Literal question
IDENTIFICATION
PLACE NAME _____
NAME OF HEAD OF HOUSEHOLD ______
HOUSEHOLD NUMBER ____
PLOT NUMBER ____
CLUSTER NUMBER _____
REGION ____
DEPARTMENT ____
SANITATION DISTRICT ____
URBAN/RURAL
URBAN 1
RURAL 2
MILIEU ____
DAKAR/REGIONAL CAPITAL/OTHER CITY/RURAL
DAKAR 1
REGIONAL CAPITAL 2
OTHER CITY 3
RURAL 4
WOMAN'S NAME AND LINE NUMBER _____
CHECK COVER PAGE OF THE HOUSEHOLD QUESTIONNAIRE
HOUSEHOLD SELECTED FOR DOMESTIC VIOLENCE MODULE (DV)?
YES 1
NO 2
IF HOUSEHOLD SELECTED FOR DV, CHECK WOMEN'S SELECTION TABLE (Q157A OF HOUSEHOLD QUESTIONNAIRE)
WOMAN SELECTED FOR DOMESTIC VIOLENCE MODULE (DV)?
YES 1
NO 2