children ever born Children ever born Children ever born Recoded Variable Women age 15-49 Dead children Dead children Dead children Dead children Dead children Recoded Variable Women age 15-49 Number of children surviving Number of children surviving Number of children surviving Number of children surviving Number of children surviving Recoded Variable Women age 15-49 Women's sample weight Women's sample weight Women's sample weight Women's sample weight Women's sample weight Recoded Variable Women age 15-49 The sample is not self weighting therefore survey sample weights have been created using urban and rural population estimates at the regional level. (See data processing folder under external documents which contains excel sheets and syntax files related to constructing and merging sample weights to file). Wealth index score Wealth index score Wealth index score Wealth index score Wealth index score Recoded variable Households Wealth index quintiles Wealth index quintiles Wealth index quintiles Wealth index quintiles Wealth index quintiles Recoded variable Households 1 Poorest 2 Second 3 Middle 4 Fourth 5 Richest Imputed date of birth of woman Imputed date of birth of woman Imputed date of birth of woman Imputed date of birth of woman Imputed date of birth of woman Recoded Variable Women age 15-49 Flag for date of birth of woman Flag for date of birth of woman Flag for date of birth of woman Flag for date of birth of woman Flag for date of birth of woman Recoded Variable Women age 15-49 Imputed age of woman Imputed age of woman Imputed age of woman Imputed age of woman Imputed age of woman Recoded Variable Women age 15-49 Imputed date of marriage of woman Imputed date of marriage of woman Imputed date of marriage of woman Imputed date of marriage of woman Imputed date of marriage of woman Recoded Variable Women age 15-49 Flag for date of marriage Flag for date of marriage Flag for date of marriage Flag for date of marriage Flag for date of marriage Recoded Variable Women age 15-49 Imputed age at marriage Imputed age at marriage Imputed age at marriage Imputed age at marriage Imputed age at marriage Recoded Variable Women age 15-49 Imputed date of birth of child Imputed date of birth of child Imputed date of birth of child Imputed date of birth of child Imputed date of birth of child Recoded Variable Women age 15-49 Flag for date of birth of child Flag for date of birth of child Flag for date of birth of child Flag for date of birth of child Flag for date of birth of child Recoded Variable Women age 15-49 Imputed survival status Imputed survival status Imputed survival status Imputed survival status Imputed survival status Recoded Variable Women age 15-49 1 Alive 2 Dead Imputed age at death of child Imputed age at death of child Imputed age at death of child Imputed age at death of child Imputed age at death of child Recoded Variable Women age 15-49 Flag for age at death of child Flag for age at death of child Flag for age at death of child Flag for age at death of child Flag for age at death of child Recoded Variable Women age 15-49